Anita Wiener and Eugene Wiener (1990) Expanding the Options in Child Placement Lanham MD: University Press of America 0 8191 7566 8
Anita and Eugene Wiener both worked at Haifa University, Israel, she as Head of Continuing Education in the School of Social Work and he within the Department of Sociology. In the summer of 1973 they were involved in an action research project inspired by the permanency planning movement to develop plans for around 750 children in care. At the time few children in Israel were fostered and so most children in extra-familial care had their first placement in a, usually large, residential home.
Following a pilot study in 1982, they obtained funding to carry out a study between 1985 and 1987 on the outcomes of the earlier work for 268 children who had been admitted to three institutions in northern Israel. Two thirds had been placed in residential care before the age of one, none of the institutions provided significant individualised care and there was little awareness of children’s emotional needs.
This study is significant in a number of ways:
- The sample consists of a very high proportion of those taken into care during a particular period.
- It was assumed that all the children would be found family placements, whether in adoptive, foster or their natural families.
- 100% follow up was achieved.
- The combination of sample size and length of time was exceptional.
- Care in large residential institutions does not damage children.
- Five or more moves in fourteen years adversely affects the outcome of any form of care.
- Parental involvement is normally associated with better outcomes of care.
- Contact with siblings and the extended family is associated with better outcomes of care.
- Admission to care between three and twelve months old is associated with long term relationship difficulties.
- Children placed at home do less well because they lose access to support which is available to children in extra-familial care.
- Planning has no measurable impact on outcomes.
In Chapter 1 The study and its context the authors set out the assumptions that the study tested, noting the more positive image that residential care has in Israel compared with most western countries, and describe the background to the earlier study and how the research for the main study was carried out.
In Chapter 2 Outcomes: some general characteristics, the authors report that 25% of the children were living with their parents, 24% in residential care, 19% with adoptive parents and 10% in foster care and the remainder, apart from three who had died, were in the army, an institution for people with disabilities, with their extended family or married. 10% had a physical disability, mostly arising from a birth defect, but the remainder were in good health; half of them felt they had been involved in life decisions; most had no problems with authority; few had the shallow emotions that are alleged to accompany institutional rearing; although most were still at school, over half had had some form of paid work; almost all those who had reached the age for national service had been accepted and those who had not met the normal criteria for exemption. However, when asked to draw family pictures, those who drew positive pictures of family life came from adoptive homes.
Two thirds of the children had poor educational attainments but the one third who did not had predominantly lived in adoptive families or in residential care where, in spite of moves, they had retained contact with a significant adult, usually a parent, with whom they had had emotionally significant conversations. Children who had had multiple moves or had attended schools in the community which were not resourced to deal with learning difficulties did worse.
Children with emotional problems were more likely to record lower scores on IQ tests but length of residential care was not a factor. Behaviour problems were more likely the more children moved placement, where there was little emotional content to parental relationships or where the child was not doing well at school but only 38% of the children were recorded as ever having behaviour problems.
Though welfare records often recorded difficulties with peers, 83% had close, long-term friends over half of whom had had them for more than ten years; however, those placed in care between the ages of three months and one year had the greatest difficulties with relationships, often had no school friends and did less well at school.
In Chapter 3 Placement alternatives and their differential impact on the welfare of the children the authors note that nearly half the children experienced more than one type of placement, including some who went to their extended family.
Though the adopted children had not differed significantly from the rest of the sample when initially placed, most placements were successful and adopted children gained the most from their placements. However their natural parents and those left to deal with them both felt unsupported.
Those who had been returned home shortly after 1973 had been regarded as doing significantly better than the other children in the sample but, by the time of the follow-up, they were doing significantly less well than other children. Similarly, those who had suffered a family breakdown or returned to their families following a breakdown in another placement had done less well though all had gained from the experience of being part of their families again.
Apart from those who had severe disabilities, those who had remained in residential care throughout scored second best after the adopted children, particularly if they had had a stable relationship with a member of their family. Although residential care involved moves because of the homes’ age ranges, they were seen as positive because they were part of growing up.
Foster care proved the least durable placement, not least because natural parents who wanted to maintain contact with their children would normally seek to have their children moved elsewhere, and the price of a stable foster placement was often loss of family contact. While foster care proved particularly beneficial to children who had experienced failed institutional or family placements and needed a positive experience of family life, for children who had experienced parental rejection, foster parent rejection leading to a placement breakdown was particularly devastating.
Though placements with the extended family were rarely considered, they were used with some success for a small number of children.
Overall, 39% of children experienced a single move — from the original institution — and 10% five or more moves during the fourteen year period of the study. Though those who had had five or moves did not suffer educationally, they all suffered emotionally, socially and behaviourally. Those who were returned to their parents were least likely to get support for difficulties they encountered but those who maintained family contact, whether or not they returned home, gained advantages over those who did not.
In Chapter 5 The significance of the family, the authors show that, though most children had been taken into care because of their parents’ perceived failings, relatively little had been done to help parents in the intervening years, so they were ill-prepared to support their children. Many adopted an approach of ‘concerned helplessness,’ others were indifferent and 22% rejected their children; unfortunately, the children of these parents were often then placed in foster care where they experienced a second rejection — a placement made because agreeing to adoption would have forced the parents to face up to their rejection, something they were unwilling to do.
Only a third of children had contact with siblings but this was associated with more positive outcomes, as was a stable relationship with another adult, for example, with a foster parent or a member of their extended family. Excluding adopted children, well over half the children had such a relationship.
In Chapter 5 Social service intervention and its impact, the authors show that social work intervention tended to be confined to problems; as long as things were going well, or if the children were placed at home, little support was given. For only around half the children had plans been developed in 1973 but these had had no impact on outcomes. The authors suggest that this was in part because the plans were drawn too narrowly along the lines of adoption, foster care or return home.
In Chapter 6 Professional assumptions reassessed: conclusions and policy suggestions, the authors argue that, in spite of problems and scandals in residential care, residential care overall offers significant advantages to children, that greater attention should be paid to the potential contribution of extended families within a more flexible approach to placements, that a small number of moves is not inherently damaging as long as it is not part of ‘drift’, that adoption provides a positive outcome for most children but not for their natural parents, that placement at home should be accompanied by greater support services but that it should not be considered in the case of rejecting parents and that parents should be much more involved in their children’s lives.
The findings about the relative success of adoption, the importance of parental involvement and contact with siblings, the less satisfactory outcomes for children admitted to care between three and twelve months of age, the negative impact of ‘drift’ and the poor quality of social welfare support were already known from other studies. However, the relative success of the different forms of extra-familial care, the significance of the number of moves a child has and the failure of planning to have an impact on outcomes were all unexpected. The importance of the extended family, while accepted by some as part of good practice, had not been explicitly supported by research.
It is perhaps worth remembering that, though the documented distress of John in the Robertsons’ study (1971) did result in relationship difficulties between John and his mother, it did not result in adverse outcomes in any other areas of his life. Similarly, Tizard (1977) had found that children reared in institutions had no more difficulties than children reared at home. As Brosse (1950) had found, children are remarkably resilient if they have a stable adult relationship, a finding confirmed in this study.
The relative improvement in children’s educational attainments in residential care had been identified by Trotzkey (1930) and linked by Taylor and Alpert (1973) and Fanshel and Shinn (1978) to the availability of an on site school while Tizard (1977) had reported improvements in IQ for early adopted children linked to parent-child attachment; Wiener and Wiener show that adoptive children also achieve higher attainments perhaps because the stability of the placement creates the environment in which problems disappear as the adoptive children grow older (Bohman, 1970).
Though Wiener and Wiener identify having a stable relationship with an adult as associated with a more successful outcome to residential care, they also note that the moves within residential care were perceived as positive stage markers, perhaps because the different homes matched the different stages in children’s cognitive development (Wolins, 1973).
Wiener and Wiener confirm that behavioural problems are associated with multiple moves but associate these with the lack of emotional content in the parents’ relationship, something highlighted by Tizard (1977), rather than with parental visiting or foster home breakdowns as do Fanshel and Shinn (1978). Their total of 38% of the children having behaviour problems over the fourteen years is consistent with the percentages from Rowe and Lambert (1973), Tizard (1977) and Fanshel and Shinn (1978) who studied much shorter periods in children’s lives but needs to be considered in the light of Tizard’s finding that teachers rated the behaviour problems more seriously than parents when the adoptive children’s actual behaviour problems were no worse than those in the middle class comparison group. Moreover, Fanshel and Shinn argue that alleged behaviour problems correlate with other factors in a child’s situation which might happen to a child in their natural family and may therefore not necessarily be related to being in extra-familial care.
Perhaps more importantly, Wiener and Wiener identify the children most likely to benefit from foster care as those who have experienced failed placements elsewhere, something which had happened to four of the five children in foster care studied by Tizard (1977), but caution that, should the foster placement then breakdown, the impact on the children can be particularly devastating, a rather sobering conclusion which suggests that the enthusiasm of Rowe and Lambert (1973) might need tempering.
Wiener and Wiener identify both a lack of support and a general unwillingness to work with children’s parents while the children were in care to address, in particular, issues of rejection which impacted on choice of placement and the sorts of interactions parents continued to have and issues of `helplessness’ which impacted on the capacity of parents to support their children on return home. It is striking that, though in the first half of the 20th century August Aichhorn (1951) and Mr Lyward (Burn, 1956) could regard working with parents as a normal part of their work, all the research from the UK, the USA and Israel in the second half of the century suggests that working with parents in any way had become a very low priority.
Wiener and Wiener also confirm the tendency noted by Tom O’Neill (1981) for social workers to ignore children when they are perceived to be ‘OK’. In the end Wiener and Wiener extend what Taylor and Alpert (1973) and Fanshel and Shinn (1978) had discovered in relation to residential and foster care - that parental involvement is significant for placement success - to placements with the natural family and remind social workers that adoption is not an excuse to ignore parents whose needs may have been the root of the decision to place a child for adoption.
Wiener and Wiener (1990) also interviewed those children who had been in residential care when they were young adults (aged 22–30) and found that none of their own children were in extra-familial care. Overall, the functioning and achievements of these alumni were quite favourable and they estimated that only about 10 -13% were not functioning well or were involved in variant behaviour.
- Aichhorn, A (1951) Wayward youth London: Imago First published 1925 Verwahrloster Jugend Wien: Internationaler Psychoanalytischer Verlag
- Bohman, M (1970) Adopted children and their families: a follow-up study of adopted children, their background, environment and adjustment Stockholm: Proprius
- Brosse, T (1950) War-handicapped children: report on the European situation Publication No 439 Paris: United Nations Educational, Scientiﬁc and Cultural Organization
- Burn, M (1956) Mr Lyward’s answer London: Hamish Hamilton See also Children Webmag May 2009.
- Fanshel, D and Shinn, E B (1978) Children in foster care: a longitudinal investigation Guildford: Columbia University Press See also Children Webmag March 2009
- O’Neill, T (1981) A place called Hope: caring for children in distress Oxford: Blackwell See also Children Webmag May 2009
- Robertson, J and Robertson, J (1971) Young children in brief separation: a fresh look Psychoanalytic Study of the Child 26, 264-315 See also Children Webmag October 2009.
- Rowe, J and Lambert, L (1973) Children who wait: a study of children needing substitute families London: Association of British Adoption Agencies See also Children Webmag September 2009.
- Taylor, D and Alpert, S W (1973) Continuity and support: following residential treatment New York: Child Welfare League of America See also Children Webmag March 2009.
- Tizard, B (1977) Adoption: a second chance London: Open Books
- Trotzkey, E L (1930) Institutional care and placing-out; the place of each in the care of dependent children Chicago: The Marks Nathan Jewish Orphan Home See also Children Webmag November 2008.
- Wiener, A and Wiener, E (1990) Children in care: longitudinal survey of children in institutions from early childhood Tel-Aviv: Shoken
- Wolins, M (1973) Some theoretical observations on group care In D M Pappenfort, D M Kilpatrick and R W Roberts (Eds) Child caring: social policy and the institution Chicago: Aldine