1. Childhood neglect: integrating family support and child protection Brigid Daniel Professor of Social Work, University of Stirling With thanks to: Cheryl Burgess, University of Stirling Jane Scott, WithScotland Julie Taylor, University of Edinburgh And to Action for Children

2. Validity of international comparison?

3. How different are we?

4. Neglect Neglectful behaviour refers to a failure (usually by a parent) to provide for a child’s basic needs. Here neglect refers to physical neglect, as distinct from psychological or emotional neglect, which are included under the definition of psychologically neglectful behaviours. Physically neglectful behaviours include a failure to provide adequate food, shelter, clothing, supervision, hygiene or medical attention (Higgins, 1998; James, 1994a; US National Research Council, 1993). Psychologically abusive or neglectful behaviour refers to inappropriate verbal or symbolic acts and a failure to provide adequate non-physical nurture or emotional availability. Psychologically abusive or neglectful behaviours include rejecting, ignoring, isolating, terrorising, corrupting, verbal abuse and belittlement (Higgins, 1998; James, 1994a; US National Research Council, 1993). https://www3.aifs.gov.au/cfca/publications/australian-legal-definitions

5. There have been children I worry about when I go home at night There have been children I worry about when I go home at night Head Teacher

6. Children need parents to take care of them, give them cuddles and enough food; I was always hungry – I never knew what a chocolate biscuit was until I went into foster care Young person

7. Series of Annual Reviews http://withscotland.org/news

8. Annual Reviews of Child Neglect with Action for Children 1. Do we know how many children are currently experiencing neglect in the UK? 2. How good are we at recognising children who are at risk of, or are experiencing neglect? 3. How well are we helping children at risk of, or currently experiencing neglect?

9. Collation of UK statistics about children already ‘officially’ neglected and affected by parental substance misuse, mental health issues and domestic abuse. Analysis of policy documents. Survey of local authorities and boards. Focus groups with professionals, parents and children and young people. Online survey of views of professionals, and adults and children in the general public.

10. Action on Neglect – A Resource Pack http://withscotland.org/exchanging-training-resources 3 meetings with: an established group of 9 parents 4 young people aged 15-18. Discussions with 3 groups of practitioners in England

11. First Annual Review- 2011 1. The most common reason for children being ‘officially’ in need of state protection. 2. Official figures are only the tip of the iceberg (could be up to 1 in 10, Radford et al 2011). 3. Health and education professionals know who the children are and the majority (81%) have encountered them.

13. Not ‘slipping through the net’ Children are ‘stuck in the net’

14. How true for Australia? ‘Emotional abuse and neglect are now the most commonly substantiated types of child maltreatment…’ Protecting Children is Everyone’s Business: National Framework for Protecting Australia’s Children 2009-2020 ‘Prevalence estimates of neglect ranged from 2% to 12%...The best available evidence suggests that the prevalence rate for neglect in Australia is 12%.’ (Price-Robertson, Bromfield, Vassallo, updated by Scott, 2013) https://www3.aifs.gov.au/cfca/publications/prevalence- child-abuse-and-neglect

15. Second Annual Review and Scottish Review 2012 1. Lots of support and services being offered by practitioners from the Universal services. 2. ‘Getting it right for every child’ (Scotland) is a promising model for integration of protection and support. 3. Many attempts to develop an integrated system but still a tendency for ‘dual pathways’ and problems of 1. ‘interface’ and 2. ‘threshold’.

16. …CAF process, led by schools, children’s centres, youth services actually worked with some families with quite complex issues, so worked successfully so children didn’t become subject to statutory child protection services. Lots of work going on around this on young children and led by children’s centres and youth services so trying to get all bases covered. Survey respondent: England …CAF process, led by schools, children’s centres, youth services actually worked with some families with quite complex issues, so worked successfully so children didn’t become subject to statutory child protection services. Lots of work going on around this on young children and led by children’s centres and youth services so trying to get all bases covered. Survey respondent: England

17. “ We need better integration; good, early preventative services delivered within a multi-agency framework. We have children’s social care and early intervention services. These two do communicate with each other but they are essentially still two separate pathways and the child goes down one route or the other. We need better integration with health services and also to work better with schools. Some schools are very good but others see social services as a nuisance or as ineffective. Survey respondent: England We need better integration; good, early preventative services delivered within a multi-agency framework. We have children’s social care and early intervention services. These two do communicate with each other but they are essentially still two separate pathways and the child goes down one route or the other. We need better integration with health services and also to work better with schools. Some schools are very good but others see social services as a nuisance or as ineffective. Survey respondent: England

18. Interface and ‘Thresholds’ There can be confusion between ‘thresholds’ relating to: the severity of the neglect and associated harm to the child or the likelihood of the parents being able to accept help and make changes without the need for compulsory measures.

19. A public health model is advocated for Australia

20. ‘As Australia adopts more elements of the “family service” orientation, is there a risk that services could become too parent-focused and fail to act quickly enough to stop maltreatment? How would a balanced position best be achieved?’ (Price-Robertson et. al 2014)

21. Two different kinds of messages about working with child neglect Parents of neglected children are amongst some of the most materially and emotionally deprived; have often experienced neglect or abuse in childhood; are affected by mental health problems, learning disabilities, substance misuse and domestic abuse; are the hardest hit by policies that exacerbate inequalities in society and, require empathic and supportive responses. (Cleaver et al. 2011; Featherstone et al. 2014).

22. Neglect is highly damaging to children in the short and long term ; is associated with risk of significant harm or death; is not necessarily caused by poverty; can be intractable; is associated with lack of engagement with parents; is a serious child protection issue. (Brandon, et al. 2013; Narey 2014).

23. Often manifests as dual pathways: children ‘in need’ get family support children ‘at risk’ get child protection It is not surprising that practitioners struggle with finding the right balance, because - It doesn’t work for neglect Mirrored in systems

24. Neglected children need support AND protection - authoritative practice The right balance between- long-term support that the parents like but which doesn’t really make the child’s life much better and heavy-handed, intrusive state intervention which, at its extreme, entails unjustified removal of a child from home. ‘Effective family support is protective, effective protection is supportive.’

25. Voluntary compulsory spectrum Empathic responses, coupled with concrete practical and emotional help, often offered by universal or third sector services can stave off many future disasters. But, some parents are not able to use of this kind of voluntary support: some find it hard to admit to needing help, some don’t really see what the problem is, some deliberately evade all professionals. May require involvement of statutory services to help assess this.

26. The fulcrum at the centre of the support and protection balance is parental capacity and willingness to change Horwath, J. & Morrison, T. 2001. 'Assessment of parental change.' In J. Horwath (Ed.) The Child's World. London: Jessica Kingsley Publishers. Dawe, S. & Harnett, P. H. 2013. 'Submission to the Queensland Child Protection Commission of Inquiry.' Griffith University. (see also - C2C) Ward, H., Brown, R. & Hyde-Dryden, G. 2014. Assessing Parental Capacity to Change when Children are on the Edge of Care: an Overview of Current Research Evidence London: Department for Education. Scottish Government (2012) National Risk Assessment: To Support the Assessment of Children and Young People. Edinburgh: Scottish Government.

27. Authoritative practice Couples empathic support for parents with an unwavering focus on improving children’s lives.

28. Third Annual Review- 2013 Views of parents, children and young people 1.Confirmed the prevalence of neglect, especially as recognised by children 2.Offered insights into the experience of neglect and the kind of help that parents and children appreciate. 3.Helped to illustrate the spectrum of support that is required. 4.Illustrated that parents and children can also recognise the need for authoritative practice.

29. Protective support and Supportive protection

30. Protective support: recognising the structural Cuts and changes to welfare provision are having an impact on families AND on services. Parents were struggling with poverty, tight budgets and housing costs. ‘Greater poverty or deprivation’ was the top reason given by professionals for increases in suspected child neglect. All professional groups said that spending cuts will make it more difficult to intervene in the future.

31. It’s really hard to manage on the money even if you’re working. If you’re a single parent with one child you are better off working, but if you have more than one child you’re not Our area is not one which you could let the kids play out by themselves. One park has a warden, which is fine, but others are strewn with needles and broken glass and teenagers often use the parks at night. We also have to move into areas where we don’t have family or friends.

32. Please don’t judge my parents, just because they are struggling doesn’t mean they are bad… The Government needs to listen and sometimes even to angry people as there could be really good reasons underneath about why people are angry.

33. ‘…parents who…have very limited parenting skills are often attempting to meet the needs of their child in a context that even the most competent parents would find challenging ‘(Horwath 2007: p. 38). Practitioners need to 1. recognise the extent to which poverty and deprivation elevate the likelihood of neglect and 2. take proper account of the effects of poverty and deprivation when working with families.

34. Protective support: empathic support Featherstone et al. (2014) suggest the system has become so child-oriented that it has lost sight of the needs of parents They could show empathy about the causes of our difficulties. Being a social worker is not just a name, you have to have some heart.

35. ...[being] shown how to parent not just telling us where we go wrong. My family support worker just sat and listened and asked ‘how can I help?’ rather than telling me what I needed – or what they thought I needed.

36. ‘Family support’, often delivered by the third sector, has to include attention to the child’s needs for protection. e.g. Action for Children’s UK Neglect Project – an Intensive Family Support programme. Evaluation of 85 cases showed that in 79% there was improvement or prevention of neglect: ‘The ability and willingness on the part of parents to engage with services was a crucial factor in deciding whether progress would be made or children removed for accommodation’ (Long et al. 2012: p.6).

37. Supportive protection: providing authority But we’d like you to know that, even though it can be a pain at the time and we may really hate you when you’re on our backs, some of us look back and think that the threat of Child Protection Plans and having our children taken away did make a difference to us and made us get our act together. And also having to go to Child Protection meetings meant that people did their jobs properly and did what they said they would

38. Maybe the mum has a boyfriend who wants all the attention and the mum might feel intimidated. He might ask her to go to the pub and she has to go and then the kids get left alone. He gets the priority. And the kids are frightened to tell anyone, that’s hard. It’s hard for social workers – they have to be suspicious because some parents are abusive, so they need to be vigilant. Some parents are very clever at covering things up and talk a good game. The social workers have to look at the child’s welfare and ask the right questions.

39. My mum couldn’t think things through – she reacted too quickly, she did things without thinking, she panicked and then she didn’t do things right. Some parents you just can’t help

40. Sometimes no-one believes you or no-one comes to your house to see what’s going on so no-one might know or can tell from the outside. Some of us had family support for years and years and it didn’t really help us much. Please respect our views if we don’t want to have this sort of help... Some parents can change and others can’t. Some are given too many chances and we are left too long at home

41. e.g. Family Drug and Alcohol Courts FDAC showing promising outcomes. Strict timescales and expectations plus intensive support and therapy. When considering the effects of neglect swifter decisions about permanent placements were made for children whose parents were not able to respond to the intensive package of support. (Harwin et al. 2011) (See also Farmer and Lutman 2014)

42. Supportive protection: accessible services Who would children turn to?

43. What young people said stops them from going to adults for help: Being unsure whether they could be trusted to keep confidences and not tell others or their parents Not knowing whether the adult is a ‘safe person’ Uncertainty about whether the adult has time to listen and what their reaction will be Uncertainty about whether the adult has training to be able to help Fear of the story being ‘twisted’ in some way Fear of other children finding out and being bullied

44. No person to turn to… My pets – they give me cuddles I used to talk to my dog and it really helped me

45. Supportive protection: inter-sectoral Teachers Teachers can be good – especially support teachers if they can find a quiet space to talk She (the teacher) realised but I think she was worried about asking me. They need more training and also need to have the time to ask children what’s going on at home – I would have told her if she’d asked me. But she was kind to me, all the same

46. Social Workers My social worker is good – she is very nice and friendly, interested in me You have to outsmart them (social workers) – prove that you don’t need them Social workers just treat you like a case, rather than a person The social worker just didn’t try to understand, they thought they knew best

47. Health Visitors …sometimes you can ask the Health Visitor but they disappear too quickly My good experience with my health visitor is because she will come and visit, try and explain things but without judging, and she is flexible. But it can come down to personal taste and how you get on together.

48. Supportive protection: being proactive It can be a big burden for a child to ask for help I think it’s the adults who need to approach children if they think something’s not right, it’s not up to the children to approach them. It can be a big burden for a child to ask for help Some children are told by their parents not to tell or talk to other adults – so it’s up to the adults who work with children to notice’.

49. A building with staff who people can go to for help. Help for everyone for everything, the lobby would be all nice and painted; they would be very nice and kind, ask what the problem is and then help to sort it out. So you don’t have to go to all different places. A young person’s blueprint for services

50. Ok, maybe there are some differences…

51. Journal papers Burgess, C.; Daniel, B. and Scott, J. (submitted) ‘Child neglect: how is practice developing in the UK?’ Developing Practice. Daniel, B. (forthcoming) ‘Child neglect: integrating family support and child protection’ in McGhee, J. and Waterhouse, L. (eds) Challenging Child Protection London: JKP Daniel, B. Forthcoming. 'Why have we made neglect so complicated? Taking a fresh look at noticing and helping the neglected child.' Child Abuse Review, Article first published online: 21 NOV 2013 DOI: 10.1002/car.2296. Daniel, B.; Burgess, C.; Whitfield, E.; Derbyshire, D. and Taylor, J. (2014) ‘Noticing and helping neglected children: messages from Action on Neglect’ Child Abuse Review (special edition on neglect), 23, 4, 274-285.

52. Brandon M, Bailey S, Belderson P, Larsson B. 2013. Neglect and Serious Case Reviews.University of East Anglia/NSPCC: Norwich. Cleaver, H., Unell, I. & Aldgate, J. 2011. Children’s Needs – Parenting Capacity. Child Abuse: Parental Mental Illness, LearningDisability, Substance Misuse and Domestic Violence (2nd edition). London: The Stationery Office. Council of Australian Governments (2009) Protecting Children is Everyone’s Business: National Framework for Protecting Australia’s Children 2009-2020 Canberra: Commonwealth of Australia. Farmer, E. and Lutman, E. (2014) ‘Working effectively with neglected children and their families: what needs to change?’; Child Abuse Review, 23, 262-273. Featherstone, B., White, S. & Morris, K. 2014. Re-imagining Child Protection. Bristol: Policy Press. Harwin, J., Ryan, M., Tunnard, J., Pokhrel, S., Alrouh, B., Matias, C. & Momenian-Schneider, S. 2011. The Family Drug and Alcohol Court (FDAC) Evaluation Project Final Report. London: Brunel University. References

53. Horwath, J. 2007. Child Neglect: Identification and Assessment. Houndsmills: Palgrave Macmillan. Long, T., Murphy, M., Fallon, D., Livesley, J., Devitt, P., McLoughlin, M. & Cavanagh, A. 2012. Evaluation of the Action for Children UK Neglect Project.. Manchester: Salford University. Narey, M. 2014. Making the Education of Social Workers Consistently Effective: Report of Sir Martin Narey’s Independent Review of the Education of Children’s Social Workers. London: Department for Education. Price-Robertson, R.; Bromfield, L. and Lamont, A. (2014) International approaches to child protection: What can Australia learn?, CFCA, AIFS Radford L, Corral S, Bradley C, Fisher H, Bassett C, Howat N, Collishaw S. (2011) Child Abuse and Neglect in the UK Today. NSPCC: London.