Background
to the Research
- Little
attention has been paid to the residential care needs of children
and adolescents with disabilities. While most natural parents now
care for disabled children at home, with increased provision of respite
breaks, the demand for such breaks far exceeds supply. Families often
have to struggle on, or the children have to experience multiple placements.
- This
study had three main aims: to document, for one administrative area
in NI, the characteristics of 'looked after' children with disabilities
who spent at least 90 days in a twelve month period living away from
the family home; to describe their current 'out-of-home' placements;
and to estimate the future needs of these children as indicated by
the key-worker for the child in the local H&SS Trust.
Research
Approach
- Inclusion
criteria were used to identify the study population, and contacts
were made with various services that work with disabled children.
· The study focussed on one of the H&SS Boards (responsible for 4
H&SS Trusts) in NI, namely that which covers Belfast city and most
of Co.Down. 108 children were identified, and their key worker undertook
a structured interview using a standard pro forma.
Main
Findings
- The
proportion of 'looked after' children varied across the 4 Trusts.
Possible explanations are differences in social work ethos practices,
differential staff shortages and differences in the real needs of
the children and families.
- 64
(59%) of the children were male and 44 (41%) were female. The proportion
of males was higher among the 1-14 year old group than those aged
15-20 years.
- 51%
of children were reported to have severe learning disabilities, 29%
had profound or multiple disabilities, 10% had mild or moderate learning
disabilities, and 11% had physical disabilities.
- Nearly
half of the sample were reported to have challenging behaviour, with
a third experiencing severe communication difficulties and nearly
one fifth with autism or autistic spectrum disorder. 14% were classed
as technologically dependent, while three children were noted as requiring
a 'highly supervised' environment because of their behaviour.
- There
were significant variations across the four Trusts in terms of the
children's special needs.
- One
or more family problems were listed for all but 8 of the children.
Those most frequently mentioned were parents not coping/stressed,
children neglected/suspected abuse, single parent, physical illness
of mother or father, mental health problem and alcohol or drug abuse.
- 8 parents
were reported to have learning disabilities; a care order was in place
with 8 families, and domestic violence was reported for 5 families.
- There
were significant differences across the trusts in the children's place
of abode.
- Overall,
48 children were living with their natural families on either a full-time
or shared care basis; 34 were presently living in some form of residential
facility; 25 children were in foster care; and 1 was in a long-term
family placement. The child's place of residence was found to vary
according to the age of the child and also to disabilities.
- 14
families (from a total of 74 who had children living with them either
as natural or foster parents) were reported to receive no respite
services, 34 to have one respite service, 26 two respite services
and 5 three or more services. This most commonly took the form of
short-stays in a children's facility, followed by the use of adult
facilities.
- A total
of 153 services were mentioned in terms of future service needs. Most
children (72%) had only one future service need named for them.
- Overall,
the greatest need was for more respite and shared care services. The
need for child and adolescent residential facility was noted for 32
children, 36 families needed in support services, and 11 children
needed foster care. Again, there were differences between the 4 Trusts.
- An
attempt was made to assess the likely need for new residential services
in particular, with the data suggesting that 16 children presently
living with their families or with foster carers require a part- or
full-time specialist residential place. A further 14 already in residential
care were noted to require more appropriate accommodation. The requirements
for additional respite services and foster care were difficult to
identify.
Conclusions
- These
children and families have complex needs which require specialist
support from a range of health and educational professionals, as well
as specialist social services. Administrative systems often fail to
co-ordinate the planning required.
- Given
the variations highlighted in neighbouring geographical areas, there
is a need for more localized identification of needs.
- The
increased need for long-term residential options is highlighted, with
new places needed to accommodate children with challenging behaviours;
those with autism and a small number of technologically dependent
children. However, little investment has been made in this area, placing
extreme pressure on families and on community services who have a
statutory duty to meet the children's needs.
- The
needs of teenagers must be factored into the planning of housing and
support services for adult persons, if continuity of care is to be
maintained for young adults.
- Studies
such as this are recommended to be repeated at regular intervals and
at a minimum of every 5 years to review service needs.
- Evaluations
are also needed for existing residential facilties.
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