CommentaryAbuse of children in foster and residential care
Introduction
CHILDREN WHO ARE abused and neglected or those who cannot be cared for by their families for various reasons may be placed in the protective care of the local authority. There is an expectation that although there may be inherent difficulties of care within an official public system that at least children will be protected from further maltreatment. The converse however appears to be the case despite the duty put on the local authority that “children living away from home are entitled to the same level and standard of protection from harm as is provided for children in their own homes” (Working Together, 1991).
In England and Wales there are about 48,000 children “looked after” by the local authority, of who 31,800 are in foster care, and 8,000 in residential care. Both the number of children in children’s homes and the size of the homes have fallen with currently on average 10 children in each home: 65% of children were fostered in 1995 (58% in 1991).
Previous studies suggest that children in foster and residential care form an “at risk” group as a consequence of earlier abuse, neglect, abandonment and inadequate care at home Benedict et al 1994, Bolton et al 1981. Ball (1991) estimated that 66% of “looked after” children had been previously abused, and Chernoff (1994) in looking at the reason for placement described a history of abuse in 81% of their sample. Certain children are more vulnerable. These include young children, children with disability, and children with behavioral and emotional difficulties (Utting, 1997). These problems are often greater in children in residential care (Polnay, Glaser, & Rao, 1996). Many children entering care have already been harmed psychologically and emotionally and have developed difficult behaviors experienced as dysfunctional to new carers. Foster carers may also care for more than one foster child with such difficulties and sometimes care for many such children. Their experience, training, and support will be crucial to any success in meeting these children’s long-term and complex needs. Risks may increase in long-term foster care had particularly where the foster carers have had care of the child for a long time, and may have been less well supervised (Utting, 1997). A further factor which may reduce protection for these children is a criminal justice system which is not working “in a way which protects children against abuse” (Utting, 1997)
Recently extensive abuse has been uncovered in children’s homes in North Wales. People who wish to exploit children seek occupation or voluntary work, which gives them easy access to their prey (Utting, 1997). The Warner Report (1992) focused on tighter regulations around the appointment of staff but many of the recommendations were not implemented. Previous reports (Utting, 1991) have looked at safeguards for children in residential settings but again not all the recommendations were implemented. However it is now expected that with current changes in practice, the North Wales situation will not be repeated. Finally it should be noted that many of the confirmed reports of maltreatment in out-of-home placements are serious in nature (Rosenthal, Motz, Edmondson, & Groze, 1991).
Pediatricians in Leeds, a large city in the North of England, became aware that they were being asked to see an increasing number of children who were in foster or residential care where there were concerns that they may have been abused, either physically or sexually or both. A small number of high profile cases included one in 1986 and one in 1995 where a child who was fostered was killed by a foster carer. The question was asked whether these children suffer increased vulnerability to abuse?
Leeds is part of West Yorkshire, which has rates of referrals for legal proceedings under the Children Act 1989 above the national average (Children Act Advisory Committee, 1993). No evidence was found, however, on review by a senior judge of over-reporting of cases to the legal system.
The study aimed to determine the frequency and pattern of abuse and neglect of children seen by pediatricians and who were placed in foster or residential homes over a 6-year period.
The reasons for placement of the child in care and problems the child was experiencing were also studied. Comparison of the frequency of referred cases of children in foster and residential care with those referred from the general population to the same pediatricians was made. In addition the interagency response to these children was examined in terms of investigation, protection, and management.
Children in foster or residential care in whom there were concerns regarding physical or sexual abuse over the 6-year period 1990–1995 were identified retrospectively from medical reports written following full assessments by pediatricians experienced and specially trained in this work. Information was extracted from the reports and case records and analyzed. It is the local inter-agency policy that children with inadequately explained, unusual, or repeated injuries are referred to the specialized pediatric team for assessment as soon as such injury is recognized. Pediatric follow-up appointments at the clinic provide continuing assessment and support with on-going care. At the follow-up appointment a further physical examination is carried out if there are worrying symptoms or signs, for example, bruising, vaginal soreness, specific behaviors (sexualized or an unexpected change in behavior).
The details of the author’s diagnostic approach to both physical and sexual abuse have been dealt with in previous publications (Hobbs, Hanks, & Wynne, 1993). The diagnosis is constructed in the same way as a jigsaw puzzle with information being added until a picture is assembled.
Section snippets
Results (Tables 1–3)
Discussion
The majority of children looked after by local authorities in the United Kingdom are placed in foster care. On 31st March 1995, 49,000 children were being looked after by social services departments in England of whom 31,800 (65%) were fostered (Social Services Inspectorate—Department of Health, 1996, Inspection of Local Authority Fostering, 1995–1996).
The local authority fostering service is a major component of services provided for children and families under the Children Act 1989. There has
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2022, European Journal of Trauma and DissociationAbuse after abuse: The recurrent maltreatment of American Indian children in foster care and adoption
2021, Child Abuse and NeglectCitation Excerpt :While these studies suggest maltreated American Indian children are at elevated risk for maltreatment rereport (English et al., 1999) and recurrence (Fluke et al., 2008; Hélie et al., 2013; Hélie, Poirier, & Turcotte, 2014), they focus on child protective services samples, and at best include children exiting out-of-home placement, rather than capturing the maltreatment recurrence of American Indian children that occurs in foster and adoptive homes. This study expands upon previous research which suggests that while foster care is meant to protect children, children in foster care are at increased risk for maltreatment recurrence (English et al., 1999; Euser et al., 2014; Fluke et al., 2008; Font, 2015; Hobbs et al., 1999; Poertner et al., 1999; Tittle et al., 2001, Tittle, Poertner, & Garnier, 2008). As such, this study fills a gap within the literature by exploring the maltreatment recurrence of American Indian children in foster care and adoption.
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