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Parenting assessments
Parenting assessments at Orchard House follow the Department of Health (2000) Assessment Framework as a practical model to place parenting functioning in context. Within the Framework it is stated that in order to meet a childs developmental needs and promote his or her welfare, parents need to provide the following:
Basic care
Ensuring safety
Emotional warmth
Stimulation
Guidance and boundaries
Stability.
Children are placed in the centre of a triangle comprising:
A childs developmental needs
Parenting capacity, and
Family and environmental factors.
At Orchard House our comprehensive parenting assessment includes an assessment of each parent, each child and family functioning, as well as a specific assessment of parenting capacity and parent/child interaction. Usually at the viability assessment stage a full history of the parents and children is taken. This is used together with background records and observations of the interaction of parents and children to gain a picture of the functioning of the family.
A full parenting assessment includes extensive observation and data gathering focussing on the following areas of parent/child interaction:
Child
Attachment behaviour
Emotional functioning
Emotional and social behaviour
Responsiveness to parent
Parent
Psychological aspects
Emotional functioning
Responsiveness
Warmth/empathy
Capacity to provide appropriate stimulation/verbal
interaction
Capacity for co-operative interaction and play
Behaviour management/rules and boundary setting
Distance/closeness regulation
Emotional management/containment
Ability to provide routine
Physical care
Feeding
Bathing/changing
Ability to support and to manage the
sleeping/bedtime routines of the infant/child
Capacity to ensure safety
Standardised assessments, including the Parenting Stress Index and the Parenting Assessment Manual are used alongside clinical assessment.
As part of the assessment we also aim to understand the level of insight that a parent has in relation to the difficulties that they have experienced and also with regard to the effects that the difficulties may have had on the child/children.
We also aim to assess motivation to change and the capacity that the parent or parents may have to sustain any changes or developments that may have been achieved.
Service Model
At Orchard House it is our aim to provide comprehensive evidence based and cost effective assessments. We are aware of the need to avoid delay and it is a priority to provide assessments in a time frame appropriate for children. We are also able to co-ordinate assessments to work in collaboration with other appointed professionals
Viability assessments are always conducted. The assessment will be carried out at the appropriate location. This may be in obstetric units, mother and baby foster placements or at Orchard House. If viability assessments are not conducted at Orchard House we would encourage parents and any school age children to visit Orchard House in advance of the assessment. In some instances we are able to review documents to assess whether a residential assessment is in the best interests of the child or children and whether, in principle, the assessment proposed meets the criteria of Orchard House. There is usually no charge for this form of viability assessment. Recommendations for any assessments are always made if it is considered to be in the best interests of the child. This is the primary criterion for any recommendation.
Recommendations are also made using a staged approach. This means that if an assessment is recommended the initial assessment phase is usually for a period of between 2 and 6 weeks. This enables the staff to focus on essential issues in advance of an early review. If specialist placements are recommended for parents with mental health or learning difficulties, specialised staff, usually a clinical psychologist will be provided to ensure that the assessment is conducted according to the needs of the child and the parents. Any feedback provided is appropriate for the parents.
In this way our assessments are comprehensive and commensurate with any special need. A member of staff will attend court if required. This will usually be the professional who completed the viability assessment.
Before admission we require a Risk Assessment, Placement Agreement and the Financial Agreement to be signed by the Local Authority. We also require any necessary medical information in advance of admission. Any parents or children with long term conditions such as diabetes, or with any other ongoing need for medication will need to have their medication and any necessary medical equipment for the period of the placement.
Educational needs for children are also established and arranged at this stage. At the beginning of the assessment we arrange a planning meeting with the parent/s, Local Authority and the Childrens Guardian. Final plans for the placement are made at that stage and a Key Worker from the family assessment team and any specialised staff are identified. The parents will be shown around Orchard House and they will be made aware of the facilities and the services that are offered. We will also ensure that the parents are aware of the CCTV cameras and the rules and regulations of Orchard House.
It is our usual practise at the Planning Meeting to agree all individual issues such as the need for any visitors or visits or attendance at any meeting or other appointments.
It is our policy to ensure that placements are individual and specifically designed to meet the needs of the child whilst ensuring that the assessment is appropriate and representative. During the first day, the parents are provided with support to settle in.
We make every effort to ensure that the children and parents feel comfortable at Orchard House. We also make every effort to accommodate particular needs and preferences. Visits to schools are arranged for the children and parents during the first week. It is our usual policy to recommend a Review Meeting after 2 to 4 weeks depending on the assessment period recommended. An Interim Report is provided to all parties at this stage.
The local GP surgery will meet urgent needs and routine care but they regret that they are unable to provide prescriptions for long term conditions.
The Framework for the Assessment of Children in Need and their Families (DH 2000) forms the basis of our parenting assessments. The Parenting Assessment Manual, Sue McGraw and Every Child Matters (2007) are also used to inform assessments. Additional theoretical and clinical perspectives are also used depending on need. The use of any other specific assessment perspectives will be discussed following the Viability Assessment. The Final Report is provided within 4 weeks of discharge. Any specific instructions in addition to the assessment of parenting will be addressed. All reports are provided in a format for court. The author of the report and or the Manager will be available to attend court. It is helpful if Orchard House can be notified of the date of the final hearing as soon as possible..
Assessments for Parents with Learning Difficulties
Approach
It is essential when assessing parents with learning difficulties to be aware of the current clinical and research evidence to ensure best practice.
Assessments of parents with learning difficulties are regularly conducted at Orchard House, and we have appropriately qualified staff and specific expertise. We are therefore able to provide detailed and comprehensive assessments.
It is our practice to allocate a qualified clinical psychologist to each family placed with us to ensure that the assessment is sensitive to the specific learning difficulties of parents, whilst ensuring the safety of the child.
Background
It is well documented in psychological literature that overall IQ score is not a reliable predictor of the capacity or potential capacity to provide appropriate parenting. It is recognised that it is essential to have information with regard to the specific profile of cognitive and adaptive functioning of the parent.
A parent may, for example, be able to achieve an average to low average score on performance skills demonstrating a capacity to plan, but they may have very low scores on verbal reasoning. They may also be able to perform over-learnt skills but find it difficult to flexibly apply learning to situations necessary for parenting. Difficulties with verbal reasoning may also prevent a parent from being able to understand information provided by professionals relevant to parenting.
It is essential for this information to be available in advance of the assessment to ensure the integrity and the appropriateness of the assessment process.
At Orchard House we are able to provide a detailed assessment of the cognitive and adaptive functioning if this has not been provided in advance. These assessments will be conducted by the clinical psychologist allocated to the family.
When these initial assessments are completed, the clinical psychologist and other experienced staff are able to provide appropriate information to the parents. Evidence based methods are always used, which include a variety of modes to convey information including the use of pictures, television clips and modelled behaviour rather than relying on verbal or written information.
These and other methods of conveying information and training parents have been found to be effective when specifically adapted to the individual needs and abilities of parents (Morris, 2003; Shearn 2001). The most efficient forms of education are interactive, practical, involve repetition or reinforcement and use pictorial materials (Hurr, 1997; McGraw, Ball & Clark, 2002; Feldman & Case, 1999; Llewellyn et, al, 2002).
At Orchard House we are also able to assess families with regard to other important factors which have been found to have an impact on the overall ability on the parents and to meet the changing needs of the children. These factors include:
A parents childhood experiences
Previous parenting experience. During any
assessment the past parenting experiences and the
parents own experience of being parented will be
assessed. The assessments will include The
Parenting Assessment Manual (McGraw, et al, 1998).
Clinical Psychologists will also assess the insight and
understanding that a parent has, to assess risk and
their capacity to understand and meet the changing
needs of a child.
Contribution of partner, family and other social
support. For any assessment of parenting, the
parenting ability of the parent is essential. If parents
are to provide parenting to the child or children
together, a joint assessment is evidently
recommended. If a partner is not to be a full time
parent their contribution to the overall parenting is
important to assess. The role and possible support of
the wider family is also an essential aspect of the
overall parenting assessment.
Mental health and emotional functioning
Environmental factors and social stressors. For
parents with learning difficulties any problem with
mental health and psychological functioning are
assessed. If any symptoms are found to be
contributing to difficulties with regard to parenting,
appropriate intervention or other management may be
provided.
We also make every effort to establish contact with community mental health services and/or learning disability services as soon as possible so that any intervention can be continued following discharge.
Social skills
Ability to generalise learning
Capacity to work with professionals
Engagement with services in the community the
capacity for parents to develop the skills required to
manage day to day life with their child can often be
organised and assessed within the community.
This becomes possible when appropriate base line
assessments have been conducted.
It is therefore our practice, when appropriate, to recommend day or overnight assessments or community based assessments. We are also able to provide intensive and if necessary, long-term follow up in the community.
These important factors are included in all assessments and a psychological overview will be provided as a part of the assessment.
When these methods and techniques are employed parents can respond very swiftly and the integrity of the assessment can be assured.
References
Feldman, M.A. & Case, L. (1999) Teaching child-care and safety skills to parents with intellectual disabilities through self-learning. Journal of Intellectual and Developmental Disabilities.
Hurr, J. (1997) Review of research on parenting training for parents with intellectual disability: methodological issues. International Journal of Disability, Development and Education, 44 (2), 147-162.
Llewellyn, G., McConnell, D., Russo, D., Mayes, R., & Honey, A. (2002) Home-based programmes for parents with intellectual disabilities: lessons from practice. Journal of Applied Research in Intellectual Disabilities, 15, 341-353.
McGraw, S. Ball, K. & Clark, A. (2002) The effect of group intervention on the relationships of parents with learning disabilities. Journal of Applied Research Intellectual Disabilities, 15, (4) 354-366
McGraw, S., Beckley K., Connolly,N., & Ball, K. (1998) Parenting Assessment Manual. Pill Creek Publishing.
Morris, J. (2003) The Right Support: Report of the Task Force on Supporting Disabled Adults in their Parenting Role. Joseph Rowntree Foundation.
Shearn, N. (2001) Too dependent on services. Community Care.