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Paper

A picture of the outcomes for children in care in Victoria: using the Looking After Children records for knowledge building and service improvement

abstract

Background and introduction

Before their placement in out of home care, most children have experienced serious adversity as a result of abuse or neglect relating to increasingly complex family problems. Children placed in out of home care need to be assisted to recover from their trauma and provided with better life experiences that promote healthy development and improve their life chances. However, in Australia at present very little data is routinely collected that focuses on the individual progress of children in care, and even more rarely has any outcomes data been aggregated to inform service development and policy.

Looking After Children (LAC) has been progressively implemented since 2002/2003 as the best practice framework for the provision of out of home care services supported by community service organisations (CSOs) in Victoria (Australia). Although the LAC Assessment and Action Records (A&ARs) were designed for child outcomes monitoring, to date the A&ARs have been used in Victoria primarily by the child's care team to assess individual child needs.

Aims

The LAC outcomes data project aimed to exploit the potential of the A&ARs by aggregating information recorded in the course of everyday practice in order to establish a baseline for monitoring children's progress over time, and to determine the feasibility of using A&AR data for this purpose in an ongoing way.

In March 2007, all CSOs providing out of home care were invited by the Department of Human Services (DHS) to participate in the current project. CSOs were given instructions to forward de-identified copies of current A&ARs that had been completed for children in their care since July 2006 (for children under 5 years of age) and 1 January 2006 (for children aged 5 years and above) provided that the child had been in their care for at least three months.

Method
The final sample comprised 614 children from all eight DHS regions in 32 services provided by 25 different providers.

DHS contracted the Australian Institute of Family Studies (AIFS) to develop an electronic database of all the items recorded on the A&ARs and to conduct analyses on a select item set. A systematic process was undertaken whereby an initial set of 55 measures was identified for preliminary analysis and ultimately reduced to 29 based on response rates and variance.

A minimum 85% response rate was achieved for all items in the current analysis, and there were many items that were reassuring from a reliability perspective, including good internal consistency reliability of composite measures and expectable findings.

Three sets of analyses were performed for each measure: univariate analyses, bivariate analyses for three service types (home based care, residential care, lead tenant), child gender, and by age; and Logistic and Poisson multivariate regression analyses.

Key findings

Although there are a number of caveats on the conclusions that can be drawn from these findings, there were a number of positive results. These included good health monitoring with a high proportion of young children being fully immunised and most children not participating in risky health behaviours, good educational inputs for young children such as book ownership and daily reading, most children having a special friend and a supportive adult other than their carer/parent whom they could turn to in a crisis, very few experiencing teasing, life story books being completed for most younger children, most being able to adjust their behaviour in different social situations and a high proportion can explain why they are in care.

However there were many areas where the life experiences of children in care need improvement. It was found, for example, that a number of children were having difficulties in relation to their family and social relationships, education, emotional and behavioural functioning, in always having suitable clothes to wear, and in developing age appropriate daily living skills, most especially those relevant for leaving care but also noting some concerning deterioration commencing at ages five to nine. There were also a number of predictable trends in the data, including better outcomes for younger, rather than older children, and for children in home based care compared to residential care.

On balance, gender and regional location were relatively unimportant for the prediction of children's progress in care. These findings about the current outcomes for children in care, whether encouraging or concerning, are generally applicable system-wide.

Implications for policy, practice and research

Although the process of interpretation and analysis of the implications for future policy and practice in Victoria is still at an early stage, these findings add weight to the work already underway to develop more therapeutic approaches, especially within residential care, to redress the impact of trauma and promote positive wellbeing. Other potential implications include the need to promote more positive contacts with family members and peers outside of the classroom, improve educational outcomes, increase children's participation in community activities, develop age appropriate daily living skills, and support positive social presentation.

This project also provides some potentially useful baseline data from which to evaluate the impact of the recent legislative reform and inform the current review of out of home care.

There were a number of lessons learned from the current project about how the reliability of the A&AR data might be improved, including modifying certain items to improve consistency across the A&AR formats and enhance content validity.

Given how hard it is to collect outcomes data on the out of home care population through other means (eg. surveys) this project has demonstrated the potential of the A&ARs to utilise data collected in the course of everyday practice for outcomes monitoring.

Contact details

Ruth Champion, Senior Policy and Program Adviser, Department of Human Services, Level 9, 50 Lonsdale Street, Melbourne, Victoria, 3000 Australia

Email: ruth.champion@dhs.vic.gov.au

Sarah Wise, Principal Research Fellow, Australian Institute of Family Studies, level 20, 485 La Trobe Street, Melbourne, Victoria, 3000 Australia

Email: sarah.wise@aifs.gov.au

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