Educational and health outcomes of schoolchildren in local authority care in Scotland: A retrospective record linkage study

Background Looked after children are defined as children who are in the care of their local authority. Previous studies have reported that looked after children have poorer mental and physical health, increased behavioural problems, and increased self-harm and mortality compared to peers. They also experience poorer educational outcomes, yet population-wide research into the latter is lacking, particularly in the United Kingdom. Education and health share a bidirectional relationship; therefore, it is important to dually investigate both outcomes. Our study aimed to compare educational and health outcomes for looked after children with peers, adjusting for sociodemographic, maternity, and comorbidity confounders. Methods and findings Linkage of 9 Scotland-wide databases, covering dispensed prescriptions, hospital admissions, maternity records, death certificates, annual pupil census, examinations, school absences/exclusions, unemployment, and looked after children provided retrospective data on 715,111 children attending Scottish schools between 2009 and 2012 (13,898 [1.9%] looked after). Compared to peers, 13,898 (1.9%) looked after children were more likely to be absent (adjusted incidence rate ratio [AIRR] 1.27, 95% confidence interval [CI] 1.24 to 1.30) and excluded (AIRR 4.09, 95% CI 3.86 to 4.33) from school, have special educational need (SEN; adjusted odds ratio [AOR] 3.48, 95% CI 3.35 to 3.62) and neurodevelopmental multimorbidity (AOR 2.45, 95% CI 2.34 to 2.57), achieve the lowest level of academic attainment (AOR 5.92, 95% CI 5.17 to 6.78), and be unemployed after leaving school (AOR 2.12, 95% CI 1.96 to 2.29). They were more likely to require treatment for epilepsy (AOR 1.50, 95% CI 1.27 to 1.78), attention deficit hyperactivity disorder (ADHD; AOR 3.01, 95% CI 2.76 to 3.27), and depression (AOR 1.90, 95% CI 1.62 to 2.22), be hospitalised overall (adjusted hazard ratio [AHR] 1.23, 95% CI 1.19 to 1.28) for injury (AHR 1.80, 95% CI 1.69 to 1.91) and self-harm (AHR 5.19, 95% CI 4.66 to 5.78), and die prematurely (AHR 3.21, 95% CI 2.16 to 4.77). Compared to children looked after at home, children looked after away from home had less absenteeism (AIRR 0.35, 95% CI 0.33 to 0.36), less exclusion (AIRR 0.63, 95% CI 0.56 to 0.71), less unemployment (AOR 0.53, 95% CI 0.46 to 0.62), and better attainment (AIRR 0.31, 95% CI 0.23 to 0.40). Therefore, among those in care, being cared for away from home appeared to be a protective factor resulting in better educational outcomes. The main limitations of this study were lack of data on local authority care preschool or before 2009, total time spent in care, and age of first contact with social care. Conclusions Looked after children had poorer health and educational outcomes than peers independent of increased neurodevelopmental conditions and SEN. Further work is required to understand whether poorer outcomes relate to reasons for entering care, including maltreatment and adverse childhood events, neurodevelopmental vulnerabilities, or characteristics of the care system.

Accidents in agriculture involving muscle skeletal system in children. Analysis based on hospitalization in the Paediatric Orthopaedics and Rehabilitation Department University Children’s Hospital in 2010-2019

Introduction. Accidents in agriculture involving children happen every year. They are attributable to a lack of safety and low awareness of caretakers, who oftentimes don’t pay enough attention to the little ones. Injuries in agriculture involve mainly falls from great heights: ladders, trailers, tractors; crushing by various types of agricultural machinery; partial or complete amputations within the regions of upper and lower limbs: amputations of feet or fingers. Those cases often include multi-tissue damages, which means that in addition to bone fractures, there might also occur other concurrent injuries like interstitial infections, crushing, neurovascular damages, or soft tissue damage. Material and Methods. In the years 2010-2019 there were 207 patients hospitalized in the Paediatric Orthopaedics and Rehabilitation Department of University Children’s Hospital in Lublin due to accidents in agriculture. Patients who suffered bone injuries, either caused by falling from heights or falling from agricultural machines, constitute the majority of the total 207 cases. The second case in terms of frequency, were the children whose limbs got stuck, or struck, by moving parts of agricultural machines and devices, which resulted in amputations at different levels. The third group consisted of patients crushed by agricultural machines or livestock. Results. The following data indicate a gradual decrease in the number of children requiring hospitalization. Between 2010 and 2019 there was a year-onyear decrease of 38.4%. Conclusions. After the analysis of causes and mechanisms of the injuries mentioned before, we conclude that the vast of these accidents could have been avoided if the caretakers looked after children with due attention, and the children were not allowed in the vicinity of currently functioning agricultural machines.

‘What about me?’ Stories of the educational experiences of care-experienced children and young people in a Scottish local authority

This qualitative study explores the educational experiences of looked after children and young people in one Scottish local authority. The preoccupations of government are academic achievement and school attendance, but these are not the prime concerns of the children, carers and professionals involved. Moreover, they can be both enhanced and restricted by the background characteristics and care situations of the young people and the responses of schools to their needs and behaviour. Five influential factors emerged from interviews and focus groups with professionals, carers and young people: behaviour; school attendance; carers as educators; friendships; and communication between home and school. Each of them is discussed with extended quotations that convey the voices of participants.

11. Child Protection: State Support for Children

This chapter considers how the Children Act 1989 provided a legal framework within which the state can support children to remain with their families through difficult situations and intervene to protect them when they face unacceptable risks. The chapter starts by giving a brief history of child protection law. The chapter then looks at the inherent tension in protecting children while aspiring to support their life with their families, before considering local authorities' powers and duties, resources, and the ever-increasing numbers of children who are involved with social services, whether as c hildren in need, looked after children, or as subjects of child protection investigations or applications.