Comparing long-term outcomes for young children in care: Does type of placement really matter? Findings from the Northern Ireland Care Pathways and Outcomes Study NISCC Lunchtime Seminar 19th September 2016 Montserrat Fargas Malet Queen’s University Belfast

Care Pathways and Outcomes Study Location: Centre for Evidence and Social Innovation (CESI), School of Social Science, Education and Social Work, Queen's University Belfast Funded by: The HSC Development Division of the Public Health Agency (Phases 1 to 3); Economic and Social Research Council (Phase 4 - Current) What is it about? Longitudinal study that examines placement patterns for a population of children (n=374) under 5 years old and in care in Northern Ireland on the 31st March 2000. It explores how the children & their parents/carers get on in comparative terms within different types of placement Key question: does type of placement make a difference to longer-term outcomes?

Phase 3: The Children’s Perspective Research Team: Dominic McSherry, Montse Fargas Malet, Kerrylee Weatherall, and Greg Kelly Interviewed sub-groups of children and their parents/carers 77 children: 18 adopted; 19 long-term stable foster care; 13 long-term stable kinship care; 15 on Residence Order; and 12 with birth parents Profile of children interviewed: Adopted Foster Care Kinship Care Residence Order Birth Parents Av. age enter placement 1yr 8 mts 4 yrs 3 yrs 5 mts 1 yr 5 mts 4 yrs 6 mts Av. time in placement 10yrs 1mt 8yrs 5mts 8yrs 11 mts 10yrs 3 mts 8 yrs 3 mts

Findings Placement stability Contact Attachment Family communication Self-esteem and happiness Social services involvement Health and behaviour Social support Education Parenting stress

Placement Stability

Children’s attachments to their parents/carers IPPA-R results

Children’s self-esteem and happiness Piers-Harris self-concept scale

Children’s health and behaviour Who had behavioural difficulties according to SDQ?

Children’s health and behaviour (contd.) Which children had serious health problems according to parents/carers: 1/11 in kinship care (9%) 5/15 in foster care (33%) 6/15 on Residence Order (40%) 5/12 with birth parents (42%) 11/18 Adopted (61%) Children had a range of conditions, BUT these most prevalent in the adoption group, e.g. 8 diagnoses of FAS in total (n=77), with 5 of these in the adopted group. The majority believed that child’s behaviour had stayed the same or improved. Many parents/carers highlighted the strengths of children and positive behaviours.

Children’s education The majority of children had poor scores in the BPVS The majority of children adopted by previous foster carers and nearly half of those in foster care receiving some additional supports at school. Most children living with birth parents not receiving supports, despite needing it most. The majority of parents/carers believed children were coping very well/ “alright” at school (considering their limitations), a few identified problems (e.g. bullying and behavioural problems). A few children appeared to do very well at school and had passed the Eleven Plus test – but low expectations from teachers and social services.

Parent/carer stress PSI/SF results

Contact with birth family

Children’s reactions to contact Different reactions Reactions changed with time ‘Negative’ effects when children were younger (e.g. upset, frightened, etc.) Situations improved, as a result of: modifying contact arrangements stopping contact altogether child able to understand the purpose of contact dealing /coping with : sad memories & painful stories, feelings of abandonment parents’ mental illnesses family history of domestic violence alcohol and substance abuse

Family communication Different parents/carers’ attitudes towards sharing info about birth family/past in care: Sharing all the information; Concealing certain facts deemed potentially distressing (adoptive); Giving a simplified/romanticised version of the past / birth family (adoptive & kinship). Different children’s attitudes: Asking questions/talking about birth family; Not asking now but did in the past; Never did ask, because already knew everything, had forgotten, or were not interested. A few children were curious about their birth family BUT parents unaware of this.

Social Service Involvement Birth parents were the most critical of the support provided by social services (feeling marginalised, undermined and distrusted by social services). Some adoptive parents advocated for a continued role of social services; others in addition to some RO carers felt a sense of ‘abandonment’ by social services post-adoption/post-Residence Order. A few kinship carers experienced a sense of disregard and lack of support, felt less valued/supported by social services precisely because they were relatives. Some Residence Order carers were happy that social services were no longer there, leading ‘normal’ family lives; others advocated a continued role for social services, in terms of the provision of financial support. Most kinship carers were happy with the support being provided by social services.

Social support The most important source of support provided for parents/carers = their family. Birth parents had the least extensive network of support, in relation to both family and friends Foster carers and RO carers had access to the most extensive family support networks. Their extended family were closely involved in the lives of their children. Support from extended family also provided for the majority of adoptive parents who also fostered child.

Summary Placements characterised by stability, not much evidence of instability, BUT mostly entering teenage years – What happens next is critical. All long-term placements have the potential to nurture positive outcomes for children in terms of their attachment to parents/carers and self-concept. Highlights the importance of speaking to both carers/parents and children Does placement type make a difference? Children’s perspective, most securely attached and happy, irrespective of placement type - NO Parental/carer perspective, higher level of perceived problem behaviours and parenting stress for foster carers and birth parents, high levels of health needs for adoptive children, and educational difficulties for children returned home – YES Depends on WHO and WHAT you are asking

Next steps: The teens and early adulthood Plan to interview approx. 200 (of 374) young people (aged 18 to 22) and their parents/carers. Two visits per young person: First visit: Gathering data from a range of outcome measures, through the use of an electronic questionnaire (set up in a computer tablet) for young people and another for parents/carers. Second visit: Conducting semi-structured interviews with young people and their parents/carers (separately); using a computer tablet to guide young people through a life map to facilitate the interview.

Care Pathways and Outcomes Study Thank You! McSherry, D., Fargas Malet, M. and Weatherall, K. (2013). Comparing long- term placements for young children in care: The care pathways and outcomes study – Northern Ireland. London: British Association for Adoption and Fostering (BAAF). McSherry, D., Fargas Malet, M. and Weatherall, K. (2016). Comparing long-term placements for young children in care: Does placement type really matter? Children and Youth Services Review, 69, 56-66. http://dx.doi.org/10.1016/j.childyouth.2016.07.021 Range of blog posts on findings: http://blogs.qub.ac.uk/pathways