Llewellyn, G., McConnell, D. & Ferronato, L.,

2003,

Reviewed by Dr Susan McGaw
Cornwall Partnership (NHS) Trust

Study aims

This study set out to capture prevalence and outcomes data on parents with disabilities and their children in statutory child protection proceedings. The sample group included parents with a wide range of disabilities: parents with an intellectual disability (including those within the borderline range IQ<80), parents with a psychiatric disability (such as psychosis, mood, anxiety and personality disorders), parents with a physical disability (an acquired brain injury or other permanent physical disability), and parents with a sensory disability (vision or hearing impairment).

Background to the study

High rates of child removal from parents with psychiatric disability and parents with disability are reported in the literature. Removal rates range from 41% (39 of 96 children) to 45.5% (103 of 226 children) across families (Mirfin-Veitch et al ., 1999). Parents with disabilities appear more prevalent among studies that have examined parent populations among court samples. Regarding parents with a psychiatric diagnosis, Taylor (1991) reported that 50% (101 out of 206 cases) of court samples involved a parent with this classification. Also, Quinton and Rutter (1984) found that over three-quarters (78%) of mothers with children in care, suffered a psychiatric disorder of some kind. Further clarification is needed regarding the vulnerability of parents with a disability and whether sub-classifications of disability render the children at increased risk of removal from their families within the judicial process.

Methodology

A systematic analysis was conducted on all court files involving care and protection matters, initiated by the statutory child protection authority, and finalized in a 9-month period at two Children's Courts in New South Wales , Australia . A between group comparison was made across five groups of parents ( N = 285 families and 469 children) all of whom had been identified as having a disability of some kind and who had been involved in care proceedings during this period. Statistical comparisons were made between theses groups in terms of their characteristics, e.g. family characteristics, case characteristics and court process characteristics.

Critical appraisal

• A well-designed, large scale retrospective review which provides useful prevalence and comparative data across a range of parents with disabilities whose children were the subject of statutory child protection proceedings. The study usefully expands on the findings of Taylor 's earlier study (1991) and Glaun's smaller study (1999), both of whom examined court records involving parents with intellectual disabilities with the aim of identifying factors that could precipitate a crisis in child care and a bias against this parent population in the courts.
• Tensions arise in the study resulting from inclusion of a relatively small heterogeneous sample of parents with intellectual disabilities with whom a between-subject comparison with other parents with disabilities was made. Consequently, compromises were made which, ultimately, may have weakened the reliability of the findings. For example, the study attempted to control for drug and/or alcohol use across four groups of parents with disabilities (psychiatric, physical or sensory) but compromised with Group 5 (parents with intellectual disabilities, N = 25) of whom five were suspected of substance misuse. Eight parents in this group also suffered secondary disabilities (psychiatric disabilities: N = 6, sensory disabilities: N = 1, and physical disabilities: N = 1) in addition to their intellectual disabilities. Outcome data need to be viewed cautiously regarding the findings in relation to the types of court orders made on families headed by a parent with learning disabilities, and the disproportionately high number of out-of-home non-family placements recommended by the courts. Given the Australian location of this study, readers also need to make a judgement about the relevance of the study's findings to the UK context. Despite difficulties with sampling and population sizes, this was a rigorously executed study.

Key research findings

In almost one-third of court cases (29.5%) parents with disabilities were involved. Further examination revealed that parental psychiatric disability was the most prevalent (21.8%), followed by parental intellectual disability (8.8%) across the parent populations involved in child protection proceedings. Significant associations were found between parental disability and court outcome, with a disproportionately large number of children of parents with intellectual disability being made wards of the state. Across the groups, parents with intellectual disabilities had, on average, the highest number of children subject to care proceedings (mean = 2.12). The authors concluded that parents with disabilities are significantly over-represented in statutory child protection proceedings and that a parent's disability type appeared to influence the outcomes of these proceedings.

Implications for practice and policy

This is an important study that shows parity with the recommendations of Right Support for Parents with Disabilities (Morris, 2003), which advocates for earlier intervention for these families to reduce the risk of implementation of care proceedings. The study's findings need to be considered in view of the forthcoming changes in legislation and practice resulting from Every Child Matters (DoH, 2003) and Protocol for Judicial Case Management in Public Law Children Act Cases (Family Policy Division, 2003) currently underway in the UK .

References

Department of Health (DoH) (2003) Every Child Matters.

Family Policy Division (2003) Protocol for Judicial Case Management in Public Law Children Act Cases. Lord Chancellor's Department: London .

Mirfin-Veitch, B., Bray, A., Williams, S., Clarkson, J. & Belton, A. (1999) Supporting parents with intellectual disabilities. New Zealand Journal of Disability Studies, 6, 60-74.

Morris, J. (2003) Right Support for Parents with Disabilities. Joseph Rowntree Foundation.

Taylor , C.G., Norman , D.K., Murphy, J.M., Jellinek, M., Quinn, D., Poitrast, F.G. & Goshko, M. (1991) Diagnosed intellectual and emotional impairment among parents who seriously mistreat their children: Prevalence type, and outcome in a court sample. Child Abuse & Neglect, 15, 389-401.