Children’s Needs – Parenting Capacity

1 children s Needs Parenting Capacity Child abuse: Parental mental illness, learning disability, substance misuse, and domestic violence Hedy Cleaver Ira Unell 2nd edition Jane Aldgate children S Needs Parenting Capacity Child abuse: Parental mental illness, learning disability, substance misuse and domestic violence 2nd edition HEDY CLEAVER, IRA UNELL AND JANE ALDGATE LONDON: TSO 540 1 VCMJTIFE CZ 540 5IF 4 UBUJPOFSZ 0 GGJDF BOE BWBJMBCMF GSPN 0 OMJOF XXX UTPTIPQ DP VL .BJM 5 FMFQIPOF 'BY & NBJM 10 #PY /PSXJDI /3 (/ 5 FMFQIPOF PSEFST (FOFSBM FORVJSJFT 'BY PSEFST & NBJM DVTUPNFS TFSWJDFT!UTP DP VL 5 FYUQIPOF 540!#MBDLXFMM BOE PUIFS "DDSFEJUFE "HFOUT Published for the Department for Education under licence from the Controller of Her Majesty s Stationery Office. All rights reserved.))

2 Crown Copyright 2011 You may re-use this information (excluding logos) free of charge in any format or medium, under the terms of the Open Government Licence. To view this licence, visit or e-mail: Where we have identified any third party copyright information you will need to obtain permission from the copyright holders concerned. This publication is also available for download at ISBN: 9780117063655 Printed in the UK by The Stationery Office Limited J2441707 09/11 11130 Contents List of figures and tables vi Preface vii Acknowledgements viii Introduction 1 Research context 1 Legal and policy context 8 Limitations of the research drawn on in this publication 16 Structure of the book 18 PART I: GENERAL ISSUES AFFECTING Parenting Capacity 21 1 Is concern justified?

3 Problems of definition and prevalence 23 Problems with terminology 23 Prevalence of parents with problem drinking or drug misuse: general Summary of the evidence for a link between parental disorders and Prevalence 27 Prevalence of parental mental illness: general population studies 28 Prevalence of parental learning disability: general population studies 33 population studies 36 Prevalence of domestic violence: general population studies 43 child abuse 47 To sum up 48 2 How mental illness, learning disability, substance misuse and domestic violence affect Parenting Capacity 49 Physical and psychological impact on parents health and well-being 50 iv children s Needs Parenting Capacity Impact on Parenting 61 Social consequences 74 To sum up 80 3 Which children are most at risk of suffering significant harm?

4 85 What constitutes significant harm? 85 Vulnerable children 86 Protective factors 90 To sum up 93 Moving on to explore the impact on children at different stages of development 95 PART II: ISSUES AFFECTING children OF DIFFERENT AGES 97 4 Child development and parents responses children under 5 years 99 Pre-birth to 12 months 99 Pre-birth to 12 months the unborn child 99 To sum up 108 Pre-birth to 12 months from birth to 12 months 108 To sum up 115 children aged 1 2 years 116 To sum up 124 children aged 3 4 years 125 To sum up 134 Identified developmental Needs in children under 5 years 135 5 Child development and parents responses middle childhood 137 children aged 5 10 years 137 To sum up 155 Identified unmet developmental Needs in middle childhood 157 v Contents

5 6 Child development and parents responses adolescence 159 children aged 11 15 years 159 To sum up 179 children aged 16 years and over 180 To sum up 193 Identified unmet developmental Needs in adolescence 195 PART III: CONCLUSIONS AND IMPLICATIONS FOR POLICY AND PRACTICE 197 7 Conclusions 199 8 Implications for policy and practice 201 Early identification and assessment 201 Joint working 204 Flexible time frames 205 Information for children and families 206 Training and educational requirements 207 To sum up 208 Bibliography 211 Index

6 253 List of figures and tables Figures Figure The Assessment Framework Tables Table Prevalence of mental illness among adults in the general population Table Prevalence of mental illness among parents in the general population Table Relationship between the rate of recorded parental problems and the level of social work intervention Table Proportion of children with identified unmet Needs children under 5 years Table Proportion of children with identified unmet Needs middle childhood Table Proportion of adolescents with identified unmet Needs Preface It is probably true to say that, for most people, childhood is a mixed experience where periods of sadness and loss are balanced with moments of happiness and achievement.

7 Such complexity, however, is rarely represented in the literature of childhood. Indeed, much of the written word in the nineteenth and twentieth centuries depicts childhood in one of two contrasting ways. For example, Milne s poem In the Dark , first published in 1927, (Milne 1971) shows childhood as a golden era where children are loved and nurtured by caring parents. It is a time characterised by innocence, unqualified parental love, irresponsibility, peer friendships and a thirst for adventure and knowledge. I ve had my supper, And had my supper, And HAD my supper and all; I ve heard the story Of Cinderella, And how she went to the ball; I ve cleaned my teeth, And I ve said my prayers, And I ve cleaned and said them right; And they ve all of them been And kissed me lots, They ve all of them said Good-night.

8 But never far away is the alternative experience, typified by parental desertion, illness, isolation and poverty. James Whitcomb Riley (1920), who penned uplifting poems of perhaps questionable quality for children during the 1890s, paints a much bleaker picture in his poem The Happy Little Cripple . I m thist a little cripple boy, an never goin to grow An get a great big man at all! cause Aunty told me so. When I was thist a baby onc t, I falled out of the bed An got The Curv ture of the Spine at s what the Doctor said. I never had no Mother nen fer my Pa runned away An dassn t come back here no more cause he was drunk one day An stobbed a man in thish-ere town, an couldn t pay his fine! An nen my Ma she died an I got Curv ture of the Spine! Acknowledgements We acknowledge with sincere thanks the many people who gave generously of their time to help us with this work.

9 We particularly appreciate the expertise and advice offered by Arnon Bentovim, Richard Velleman, Lorna Templeton, Carolyn Davies and Sheena Prentice. The work has been funded by the Department for Education and we thank staff in the department, particularly Jenny Gray who supported us throughout the work with her interest and valuable comments. The work was assisted by an advisory group whose membership was: Isabella Craig and Jenny Gray (Department for Education); Christine Humphrey (Department of Health) and Sian Rees (NICE); Arnon Bentovim (consultant child and adolescent psychiatrist at the Great Ormond Street Hospital for children and the Tavistock Clinic); Marian Brandon (reader in social work, University of East Anglia); Carolyn Davies (research advisor, Institute of Education, University of London); Jo Fox (social work consultant, Child-Centred Practice); David Jones (consultant child and family psychiatrist, Department of Psychiatry; University of Oxford); Sue McGaw (specialist in learning disabilities, Cornwall Partnership Trust).

10 Sheena Prentice (specialist midwife in substance misuse, Nottingham City PCT); Wendy Rose (The Open University); Lorna Templeton (manager of the Alcohol, Drugs and the Family Research Programme, University of Bath); and Richard Velleman (University of Bath and director of development and research, Avon and Wiltshire Mental Health Partnership NHS Trust). Introduction This second edition of children s Needs Parenting Capacity provides an update on the impact of parental problems, such as substance misuse, domestic violence, learning disability and mental illness, on children s welfare. Research, and in particular the biennial overview reports of serious case reviews (Brandon et al 2008; 2009; 2010), have continued to emphasise the importance of understanding and acting on concerns about children s safety and welfare when living in households where these types of parental problems are present.