Pathways of Care: Longitudinal study of children & young people in out-of-home care The artist is a young person who grew up in care. “The banner shows many pathways through the care system with a carer or caseworker acting as a guide, ultimately leading to independence for every young person. Whether we live with family or strangers, study, work, or just try our best, the paths we choose and are guided through in our youth are what we use to prepare ourselves for the happiest adulthood we can achieve” Billy Black ACWA Conference August 2012

Acknowledgement We acknowledge Aboriginal nations as the first people of Australia and pay our respects to their Elders past and present. We remember the Stolen Generations – Aboriginal and Torres Strait Islander children forcibly removed from their families, communities and culture under past government practices.

Outline Introduction Why this study? Who is conducting it? What is the design? Questionnaire development Ethics approval Recruiting and engaging carers, children and young people Data collection Next steps Acknowledgments

Introduction  Extensive reform of the child protection system in NSW:  Wood Special Commission of Inquiry in 2008  Keep Them Safe reform agenda.  FACS is working with others to:  Ensure children and young people most at risk of abuse and neglect get the help they need when they need it.  Reduce the number of children and young people entering OOHC.  Ensure those that cannot stay at home with their parents have the same opportunities as their peers in the community.  Focus on results; on the child’s experience and their future.

What is Pathways of Care? A representative and prospective longitudinal study of children and young people entering out-of-home care (OOHC) in NSW for the first time on Children’s Court Orders.

Why Pathways of Care? Pathways refers to childrens’ pathways : Into care – what brought them into care Through care – placements, physical and socio- emotional health and educational development, and experiences in OOHC Of service use and supports Out of care – various pathways to return to birth family to adoptive family as care-leaver (leaving and after care)

Why this study? To inform policy and practice: T o improve outcomes for children and young people in OOHC. To describe : Characteristics, child protection history, development and well-being of children and young people at the time of entry into care Services, interventions and pathways for children and young people in OOHC, post restoration, and on leaving care at 18 years Children and young people’s experiences and outcomes. To understand: Factors influencing outcomes for children and young people Growing up in OOHC Post restoration or adoption On leaving care at 18 years.

Specific questions? How do children fare in relative/kinship care vs foster care? Do these children differ at entry to care? How long do they stay? What are their outcomes? When children return home from OOHC how do they fare? Under what circumstances do they return home, and stay home? Or re- entered care? How well are children’s needs and wishes for family contact met? Do children in OOHC get the health and education services they need?

Who is conducting this study? Community Services (NSW Department of Family and Community Services) with assistance in: Study design and data analysis Australian Institute of Family Studies (AIFS) consortium - Australian researchers Chapin Hall Centre for Children, University of Chicago Data collection I-view, experts in social research data collection Advice and support Community Services Aboriginal Services Branch, Multicultural Services Unit, OOHC Policy Create Foundation, AbSec, Connecting Carers Topic experts and stakeholders

What is the study design?  Census of all children and young people who entered care in NSW over 18 months (May Oct 2011) for the first time  into statutory care on final orders e.g. all areas, ages, placements, order lengths  Three waves of data collection 18 months  Study child will remain in the study regardless of their circumstances (e.g. placement changes or restoration or adoption or ageing out of care).

What is the study design? Comparison groups:  Within the study participants Children remaining in OOHC Children returning home Young people leaving care  With other children and young people in OOHC  With children and young people in the general population Standardised measures and questions Administrative data through record linkage

What are the data sources? Primary data collection Interviews including standardised measures with: Children and young people Carers Birth parents and adoptive parents Surveys with caseworkers and teachers Agency databases Community Services - child protection and OOHC data Record linkage (e.g. education, health, JJ, disability, housing) Ministry of Health Blue Book

Conceptual Framework: factors influencing outcomes

Preparation for data collection Questionnaire development Ethics approval Preparation for fieldwork Recruitment and engagement Interviews with carers, children and young people Feedback to participants Analysis and results

Questionnaire development Informed by literature, consultations and focus groups (outlined in next slide). Create Foundation consulted with young people in OOHC about participation in research, appropriate data collection methods and sensitive questions. Standardised measures with established reliability and validity. Questions sourced from other studies to allow for comparisons (eg. Longitudinal Study of Australia’s Children (LSAC)). New questions were developed to address issues identified during the focus groups and consultations.

Questionnaire development Aboriginal carers9 Non-Aboriginal carers12 Muslim carers Vietnamese carers 9999 Caseworkers12 Managers Casework14 TOTAL65 10 focus groups were conducted to inform the development of the carer questionnaire. Discussion focused on “What factors lead to a successful placement?”

Ethics approval Human Research Ethics Committee  University of New South Wales HREC approval in February Aboriginal Ethics Committee  1:3 children and young people in OOHC in NSW are Aboriginal  Approval from Aboriginal Health & Medical Research Council (AH&MRC) of NSW Ethics Committee in March 2011.

Preparation for fieldwork  Pilot testing - Recruitment, field work processes and questionnaires  Interviews conducted by an independent agency. Interviewer training is very important - OOHC context, potential concerns of Aboriginal carers, interviewing children, risk of harm reporting, interviewer welfare, confidentiality  Interpreters and Aboriginal interviewers where required  Supports set-up for participants - Create, AbSec, Connecting Carers

Recruitment Study eligible children are identified in Community Services administrative database (KiDS) Details are verified by caseworkers and casework managers Community Services send letter about the study to the carer Follow-up phone call to the carer about the study Carer contact details provided to I-view with carer’s consent I-view phone carer to invite participation, confirm details, and notify carer of the interviewer’s name Interviewer contacts carer to make appointment for interview Formal consent provided prior to the interview

Engaging carers, children & young people Study information brochure for carers (translated if required) Study DVD for children and young people Study webpage and 1800 number Aboriginal interviewers and translators if requested Certificate of research appreciation (for the kids participating) Information about OOHC and support provided at the interview eg Caring For Kids guide, Charter of Rights for kids in care Feedback to participants after each wave  PLAY DVD VIDEO

Carer interview Two hour face-to-face (CAPI) interview Open-ended questions Self-completion sections for sensitive questions Incentives and thank-you Copy of the consent and revocation form to keep

Child interview (3-11 years) Activities: Peabody Picture Vocabulary Test (3 years+) Matrix Reasoning (6 years+) Felt security/ closeness activity (7 years+) Short face-to-face (CAPI) interview (7-11 years): Study agreement form to keep Gifts: Picture book (3-6) Gift voucher (7+)

Young person interview (12-17 years) Activities: Peabody Picture Vocabulary Test Matrix Reasoning Felt security/ closeness activity ACASI (self complete) interview: iPad Flexible routing Verbatims checked for risk of harm disclosure Study agreement form to keep Gifts: Gift voucher Headphones

Progress to date (as at 15/8/12) Wave 1 sample and data collection: 1856 children and young people currently study eligible 1682 study child data verified by CS regional staff 1158 carers of study children agreed to participate 685 interviews with carers completed 157 interviews with 7-17 year olds completed

Next steps  Wave 2 questionnaire programming, testing and ethics update.  Data collection includes: Carer interviews (same carer, new carer, birth parents, adoptive parents) Child and young person interviews Teacher and caseworker surveys  Building Wave 1 study database holding primary data, longitudinal Community Services administrative data & record linkage data  Wave 1 data analysis and report (mid 2013)

Acknowledgements Carers, children and young people who are participating in the study The carers and caseworkers who participated in the consultations, focus groups and pilot study during the design stage Create Foundation for conducting the consultation with young people Community Services regional staff who are verifying study eligibility to ensure client data is accurate before recruited to the study Create Foundation, AbSec and Connecting Carers for supporting participants Stakeholder and experts who have provided support, assistance and advice

Further Information Contact Community Services’ Research Centre Phone: (02) or Online: Webpage:

Recent reviews of Australian OOHC research McDonald, M., Higgins, D., valentine, k. & Lamont, A. (2011). Protecting Australia’s children research audit (1995–2010) [A report to the Australian Government Department of Families, Housing, Community Services and Indigenous Affairs]. Melbourne: Australian Institute of Family Studies & Social Policy Research Centre – University of New South Wales. Bromfield, L., Osborn, A. (2007) Getting the big picture’: A synopsis and critique of Australian out of-home care research. Child Abuse Prevention Issues (26) National Child Protection Clearinghouse, Australian Institute of Family Studies. Osborn, A. & Bromfield, L., (2007) Outcomes for children and young people in care. Research Brief (3) National Child Protection Clearinghouse, Australian Institute of Family Studies. Bromfield, L., Higgins, D., Osborn, A., Panozzo, S., & Richardson, N. (2005). Out-of-home care in Australia: Messages from research. Melbourne, Vic: Australian Institute of Family Studies, for the Community Services Ministers’ Advisory Council, commissioned by the Australian Government Department of Family and Community Services. Cashmore, J., & Ainsworth, F. (2004). Audit of Australian out-of-home care research. Sydney, NSW: Child & Family Welfare Association of Australia.