Change Fund Specialist LAAC Health Visitors

Context  A proposal was submitted from health, social work and education to the Early Years Change fund for LAA 2 year olds.  In July 2012 there were 66 LAAC 2 year olds in North Lanarkshire, however the number is variable.  Funding was allocated to implement an innovative approach to improving outcomes for these children  Growing awareness of lifelong impact of adverse experiences in infancy and early childhood (IRISS 2011)  Research has consistently shown that for LAA children who remain in care have significant poorer outcomes than the rest of population (Ford et al 2007)

Outcomes for LAA children  Mental health problems 52% compared with 8% of their peers as children and adults, including risk of suicide.  50% of LAA year olds more likely to smoke than their peers.  50% are at risk of misusing alcohol.  31% are more likely to use drugs whilst in care. (Scott & Hill 2006)

Outcomes for LAA children  Sexual health risks and teenage pregnancy's are higher  Over represented as adults within prison -50% of young people in Scottish prisons are previous LAA children. (Christie 2011)  Over represented within homeless population.  Poorer school attendance and are more likely to be excluded from education.  Have fewer and poorer educational attainments. (Scott & Hill 2006)

Learning /Improvements  A targeted intensive health Visiting service provided, incorporating Video Interactive Guidance (VIG).  Agreement around the knowledge, skills, training and education required by the LAA Nurses.  Meets criteria of Early Years Collaborative (EYC) stretch aims for LAA children  VIG is effective at promoting positive relationships between parent and child and is effective at enhancing attunement and attachment between parent and child.

Learning /Improvements  There are early indicators of evidence of parental capacity for change and evidence of improvement will continue to be assessed over the project period by HV and researchers.  VIG is also used to gather information when there is no parental capacity for change which links to EYC stretch aims.  Early learning is around the impact of the Knowledge and Skills of the agencies around Infant Mental health, observation and attachment

Learning /Improvements  Cross fertilization of knowledge across multi disciplinary team.  VIG is an evidence based therapeutic intervention to improve parent and infant attachment recommended by NICE (2012)  The findings of this research project will influence the way LAA children are supported in the future in Lanarkshire.  This project is being evaluated by a research team from Psychological services

Case Study Case study 1 Child A -16 month old boy Background: Young vulnerable mother- previous substance and alcohol misuse, chaotic lifestyle, recurrent homelessness and lack of support. Childs second LAAC period. Previously on CP Register. Following intervention /use of VIG child returned to care of mother.

Case Study Case study 2 Child B – 3 month old boy Background: Both parents history of substance misuse, domestic violence and criminality. LAA child from birth, premature and neonatal abstinence. Previous half sibling with natural father Following intervention/ VIG child returned to care of parents who continue to make good progress.

Next Steps  Lessons learned from this research project will hopefully inform future practice and planning to improve services, outcomes and reduce inequalities for LAA children.  Utilise the evidence from this project to influence future provision across Lanarkshire for this client group to ensure their needs are at the centre of decision making.

Cost to Society  LAA children are more likely to have experienced severe neglect, abuse, trauma, social, emotional or behavioural difficulties which leads to inequalities in potential future outcomes.  The number of children who are looked after by Scottish councils is approximately 15,000 annually. (Audit Scotland 2010)

Cost to Society £250 million per annum (Audit Scotland 2010)

For More Information Jean Smith /Henrietta Burns Specialist LAAC HV c/o Families First John Mann Centre Farmgate Square Bellshill ML42AE Tel: