Permanence for disabled children and young people through foster care and adoption: A selective review of international literature


Review discusses concerns and policy directions regarding permanency, policy shift towards adoption and how this is seen as the gold standard of permanency, despite warnings to avoid such a hierarchy.

  • Vicki Welch, Christine Jones, Kirsten Stalker and Alasdair Stewart
  • Children and Youth Services Review Vol 53, (2015)

Children in care need stability and permanence; this is true for disabled children as for others. As disabled children are over-represented in care populations it is especially important that their needs are considered when formulating policy and practice. Despite this, many children are still subject to extended periods of uncertainty and instability, although the importance of achieving permanence within a timescale which meets children's needs is increasingly acknowledged.

Maintaining a focus on issues relevant to UK permanence, this review of literature covers international material related to stability and permanence for disabled children, in particular that achieved through fostering and adoption.

Permanence and disability

The review discusses concerns and policy directions regarding permanency, policy shift towards adoption and how this is seen as the gold standard of permanency, despite warnings to avoid such a hierarchy. Irrespective of placement type, permanence is referred to as an intended commitment to the long-term.

The authors include literature on children with physical or sensory impairments, intellectual disabilities, behavioural disabilities, mental health needs or being on the autistic spectrum, to maximise potentially relevant material.

Outcomes

A longitudinal study of 3,351 children who entered foster care in the US in 2006 found that 32 per cent of disabled children were adopted, compared to 8.3 per cent of their non-disabled peers. However, this was because the majority of the latter returned home. Although disabled children in the US and UK typically wait longer to be adopted than other young people, for the most part these adoptions succeed and children achieve permanence.

Disabled children remain in foster care and other out-of-home placements longer than others, some achieving a form of permanency through foster care. However, some studies found that disabled children are more likely than others to be placed out-of-authority or in "inappropriate" placements - independent living arrangements poorly rated by former foster-carers and workers.

Characteristics

The review explores the relationship between achieving permanence and four characteristics: age, gender, ethnicity and impairment. There were significant differences noted in outcomes for children with different impairments.

  • Children on the autistic spectrum typically experienced stays in out-of-home care which were 1.6 times longer than other children.
  • Children with emotional/behavioural disabilities are among those less likely to reunify with parents, are more likely to experience poorer outcomes in adoption and are 3.6 times more likely than others to experience placement instability.
  • Children with mental health needs are less likely than others to reunify with birth families, or to have a successful exit from foster care, have less chance of timely adoption and are 10 times less likely to be given a probationary adoption placement.

Implications for practice

  • There is limited evidence that shows certain interventions help some groups of children, for example interventions to increase placement stability for children with challenging behaviours are beneficial.
  • The provision of specialist services is crucial to placing disabled children successfully.
  • Inclusive ideas must be introduced into policy, practice and training to shift the emphasis away from an individual deficit model, for example the "social model of disability", "strengths-based approaches" or "whole-child approaches".
  • Increasing awareness and visibility of disabled children and their views such that they are fully integrated into assessment protocols, decision-making, recruitment and preparation of carers is vital.
  • Development of non-traditional approaches to facilitate interaction between the child, worker and carers such as adoption parties, videos, carer-led family finding, technological innovations, and assistive communication.

Further research is needed in a number of areas to understand the processes of assessment and decision making for disabled children and how decisions link to their longer term outcomes.

The research section for this special report is based on a selection of academic studies which have been explored and summarised by Research in Practice, part of the Dartington Hall Trust.

This article is part of CYP Now's special report on special educational needs and disabilities.
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