Adoption and fostering glossary
A guide to the adoption and fostering legal, medical and social work terminology used on Be My Parent online and in the Be My Parent newspaper.
A
Accommodated
Adoption and Children Act 2002
Adoption financial support
Adoption order
Asthma
Attachment difficulties / disorder
Attention Deficit Hyperactivity Disorder (ADHD)
Autistic spectrum disorder
B
Behavioural, emotional and social difficulties
Bipolar disorder
C
Can present younger than their years / emotionally behind their years
Care order
Cerebral palsy
Challenging behaviour
Child and Adolescent Mental Health Services (CAMHS)
Cystic fibrosis
D
Developmental delay
Developmental milestones / age appropriate
Developmental uncertainty
Difficult early experiences
Direct (or face-to-face) contact
Disability Living Allowance (DLA)
Disabled
Disruption
Down’s syndrome
Dyspraxia
E
Eczema
Emergency foster care
Enhanced fostering allowance
Epilepsy
F
Failure to thrive (FTT)
Foetal alcohol spectrum disorder (FASD)
Fostering allowance
Freeing order
I
Inappropriate behaviours
Independent fostering agency
Indirect (letterbox) contact
Individual Education Plan (IEP)
Interim care order
L
Lack of care
Learning difficulties / disabilities
Life story work
'Looked after'
M
Mainstream school / education
Makaton
Means-tested
Mental ill-health
Mother and baby care
Motor skills
P
Paediatrician
Parental responsibilities order
Permanent fostering
Personal / self-care
Personal Education Plan (PEP)
Physiotherapy
Piedro boots
Placement order
Play therapy
Police checks
Portage
Post-adoption support
Post-traumatic stress disorder (PTSD)
Preferred area for placement
R
Reflux
Residence order
Residential care
S
Schizophrenia
School Action / School Action Plus
Short break (respite) care
Short-term fostering
Sign language
Special educational needs
Special guardianship
Special needs
Special school / education
Speech and language difficulties
Speech and language therapy / service
Splint
Squint
Standard Assessment Tests (SATs)
Standing frame
Statement of special educational need (SEN)
Supervision requirement (Scotland only)
Support networks
T
Therapeutic support
Traveller / travelling background
Treated for drug withdrawal
V
Visual impairment
Voluntary Adoption Agency (VAA)
Accommodated
When a child is accommodated by the local authority, they provide the child with somewhere to live safely. The local authority has the consent of the child’s birth parents to care for the child and they retain full parental responsibility. This is a temporary arrangement until the child is able to return home, or alternative arrangements are made.
Adoption and Children Act 2002
The Adoption and Children Act 2002 (England and Wales) was the biggest overhaul of adoption law for 26 years. It was designed to improve and modernise the adoption process, including intercountry adoption, and ensure that the needs of the child are paramount. The Act was fully implemented in December 2005. Similar changes to adoption legislation are planned for Scotland and Northern Ireland.
Adoption financial support
Lump sums or ongoing payments may be made at any stage. All financial support payments are means-tested, so the financial circumstances of adopters have to be assessed. The payment is made by the placing authority.
Adoption order
An adoption order grants complete parental responsibility to a child’s adoptive parents and removes it from all others including the child’s birth parents and the local authority. An adoption order cannot be applied for until a child has lived with his or her adoptive parents continuously for at least ten weeks (13 weeks in Scotland).
Asthma
Asthma can affect anyone of any age. It is an extremely common condition, characterised by inflamed, swollen or sensitive airways. A child may wheeze or cough or find it hard to get breath, or their chest may feel tight. The frequency and severity of asthma varies from person to person but it often has a trigger, such as exercise, dust or a viral infection. Asthma is usually controlled quite successfully, either with inhalers and/or preventative medicines. Children may find they outgrow the condition, particularly if their symptoms are mild. The cause of asthma is uncertain, though it is believed to be a mix of genetic and allergic factors.
You can find more about asthma from NHS Direct (free service).
Attachment difficulties / disorder
This is when an individual has difficulty building or maintaining healthy, close relationships because attachment between caregiver and child was unsatisfactory in the pivotal first two years of life. Children with attachment difficulties display a wide range of behaviours.
- Avoidant attachment patterns mean an individual is overly self-reliant, often because as an infant their needs were denied or rejected.
- Disorganised attachment patterns cause an individual to be controlling and distrustful because a caregiver was a source of anxiety as well as comfort.
- Ambivalent attachment patterns mean a caregiver may have responded unreliably and unpredictably to an infant’s needs, prompting extremes of behaviour in later life.
Attention Deficit Hyperactivity Disorder (ADHD)
Attention Deficit Hyperactivity Disorder (ADHD) is marked by disruptive behaviours seen in several places, not just school, and unexplained by any other condition. It is usually first noticed in early childhood. Children with ADHD may have difficulty focusing and concentrating, be hyperactive and impulsive, and experience mood swings. ADHD is thought to be common, affecting three to seven per cent of school children. Until recently, it was thought that children outgrew ADHD, but research now suggests that symptoms can continue into adulthood. ADHD can be managed in a range of ways. Some children may respond to behavioural therapies or dietary regulation, such as avoidance of caffeine or artificial colourings. Others may benefit from medication.
You can find more about ADHD from Contact a Family (you can look up five terms a month before you will be required to pay for this service).
It is really important that you find out how this medical condition specifically impacts on this particular child, as this may vary widely. We are recommending that agencies ask their medical adviser to provide information on this, and this will be included in the child’s profile when available.
Autistic spectrum disorder
Autistic spectrum disorder (ASD) affects how the brain functions, usually causing difficulties with social interaction and communication. Asperger’s syndrome is one of the disorders in the range of ASD. About two to three people in every 1000 have ASD, with males three times more likely to be affected. Symptoms usually appear at under, or around, two years old. They vary and range from mild to severe; some people have learning difficulties, while others excel academically, often in particular areas. The cause of ASD is unknown but there is ongoing research into hereditary and/or environmental factors. There is no cure, and someone with ASD will always have difficulties, although their symptoms may change. Treatment tends to focus on the areas of support and therapeutic input.
You can find more about autistic spectrum disorder from Contact a Family (you can look up five terms a month before you will be required to pay for this service).
It is really important that you find out how this medical condition specifically impacts on this particular child, as this may vary widely. We are recommending that agencies ask their medical adviser to provide information on this, and this will be included in the child’s profile when available.
Behavioural, emotional and social difficulties
These broad terms describe how an individual often cannot, or does not, respond appropriately to a situation, either emotionally, behaviourally and/or socially. That response will vary in severity and output for each individual. Common responses include, however, being confrontational, verbally aggressive, having poor concentration, withdrawing, and finding it difficult to communicate.
Bipolar disorder
Bipolar disorder is a mental health condition in which a person’s moods vary from one extreme to another. There are episodes of depression and episodes of mania (feeling ‘high’ and happy), often with stable periods in between. Treatment usually includes medication, such as lithium, to stabilise moods, and may also involve therapy. Bipolar disorder used to be known as ‘manic depression’. It can affect young people from around the age of puberty onwards but is very rare before then. It is thought that someone is slightly more likely to have bipolar disorder if someone else in their family is affected.
You can find more about bipolar disorder from Contact a Family (you can look up five terms a month before you will be required to pay for this service).
It is really important that you find out how this medical condition specifically impacts on this particular child, as this may vary widely. We are recommending that agencies ask their medical adviser to provide information on this, and this will be included in the child’s profile when available.
Can present younger than their years / emotionally behind their years
Although all children develop at different rates, there is a general pattern to their development, for example by the age of six or seven most children are rapidly developing their imaginative skills and can understand rules for behaviour. Children who have special needs, including attachment issues, may be behind in their social and emotional development. Depending on their age, this may present in a number of ways, such as: difficulty expressing feelings; reluctance to try new activities; low self-esteem and confidence; difficulty understanding the difference between right and wrong; and lack of empathy for others.
Care order
A child may be subject to a care order if the court considers it unsafe for them to live at home. The child is ‘looked after’ by the local authority, who shares parental responsibility with the child’s birth parents. The local authority is responsible for decisions about the child’s welfare including where they live and who they have contact with.
Cerebral palsy
About one in every 500 children has cerebral palsy. It is the name given to a range of conditions which affect movement and are caused by damage to the brain while a baby is in the womb, or during or shortly after birth. Cerebral palsy affects different people in different ways, can vary from very mild to severe, and can affect all or part of the body. Children with cerebral palsy may have difficulty moving their muscles, or not enough control over their movements. There is no cure for cerebral palsy, but treatment often includes regular physiotherapy sessions to assist movement. Other types of support may include medication, speech therapy or occupational therapy.
You can find more about cerebral palsy from Contact a Family (you can look up five terms a month before you will be required to pay for this service).
You can find out more about cerebral palsy from NHS Direct (free service).
It is really important that you find out how this medical condition specifically impacts on this particular child, as this may vary widely. We are recommending that agencies ask their medical adviser to provide information on this, and this will be included in the child’s profile when available.
Challenging behaviour
Children with particular special needs may display what is known as challenging behaviour. For example, some children may have tantrums, show aggression, or be verbally abusive. Adopted and fostered children often have special needs related to their history and circumstances. A child with attachment issues, a learning difficulty, or a disability may exhibit challenging behaviour. Training in dealing with challenging behaviour is available for prospective adopters and foster carers from their approving agency.
Child and Adolescent Mental Health Services (CAMHS)
Most local authorities offer a CAMHS service, which provides an inclusive approach to supporting the mental and psychological health of children and young people. The aim is for these children to be assessed and professionally treated and supported, along with their family, across a wide spectrum of services, such as health, education and social care. Such support is generally NHS-provided.
The approach CAMHS uses is organised around a four-tier framework, which ascends according to the extent of the child's difficulties. For example, a child on tier one will not need to be referred to mental health specialists, but instead get support from people such as GPs, teachers or voluntary agencies. A child on tier four, however, may require admission into hospital or a specialist day unit. Some children may need support in more than one tier, or even all four, at the same time.
Cystic fibrosis
Cystic fibrosis is a life-threatening inherited condition affecting over 7,500 people in the UK. It causes the lungs and other internal organs to become clogged with thick, sticky mucus. This makes it hard to breathe and digest food, which can lead to infections and poor weight gain. Cystic fibrosis affects one in every 2,500 babies. Treatment includes medication, a special diet to help weight gain, and physiotherapy to clear the mucus, which parents and carers can be taught. Although there is currently no cure, treatment has improved in recent years and many children will live well into adulthood.
You can find more about cystic fibrosis from Contact a Family (you can look up five terms a month before you will be required to pay for this service).
It is really important that you find out how this medical condition specifically impacts on this particular child, as this may vary widely. We are recommending that agencies ask their medical adviser to provide information on this, and this will be included in the child’s profile when available.
Developmental delay
Children who fall behind the progress made by most other children their age are said to be developmentally delayed. A child with global developmental delay may be behind in all areas, while other children may only show delay in particular areas, such as motor or language skills. Where this delay is due to past experiences, it may be temporary. It can also last for longer. For some children, their delay may be linked to learning or physical impairments.
Developmental milestones / age appropriate
Developmental milestones are age-appropriate developmental goals, such as crawling, based on the ‘average’ age that a child will achieve them. Where there is failure to meet such targets within the expected timeframe, the child is said to be developmentally delayed. Where a child is meeting those milestones, their development is regarded as age appropriate.
Developmental uncertainty
This can refer either to children who are developmentally delayed and it is uncertain whether this delay is permanent or for how long it will continue, or for children who for various reasons, perhaps because they are too young, have not had a precise developmental assessment.
Difficult early experiences
Difficult childhood experiences should usually be hinted at it in a public profile, unless there is particular relevance in doing otherwise. It is often insensitive or inappropriate to go into detail about early experiences, or there may simply not be the word-count to accommodate an in-depth account. Difficult early experiences can cover many events, from different types of abuse to multiple moves.
Direct (or face-to-face) contact
This involves a meeting or a visit; it often takes place in a neutral area, such as a family centre, sometimes under the supervision of a social worker. Contact can also be made by telephone.
Disability Living Allowance (DLA)
This is a tax-free benefit for anybody under 65 years who needs help with personal care or mobility because of a physical or mental disability. The amount of money received varies depending on how much the disability affects them. To get DLA, either the receiver, or somebody acting on their behalf, has to actively apply for it. DLA is usually mentioned in a child’s profile only when it is already being paid for disabled child.
Disabled
The Disability Discrimination Act (1995) defines a disabled person as someone with “a physical or mental impairment which has a substantial and long-term adverse effect on [their]…ability to carry out normal day to day activities.” It is Be My Parent’s policy to use ‘disabled’ over ‘someone with a disability’, where possible, because we believe this stresses that children with impairments are ‘disabled’ by society’s discriminatory arrangements.
Disruption
This is the term given to an unplanned ending to an adoptive or permanent foster placement.
Down’s syndrome
Down’s syndrome is the most common chromosomal disorder, affecting one person in every 1000, and it is one of the most common causes of learning difficulties. The severity with which a person will be affected varies, but there will usually be some health problems, developmental delay and distinctive facial features. Down’s syndrome occurs across all ethnic groups and in both genders. With suitable treatment and support, average life expectancy is about 60 years.
You can find more about Down’s syndrome from Contact a Family (you can look up five terms a month before you will be required to pay for this service).
It is really important that you find out how this medical condition specifically impacts on this particular child, as this may vary widely. We are recommending that agencies ask their medical adviser to provide information on this, and this will be included in the child’s profile when available.
Dyspraxia
Dyspraxia is a condition mainly marked by difficulties with movement, though also associated with difficulties with language, perception and thought. Somebody with dyspraxia may have poor balance, co-ordination and handwriting, trouble remembering and following instructions, and under-developed social skills.
Up to ten per cent of the population show symptoms of dyspraxia, with around two per cent being severely affected. Men are four times more likely to be affected than women. Little is known about what causes dyspraxia. The possibility of it running in families has been put forward, though not confirmed. Other theories propose irregularities in, or impairment of, neurone and cell development. However, research continues.
Dyspraxia is managed with therapeutic input from a wide range of professionals, most commonly speech and occupational therapists.
You can find more about dyspraxia from NHS Direct (free service).
It is really important that you find out how this medical condition specifically impacts on this particular child, as this may vary widely. We are recommending that agencies ask their medical adviser to provide information on this, and this will be included in the child’s profile when available.
Eczema
Eczema is an inflammatory condition of the skin, which can occur anywhere on the body. It is marked by itchy, dry and red skin, and ranges from mild irritation to severe scaling. The most common types in children are atopic eczema, which affects around twenty per cent of children and is often associated with asthma and hay fever, and infantile seborrhoeic eczema (or ‘cradle cap’), which affects babies under one year old, and usually spreads from the scalp or nappy area. Unless the inflammation is very severe, treatment usually consists of emollients (moisturisers) and medicated creams. Many children will find that the condition lessens with age, or disappears altogether, especially if an allergic cause is found and avoided.
You can find more about eczema from NHS Direct (free service).
Epilepsy
Epilepsy is common, and can develop at any age. It is characterised by recurrent seizures, which occur when there is abnormal electrical activity in the brain. ‘Generalised’ seizures involve both sides of the brain and consciousness is lost; ‘partial’ seizures involve a specific part of the brain and consciousness is not lost, or impaired only slightly. About two thirds of childhood seizures are partial seizures. Epilepsy may result from a disability, an accident or illness involving brain trauma, a genetic predisposition, or it may have no known cause. It is managed or treated with anti-convulsant medication. About a third of children ‘grow out’ of their epilepsy by the time they reach adulthood. Many will still need medication on a long-term basis.
You can find more about epilepsy from Contact a Family (you can look up five terms a month before you will be required to pay for this service).
It is really important that you find out how this medical condition specifically impacts on this particular child, as this may vary widely. We are recommending that agencies ask their medical adviser to provide information on this, and this will be included in the child’s profile when available.
Emergency foster care
Emergency foster care is fostering at very short notice, such as in the middle of the night if a child’s birth parent is taken into hospital. It is usually a temporary placement until another is found.
Enhanced fostering allowance
All foster carers receive an allowance for caring for their foster child or children to reimburse them for the costs of maintaining a child. Some receive an enhanced allowance on top of this, usually because they have extra skills, experience and training that make them able to care for children with special needs. This can include children with serious health conditions or disabilities, children with challenging behaviour, or children who have frequent contact with their birth family, eg several times a week.
F
Failure to thrive (FTT)
Failure to thrive is fairly common and is sometimes called faltering growth. It refers to children who are not growing or gaining weight at the expected rate for their age and sex. It is usually noticed in the first few years of life.
A failure to thrive is diagnosed by looking at factors including the child's height, head circumference, weight, and weight gain against a chart of what should be expected. If a baby was premature or has birth parents who are smaller than normal, this is taken into account.
There are a number of possible causes of failing to thrive, such as problems with feeding and/or nutrition, illness or a specific health condition. It can also be linked to problems during pregnancy, including illness and a birth mother's use of drugs or alcohol, and problems at home, specifically lack of care (or neglect) both practically and emotionally. For this reason, many adopted and permanently fostered children may be identified as failing to thrive when they first come into the care system.
There may be an increased chance that a child who failed to thrive goes on to experience some level of developmental delay.
Foetal alcohol spectrum disorder (FASD)
Foetal alcohol spectrum disorders (FASD) is used to describe a wide range of disorders affecting children whose birth mother misused alcohol during pregnancy. They are also known as foetal alcohol syndrome (FAS) or foetal alcohol effects (FAE). It is not clear what level of alcohol use – including volume, frequency and duration – can trigger structural damage to the brain in unborn babies.
Characteristics of foetal alcohol syndrome (FAS) often include abnormalities of growth, a weakened immune system, and certain facial characteristics. Children with some, but not all, of these characteristics are said to have foetal alcohol effects (FAE). Most babies with FASD will seem irritable, have trouble eating and sleeping, and be sensitive to sensory stimulation. They may also have some level of developmental delay and learning difficulties at a later stage. FASD cannot be cured, but with consistency, support and loving care, children can be helped to understand and live with their condition.
You can find more about foetal alcohol spectrum disorder from Contact a Family (you can look up five terms a month before you will be required to pay for this service). You can also read the Be My Parent feature Prenatal exposure to drugs and alcohol.
It is really important that you find out how this medical condition specifically impacts on this particular child, as this may vary widely. We are recommending that agencies ask their medical adviser to provide information on this, and this will be included in the child’s profile when available.
Fostering allowance
This is always paid to foster carers, but the exact amount of money varies for each local authority and fostering agency. In England, the national minimum allowance for foster carers came into effect in April 2007.
Freeing order
Under a freeing order, all parental responsibility is transferred from the birth parents to the local authority and the child is ‘freed’ for adoption. Freeing orders were often granted when the birth parents are considered to be unreasonably withholding their consent to their child being adopted. They were replaced by placement orders in December 2005. However, there are still some children under freeing orders who are waiting for a new family.
G
Gastrostomy
A gastrostomy is a tube inserted into the stomach through a hole in the abdomen. It is used to feed children who cannot eat or are not getting enough nutrients. For example, a child may have a health condition or disability that causes digestive problems or makes it difficult to chew or swallow. A gastrostomy may be needed for a long or short length of time. Depending on whether there are any other health conditions or disabilities, most children with a gastrostomy are able to lead a normal, active life, and can take baths and showers and go swimming. A nurse will advise on how the gastrostomy works and how to look after it. Usually children with a gastrostomy will need regular monitoring either at their GP surgery or the hospital.
Glue ear
Glue ear, also known as otitis media, is a very common cause of hearing problems in children. Fluid builds up in the middle ear and causes inflammation, leading to dulled hearing, and sometimes ear pain. In most cases, no treatment is needed. Some children may benefit from antibiotics if there is also an infection, but if the glue ear keeps recurring they may need an operation to drain the ear and insert grommets. Some may also need their adenoids (small lumps at the back of the throat that are part of the immune system) removed.
You can find more about glue ear from NHS Direct (free service).
Grommets
Grommets are used to treat glue ear (fluid build-up that causes hearing problems) in children. They are small, plastic drainage tubes inserted into the eardrum during a short operation. First the fluid in the ear is drained out, and then the grommets are inserted. Grommets usually fall out naturally after six to nine months. If the child still has glue ear after this time, they may need to have another set of grommets fitted.
Hepatitis B
Hepatitis B is a virus that is transmitted through contact with infected blood or bodily fluids. Infected mothers can transmit the virus to their baby during pregnancy, childbirth or breastfeeding.
Symptoms of the virus usually develop within one to six months. It is estimated that one-third of infections produce no symptoms, another third have mild symptoms similar to those of flu, and a final third experience severe illness, which can include abdominal pain, diarrhoea and jaundice.
Many people will clear the hepatitis B virus and become immune, but those who retain the infection for longer than six months are said to have developed a chronic reaction. This is more common in babies and children.
If a baby is diagnosed as having the hepatitis B virus they will be immunised and given a course of immunoglobulin injections. Their progress will also need continual monitoring and regular check-ups. However, the majority of people with hepatitis B will not need medical treatment.
You can find out moer about hepatitis B from NHS Direct (free service).
It is really important that you find out how this medical condition specifically impacts on this particular child, as this may vary widely. We are recommending that agencies ask their medical adviser to provide information on this, and this will be included in the child’s profile when available.
Hydrocephalus
Hydrocephalus is a condition that occurs when there is too much fluid in the brain, because it does not drain away as it should. This fluid is called cerebrospinal fluid.
To treat hydrocephalus, many people benefit from having a thin tube, or ‘shunt’, inserted into the brain. This drains the fluid to another part of the body, as normally happens with people who do not have hydrocephalus. As the shunt is usually permanent, it is important to have regular medical appointments to monitor progress and prevent infection.
The cause of hydrocephalus is not known, but it is thought to be due to damage to the brain or the blood supply to the brain, an infection, or another condition such as spina bifida. It may be present at birth (congenital) or may develop later. Babies with hydrocephalus may have an enlarged head and symptoms such as vomiting, poor feeding and irritability. Children with hydrocephalus may have developmental delay and behavioural and learning difficulties.
You can find more about hydrocephalus from Contact a Family (you can look up five terms a month before you will be required to pay for this service).
You can find out more about hydrocephalus from NHS Direct (free service).
It is really important that you find out how this medical condition specifically impacts on this particular child, as this may vary widely. We are recommending that agencies ask their medical adviser to provide information on this, and this will be included in the child’s profile when available.
Inappropriate behaviours
This applies to a wide range of behaviours that are seen to present difficulties, and may be socially unacceptable. Such behaviour is often intimidatory or invasive, such as outbursts of aggression, both verbal and physical, or sexualised behaviour. It may mean a person is simply behaving unsuitably in certain social situations; for example, it is appropriate that a child is friendly among friends and family, but such behaviour becomes inappropriate when a child is indiscriminately friendly to strangers.
Independent fostering agency
Local authorities and voluntary organisations, such as NCH and Barnardos, have provided foster care for decades. In the last ten to 15 years, a new trend developed, with independent people setting up their own agencies. These have been inspected and regulated since April 2002.
Indirect (letterbox) contact
This may include progress reports, letters, videos or photographs of the child, usually sent or exchanged through a third party, such as a social worker or an agency.
Individual Education Plan (IEP)
Some children may need, or may receive as part of their school’s policy, an Individual Education Plan (IEP). This legal document sets out the strategies used to meet the identified needs of an individual child who may have learning difficulties or disabilities, or perhaps be excelling academically. Plans are set, with expected outcomes, and everything is written down so that the child is constantly monitored. The IEP may include the Special Educational Need (SEN) Code of Practice.
Interim care order
An interim (or temporary) care order may be granted while waiting for a final care order court hearing. This will give the local authority and others involved more time to gather information about the child’s welfare to help the court make its decision. The order lasts for eight weeks, but the local authority can apply to the court for an extension.
Lack of care
‘Lack of care’ is a phrase used for a wide spectrum of oversight, from carelessness and negligence to chronic neglect and abuse.
Learning difficulties / disabilities
People with a significant impairment in their ability to learn are described as having learning difficulties/disabilities. ‘Difficulties’ and ‘disabilities’ are often interchangeable terms but ‘disabilities’ sometimes implies a lifelong condition, and/or a symptom of a diagnosed disorder. Learning difficulties/disabilities are often described as ‘mild’, ‘moderate’ or ’severe’.
Life story work
As much information as possible about the child and their history and identity is pulled together as a resource for the child as they grow up outside the birth family. This is usually part of the preparation for an adoptive or permanent foster placement.
'Looked after'
A looked after child is ‘in the care of’ or ‘accommodated by’ their local authority, often within a foster family, because their birth parents are temporarily unable to care for them. Most children return to their birth families within a short time but other alternative options, such as adoption or permanent fostering, may be considered to be in their best interests.
Mainstream school / education
Mainstream schools promote an inclusive education, open to everyone and catering for pupils of all needs and abilities. Pupils with special educational needs will usually receive specialist help and support within the mainstream classroom.
Makaton
Makaton is a trademarked communication system based on a combination of speech, sign language and graphic symbols. It is used internationally, in slightly adapted forms.
Makaton is primarily used by children and adults who, for various reasons, such as being on the autistic spectrum or having learning disabilities, have difficulties with speech or reading. Those using Makaton will speak using visual signs, or read by looking at pictorial signs. The eventual aim is for the signs to no longer be a necessary prop.
Makaton is a system that the child will have to learn and build upon, with input from their carer. In the UK, there is a national network of qualified Makaton tutors who provide training workshops for carers. Others may prefer to purchase distance training packs. If Makaton has been recommended for a child by a professional, such as a speech therapist, they may share their own training resources with the carer.
Means-tested
This means that support is based on the financial circumstances of the carer(s), and that more financial support will be provided for those with lower incomes or fewer savings.
Mental ill-health
One in four people in the UK experience mental ill-health at some point in their lives. Different people are affected in different ways and often there is no clear or specific cause.
There are many different types of mental health issues including schizophrenia, depression, and eating disorders. Some types have a genetic element, which means they tend to run in families, while for others, there is no clear cause.
Various types of treatment are available for mental health problems. Some people benefit from regular medication, a course of counselling, or other types of therapy.
Mother and baby care
Sometimes a birth mother under the age of 18 will move into a carer’s home with their baby, so that the carer can provide support and teach them how to care for their child. This is called a ‘mother and baby’ placement.
Motor skills
Learning motor skills is part of the complicated process of child development. Motor skills are what you use when you move the muscles in your body. Gross motor skills use large parts of the body to produce movements such as crawling, walking, and throwing. Fine motor skills are more refined, and use smaller parts of the body to produce movements such as grasping a toy, holding a pencil, or sticking out your tongue. Children with motor skills difficulties may benefit from support such as physiotherapy.
Neurofibromatosis
Neurofibromatosis is a genetic disorder causing tumours, usually benign (posing no danger to a person’s health), on nerve tissue. Although genetic, neurofibromatosis can occur spontaneously in a family, and from there on be inherited. It is already present in a person at birth, though typically diagnosed later in childhood.
Some people with neurofibromatosis are almost entirely unaffected by it, while others are disabled by the disorder. The disorder has two types – NF1 and NF2 – and symptoms between the two can vary slightly. For example, people with NF2 generally develop tumours on the nerves in both ears, causing hearing loss, possible deafness, and problems with balance.
Indications that a person has neurofibromatosis include 'café au lait' spots, nodules, lumps, and unusual freckling on the skin. More occasional features are short stature and large head size.
Other complications, although uncommon, can occur. These include abnormalities of the skeleton, cancerous growths and seizures.
There is currently no cure for neurofibromatosis. The disorder is instead treated by surgically removing tumours. Additional therapeutic support, such as physiotherapy, occupational therapy and speech therapy, can also be helpful, depending on the individual's symptoms.
You can find more about neurofibromatosis from Contact a Family (you can look up five terms a month before you will be required to pay for this service).
It is really important that you find out how this medical condition specifically impacts on this particular child, as it may vary widely. We are recommending that agencies ask their medical adviser to provide information on this, which will be included in the child's profile when available.
Occupational therapy
Occupational therapy assesses and treats people with physical, psychological or learning disabilities that affect their quality of life. The aim of the therapy is to help them achieve more independence.
Occupational therapists work with people of all ages, and also offer support to the carers of children with special needs. A child’s main ‘occupation’ is to learn and play, and occupational therapy may be recommended for children who have difficulties with their cognitive, physical and motor skills, such as those with developmental delays, spina bifida or cerebral palsy.
Occupational therapists work in various community settings, but will usually visit patients at home. Assessment can then include suggesting how they might adapt to their surroundings, e.g. by installing wheelchair ramps in the home, as well as helping them learn new ways of doing things.
Paediatrician
A doctor who specialises in the care and treatment of children. Children needing a permanent placement will have medical information available about them for perspective carers.
Parental responsibilities order
A local authority can apply to the court for a parental responsibilities order. This means they will have complete parental responsibility for the child in question. The child’s birth parents have greatly diminished parental responsibility but retain the right to oppose their child being adopted or freed for adoption.
Permanent fostering
The aim of permanent fostering is to sustain a child within a family, and enable them to feel secure, until they reach adulthood. Permanent fostering is more suitable than adoption in some cases, such as for an older child who needs to maintain regular direct contact with birth family, or a disabled child who needs continuing social work input and support. Although the foster placement is a permanent one, legal responsibility remains with children services.
Personal / Self-care
Personal/self-care refers to both upkeep of appearance and generally being able to ‘look after’ oneself. This can refer to self-presentation or something more specific, such as a child’s potty training. For confidentiality reasons, Be My Parent uses only general terms, particularly for older children. Where there may be difficulties, such as when a child is wetting the bed, we may mention that he or she needs help with aspects of his or her personal/self-care skills.
Personal Education Plan (PEP)
Every child and looked after young person must receive a Personal Educational Plan (PEP). This document should establish clear objectives, milestones and targets, both academic and behavioural, with the aim of encouraging dialogue between social workers, schools and carers. Other existing plans should fit into, and be integrated with, the PEP. These may include an Individual Education Plan (IEP).
Physiotherapy
Physiotherapy treats difficulties with physical movement. Treatment concentrates on certain areas of the body such as the muscles, joints, bones, and lungs, and the different techniques include manipulation, heat, massage, exercise, stretching and hydrotherapy (which happens in water).
Many people may benefit from physiotherapy, including people with long-term health conditions, e.g. arthritis, and people with injuries, such as those that are sports-related. Children with cerebral palsy, asthma, Down’s syndrome, cystic fibrosis, spina bifida, and any condition that affects movement, posture, growth and development, may also benefit.
A course of physiotherapy usually takes place over a number of sessions, depending on what is being treated. Often, a physiotherapist will teach their patient some exercises to practice at home between sessions, either alone or with the help of a carer.
Piedro boots
Piedro boots are special shoes for children who need extra ankle or arch support to maintain good standing and walking positions. They are often prescribed by physiotherapists.
Piedro boots are easier to put on than normal shoes, as they open closer to the toes. They have removable insoles and come in several widths and sizes.
Placement order
A placement order gives a local authority permission to place a child for adoption with or without the birth parents agreement. Placement orders are often granted when the court decides that adoption is in a child’s best interests but the birth parents are unreasonably withholding their consent. Parental responsibility for the child is shared with the local authority; the birth parents and the adoptive parents until the child is legally adopted. Placement orders replaced freeing orders in December 2005.
Play therapy
This is a form of therapy that uses play situations to help children act out and express their feelings and experiences, with the aim of diagnosing and treating difficulties in various areas, such as learning or social development.
Police checks
Anyone who is assessed by an adoption or fostering agency has a police check (carried out by the Criminal Records Bureau for England and Wales). It is essentially a check of your police record, so your agency is told of anything on your record that would preclude you from adopting or fostering, such as offences against children.
The Be My Parent website has an area of children's profiles that is accessible only to subscribers who have had a satisfactory police check, as verified by Be My Parent. This is in addition to the main area of children's profiles (accessible to all subscribers).
For more information, see Criminal Records Bureau website (England and Wales).
Portage
Portage provides regular home-visiting, pre-school education for children with additional needs, and their families. Such children may be disabled and/or have developmental delay and special educational needs. The Portage network in the UK is monitored by the National Portage Association.
Post-adoption support
The Adoption and Children Act 2002 for England and Wales has produced legislation which requires local authorities to provide post-adoption support, either themselves or by arrangement with specialist services.
Post-traumatic stress disorder (PTSD)
Post-traumatic stress disorder (PTSD) is diagnosed when people show a range of psychological symptoms, considered to be extreme or particularly long-lasting, after a distressing and/or threatening event. Children in the care system who have PTSD, for example, may have witnessed or experienced abuse, whether sexual, emotional or physical.
Somebody with PTSD will usually feel that they constantly 're-live' the trauma, with symptoms including flashbacks and nightmares, intrusive thoughts, and episodes of panic. They may appear emotionally detached, and avoid anything that reminds them of the event. Children will often re-live the trauma in their play. Symptoms can vary in severity, and can emerge at any point – even years after the actual event.
Symptoms of PTSD can be lessened and usually resolved. Generally, medication is not recommended, unless in conjunction with other support. Most specialists advise that somebody with PTSD be encouraged to talk to others about their feelings. If appropriate, they may especially benefit from talking to professionals or people who have gone through similar traumas. Getting support from their adoptive or permanent foster family will also be a vital part of a child's recovery process.
Preferred area for placement
In this part of the profile, agencies indicate the areas of the UK they would consider for prospective families for the child or children they are looking to place. These are indicated by their initials. See map below for key.
On the whole, it may be preferable to look first for children in your own area, as this could be more convenient for arranging meetings and having access to support, or if direct contact is to be envisaged. However, if you feel you are the right family then it may be worth discussing your situation with the social worker.
Reflux
Reflux occurs when the content of the stomach rises up into the oesophagus (food tube). The most common symptom is heartburn, although other features may include chest pain, hoarseness, difficulty swallowing and asthma. As stomach content often includes acid, reflux can occasionally damage the lining of the oesophagus or, if it backs up into there too, the larynx (voice box). Rarely, it can lead to cancer.
Reflux may be harder to diagnose in infants and small children. Things to look out for include poor weight gain, frequent spitting and vomiting, excessive crying, recurrent pneumonia, coughing and discomfort feeding. Many children tend to outgrow the condition. However, reflux can also re-occur in later life.
The symptoms of reflux can be alleviated in a variety of ways. There are medications on the market to reduce stomach acid, many of which are available without prescription. Changes in diet can also ease reflux, such as avoiding spicy or fried foods. Not lying down after eating is recommended, as this can make reflux worse. In severe cases, surgery may be an option.
Residence order
A residence order decides who a child lives with. It can be granted to any person that cares for a child and it means that they share parental responsibility with the child’s birth parents. A residence order can be granted to a parent, other relative, friend or foster carer (if the child has lived with them for a year or more).
Residential care
In most cases, when a local authority ‘looks after’ a child or young person they place them with a foster family, but sometimes residential care is preferred. This is normally a centre where the young person lives with other young people; their care is provided by members of staff. Usually young people stay in residential care temporarily until it is safe for them to return home, or until a new permanent family is found. Often, they have regular contact with their birth family during this time. Some people refer to residential care as children’s homes.
Schizophrenia
Schizophrenia is a major mental health disorder, characterised by a severe disturbance in thought, mood and sense of reality. Although symptoms vary, common indicators include hallucinations and delusional thoughts. Schizophrenia affects about one in every hundred people, and is usually treated with medication and/or psychological therapies. Symptoms might be continuous or reoccurring, or be part of a one-off episode.
Statistically schizophrenia tends to ‘run in families’, with the risk becoming higher if the biological relationship is closer. However, the reasons for this are uncertain, and current evidence points towards a possible combination of genetic and environmental factors.
People genetically predisposed may wish to avoid potential triggers, such as intense stress or particular drugs. Additionally, offering a secure and loving home to a looked after child, with a genetic risk of schizophrenia, may be one of the best preventative treatments of all.
You can find out more about schizophrenia from NHS Direct (free service).
School Action / School Action Plus
The Special Educational Need (SEN) Code of Practice is a plan of three stages, which ascends in degree of response to children with special educational needs. The first two stages are School Action and School Action Plus. School Action involves extra support within the school. A child who makes little or no progress may then graduate to School Action Plus, which includes support from outside specialists.
Short break (or respite) care
Short break (or respite) care is when children live with their own family or foster carers, but having short stays with another foster family, to give their main carers a break. Disabled children with special needs or children with behavioural difficulties may benefit from this type of foster care. This is also known as Family Link or Shared Care.
Short-term fostering
Short-term fostering can cover any non-permanent period, from a day to several months. It is a short-term arrangement until the child can return home to their birth family, or an adoptive or permanent foster placement is found.
Sign language
Sign language is a way of visually communicating with others, used mainly by people with hearing difficulties, and involves gestures, facial expressions and body language.
Sign language is not a universal language, and different types are used in every country. Even in the UK, not everyone communicates with the same form, though the most popular by far is British Sign Language, which is used by around 50,000 people. It has its own grammatical structure and syntax, and can vary regionally.
If you are thinking about adopting or permanently fostering a child who uses sign language, and do not know how to use it, there are plenty of books and educational courses to help get you started.
Special educational needs
The Education Act 1996 says a child has special educational needs if they have a “learning difficulty which calls for special educational provision”. Schools have a duty to identify and meet special educational needs, with help from local/health authorities. There is a Special Education Needs Co-ordinator (SENCO) in all state schools, ensuring such children receive the right support.
Special guardianship
Special guardianship provides permanence for children for whom adoption or fostering is not the best option. The special guardian is the child’s permanent carer and can exercise parental responsibility to the exclusion of others on most issues. Although the child’s birth parents are still legally responsible for them, their rights are very limited. Support services for special guardians are similar to those for adopters. Special guardianship is a new option introduced under the Adoption and Children Act (2002) England and Wales.
Special needs
This is a term that points to the ‘particular’ needs of the child. Such needs can range from the medical to the emotional, the behavioural to the developmental. A child may have ‘special needs’ because they are part of a large sibling group, or because they are an older child and present the ‘special needs’ that one might expect from an older child who has been looked after for a long time.
Special school / education
Special schools are schools with a special curriculum, and which usually cater for children with special educational needs. Special schools are often run by their local authority, but there are also non-maintained special schools, usually run by charities, and independent special schools.
Speech and language difficulties
People with difficulty communicating to the best of their ability are said to have speech and language difficulties. This may be associated with physical disabilities, such as cleft palate, or other physical difficulties, such as those involving feeding, chewing and swallowing.
Speech and language difficulties may also stem from neurological disorders, learning disabilities, hearing loss and other identifiable sources. However, there may be difficulty with using and understanding language with no obvious physical trigger, and which may or may not be rooted in emotional grounds.
Speech and language therapy / service
People with difficulty communicating to the best of their ability may be referred to a speech and language therapist. A speech and language therapist sometimes works in isolation with the individual, but more often will work alongside caregivers and appropriate professionals, such as those from school if the patient is a child. People are often referred to speech and language therapists by their GP. The therapy will usually take place in either a hospital or health centre, community centre or a school. Sometimes the speech and language therapist will visit the patient at home.
Splint
Splints are used to support, protect or hold a part of the body still to restrict movement. In children, for example, a splint may be needed to correct a growth problem, mend a bone, or protect an area from further injury.
Splints are moulded to a specific part of the body, e.g. hand, leg, wrist, toe, finger, or elbow, and are usually made of plastic.
Children may need to wear a splint for a set length of time, such as a few months or longer. They may need to wear their splint all the time, for part of the day, or only at night.
It is important to keep the splint (and the skin around and underneath it) clean and keep an eye out for problems such as pain, discomfort or a rash.
Squint
With a squint, one eye looks in a different direction – usually inwards. About one in every 25 children has a squint and it is usually noticed between the ages of 18 months and four years. Although the exact cause of a squint is not always known, they can run in families and more commonly affect children who are long-sighted. Treatment often involves wearing glasses, or a patch over one eye, until the squint is corrected, as well as eye exercises given by an eye specialist. Some children may need a small operation to correct the squint.
You can find more about squint from NHS Direct (free service).
Standard Assessment Tests (SATs)
SATs are examination tests, given in the areas of English, maths and science, to children at the end of school years two, six and nine. These school years roughly correspond with the ages of six/seven, ten/eleven, and thirteen/fourteen. SATs are used to show a child's academic progress compared with other children born in the same month.
Standing frame
A standing frame is a mobility aid, like a wheelchair. Through pads and straps, which give support, a person can stand up on it to move around. Some people with mobility difficulties may prefer this positioning to that of a wheelchair, finding it better for their independence and self-esteem. However, to use a standing frame, a person will have to be able to bear a certain amount of their own weight, though the exact amount will vary according to the make and model of the frame.
Statement of special educational need (SEN)
The SEN Code of Practice is a plan of three stages, which ascends in degree of response to children with special educational needs. The final stage is statemented provision, which is granted by the local authority when it assesses a child’s needs cannot reasonably be met by their school. Local authorities are legally bound to arrange the provision specified in the statement of special educational need, and a school named as best meeting the child’s needs has a duty to admit them. The statement is annually reviewed.
Supervision requirement (Scotland only)
The child is placed under the supervision of the local authority but the birth parents retain parental responsibility. A supervision order may be granted if the court considers the child to be at risk of significant harm.
Support networks
Your support networks are your friends, family, and anyone in your wider community, such as religious associates. Agencies will usually want to know more about your support networks, as this helps them understand who will be there for you, and with whom your child will interact. This may be even more relevant if you are a single carer, or if you are planning to adopt or permanently foster a large sibling group.
Therapeutic support
Therapeutic support is a general term used for many types of support that a child may receive, or would benefit from receiving in the future. Some children receiving therapeutic support may have had difficult early experiences, for example being neglected, abused, or witnessing domestic violence. Others may have behavioural difficulties or developmental delay. Many adopted and fostered children have attachment difficulties, and therapeutic support for the child and their new family may be helpful.
In Be My Parent, the term often refers to counselling, psychotherapy, play therapy, but can also include speech and language therapy, behavioural therapy, occupational therapy and physiotherapy.
Traveller / travelling background
Travellers come from a number of different cultures, backgrounds and geographical areas, and speak different languages. Some groups travel permanently, some for part of the year, some occasionally, and some not at all.
These groups include:
• Irish travellers
• Romani people or Romas (sometimes referred to as 'gypsies')
• Fairground or circus travellers (often called occupational travellers)
• New or new age travellers
Being a traveller is an important part of a person’s identity and many types of traveller belong to a recognised ethnic group, for example Romani. If you are adopting or fostering a child from a travelling background it is important to actively develop their ethnic and cultural identity, as any other.
Travellers have a history of encountering discrimination from local communities where they settle or pass through. Children from travelling backgrounds may have experienced many moves and breaks in their formal education.
Treated for drug withdrawal
A newborn whose mother used drugs during pregnancy may need to remain in hospital for a short while to be monitored for drug withdrawal symptoms. These may include problems feeding, irritability, tremors, diarrhoea and vomiting. Treatment involves ‘weaning’ the baby off the drug, for example by giving them small amounts of a safe form of the drug until they no longer need it. There may be some uncertainty about the baby’s future development, so they will continue to be monitored by health and social care professionals after they have been discharged from hospital.
For more information, see the Be My Parent feature Prenatal exposure to drugs and alcohol.
It is really important that you find out how this medical condition specifically impacts on this particular child, as this may vary widely. We are recommending that agencies ask their medical adviser to provide information on this, and this will be included in the child’s profile when available.
Visual impairment
People who are blind or partially sighted are said to have a visual impairment. A person with severe sight loss may be described as blind even if they have some degree of vision. Some children with a visual impairment may have another health condition or disability such as diabetes or cerebral palsy. Visual impairment may also be caused by an injury to the head.
You can find more about visual impairment from Contact a Family (you can look up five terms a month before you will be required to pay for this service).
You can also find more about visual impairment from NHS Direct (free service).
It is really important that you find out how this medical condition specifically impacts on this particular child, as this may vary widely. We are recommending that agencies ask their medical adviser to provide information on this, and this will be included in the child’s profile when available.
Voluntary adoption agency (VAA)
A VAA is a registered and inspected adoption agency run by non-statutory organisations, e.g. by charities like Barnardos and NCH. They range in size and often specialise in the type of adoption they offer. They may seek adopters for black children or sibling groups.
Last updated: 02 June 08
