FAMILY WITH PROBLEMS IN CHILD DEVELOPMENT AND
FAMILY AND ENVIRONMENTAL FACTORS: OUTCOME
WORSENED AFTER 6 MONTHS
This was a white single parent family with a mother and one daughter aged 5. They
lived in council accommodation, the mother did not have waged employment and so
the family was reliant on benefits.
Summary
We can see from this example how this family, already with a range of problems in
all three domains of Child Development, Parenting Capacity and Family and
Environmental factors, experienced a marked deterioration in their circumstances
over six months. Where there were already three severe problems in the Child
Development domain at initial assessment, this increased to five six months later
(with Cognitive and Education problems upgraded from ‘present’ to ‘severe’ after six
months). In the domain of Parenting Capacity, four areas where no problems were
identified at initial assessment were identified as having problems six months later
(Home Management, Personal Illness/Disability), Acute Psychological Distress and
Depression). At both points Provision of Guidance was rated ‘severe’. In the
domain of Family and Environmental factors, Housing Problems were rated as
severe at both points, but financial problems, rated as present but not severe at
initial assessment, were upgraded to sever six months later.
The Parent Concerns Questionnaire – Parent’s Problem
ratings
The Parent Concerns Questionnaire was completed as follows at Initial Assessment
and six months later (Follow Up) – see next page.
First
Completion
Present
Severe
6 month Follow Up
Present
Severe
Child Development
Emotional
Behavioural
Cognitive
Social involvement
Uncertain/confused identity
Physical health
Somatic
Education
School behaviour
Deviant/criminal behaviour
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
Parenting Capacity
Parenting
Limited attachment/bonding
Provision of guidance
Involvement with child[ren]
Unrealistic expectations of child
Hostility/criticism of child
Physical care of child
Parenting context
Home management
Primary Parent criminal
Other parent adult family criminal
Drug/alcohol
Personal illness/disability
Family illness/disability
Reproduction
Acute psychological distress
Feelings of depression
Family [adult] mental illness
0
0
0
0
0
0
Family and Environmental
Housing
Financial
Occupational
Formal organisations
Race/Culture
Marital/partner
Extended family
Friends
Isolation/lack of relations
Sex abuse/violence
Loss
0
0
0
0
Scoring for problems is as follows
Severe problem
Problem, but not severe
No Problems
=2
=1
=0
Overall picture
At Initial Assessment
Child development
There were Severe Problems identified in Child Development as follows
Emotional problems
Behavioural problems
Somatic problems
There were problems that were not severe as follows
Cognitive
Social Involvement
Education
School Behaviour
This leaves a score of
3 severe problems
4 non severe problems
Total score
10
= 6
= 4
= 10
Parenting Capacity
There were Severe Problems identified in Parenting Capacity as follows
Provision of Guidance
This leaves a score of
1 severe problems
0 non severe problems
Total score
2
= 2
= 0
= 2
Family and Environmental Factors
There were Severe Problems identified in Family and Environmental Factors as
follows
Housing
There were problems that were not severe as follows
Financial
This leaves a score of
1 severe problems
1 non severe problems
Total score
3
= 2
= 1
= 3
Overall Score at initial assessment
Child Development
10
Parenting Capacity
2
Family and Environmental factors 3
Total PCQ Score
15
At Six Months after Initial Assessment
There were Severe Problems identified in Child Development as follows
Emotional problems
Behavioural problems
Cognitive problems
Somatic problems
Educational problems
There were problems that were not severe as follows
Social involvement
Uncertain/confused identity
School behaviour
This leaves a score of
13
5 severe problems
3 non severe problems
=
=
10
3
Total score
=
13
Parenting Capacity
There were Severe Problems identified in Parenting Capacity as follows
Provision of Guidance
There were problems that were not severe as follows
Home management
Personal illness/disability
Acute psychological distress
depression
This leaves a score of
6
1 severe problem
4 non severe problems
= 2
= 4
Total score
= 6
Family and Environmental Factors
There were Severe Problems identified in Family and Environmental Factors as
follows
Housing
Financial
There were no problems that were not severe
This leaves a score of
2 severe problem
4
= 4
0 non severe problems
= 0
Total score
= 4
Overall Score at Six Months after Initial Assessment
Child Development
Parenting Capacity
Family and Environmental factors
11
6
4
Total PCQ Score
21
Comparing Initial Assessment to Six Months Later
There is clearly a marked deterioration in the situation after 6 months
Initial Assessment
6 months later
Child Development
Parenting Capacity
Family and Environmental factors
10
2
3
13
6
4
Total PCQ Score
15
23
This shows a clear deterioration in all three areas, and overall, with the most marked
deterioration in Child Development and Parenting Capacity.
Taking a Closer Look
For practice purposes, it is as important to look at the changes in individual areas
(items) as it is to look at the overall score. What had happened over the six months
for this family?
Well clearly this family had serious problems: where an individual severe problem is
marked as 2, then a score of 15 is of concern. One that deteriorates markedly to a
score of 23 presents a concomitant increase in concern.
Severe problems at six months follow up
Child Emotional, Behavioural and Somatic problems, each rated as severe in the
initial assessment remained severe 6 months later. Furthermore, Child Cognitive and
Educational problems, both of which were rated as present but not severe at initial
assessment, were rated as severe 6 months later.
In the Parenting Capacity Domain, the Provision of Guidance rated as severe at the
initial assessment remained so six months later. The same was the case in the
domain of Family and Environmental Factors in relation to Housing problems.
However, Financial problems were upgraded from present to severe between the
initial and assessment and the six month follow up.
Problems that were present but not severe at six months
In the Child Development domain, social involvement and school behaviour
remained the same – present, but not severe as problems.
But Uncertain/confused identity, which was not a problem at initial assessment, was
identified as a problem six months later.
Additionally in the domain of Parental Capacity, Home management, Personal
Disability, Acute Psychological Distress and Depression, all of which were not rated
as problems at initial assessment were rated as problems six months later.
What then was the situation at six months?
We can conclude that a situation which identified significant problems and needs at
the initial assessment had deteriorated markedly, according to the parent, six months
later. These problems were multiple and widespread, covering all three domains:
Child Development, Parenting Capacity and Family and Environmental Factors.
This was a family where the mother felt her parenting capacity was impaired, that her
child’s development was far from what it should be, and who was finding
considerable difficulty with her physical environment. These features were getting
worse.
It is difficult to avoid the conclusion that this was a family who was in considerable
need of support to help them turn round a worsening situation.