A Community Health Approach to the Assessment of Infants and their Parents

This book is a practical guide to the CARE programme, a home visiting programme that aims to assess infants? growth, development and psycho-social transitions in their first year of life and that together with the Index of Need checklist aims to engage parents in risk assessment. It provides evidence-based research for the programme, and gives clinical examples of how to use the assessment tools (including the Index of Need) and how to work with parents. The authors take a ?partnership with parents? approach throughout, while bearing in mind the practical workload issues that practitioners face.

About the Authors vii

Preface ix

Acknowledgements xi

1 Introduction: Childcare and Protection –a Public Health Approach 1

2 Overview of the CARE Programme – the First Year of Life 12

3 The Index of Need 31

4 The Emotional Development of Infants and Their Parents 54

5 Observation of Parent-infant Interaction 70

6 Caseload Management 89

7 How to Help Parents in the Best Interests of the Child 97

8 Child Protection 113

9 Case Illustrations of the CARE Package 121

10 Evaluation of the CARE Programme 134

11 Conclusion – the Cost-effectiveness of Community Nurse Home Visiting 149

Appendix 1: ‘Looking at Your Needs’ Booklet for Midwives 157

Appendix 2: ‘Looking at Your Needs’ Booklet for Health Visitors 163

Appendix 3: Form A 169

Appendix 4: Form B 175

Appendix 5: Form C 185

References 199

Index 213

"…a timely book…after reading this, I believe it helps inform the debate on how to improve outcomes for children." (Children Now, April 2007) Jo Douglas is a child clinical psychologist and was Head of Psychology at Great Ormond Street Hospital, London. She is the author of seven books, including Toddler Troubles published by Wiley in 2002.

Kevin Browne is Professor of Forensic and Family Psychology at Birmingham University. He has edited two Wiley books, and was one of Child Abuse Review's founding editors.

Catherine Hamilton is a lecturer in Applied Psychology at the University of Birmingham. She is co-editor of Early Prediction and Prevention of Child Abuse, which was published by Wiley.

This book describes a method of assessment and intervention for infants and their families entitled the Child Assessment Rating and Evaluation (CARE) programme. The aim of the programme is the early prediction and prevention of problems for child health, development and protection.

All aspects of the programme are discussed in full, including assessing the emotional development of infants and their parents, observation of parent-infant interaction and child protection issues. The evidence-based research behind the programme is discussed and a detailed evaluation of the programme’s effectiveness is provided. This practical volume also includes:

• assessment tools and guidelines on how to use them (including the Index of Need)
• guidance on working with parents
• detailed case illustrations
• tips on managing workloads
• advice on caseload management
• discussion of the cost effectiveness of home visiting.

A Community Health Approach to the Assessment of Infants and their Parents aims to inform policy and practice. It is an invaluable tool for all primary care health workers, including health visitors, social workers and paediatricians.