Child Care in Practice 11/3

ISSN 1357-5279
VOLUME 11 NUMBER 3
JULY 2005

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Contents and Abstracts

Foreword
Arlene Healey287

Targeting Disadvantage among Young Children in the Republic of Ireland: An Overview
Jacqueline Fallon / 289

It has been recognised for some time that the effects of disadvantage are in place early in a child's life, and early intervention has become an established element of efforts to alleviate such effects. This paper describes the range of interventions that exist to address disadvantage among children in the birth to six age range in Republic of Ireland (RoI). The characterisation of early childhood care and education (ECCE) in RoI has not heretofore been inclusive of all settings for children in the birth to six age group, with a demarcation existing between school and non-school settings. Such a demarcation is not tenable in the context of progress towards a cohesive, coordinated ECCE sector in RoI. It is most noticeable in the dichotomy that exists between the concepts of care and education. While the major policy papers over the past number of years have recognised that care and education are indivisible elements in a child's life, programme implementation has not, to date, reflected this awareness. This profile brings together information on categories of provision, programme implementation, funding streams and supporting structures, Following an introduction, the involvement of community/ voluntary groups in service provision is considered. This is followed by a description of interventions emanating from three government departments: the Department of Education and Science; the Department of Justice, Equality and Law Reform; and the Department of Health and Children. While there appears to be general agreement here on the importance of intervention in the early years of a child's life, it is less clear what constitutes effective intervention in the Irish context. Coordinating all the efforts described across both statutory and non-statutory provision can only benefit our ability to offer real opportunities to children experiencing, or at risk of, educational disadvantage, provided that coordination is informed by indigenous research.

Substance Abuse among 12 and 13-year-old Young People in Belfast at High Risk of Developing Problem Drug Use
Patrick McCrystal, Kathryn Higgins & Andrew Percy / 313

Twenty-nine young people aged 12-13 years considered to be at a high risk of substance abuse primarily because they no longer attend mainstream school participated in the study by completing a questionnaire designed to obtain information on their drug-using behaviours. The evidence in this paper suggests that many of them are already at a high risk for problem drug use compared with their peers in mainstream education. This is heightened by the fact they are excluded from school and are not accessing school-based prevention programmes delivered to their contemporaries at school. The paper concludes by suggesting that additional resources are needed to fully meet their requirements in relation to identifying and delivering appropriate drug prevention strategies.

Training Staff in an Adolescent Inpatient Psychiatric Unit in Positive Approaches to Managing Aggressive and Harmful Behaviour: Does it Improve Confidence and Knowledge?
Steve Killick & David Allen / 323

This study examined the implementation of a model of managing aggressive and harmful behaviour in an adolescent in-patient psychiatric unit. This model, Positive Behaviour Management, replaced a previous model, Control and Restraint, which was considered unsuitable. Both models included the use of physical interventions, and the research into such techniques is considered, The aims of the study were to evaluate the effects of three training courses on staff confidence in managing aggressive behaviour, knowledge about good practice and staff satisfaction with the new model. A multiple baseline design was used to examine change before, during and after the training period, and at one-year follow-up. The study found that staff confidence increased significantly following training but had returned to baseline levels by the time of follow-up. Staff knowledge significantly increased during the study periods but did not appear to be directly linked to the training courses, and was maintained at one-year follow-up. Staff reported significantly higher levels of satisfaction with the new model

Teenage Kicks: Young Women and their Involvement in Violence and Disorderly Behaviour
Neil Jarman / 341

The issue of young people's involvement in forms of violence and anti-social behaviour is one that is generating increasing concern across Northern Ireland. Young people are frequently regarded as one of the primary sources of social disorder and are often blamed for provoking fear and a sense of insecurity among elder members of the community. However, in much of the recent writing and in most of the policy responses to problems of anti-social behaviour, there is an inappropriate use of the term "young people': which effectively functions as a gloss for "young males': Young women are implicitly included in the concept of "young people as problem" but are effectively excluded from policy considerations, which largely focus on dealing with young men. This paper draws upon research into young people's attitudes to and experiences of violence and disorder in Northern Ireland, but focuses specifically on the views of young women and explores their experiences and knowledge of violence and disorder. The paper considers how far young women's concerns are being acknowledged and questions how far the needs of young women can be accommodated or the risks some of them pose are being addressed by subsuming them within the broader category of “young people”.

The Contextuality of Children's Communication Difficulties in Specialist Practice: A Sociological Account
Sirkka Komulainen / 357

This paper reports findings from fieldwork in situations that brought young children and child welfare practitioners together with the aim of diagnosing and treating children's communication difficulties. The findings suggest that communication difficulties tend to be treated as a property of the individual child rather than as an emergent, contextual property of interaction. The attention will be steered from clinical definitions of "impairment" and "disability" to dynamics of social interaction, where understandings of "good" and "normal" communication playa central role. The findings have implications for current recommendations for good practice, which derive from needs-led, rights-led and skills-led approaches,

"One More for My Baby": Foetal Alcohol Syndrome and its Implications for Social Workers
Wendy Cousins & Karen Wells / 375

Foetal alcohol syndrome has been described as the commonest preventable cause of mental retardation in the Western world. It refers to a pattern of malformations, growth retardation and central nervous system impairments found in children of mothers who drink large amounts of alcohol while they are pregnant. This paper describes the nature of foetal alcohol syndrome and the related condition of foetal alcohol effect, presents findings from a study of young children in the care of social services in Northern Ireland and discusses the implications for Social Workers working with affected children and families.

Book Reviews

Counselling Adolescent
Kathryn Geldard & David Geldard (reviewed by Alison Templeton)385

Deliberate Self-harm in Adolescence
Claudine Fox & Keith Hawton (reviewed by David Cameron)386

The Child Abusers, Research and Controversy
Colin Pritchard (reviewed by Desi O'Hagan)390

Fostering a Child. A Guide for People Interested in Fostering a Child
H, Bond (reviewed by Dr Colette Gray)391

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Foreword

Arlene Healey
Consultant Family Therapist, Family Trauma Center, S&E Belfast H&SS Trust,

This edition of Child Care in Practice highlights many of the issues and difficulties facing young people in Ireland both North and South today, The papers highlight various challenges faced by those of us working with these young people, their families and their carers. Together these papers provide important information to help us improve our understanding of the complex nature of the children with which we work. Patrick McCrystal, Kathryn Higgins and Andrew Percy's study into substance abuse among very young teenagers (12-13 years), in Belfast indicates a very high level of risk, particularly among those excluded from school. Excluded children are at much higher level of risk than their peer group in mainstream education, which can act as a protective factor. Outside of mainstream education young people are at a higher risk of developing drug and alcohol problems and are more likely to face social exclusion. The authors conclude that more resources are needed for this group whose exclusion from school also excludes them from the school based prevention programmes. Those working with such young people know only too well how difficult it is to address such difficulties that are further compounded by the lack of appropriate services for children excluded from school. In my practice school exclusion is also an increasing problem in the primary school age group, raising additional concerns.

Jacqueline Fallon looks at targeting disadvantage among young children in the South of Ireland. The paper presents information from a wide range of organisations providing a range of interventions with children aged from birth to six years. She argues that the Republic of Ireland has never had a cohesive, co-ordinated early childhood and education (ECCE) sector and outlines the arguments for such a cohesive integrated approach. She also comments that children who attend schools designated as disadvantaged have considerably lower achievement rates than their peers nationally.

Neil Jarman's paper Teenage Kicks is another local study, which considers the involvement of young woman in violent and disorderly behaviour, a very underresearched subject. He locates the study in the context of Northern Ireland's violent troubled past but also pays attention to its more troubled present. Noting an increase in racist and homophobic violence and harassment, domestic violence, sexual offences and intimidation, painting a concerning picture of increasing levels of violence and disorder across Northern Ireland. With regard to young women he describes the different ways young women are involved in violent activity, from being victirnised to participating in a range of different types of engagement. This paper highlights the need for a more complex understanding of the issue and young woman's agency in relation to violence indicating once again the need for more research.

Wendy Cousins considers Foetal Alcohol Syndrome (FAS) and notes that it has been described as the commonest form of mental retardation in the western world. The condition is found in children of mothers who drink large amounts of alcohol while they are pregnant. This is an area that those of us working with children need to understand more about. The study presents the findings from a group of young children in care in Northern Ireland. Understanding the condition has particular implications for social workers and she looks at these implications when working with affected children and families. Children with FAS have many complex behaviour problems and are also more at risk of being involved in the criminal justice system. The need for early assessment is essential if there is to be any possibility of their complex needs being cared for. She highlights the need for support for families to be made available on a long term-basis particularly support for birth families, which could prevent the need for admission to care. She argues for increased public awareness, as our understanding of this complex syndrome is poor in Ireland and improved knowledge particularly in the public domain could help with prevention.

Steve Killick analysed the impact of staff training in an adolescent inpatient psychiatry unit. In particular he considered the Positive Behaviour Management model, which replaced the previous model, Control and Restraint. He looked at the relationship between staff training and staff confidence. He found that staff confidence increased significantly during the training period but returned to the baseline by the time of follow up. The staff, however, were happier with the new model, and this was maintained at follow up. Despite the difficulties experienced in undertaking the research many important issues are highlighted. In patient adolescent psychiatric facilities pose many challenges for the staff team, working with a particularly vulnerable group of young people. It is an area where best practice is essential. More research is needed in what Killick refers to as an under-researched subject.

Finally, Sirkka Komulainen's paper reports on findings from fieldwork she conducted in England and considers the importance of a contextual perspective in understanding children with communication problems. She challenges us to think differently about our work with children. She argues that thinking in terms of "cases" is a very limiting way to think. By thinking about communication problems experienced by children in relation to human interaction more therapeutic outcomes can be achieved.

This collection of papers remind us of the continued impact of poverty and social exclusion on children. They also highlight particular difficulties children experience and how we need to know more to be able to effectively help them, their families and their cares. Several of the papers call for additional resources to be allocated for our most vulnerable children and the need for more research. This is a great challenge in the present financial climate. Even thinking differently about our work can however make a therapeutic difference. Many of the papers contain research conducted locally and they have particular relevance for those working with children in Ireland, yet they draw on international research and their findings are of international relevance.

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