Pre-Birth Risk Assessment

Pre-Birth Risk Assessment

Gwynne Rayns Development Manager

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The Need for a New Model

• 42% of SCRs relate to children under 1 (Brandon 2012)

• Quality or absence of pre-birth assessments recurrent theme (Ofsted)

• Partial picture captured during assessments

• Lack of rigour and transparency in decision making

• Failure to protect

• Missed opportunities for prevention

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Research and Development Team

• Gwynne Rayns Development Manager NSPCC

• Prof Jane Barlow University of Warwick

• Prof Harriet Ward Loughborough University

• Clare Lushey Research Associate Loughborough University

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Development Process

Literature search

Survey of LSCBs current practice

Examination of LSCB procedures

Identification of innovative practice

Interviews with range of professionals

Input from expert advisory group

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Findings

• Professional Perceptions that it is better to wait until later stages of pregnancy (Hart 2001; 2010; Corner 1997)

• In practice pregnant women often not assessed until as late as 36 weeks - Ineffective in terms of developing trusting relationship with parents; or giving them the opportunity to change or develop and prepare for relationship with baby (Ward 2012)

• Lack of guidance about what to include in pre-birth assessments

• Poor quality of pre-birth assessments re detail of child’s needs and circumstances (e.g. child’s development domain of triangle ignored because child not yet born)

• Professional anxiety about pre-birth assessment , particularly in relation to first time parents

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Risk and Protective Factors

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Model: Underpinning Principles

• The importance of engagement and partnership

• Working with the past in the present

• Promoting affect regulation (emotional control)

• Developing mentalization, reflective functioning and prenatal attachment

• Promotes assessment of both parents

• Evidence informed model of decision making

• Importance of “social workers” as change agents

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Model: Stages and ProcessStage One Cross sectional

assessmentT1 scores from measures

Stage Two Case conceptualisation

Stage Three Collaborative Goal setting

Stage Four Provision of evidence based intervention

Stage Five Re administer measures and document change

T2 scores from measures

Stage Six Integration and analysis of data to inform decisions

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Model: Pilot Testing

Feasibility study

How acceptable is the model in a range of social work settings?

How acceptable is the model to parents?

Can it work in practice?

4 Local Authority Pilot sites

Next Steps

2015 : revise and re-design model in light of findings

2016: in-depth pilot