Assessment & screening

Social Care

Screening/assessing ‘high risk’ populations

 As many as 50% of children taken into care have diagnosable conditions such as autism and ADHD which may have contributed or caused the need for them to be separated from their families (Ford et al, 2007).

“Children looked after by local authorities had higher levels of psychopathology, educational difficulties and neurodevelopmental disorders, and ‘looked after’ status was independently associated with nearly all types of psychiatric disorder after adjusting for these educational and physical factors. The prevalence of psychiatric disorder was particualrly high amongst those living in residential care and with many recent changes of placement”.

In many cases, crisis situations arise before adequate assessment can take place and most social care professionals do not have the training to carry-out mental health evaluations in order to determine parental capacity, or placement suitability. Increasing wait times for psychological/psychiatric assessessment means that placement decisons are often ‘hit or miss’. The high costs to children and young people (CYP) can be measured by the high number who experience multiple placements and very poor outcomes.

Using the SDQ as a simple screening tool for all ‘at-risk’ CYPs can support social workers to identify those having a high risk of having a neuropsychiatric disorder whilst the DAWBA can then provide a quick comprehensive assessment to determine the likely underlying causes. Both the SDQ and DAWBA were recommended in the report ‘What Works in Preventing and Treating Poor Mental Health in Looked After Children?’ (p.73).

With a turnaround time of 5 working days (from completion of the structured diagnostic interview), the DAWBA is a sensible and cost-effective route to high quality assessment for these very vulnerable children.

“Developmental disorders such a autism and ADHD may be more prevalent among children looked after by local authorities owing to the failure of services to provide adequate support to families trying to cope with these very demanding children.”

Sample DAWBA report for child taken into care despite high clinical ratings for autism.

Reference: Psychiatric disorder among British children looked after by local authorities: comparison with children living in private households. (Ford et al, BJP, 2007, 319-325. doi: 10.1192/bjp.106025023)