New guidance to help social workers assess attachment for children in care

Social workers have been given new guidance on how to assess a child’s attachment needs, and what they should do if issues are found.

The guidance, published today by the National Institute for Health and Care Excellence (NICE), said all children, young people and their parents should get equal access to attachment interventions regardless of care status.

The guidance also set out specific attachment interventions for children on the edge of care, in care, in special guardianship arrangements and at different ages.

As part of NICE’s key priorities for implementation, it recommended that social care, health and education processes should remain consistent and stable for children with attachment difficulties, and that a case management system to coordinate care and treatment should be used.

A young person should also have the same social worker, key worker or personal advisor throughout the period they are in the care system or edge of care, NICE said.

Unaccompanied asylum-seeking children

Social workers should assess all unaccompanied asylum-seeking children for attachment difficulties, once a placement was found, it said.

The guidance could be used in homes, clinics, and schools, said Jane Barlow, deputy chair of the group who developed the guidance and professor of public health in early years at the University of Warwick.

“This guidance will… be key to promoting the long-term social and emotional wellbeing of a group of high-risk children, and we must work hard to ensure that these interventions are routinely available, and that staff in health, education and social care settings have the necessary training to support the attachment needs of this group of children,” she said.

Parents of pre-school children on the edge of care should be offered a video feedback programme to help improve how they nurture their child, improve their understanding of a child’s behaviour and behave in ways that are not frightening to the child, NICE recommended.

Modify interventions

Practitioners should modify interventions for young people in care, subject to SGO or adopted from care, the guidance said, to allow for physical and sexual development, transitions to adolescence and the re-awakening of emotions about their birth parents or original family.

For primary school-age children, living in foster care, special guardianship arrangements or with adopters, practitioners should consider “intensive” training and support before the placement, and for 9-12 months after.

A group-based training and education programme should be considered for children in the care system, subject to special guardianship orders and adopted from care who are of late primary or secondary school-age, and the same should be considered for their carers, NICE recommended.