Research into practice

Katy Burch looks at recent research promoting
alternative ways toco-ordinate assessments of children with a range
of disabilities.

The long-awaited, much-trumpeted and now
well-embedded Framework for the Assessment of Children in Need
and Their Families reflected, among other things, the national
mood for “joined-up” public services.

The assessment framework, it was claimed,
would “mark a radical departure in assessment, moving from single
agency service-led assessments to assessments of the whole child by
a co-ordinated group of professionals”.

This was entirely in keeping with more than a
decade of user and carer-related research that identified the need
to improve the co-ordination of assessments and service delivery,
particularly for those children with complex needs.¹
Unfortunately, the framework fell short on suggesting exactly how
best to ensure that assessments were better co-ordinated for
disabled children and their families.

The government’s approach includes various
ring-fenced funds that are now available to develop individual
service areas, such as learning difficulties, on the basis of
pooled budgets.

To date, there is still a big question around
the extent to which pooled services are best suited to the needs of
young people.² They have been reported as expensive to
operate. Neither is it always easy to identify the extent to which
these “Rolls Royce” services have had a positive impact on the
families concerned.

Other recent research has revealed some
alternative approaches to improving the integration and
co-ordination of assessment of disabled children. For example:

– A key-worker service. Key
workers generally provide families of disabled children with a
single point of contact to help clarify expectations and rights,
co-ordinate services and provide support. Evaluations of pilot
key-worker schemes seem to indicate that they are generally very
well received by families, particularly where the professionals
involved are well-briefed from the outset, and where they are
provided with sufficient time out of their “other” commitments to
do this work.³

– Improving methods of consultation
with children with communication problems. Recent research
has identified that social workers need better training in
communicating directly with disabled children. One study in the
recent Children Act Now report identified that very few
services had found effective ways of consulting directly with
children about their wishes and feelings, particularly with
children who are unable to speak.⁴ Other research has
suggested that, while disabled children are a high risk group for
abuse and neglect, and should be over-represented in our child
protection systems, they are in fact significantly
under-represented. Their increased vulnerability has been
attributed to a variety of factors, including communication
difficulties.⁵

Although governmental inclinations may be
towards pooling budgets and services – and indeed many parents
caught in a “services shuffle” from one agency to another may
welcome such a single point of contact – organisational change in
the past has not always delivered the expected elixir of provision.
Sometimes reorganisation produces service paralysis while jobs,
accommodation and parking spaces are allocated. Instead, many of
the goals of a single agency could be achieved in advance of
re-organisation, and the key worker and other schemes carried out
as a precursor to a single agency.

Katy Burch is senior researcher at the
social services research and development unit, Oxford Brookes
University.

References

¹ Social Services
Inspectorate, Removing Barriers for Disabled Children:
Inspection of Services to Disabled Children and Their
Families, SSI, 1998

² Joseph Rowntree
Foundation, Supporting Disabled Children and Their
Families, JRF, 2001, see www.jrf.org.uk  

³ S Mukherjee, B Beresford,
PSloper, Unlocking Key Working, Joseph Rowntree
Foundation, 1999

⁴ Robinson et al,
Making Progress in The Children Act Now: Messages from
Research, Stationery Office, 2001

⁵ R Oosterhoorn, A
Kendrick, “No Sign of Harm: Issues for Disabled Children
Communicating About Abuse,” Child Abuse Review,
July-August 2001