Making a difference to child neglect
Paul Whalley and Gillian Churchill, NSPCC Senior Evaluation Officers, discuss how working with families at risk of neglect has produced positive outcomes.
The NSPCC has now completed a five-year learning programme about neglect with our local partners. Together we have developed and implemented two assessment approaches and three services to help achieve 'healthy living environments and healthy relationships for children'.
From the evaluations of Video Interaction Guidance (VIG) [ii] and Pathways Triple P [iii] we learned that children's emotional and behavioural difficulties, and adults’ levels of parenting, improved following both programmes. The evaluation of SafeCare [iv] found that the programme helped prevent the need for further intervention in relation to neglect, amongst families with the most difficulties. All of this evidence shows that with the right knowledge and support, it is both possible and realistic for practitioners to make a difference with neglect.
We’re going to talk through these three services, looking at how they worked to make a difference when tackling neglect and improve outcomes for families. We will highlight three specific examples where a practitioner worked with parents to improve their approach.*
SafeCare is a structured, preventative programme for use with parents of children under six who are at risk of experiencing significant harm through neglect. It focuses help on three key areas that are known to be associated with neglect: parental interaction with the child or infant; home safety; and child health. The programme is delivered within the family home, providing natural opportunities to train parents in practical skills to use with their children.
Harsha Yedev, NSPCC Children’s Services Practitioner, explained how SafeCare helped one family she worked with:
‘SafeCare helped a dad to understand his children’s emotional and physical needs. The children were all of different ages and gender, so dad wanted to put structured routines in place to manage appropriate behaviours. He had previously undertaken several parenting programmes. However, modelling and practising the parenting skills at home helped to build his own confidence in his parenting abilities. The parent handouts supported the learning and the importance of building positive relationships.’
The evaluation showed that parents thought SafeCare helped them develop their parenting knowledge, skills and behaviour.
They felt that:
- establishing a trusting relationship with the practitioner and a partnership approach was vital in helping them engage with the programme
- receiving the programme at home provided a safe place to practise their parenting skills
- receiving positive and constructive feedback helped to build confidence in their parenting abilities.
Video Interaction Guidance
Video Interaction Guidance (VIG) uses edited video clips of parent/child interactions to help parents become more attuned and responsive to their child’s verbal and non-verbal communications. Parents can see and understand things from a different perspective and from this identify feelings, and develop their own ideas and suggestions about the changes they would like to make to improve relationships within their family.
Kay McGregor, NSPCC Children’s Services Practitioner worked with a mum and her 5-year-old son:
‘Through reflecting on interactions within the film in the shared review the mother could see herself touching her son’s arm, and also sitting with her arm around him whilst reading together. The mother was able to reflect on how this felt and see how her son responded to this touch from his mother: for example, he sought more by snuggling into her. She was able to see how much her son needed her love and attention and how, in giving this attention to him, this then gave her son confidence and self-esteem. The mother learnt how she could use her tone of voice, expression and body language to communicate with her son. She learnt what it felt like to play. It was a delight to see both engage in imaginative play, while laughing and enjoying their time together.’
The evaluation showed that relationships between parents and their children improved after Video Interaction Guidance. Parents reported better involvement and communication with their child and were able to set limits for their child. Receiving practical and emotional support for their parenting helped these changes.
Partnership between parent and practitioner was key. It was important that the VIG practitioner was committed, non-judgemental and able to provide new ideas and suggestions.
Parents reported improvements in their child’s behaviour by the end of the programme, for example, seeing fewer temper tantrums or fighting, and increases in their child’s positive behaviour including sharing and being considerate, helpful and kind.
Pathways Triple P
Pathways Triple P helps parents to:
- manage stress, anger and mood swings
- improve how they communicate with their child
- improve their parenting skills (including how to handle behaviours that challenge)
- increase confidence in their parenting.
We visit families at home and help parents agree some goals to aim for. We then support parents to reach their goals both during the visits and in the future.
Lee Hawksley, Children’s Services Practitioner, worked with a mother with four children, where one of children was presenting behaviours that challenged:
‘An essential part of Triple P is supporting parents to develop skills in promoting desirable behaviour. From the start it became evident that mum was struggling to identify any positives about her daughter and would constantly challenge her behaviour. This was likely to be making her daughter feel more isolated from the family, causing her to misbehave more. After spending time helping mum to understand how her negative responses affected her daughter’s behaviour, time was then spent supporting mum to change her approach.
‘For example, she agreed to try and praise her at least five times per day. Although she struggled and didn’t always meet her target she was able to identify times when she had praised her daughter. Further observation sessions reinforced how Mum could praise and reward her child. As the sessions progressed it became more noticeable that her daughter was becoming less defiant and that the home environment was more relaxed.’
As with Video Interaction Guidance, the evaluation found that parents thought a key element of Triple P's success was having a practitioner who was flexible with new ideas and suggestions and non-judgmental in their approach.
Relationships between parents and their children significantly improved following Pathways Triple P. For example, parents reported improvements in communication with their child and in setting limits and giving appropriate autonomy to their child.
All our neglect services have been carefully evaluated and we have received input from members of an Expert Advisory Group. This is the first time that such a programme has been rolled out specifically for child neglect in the UK.
We want to keep building the evidence base by testing our early help provision for neglect to find out more about what works, with which families and why, and whether improvements can be sustained over time. For example, the NSPCC has developed a new evidence-based neglect model, Thriving Families. This model provides a co-ordinated and concentrated local response to child neglect which aims to be flexible enough to fit the needs of families and referring agencies locally. It consists of two distinct elements: the Bespoke Assessment Approach, which is a holistic assessment for neglect, and the three proven intervention services described above (SafeCare, Triple P and Video Interaction Guidance). Thriving Families is being implemented in five sites in England and Wales, and will be evaluated over the next five years. The evaluation will test whether we are successful in matching families’ particular needs with the best fitting service and whether this happens in a more timely way.
*Identifying features of parents and children have been changed.
[i] Brandon M, Bailey S, Belderson P, Larsson B (2013) Neglect and Serious Case Reviews. NSPCC and the University of East Anglia.
[ii] Whalley P, Williams M (2015a) Child neglect and Video Interaction Guidance: An evaluation of an NSPCC service offered to parents where initial concerns of neglect have been noted. London: NSPCC.
[iii] Whalley P (2015b) Child neglect and Pathways Triple P: an evaluation of an NSPCC service offered to parents where initial concerns of neglect have been noted. London: NSPCC.
[iv] Churchill G (2015) SafeCare – parents’ perspectives on a home-based parenting programme for neglect. London: NSPCC.