Disruption Chair Post Meeting Questionnaires
‘Improvingoutcomes for children and families involved in adoption’
DISRUPTION CHAIR’S POST MEETING QUESTIONNAIRES
NAME OF CHAIR :
DATE MEETING HELD:
Disruption Meeting Case
Identification Number: (Ad22 to provide)
Name of Child’s Agency:
Name of Family’s Agency:
Please state whether this was a single child placement or sibling placement:
Duration of placement:
Details of all children involved in the Disruption: Child 1:
Child 2 :Child 3 :
Other Children: / Name Age Gender Ethnicity
Name Age Gender Ethnicity
Name Age Gender Ethnicity
Name Age Gender Ethnicity
Name of any child/Children who have remained in the placement:
/ NameName
Did Prospective Adopters attend the Disruption Meeting?
Pilot document agreed at RAMs meeting 14th June 2010
Review date February 2011
Page 1 of 7
Disruption Chair Post Meeting Questionnaires
CHILD’S NAME:
POST MEETING QUESTIONNAIRE
IDENTIFIED DISRUPTION FACTORS –AGENCY
Indicate your view with an x as approriate
AGENCY
/ VerySig. / Sig. / some sig. / No
Sig. / COMMENT
Poor assessment of child’s needs:
Lack of Preparation:
Child:
Life Story Work:
Goodbye Visits:
Delay:
Prior to Best Interest:
Post Best Interest:
Sibling Groups:Poor assessments re keeping siblings together:
Problems arising from placing siblings together from separate foster care placements:
Change of Workers at crucial times:
Lack of availability of Workers:
Concerns emerging during introductions not given sufficient weight:
Contact issues – unclear and not fully addressed:
Factors re assessment and preparation of adopters:
Introductions too hasty or too ambitious:
Inadequate preparation:
Lack of understanding about attachment issues:
Not clear why a particular family is being chosen:
Matching:
Child’s information out of date:
Unclear understanding why particular family has been chosen:Inadequate assessment of adopters:
Foster Carers:
Lack of clarity regarding their role:Foster Carers not co-operating with plan:
Adoption support plan not adequate:
IDENTIFIED DISRUPTION FACTORS – AGENCY Cont
Any other factors not identified above:
COMPLETED BY:
AGENCY:
DATE:
Pilot document agreed at RAMs meeting 14th June 2010
Review date February 2011
Page 1 of 7
Disruption Chair Post Meeting Questionnaires
CHILD’S NAME:
POST MEETING QUESTIONNAIRE
IDENTIFIED DISRUPTION FACTORS – CHILD
Indicate your view with an x as approriate
CHILD
/ VerySig. / Sig. / some.
sig / No
Sig. / COMMENT
Attachment Issues:
Numerous moves:
Chaotic background:
Numerous previous carers:
Child’s history:
History of abuse/neglect:
History of parental substance misuse:
History of domestic violence in birth family:
History of sexual abuse:
Delay/drift/too long in previous foster placement:
Previous losses not dealt with:
Difficulties relating to separation from siblings:
Lack of goodbye visit to birth parents:
Child’s lack of understanding:
Previous unrecognised emotional/health issues or abuse issues:
Previous disruption of adoptive placement:
Identity issues:
Child placed in trans-racial placement:
Learning difficulties:
Child’s behaviour:
Child regressed:
Sexualised behaviour:
Lying:
Stealing:
Disobedient/destructive:
Cruelty to animals:
Food issues:
Soiling:
Extreme distress:
Poor sleep:
Jealousy:
Housing/room sharing:
IDENTIFIED DISRUPTION FACTORS – CHILD continued
Poor relationship with adopters other child/children:Difficulty sharing “parents”:
Other issues not identified above:
COMPLETED BY:
AGENCY:
DATE:
Pilot document agreed at RAMs meeting 14th June 2010
Review date February 2011
Page 1 of 7
Disruption Chair Post Meeting Questionnaires
CHILD’S NAME:
POST MEETING QUESTIONNAIRE
IDENTIFIED DISRUPTION FACTORS – ADOPTERS
Indicate your view with an x as approriate
ADOPTERS
/ VerySig. / Sig. / Some sig. / No
Sig. / COMMENT
In Respect of Child:
Unrealistic expectations of child:
Lack of information about child:
Reality of lack of early emotional response from child:
Unprepared for reality of rejecting behaviour from child:
Unprepared for level of impact of perceived behaviour
In respect of Sibling group placement:
Adopter’s rejection of individual child/children within a sibling group:
Overwhelmed by impact of individual needs within a sibling group:
Impact on existing children within family
Placement creating Negative impact on family lifestyle:
Change in original preferred approval status:
Life change impact underestimated:
Difficulties with Workers inc. breakdown of communication with agency:
No allocated support Worker:
No proactive Support Worker:
Death or illness in adoptive family:
Feelings of lack of control – i.e. timing of Introductions etc.:
Lack of understanding relating to impact of Introductions:
Introduction process overwhelming:
Unwilling to work closely with foster carers:Conflict in respect of parenting skills /abilities:
Pilot document agreed at RAMs meeting 14th June 2010
Review date February 2011
Page 1 of 7
Disruption Chair Post Meeting Questionnaires
IDENTIFIED DISRUPTION FACTORS – ADOPTERS Cont
Impact of differing parenting styles
Poor relationship with foster carers
No early meeting with Foster Carers
Less than two year age gap with existing childrenAdopters not seen photograph of child/ren
Timescales – process – initial interest to placement
Early return to work of main carer
Rejection by child of one of the carers
Unresolved loss issues
Impact on adopters’ relationship with each other
Reluctance to seeking advice/support from Agency
Inflexible Parenting Style
Relationship instability in past not assessed properly
Experience of previous Disruption
Other Issues not identified above:
COMPLETED BY:
AGENCY:
DATE:
Pilot document agreed at RAMs meeting 14th June 2010
Review date February 2011
Page 1 of 7