Reunifying abused or neglected children: Decision-making and outcomes
Research in Practice
Tuesday, March 14, 2017
This longitudinal study examines one of the most critical decisions in social work practice - whether a child removed from home due to poor parenting should be returned.
- Nina Biehal, Ian Sinclair, Jim Wade
- Child Abuse and Neglect, (2015)
Research regarding reunification demonstrates breakdown to be common, with varying rates of re-entry to the care system in different parts of the world. Re-entry is often prompted by further maltreatment.
Here, the authors focus on two questions:
- What drives decisions to reunify children and what are the consequences for their lives?
- How do consequences compare for children who face similar adversity but an alternative decision?
Data was collected on all children in, or admitted to, care in 2003-04 from seven local authorities. Data from two subsequent years supplemented this. Here, the authors use a sample of 149 children who either remained in care or were reunified. All had been admitted to care following maltreatment. They were aged 12 or under at point of admission; 52 per cent were male. Eighty-nine per cent had experienced at least two forms of maltreatment. Their backgrounds were characterised by multiple parental problems including domestic violence, substance misuse, criminal activity and mental illness.
Outcomes for this sample were assessed six months after the decision and at final follow up - about four years following the decision on average. Case file data, social work surveys, and questionnaires to teachers were used to gather data.
Planning and decision making
Reunification was the decision for 68 of the children (home group); the other 81 remained in care (care group). This decision was made within one year of admission to care for 79 per cent of the children. The forms of maltreatment experienced and the number of parental problems present at admission were used to provide a cumulative adversity score. The home group had a mean score of five, compared with nine for the care group. Analysis showed one third of the home group were returning home to unchanged circumstances.
Case files were used to establish evidence on planning and decision making for reunion. Social work planning was evident for two thirds of the children and family inclusion apparent for nearly three quarters. Evidence in other dimensions, including risk to the child and multiagency involvement, was variable.
Five factors evident in the case file data suggested children were less likely to return home:
- Experience of sustained neglect
- The child had a learning disability
- Contact with birth mothers was less frequent
- Risk to the child's safety was deemed unacceptably high
- Parental problems were deemed not to have improved.
Outcomes for children
At six months follow up, concerns about children's safety had been recorded for 52 per cent of the home group and 16 per cent of the care group. Concerns for care of the home group were significantly less likely if they had been returned to a different parent than the one responsible for the maltreatment. Stability was greater for the care group, but both groups showed similar numbers of moves. One fifth of the home group had never settled, moving between relatives before eventually returning to care, and over a third of the group had returned to care within six months of reunification.
At final follow up, 37 per cent of the home group had remained continuously with a birth parent; the remainder had all been returned to care at some point. The majority of the care group had been in their placement for two or more years, five had returned to parents or other relatives and three had been adopted (not included in the analyses of outcomes).
A variety of factors were found to be relevant when analysing outcomes including:
- The nature of abuse prior to admission
- Whether children had lived with both parents but only returned to a mother
- Whether children had lived with a stepfather.
Subsequent research has also shown that multiple failed returns are strongly associated with poor outcomes for children (Davies and Ward, 2012).
Implications for practice
For this small sample outcomes were more positive for those remaining in care. The multiple adversities experienced by the children emphasise a key task of the care system to be compensating for prior disadvantage. This highlights the importance of good quality risk assessment and purposeful care planning.
The findings evidence the particular care to be taken when assessing changes in parents who had previously neglected or emotionally abused their children; these changes were either insufficient or not sustained, resulting in poor developmental outcomes for these children. Support following return is also crucial. Problems in the early stages of reunification predicted significantly reduced child wellbeing at final follow up.
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 foster care. Click here for more