WED July 11, 2018 WED July 11, 2018
1:30 pm 1:30 pm
International I International I

Jeanne Kaniuk

Managing Director, Coram

John Simmonds

Director of Policy, Research and Development, CoramBAAF

Elaine Dibben

Adoption Consultant, CoramBAAF

Symposium: Early Permanence – The development of, evidence for and outcomes for children placed with foster carers who may become their adoptive parents

The Coram Concurrent Planning project: Outcomes for children into the Adolescent Years

In the UK most adopted children come into care via the courts because of abuse or neglect. Coram’s concurrent planning scheme provides permanence for vulnerable children under age 2 years in court proceedings. To avoid placement moves and separations, the children are placed with dually approved adopter/ foster carers. The children may return to the care of parents/extended family at the end of proceedings. If not they will be adopted by their foster carers. Assessments of the parental ability to change within the child’s timescale are undertaken as well as assessment of any extended family members willing to offer permanence. The Outcome Study undertaken on children placed between 1999 and 2011 indicated a range of outcomes.

Findings: 57 children placed, records reviewed; 28 families interviewed; 21 SDQs administered; 27 KPS Surveys administered

Children’s characteristics: Most children placed under 6 months; 22% had low birth weight. 74% of mothers had severe substance abuse/ many children suffered drug withdrawal at birth; 33% of mothers experienced DV in pregnancy; 50% of mothers and 25% of fathers had a mental health diagnosis; 88% of mothers had older children mostly in care. Many children experienced multiple adverse background factors. Because of the small sample size and cocktail of adverse factors experienced by most children it was not possible to identify which factors were more toxic or protective.

3 of the 57 children had returned to care of parent/ extended family. All the children placed were still with the family where they had been placed following the court proceedings, demonstrating placement stability. Study considered outcomes holistically: family relationships, physical/mental health/ school/ peer relationships.

Outcomes: All the parents demonstrated high levels of commitment to their children and there were no disruptions.
Group 1: These children had flourished within the family, social networks and school. No support services required.
Group 2: These children needed standard support services e.g. within the classroom.
Group three: These children had moderate to high support needs , including autism/Asperger’s /other difficulties requiring special schooling and mental health services.

Follow up study, 2017: In depth telephone interviews with parents and one adoptee. Analysis to be completed by end March 2018. Early indications are that adolescence has proved challenging; likely contributory factors will be considered.

Implications: Previous expectation: if children removed from adverse conditions at young age to stable alternative family care, the child would grow up without major difficulties. This study appears to confirm the vital importance of neurological development of babies in utero, and impact of early adversity post birth with wide implications for planning for children. Importance of early intervention and follow up support services demonstrated.

The design and implementation of early permanence as an intervention

The design and implementation of any programme of intervention must be evidence informed and focussed on the issues that are planned to improve as a result of the intervention. The principle of doing ‘no harm’ obtaining consent and addressing a broad range of ethical issues form a critical part of the design. Adoption as an intervention is at the extreme end of this range of issues. It is lifelong in its impact, life changing in its intention and requires addressing a multidimensional set of interacting issues with a large set of ‘unknowns’.

The presentation will identity the key features of early permanence as an intervention with a specific focus on exploring the evidence in relation to parenting and the relational world of family life over the life course. The concept of ‘attachment’ has had a strong influence on what we have come to know about parenting and children’s development. And the establishment of a pattern in the attachment relationship from birth and over the next 6-8 months has significantly influenced policy and practice generally and then specifically in adoption. But the establishment of a pattern of attachment between adopters and the child also means disrupting the existing relationship between the child and their carers whether this is the birth parents or foster carers or other adults. Although in many different forms, adoption as an intervention typically means for the child breaking one relationship to begin another. In cases of abuse and neglect, this will typically mean breaking a relationship that has been a significant risk to the child and may have damaged their development to date. The advantages of doing so from the child’s perspective could not be clearer but that must also include some recognition of the longer life long impact of what has been ‘broken’ – the developmental consequences and the issues for the child including their curiosity about their birth parents and family. The argument for early permanence could not be stronger but that does not mean that the ethical, legal and practice issues are not complex and must be addressed as in the design of early permanence as an intervention.

The presentation will explore the research evidence about children’s development what how it has come to frame policy, the law and practice in England. But the strength of that research evidence will also be contextualised by factoring in the ‘unknowns’ and the need to keep in mind uncertainty, anxiety and curiosity which are also embedded in what is intended to be a core child centred and life changing intervention.

The implementation and development of policy and practice of early permanence across England.

The wider use of early permanence placements were encouraged through Government Guidance in 2013 and strengthened by legislation in 2014. As part of a grant funded project, information was sought from adoption agencies through focus groups, questionnaires and direct interviews about how this practice development was being implemented. Views were also sought from early permanence carers so their experiences could be reflected in the subsequent good practice guidance.

The findings showed that there was significant variation in how proactive and committed adoption agencies had been. Some agencies had made a number of placements, instigated robust tracking systems, written clear policies and procedures to support social workers in their decision making, provided training across their workforce and liaised with external agencies and those involved in the judicial process so there was a shared understanding of the principles of early permanence and the benefits to children of this route to permanence. Other agencies had been wary of embarking on this route, reluctant to address opposition from courts, children’s guardians and legal professionals or attempted to use early permanence for specific cases without having all the necessary structures in place.

There was evidence of the willingness of prospective adopters to consider then embrace the principles and reality of foster to adopt carers. They saw the benefits for the child whilst acknowledging that a court may find that it is in the best interests of the child to return to the care of members of their birth family. The importance of providing information and training from the earliest points of contact was highlighted and the value of joint working across Adoption and Fostering teams to provide support to Early Permanence carers managing their dual role. There was also learning about the importance of support for those carers and agencies who have experienced a change in the care plan for a child and their subsequent return to their birth family. Revisions to current statutory guidance would improve the experience of both children, their carers and birth family. We have highlighted the need for improved preparation and training for carers to equip them for their role as foster carers and on how existing legislation can be used to facilitate placements with adopted siblings.

The findings from this project show that there has been some very positive progress in introducing this new option for young children and there is much that can be learned from those who have already achieved some successes in introducing this. Whilst this route will not be the right for all children, we are confident that by highlighting and promoting existing best practice that the benefits of Early Permanence can be extended. where it lies outside of the child’s birth family, provides them with security and stability during the uncertainties of the decision making and judicial process.