Turning the corner on child neglect
Dr Alice Haynes (@AliceHaynes85), Senior Policy and Research Analyst at the NSPCC, discusses the need for a system-wide preventative approach to child neglect.
Child neglect can seem like an insurmountable challenge. It continues to be the most prevalent form of child maltreatment in the UK [i], with an estimated one in 10 young adults having been severely neglected by parents or guardians during childhood [ii]. Our response to child neglect often comes too late, triggered once children have already suffered. The impact of that ‘late intervention’ [iii] reverberates across families, communities and generations.
And yet, new evidence is beginning to show us the way. Drawing on a five-year programme of learning developed in collaboration with a wide range of partners [iv], the NSPCC has set out a framework for preventing and intervening early in neglect. The Thriving Communities Framework[v] identifies a range of concrete actions at different levels in society – children, parents, universal services, communities and local government – that will make a difference in preventing and intervening early in child neglect.
Sitting across these actions are three essential building blocks:
Evidence shifts practice from what we think works to what we know works [i]. There has been a woeful lack of research on the effectiveness of interventions with children and families. This is starting to change [ii], and we need to continue to build the evidence base, testing our preventative and early help provision for neglect to find out more about what works, with which families and why. Where we do know what works, we need to make the most of that knowledge by ensuring evidence-based services are commissioned locally.
To contribute to the evidence base, the NSPCC has evaluated interventions with children and families where neglect is a concern, testing to see if they are effective at tackling neglect within the UK context. We have evaluated two assessment tools aimed at supporting practitioners to measure neglect and make the right decisions for a child - the Graded Care Profile [iii] and the North Carolina Family Assessment Scale [iv] – and found both to be effective. We’ve also tested three services for children and families – Video Interaction Guidance (VIG), SafeCare® and Standards and Pathways Triple P. The findings from the VIG [v] and Triple P [vi] evaluations showed that following both programmes children's emotional and behavioural difficulties, and levels of parenting, improved. The evaluation of Safecare® [vii] found that the programme helped prevent the need for further intervention for neglect. Of the families with the most difficulties at the start of the programme (those which SafeCare® practitioners considered significant enough to warrant a statutory intervention for neglect), two thirds improved to a point where no such intervention was considered necessary.
Knowledge and awareness matters
Understanding what child neglect looks like, why it happens and what to do about it is essential in tackling it. If people understand about healthy child development, they are more likely to notice earlier when parenting (both their own and others’) is not meeting the needs of a child. If people understand why neglect happens, that it is often the result of parents being under significant pressure as a result of, for example, mental health problems, domestic abuse, substance misuse or past trauma[viii], they are likely to want to offer support. If people know how and where they can get help, whether that is children or parents themselves or community members and practitioners, we have a better chance of getting that help to families at the earliest possible point.
If practitioners working with families have the knowledge and skills to help parents engage with sources of support, we have a better chance of that help being effective. And if local decision-makers understand the urgency of the problem of child neglect, and they are equipped with evidence-based approaches to tackling it, they can make sure that prevention and early help is supported and enabled at a strategic, area-wide level.
Child neglect happens when relationships do not form or when they break down. Most important is the relationship between parents and their child, but the relationships that orbit around that are also vital in tackling neglect. The relationships that parents have with other adults can make a real difference to the capacity and ability of parents to care for their child. Parenting poses challenges for most of us as parents, and we need support from friends, family and our local community to manage those challenges. Parents also benefit from help from professionals, whether that is from support that is provided to all new parents from universal services like midwives and health visitors [ix], or help for specific challenges that some parents face, like mental health problems or substance misuse. Relationships are vital for this help to be effective.
It is not only parents who need support from practitioners, but also children and young people. A positive relationship between a child and their teacher or GP, for example, might be the difference between a child telling about neglect at home or suffering in silence. Finally, the quality of the relationship between different practitioners working with children and families is important to preventing neglect. Practitioners need to be able to reflect on and discuss concerns together, to get advice, to challenge one another and find the right solutions for the children and families they work with.
By using the evidence, working together and building on these three key principles, we can prevent neglect.
If you would like to read more about our policy recommendations for moving towards a more preventative approach to child neglect see Thriving communities: a framework for preventing and intervening early in child neglect.
To learn more about the NSPCC’s work on child neglect, go to www.nspcc.org.uk/tacklingneglect.
Related Research in Practice resources:
[i] Chaffin, M. & Friedrich B. (2004). Evidence-based treatments in child abuse and neglect. Children and Youth Services Review. 26(11), 1,097–1,113.
[iii] Johnson, R. & Cotmore, R. (2015). National evaluation of the Graded Care Profile. London: NSPCC.
[iv] Williams, M. (2015). Evidence-based decisions in child neglect: An evaluation of an exploratory approach to assessment using the North Caroline Family Assessment Scale. London: NSPCC.
[v] Whalley, P. (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.
[vi] 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.
[vii] Churchill, G. (2015a). SafeCare: evidence from a home-based parenting programme for neglect. London: NSPCC.
[viii] Sidebotham, P. & Heron, J. (2006). Child maltreatment in the “children of the nineties”: a cohort study of risk factors. Child Abuse and Neglect, 30 (5), 497–522.
[ix] Haynes, A. (2015). Realising the potential: Tackling child neglect in universal services. London: NSPCC.