Neglect Neglect

Dr Paul Rigby4 November 2015

What’s in a name ?What’s in a name ?

“Does the formal definition matter? Is it not more about the impact on the individual child and the need to intervene early before there is too much impact on them?”

“Sometimes I think neglect is used as a category even if it is really emotional abuse. Neglect may better be called ‘lack of parental care’.”

Daniel et al 2012

National Guidance 2014

Emotional abuse is persistent emotional neglect or ill treatment that has severe and persistent adverse effects on a child’s emotional development. It may involve conveying to a child that they are worthless or unloved, inadequate or valued only insofar as they meet the needs of another person. It may involve the imposition of age - or developmentally - inappropriate expectations on a child. It may involve causing children to feel frightened or in danger, or exploiting or corrupting children. Some level of emotional abuse is present in all types of ill treatment of a child; it can also occur independently of other forms of abuse.

Neglect is the persistent failure to meet a child’s basic physical and/or psychological needs, likely to result in the serious impairment of the child’s health or development. It may involve a parent or carer failing to provide adequate food, shelter and clothing, to protect a child from physical harm or danger, or to ensure access to appropriate medical care or treatment. It may also include neglect of, or failure to respond to, a child’s basic emotional needs. Neglect may also result in the child being diagnosed as suffering from “non-organic failure to thrive

Scottish Government (2015) Children’s Social Work Statistics 2013-2014 www.gov.scot/Topics/Statistics/Browse/Children/PubChildrenSocialWork/AdditionalTables2013-14

Daniel et al (2012) Review of Neglect in Scotland

• Neglect is damaging to children in the short and long term.

• Neglect is associated with some of the poorest outcomes.

• It affects children in the early years, but teenage neglect, often overlooked, is also damaging.

• 1/1000 Scottish children on register primary reason of neglect.

• We don’t know the extent of unmet need of children about whom people are worried, but whose circumstances are not judged to warrant registration or compulsory measures of care.

Year 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014

Unborns - - 18 31 22 38 44 80 93 125 120

0-4 1,020 1,026 1,044 1,232 1,200 1,341 1,262 1,277 1,340 1,333 1,402

5-10 794 710 777 855 787 845 815 803 765 806 896

11-15 414 413 435 460 412 446 391 399 407 357 449

16+ 17 8 14 15 11 12 4 12 3 23 15

Unknown - - - - 1 - 2 - 90 1 0

Total 2,245 2,157 2,288 2,593 2,433 2,682 2,518 2,571 2,698 2,645 2,882

Scottish Government (2015) Children’s Social Work Statistics 2013-2014 www.gov.scot/Topics/Statistics/Browse/Children/PubChildrenSocialWork/AdditionalTables2013-14

Ages of children subject to registration

Adolescents

• 25% of the 161 children who died or who were seriously injured over 11 years old

• 9% over 16 years of age

• ‘little or no help was being offered because agencies appeared to have run out of helping strategies’

(Brandon et al., 2008)

Aged 16+ no longer children ?

Adolescent neglect consequences

Mental health and well beingEngaging in risky behavioursRunning awayBullyingPoor educational engagement, conduct and achievementAnti-social behaviour

NB correlations not causal links Stein et al 2009

Young People’s Experiences and Attitudes

• Some young people described engaging in ‘risk taking’ behaviours in order to draw attention to the neglect and abuse they were experiencing

• Going missing was the most common way that young people in the study signalled that they were being mistreated at home (Rees et al. 2010)

• Young people often do not recognise neglect as a form of abuse

(Stein et al. 2009)

Challenges to change

• parental circumstances / risk factors that appear to particularly impact on progress include domestic violence, parental substance use, mental health and offending.

• for some families capacity and motivation for change may be limited, despite substantial multi-agency input.

• assessments and plans need to take account of individual circumstances

Rigby et al (unpublished Glasgow CPC report 2015)

Graded Care Profile (Polnay & Srivastava 1995)

adapted by Fountain 2007 and Glasgow CPC 2008

• challenges in using a standardised assessment tool……decision-making tools can only improve practice if their design and application acknowledge the centrality of professional judgment within the assessment process.

• parents and practitioners generally responded positively to the way it breaks parenting tasks down, and highlights elements of care where it is thought most targeted support is needed.

• However, …….the dialogical use of the tool (to encourage discussion between carer and practitioner about levels of care) is in tension with its diagnostic use (to grade care, particularly with a view to practitioners identifying substandard areas of it).

Are tools helpful? (Sen et al 2013)

Final thoughts (Daniel et al (2012)

There is better recognition of children in Scotland who are experiencing neglect although this is only helpful if accompanied by an effective response

GIRFEC – ability to work well and widen the options for families by the provision of support without invoking compulsory measures of care.

Formulating an effective response to neglect still poses national and local challenges

“I would say that there are adequate services to help children but whether their involvement results in a positive outcome for children in neglect cases is debateable.”

Responses to neglect

T h r es h o ld f o rin te r v en tio nP

HYSICAL

ABUSE

SEXUAL

ABUSE

NEGLECT

NEGLECT

NEGLECT

NEGLECT

& LUTON SAFEGUARDING CHILDREN BOARD

Final thoughts and your views?

Tools are being developed – will these help?

Categories of concern at registration – helpful ?

Problems with organisational and individual thresholds ?

Austerity, poverty and neglect (Burgess et al 2012/13) ?

Definitional issues? Abuse or neglect ? Does the formal definition matter?

What works in your opinion?

Thank You

paul.rigby1@stir.ac.uk