Support Programs for Young People with Disability and Experiences of Trauma or Abuse

Abstract

Executive Summary

A significant proportion of children and adolescents in out-of-home care have one or more disabilities. Children and young people with disabilities, experience of trauma, challenging behaviours, and other co-morbid conditions may be supported in family-based or foster home care, or in residential units. In addition, families may be supported to keep the child at home. The overall aim of this scoping review was to identify models of care, interventions and programs for adolescents and young people with disability and experiences with trauma or abuse that: 1. Address behavioural issues that minimise the longer term options of young people to live in the community as adults 2. Support improvements in long term functioning, including daily activities of living and mental health for young people. There were 24 documents that met the search criteria: 12 research articles, four reviews, and eight reports. Many of the programs identified aimed to improve behaviours, autonomy, self-esteem, natural supports and interpersonal relationships, and mental health through a variety of approaches. Other programs focused on daily functioning, independent living skills, and access to community supports. These factors are all elements of resilience – a concept that recognises multiple elements, individually and in concert, that allow a person to recover, or ‘bounce back’ from an adverse experience or event. Support organisations and programs should strive to normalise the life course trajectory of every child or young person in contact with the child protection system. It is clear from this review that there is no single intervention or program to suit all young people with disability, exposure to trauma and contact with the child protection system. Similarly, there is no single program that will fit into the working of every support organisation. It is likely that a multi-modal approach will be necessary to suit all parties. In addition, services will need to be able to respond quickly and appropriately to any changes and challenges in the young person’s life. However, there are some commonalities, and some recommendations to be made, based on the literature reviewed. • Care for children and young people with disability and experience of trauma in the child protection system should be strengths-based, person-centred, flexible and responsive, individualised, and involve family and the community as far as is possible. • Effective and responsive co-ordination of the various services and agencies involved in care of the child or young person with disability and experience of trauma is vital to the child’s life within and outside the child protection system. • Trauma-informed programs and therapy should be available to all children from first contact with child protection. The therapy should aim to improve the child’s emotional and mental health, and to promote resilience to future trauma. • Skills training, particularly skills of daily living, self-determination and decision-making, should be an integral part of out-of-home care and throughout the time of contact with child protection. All children and young people need to develop the skills necessary to live outside the family home, and children and young people with disability and experience of trauma are not excepted. • A major responsibility of care providers should be to help establish and sustain authentic and lasting relationships between the child or young person in care and people who may be expected to support the young person as they transition out of out-of-home care. • Advocacy support to establish and sustain a suitable living arrangement and support system should be available for all young people ageing out of the child protection system. This may include assisting with NDIS planning, supporting applications for public and/or affordable housing, and assisting with the move to a suitable community-based disability support organisation. Advocacy or mentoring for daily living, employment or further education may also be necessary.