I am a professional working in a safeguarding field, but more importantly, I am the mother of a child with multiple health and development issues. I have wanted to write about early intervention and the CAF (Common Assessment Framework) process for some time as I feel it is an invaluable but underused resource that produces great benefits to children and families.
CAF is a process to help children who have problems across a range of issues or difficulties that cannot be helped by one agency alone. As a parent, I found the process invaluable. I also saw lots of benefits to the professionals involved in my son’s care. However, the place where I saw the most impact was in my son himself and in the progress he made at a key point in his early life.
My son had his first CAF when he was three. He had speech delay, sporadic hearing difficulty, breathing problems, lack of progress with toilet training and some behaviour issues. We were doing what we could as parents and had already made use of community resources and self-help materials. My son was also receiving intervention from the speech department, on-going assessment from the audiology department and support with his toilet training from the Sure Start Children’s Centre where his childcare was provided.
Preparing our son for nursery
Our key hope was to ensure our son was prepared as well as possible for the start of state nursery. We didn’t want him to start at the school nursery incontinent, incomprehensible and with difficulties paying attention. This aim was starting to be difficult because of the number of agencies and services involved in my son’s care.
The range of problems and level of intervention meant that good communication and co-ordinated support were essential. It is exactly this type of situation that CAF was designed for. The CAF process allows for assessment across a range of areas. This holistic approach tends to represent a family’s perspective of a child’s strengths and support needs better. My son’s speech development was linked to his difficulties with attention etc. so it was helpful to look at all of the problems together. Having done this, there were then clear areas of involvement from particular professionals and departments.
The CAF process also collects information of everyone involved in one central place. This is helpful to everyone connected to the child. The process also allows the family to identify outcomes. Again, this better matches a family’s perspective. The ‘problem’ may not be solved when a single, time-limited intervention is over. However, there are many places where the impact of the intervention may be supported or embedded. The CAF process looks beyond individual service intervention and identifies the many ways in which an outcome can be supported.
A co-ordinated and outcome focussed approach
My son was referred to a community paediatrician for a generalised development assessment. This led to a further referral to ENT (Ear, Nose and Throat department) and a diagnosis of severely enlarged tonsils, obstructive sleep apnoea and a dust mite allergy. Treatment for each of these conditions led to an improvement in breathing, speech and behaviour.
My son was also referred to a child psychologist within the CAPS Team (Child and Parent Support Team). She identified that there was a link between my son’s delay in toileting, his speech/ comprehension difficulties and his impulsive behaviour. This meant that we needed a separate programme to explain and encourage continence for him. This was not advice we would have found in any readily available book on toilet training or childhood development and it had a massive impact on my son’s continence.
And most importantly:
My son had these interventions BEFORE he started at full time school nursery. The process meant that he benefited from early intervention at a key time in his development that ensured that some preventable problems were, quite simply, prevented. It also meant that he started nursery with one multi-agency plan for intervention, including a summary of everyone involved and what they were committed to do as part of their regular remit of work. This was incredibly helpful for the school and guided his early school action plus input.
Challenges to getting a CAF
Getting a CAF is not always easy. There is a lot of misunderstanding about the role it can play. Many professionals think it is only for serious child protection cases – times when there is a risk of serious harm and where that harm will most likely come from the action (or inaction) of parents. Other professionals worry it is time consuming or might commit them to doing things that are outside of their job.
I understand these concerns; people are busy, there are so many commitments and targets that need to be met. However, I also know that no professional gets up in the morning with the intention of failing a child due to a lack of communication. CAFs are specifically there to help children (and professionals) where no agency alone could possibly solve a problem. It is great that everyone has their own specialist area, but some children have complex problems that need a co-ordinated approach for any one intervention to be successful.
It is also true that there are some times when there are risks posed when a CAF would be used (e.g. where there is domestic abuse that is not of a level where more intensive/statutory intervention is considered necessary). However, CAFs are most effective when they are used as a multi-agency approach to help children with complex needs or else as a tool to guide early intervention for a child who could not possibly meet their potential without this early support.
Perspective of a professional
When it comes to my son’s case, I am first and foremost, a parent. However, I work in a connected safeguarding field and have another perspective as well. Five things that I know from this perspective are:
- Professionals are often as frustrated as parents by lost referrals, uncoordinated support and lack of communication. This makes their job harder and can be very demoralising. A CAF is designed to improve joint working which is to the benefit of everyone.
- Professionals like other people to think well of their service. A CAF won’t get you anything for your child that you are not entitled to. However, it will get you the best of whatever is available that you are eligible for.
- Professional embarrassment is a powerful force. If someone says they are going to do something they are unlikely to turn up to a meeting of their peers and admit they haven’t done the one reasonable thing they agreed to do at the last meeting.
- Parents will ask for help for anywhere they think they can get it. This can lead to duplicated effort from different professionals. A CAF prevents this happening and means that everyone is clear on who is doing what.
- People who are doing this kind of work like to see the impact of their intervention and adore success stories. A CAF is an excellent way for professionals to see the role their work plays in far larger successes such as making a wide-ranging and long term impact on the life of a child and a family. It’s really nice to share that success.
Ultimately, a CAF is just a set of forms and series of meetings. It is the process that this unlocks that is truly helpful to a child. The problems above are not the only difficulties my son has faced and the CAF described is not the only one he has had. I would recommend the CAF process to families with children facing multiple difficulties. I would also recommend involvement for any professionals involved in working with children and families.
I am grateful to the CAF process and all the professionals involved for helping us to work towards our priorities and to deliver their interventions in the best interests of my son. It helped relieve stress for my family, improved the quality of support my son received and will ultimately bring my son closer to achieving his potential as an individual. As a parent these are some of our key priorities and outcomes worth working towards.
Have you used the CAF process? What were your experiences? Leave a comment below