Effective services to support children in special circumstances.
BACKGROUND
Children living in special circumstances, defined as those who are at risk of achieving poorer outcomes than their peers, have a particular need of good quality, accessible services to promote their health and well-being, yet may be least likely to receive them.


OBJECTIVE
This review considers the evidence for effective services to support children living in five kinds of special circumstances: (1) those at risk of offending; (2) teenage parents; (3) children whose parents have drug, alcohol or mental health problems; (4) children living with domestic violence; and (5) children who have been abused or neglected. In practice, there is often considerable overlap between these groups, and many children face multiple disadvantage. The review also aims to identify effective strategies for making support services more accessible to hard-to-reach groups.


METHODS
Relevant literature was identified through searches of databases and websites, and consultation with experts. Given the broad scope of the topic, the aim was to provide an overview of best evidence rather than to undertake a systematic review.


RESULTS
Similar themes underpin the most promising approaches to supporting children in special circumstances. These include: (1) a holistic, multi-agency approach addressing the needs of the whole child rather than compartmentalising children's social, educational, health and care needs; (2) the importance of links between adults' and children's services so that children who are in need because of their parents' circumstances can be identified and supported; and (3) the value of providing children in special circumstances with intensive, targeted support within a framework of universal provision.


CONCLUSIONS
Overall, there is a lack of well-designed evaluations of the effectiveness of UK services and programmes for children in special circumstances. The existing evidence base would be strengthened by the development of better outcome measures, by exploring the characteristics of effective services from the perspective of different stakeholders (including children and young people themselves) and by extending the current problem-oriented approach to consider the factors that promote resilience and coping.
Statham
J
J
Thomas Coram Research Unit, Institute of Education, University of London, London, UK. j.statham@ioe.ac.uk
D002648:Child; D002662:Child Health Services / Q000592:standards*; D002669:Child Welfare; D002671:Child, Exceptional; D019317:Evidence-Based Medicine / Q000379:methods; D006801:Humans; D011610:Psychosocial Deprivation; D006113:United Kingdom