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Social Work with Children and families
Response to a letter from the GP of Amita Kaur, the mother of Gurnam. As a student social worker in a local authority Children with Disability team you will undertake an assessment in relation to Gurnam and his family.
This report lays out the proposed method of assessment for Amita Kaur (DOB: 2.3.75) and her family of three children. The approach taken towards the assessment of Gurnam and his family draws from contemporary publications of professionals working in the fields of mental health, learning disabilities, education, and social service provision.
The initial assessment of Ms Kaur’s health already made by her G.P stated that Ms Kaur has been ‘in a state of some considerable distress’ and that it was the opinion of her G.P that ‘she is quite worn out as a result of having to cope with substantial family responsibilities and pressures for a long period of time.’ As Ms Kaur is showing symptoms of depression, coupled with her own expression of concern that she was unable to maintain an adequate level of support for her children I propose that some form of social support is offered to help the family for the foreseeable future. I suggest that in order to ascertain the extent of Ms Kaur’s difficulties, and before I suggest any means of intervention, I would like to hear Ms Kaur’s opinion of her and her family’s situation. As highlighted by Gallimore et al (1999, p. 56) it is necessary for social services professionals “… to regard families as partners to be empowered as active co-decision-makers rather than as cases to be managed”. The impact of parental mental-health problems on their children has already been well-established by research (Rutter & Quinton 1984; Beardslee et al. 1998; Stallard et al. 2004. In Slack and Webber (2007). That Ms Kaur is experiencing feelings of vulnerability and concern for her children is an important consideration when considering the type of service to be offered. It is important that the family recognise that social services are here to offer support based upon informed cooperative decisions made between ourselves and themselves, and that we are here to constructively assess them. In our assessment it is important to consider the family as a whole; a working dynamic that has, up until now, been successful. As research suggests, family-centred services for young children with disabilities have promoted a ‘strength-based approach in promoting positive family functioning (Dunst, Trivette, & Deal, 1988, 1994; Powell, Batsche, Ferro, Fox, & Dunlap, 1997; Weissbourd & Kagan, 1989. In Lesar, (1998), p.263). This approach highlights the strengths in families that they can build on and that ‘the family’s strengths, including the social networks and informal supports already available to and within the family, should be the foundation upon which new supports are designed or provided’ (Dunst et al., 1994. In Lesar, 1998, p.263). Through using family strengths as ‘building blocks and tools, the family becomes even stronger and more capable of supporting the well-being of individual family members and the family unit (Trivette, Dunst, Deal, Hamby, & Sexton, 1994. Ibid). It is thus the aim of this assessment to work towards providing a program of support that can help to re-establish this working equilibrium between the family members, within the varying contexts of their home, working, and education environments.
The extent of provision for the children’s disabilities while they are at home needs to be looked into, and the fact that the children are having negative experiences at school is something that also needs to be investigated further. These experiences could be related to independent stressors – such as emotional changes in the individual children, or a change in their school environment – and/or they could be directly associated to the stress being felt by Ms Kaur in their domestic environment. As suggested by Glidden, (1993, p.482), “…a family with a child who has a disability is a family with a disability.” Glidden adds that in assessing the problems faced by such families, it is important to understand and distinguish between demands and stress exacerbating and causing situations (Glidden, 1993). The situation faced by Amita and her family entails a situation that has been building slowly, but steadily, over a period of time, and now represents a point that is beyond her control in terms of mental, financial, and time control. The long-term stress and demands of her situation, along with increased personal care have prompted the situation whereby her doctor has intervened with the Children’s Directorate Children with Disability Team. Gallimore et al (1999, p. 57) refer to this sort of situation as arising from “…the emotional costs of daily demands and strains”, and that the need for a sustainable daily routine that has manageable long term solutions for helping to reduce the sources of the problems is a paramount objective to the intervention of social services (Hansen, 1993).
Throughout the assessment process we will do everything within our capabilities to reassure Ms Kaur that any intervention will be minimal and will aim to cause as little disruption to the family dynamic as possible. As research has suggested – the influence of social support on families of children with disabilities is closely associated with:
- Better, more cohesive family adaptation (Bristol, 1983)
- A decrease in the number of out-of-home placements (Cole & Meyer, 1989; Ger- man & Maisto, 1982)
- greater maternal life satisfaction (Crnic, Greenberg, Ragozin, Robinson, & Basham, 1983)
- Lowering of maternal stress levels (Kazak & Mar- vin, 1984)
- Better parent-child interaction (Dunst, Trivette, & Cross, 1986). (In Marcenko and Meyers (1991), p.186).
It is thus our aim to offer a service of provision that will improve the family’s quality of life through measures which are constructive, supportive, and reliable. An efficient and prompt assessment process is essential as early intervention, can, in some cases, be crucial in avoiding the onset of more serious problems, which negatively affect parenting capacity and cause family life to ‘escalate into crisis or abuse.’ (D.O.H, 2000: p.xi).
The government document “Framework for the Assessment of Children in Need and their Families” (Department of Health, 2000) has put forth a systematic guidance for the assessment of needs through analysis and recording of what has been and is happening in the household, as well as to the children. This document is written in close association with “The Children Act 1989”. The latter document states that:
A child shall be taken to be in need if –
a. he is unlikely to achieve or maintain or to have the opportunity of achieving or maintaining, a reasonable standard of health or development without the provision for him of services by a local authority …
b. his health or development is likely to be significantly impaired, or further impaired, without the provision for him of such services; or
c. he is disabled (Children Act 1989 s17(10). In DoH, 2000: 6)
Considering that the family’s GP has already expressed concern about the children’s performance at school it is clear that the children’s needs meet the criteria as outlined in parts a-c of the Children’s Act 1989. Under that Act, the welfare of children is set forth under a series of requirements, regulations, and laws. Under Part V – Protection of Children – practice guidance suggests that child assessment orders should allow for differing techniques to be employed to see to the needs of children based upon application by their family, the child, and or agencies.
As Ms Kaur’s GP has expressed concerns for the children’s performance at school I think it appropriate that a joint assessment be undertaken by a staff member of the school and by a child support worker – who together can make an informed and unbiased assessment of the children’s behaviour and performance at school. As highlighted by the DoH (2000:p.6) professionals from different agencies, especially from health and education, are ‘a key source of referral to social services departments of children who are, or may be, in need [..] they will be key in assisting social services departments to carry out their assessment functions under the Children Act 1989.’ Information from the school could be very helpful in the overall assessment and plan for service provision. I would also recommend that a leading professional who works full time with disabled children be called in to undertake an informal assessment of Gurnam. These reports should then be submitted to the head of our department where they will be jointly discussed and used to inform our agency’s plan for services. Ms Gaur’s son Manjit, has been described by the family’s GP as ‘a cause for concern.’ The situation is described as follows:
‘He has a heart condition which has been successfully treated with surgery but which needs to be monitored on an out-patient basis. He has also been assessed as having some learning disabilities. While Amita is very satisfied with the educational programme that the school has been put in place for him, she is concerned that he has been bullied by other children for some considerable time. This has resulted in him being distressed and reluctant to go to school recently.’
The Special Education Needs and Disability Act (2001) suggests that it is the responsibility of the governing education institutional to make sure that the child is not placed at a disadvantage within the schooling system (Part 2). As Ms Akur is satisfied with the actual programme in place for Manjit there is no immediate cause for concern that he is experiencing discrimination. However, from the information given it appears that the physical problems which Manjit is experiencing is causing additional stress – possibly arising from the negative attitudes of his peers towards him. Ms Kaur should be advised to approach the school about this problem, with an accompanying letter from her GP if necessary. As suggested by Sally Beveridge in her discussion concerning schools and special education needs, there will arise certain cases where a pupil will not be able to fully participate due to their having a restrictive impairment, and it is necessary that teachers know as much about children with SEN as possible before teaching them (Beveridge: 1999, 39). Therefore we would advise that the school make individual assessments of Manjit and of Gurnam possibly discussing the outcomes and proposals for action with us.
The assessment plan will be agreed between all children and their mother.
For the planning of children’s services it is necessary to recognise how problems can be interlinked, and that ‘everyone benefits if services are properly co-ordinated and integrated.’ (DoH, 2000:1). It is also the aim of Children’s Services Planning (Department of Health and Department for Education and Employment,1996. In DoH 2000: 1) to ‘identify the broad range and level of need in an area and to develop corporate, inter-agency, community based plans of action to provide the most effective network of services within the resources available.’ (Ibid). When assessing Ms Kaur and her family we must therefore consider the nature and availability of resources in their local area and how they can be best matched with the needs of the family. As outlined by the Doh (2000) service users sometimes report that they find assessment procedures to be ‘repetitive and uninformed by previous work.’ (p.7). However, having outlined a clear and cohesive framework for this assessment I am confident that Ms Kaur and her family will receive an efficient and constructive assessment by our team; one that will provide a fully comprehensive proposal for service provision that will suit their individual needs and their needs as a family.
Beveridge, S., 1999, Special Educational Needs in Schools. London: Routledge
Department for Children, Schools and Families (2008) Common Assessment Framework. Retrieved on 11 February 2008 from http://www.everychildmatters.gov.uk/deliveringservices/caf/
Department of Health (2000) Framework for the Assessment of Children in Need and their Families. Stationary Office, Department of Health, London, United Kingdom [online]. Available from: http://www.doh.gov.uk/quality.htm [Accessed 17/07/08]
Gallimore, R., Bernheimer, L., MacMilan, D., Speece, D., Vaughn, S. (1999) Developmental Perspectives on Children with High-Incidence Disabilities. Lawrence Erlbaum Associates. Mahwah, N.J., United States
Glidden, L. (1993) what we do not know about families with children who have developmental disabilities: Questionnaire on resources and stress as a case study. Vol. 97. American Journal on Mental Retardation
Hansen, D. (1993) The child in family and school: Agency and the workings of time. In Cowan, P., Field, D., Hansen, D., Skolnick, A., Swanson, G. Family, self, and society: Toward a new agenda for family research. Lawrence Erlbaum Associates, Hillsdale, N.J., United States
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Lesar, S., ‘Parental Coping Strategies and Strengths in Families of Young Children with Disabilities.’ Family Relations, Vol. 47, No. 3, (Jul., 1998), pp. 263-268 National Council on Family Relations
Office of Public Sector Information (2008) Children Act 1989. Retrieved on 11 February 2008 from http://www.opsi.gov.uk/acts/acts1989/Ukpga_19890041_en_1.htm
Marcenko, M.O, and Meyers, J.C, (1991), ‘Mothers of Children with Developmental Disabilities: Who Shares the Burden?’ Family Relations, Vol. 40, No. 2, (Apr., 1991), pp. 186-190. National Council on Family Relations
Pardeck, J.T, (1999), Family Health: A Holistic Approach to Social Work Practice. Westport, CT: Auburn House
Sheppard, M., (1991), Mental Health Work in the Community: Theory and Practice in Social Work and Community Psychiatric Nursing. London: Falmer Press
Slack, K, and Webber, M, ‘Do we care? Adult mental health professionals’ attitudes towards supporting service users’ children.’ Child and Family Social Work . London: Blackwells (2007) 13, pp 72–79
Starfield B. Primary care: balancing health needs, services and technology. New York: Oxford University Press; 1998.
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Umbarger, G., Stowe, M., Turnbull III, H. (2005) The Core Concepts of Health Policy Affecting Families Who Have Children with Disabilities. Vol. 15. Journal of Disability Studies
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