Community Services Directorate
Child Profiling
Discussion Paper
March 2014
Contents
1.
Purpose ....................................................................................................................................... 3
2.
Background ................................................................................................................................. 3
3.
Child Profiling Tool ...................................................................................................................... 3
4.
Validation .................................................................................................................................... 5
5.
Results ......................................................................................................................................... 6
6.
Discussion.................................................................................................................................. 10
7.
Conclusion ................................................................................................................................. 13
Attachment A: Child Complexity Tool – Jurisdiction Analysis ........................................................... 15
Attachment B: Complexity Assessment Tool (CAT) .......................................................................... 18
Attachment C: Counting Rules .......................................................................................................... 22
Attachment D: Case Study ................................................................................................................ 23
Attachment E: Reference list ............................................................................................................ 26
2
1. Purpose
The purpose of the Child Profiling project was to gain a population measure of all children and young
people in out of home care in respect to their current levels of need and the complexity of their
behaviours. The project is a key deliverable to develop the five year Out of Home Care Strategy
(Strategy) and the findings will be used to design future service models and interventions. Further
discussions about the results will be held throughout the course of the Strategy’s development in
order to deliver a more targeted and individualised system that best meets the needs of children
and young people in the ACT.
The paper also seeks to explain the methodology utilised to complete the project and provide a
baseline for future research to ensure the out of home care system adapts to the population over
time.
2. Background
The Child Profiling project was part of a suite of research and data activities undertaken to inform
the development of the Strategy. The project aimed to address the limited understanding about the
needs and behaviours of children and young people in out of home care as a population group. It
was recognised individual children and young people are assessed regularly through case planning
activities however there were limited assessments, other than for national reporting requirements,
to look at the out of home care population as a whole. Furthermore, national reporting often looks
at outputs and activity based reporting through quantitative data, this project sought to look
qualitatively at the needs of children in care and what conclusions might be drawn from the findings
about their needs when mapped against some basic demographic information.
3. Child Profiling Tool
The child profiling project started in May 2013 and was undertaken by two Care and Protection
Services senior practitioners. At the start of the project the purpose was:
•
To identify a tool that could be used to create a profile of children and young people in out
of home care. The data would aim to reflect relative levels of need and complexity by
percentage of population. The data would support the development of the Out of Home
Care Strategy.
•
Gain a population measure of all children and young people in care according to their level of
behavioural complexity and needs.
In order to meet the first purpose Australian jurisdictions were contacted to ascertain if they
conducted any child profiling assessments. An overview of feedback from other jurisdictions is
provided in a report at Attachment A. The findings from the analysis recommended the use of the
Complexity Assessment Tool (CAT) which was authored by Professor Paul Delfabbrio for Families SA.
Families SA agreed to give the ACT permission to use the tool for their analysis. The CAT is at
Attachment B.
The CAT is a standardised screening instrument for assessing the complexity of children and young
people and was developed for Families SA to use when children and young people enter out of
home care, when they change placement, at the time of the Annual Review and when there is a
review of the carers subsidy.
3
The CAT is split into the following components:
Part A: Children’s behavioural complexity
• Substance use
• Sexualised behaviour
• Offending behaviour
• School behaviour
• General behaviour
Part B: Children’s special needs
• Physical health
• Child development and intellectual health
• Mental health
• Physical disability
For each component the assessor scores the child or young person using a severity rating (A-E), the
score is assessed using a guide that describes behaviours a child would exhibit to be considered for
each severity rating. A formula is then used to add the severity ratings together to provide a single
assessment score in one of the following levels:
• Level 1: Minor or no problems
• Level 2: Moderate problems
• Level 3: Significant problems
• Level 4: Extreme problems
South Australia identified the range of supports needed to assist children and young people in the
various levels. These supports ranged from interventions for the child, the placement or the carer.
In terms of children assessed at a level 1 their needs were identified as those similar to the general
population and included needs such as food, clothing, shelter, safety, love, nurturance, stability,
spirituality, educational, psychological and maintained connections with families. Level 1 children
needed an environment that is consistently responsive, nurturing and has a therapeutically
supportive parenting environment. The carer is expected to act as any other parent and attend
meetings, routine appointments and facilitate social, recreational and cultural activities.
Children who were assessed at a level 2 were identified as displaying more challenging behaviours,
may have moderate developmental delays, disability or have additional health needs. The additional
needs for the child may include additional supervision, additional educational support (tutoring,
classroom support), therapeutic interventions and more frequent care planning reviews and
assessments. These additional needs mean the carers should be more on hand to participate in
various meetings and reviews and be generally more available to the child or young person.
Children who were assessed at a level 3 were identified as having a significant level of challenging
behaviour that placed themselves or others at risk and/or they have significant developmental
delays, disability and health or educational issues. The aim of the placement would be to assist the
child’s recovery and help them to gain stability in relation to the management of their behaviours. A
child in this level would need close supervision, alternative or structured educational programs,
developmental programs, ongoing assessments and often have an emergency safety plan. A carer of
4
a child in level 3 would need to maintain close communication with their case worker, participate in
intensive therapeutic intervention plans and implement the emergency safety plan.
Children who were assessed at a level 4 were identified as having severe developmental delays,
disability and health or educational issues and/or whose behaviours place themselves or others at
extreme risk of significant harm. The aim of the placement would be to assist recovery in the child
or young person and enable them to function in a less intensive/restrictive environment. Carers of
these children would need to offer intensive supervision, monitoring and highly structured activities.
Carers would need to be available to attend all appointments, maintain close communication with
their case worker, implement the emergency safety plan and facilitate connection to a less
restrictive environment.
The South Australian system operates on the premise that all carers for children and young people in
out of home care should offer a therapeutically supportive parenting environment.
At 25 June 2013, there were 578 children and young people residing in out of home care in the ACT.
However, from this total number 102 were assessed as not meeting the criteria to be included in the
profiling exercise. Therefore, a total of 476 children and young people were assessed for the
purposes of this project. Reasons for children and young people not being assessed included
children subject to an Enduring Parental Responsibility Order, young people who had self placed
with birth family and children and young people who were going through an active reunification
process at the time of the assessment.
The following criteria were applied for inclusion:
• Residing in out of home care including, residential, foster care, kinship care, living
independent or in a refuge; and
• Were in the full or shared care of the Director-General; and
• Were under the age of 18 years at 25 June 2013.
A full list of the counting rules is at Attachment C.
At the same time the assessor completed the CAT the following data was collected:
•
•
•
•
•
•
•
•
•
•
•
•
•
•
Name;
CHYPS ID;
Date of Birth;
Aboriginal and Torres Strait Islander status;
Cultural background;
Placement type;
Gender;
Number of siblings;
Number of siblings in care;
Length of Order;
Age at assessment;
Age child came into care;
CAT level; and
Current subsidy level.
4. Validation
There were limitations to the way the assessments were conducted. The assessments were based
on the opinion of two senior practitioners conducting the project and heavily relied on the quality of
5
documents used about the child or young person. The main documents used for the assessment
were the Annual Review, Care Plan and/or Child Protection Assessment Report (CPAR).
The senior practitioners undertook a range of processes to provide additional validity to the project.
The processes included:
1. the senior practitioners undertook random samples of each other’s assessments;
2. the senior practitioners verified 127 assessments with caseworkers and there were only two
instances where the caseworker recommended a higher or lower complexity level; and
3. the senior practitioners asked caseworkers to identify the children or young people they
thought would be in level 3 and 4 and reassessed these children.
Following the third validation exercise the level of need rating was adjusted for 13 per cent of
children. These changes have compromised the validity on this small cohort of the project
somewhat as the senior practitioner in the third validation sought information from a wider range of
sources than what was used in the original assessment. The wider range of documents included
affidavits, Child at Risk Health Unit (CARHU) reports and agency reports.
The quality of all the documentation used for the assessments was highly variable and when
additional documents were reviewed it was clear to see the story of the child or young person was a
lot more complex that what is often portrayed in an Annual Review or Care Plan. A finding for the
next evaluation will be to use a consistent document that is more holistic in nature and includes
results of standardised testing.
5. Results
For most of the analysis presented, those with levels of need above minor are considered as a single
group. This is because of the low number of children with higher levels of need.
The main findings from the analysis include:
Level of need

A total of 476 children and young people were assessed as they presented at 25 June 2013.
The numbers of children and young people in care was non-linear in terms of declining
numbers through the four levels.
Table 1: Level of need
Data Item
Group
Number
Level 1: Minor
Level of need
Percent*
382
80.3
Level 2: Moderate
46
9.7
Level 3: Significant
22
4.6
Level 4: Extreme
26
5.5
* These figures do not add to 100% because they were rounded up.
Sex
6

There were more males 258 (54.2%) than females 218 (45.8%) in the assessment.
Cultural background

There were 44 children and young people (9.2%) from culturally diverse backgrounds. The
children were identified as culturally from 18 different countries. The highest proportion of
children came from countries in Europe with the exception of Sudan.
Placement Type

The majority of children and young people were placed in kinship care 257 (54%). There
were 183 (38.5%) children and young people in foster care and 36 (7.6%) in residential care
or living independently.

Children in kinship care were less likely to be identified as having a level of need above
minor (10%) than children in foster care (21%) or residential care (75%).
Siblings in care

The majority of children have all of their siblings in care; this equates to 231 (65.1%).

Children in out of home care who had two siblings not in care were less likely to have a level
of need above minor – 71% compared to 82% for all other children with sibling information.
Age child came into care

A large proportion of children came into care when they were 4 years and under (66%) –
under 1 year - 127 (26.7%); 1-2 years - 106 (22.3%), 3-4 years - 81 (17.0%). This means 34%
were aged over 5 years at entry to care.
Aboriginal and Torres Strait Islander children and young people

At the time of the assessment Aboriginal and Torres Strait Islander children and young
people made up 28.4% of the out of home care population.

There is double the number of Aboriginal and Torres Strait Islander males (90) than
Aboriginal and Torres Strait Islander females (45) in the care system. Aboriginal and Torres
Strait Islander males make up 34.9% of the male population and Aboriginal and Torres Strait
Islander females make up 20.6% of the female population.

Aboriginal and Torres Strait Islander children are more likely than non-Indigenous children to
have a level of need above minor (27% to 17%). Aboriginal and Torres Strait Islander males
are almost twice as likely to have a higher level of need (32%) than both Aboriginal and
Torres Strait Islander females (16%) and non-Indigenous males (17%).

Two-thirds of Aboriginal and Torres Strait Islander males in the oldest age group (15-18
years) had a level of need above minor.
7
Figure 1: Proportion of the total number of Aboriginal and Torres Strait Islander children and nonIndigenous children per complexity level
Length of time in care

Over 80% of children had been in the care system for less than nine years.

Out of the total number of children and young people who had been in care for at least nine
years, children in this age group were more likely to have a level of need above minor (33%)
compared to all other age groups (17%).

Five of the 13 Aboriginal and Torres Strait Islander males in care for at least nine years were
in the extreme level of need category. In contrast, only two of 39 non-Indigenous males in
care for at least nine years were in the extreme level of need category.

Young people aged at least 15 showed significant variance in terms of the length of time
they have been in care and if they had a level of need above minor. For example, 41% of
such young people with 2-3 years care before assessment, 56% with 4-5 years, 28% with 6-8
years and 46% with at least 9 years care before assessment.
Figure 2: Young people aged 15 years and their CAT level versus the number of years they have
been in care
8
Age of children in care at assessment

Children who came into care aged 9-18 years were more likely to have a level of need above
minor (36%) than those who came into care at younger ages (17%). Of these children,
Aboriginal and Torres Strait Islanders were only slightly more likely (40%) to have higher
levels of need than non-Indigenous children (35%).

A significant proportion of children aged 15-18 years when assessed (43%) had levels of
need above minor. This compares with only 15% for younger children.
Subsidy payment

The majority of children who were assessed at a minor level of need were paid a standard
payment (317). There were 56 children whose carers were being paid at a higher subsidy
rate than standard who have been assessed as having minor needs.

Of the 56 children whose carers are being paid a higher subsidy rate than standard and who
have been assessed as having minor needs 36 children are in foster care and 16 are in
kinship care.

Alternatively, there were 22 children assessed at a level higher than minor who are only on a
standard payment. Of these six children were in foster care and seven were in kinship care.
Table 2: Subsidy level versus CAT level
Standard
Care Level 1
Care Level 2
Intensive
Other*
Total
Minor
317
20
30
6
9
382
Moderate
14
4
8
9
11
46
Significant
3
1
1
7
10
22
9
Extreme
5
1
0
9
11
Total
339
26
39
31
41
26
*Other includes negotiated rates, residential, payment by other state, therapeutic – On Track or no
payment
6. Discussion
There is significant research that evidences the negative impact on a child or young person’s long
term outcomes when they have resided in out of home care. There is continued debate about
whether the poor outcomes are related to pre-care adversities, the placement in out of home care
or a combination of both (Wade et al, 2011). Alarming research coming from the United States is
showing children who are exposed to multiple trauma episodes have a life expectancy of 20 years
less than the general population (Griffen, 2014). Reading through the case documents to undertake
these assessments it is clear that the majority of children and young people who enter care have
already experienced multiple trauma events and often experience additional trauma whilst in care
as a result of continuing service failures including placement breakdowns and discontinuities of
caseworker personnel.
The personal, financial and social impacts of abuse, neglect and out of home care is well
documented in national and international research. As noted in the Australian Institute of Family
Studies (2013) information paper on the costs of out of home care, adverse impacts include:

future drug and alcohol abuse;

mental illness;

poor health;

homelessness;

juvenile offending;

criminality; and

incarceration
The research to date simply highlights the need to ensure children have safe and stable placements
where they can grow and develop into healthy adults.
The ACT has very little population data for children and young people in care as it is generally only
collected at an individual level. Ongoing individual case planning considers the child’s wellbeing and
placement needs throughout the child’s time in care. This case planning information is used to
inform decision making about whether a child should be reunified with their birth parents, the type
of placement they require, what supports the carer will need to care for the child and whether the
child’s placement should become permanent. This information is not able to be aggregated readily
by the current child protection information system and as a result Care and Protection Services has
had limited ability to understand the complexity of the needs of children and young people in care
as a cohort and whether this has changed as a result of Care and Protection Services intervention.
This is the first project of its kind in the ACT.
The project found that at the time of the assessment 80% of children and young people in care had a
minor level of need. In contrast, this means 20% of children and young people fell in a level higher
10
than minor. Interestingly, the level of complexity for children was non-linear in terms of the
decrease from minor through to extreme needs. There were more children in the extreme
behaviour category as opposed to the next level down, the significant level. This means there were
more children exhibiting extremely complex behaviours that required very intensive interventions
and needed additional assistance to support their placements than those with significantly complex
needs.
A case study for each level of need is provided at Attachment D.
Children and young people found in the extreme level of need appeared to have some very similar
characteristics. The majority of children in the extreme level are adolescents (76% are 12 years or
above) and many present with the following characteristics:

Multiple diagnoses including:
-
Foetal Alcohol Syndrome
-
Attention Deficit Disorder
-
Attention Deficit Hyperactivity Disorder
-
Post Traumatic Stress Disorder
-
Obsessive Compulsive Disorder
-
High levels of anxiety

Were older when they came into care (>8 years);

Multiple placements moving back and forth between birth family, kinship carers, foster
carers, residential care and Bimberi Youth Detention Centre;

Engagement in criminal activity

Drug and alcohol abuse

Disengaged from education

Exposure to domestic violence and parental drug and alcohol abuse as young children
These characteristics should pose as early warning signs for other children who are moving into
adolescence and starting to engage in similar behaviours. There are a number of children assessed
as having lower levels of need in the moderate or significant categories that were brought into care
when they were older children, are now starting to disengage from school, are participating in low
level criminal activity and are in unstable placement situations. These children are at high risk of
their needs escalating as they become teenagers.
Although the assessments were not undertaken to generate an understanding of how much it might
cost to care for a child or young person with complex needs the comparison data between the CAT
assessment and subsidy level is worth discussing. The majority of children who were assessed at a
minor level received a standard payment to their carer. However, there were 56 children and young
people whose carers were being paid a higher subsidy even though their needs were assessed as
minor. One reason for this was a policy decision made in 2006-2007 to not reduce a carer’s higher
level payment, regardless of whether the child's needs stabilised or decreased. Also, of the 56
children, a large proportion was in foster care. This is consistent with research whereby foster
carers are often provided with a higher level of payment than kinship carers (Yardley, Mason &
11
Watson, 2009). Kinship carers generally do not ask for more assistance and can be concerned there
may be repercussions if they identify problems within the placement (Yardley, Mason & Watson,
2009). These findings raise important questions about equity of access to financial and other
supports for children in kinship placement who now comprise the majority of children in out of
home care in the ACT (53%).
Another interesting finding was the age children and young people upon entry to care. The care
population at the time of assessment showed a large proportion of children came into care when
they were four years and under (66%) and half (49% when they were aged two years and under.
There is qualification to this finding as some older children would have been excluded from the
population for the project if they were self placed or returned to birth family. On the other hand all
children who are on an Enduring Parental Responsibility were also excluded and a proportion of
these children are under 10 years.
This finding should elicit increased focus on developing policies for addressing the impact of trauma
on children in care aged five years and under for two reasons - the majority of children are entering
care in this age group; and there was another finding which showed children who had been in the
care system for nine years or more were still showing high levels of complexity. The ACT service
system needs to be more responsive to young children and be designed to create opportunities to
move young children into stable placements, either back at home with family or into a permanent
arrangement, as quickly as possible. The second reason may be demonstrating that young children
who are entering the ACT care system are not receiving the attention they require at an early age to
address the impact of abuse and neglect on children. Research shows that exposure to repeated
adverse experiences can alter a child’s brain resulting in enduring emotional, behavioural, cognitive,
social and physical problems which often don’t present until later in a child or adolescent’s life
(Perry, 2006; as cited in Webb, 2006).
Further support to focus early on young children is that older children aged 12 years or more are
highly vulnerable with a significant proportion of young people aged 15-18 years (43%) showing level
of needs above minor. Young people in care, even if they have been in care for a long time, may still
display trauma behaviours related to trauma in their early years. Conversely, any findings about 15
year olds must be considered in light of normal adolescent behaviour as well. Adolescents do not
develop higher order thinking until late into their teens and early 20’s as their pre frontal cortex
undergoes significant development (Blakemore & Choudhury, 2006). The majority of 15 year olds in
the general population also engage in a range of exploratory and risk taking behaviours.
The result that children and young people in kinship care are less likely to have a level of need above
minor is consistent with other research in this field. There are some qualifications for this finding
including that the results should not be taken at face value as kinship carers demonstrate continual
underreporting of issues and often tolerate more episodes of difficult behaviour (Yardley, Mason &
Watson, 2009). Therefore, the service system should not underestimate the complexity of children’s
needs in kinship care based on self reporting from carers alone. Another consideration for
understanding this finding is that children and young people with more complex behaviours may be
placed in foster care because there isn’t an appropriate placement with family or that children in
kinship care stabilise in the placement at a greater rate because they are with their kin.
The findings clearly show the system needs to have a greater focus on Aboriginal and Torres Strait
Islander children and young people in terms of developing services that offer targeted support,
particularly to male children and young people with very complex needs. Aboriginal and Torres
Strait Islander children are overrepresented in the care system and interestingly there is double the
number of male Aboriginal children to female Aboriginal children in out of home care. Aboriginal
children were more likely than non-indigenous children to have a higher complexity level (27% to
17%) and this is further compounded for Aboriginal males who are almost twice as likely to have a
12
higher level of need to Aboriginal females and non-Indigenous children. Aboriginal male young
people seem particularly vulnerable in the care system, as 75% of Aboriginal males between the
ages 15-18 years had a level of need above minor and 38% were in the extreme level of need.
There appear to be different effects of being in care long term for non Indigenous and Aboriginal
males. Aboriginal males who had been in care for nine years or more were much more likely to have
an extreme level of need (38%) than non-Indigenous males (5%). Non-Indigenous males often
showed a higher level of needs than minor but there were only 2 out of 39 that were in the extreme
level of need.
Interestingly, 15 year olds who came into care when they were 7-8 years old or 12-13 years old
displayed lower needs than 15 year olds who had been in care since they were six years old and
under. This finding should be considered carefully and further researched. The finding may be
showing that the placements continue to be vulnerable regardless of the age the child came into
care or the length they have been in care.
7. Conclusion
The purpose of the Child Profiling project was to gain a population measure of all children and young
people in out of home care in respect to their current levels of need and the complexity of their
behaviours. The findings will be used to design future service models and interventions that are
more targeted and individualised to best meet the needs of children and young people in the ACT.
Several aspects of the findings are worthy of note. The ACT’s system is made up predominantly of
children who come into care at a very young age ie. prior to school commencement with 49% two
years old and under. One of the implications for the service system is that it needs to be more
strongly focused on meeting the needs of very young children coming into care - treating effects of
trauma, attempting reunification and finding permanent placements for those children who cannot
return to live with their birth families.
In developing a new system of out of home care, particular attention should also be paid to
addressing the needs of those children and young people found to be in the significant or extreme
level of needs. New, creative and more flexible solutions are required.
In particular this exercise suggests that without powerful intervention, male Aboriginal and Torres
Strait Islander children and young people are at high risk for continuing difficulties that will result in
poor outcomes. The exercise assessed 135 Aboriginal and Torres Strait Islander children and young
people in care and found that there are many more Aboriginal and Torres Strait Islander male
children and young people than female and Aboriginal and Torres Strait Islander children and young
people were overrepresented at the higher needs levels.
The exercise also found that children and young people in long term care are still displaying high
level of needs and require a service response beyond the first few years in care. The extent to which
initial trauma contributed to these poor outcomes versus adverse events in care is unclear.
It would be extremely beneficial to undertake the assessments on a regular basis to start to gain a
picture of the impact of out of home care on the overall population and specific cohorts to ensure
that there is a current understanding of the needs of children and young people in out of home care
in the ACT.
13
14
Attachment A: Child Complexity Tool – Jurisdiction Analysis
Background
A review was undertaken to gather information from states and territories in Australia, national and
international research about child profiling. Although there are endless articles on out of home care
(out of home care) past and present practices, it was difficult to find assessment tools that have
been or are being used in current practice with the purpose of understanding the out of home care
populations level of complexity.
Australian Capital Territory
Assessment tools on Children and Young People System (CHYPS) which are used for Care and
Protection Services (CPS) and Early Intervention and Prevention Services (EIPS) include Being a
Parent Scale, Depression Anxiety Stress Scales (DASS), DASS 21, Edinburgh Postnatal Depression
Scale, Family Activity Scale 206, Family Activity Scale 7 – 12, Parenting Daily Hassles, Recent Life
Events, Strengths Difficulties Questionnaire, socio economic information, Winterberry scale and the
Family Support Scale.
Currently across the Office for Children, Youth and Family Support (OCYFS) and the funded service
providers the following information tools are in use, Looking After Children (LAC) by out of home
care providers, Child and Family Centre (CFC) Intake Form, CPS Child Protection Child Concern
Report (CPCC), CPS Child Protection Assessment Report (CPAR), Common Assessment Framework
(CAF).
New South Wales
Many research projects have been conducted in NSW and most recently the Children in Care Study
conducted in 2007 found that children in care were found to have multiple and complex mental
health problems and placement insecurity. Children in the study were reported as having
exceptionally poor mental health and social competence.
The Child Assessment Tool has been utilised in NSW from 2012, and is designed to identify the most
appropriate level of care from general foster care to intensive residential care based on the child’s
behaviour, health and development issues.
The tool:




Determines the level of care that will best meet the needs of the child,
Enhances transparency and consistency of placement decisions,
Improves the matching of a child’s specific needs with a particular placement and
Creates a common framework for placement decisions, which is shared between
Department of Community Services (DoCS) and non government services.
Queensland
In 2005, as part of its reform of child protection the Department of Child Safety introduced the
Structured Decision Making model, a licensed trademark. The Child Strengths and Needs
Assessment (CSNA) which forms part of the Structured Decision Making model and involves the use
of eight assessment and decision making tools from intake information received about a child
protection concern, screening criteria, response priorities, safety assessment, family risk evaluation,
child strength and needs assessment, parental strengths and needs assessment, family risk reevaluation and family reunification assessment.
South Australia
15
A standardised screening instrument for assessing complexity in children entering out of home care,
is being utilised in South Australia, and that is the Complexity Assessment Tool (CAT). The CAT
measures the behavioural and special needs of children and young people. It assesses and then
scores children across specific areas to identify high and complex needs in order to assist in
placement planning and service provision.
South Australia undertook a research project, with the aim to differentiate children in terms of their
level of need so that services and funding can be apportioned more strategically. As children entered
care, an assessment would be completed, their level of need would be identified and services would
be matched to their needs.
Northern Territory
Northern Territory has used the South Australian CAT tool as an audit of children in out of home
care. Like South Australia, they are now looking at using this tool further to link it with the financial
subsidy given to carers linked directly to the identified needs of the child/ren in their care, from the
CAT assessment.
Victoria
Victoria were undertaking a similar project to the ACT. Research from Victoria shows increasingly,
families with multiple and complex needs have become the primary client group of modern child
protection services. Recent research has shown that they typically have five or more disadvantages
including living with poverty, unemployment, poor quality housing and disabilities. Further to that,
data shows family violence, substance abuse and mental illness as commonly co-occurring
difficulties for families involved with child protection, a pattern also reflected in the analysis of child
death reviews. A comprehensive family assessment is undertaken which balances the strengths and
protective factors versus the pattern and severity of harm and likelihood of harm.
In July 2004, the Victorian Department of Human Services participated in a national research project
regarding children with high support needs in alternative care. Questions asked were “What were
the profiles? What were the pathways into care? What were the interventions? and what were the
histories of young people in care who experienced repeated placement breakdown?” It was
proposed that the research would contribute to greater placement stability and positive outcomes
for high needs and at risk children. It was shown that trauma was the universal, underlying theme of
children’s challenging behaviours caused by experiences of repeated multiple forms of abuse and
neglect which led to the development of conduct and attachment disorder type behaviours and
developmental delays.
A recommendation from the project was that prevention was to be predicated by a three pronged
approach that is:



timely intervention , available expertise, coordination, one stop shop;
holistic whole family needs assessment; and
stability of care to be achieved by expertise that informs assessment, planning and the
development of therapeutic placement options and support.
The longitudinal study on young people leaving care is a long term research project about the lives
of young people in out of home care and their experiences transitioning from care in Victoria. The
study will be conducted over five years and is the first of its kind to be conducted in Victoria. Data
collection commenced in 2013 and will run until 2017 and the Australian Institute of Family Studies
is taking carriage of this study.
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The purpose of the study is to inform government policy in supporting more effective transitions for
young people when leaving out of home care. In particular, it will aim to improve young peoples’
move towards interdependent relationships and eventual independence by:




Providing insights into the critical success factors associated with transition from;
Proposing ways of enhancing out of home care;
Proposing improvements in the transition from care; and
Proposing improvements post transition from care.
Western Australia
Since 2008, Western Australia have utilised the Signs of Safety as a child protection practice
framework. Each child in out of home care has a child history folder, which incorporates the child’s
care needs, history, development and progress. The Signs of Safety framework incorporates
strengths based principles alongside an exploration of danger and risk.
Tasmania
In Tasmania, the Common Assessment Framework is currently used to assist and support
professionals in consistently assessing, planning and responding to the needs of children and young
people. This tool is designed to make an effective assessment which involves collecting a range of
information to support the decision making process. The information gathered through the
assessment process is often used to identify and address the presence of risks and support needs in
the areas of health, safety, development and wellbeing.
Nationally
From research nationally, the seven domains of child wellbeing indicators of health, emotional and
behaviour development, self care and wellbeing, education, identity, family and social relationships
as well as social presentation are common indicators currently used.
Australian Research Alliance for Children and Youth (ARACY) in 2010 undertook a review and piloted
a national tool known as the Common Approach to Assessment, Referral and Support (CAARS).
The role of the CAARS taskforce was to decide on a process for the development of a national
approach to the prevention of child abuse and neglect, supported by common assessment and
referral as well as to guide the development of common approach components.
Profiling/Needs Assessment Tools
Australian Capital Territory
Western Australia
Tasmania
Victoria
New South Wales
Queensland
South Australia
Northern Territory
In process of choosing a tool
Signs of Safety
Common Assessment Framework (CAF)
In progress of establishing a tool
Child Assessment Tool (CAT)
Structured Decision making model incorporating
Childs Strength and Needs Assessment (CSNA)
Complexity Assessment Tool (CAT)
Reviewing current practice, have completed an
audit of children in out of home care using the
CAT
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Attachment B: Complexity Assessment Tool (CAT)
Reproduced with permission from Families SA.
The Complexity Assessment Tool (CAT) is a screening instrument that measures the behavioural and
special needs of children and young people. It assesses and scores children across specific areas of
behaviour and need to assist in identifying what services and supports are required to facilitate
successful placement in alternative care.
Children are grouped according to their level of need as belonging to one of four groups. These are:
Level 1: Minor or no problems
Level 2: Moderate problems
Level 3: Significant problems
Level 4: Extreme problems
This level-of-need classification system corresponds to the most suitable placement option for the
child. For example, a child assessed as Level 1 would require less intensive forms of care and
support than a child assessed as Level 4, who would require very intensive, specialised support and
care.
These levels are explained in the following section.
Level 1: Minor or no problems
The child or young person in this category is generally well-functioning, e.g.: attends school and is
able to form positive connections with family, community and culture. The level of supervision
required is at a general (age appropriate) level only.
Level 2: Moderate problems
The characteristics of the child or young person at this level includes: moderate developmental
delays, disability and health, behavioural or educational issues, requiring ongoing review and/or
treatment.
The child or young person does not require intense supervision and with structures in place is able
to attend school and form positive connections with family, community and culture (although there
may be intermittent conflicts which require periodic intervention).
Level 3: Significant problems
The child or young person at this level has major health or disability issues that affect everyday
functioning and/or the child or young person's existing and/or prior living arrangements or
placements are continually in crisis as a result of the young person's challenging behaviours.
Additional supervision, support and liaison with specialist services are required to: maintain the
young person’s stability of placement; sustain engagement in education, employment or training;
and cultivate the young person’s connections with family, culture, personal interests and community
integration.
Level 4: Extreme problems
The child or young person has severe problems in one or more areas of functioning that present an
imminent and critical danger of harm to self or others. Their existing and/or prior living
arrangements or placements are continually in crisis.
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Intensive supervision, support and liaison with specialist services are required to: maintain the
young person living in alternative care accommodation; reconnect and sustain engagement in
education, employment or training; and cultivate the young person’s connections with family,
culture, personal interests and community integration.
Part A
Behavioural complexity
Part A of the CAT assesses the child or young person’s behaviour across five categories, specifically:
1. Substance use
2. Sexualised behaviour
3. Offending behaviour
4. School behaviour
5. General behaviour
Within each of the above categories of behaviour select the A to E select the description which best
describes the behaviour being assessed.
Behaviour
Substance use
Sexualised behaviour
Offending behaviour
School behaviour
General behaviour
Severity Rating A-E
Numerical Score
Next, in the column headed 'Numerical Score' allocate a numerical score for each A to E rating
where A =1, B =2, C =3, D=4, E =5.
Part B
Special needs complexity
Part B of the CAT assesses the child or young person’s special needs complexity across four
categories, specifically:
1. Physical health
2. Child development and intellectual health
2. Mental health
3. Physical disability
As in Part A, within each of the above categories of behaviour a series of descriptors, ranked A to E,
are available to choose from. From the available options, select the descriptor which best describes
the special need being assessed.
Assess the four special needs and select the A-E rating which best describes each one. Then, enter
the A-E rating for each special need in Table 2, Part B of the CAT in the column headed 'Severity
Rating A-E.
Next, in the column headed 'Numerical Score' allocate a numerical score for each A to E rating
where A =1, B =2, C =3, D=4, E=5.
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Special Needs
Physical health
Child development and
intellectual ability
Mental health
Physical disability
Severity Rating A-E
Numerical Score
Part C
Calculate overall complexity
In Step 3, we combine the results from Step 1 and Step 2 to produce a final CAT score.
3.1
Square the value obtained in Step 1
I.E.:
=2x2
=4
3.2
Square the value obtained in Step 2
I.E.:
=3x3
=9
3.3
Add these values together
I.E.:
=4+9
= 13
3.4
Divide this value by 50 to convert into a proportion
I.E.:
= 13/50
= 0.26
3.5
Record the final value
I.E.:
= 0.26
Interpreting scores
The following table describes the way in which scores are to be interpreted. The lower the score
obtained, the less complex are the needs of the child. Conversely, the higher the score, the more
complex are the needs of the child.
Up to 0.20
0.21 - 0.36
0.37 - 0.50
0.51 - 1.0
Interpretation of scores
Level 1
Level 2
Level 3
Level 4
Minor or no problems
Moderate problems
Significant problems
Extreme problems
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Assessor’s critique
ATSI
Cultural background
Siblings in family
Siblings in care
Placement type
Length of order
Age child came into care
Childs’s name
Child’s date of birth
Name of document used to make assessment
Name of persons spoken to (child, young person, carer, caseworker etc.)
Level of complexity of need
Justification for this level
Assessors name
Date of assessment
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Attachment C: Counting Rules
The review was based on the latest version of the Annual Review, Care Plan or Child Protection
Assessment Report.
The counting rules are as follows:
• If a child or young person resides with their birth families they are not counted.
• Children who were going through an active reunification process were not counted.
• If a child or young person has self- placed with their birth families for longer than 12 months
at the time of the review they will not be counted.
• If a child or young person is on an Order and paid by an interstate jurisdiction but is residing
in the ACT they are counted.
• If a child is on an Enduring Parental Responsibility, Adoption Order or in permanent care
they are not counted.
• If a child has siblings over the age of 18 years (adult) they are not counted.
• Young people who are on a Care Order who are in Bimberi were counted.
• If a child is on a Voluntary Care Agreement they were not counted.
• Children on Interim Orders and Final Orders were counted.
• Young people over the age of 18 years were not counted.
• Half siblings are counted as being ‘siblings’. This means some siblings are not in out of home
care because they are placed with a different parent to the child being assessed. Step
siblings or other children residing in the placement (biological children of carers) were not
counted as siblings.
• Children who are not in the care of the Director-General were not counted.
• Age when child entered care was counted from the date the child was first placed on a Care
Order and were placed away from their birth parents. This date may then include periods
of time when the child was restored to their birth parents.
• Cultural background as written in the document used to make the assessment.
• The assessments used the latest version of the Annual Review Report, Care Plan or Child
Protection Assessment Report (in lieu of an Annual Review Report).
• Age at assessment was taken at a single point in time – 25 June 2013.
• Placement was categorised using the CHYPS identifier.
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Attachment D: Case Study
Level 1: Minor needs
The child is three years old and was born four weeks prematurely and showed some symptoms of
drug withdrawal at the time of birth. The child was removed from their parents at three months of
age when both parents were incarcerated. The child was placed with their grandmother where their
two siblings were already residing. The child is accessing services on a monthly basis to assist the
child’s speech delay. The child attends child care two days a week and really enjoys story time and
playdough. The child is meeting their age milestones and no longer needs adjustments because of
their premature birth.
The child looks to their carer when they are hurt or tired and sometimes throws tantrums when they
are told ‘no’. The child requires supervision at the same level as any other three year old child.
Level 2: Moderate needs
The child is nine years old and Care and Protection Services have been involved since the child was
born. There were concerns the child was exposed to physical abuse and neglect when living at
home. The child’s mother had been diagnosed with a moderate intellectual disability and bi polar
disorder and refused to engage in mental health treatment. After six years the child and their
younger sibling was removed. After three years and four placement changes the child was placed on
long term orders and moved to a long term foster placement. The child is approximately six months
behind their peers academically and attended two different primary schools. The child has
established some positive friendships but has some difficulty regulating their emotions and has
occasional outbursts. The child’s needs are closely monitored using an Individual Learning Plan by
the school and the carer is required to attend monthly school meetings. The child participates in a
special reading group twice a week and has tutoring once a week in response to their educational
delay.
The child has moderate level asthma that requires regular three monthly reviews by the GP but no
other health issues.
Level 3: Significant needs
The child is a 12 year old Aboriginal child who has been known to Care and Protection Services since
they were four years old. The child is one of five children all of whom were placed in care when the
child was seven years. The child was removed and placed in foster care due to exposure to ongoing
domestic violence towards their mother by several male partners and parental drug and alcohol
abuse. Reunification was attempted over the course of twelve months when the child was eight
years however was unsuccessful. The child and the siblings had been separated as the some siblings
were placed with their kin and others in foster care. Following a kinship assessment the child moved
to reside with their maternal aunt however this placement only lasted six months before the aunt
was unable to care for the child. The child moved to another foster care placement with one of their
siblings.
The child was born with hearing difficulties which has impacted their speech and cognitive
development. The child has been to four different primary school because of their placement
changes and is reading and writing two years below their peers. The child has become oppositional
in the classroom and refuses to undertake certain classroom activities. The child has been assessed
as needing learning support but the child refuses to work with a teacher’s aide claiming they don’t
want to stand out from the other students. The child has issues forming relationships in the
classroom, displays bullying behaviour, frequently swears and due to non-compliant behaviour has
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been suspended three times in the past 12 months. The carers have difficulty getting the child to
school every morning because of the child’s school refusal. The school is planning to transition the
child to high school however they are concerned this will further disengage the child from schooling
even further.
The child demonstrates very challenging behaviour at home which is triggered by poor self
regulatory behaviours. The child’s carers use respite every second weekend whereby the child is
placed with different carers as many respite carers are unable to cope with the child’s challenging
behaviours. The child has had difficulty attaching to their most recent carers and the carers are
concerned the child will not settle with them. The child frequently runs away, has uncontrolled
bursts of anger that are triggered by seemingly innocuous events and has damaged the carers
property numerous times. The child has been cautioned twice by the police for shoplifting and
graffiti.
The child is due to see their birth mother once a week however this contact is often cancelled at the
last minute by the mother. The child becomes withdrawn and the problem behaviours escalate
when this occurs.
Level 4: Extreme needs
The young person is now 16 years old and has been known to child protection services since they
were five years old. Over the course of six years a number of child protection reports were received
in relation to the young person’s repeated exposure to domestic violence. When the young person
was 11 years old the young person’s mother agreed for the young person to come into care through
a Voluntary Care Agreement and final Care and Protection Orders were made three years later.
Following entry into care the young person experienced multiple placement changes moving from
kinship care, back to birth family, foster care, residential care and youth detention. Many later
placement changes were initiated by the young person and were not approved by Care and
Protection. The young person has not been able to manage residing in home-based placements for
some years although they continue to return to their birth family and kinship carers even after
significant relationship breakdowns.
The young person has been diagnosed with a multitude of mental health disorders including
Obsessive Compulsive Disorder, Oppositional Defiance Disorder and Attention Deficit Hyperactivity
Disorder. The young person has intermittent depressive tendencies, suicidal ideations and
demonstrates erratic and violent behaviours when stressed or anxious. The young person’s
behaviour problems impair their every day functioning to a significant degree. The young person
doesn’t have any physical disabilities but when they were young they were developmentally delayed
manifesting through a speech delay and poor fine and gross motor development.
The young person disengaged from education when transitioning to high school, the young person
has engaged in a number of training programs in youth detention and enjoys hands on learning
including arts and crafts. The young person is unable to read and write and has the same cognitive
skills as seen in Year 4 students.
The young person has engaged in escalating forms of criminal behaviour and frequently breaches
their bail conditions. The criminal behaviour is linked to peer pressure and using drugs. The young
person admits to using drugs and alcohol over the course of several years and this has a significant
impact on their violent behaviour both when using drugs and when trying to obtain drugs. The
young person is connected with peers who also engage in risk taking behaviour including using drugs
however the young person has difficulty in sustaining peer relationships due to displaying
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behaviours that can intimidate others. They frequently fail to show any empathy or remorse for their
actions. The young person has had one serious romantic relationship which was described as
controlling and volatile. The young person has a child who they see on a supervised and infrequent
basis.
The young person has no real aspirations at this stage, they can’t identify any potential career path
and the only desire they articulate as having is to not return to youth detention.
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Attachment E: Reference list
1. Australian Institute of Family Studies. (2013). The economic costs of child abuse and neglect.
Retrieved from: http://www.aifs.gov.au/cfca/pubs/factsheets/a142118/
2. Australian Institute of Health and Wellbeing. (2013). Child protection Australia 2011-2012.
Canberra, Australia: AIHW.
3. Blakemore, S.-J. and Choudhury, S. (2006). Development of the adolescent brain:
implications for executive function and social cognition. Journal of Child Psychology and
Psychiatry, 47: 296–312.
4. Family and Community Services. (2013). A Safe Home for Life. Sydney, Australia: Family
Community Services. Retrieved from:
http://www.facs.nsw.gov.au/__data/assets/file/0018/279000/A_Safe_Home_For_Life_Cons
ultation_Report.pdf
5. Griffin, E. (2014). Trauma Informed Care in the US Child Protection System. Responsive
Pathways to Vulnerable Children Conference. Sydney, Australia.
6. Webb, S.A. (2006). Social Work in a risk society: Social and Political Perspectives. London,
Pelgrave, MacMillian.
7. Yardley, A., Mason, J. And Watson, E. (2009). Kinship Care in NSW: Finding a way forward.
Sydney, Australia: Social Justice and Social Justice Change.
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