Participation of disabled children in individual decisions about their lives and in public decisions about service development

A literature review was carried out to establish what evidence exists about disabled children's participation in decision‐making, both regarding their own lives and about the shape of service delivery. There is evidence that disabled children hold and can express views, given the right environment. However, participation of disabled children needs further development. Measures proposed include addressing organisational systems so that they promote participation, extending advocacy services, the adoption of inclusive approaches and staff training, plus education and information for disabled children and their parents. There remain significant gaps in the research evidence available.     

Child abuse,child protection and disabled children: a review of recent research

This paper reports the results of a scoping study that reviewed research about child abuse, child protection and disabled children published in academic journals between 1996 and 2009. The review was conducted using a five stage method for scoping studies. Several studies have revealed a strong association between disability and child maltreatment, indicating that disabled children are significantly more likely to experience abuse than their non‐disabled peers. Those with particular impairments are at increased risk. There is evidence that the interaction of age, gender and/or socio‐cultural factors with impairment results in different patterns of abuse to those found among non‐disabled children although the reasons for this require further examination. It appears that therapeutic services and criminal justice systems often fail to take account of disabled children's needs and heightened vulnerability. In Britain, little is known about what happens to disabled children who have been abused and how well safeguarding services address their needs. Very few studies have sought disabled children's own accounts of abuse or safeguarding. Considerable development is required, at both policy and practice level, to ensure that disabled children's right to protection is upheld. The paper concludes by identifying a number of aspects of the topic requiring further investigation. Copyright © 2010 John Wiley & Sons, Ltd.     

National consistency and provincial diversity in delivery of long-term care in Canada

The aim of this article is to demonstrate the diversity in delivery of long-term care at the provincial level, within a national legislative framework that provides universal health insurance and public administration. Not all provinces have legislated provision of long-term care, but mandates for provincial long-term care programs typically address the needs of those with chronic health needs and maintain them in the community for as long as possible. Eligibility is based on common criteria of residency, health need, facility, assessment, and consent. The three common components of the service delivery system are institutional care, community-based services, and home-based services; the kinds of services within each component and the mix among them vary from province to province. There are also five common features in provincial service delivery systems: single point of entry, assessment, client classification, case management, and single administration. Throughout the article, examples from different provinces show the varying ways in which these aspects of service delivery have been addressed, and recent innovations have furthered this diversity. A detailed account of quality management systems also shows that while all provinces have adopted a common set of principles, they use a range of methods to pursue quality of care and to promote good practice.     

Coordinated Service Delivery and Children's Well-Being

ABSTRACT

Interagency collaborations are uniquely suited to meeting the increased needs of communities in today's environment of reduced federal funding and devolution of services to the state and local levels (Gore, 1993). In Texas, interagency collaborations take place through Community Resource Coordination Groups (CRCGs), which were created by the Texas Legislature to coordinate local service delivery for children and their families who often “fall through the cracks” due to having multiple needs. This article presents an evaluation of CRCG operations, with a focus on identified best practices, related obstacles, and suggestions for improvement. The researchers visited CRCG sites, and conducted semi-structured face-to-face interviews, as well as a mail survey, with CRCG staff. Overall, CRCGs appear to effectively enhance the delivery of coordinated services in an effort to meet the multiple needs of the children and families that they serve. Recommendations for policy and practice are discussed, such as spearheading community action structures (Poole, 1997) that may help CRCGs more effectively meet the needs of their respective local communities.     

An Aging Workforce in an Increasingly Global World

Summary

The aim of this article is to demonstrate the diversity in delivery of long-term care at the provincial level, within a national legislative framework that provides universal health insurance and public administration. Not all provinces have legislated provision of long-term care, but mandates for provincial long-term care programs typically address the needs of those with chronic health needs and maintain them in the community for as long as possible. Eligibility is based on common criteria of residency, health need, facility, assessment, and consent. The three common components of the service delivery system are institutional care, community-based services, and home-based services; the kinds of services within each component and the mix among them vary from province to province. There are also five common features in provincial service delivery systems: single point of entry, assessment, client classification, case management, and single administration. Throughout the article, examples from different provinces show the varying ways in which these aspects of service delivery have been addressed, and recent innovations have furthered this diversity. A detailed account of quality management systems also shows that while all provinces have adopted a common set of principles, they use a range of methods to pursue quality of care and to promote good practice.     

A study of disabled children and child protection in Scotland — A hidden group?

This paper is based on analysis of data collected for a study, commissioned by the Scottish Government, which examined child protection work with disabled children. At a conceptual level, the paper draws on Goffman's frame analysis and on different models of disability. Focus groups were conducted with five Child Protection Committees (40 individuals) and semi-structured interviews with a further 21 practitioners from social work, education, health services, third sector organisations and the police. The findings show that, for various reasons, abuse of disabled children may go undetected. Where it is suspected, effective action does not always follow, for example, where practitioners over-empathise with parents. When child protection work is undertaken, disabled children may remain relatively invisible in terms of participation and professional focus. It is suggested that the ways in which practitioners and managers “frame” disabled children has implications for how abuse is responded to and how well these children are protected. Participants also “framed” disability in different ways, and it is suggested that a social relational model seems particularly applicable. In conclusion, in many respects disabled children experiencing abuse may remain absent from or to some extent hidden within child protection services in Scotland. While some creative work is taking place, considerable changes are required to make child protection services accessible to all disabled children, sensitive to their needs and respectful of their rights.     

Program Design and Planning Strategies in the Delivery of Culturally Competent Health and Mental Health Prevention and Treatment Services to Latino Communities

SUMMARY

It is important that the delivery of health and mental health prevention and treatment services within Latino communities be culturally sensitive. This article outlines several ways in which agencies can develop programs that can meet the needs of Latino communities. The most important aspect of the provision of health prevention and treatment services is that the organization integrates itself into the community through outreach, recruitment, and inclusion in decision-making. In addition, the organization needs to be structured so communication and participation from the community and health professionals are open and mixed. Otherwise, the likelihood of success of the provision of services in the community will be diminished.     

At home or away? An exploration of policy and practice in the placement of disabled children at residential schools

Despite increasing policy commitment by government to the inclusion of children with special educational needs in mainstream services, significant numbers of disabled children continue to be placed away from their family home and community in residential schools. Reliable statistical information on them is elusive and there has been a dearth of research on how placement decisions are made and what the experience of such placements for disabled children and their families is like. This article reports on the policies and practice of 21 education and social service authorities in England in this area, the patterns of residential placements and the apparent reasons for them. It also highlights points of concern in relation to the protection and promotion of the welfare of disabled children in residential schools, and the apparent lack of clarity on the part of local authorities with regard to their duties in this area. Copyright © 2002 John Wiley & Sons, Ltd.     

Continuity,Engagement and Integration: Early Intervention in Remote Australian Aboriginal Communities

Over the last decade there has been at best limited implementation of preventive interventions for vulnerable Aboriginal and Torres Strait Islander children and their families in remote communities of northern Australia despite growing involvement in the child protection system. This paper describes challenges for services seeking to engage parents who are subject to child protection measures. Brief case studies from an early intervention program in a remote community illustrate that responsiveness and continuity of engagement of parents over time is a necessary basis for an integrated approach to meeting the needs of vulnerable children and families in very remote settings.     

Full-service community schools: a strategy--not a program

The concept that drives the emerging full-service community school movement is this: Schools cannot address all the problems and needs of disadvantaged children, youth, and families. Community schools are operated jointly by school systems and community agencies, are open extended hours, and may provide the site for after-school programs, primary-care health services, mental health counseling, parent education and involvement, and community development. No two community schools are alike. They grow out of a planning process that involves all stakeholders, school personnel, community-based organizations, city and county government, parents, and students. The Quitman Street Community School in Newark, New Jersey, exemplifies this approach.     

Independent living and community care: a disempowering framework

The British disability movement has had significant achievements in its struggle for independent living. However, the current community care framework contains many barriers to independent living. This article sets out a conceptual framework for an understanding of independent living and provides an analysis of the barriers posed by the social care system. These range from financial incentives for placing disabled people in residential care, to a failure to address needs relating to employment, parenting and leisure. Disabling attitudes held by social services professionals about 'risk' and 'capacity' are also major barriers. It is clear that, unless the legislative framework is amended to include an entitlement to independent living, disabled people will continue to be denied their full human and civil rights.     

Overcoming Barriers to Homeless Delivery Services: A Community Response

Homelessness is one of the most pressing social problems today. The.lnstitute of Medicine defines the problem as a failure in the support systems created to prevent the problem and a tighter housing market. The assumption is that the support system should help to prevent the occurrence of homelessness. The Eastern Fairfield County area peiformed a study to look at the relationship between those services serving people who are homeless and near homeless to determine the availability, accessibility, and adequacy of services for homeless people. The study identified several barriers in the service delivery system. A strategy was then developed to address these barriers. This paper shows how a research process can facilitate a community response to a social problem. The paper presents the steps that were taken so other communities may replicate the process.     

Sure Start Local Programmes: implications of case study data from the National Evaluation of Sure Start

This paper is based on case study data on Sure Start Local Programmes collected within the Implementation Module of the Department for Education and Skills commissioned National Evaluation of Sure Start, between 2002 and 2004. Part one describes and discusses some key challenges for programme stakeholders which are associated with the optimum delivery of services for children and families, including managing partnerships; meeting the needs of a diverse community; and targeting. Part two explores the relevance of these findings for future government policy for children and families; and concludes by highlighting the value of an emphasis on ‘building knowledge’.     

Disabled children,child protection systems and the Children Act 1989

It is now widely recognized that disabled children are particularly vulnerable to abuse but that a number of factors get in the way of protecting them. This article discusses research on the implementation of the Children Act as it applies to disabled children and the findings from in‐depth interviews with young disabled people. The research concluded that: current child protection systems are not addressing the particular needs of disabled children; the Children Act regulations on short‐term and long‐term placements are often not complied with; and disabled children and young people have little say in decisions which affect them and few opportunities to communicate their experiences. Copyright © 1999 John Wiley & Sons, Ltd.     

Overcoming Barriers to Homeless Delivery Services: A Community Response

Homelessness is one of the most pressing social problems today. The Institute of Medicine defines the problem as a failure in the support systems created to prevent the problem and a tighter housing market. The assumption is that the support system should help to prevent the occurrence of homelessness. The Eastern Fairfield County area performed a study to look at the relationship between those services serving people who are homeless and near homeless to determine the availability, accessibility, and adequacy of services for homeless people. The study identified several barriers in the service delivery system. A strategy was then developed to address these barriers. This paper shows how a research process can facilitate a community response to a social problem. The paper presents the steps that were taken so other communities may replicate the process.     

Effectively addressing mental health issues in permanency-focused child welfare practice

The purpose of this paper is two-fold: to highlight to the professional community the ongoing and shifting mental health needs of children exiting the child welfare system into permanent plans, dismissed from public caseloads yet still much in need of services, and, to present a model of one agency's integrated, outpatient intervention with promising preliminary data. The model offers a specialized; effective approach to the field to address the needs of families built by adoption and relative caregiving. The increasing number of adoptions, and relative and near-kin placements, mandate that competent, lifelong services to children and their permanent families correspondingly increase. This practice model poses one example of translating this responsibility into action, so that these children are discharged not just to one permanent family, but also with a plan for permanent competent support.     

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

Children who have been removed from their parents need stability and permanence; this is as true for disabled children as it is for others. Yet many children are subject to extended periods of uncertainty and instability. Growing attention has been paid to the need to achieve permanence within a timescale which meets children's needs. As disabled children are over-represented in looked after (in care) populations it is especially important that their needs are considered when formulating policy and practice in this area.This review of literature covers international material related to stability and permanence for disabled children, in particular permanence achieved through fostering and adoption. A scoping method was used to identify and analyse a broad range of material. Ninety texts were included in the review, including material from the US, the UK, Canada, Australia, China and the Netherlands. Empirical research included quantitative, mixed methods and qualitative studies. Other sources included literature reviews and a small number of research-based ‘think pieces’ and briefings.Disabled children often have permanence outcomes and experiences which differ from those of other children; most often they are disadvantaged by systematic features of services and by the latent disablism of decision-makers, professionals, carers and potential carers. The findings also show that disabled children are not a homogenous group and that characteristics such as age, gender, ethnicity and impairment type show complex relationships with permanence through adoption and foster care.Important gaps in current knowledge are identified, including disabled children's views and experiences in relation to achieving permanence. Several areas of policy and practice are highlighted where effort to improve permanence needs to be made. These range from tackling negative professional attitudes about the prospects of placing disabled children to further development of non-traditional approaches to the recruitment of foster carers and adopters.     

Representing the Views of Disabled People in Community Care Planning

The 1990 NHS and Community Care Act requires social services departments in Britain to involve representatives of service users in the preparation of their annual community care plans. This paper gives a critical account of the different ways in which the views of disabled people are sought and represented in community care planning; and of the organisational and practical barriers which disabled people and their organisations are likely to encounter in representing their views to service planners. People with learning disabilities, older disabled people, people with sensory impairments and disabled people from Black and ethnic minority communities are particularly likely to be excluded from current consultation procedures. The paper concludes that present methods of representation place considerable burdens on both individual disabled people and on their organisations. Consequently, disabled people may increasingly question the effectiveness and usefulness of their involvement in community care planning, in the light of the many other issues which are important to them.