1. Change Fund Specialist LAAC Health Visitors

2. 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)

3. 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 11-17 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)

4. 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)

5. 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.

6. 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

7. 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

8. 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.

9. 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.

10. 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.

11. 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)

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

13. For More Information Jean Smith /Henrietta Burns Specialist LAAC HV c/o Families First John Mann Centre Farmgate Square Bellshill ML42AE Tel: 01698 403612