Stripping the Wallpaper of Practice: Empowering Social Workers to Tackle Poverty

Stressful Events and Adolescent Psychopathology: A Person-Centred Approach to Expanding Adverse Childhood Experience Categories

Stress from cumulative adverse childhood experiences (ACEs) can pose a serious risk of experiencing anxiety, depression, and other mood disorders in adolescence. However, there is a paucity of research identifying specific profiles or combinations of exposure to other forms of stressful life events and their impact on adolescent psychopathology. This study attempted a conceptual expansion of the ACE checklist by examining these stressful events. The study used cross-sectional data from a modified version of the CASE Study survey where 864 adolescents (56% female, n = 480), aged from 11 - 18 years were recruited from four post-primary schools in the North-West region of NI. Latent class analysis of the 20-item stressful events checklist revealed 3 distinct risk classes: a low-risk class (53.5%), at-risk class (42.7%), and an immediate-risk class (3.8%). Results showed those at most risk of adolescent psychopathology had the highest probability of encountering interpersonal relationship issues, experiencing family dysfunction, and having close friends experiencing psychological difficulties. Findings indicate that the original ten ACE categories may be too narrow in focus and do not capture the wide range of childhood adversity. Expanding the ACE checklist to include other stressful events is discussed as these may also be antecedents to psychopathologic responses.

Child poverty and children entering care in England, 2015-20: a longitudinal ecological study at the local area level

BACKGROUND

Children in care face adverse health outcomes throughout their life course compared with their peers. In England, over the past decade, the stark rise in the number of cared-for children has coincided with rising child poverty, a key risk factor for children entering care. We aimed to assess the contribution of recent trends in child poverty to trends in care entry.

METHODS

In this longitudinal, ecological study of 147 local authorities in England, we linked data from the Department for Work and Pensions and HM Revenue & Customs on the proportion of children younger than 16 years living in families with income less than 60% of the contemporary national median income, before housing costs, with Department for Education data on rates of children younger than 16 years entering care. Using within-between regression models, and controlling for employment trends, we estimated the association of changing child poverty rates with changing care entry rates within different areas. Our primary outcome was the annual rate of children younger than 16 years starting to be looked after by local authorities in England.

FINDINGS

Between 2015 and 2020, controlling for employment rates, a 1 percentage point increase in child poverty was associated with an additional five children entering care per 100 000 children (95% CI 2-8). We estimate that, over the study period, 8·1% of the total number of children under the age of 16 entering care (5·0-11·3) were linked to rising child poverty, equivalent to 10 351 (6447-14 567) additional children.

INTERPRETATION

We report evidence that rising child poverty rates might be contributing to an increase in children entering care. Children's exposure to poverty creates and compounds adversity, driving poor health and social outcomes in later life. National anti-poverty policies are key to tackling adverse trends in children's care entry in England.

FUNDING

National Institute for Health Research (NIHR) School for Public Health Research, NIHR Public Health Policy Research Unit, Swedish Research Council, Wellcome Trust, Medical Research Council, and NIHR Applied Research Collaboration North West Coast.

Screening for economic hardship for child welfare-involved families during the COVID-19 pandemic: A rapid partnership response

BACKGROUND

Pandemics have a wide range of economic, health and social consequences related to both the spread of a disease and efforts made by government leaders to contain it which may be particularly detrimental for the child welfare-involved population. This is because child welfare agencies serve some of the highest needs children and families. A significant proportion of these families face economic hardship, and as a result of containment measures for COVID-19, more families inevitably will.

OBJECTIVE

Given the range of negative consequences related to the pandemic and the evolving supports available to families, child protection workers needed a clinical tool to guide and support work with families informed by an understanding of economic hardship. The objective of this paper is to report on the development and implementation strategy of a tool to be used for practice intervention during the pandemic.

METHODS

Action research methodology was utilized in the creation of the clinical tool. The tool's development and implementation occurred through an academic/child welfare sector partnership involving child welfare agencies representing diverse regions and populations in Ontario, Canada. Factor analysis of representative child welfare data from the Ontario Incidence Study of Reported Child Abuse and Neglect 2018 (OIS-2018) on economic hardship was used to inform the development of questions on the clinical tool.

RESULTS

The development and implementation strategy of the clinical tool are described, including the results from analyses of the OIS-2018.

CONCLUSIONS

Future directions for the project are discussed, including considerations for using this tool beyond the pandemic.

“Essential” services, risk, and child protection in the time of COVID-19: An opportunity to prioritize chronic need

In many North American jurisdictions, socioeconomically vulnerable families are more likely to be involved with child protection systems and experience ongoing challenges. The current public health response to the COVID-19 pandemic is having a disproportionate impact on these families via unemployment, “essential” work, isolation, and closures of childcare and schools, with negative implications for children’s developmental wellbeing. Experts warn that while child protection referrals have gone down, children who are at risk of maltreatment are less exposed to typical reporters (e.g., school professionals). At the same time, physical distancing measures are prompting many human service settings to shift toward virtual intervention with children and families. In this commentary, we suggest that a focus on short-term risk in the response to COVID-19 may obscure support for children’s long-term outcomes. We propose two policy considerations: (1) in the immediate term, that child protection workers be deemed “essential”; and (2) in the longer term, that permanent, universal basic income guarantees be implemented to support a baseline of predictability both in families’ material wellbeing and in fiscal budgets in the case of a future crisis. As we write, it is impossible to predict the longevity of these closures nor the extent of their impact on children and families. However, the present article mirrors commentary following previous crises noting the importance of going beyond immediate health risk mitigation to consider wellbeing with regard to children’s development and families’ socioeconomic needs in the long term.

Supporting Children, Blaming Parents: Frontline Providers’ Perception of Childhood’s Adversity and Parenthood in Indonesia

This article explores the construction of childhood and parenthood in rural communities in Indonesia based on a series of focus group discussions with service providers, community decision makers, and paraprofessionals; a group that we refer to as “frontline providers”. By examining the providers’ definition of successful children and their perception of factors that could undermine a child’s success, we provide insights into how frontline providers understand the role of parents, and how parenthood is constructed accordingly. We found that the providers’ definition of successful children reflects a strong neoliberal logic and that education is seen as the primary mechanism of such investment, an evolution of the idea of a modern nation under the previous regime that has permeated into an individual assessment. The paternalistic culture has further cemented the tendency among the frontline providers to problematize parents as the main risk factor for children’s educational achievement and to ignore the structural and ecological factors. We traced this paradigm in Indonesia’s educational and child protection policy framework, prompting a myriad of parenting programs that put parents from the underprivileged group as the main subject of intervention. Informed by studies in different countries, we argue that without changes in structural factors, any intervention on parenting will be deemed ineffective.