1. Breaking down the Barriers
The challenges that children and young people bring with them into Care

2. Research Study
99 children in foster care were compared with 100 school-children (living with family) who were matched for age and gender.
We looked at the number and range of negative life events that the children in care experienced and compared them with the children in the community
We called these events and situations risk factors. The maximum number was 25.

3. Ashwood Screening Questionnaire
Significant Life events
Background Factors
Teenage parent, poor home conditions, multiple school placements, school exclusion, parent in care, CPP, mother no qualifications.
Relationship Factors
Early maternal rejection, abandonment, abuse and neglect, loss of contact with birth parent, death of either parent, change in fathers, emotional abuse, neglect, separation from siblings

4. Ashwood Screening Questionnaire
Significant Life events
Lifestyle Factors
Family crime, witness to violence, multiple carers, parents drug/alcohol use, mother in prison, parents mental health, changes of address

5. Research Findings
Children in Care – average 9.5 risk factors present per child.
Comparison Group – average 0.5 risk factors per child

6. Children at Most Risk – Prior Factors
Research Study
Children at Most Risk – Prior Factors
Having a child protection plan for any reason
Family relationship problems ( family violence, multiple “parents”, chaotic home-life, parent in prison)
Parents using substances, teenage parents, multiple home moves, death of parent(s)

7. Children at Most Risk – In Care Factors
Research Study
Children at Most Risk – In Care Factors
Multiple placements
The highest number of placement moves occurred in the 5-11 years age group,
The 3-4yrs age group moved less but multiple moves in all age groups were associated with poorer outcomes
Siblings placed elsewhere
The siblings might have remained with birth family or been placed separately in the care system

8. Weaker Links to Poor Outcomes But they were still linked
Research Study
Weaker Links to Poor Outcomes
Developmental Disorders
Early Failure to Thrive
Sensory Impairments
Long-term Medication
Physical Health Issues
Exclusion from School
But they were still linked

9. Research Study
Academic Progress and Learning Outcomes Greater Risk Rating = more attachment and mental health and behavioural problems = poorer progress and attainment

10. Research Study
Negative Life Events which were significantly associated with Attachment, mental heath and behavioural difficulties:-
Placement instability
Developmental disorders
Maternal Rejection
Multiple changes of accommodation

11. Case Study Billie needed very special care ...
Billie is a girl with sensory impairment, one of two girls born to a mum with heroin addiction which caused her death. Both girls adopted by mother’s sister when they were 3 years old, but Billie, the older girl, was rejected by the aunt and her new partner while Zoey her sister remained with them.
Billie needed very special care ...

12. Case Study
At the age of 3 years Louisa witnessed her mother punching step-sister Bella who was on the table at breakfast time. Bella fell from the table and died and mother was imprisoned for manslaughter. Louisa and her older sister India were fostered separately. At age five years Louisa was a very challenging and distressed child, ripping at her skin, screaming and sobbing at the least upset, unable to sleep ...

13. Toxic Stress
Lack of stimulation and opportunity to develop a healthy attachment to a primary caregiver
Over a prolonged period of time, stress responses become excessive and toxic to the body, which can have life long consequences.
Toxic stress turns off any functions that slow down reactions - functions that can be essential to protecting ourselves when faced with a threat.
Lower regions of the brain are developed first and protect the body from danger, commonly known as the fight, flight or freeze response. However, if this system becomes chronically overactive it will impact on the development of the higher regions of the brain, resulting in cognitive delay and impairments in executive functioning. Consequently, the ability to think before reacting is severely affected, as the limbic system takes over when threatened and the child is unable to think through the consequences of their behaviour before reacting.

14. Toxic Stress These lost functions include the ability to:
self-regulate
process information
make sense of the world
interact positively with other people
And often children struggle with every aspect of daily life
Children and young people who have experienced adversity that creates toxic stress are traumatised and often struggle with every aspect of daily life.

15. Self-regulation
Children & Young People who struggle with self-regulation are
likely to be perceived as presenting challenging behaviour.
They may be hyper-aroused and acting out, or dissociated
and switched off.
Processing disorders add to the child's difficulties, leading them to misinterpret neutral events as frightening,
They lack the ability to account for their own feelings and behaviour.
However, although the plasticity of the brain decreases over time, throughout childhood, depending on the severity of the trauma experienced, it continues to make those necessary synaptic connections to develop the functions of the higher brain, such as language, empathy, regulation of emotions and reasoning.

16. Impact on learning The child or YP may not :
have the capacity to experience curiosity and joy
be engaged or enthused by learning
have the excitement about mastering skills or understanding
have the ability to use reasoned thought or language to understand and explain behaviour

17. Impact on learning The child or YP may not :
Be able to take risks necessary to learn
Be able to overcome their feelings of shame and loss of self-esteem
Cope with any form of criticism or praise
Relate appropriately to peers
Relinquish their role of protector to younger siblings

18. Case Study 1
Michael describes what happened ‘I saw my Dad at the weekend – I only see him about every month, usually at his place or sometimes we go out. I like to see him because he is my Dad. When I went to his flat on Saturday we watched a new video and had a takeaway but then he told me that my Mum has a new boyfriend and she’s going to have a baby. I couldn’t really understand because I haven’t seen my Mum for about two years and then she was still doing drugs. I wanted to cry but I couldn’t. All week, I kept getting into trouble at school, I just wanted to smash something – how come she can have another baby but not want me?’
Contact visits with birth parents and families are
sometimes painful for looked after children. Parents
and children may desperately want to remain in
contact even though it raises mixed feelings.
Children and young people may be reminded that
their parents cannot care for them and feel angry
and sad about this but have nowhere to direct these
feelings. It may also reawaken their feelings of loss
and abandonment. It can be hard for children and
young people to contain such strong feelings, which
they may spill out into other parts of their life. It is
also very difficult for them to talk about their feelings
– they may not have the words to explain, or they

19. Case Study 2
Sammie explains what often happens ‘I don’t like lunch times because we all have to go in the playground and there are too many people rushing round and the little ones are making noise. Then, each class has to line up when we are told to go to the hall for lunch. At lunch you have to choose what you want and I don’t always like it and sometimes I can’t sit with my friends. I am always getting told off for not eating my dinner because I’m talking. Sometimes I feel hungry in the afternoons and I get grumpy. I like mornings best at school, really.'
Many children with attachment difficulties find large
groups quite threatening. They become hypervigilent
and constantly scan the environment for danger.
They are not likely to be aware they are doing this,
as it is an automatic response to being in a stressful
situation. Some children will also be very dependent
on their friendship group and only feel safe when
they are with their friends – they will often go to
great lengths to be with their friends, because they
are the safer option.
Food and eating can be very difficult for some
children and young people and, in a stressful
situation, they may lose their appetite or overeat for
comfort. They may not be able to settle long enough
to eat a meal (meals may have previously been
erratic or something to eat quickly) or they may crave
food that gives a quick burst of energy.
Background
Sammie is 10 years old and in Year 5 at primary school. She has been in this school for a year
and lives with foster carers and their family. She seems to be happy and settling well although
she is a very anxious child and needs to have her friendship group around her to feel secur

20. Case Study 3 when I do what they want, they are still going on at
‘I don’t see the point of all this work at school. Even
when I do what they want, they are still going on at
me, I could have done this or written a bit more. What’s
the point of me doing it if it’s still not good enough?
Some teachers are ok but some just needle me all the
time – like they don’t think much of me – they say stuff
like, “No homework again, Marcus? It’ll hardly be
worth you sitting the GCSE, will it?“. If I’m having a
bad day, I just explode when they say something like
that and get chucked out of the classroom, but at
least I don’t have to listen to them getting at me.’
Children and young people with attachment issues
may fear failure and so will not put themselves in
a position where they might fail. School work is,
by its nature, commented on along with suggestions
for improvement and these children may interpret
this as failure. These are the children who often do
not work at school even though their teachers say
they are able pupils. For them, rejection has been
a common experience throughout their lives and
they will not want to risk feeling that again – in any
part of their life. For some children, being told off
in school or receiving sarcastic comments can
reawaken the intense feelings of distress following
repeated rejections by their main caregiver, and some
children and young people cope with this through
angry behaviour.
The scene
Marcus is 15 years old and in Year 10 at school. He has been at this school for three years and
so far is only just meeting his targets. His teachers constantly say that he does not work even
though they believe he is able. They believe he can achieve academically, if he puts in the work
and effort. He is also known for having a volatile temper and is frequently sent out of class
following an outburst, often about uncompleted work. Because Marcus has become taller and
bigger, some teachers find his behaviour threatening. Marcus lives in a residential children’s
home and has been back and forth between different carers and his birth mother many times.
He is determined to keep in contact with his birth mother and still sees her occasionally, but
has come to accept that he cannot live with her.

21. Acknowledgments Thank you Ashwood Associates and
National Children’s Bureau for ‘Understanding Why’ Workbook

22. Acknowledgement
Thank you for this very important message Michael, Sammie, Marcus………………….
'I do appreciate you being there for me and trying to understand me even on the days when things are difficult’