An evaluation of the effectiveness of intervention in families with children with behavioural problems within the context of a sure start programme

Sure Start is a Government project that aims to prevent social exclusion by targeting children between 0 and 4 years of age living in areas of social and economic deprivation. This study examined whether a Tier 2 Behaviour Support Service within a local Sure Start project was able to bring about improvements in children's behaviour and the levels of stress experienced by parents.

Children and their families referred to a Sure Start Behaviour Support Service between October 2001 and April 2002 were assessed. Intervention with the families took the form of Parent Management Training with Solution Focused Brief Therapy.

Thirteen children were referred and intervention took place with 10 children. Some initial improvement was found in all cases; however, efficacy appeared to be low in multiproblem families and six children required further referral for multidisciplinary assessment and treatment. Due to the small size of the study, it was not possible to carry out a statistical analysis. This study, however, raises questions about the level of behavioural support available to multiproblem families and the strength of links between Sure Start and core services.     

Mother's Stress: Implications for Attachment Relationships

This study included thirty-three mothers of children who were attending a preschool program for high-risk families. The children's age ranged from 36-54 months. The Attachment Q-Set and the Parenting Stress Index were used to measure the relationships between parental stress and the security of attachment relationships. Results showed a significant negative relationship between the Child Domain section of the PSI and Attachment Q-Set scores. Within this sample the mean security scores were significantly higher for the group of mothers with the lowest stress scores.

Implications for the field include the importance of a comprehensive, multi-agency-coordinated, early intervention service delivery model which could operate on a variety of levels at once. Service providers need to be cognizant of the impact of the stress cycle on families and its developmental outcomes for young children. A paradigm shift may be necessary in order to move early intervention services from a crisis to a preventive-based model.     

The Influence of Household Substance Use on Children's Later Cigarette, Alcohol and Drug Use: A Three Factor Model

During the development of a psychometric instrument designed to identify adolescents at risk from developing an addictive state later in life, a strong association was found between family and adolescent substance use.

Adolescent cigarette, alcohol and drug use was found to be higher in families where these substances were used than in families that were abstemious. Not only did an association exist between adult and adolescent use of the same substance, it was also found that a cross-over effect existed whereby, for instance, adult alcohol use was associated with increased adolescent cigarette smoking. This effect was particularly strong where adult cigarette smoking appeared to be a significant factor in adolescent drug use.

A three factor model comprising of Modelling, Attitude and Availability is suggested to explain the difference in adolescent substance use in using and non-using households.     

Co-operating to protect children -shifting the thresholds

It is now 30 years since Kempe delivered his watershed address to the American Academy of Paediatricians graphically describing the battered child syndrome. In the 30 years that followed elaborate child protection procedures, supported by strong legal powers, have developed not only in the UK and the USA but also in may countries around the world. In the last 5 years or so, however, there has been another great watershed. Independently in both the USA and in the UK, evidence has accumulated which is questioning the efficacy of our elaborate child protection systems. For social workers in the UK the history is familiar; the child abuse inquiries leading on to the Cleveland Inquiry, on going scandals in residential care and concern about the outcomes for children in the public care system, and, finally, the recent message from the Department of Health in 1995 “Child Protection - Messages from Research”. Less familiar will be the concerns which emerged in the USA. There, following the introduction of mandatory reporting which in some states is mandatory even for civil citizens, there was a huge rise in the number of children reported (3 million reported in 1992 of which less than half were substantiated). This largely incapacitated the child protection agencies and led to large numbers of children being admitted into the public care. In 1990 the US Advisory Board on Child Abuse and Neglect concluded that there was an urgent need to develop new approaches.

The answer put forward in this country and the USA has been the rediscovery of targeted preventive approaches. Central to these approaches is what we call family support and what is called social support in the USA.

Child protection is an important and demanding activity

- research and our own limited local information does pose serious questions about the efficacy of the process;

- this points to the need for reviews by area child protection committees;

- research also tells us important things about the characteristics of families involved especially about their social and economic circumstances. These need to be addressed.

Addressing these needs requires several things

- a good individual assessment and population assessment to plan appropriate services;

- a sound interagency/multiprofessional approach;

- maximising all the resource options and taking a broader view of the task - as well as mainstream services as currently arranged, we need to embrace a community development approach and to view die families involved in terms of their inclusion or exclusion from society and address these shortfalls.

We are only at the threshold of the implementation of the Order and we need to approach it with a broad vision.     

Can early indicators of neglecting families be observed: A comparative study of neglecting and non-neglecting families

This study attempted to establish whether early indicators of neglect were observed in those families whose children were later registered on the Child Protection Register under the category of neglect. The aim of the study was to promote better understanding leading to earlier identification of negligence.

A sample of families whose Children's names were registered on the Child Protection Register under the category of neglect were compared with a sample of families whose Children's names were not on the Child Abuse Register. The study showed overwhelmingly that indicators of neglect were present in the neglecting sample and therefore neglect may be assumed to be predictable when these indicators are present.     

An evaluation of the mencap family adviser service in Northern Ireland

For over three years, Mencap (Nl) has provided and largely funded an 'Information and Advice Service' aimed primarily at family carers and people with learning disabilities. The service employs four advisers who cover most of Northern Ireland, offering telephone but also face-to-face contact with enquirers. They have access to a specially developed, computerized database that contains details of local as well as national resources.

This paper describes the service and the evaluation process used. Information was obtained from four stakeholder groups, namely service-users; service-funders; the leaders of learning disability teams in Health and Social Services (HSS) Trusts and the chairpersons of Mencap local societies.

The features of a good information and advice service are noted, along with the developments required to the existing service. In the main these relate to improved partnership working with statutory agencies and increasing the profile of the service with services, family carers and people with learning disabilities.

The lessons learnt in Northern Ireland could usefully inform the development of similar services that are proposed for the Irish Republic, Scotland, England and Wales.     

Multi-dkcbplinary team working in child protection

'Multi-disciplinary Team Working in Child Protection' is an extract from a research thesis successfully undertaken for the Ms(Sc) Social Work degree, QUB. The title of the research thesis was 'Designing a Service Model for NSPCC and North & West Belfast Health & Social Services Trust: A multi-disciplinary assessment team in Shankill Resource Centre'.

As the title suggests, the thesis dealt with a number of factors that contributed to a service model for a multi-disciplinary team set up in partnership between NSPCC and North & West Belfast Health and Social Services Trust. One of the factors explored in the thesis was multi-disciplinary team working A literature review was followed by interviews with managers in four multi-disciplinary teams in Greater Belfast. Questionnaires were then distributed to team members in the teams.

The advantage of improved co-ordination and co-operation between disciplines are evidenced. But multi-disciplinary teams can be difficult to manage. The teams studied did not share a single model of multi-disciplinary working.     

The effects of day care: A critical analysis

Maternal employment has increased over the last thirty years in the USA. The result of this increase means more families are in need of day-care for their children. Examined in this paper are research findings on the effects of day-care on pre-school children and their families. The implications of these findings for policy development are critically discussed.

Currently in the USA, over 50% of mothers work outside the home; this figure is expected to rise to 75% by 1990. The fastest growing segment of the working mother population is among those with children under two (Zigler and Gordon, 1982). This increasing rate of maternal employment over the last two decades has created the need for alternative arrangements for infants and young children. There is some concern among child developmental specialists that these alternative arrangements of caremay have detrimental effects on a child's social and psychological development.

Much of the concern about substitute care is based on the theory and research related to the negative effects of institutionalization on young children (Bowlby, 1951; Spitz, 1945). This body of literature, however, tells one little about the typical forms of substitute care experienced by most children. Obviously, children generally do not experience the extreme physical and social deprivation reported on in the institutional literature (Advisory Committee on Child Development, 1976: 117). Consequently, the quality of substitute care received by the majority of children is not comparable to the type of care studied in the institutional literature.

Still, the possibility remains that even with high quality care, differences may be found in the behavior and development of children as a function of the type of substitute care received. The literature reports numerous studies on the impact of various forms of substitute care; however, most of these studies are not well designed (Advisory Committee on Child Development, 1976: 118). The typical form of substitute care focused on in the literature has been high quality, university based day-care settings, a form of substitute care most children do not have access to (Santrock, 1983: 159). Even though the majority of these studies have weak methodological designs and are based on day-care settings not experienced by most children, some meaningful findings have emerged in the literature. This paper will focus on those relevant studies reporting on the impact of one very common form of substitute care, day-care for the pre-school child. The major emphasis of the review will be on how day-care impacts the pre-school child's intellectual development, emotional development, social development, and the child's family system. The authors will draw from these findings several major policy implications.     

Aetiologies of Autism: Psychodynamic, Pharmacological and Behavioural, Related to Kuwait

Autism is a severe form of childhood psychopathology which has enormous impact on the child, his/her family, and the wider community. It challenges the expertise of doctors, teachers and therapists.

In Kuwait, recognition of the disorder is still in its infancy. However, the government has established a new Centre for Autism, the first of its kind in the country, to provide up-to-date medical care and education for autistic children.

This article will assess Kuwait's progress in catering for autism, in the light of current international thinking. Discussion of the roles of the main governmental and non-governmental bodies concerned with provision for autistic children in Kuwait, with an account of the only two special schools which are currently known to cater specifically for this disorder, is given.

It was found that, in Kuwait, provision is limited and fragmented compared with that of the UK and the USA. Moreover, there is, as yet, relatively little information available to researchers, parents, or the general public. Accordingly, recommendations are made for both action and research, in order to raise the profile of this disorder in Kuwait and extend provision.     

Evaluation of Early Childhood Enrichment Programs

Leaders in the field of enrichment programs for young children and their families often have a difficult time when considering the pros and cons of program evaluation. Their major energies are focused on thinking through programmatic philosophy and implementation procedures to enhance children's lives. Yet when evaluation components are carefully built into the planning process, they can often serve as a powerful adjunct to enhance the quality of service provision. Decisions as to how much evaluation to do, how to choose instruments, and how to train testers, observers, and interviewers become crucial for establishing not only the technical dimensions of evaluation but also the valueof evaluation. When leaders are clear and convincing, then staff realizes how important this component will be in helping a program meet its targeted goals for families; they may change from suspicion of evaluation to enthusiastic support.

Program evaluations have many dimensions. Systematic efforts to evaluate an enrichment or intervention program requires much decision making. Depending on the goals of the evaluation, the form and focus, intensity and extensiveness of the procedures and the level of formality will vary (Honig, 1995).     

The Development of a Model of Process-Oriented Quality in Early Childhood Services with a Preschool Component

Ten early childhood services in South Australia were researched using a model of process-oriented quality. These process-oriented components are information, communication, relationships and curriculum. They are crucial to a service as they are the aspects on which staff directly impact and hence determine the level of quality they provide.

To obtain the data required, contextualised observations, interviews with staff and families, two surveys, photographs and document analysis were used. This paper discusses the findings from the research.     

Effect of Intervention on the Language Facility of Poor, Black Adolescent Mothers and their Preschool Children

This study investigates the effects of varying degrees of mother-child language stimulation activities on the test performance of poor Black children and their adolescent mothers.

The sample consisted of 60 mothers paired with their three or four year old children who attended full day preschool. The families were randomly assigned to one of three groups for a twelve week period.

The tests used in the study were the Peabody Picture Vocabulary Test; the Cultural Language Test — Mean Length of Utterance; the Cultural Language Test — Standard English; and the Conversation — Mean Length of Utterance Measure.

Three major findings result from the study:

1. The children of mothers provided with intensive training and practice (Group 1) scored significantly higher on all four tests than did the children whose mothers received minimal help (Group 2) or children whose mothers received no help at all (Group 3).
2. Group 2 children did not score any higher than did Group 3.
3. Group 1 mothers scored significantly higher on all measures.

     

Parental health and stress in families with a child who has multiple disabilities

The presence of a disabled child is known to increase family stress and parental ill-health. However, it is unclear the extent to which support services can alleviate this.

Families using two, short-break services - both residential and domiciliary - formed the study population (N = 68). Measures were taken using standardised instruments of children's development and maladaptive behaviours, parental stress, parental health and the supports that the families received from services, professionals and relatives and friends.

Significant proportions of these service users were stressed and had high levels of psychiatric morbidity. The sole predictor of stress was parental ill-health which in turn was linked with children who had higher scores on motor skills and the presence of other disabled dependants in the family. Families who were most stressed or in poorer health received no greater amounts of support.

The findings reinforced the complexity of disentangling the relationships between family needs and service supports. They also suggest that existing presumptions about more services reducing family stress are too simplistic. It is argued that the meaning of support for families needs to be critically reviewed along with an examination of the coping strategies used by families. This should result in better matching of support services to individual family needs.     

Taking action for children's rights: The foyle experience

The Convention on the Rights of the Child was passed unanimously by the United Nations General Assembly on the 20 November 1989. The United Kingdom ratified die Convention in 1991 signalling its willingness to meet the provisions and obligations set out within it. In January of this year, ten agencies drawn from both the statutory and voluntary sectors in Deny came together and formed a partnership to take affirmative action widi regard to the issue of Children's Rights. They identified two estates within the city, one on the west bank and one on die east. Aldiough the two estates represented bom traditions, they shared many similarities regarding levels of deprivation and absence of facilities.

Summary

We found overall gratitude and appreciation for enlightenment of Children's Rights. Many people enquired whether this project would be carried out in areas where their friends and relatives lived and when told that there were no plans for this in the immediate future then they asked for extra literature for their friends and relatives.

Aside from the Project we found varying degrees of anger, frustration, disillusionment and apathy in the estate regarding raised hopes in the past by surveys, and an acknowledgement of need, but there was no movement on provision of facilities which might help parents keep children safe both at home and away.

Things like - safe play areas - playgrounds, nursery school, playgroup, youth club, library, health clinic. People were saying, “anything we have, we bought and paid for ourselves and it looks as if the more you do yourself, the less you get from the public purse.”     

Children's Services Planning in Northern Ireland: Developing a Planning Model to Address Rights and Needs

This article reflects on a number of key concepts and planning tools that have been developed or adapted through the inter-agency planning of services for children and young people in Northern Ireland (Children's Services Planning). These conceptual models have been developed between 1999 and 2005 and illustrate the key contribution of Children's Services Planning to two significant shifts in how the planning task has been understood. These refer to, firstly, the movement from service orientation to needs orientation, and secondly, the progression from needs to rights within service planning.

Children's Services Planning in Northern Ireland is now based on the United Nations Convention on the Rights of the Child and the Whole Child Model, which demonstrates the understanding that there is no such thing as a uni-dimensional child who only requires services from one agency. The Family Support model has been in use for some years within the process, and the joint outcomes framework, to be designed to enable agencies to address rights and needs has also been adopted across all four Children and Young People's Committees. In terms of outcomes, an overarching Strategy for Children and Young People will develop an outcomes framework within Northern Ireland, which is likely to build upon that of Every Child Matters, as well as children's rights. Children's Services Planning has also demonstrated that the approach to planning of universal services must be consistent with the planning of services for children with additional needs. There needs to be a strong linkage between the planning and delivery of universal and targeted services.

It is a contention of the article that concepts such as those described are required for multi-sectoral planning, and that a whole system planning approach is required to address the rights and needs of children and young people.     

Research Note: Unmet Needs for Education of Primary School Children in Nigeria

According to the Convention on the rights of the Child, every child is entitled to receive compulsory basic education, and no child should suffer any discrimination irrespective of origin, birth, colour, sex, social beliefs, status or disability.

Bearing in mind these stated objectives of this Convention, three hundred children and three hundred teachers from twenty public schools in Lagos were the subjects of a survey carried out to Identify the unmet needs for education of Nigerian children.

About 90% of the teachers surveyed, admitted that the quality of education was poor and deteriorating on a daily basis. Reasons given were for the poor condition of services, poor teacher morale due to poor condition of service, lack of parental cooperation and general lack of interest among the children.

An observation of the children in the school showed that about 60% of the children had chronic malnutrition with ravages of diseases such as malaria, cough, catarrh, diarrhoea, and skin rashes. Many of the children complained of lack of adequate supply of water and electricity at home for several weeks. A large number (70%) were also found to be unkempt, without decent uniforms and textbooks.

Suggestions were made for proper teacher training, remuneration and more parental concern and involvement for the proper education of their children.     

The Education Welfare Service -A Naswe Perspective

NASWE members have a professional Code of Principles and Practice and work to protect the rights of children and young people in education. This is more simply expressed by the NASWE motto “For every child a chance”. In this submission “The Education Welfare Service” we, as members of Executive Committee of NASWE have presented an overview of the EWS giving its historical background and ongoing development including adapting to changes in Child Care legislation. The submission provides a policy statement containing aims and objectives and examines the role of die EWS and the duties undertaken by it. It gives the legal framework from which die service operates. The impact of die recent implementation of the Children (M) Order 1995 has been reviewed under the headings of legislation, partnership and initiatives.

It is hoped that this submission will help in some way to promote the EWS and raise awareness of its function in die wider field of Child Care practice generally     

Beech Tree House—a democratic setting for helping multiply-handicapped children with behaviour problems

An experimental unit for multiply handicapped children with severe behaviour problems is described. Particular attention is paid to certain organisational features believed to be critical in maintaining a high standard of service to the children and their families.

A second section considers the service patterns which spring from 'Preventive' and 'Crisis Intervention' strategies for helping children with behaviour problems: the Regional Intervention Programme and the authors' unit being respective examples of these contrasting approaches.

In the concluding section the authors describe a unit which they hope to establish in which a synthesis of the two approaches can be examined. In addition to its ability to deliver an all-round service this model should be particularly attractive because of the low capital and running costs predicted.     

Implementing the children (ni) order 1995 - researching the initial impact on social services provision to disabled children in northern ireland

The Children (Nl) Order 1995 was implemented in November 1996. This paper summarises the findings of a research project carried out by the Centre for Child Care Research studying the initial impact of the Order on the planning and provision of personal social services for disabled children and their families. The Order recognises disabled children as children first and foremost and raises their profile and priority in social policy in relation to families and child care. The research found that there had been some development of support services with indications of increased service delivery, and re-structuring of organisational arrangements. Generally, researchers found that professionals in both statutory and voluntary agencies thought that the profile of disabled children had been raised within Health and Social Service Trusts. There was also evidence of improved partnership working with other statutory agencies and with the voluntary sector, and developments in terms of partnership working with parents. However, progress has been slow regarding implementing the registers of disabled children and in developing ways of listening to the views of disabled children. In addition, the need for good information sources is becoming critical to both needs assessment and service provision, so that real advancement can be made towards the development of needs-led services. The research found that, while progress has been made in implementing the Children (Nl) Order in relation to disabled children, there is still some way to go if the underpinning philosophy is to be fully achieved.