Responding to children with complex needs
What's Important To Us
Working with children who have complex needs requires a multi-disciplinary approach; no one agency can meet these needs satisfactorily or safely on their own. Taking this approach will ensure these children are receiving the right response from the right people within the best possible timeframe.
There is no ‘quick fix’ option when it comes to working with children who have complex needs. These needs will likely have built up over months and sometimes even years, and cannot be easily resolved. Working with, and responding to, children with complex needs requires good planning, widespread consultation, and a willingness to think creatively about how the needs can best be met within the child’s own community.
What are complex needs?
Rankin & Regan (2004) identify the essence of complex needs as implying both breadth (multiple needs that are interrelated or interconnected) and depth of need (profound, severe, serious or intense needs).
According to Rosengard, Laing, Ridley & Hunter (2007), children with complex needs may have experienced (or be experiencing) one or a combination of the factors including mental ill-health, disability, developmental delay, substance abuse, challenging behaviour at school/home, poor living conditions, abuse or neglect.
How should we respond?
The impact of having a child with complex needs in the family can have both positive and negative consequences. On the one hand, the family may be proud about the accomplishments that the child has made; on the other, they may feel sad about the child missing certain opportunities as a result of their complex needs. In most cases, families will demonstrate incredible resilience and develop coping strategies to help them respond to their child’s challenging behaviour. When families are struggling to respond to these complex needs, interventions need to empower them so that they remain in control of their lives and the life of their child (McConkey, Barr & Baxter, 2007).
In working with children who have complex needs, keep in mind the following core values:
- Parents know their children better than anyone else so treat them respectfully as equal partners given the expertise they have in the care of their child
- Professional supports need to be co-ordinated and responsive to the needs of individual children and families
- Risks to the child need to be managed in ways that provide safety and a quality of life to the child and their family
- Partnership working across disciplines and agencies is essential (McConkey, et al., 2007).
When responding to children with complex needs, there are some key things we can do to help us with our assessments and to make successful plans:
Consult widely: If a child has a disability, talk with your Regional Disability Advisor as early as possible to ensure that the assessment and plan has captured the main issues and has looked at the wide scope of interventions available to the child. Are there other professionals or agencies that we should be consulting with (i.e. a paediatrician, special health unit or school) that could meet the child’s needs better?
Do your research: Take the time to become a ‘pocket expert’ about a child’s disability or special need. The internet, library and support agencies (i.e. Epilepsy Society) can provide educational material that will give depth to your assessment and inform your interventions. It is also important to connect families with local support agencies that can help them with education and practical advice.
Give support: Families often struggle to provide care for a child with complex needs and continued crises can discourage a family to the degree that they want to ‘walk away.’ We need to be attentive to the support needs of the whānau, involve them in the decision-making about the child, and discuss their support needs with providers. Make sure that there are regular liaison meetings between you, service providers and the child and their family to keep the child’s needs at the forefront of decision-making.
Provide a ‘one team’ response: If a child with complex needs offends, families are looking for a Child, Youth and Family response that is professional, effective and timely. The difference between youth justice and care and protection is an organisational issue, not a family issue, and we need to provide a response that best meets the needs of the child and their family. Robust plans will be made if youth justice and care and protection meet together following allocation and continue to meet or consult to ensure that the plan continues to be robust. Use the Child and Family Consult to identify gaps and make decisions about what response is needed. Remember, when a child offends, sound collaborative plans will ensure that this first offence is their only offence.
Seek specialist knowledge: When a child is exhibiting harmful or concerning sexual behaviour, it is important to remember that they still have the needs for belonging, education and family relationships that all children have. Assess these needs and recognise the importance of keeping other children safe and provide the right therapeutic interventions. When a child is involved in harmful or concerning sexual behaviour, or this is suspected, it is important to access specialist knowledge to assess risk and therapeutic needs to bring about the best outcome for the child.
See the Key Information: Working safely with families where children are displaying concerning sexual behaviour for more information.
References
McConkey, R., Barr, O., & Baxter, R. (2007). Complex Needs: The Nursing Response to Children and Young People with Complex Physical Health Care Needs. Belfast, Ireland: Department of Health, Social Sciences and Public Safety/University of Ulster.
Rankin, J. & Regan, S. (2004). Meeting Complex Needs: The Future of Social Care. London, UK: Turning Points/Institute of Public Policy Research.
Rosengard, A., Laing, I., Ridley, J. & Hunter, S. (2007). A Literature Review on Multiple and Complex Needs. Edinburgh, Scotland: Scottish Executive Social Research.
