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Blackwell Publishing LtdOxford, UKCFSChild and Family Social Work1356-7500© 2006 The Author; Journal compilation © 2006 Blackwell Publishing Ltd

2007

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Book Review

Book Review

Jo Dixon

Book Reviews

Book Review Editor: Jo Dixon

Costs and Outcomes of Non-infant Adoptions

Julie Selwyn, Wendy Sturgess, David Quinton and Catherine Baxter

British Association for Adoption and Fostering (BAAF),

London, 2006, 305 pp. £12.95. ISBN 1903699 193

This is an important book for a wide range of people:social workers and their managers, adoption panelmembers, those determining budgets within localauthorities, as well as policy-makers. It is importantat least as much for the depressing messages as forconfirming the best practice that can occur in statecare of children.

A not unusual pattern of ‘care’ in the UK afterchildren have been removed from an abusive orneglectful family, includes frequent moves and some-times long delays before a permanent placement isfound. These moves and delays inevitably underminethe child’s capacity to lead a fulfilled and secure life.For older children, constant change of family may alsomean changing schools and friends, and the delay anduncertainty are in themselves painful. Adoption isnow the permanent placement favoured by govern-ment for children who are unable to return to theirbirth families in a timescale that can be interpreted asin the child’s best interests. The proportion of looked-after children who are finally placed with an adoptivefamily is small (for the last 4 years an unchanged 5–6% of children looked after for more than 6 months),although numbers have risen sharply from 2700 in2000 to 3700 in 2004.

Most studies of adoption outcome start from thepoint at which children enter adoptive families.Uniquely this study by Selwyn

et al

. starts from thedecision of ‘adoption in best interest’ (AIBI) that hadbeen made between 1991 and 1996 for all 130 chil-dren in a single authority. The design enabled theauthors to avoid the risk of adoptions appearing toprovide a more successful setting than other forms ofcare, when the non-adopted groups may contain chil-dren for whom adoption was not carried through. Sixto 11 years after the AIBI decision, 96 (74%) childrenhad been adopted and 80 were still in the adoptive

placement at follow-up. Of these, roughly a quarterhad been adopted by their foster parents, and nearlyall the rest by stranger adopters. Of the remainingchildren, 34 had experienced some form of perma-nent (foster) placement, but 16 children had a historyof constant instability. Data on the children’s back-ground were collected from case files, and from inter-views with carers.

The authors summarize the policy and practiceimplications of what they found from the children’srecords and the family interviews. They report someextraordinarily poor record-keeping, and the frequentabsence of chronologies, which inevitably made theresearch task of understanding the planning decisionsdifficult. They also comment that the lack of rigorousassessments in a majority of cases contributed to lackof appropriate intervention and slow decision-making.Delay (defined as lack of active planning after12 months in care) was noted for nearly a third of thechildren. For half the ‘delay’ cases, active planningappeared to have ceased once the children were safelyplaced in foster care.

Comparison of the background characteristics ofthe three groups showed that the adopted childrenwere younger on coming into care and experiencedspeedier decision-making once they were in care. Theauthors point to the importance of the current policyemphasis on rigorous assessments and early decisionsin child care cases. Distinctively, the ‘unstable’ groupwere more likely to have suffered multiple abuse, tohave had more foster care placements and more dis-ruptions before the AIBI, and to be showing violentbehaviour. This highlights the need to identify thera-peutic services for the children as the permanencyplans are made. One of the most worrying findings ofthe study is the extent of the children’s special needsat the time of the AIBI. At the time the children’splans went to panel, 95% had identified special needs,nearly half with more than four serious problems. Atany one time in the follow-up years, only a third ofthe adoptive families wanted no support from outsideprofessionals, whilst the rest reported that additionalhelp was most often too little and too late.

The information on unit costs was also affectedby the record-keeping available to the authors. For

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example, referral of a child to specialist agencies wasnot supported by data on whether treatment wasundertaken and for how long. This meant that onlythe unit costs to the social service departments (SSD)could be reliably determined; these are considerable.For the adopted children the total costs up to 2001to the SSDs per child were estimated at nearly£76 000; for the stable foster placements, £208 000;and for the children with unstable care careers,£540 000. For the adopted children, SSD costs werelargely limited to the period before the adoptionorder. For the other children, costs might have cov-ered 10 years. On the face of it, this suggests thatadoption is a ‘best-buy’. But this neglects the possi-bility that the other children in the AIBI group mightwell have been successfully adopted if more therapeu-tic work and parental support was undertaken, whichwould have the effect of bumping up the costs perchild adopted.

Practitioners and service managers will find this achallenging book, but one from which more goodpractice could follow. Although the AIBI decisions forthe original sample were taken between 1991 and1996, sadly it is not difficult still to find examples ofpoor management, and lack of appropriate supportfor the looked-after or adopted child and theirparents.

Elizabeth Monck

Senior Research OfficerInstitute of EducationThomas Coram Research Unit

Blackwell

Publishing

LtdOxford, UK

CFSChild and Family Social Work1356-7500© 2006 The Author; Journal compilation © 2006 Blackwell Publishing Ltd

2007

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Review

Book Reviews

Jo Dixon

Foster Placements. Why They Succeed and Why They Fail

Ian Sinclair, Kate Wilson and Ian Gibbs

Jessica Kingsley, London, 2005, 272 pp. £18.95. ISBN

1 84310 173 4

This book forms part of the trilogy by the group ofresearchers led by Ian Sinclair, which provide adetailed account of a complex study on foster care,carried out over 6 years, with an extensive sample ofalmost 600 cases. While the other two works focus onfoster carers (Sinclair

et al.

2004) and on foster chil-dren (Sinclair

et al.

2005), the aim of this book is toanalyse the process of foster care and its role in thechild care system. Each one of the books can be readseparately, however, the way in which they comple-ment one another and the depth of analysis from thedifferent perspectives makes it highly recommendableto read the complete trilogy.

We are accustomed to high quality from the teamat the University of York in their contributions toresearch in different areas of child care, and this bookis no exception. The methodology is complex andcomprehensive, combining quantitative data andquestionnaires with a complementary in-depth studyof cases. The sources of information include all ofthose involved: foster carers, foster children, socialworkers and family placement workers. Moreover, thedesign includes a follow-up with a second set of data14 months later, which permits interesting analysis onthe evolution of the cases.

Given the complexity of the approach, it is surpris-ing that the authors manage to present a huge quan-tity of data and interactions between variables withoutconfusing or boring readers with a long series of sta-tistical tables. The analysis is rigorous, but neverthe-less accessible to a range of readers, from researchersto professionals, and even to the general public inter-ested in the topic.

The results form the basis of more than a meredescription of foster placements, which in itself wouldbe quite valuable. The authors conclude that there isa need to consider the role and function of foster care,based on two crucial limitations observed in the data:on the one hand, foster care is not capable of offeringthe stability these children need and desire; and onthe other, it struggles to achieve changes andimprovements in behavioural and developmentalaspects of the children. Foster care thus appears tofulfil a function of ‘a port in a storm’, as the authorsso rightly point out, but the investment of so muchemotional capital surely merits aiming for highergoals. The challenges, then, are twofold: how to pro-vide stability and permanence, and how to make fos-ter care an experience of improvement and change forchildren.

We totally agree with this need to define foster careat a point when it is in serious difficulty in manycountries. Rather than introducing small improve-ments in specific aspects, it may be time to provide itwith a conceptual framework and a new function. Theauthors write of the need for a theoretical frameworkand cite the theories of attachment and social learningas especially pertinent and productive, and to whichcould, undoubtedly, be added the theories on resil-ience or ecology of development. With regard toimproving permanence, the authors propose breakingthe traditional barrier between foster care and adop-tion and seeking intermediate alternatives and flexi-bility for moving between them, and this is anexcellent contribution to an intense debate.