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• number of moves child has undergone • number of schools child has attended • was Care Plan implemented?

• how long did implementation take? • therapy received by child/or family 4. Current state of child

• ? Allocated social worker

• child’s current placement, including with/out siblings • number of schools child has attended

• nature of carer-child relationship gained from semi-structured interview with primary carer(s)

• child’s current contact with biological family members

• child’s current emotional, behavioural, academic, social development. These data will be collected using the following schedules and questionnaires: Strengths and Difficulties Questionnaire completed by parents/carers and school; SAJCA & CDI completed by child with interviewer.

• child’s view and understanding of Court’s decision to be gained from semi­ structured interview with child. (NB This data will not be collected from children aged under 7, and from those children living with their biological parents.) Children will not be asked to describe past abuse which they might have experienced.

Base line data will be collected from assessment reports in the case files o f all the children eligible for the study, who were seen in the Child Care Consultation team, in the Department of Psychological Medicine, Great Ormond Street Hospital.

The Lord Chancellor’s Department has been approached to help with data collection of Part 2.

Social Services departments will be approached by the clinical/research team. Data for Part 3 will be obtained from Social Services Departments, by interviewing the appropriate Social Workers over the telephone.

In Part 4, for those children still subject to a Court Order, or where there is still an allocated social worker. Social Services departments will be given a letter of introduction to be passed on to the children’s current carers and the children. For children now adopted, carers and children will be approached via the adoption agency. Separate interviewers will meet with carers/parents and the child, at home. Schools will be approached with the carers’ and the child’s agreement. Carers and children will be assured that their identity will not be known by others than the interviewers and their responses will remain anonymous. All information given by the carers and the children, other than indicators of current Significant Harm will remain confidential to the research team.

SAMPLE

Approximately 300.

Between 1993-1996, approximately 500 children were assessed for Public Law Proceedings under the Children Act, 1989. The projected number allows for refusals and children not traced.

Inclusion criteria will be all children now aged between 3 and 16 years who were assessed for Public Law Children Act proceedings and seen by the Child Care Consultation team. Great Ormond Street Hospital, between 1992 and 1996.

Statistical Analysis

If children are twice as likely to have their well-being favourably assessed for a particular court decision as opposed to the alternative (an odds ratio of 2) and the multiple correlation coefficient between the court decision and the 11 potential confounders is 0.8, then the study has 90% power to detect this difference at the 5% significance level after taking account of the confounders. If the multiple correlation coefficient is only 0.33, then the odds ratio of 1.5 can be detected with the same power and significance. Increasing the power to 95%, odds ratios of 2.5 and 1.6 respectively can be detected at the 5% significance level.

Logistic regressions will be used to relate each of the binary outcomes that defines well-being to the court decisions that were taken, after adjustment for the confounding

What data will be collected on those who refuse consent?

Baseline, Court and Social Services data.

We shall send a summary of our findings to all the children and their carers who participated.

Dr Danya Glaser

Department of Psychological Medicine Great Ormond Street Hospital

London WCIN 3JH Tel 0171 829 8679

OUTLINE OF SEMI-STRUCTURED INTERVIEW WITH CHBLD SETTING THE SCENE

Who lives here with you?

Do you have any brothers or sisters who live elsewhere? How long have you been living here?

QUESTION 1: Positive aspects of current life

Would you like to tell me about three good things you like about your life now? Three best things not to be ranked. I f the child has difficidty nominating three things, prompt M’ith the following aspects o f the child's life:

• Current parents/carers * (not asked o f children living at home)

• Current siblings (biological or otherwise) * (not asked o f children living at home) • Friends

• Family activities: (a) domestic (b) outside home • Non-family activities/hobbies

Prompts regarding the child's family o f origin are not to be used I f the child

spontaneously nominate this aspect o f their life, the follow-up question may be asked I f necessary, follow-up question:

What’s good about it? Best thing 1:

Best thing 2:

Best thing 3:

Code

Current parent s/carers

QUESTION 2; The child’s understanding of their situation

As you haven’t always lived here, imagine you had a younger brother or sister who could not remember or understand what had happened, how would you explain to them how it happened that you came to be living here?

This question is to be explored and coded according to two dimensions: 1. Coherence o f child's understanding

2. Attribution o f responsibility for lea\’ins family o f origin 1. Coherence o f child^s understanding

I f child has little wider standing, ask if s/he recalls having been given an explanation o f what happened.

2. Attribution o f responsibility for leavins family o f orisin

Who do you think was responsible for your moving away from home?

I f the judge, social worker or other professional nominated, ask: What was in their mind, do you think?

I f it would help the child, offer the visual image o f someone thinking:

I f the child attributes responsibility to a professional, but does not give any reason why that professional acted as they did, probe:

What made that person be responsible/act in that way, do you think?

I f the child says that they were responsible fo r what happened, ask: What was it that makes you think you were responsible?

And:

Do you still think that you were responsible?

I f the child says 'the abuse ’ was responsible fo r their moving away from home, code under 'other ’ and probe:

Some children think it’s their fault when there’s been abuse, do you think that?

Code:

No current self-blame Current self-blame

Question 2 codes:

Enter fo r each significant move made by the child: 1. Coherence: Account makes sense:

No

Somewhat Yes

2. Attribution of responsibility for leaving home: Self

Family (parents) of origin Siblings

Social workers Court

Other