Journal Summaries

ICPS Edition 4 We are pleased to bring you the fifth edition of the journal, Communities, Children and Families Australia – March 2010.

On holidays and lunching with friends recently I was asked, “Is it true that child abuse has reached pandemic proportions in Australia?”. This popular view of skyrocketing abuse and increasing numbers of children removed from their families brings home the need to understand what is actually happening for children in Australia and how little we actually know. In this edition we are fortunate that Lance Emerson, Chief Executive of the Australian Research Alliance for Children and Youth (ARACY), took up our invitation to provide a reflection of some of the major challenges we face in making a positive difference for the future of young Australians. High on his list is how our lack of knowledge about how children are actually “faring”, particularly our incomplete measures of children’s wellbeing, means that many issues affecting children and young people remain “under the radar”. Lance discusses some of the critical challenges in developing shared and systematic data collections such as the development of a common approach to assessment, referral and support (CAARS) for children who may be at risk of child abuse and neglect. While a high level of support exists for such an approach, Lance argues that difficulties clearly remain in how any tool can be applied across disciplines. There is also the question of the effectiveness of an approach that assumes a comprehensive network of services and programs is available to vulnerable children and families once they are assessed.

To his thoughts about the CAARS could be added concern that the “tool” may be inadvertently used as a mechanism for increased surveillance rather than as a way of increasing the understanding of families’ needs and helping them obtain the assistance they require. Without consideration of how the tool is administered and by whom, and mechanisms for increasing collaboration between targeted and universal services , there is a real possibility that schools, child care services and general practitioners may reduce the level of everyday informal support they provide to families and that direct referrals to the tertiary sector actually increases.

Lance also raises challenges in achieving the cultural change required to support a public health approach, especially the culture of shared responsibility for prevention so that “children and families are supported at every stage of development and family life”. A main message in his reflection is the need for Australia to “nudge along” this social agenda through use of social marketing and associated policy, program and legislative change. ARACY has made representation to the Australian Government on the need for a large scale strategy such as beyondblue in the case of mental health and depression. Lance’s reflection ably puts the case that primary prevention strategies underway are important, but population-level social change led through social marketing has the potential to make a real difference to the future of young Australians.

Some of these issues, particularly that of helpful data about children, are taken up in the peer-reviewed articles in this edition. Most articles focus on out-of-home care, particularly on what is not well known and where further research based on more rigorous data collection and analysis is needed. In our first article Clare Tilbury calls for a more careful analysis of data sets to better inform decisions in child welfare policy. In response to claims that the child protection system is overwhelmed by rising admission of children to care, Clare argues the importance of a “stock and flow” analysis of data (with “stock” referring to the prevalence of children in care at any particular time and “flow” referring to the incidence of children flowing in and out of care during the year). The tendency to rely on ‘point in time’ prevalence data to investigate trends in out-ofhome care can be misleading.

By analysing both prevalence and incidence administrative data provided by state and territory governments over eight years (2000-01 to 2007-08) it is shown the rate of admissions to out-of-home care across Australia has, overall, actually declined, although there are marked differences among jurisdictions. The data indicates that while children have come into care at about the same rate over the past 8 years they are tending to stay in care longer, and this is the main reason for the increased numbers of children in care at a point in time. Tilbury speculates about possible reasons, such as reunification efforts declining alongside a greater policy and practice focus on permanency planning through permanent care orders or adoption, but concludes that more empirical research is required to understand reasons for changing placement patterns.

With children apparently spending longer periods in care, even for most of their childhoods, the study by Alexandra Osborn and Paul Delfabbro in the second article is pertinent and, like Tilbury’s article, challenges orthodox thinking about out-of-home care. The aim of this study was to assess foster carers’ perceptions of the psychosocial effects of family contact on children, as well as their broader attitudes towards contact with birth families. Findings support the view articulated in a number of reviews over the past 25 years that family contact arrangements are much more complex and challenging than is often assumed. Although small in sample size, the study found that carers perceive that many children became distressed and more behaviourally challenging after contact. There was generally a pessimistic view among foster parents about the value of family contact, particularly in relation to its impact on children’s short-term adjustment in out-of-home care.

The authors discuss the influence of children’s age, gender and general level of psychological wellbeing as factors associated with their perceived adjustment to parental contact. The authors conclude with a restatement of the need for contact arrangements to remain a priority for out-of-home care research and for an extension of this research priority to include, firstly, children in placements of varying duration and, secondly, children with higher levels of “emotional and behavioural maladjustment” problems. A message implicit in this paper is the importance of decisions made by practitioners across the child protection system, including the courts, being informed by each child’s unique experience and response to contact, especially through engaging directly with the child.

Continuing a theme emerging in the above articles, Jacinta Kane and Yvonne Darlington consider the role of sibling relationships in permanency planning and the paucity of rigorous research about sibling placements in Australia. They discuss the literature, which points to the need for continuity of relationships for children, highlighting the importance of sibling relationships as one of the few enduring, unconditional relationships that children experience over their lifetimes. The primary purpose of the paper is to present a systematic review of existing research with the aim of assisting policy direction and practice decision making. Focusing on 11 studies which met the search criteria for inclusion in the review, the authors argue that, overall, findings in relation to placement stability, wellbeing and contact with siblings in care are “limited and confusing”. The review highlights, again, the need for further research about siblings and permanency, placement and wellbeing and contact. They particularly raise the need for well designed multi-method multi-informant longitudinal studies that systematically examine the relationship between sibling placements and other factors.

A key contribution of this paper is its detailed discussion of the methodology of systematic review through the examination of research papers, including details of the question refinement, search strategy, inclusion criteria and assessments of relevance and quality. As the authors note, while this methodology is well developed in health care it has been applied only relatively recently in relation to practice questions in child and family welfare.

In quite a different vein, yet consistent with the point made earlier about collaboration and sharing responsibility for the prevention of harm to children, the last article in this edition involves a collaboration between a district health service in New South Wales and the School of Nursing and Midwifery at Charles Sturt University. The article argues the case for health education as a form of primary prevention against the use of physical punishment of children. Elsa Reid and Carmel Davies consider the parental behaviour of smacking as a form of discipline from legal, social and psychological perspectives. They discuss how recent changes to legislation that define acceptable and unacceptable ways of punishing children have actually strengthened parental belief that smacking is a satisfactory form of discipline. In particular they refer to the New South Wales amendments, which, although restricting corporal punishment to the area of the shoulders and below (“thus reducing the risk of detached retinas and perforated ear drums”), do not clearly rebuke other forms of physical discipline. The authors are critical of the way these attempts at clarification stop short of educating Australians about the difference between punishment and discipline.

Defining the child health nurse’s role as encompassing child advocacy, the authors argue the case for addressing the issue of physical punishment through a health promotion framework. Reorienting health services to adopt this framework means introducing practices that support parents in adopting non-physical forms of discipline and strategies for parental skill development such as new baby and toddler management groups. The paper also supports a greater role for the media (social marketing) in promoting alternatives to smacking.

We are thankful to the College of Child Protection Practitioners for its support of the journal, particularly for enabling its production in hard copy for members of the college. We also appreciate copyediting support provided by the ACT Department of Disability, Housing and Community Services. Many thanks also to Kate Jones, Chairperson of the editorial board, Pam Floro for administrative assistance and to all our peer reviewers, who give generously of their time to ensure the quality of published articles.

Dr Gail Winkworth
Institute of Child Protection Studies
Australian Catholic University