Outcomes measurement has become a contemporary requirement for child, youth and family services in state-funded work with children and young people in out-of-home care. Such expectations are now common throughout the Western World, especially in North America (Stuart, 2008) as well as in the United Kingdom, the Republic of Ireland, Europe and elsewhere (Fulcher, McGladdery & Vicary, 2011). A policy imperative now drives out-of-home care decision-making with the expectation that service providers will demonstrate accountability around specific policy targets and achieve outcomes associated with policy agendas like Every Child Matters (2005) in England and Wales or Getting It Right For Every Child (2005) in Scotland in order to secure government funding. Fewer efforts have been made to monitor the achievement of developmental outcomes by each child or young person for the duration of her stay in out-of-home care. Such developmental achievements depend on simple, reliable and valid reporting by those most closely involved with these young people. That is the focus of this paper.
Inputs, Outputs and Outcomes
Contemporary outcomes agendas have introduced a whole new language into the provision of child, youth and family services. The ‘client’ has often become that body which purchases services and dictates what resource ‘inputs’ are available and how these are distributed. As used here, inputs involve the quantum of resources available, whether measured in terms of money, time or energies.
Outputs involve everything that carers, teachers, social workers, youth workers or others do to provide targeted out-of-home care services under court jurisdiction. Care outputs are frequently confused with care outcomes. A survey of Welfare and Family Service Agencies across Canada found that
‘only 50% [of the participating agencies] have systematic processes for integrating results of their own outcomes evaluation and needs assessments into practice, and only 30% have processes for integrating the results of external research into practice … 39% do not have any process.’ (Stevenson & Balla, 2003, p.9 cited in Ferris-Manning & Zandstra, 2003)
This study highlighted much confusion around care outputs produced by governments or through purchase of service contracts with what are known in the UK as ‘Corporate Parents’1. Whilst government departments retain a duty of care assigned by the judiciary for each child or young person in State-supervised care (Fulcher, 2002), there is growing interest amongst nongovernmental bodies, voluntary trusts and private businesses to enter into legal contracts which authorise the provision of care services.
Care outcomes are different from care outputs. Working harder with fewer resources still involves outputs and not outcomes. Care outcomes involve developmental achievements that are shaped through relationships for the duration of a young person’s placement in out-of-home care. This distinction between care outputs and care outcomes is readily illustrated on a daily basis in foster care, group homes and other residential care settings. Care outputs may involve creating opportunities for young people to develop life skills appropriate to their age and stage of development. On the other hand, care outcomes focus on the results of providing these outputs, such as the extent to which this young person can travel by herself to and from school in a safe manner. It is possible to distinguish between at least three types of outcomes: policy outcomes; service outcomes and developmental outcomes. Policy outcomes are sought by politicians and civil servants seeking annual assurances that public funding is achieving targeted objectives. Service outcomes are identified by health, education and welfare professionals seeking to show how their services are achieving targeted objectives and deserve funding.
Fewer attempts are made to monitor developmental outcomes achieved by children or young people during placements in out-of-home care. These are outcomes associated with enhanced wellbeing along with personal and social capabilities, not reports about what service providers tried to do. We assert that developmental achievements are the outcomes that really matter for young people in out-of-home care if we are to alter the history of negative statistics so resistant to change (Fulcher, 2007). Tacit recognition may be given to the importance of reporting on developmental outcomes, although most contemporary care reporting still consists of idiosyncratic accounts recorded in daily logs, with summaries pasted into court-mandated reports or inserted as anecdotal case studies into service evaluations.
Noticing – Out There and In Here
Quality out-of-home care begins when carers and social workers start noticing more closely what may be going on with each young person in their care. There are moments when we notice the need for, or an opportunity for, intervention (Garfat, 2003), whether to stop something happening, perhaps helping a child understand her own internal dialogues (Fewster, 1990) or helping her make connections with different influences which impact on her life (Garfat, Fulcher & Digney, 2012). Quality out-of-home care may also involve opportunities to intervene in cycles of maladaptive acting out or being with others (Krueger, 1988). At such moments, whilst deciding whether to intervene, carers must remain actively alert to what is happening – out there and in here – noticing what may be important right now.
While this may seem overly simplistic, it is human nature to not always notice everything that is happening around us. We commonly filter out things that are clearly there to be noticed. Sometimes we may become overwhelmed with different experiences of our world (Guttman, 1991). We need to pay special attention to the life-space and actions-in-the-environment where a young person operates so as to notice what is occurring as it is occurring. ‘Noticing’ happens when the immediate stream of events is disrupted (Eisikovits, Beker & Guttman, 1991) and also when our attention is drawn – for whatever reasons – to particular episodes in the stream of events that are occurring in a child’s life-space. Noticing begins with each carer or social worker and requires that we free ourselves from pre-conceived notions about what is and is not relevant. Sometimes we don’t notice because we don’t know about it. At other times we don’t want to know about it or choose not to know about something. It may be that we are too busy focusing on something else to notice what is going on right in front of us! As carers or social workers we need to reflect systematically on what’s ‘out there’ and what’s ‘in here; before leaping into intervention(s), attending to what Freado called ‘the outside kid’ and ‘the inside kid’ (Freado, Bussell & McCombie, 2005). Carers and social workers need also to consider what’s going on ‘out there’ and ‘in here’ for ourselves as well!
Noticing what’s going on ‘out there’ around young people helped to inform Search Institute research over four decades that identified twenty External Assets clustered around four developmental themes – Support; Empowerment; Boundaries & Expectations; and Constructive Use of Time – that are customarily wrapped around children in culturally defined ways (Fulcher, 2003). External assets involve family and extended family members, other adults, participation in community life, school, neighbourhood and peer group involvement, and purposeful use of time. Noticing ‘in here’ helped to inform twenty Internal Assets, which the Search Institute claims help youths engage socially in daily living activities. Internal assets were grouped around four other themes: Commitment to Learning; Positive Values; Social Competencies; and Positive Identity. Internal assets involve values around caring about others, equality, social justice, integrity, honesty, responsibility and restraint. Internal assets also involve how a child uses her personal power, her planning and decision-making, developing self-esteem, interpersonal and cultural skills, resistance skills and peaceful conflict resolution, along with a developing sense of purpose and hope for the future.
As shown in the graph below, Search Institute research (2001) based on social surveys of forty developmental assets with a quarter million late primary and secondary school students found that 1 in 7 young people reported having 10 or fewer assets, whilst 2 out of 5 had between 11 and 20 of the assets surveyed.
On average, boys reported having 3 fewer assets (17.3 out of 40) than did females (20.7 out of 40). Other Search Institute research showed that young people with fewer than 10 developmental assets faced particular challenges, with 9 out of 10 ‘low assets’ youths not achieving in school; 40% of these youths experimenting with drugs; and 60% involved in 3 or more acts of fighting, hitting, injuring a person, carrying a weapon, or threatening physical harm in the previous 12 months (Starkman, 2002). Statistics such as these profile the histories of a large proportion of young people placed in out-of-home care throughout the Western World.
Noticing what is going on ‘outside’ and ‘inside’ a young person reinforces the We Can and Must Do Better practice imperative (2007) adopted by the Scottish Government to nurture developmental achievements that matter for each young person in out-of-home care. A major challenge involves finding ways of assisting this ‘low assets’ population of young people to achieve developmental outcomes that ‘move them towards the population mean’. Why shouldn’t young people in out-ofhome care be given the same opportunities available to any other young person in our community? These young people need help learning to notice what’s happening – out there and in here – working through a personal relationship that nurtures and promotes developmental achievements that matter for them today and for their futures.
Outcomes that Matter Recording
Building upon this practice research, the authors compiled an Outcomes that Matter© recording format for use with children and young people to monitor weekly achievements around 20 key developmental assets during placements in out-of-home care. Twenty of the original forty Search Institute Assets (Scales & Leffert, 2004) were refined, with permission, into outcome statements for use with young people in care (Fulcher, McGladdery & Vicary, 2011). The research median was used to differentiate between ‘High and Low Developmental Assets’ groups identified within the Search Institute research population. We postulated that children or young people in out-of-home care are most frequently located within the ‘Low Assets Group’ since their life histories that resulted in placement are commonly shaped by neglect, trauma and relational challenges. If We Can And Must Do Better (Scottish Government, 2007), then everyone involved with these young people must actively attend to and nurture developmental achievements around these 20 targeted assets through participation in daily life events of caring – week to week.
An initial recording format was trialled with more than a thousand foster care placements in all parts of the United Kingdom, the Republic of Ireland, Australia and New Zealand (Fulcher, McGladdery & Vicary, 2011). For reporting purposes, these key developmental assets were clustered around the five Every Child Matters policy themes used in England and Wales and the seven Getting It Right For Every Child policy themes used in Scotland. However, such ethnocentric policy directives – no matter how relevant – posed difficulties when it came to using this recording and reporting format elsewhere, such as in the USA, Canada, Australia, New Zealand or South Africa. For that reason, the recording format was further revised to cluster outcome statements around the generic development themes of Belonging, Mastery, Independence and Generosity made popular through the work of Reclaiming Youth International (Brendtro, Brokenleg & Van Bockern, 1990). Drawing from indigenous sources of knowledge and principles of positive psychology, this framework seeks to better equip adults for work with contemporary youths.
Based on Native American teachings, the Circle of Courage framework parallels the health and wellbeing metaphor articulated by New Zealand Maori psychiatrist, Mason Durie (1994) – that of an ancestral house. Each wall of this ancestral house is essential to supporting the house as a whole (see illustration below).
Some may question why indigenous sources of knowledge – amongst others – have been used to help identify developmental themes deemed important to the lives of children and young people in out-of-home care worldwide. We assert that, historically, the application of Western social science theories have disadvantaged young people placed in out-of-home care, especially those not part of the dominant culture, accounting for much of the racial disproportionality found in out-of-home care placements (Child Welfare Information Gateway, 2011). Social work as a profession has paid greater attention to race than it attends to culture, as seen in Payne’s Modern Social Work Theory (2005), where very little attention is devoted to the significance of culture and meaning-making in social work practice with families.
Outcomes that Matter build from a strengths-based approach that reinforces child, youth and family participation in decision-making around daily life events in supervised care. Strengths and capabilities which children, young people and families possess are highlighted, thus ensuring that resilience and developmental achievements are the aims of supervised care. Ungar (2006) claimed that:
‘When faced with adversity, resilience involves one’s capacity to navigate towards and negotiate for resources that are culturally, socially and personally meaningful. Resilience also involves the capacity of one’s community to provide these resources’ (p. 55).
Resilience develops through relationships that offer opportunities for developmental achievements. These build from a secure base, where a child or young person can relax and feel safe, cared for and cared about (Ungar, 2006; Gilligan, 2009). Resilience is strengthened when a child’s personal interests and talents are recognized and encouraged, even if these may require redirection towards safer and more socially acceptable means. Resilience is further strengthened through educational achievements and opportunities for learning that are tailored to that child’s particular learning needs and capabilities. A young person’s resilience is reinforced through friendships that promote personal strengths and reliability in relationships whilst nurturing social competencies and celebrating personal achievements. Resilience requires the nurturing of social values around caring, sharing, honesty, responsibility and good decision-making. Community supports that endorse a young person’s competencies and upbringing are also important, offering recognition that this youth is someone capable of making a contribution to others as well as looking out for herself. The more we take account of each young person’s developmental capabilities, the more responsive a carer or social worker will be in their interactions with that young person during placement in out-of-home care.
The Outcomes that Matter Recording Instrument
Weekly Outcomes that Matter recordings begin with a 2-3 line narrative about the Highlight of the Week – whether identified with the young person or separately. Unless encouraged to look for weekly highlights in our relationships with children in care, it is easy to end up concentrating only on problems and difficulties. Care leavers who have accessed their case files often comment on how much negative information they found and not much that was positive. Carers next record any contact this young person had with birth family and extended family members or significant others such as former foster parents, parents of a school friend, neighbours, etc. This may include face-toface meetings, letters, telephone calls, texting, emails or other social media. Noting weekly birth family contact is important, especially when a young person has had contact restricted with certain family members, or permitted only with supervision. Carers then note any critical incidents or significant events that occurred, anything that requires formal notification, such as accidents or injuries, hitting and so forth. Such incidents normally require more detailed incident reporting with a different form. Finally, carers briefly note the extent to which the young person in their care participated in the weekly recording process.
20 Developmental Outcome Statements
The four introductory prompts are followed by twenty developmental outcome statements. Carers are asked to reflect back over the past seven days to identify daily life episodes when the young person in their care demonstrated achievement(s) using each outcome statement as a guide. Here, carers are encouraged to use a stream of consciousness process that Holocaust survivor Eugene Heimler (1985) termed ‘fragmenta vitae’ or fragments of life, a methodology refined through psycho-therapeutic work with traumatised young adults. This cognitive process operates much like a closed circuit television (CCTV) capacity that can be visually reviewed using the achievement prompts provided. Carers identify specific episodes with a child in their care through mentally scanning the past 168 hours (24 hours x 7 days) of relational interactions prompted by each outcome statement2. Carers first record a 2-3 line narrative offering a word picture that captures an episode during the past week.
After providing a short word picture narrative associated with each of the 20 outcome statements, carers then review these using the five-response Likert Achieving Scale provided to arrive at a reflective judgement about ‘how often’ the primary carer ‘noticed’ developmental achievements of this kind during the past seven days. Sometimes carers may become so overloaded with what is happening that they are unable to record achievements during any given week, or the young person may be elsewhere. In such cases, carers are asked to provide a short narrative about why an outcome statement was not recorded and prompted to pay greater attention around that outcome statement the following week. These weekly ‘pen picture’ narratives give prominence to the actual voice of primary carers. The achieving scale responses help to ensure that professionals and the public can trust Outcomes that Matter recordings to track developmental outcomes in a reliable and valid fashion.
This approach to recording differs substantially from the more traditional descriptive accounts commonly found in daily logs or in weekly child protection summaries compiled for each young person in out-of-home care. Such recordings are frequently placed in case files but rarely used other than to document what happened retrospectively when something went wrong. Outcomes that Matter recordings provide weekly glimpses of the relational episodes taking place between a carer and a young person. When compiled weekly over the course of 6-8 weeks, it is possible to monitor and report on patterns of achievement around specific developmental outcomes. The ten External Outcome statements are designated with (E) whilst the ten Internal Outcome statements are designated with (I) in order to reinforce prompts for carers as they complete their weekly recordings.
While much is said about the importance of ‘evidence-based practice’ derived through large, quasiexperimental-control group studies or meta-analysis of multiple studies, it is less common to find ‘practice-based evidence’ that helps to refine ‘evidence-based care practices’ with specific children. Outcomes that Matter recordings provide ‘practice-based evidence’ that reinforces ‘good enough caring’ –focused on each young person’s developmental needs and achievements! Parsonson (2012) notes how there is an expectation that
‘evidence supporting a selected intervention means it will be effective for this patient [child] because the research says it should be. … If the patient [child] returns, complaining of … less than expected change, the treatment may be changed or increased in intensity, but with no planned follow-up in place. … There [is] an absence of systematic methods when it comes to applying [evidence-based research findings] to individuals who present as clients. In other words, there [is rarely any] functional approach to practice-based evidence gathering’ (p. 99).
Weekly practice-based evidence is provided through the use of Outcomes that Matter recordings, ensuring that the voices of life-space carer(s) and each young person in care are heard on a consistent basis, not just selective extracts drawn from recordings by professionals who operate outside a child’s life-space. Weekly narratives and reporting on 20 external and internal achievements make it possible to track a child’s developmental outcomes over time, whether measured in weeks or months. Such reporting provides ‘practice-based evidence’ that promotes ‘evidence-based practice’.
We know of no other recording format for use with children and young people in out-of-home care, or for the mentoring of ‘NEET youths’ (those Not in Employment, Education or Training), that addresses this practice challenge in such an evidence-based, yet practical manner. Nor do we know of other recording formats that encourage full participation by a young person in the therapeutic process – whether as full participants or to the extent to which they wish or are capable of participating! Outcomes that Matter recordings build on a ‘single-case replication research design’ (Parsonson, 2012), meaning that after establishing a base-line of achievements for each individual child, thereafter it is possible to systematically monitor the same evidence-derived developmental achievements week to week. Such recordings provide a ‘powerful means of evaluating changes between the pre-intervention baseline and post-intervention findings with single patients’ (Parsonson, 2012, p. 99). Outcomes that Matter recordings are grounded in quality care-giving and therapeutic use of daily life events with young people in out-of-home care.
Belonging and Wider Family Connections
The five Belonging Outcomes involve “External Assets” that are located around a child as she enters a new home or out-of-home placement. As a young person moves into her new living environment, a sense of Belonging grows with those living in her shared life-space – greeting, connecting with and engaging her to form reciprocated relationships that embody caring and sharing. Such relationships offer ‘reciprocity’ that is important to all parties. Reciprocated relationships are important in placements where there are multiple family members or residents living together. ‘Getting to know you’ episodes and rituals of encounter or beginnings involve engaging in reciprocated relationships. Starting through external influences, Belonging gradually becomes an internalised experience. Narratives such as that illustrated in the Carer Support example below are used with all five of the Belonging Outcome statements.
(E) Carer Support: (Young person’s name)_ received personal time, physical care, encouragement and demonstrated a sense of belonging with others in their living environment.
|For example: Kirstin was sick and throwing up so couldn't travel in the car when picking up my girls from school so I made a decision to organize my niece to look after Kirstin at home while I picked up the girls.|
|Achieving||Mostly Achieving||Some Achieving||A Little Achieving||Not Achieving||Not Recorded|
(E) Safety: ――――――――――― has been safe in a variety of ways where s/he lives, at school and in the local neighbourhood.
(E) Positive Communication:――――――――――― listened to and talked with his/her carers, sought help, advice, guidance and/or representation as appropriate.
(E) Caring Relationships: ――――――――――― was offered, received and accepted support from birth family members, personal carers and other significant adults.
(E) Boundaries for Daily Living: ――――――――――― received consistent supervision and his/her whereabouts were monitored according to reasonable behaviour guidelines.
Mastery of Life Skills with a Capacity to Communicate Thoughts and Feelings
Mastery involves the achievement of both External and Internal developmental outcomes. Connecting with a young person involves carers taking an interest in what sparks learning in each young person living in a shared life-space. Motivation to learn and supportive learning environments involves External Outcomes. Whether a young person is motivated to achieve and what she is motivated to achieve are different issues, but whether actively engages in learning and what she achieves depend largely on whether she takes advantage of learning opportunities. Mastery is nurtured through achievements such as these, in relationships that matter – over weeks and months and years.
The recording format illustrated in the Actively Engaged in Learning example shown below is used with all the Mastery outcome statements.
(I) Actively Engaged in Learning: _(Young person’s name)_ got personally involved in learning activities at school, in work experiences or in other activities which further developed her/his life skills.
|For example: Kirstin has been busy with her art work for the art expo next week. She has completed 4 pieces of art work that will be displayed.|
|Achieving||Mostly Achieving||Some Achieving||A Little Achieving||Not Achieving||Not Recorded|
(E) Supportive Environments: Relationships with teachers, activity leaders and peers offered ――――――――――― security, encouragement and nurturing that stimulated his/her learning and achievements.
(E) Carer’s Involvement in Learning: Carers actively supported――――――――――― to succeed in school, in work experiences and with other learning opportunities at home or elsewhere.
(I) Motivation to Achieve: ――――――――――― did his/her best to learn and to master new life skills or to realise personal goals.
(I) Making Use of Learning Opportunities and Homework: ――――――――――― participated in learning activities at home or elsewhere while also completing and submitting school homework on time.
Growth and Development towards Autonomy and Independence
All but one of the five developmental outcomes monitored around the theme of Independence involve the achievement of Internal Assets. As a young person moves towards independence, she is required to take more and more ownership over, and internalise her own values, beliefs and daily practices so that when she travels, these ‘rules for daily living’ travel with her wherever she goes. Making good decisions and plans, learning to exercise personal power wisely, learning to behave responsibly and develop a positive view of the future are all important as young people develop growing independence from their primary carers. Continuing participation in structured social activities remains important because of the external connections these provide. Learning to engage in a particular sporting or recreational activity, youth group, music, art or drama activity increases a young person’s resilience through her capacity to use social competencies learned in one place and time when transitioning to new challenges and opportunities.
The recording narrative illustrated in the Planning and Decision-Making example below shows how the same carer completed her weekly recording associated with the Independence outcome statements.
(I) Planning and Decision-Making: _(Young person’s name)_ exercised positive planning, chose from a number of options and attempted to solve his/her problems.
|For example: Kirstin made plans for herself and at the last minute demanded that I do what she wanted. When I refused, she became angry and started swearing. Maybe it’s because she hasn’t spoken to her Mum and knows that Mum is not answering her calls on purpose.|
|Achieving||Mostly Achieving||Some Achieving||A Little Achieving||Not Achieving||Not Recorded|
(I) Personal Power: ――――――――――― expressed her/his feelings in a manner that took account of others, and able to have a say over things that happened in her/his life.
(I) Responsibility: ――――――――――― demonstrated age appropriate self care, awareness of what constitutes a healthy lifestyle and accepted personal responsibility for his/her actions.
(E) Activity Programmes: ――――――――――― participated in two or more structured community activities, hobbies, interest groups or clubs during the past week.
(I) Positive View of Personal Future:――――――――――― demonstrated a positive awareness of his/her culture or spiritual identity, found the world interesting and enjoyable while showing that he/she has a place in it and demonstrated optimism about their future.
Generosity of Spirit and Capacity for Happiness, Faith, and Purpose
The New Zealand Maori concept of taha wairua located within the Te Whare Tapa Wha framework acknowledges a spiritual dimension of human functioning that pervades the ontology of these peoples of the South Pacific. Since Plato, Western readers have experienced difficulty with this dimension, perhaps through the influential teachings of Kant, Descartes and other philosophers who explored the so-called Mind-Body Problem claiming that in a rational world the mind controls the body. By contrast, indigenous thinkers over generations have operated from a wider epistemology and ways of knowing the worlds in which they live. We think this spiritual dimension has an important place in child and adolescent development, drawing attention to morals, values and a sense purpose in daily living (Piaget, 1932; Kohlberg, 1981). Taha Wairua and Generosity of Spirit nurture one’s capacities for happiness, faith and purpose, highlighted at the front of each child’s ancestral house and thereby strengthening the other three walls of their metaphoric house: the physical; the mental and emotional; and the relational. The five outcome statements associated with Generosity focus on three internal values that are nurtured through relationships with others, and two external outcomes that involve engaging with others and expectations.
The recording format illustrated in the High Expectations example shown illustrates the carer’s recording about the outcome statements associated with Generosity.
(E) High Expectations: Carer(s) and others encouraged _(young person’s name)_ to do her/his best at school, at work or in other activities, and offered her/him recognition for doing so.
|For example: Kirstin wasn’t in the helping mood this week. She made sure that after she finished eating she hurried to her room or said she needed the toilet so that she’s not tidying up. But I made sure that she did the dishes when it was her turn, to be fair to our girls.|
|Achieving||Mostly Achieving||Some Achieving||A Little Achieving||Not Achieving||Not Recorded|
(E) Service to Others: ――――――――――― engaged in specific opportunities to help others in his/her daily living environment, in his/her neighbourhood or in their wider community.
(I) Peaceful Conflict Resolution: ――――――――――― sought to resolve potential conflicts through compromise without physical aggression or resorting to hurtful action or language.
(I) Caring: ――――――――――― demonstrated the extent to which she/he places high value on helping others and considering the needs of others.
(I)Honesty: ――――――――― showed that he/she can tell the truth even when it’s not easy.
The last four questions in the weekly Outcomes that Matter recording asks carers to pause and reflect back over the past week to review their developing relationship with this young person overall. Carers consider each side of the ancestral house and four Circle of Courage themes to add a few lines by way of summary about this young person’s flourishing and her developing resilience, health and wellbeing. The summary invites the carer to reflection any strengths, weaknesses, challenges and opportunities that impact on this young person at the end of another week, as illustrated below.
Caring and Sharing within Wider Family Connections (Belonging)
Capacity to Learn and Communicate Thoughts and Feelings (Mastery)
Growth and Development towards Self Care and Autonomy, including Health & Dental Care (Independence)
Outcomes that Matter Achievement Profiles©
Weekly recordings make it possible to plot visual Outcomes that Matter Achievement Profiles with each young person for whom a recording has been completed. A young person’s profile might look like the one generated below for 15 year-old Kristin after the first 9 weeks of this placement.
Kristin presented as a large, immature young woman with short attention span and a history of impulsive behaviours, disrupted educational experiences, exclusions from school, sexual abuse, hanging out with older peers, and very inconsistent parental supervision. The placement began well although relationship-building followed something of an erratic pattern.
Information recorded by Kirstin’s primary carer for each Belonging outcome statement facilitated initial planning by helping to identify patterns of erratic achievement around each of these developmental outcomes. In the profile above, one can see how all five ribbons ‘blipped’ in Week 5 following a dramatic and emotionally violent tantrum after Kirstin was refused permission to go out alone on a weeknight. Kirstin had learned that by throwing tantrums such as this, other carers had asked for her to be removed from placements with them. In this placement Kirstin’s new carers managed to ‘hang in’ with her, and with support from the two younger carer-family female children Kirstin’s outbursts stabilized and the placement continued, although the profile of completely achieving in weeks 6-9 may indicate a period of calm before the next outburst – for both Kirstin and her carer(s).
Outcomes that Matter recordings assist carers in their direct work with young people and family members by moving from traditional idiosyncratic recordings held in case files to narratives which capture information more systematically around specific developmental achievements during the course of daily life events in care. Such episodes are relational and give important information about what is happening between a young person and her carers. Outcomes that Matter Achievement Profiles assist in monitoring each young person’s achievements over time, offering detailed information that enhances care planning and the provision of quality services. Outcomes that Matter recordings better inform and facilitate planning for everyone involved in team parenting efforts – including family members – thereby supporting and nurturing this young person’s health and wellbeing longer term. Outcomes that Matter recordings provide closer scrutiny of developmental achievements by monitoring ways in which carers intentionally nurture ‘external’ and ‘internal’ achievements by young people that become internalised through daily interactions with others. Better care and education plans are thus facilitated, thereby enhancing the quality of developmental care provided.