Good practice for disabled tamariki and rangatahi in care

Published: May 12, 2022

This literature review focuses on identifying good practice for disabled tamariki and rangatahi in out-of-home care (OOHC).

Tamariki and rangatahi whaikaha (disabled children and young people) in Aotearoa New Zealand are some of the most disadvantaged members of our society, experiencing inequity across all areas of their lives.

The literature review was commissioned by Oranga Tamariki and conducted by the Donald Beasley Institute using an integrative literature methodology. It draws on information from Aotearoa New Zealand and overseas and centres on Te Ao Māori, right based, and social models of disability.

The literature review particularly responds to the Oranga Tamariki goals of improving outcomes for disabled tamariki who may require a care and protection placement. This includes developing new pathways and standards for placements and better supporting whānau to remain caring for their tamariki and rangatahi.

Key findings

The literature review highlights several important findings.

Prevention, including better supports

  • Using the social model as the foundation, the rights model as the justification, and a bicultural framework as an expression of Te Tiriti o Waitangi can guide our approach to OOHC, and ensure we meet the rights, needs and will of tamariki whaikaha who are already in or who are at risk of being placed in OOHC.
  • At all stages of the care journey, the absence of accessible, adequate and affordable supports and services were the most significant barrier to tamariki whaikaha and whānau-carer wellbeing.
  • Better supports can be provided to whanau-carers of tamariki whaikaha to prevent relinquishment. Importantly, revised policy and practice framework must contain a commitment to OOHC being an absolute last resort measure for tamariki whaikaha with complex disability.
  • Prevention strategies to avoid relinquishment include:
    • systems for identifying whānau who are at risk of breaking point
    • increased financial support for whānau caring for tamariki whaikaha at home
    • psychosocial support for primary caregivers
    • safety supports for all whānau members
    • consistent respite that is accessible, affordable, and responsive to diversity.

Care, reunification, and voice

  • If OOHC is required, it should be both short-term and delivered in a setting and in a manner that is as ‘whānau-like’ as possible with appropriate wrap-around services and supports.
  • Kinship care is one of the most stable OOHC options and can create positive outcomes. However, tamariki whaikaha are less likely to be placed with extended family. There must be equal commitment to these young people residing with their whānau.
  • A lack of disability support and services means that tamariki whaikaha are much less likely to achieve reunification, particularly those with complex learning (intellectual) and psychosocial disabilities.
  • Best practice for reunification include:
    • early health and disability support for tamariki whaikaha in OOHC (in preparation for reunification)
    • support for OOHC workers to enable them to understand their responsibilities in relation to Te Tiriti o Waitangi and the UN Convention on the Rights of Persons with Disabilities (UNCRPD)
    • the implementation of support and services for whānau-carers as they prepare to reunite with their tamaiti whaikaha (such as financial, psychosocial, safety, and respite support and services).
  • 4 factors enable tamariki whaikaha voice: trusting relationships; accessible information; respect for and choice and control voice over decisions that relate to them; and effective communication.
  • Tamariki whaikaha participation in the decision-making processes is critical and must be provided for (through supported decision-making) regardless of perceptions about the extent to which tamariki whaikaha can express their will and care preferences. 

Next steps

Findings generated through this mahi are intended to inform future planning and decision-making in relation OOHC systems, support and services, and to highlight factors that empower tamariki whaikaha to fully participate and have a voice in decisions about their care.