A few weeks ago I attended a very useful briefing on neglect and a new assessment tool in Bristol available to practitioners that will help them assess the risk of neglect. The session developed my knowledge of the subject and offered a practical method to understand and evaluate the harm that neglect imposes on children – the Graded Care Profile 2 Neglect Assessment Tool. It also got me thinking about some of the mistakes that I have come across in my training related to the subject of neglect that we all need to be aware of in order to ensure we are protecting children from abuse.
- Practitioners need to understand that neglect is a form of abuse even though the harm may be indirect and the parents not deliberately harmful. Neglect of course is one of the four main categories of child abuse – the other three categories, physical, emotional, sexual, are known as ‘direct’ forms of abuse, while neglect is regarded as ‘indirect’. In order to recognise abuse, we need to see the effect of the neglect on the child, not evaluate the motivation or circumstances of the parent.
- Neglect is not just depriving children of their physical needs like food, shelter and housing, but also of their emotional needs. Not answering their cries, not providing emotional support or recognition, simply not showing love, are all forms of neglect. Horwath (2007) said there are four different realms of neglect for children:
- Physical neglect failing to provide for a child’s basic needs such as food, clothing or shelter. Failing to adequately supervise a child,or provide for their safety;
- Educational neglect failing to ensure a child receives an education;
- Emotional neglect failing to meet a child’s needs for nurture and stimulation, perhaps by ignoring, humiliating, intimidating or isolating them. It’s often the most difficult to prove; and
- Medical neglect failing to provide appropriate health care, including dental care and refusal of care or ignoring medical recommendations.
- Neglect is the most common form of abuse. One in ten children experience neglect (Radford, L. et al (2011) Child abuse and neglect in the UK today.). Neglect is the most common reasonfor taking child protection action (Child protection register and plan statistics for all UK nations for 2017.), it is the most common form of abuse that appears on Child Protection plans nationally (Child protection register and plan statistics for all UK nations for 2017), and the most common reason why professionals contact the NSPCC helpline. Professionals may sometimes ‘miss’ or become desensitized to neglect because it is so common.
- Neglect in the early years – in the first thousand days of a child’s life, or just over the age of three – is likely to result in trauma and attachment disorder for the child. The harm of neglect imposed on the developing child at such a young age is profound and for the most part, irreversible. Practitioners must be able to evaluate with judgement the effect of the neglect on children of different ages.
- On the other hand, Neglect in older adolescents can sometimes be missed because it can be assumed that young people are more independent and may not be as vulnerable to neglect as younger children. In Bristol a Child Incident Review in 2018 recorded a near miss of a self-neglecting adolescent.
- The harm of persistent, pernicious but sometimes low level to moderate neglect is commonly overlooked by practitioners who may be more geared to respond to urgent situations where the harm may be more immediately apparent. Neglect appears in about 60% of all Serious Case Reviews where the child has died or become seriously harmed as the result of abuse (Brandon, M. et al. (2013) Neglect and serious case reviews: a report from the university of East Anglia commissioned by NSPCC).
- Parents who are neglecting their children may be very challenging for professionals to work with because the families can be very chaotic and there may be a lot of competing urgent concerns that may take priority over the neglect. A child who is neglected may also be suffering from another type of abuse that may also need urgent intervention. These situations may mean the neglect can be overlooked.
- There’s often no single sign that a child or family need help so, professionals need to look for a pattern of ongoing neglect before they step in. It can sometimes be a struggle for professionals across agencies to agree that a pattern of neglect has been established at the earliest possible stage, and where the threshold for neglect for each individual family should be.
In 2017 Bristol safeguarding services experienced a government inspection that highlighted the need for an assessment tool that everyone across all the agencies could use which would objectively measure degree of neglect in families. Subsequently the ‘Graded Care Profile 2’ was selected. The assessment tool had been used in some form since 1995 in the north of England and had a strong theoretical and sound evidence base attesting to its effectiveness. It was designed to be of use for all sectors in the children’s workforce, including universal, early help, social work and court services, helping them to develop a consistent picture of the neglect that can be shared across a range of agencies.
I must say that, having trained a number of professionals for many years in the subject of neglect within my Safeguarding Basic Awareness training, I was impressed by the Graded Care Profile 2 in being a very practical but intelligent tool to assess the risk of neglect in children. I felt that any professional would be able to immediately grasp the basic concepts and find the tool immensely useful.
To find out more about this initiative and the training now offered by Bristol Safeguarding Children Board, please do contact them here.