ARTICLE
This article first appeared in Representing Children, 9(2), 1996, 99-107
and is reproduced by permission of the editor
SUPPORTED PARENTING
FOR PEOPLE WITH LEARNING DIFFICULTIES: LESSONS FROM WISCONSIN
Tim Booth
Professor of Social Policy, Department of Sociological Studies,
University of Sheffield
Wendy Booth
Research Fellow, Department of Sociological Studies, University
of Sheffield
The authors are
currently working on an action research project funded by the
Joseph Rowntree Foundation which aims to develop a local support
network for parents with learning difficulties based on the principles
of advocacy and self-help.
Parents with learning
difficulties too often receive short shrift from the child protection
services. In 1991 Lancashire County Council were censured by
the Local Government Ombudsman for failing to provide the level
of counselling and support needed by a mother with learning difficulties
(Local Government Ombudsman, 1991). This is not an isolated case.
It represents a rare public example of what usually passes as
private heartbreak. There are signs, however, that more people
are beginning to recognise the prejudicial nature of the treatment
meted out to many of these parents. A new Manchester-based counselling
project for birth parents who have had their children adopted
reports that eight out of ten users have learning difficulties
(Whitely, 1995). Values into Action, the national campaign for
people with learning difficulties, reports an increase in calls
from parents and has begun to speak out on their behalf (Valios,
1995). Enable, the Scottish learning difficulties organisation,
has expressed concern that local authorities are too quick to
take a negative view of parents' capabilities. Mencap too is
at last showing a willingness to face up to the issue (Viewpoint,
1995b). Reflecting on the implications of some recent placement
decisions, an editorial in Community Care (1995) observed that
once again 'the fear of the "learning difficulties"
label and what it might mean has weighed more with a local authority
(and the legal system) than the principles of partnership that
the Children Act was supposed to entail'.
All the evidence
points to high rates (40-60 per cent) for the removal of children
from the family home, and such figures are often cited to support
a general claim of parental inadequacy. Our research (Booth &
Booth, 1994c) shows that such an interpretation forms an unreliable
basis for child protection work. Children are frequently removed
from their families for reasons other than parenting failure,
including deficiencies in professional practices, services and
supports (Booth & Booth, 1994b). Two factors are particularly
influential in tipping decisions against the parents. First,
there is the widespread 'presumption of incompetence' which leads
practitioners and the courts into making often ill-founded judgements
about parents' inability to cope (Booth & Booth, 1996). Second,
there is the emphasis currently given to the protection of children
at the expense of their broader welfare needs and the support
of their families (Farmer & Owen, 1993; Parton, 1991; Thorpe,
1995). These points need to be seen in the context of recent
child protection research (Department of Health, 1995).
There is now a substantial
body of evidence pointing to a disconcerting overreach of child
protection procedures with many thousands of children being inappropriately
sucked into the system each year. These children are drawn overwhelmingly
from poor and disadvantaged families. The great majority are
found to require no protective intervention and are more properly
classed as children in need. But a narrow focus on the issue
of abuse has led to these other needs being ignored. Although
the Children Act 1989 places a general duty on local authorities
to promote the upbringing of such children by their families,
research has shown that preventive services and support are rarely
offered. Most receive no help of any kind beyond the Section
47 enquiry. This concentration of resources on child protection
'has prevented the policy shift towards the promotion of welfare
promised by the Children Act' (Gibbons, 1995).
Parents with learning
difficulties are unwitting victims of this imbalance in the approach
to child welfare. For the great majority, parenting is an uphill
struggle made all the more difficult by social and economic pressures
known to undermine the coping abilities even of people who do
not have learning difficulties. Few are likely to succeed without
the right kind of support and too few receive it. Indeed, becoming
a parent often leads to the transfer of case management responsibilities
from the Learning Difficulties team to the Families and Children
team with a consequent loss of access to resources from the community
care budget. In turn, the lack of Section 17 provision for children
in need channels the professional response to such families down
the child protection route where the presumption of incompetence
heightens the likelihood of children being judged at risk of
significant harm. Even when support is provided, most commonly
in family centres, it is often not geared to parents' learning
characteristics. Their erratic attendance or apparent lack of
commitment or failure to show progress is then seen as further
evidence of parental inadequacy.
Almost fifty years ago, Michelson (1947) pointed out that
parents with learning
difficulties could be helped to give their children better care.
'Today's challenge', she declared, 'is to show how best it can
be done.' A lot has been learned since then (see Booth &
Booth, 1994c for a summary of the literature; also Booth &
Booth, 1994a). It is now known that training can improve the
knowledge and skills of mothers in virtually all areas of parenting,
but is less effective where parents are having to cope with external
pressures in their lives (such as debt, bereavement, harassment
etc.) and are preoccupied with crises of day-to-day survival.
Services need to be organised in such a way that parents are
made to feel competent, have a say in solving their own problems,
and feel in control of events. Support tends to be most effective
when it is consistent, non-intrusive and non-threatening. The
failure of the child care services to heed these lessons amounts
to a form of system abuse. System abuse refers to institutional
attitudes, policies and practices that 'hurt children, harm family
integrity or infringe basic rights' (Gil, 1982). It includes
all processes that damage the families they are intended to support
or protect (Cooper, Peterson & Meier, 1987). If the damaging
effects of system abuse are to be avoided in the future, greater
priority must be given to developing ways of supporting parents
with learning difficulties in their parenting.
WHAT IS SUPPORTED PARENTING?
Supported parenting
is a principled approach to helping families headed by a parent
or parents with learning difficulties. It is not about shoehorning
families into existing services but about developing new forms
of support that are responsive to their perceptions of their
own needs. Current work with these families is largely based
on a 'deficit model' of service delivery which is resource-led
and crisis-driven, focuses primarily on people's problems and
failings, and puts the professional in control. By contrast,
the supported parenting model involves working long term to build
on a family's strengths in order to promote competence and sustain
independence.
The idea of supported
parenting is grounded on a core of practice principles that have
emerged from the experience of working with mothers and fathers
who have learning difficulties and their children. Foremost among
these core principles are the following:
- Support must be based on respect for the parents and for the
emotional bond between the parents and their children.
- Parents should be regarded as a resource, not as a problem.
- Parents have needs
as people too.
- Support should be directed to the family as a unit rather than
to individual members.
- Parents should be enabled to feel in control and to experience
being competent.
- Intervention should focus on building a family's strengths rather
than on attending to its weaknesses.
- Families are best supported in the context of their own extended
families, neighbourhoods and communities.
- Parents must be engaged as active partners in service planning
and involved as equals in choices and decisions affecting their family.
SUPPORTED PARENTING IN WISCONSIN
These guiding principles
have emerged from pioneering initiatives in supported parenting
in the United States (Ullmer, 1991). The State of Wisconsin has
been among the frontrunners in this field. For over ten years,
the Wisconsin Council on Developmental Disabilities (WCDD) has
coordinated a Supported Parenting Project with the aim of helping
state and local human service and public health agencies improve
the quality and effectiveness of services to families headed
by parents with learning difficulties. Thirteen counties have
established interagency supported parenting coalitions for the
purpose of sharing information, pooling resources, training and
coordinating planning for families. Each coalition has set about
the task of identifying strategies for improving service delivery
in their area. For example, the Fond du Lac County Coalition
obtained funding to appoint a part-time case manager to coordinate
interagency planning with families; in Kenosha County the Supported
Parenting Task Force organised to provide opportunities for mutual
support and the exchange of information among otherwise isolated
practitioners; the Washington County Supported Parenting Interagency
Group focussed its efforts on the training of practitioners;
in Milwaukee the Supported Parenting Coalition set about planning
for system change by increasing the commitment of the community
to the support of families; the Dane County Consortium obtained
funding to set up a resource pool administered by a part-time
coordinator to supplement the efforts of individual agencies
and to meet needs not covered by other sources; and the Brown
County Supported Parenting Task Force introduced a planning process
for organising support for families based on the identification
of a lead agency in each individual case. The driving force behind
these initiatives has been the recognition that many of the challenges
encountered by professionals in supporting families stem less
from the parents themselves than from deficiencies in the services
(Kidd Webster, 1988). For service providers, improved communication
can result in better coordination, increased knowledge and skills,
better professional support and camaraderie, and new opportunities
for resource development. For families, it can mean less confusion,
fewer mixed messages, more trust, and better support.
The following vignettes
provide examples of specific programmes that have been set up
in Wisconsin for supporting families (Mandeville, 1992a):
- The Parents and Children Together Program in Madison provides
in-home, intensive, one-to-one, long term support to families
with at least one parent
who has learning difficulties. Services include information and
training in daily living skills, parenting skills, child growth
and development, health care etc. As one option, families can
be matched with a volunteer parent aide who spends from two to
fifteen hours a week with them and provides friendship, emotional
support, social and leisure opportunities and acts as a role
model for the parent(s). Some parents also receive assistance
with household tasks and daily errands. The programme offers
case management and maintains close contact with other agencies
in the community who are involved with the family.
- The Neighbors Network in Jackson County uses paid 'neighbours'
to provide support to a family for twelve to fifteen hours a week.
Based on a parent-to-parent
model (Llewellyn, Griffin & Sacco, 1992), the neighbours
are themselves all parents who can relate their own experience
to families who need support. The parent(s) defines what help
is needed and when. For example, the neighbour may work for a
few hours in the morning to help get the children ready for school
and then return in the afternoon when they come home. In addition,
neighbours assist in modelling routines and skills with families.
Parents in the scheme also have a county social worker who is
responsible for case management. The neighbours emphasise their
role as a friend rather than as a representative of authority.
- The Positive Parenting
Project in Brown County provides in-home, individualised and
intensive services to families with children between birth and
three years of age where one or both parents have learning difficulties
(Heighway, Kidd-Webster & Snodgrass, 1988). Services include
case management, advocacy, transportation, and parent education
in the areas of nutrition, home management, recreation and social
activities, health and safety, physical care and parenting skills.
The project uses a preventive and positive approach to build
on the family's strengths and to help the parents provide a home
environment suited to the needs of their growing child.
- The Supported Parenting
Program in Rock County provides in-home support for parents with
learning difficulties designed to improve their self-esteem and
their ability to cope with the stress of parenting as well as
their skills in the areas of budgeting, physical care, hygiene,
nutrition, play, safety, discipline and emotional stability.
Staff instruct, model and support parents in order to promote
their competence and safeguard their independence. The programme
is based on the belief that parents with learning difficulties
are capable of raising their own children, though they may not
have received any preparation for doing so. Participation is
voluntary and parents control the development of their service
plan.
- The Intensive Aide
Program in Neenah, Wisconsin provides practical training for
parents with special needs, including parents with learning difficulties.
Two aides are assigned to each family who provide training and
assistance in areas such as child management, parent-child interaction,
nurturing routines, nutrition, social skills, health and safety,
and accessing community resources. Families receive an average
of two home visits a week. The service is not time limited and
families may remain in the programme as long as needed.
These initiatives
and programmes bear witness to a concerted attempt to address
the needs of parents with learning difficulties and serve to
highlight the lack of effort that has been put into supporting
families in this country. With notable exceptions such as the
Special Parenting Service in Truro (Campion, 1993; McGaw, 1993a;
McGaw, 1993b) and the Elfrida Rathbone Women as Parents Group
in Islington (Whittaker, 1993) the special needs of these parents
have been largely ignored. Over the past ten years, a great deal
of systematic knowledge and practice wisdom has been gathered
in Wisconsin from which much can be learned in the UK. The next
section seeks to draw out some of the key lessons.
BUILDING NEW SUPPORTS
In pulling together
some of the characteristics of a more responsive and enabling
support system we have made use of formal programme evaluations
undertaken as part of the WCDD Supported Parenting Project, and
our own findings and observations from a recent research visit
to Wisconsin* . There is a danger in this exercise of appearing
to ignore Mickelson's (1947) warning against treating mothers
and fathers with learning difficulties as a different kind of
parent, and it is true that good practice in their case shares
many of the features of good practice with other families who
also come to the notice of the child welfare services. In what
follows, however, we have chosen to focus on their particular
needs as parents and people.
Long-Term Support (*This research was supported by the
University of Sheffield Research Fund.)
Parents with learning difficulties are likely to need support
on a long-term, continuing basis throughout the parenting years.
Short-term, crisis-driven services often result in frustration,
burn-out and a tendency to blame the parents on the part of
workers and mistrust, despair and cyclical crisis episodes for
families (Mandeville, 1992b). Long-term supports foster greater
mutual trust and respect, improve the ways that families use support,
allow more opportunities for preventive work, and enable a more
holistic approach (Hoffman et al., 1990).
Trusting Relationships
A positive relationship
between parent and practitioner is a crucial ingredient of effective
support and a primary goal of intervention. Many parents will
have had bad experiences of the services in the past. Overcoming
their suspicions may be a lengthy process. Breaking down these
barriers calls for a genuine appreciation of the parents as people
and a readiness to get involved with the family. Parents 'know
when you don't like them and they know when you don't like their
children.' (Snodgrass, 1992) The values and attitudes that practitioners
hold exert a more important influence on family outcomes than
their knowledge and skills (Espe-Sherwindt & Kerlin, 1990)
Maintaining Involvement
The success of a
support programme may depend as much on its ability to involve
the parents as on the abilities of the parents themselves (Espe-Sherwindt
& Crable, 1993). Keeping families interested and committed
is a common problem (New York State Commission on Quality of
Care for the Mentally Disabled, 1993), and one shared with most
early intervention programmes (Bronfenbrenner, 1974). Life experiences
that have eroded parents' sense of competence and worth are a
block to participation. Also, many parents are so overburdened
by day-to-day crises that they lack the energy and personal resources
to assume any more responsibilities. Two steps that have been
shown by the Wisconsin Supported Parenting project to ease these
difficulties are working with parents as partners in ways that
bolster their self-esteem and providing practical help aimed
at lightening the load on the family.
Family-Centred Support
The children are
usually the primary focus of attention for practitioners in families
headed by parents with learning difficulties (Llewellyn, 1993).
The parents' own needs are often overlooked or regarded as a
secondary concern. Practitioners must be prepared to adapt their
priorities. Parents may be unable to meet the needs of their
children unless their own needs are first addressed (Espe-Sherwindt,
1991). These needs may stem from an upbringing in which: 'No
one cuddled. No one nurtured. No one cherished. No one valued.
No one praised. No one played. No one supported. No one encouraged.
No one comforted. No one cared. No one loved.' (Snodgrass, 1992)
Or equally they may come from the effects of daily hardships
visited by poverty, bad housing, exploitation, victimisation,
stigma, powerlessness, isolation and the like. When support is
organised from a family-centred perspective - from the point
of view of what can be done to support the family rather than
how to protect the child - it is more likely to be mutually agreed
and less likely to be seen as threatening (Hoffman et al., 1990).
Intensive, In-Home Support
Support has been
shown to be most effective where it provided the opportunity
for one-to-one contact in the home. Characteristically this included:
frequent home visits, a high degree of availability, flexible
scheduling, and a willingness to provide 'hands-on' help with
some tasks in order to allow the parents to concentrate on more
pressing ones (Hoffman et al., 1990).
Flexible, Individualised Support
Support should be
targeted on the specific needs of the family and its members.
Practical help may be required with particular tasks the parents
cannot manage for themselves, and problem-solving support may
be necessary to help them through a crisis. The flexibility to
adjust the support to accommodate the parents' views of what
help they need is important. Similarly, where training is offered,
it must be matched to the learning characteristics of the parents
(Heighway, 1992). For example, parents with learning difficulties
do not seem to benefit from attending groups with other parents.
Adults learn from other adults 'when there is respect and trust,
when they can choose what they want to learn, are motivated,
and are offered support in a way and at a pace that is right
for them' (Sweet, 1990).
Conclusions
All too often parents
with learning difficulties are set up to fail by the services
they look to for help. Parents and their children frequently
have different professional support networks (Cross & Marks,
1995; Viewpoint, 1995a) giving rise to problems of coordination,
interagency communication and mixed or muddled messages to the
families. Parents who run into difficulties are typically referred
to the very professionals who have the main statutory responsibility
for child protection. Practitioners with the most expertise in
learning difficulties are less likely to be involved. Child protection
services are not organised to provide support over the longer
term nor do they have the skills to meet the other requirements
of a responsive and enabling approach towards these families.
Consequently, parents with learning difficulties continue to
receive rough justice and their children a raw deal. The supported
parenting model offers a way of shifting from a punitive to a
positive approach to families headed by parents with learning
difficulties. Making this shift calls for more than just a realignment
of professional responsibilities. It demands a new way of thinking
based on the rejection of the traditional deficit model of service
delivery, and in particular a switch from a focus on people as
individuals to the family as a unit; from a concentration on
the assessment of risk and vulnerability to an equal appreciation
of people's strengths and their resilience under pressure; from
a concern about promoting dependence to the goal of building
competence; from the role of professional expert to the role
of partner; and from fitting people into methods to altering
methods to fit people. Until these changes in practice take place,
practitioners will continue to lack what the Local Government
Ombudsman described as a clear view of their aims when working
with parents who have learning difficulties, and the families
themselves will continue to experience the child protection system
as a juggernaut before which they are merely hapless victims.
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