Addressing cumulative harm: responding to chronic child maltreatment in the context of an intensive family support service

Abstract

PurposeAdverse childhood experiences that are consistently experienced over a sustained period of time throughout childhood result in an accumulation of childhood adversity, which is often referred to in the literature as cumulative harm. This paper aims to closely examine statutory child protection practice, which favours an episodic and incident-focused approach to assessing risk and harm, failing to account for the evaluation of the accumulation of adversity and harm, commonly experienced by children exposed to maltreatment. The paper defines an existing gap in practice frameworks to adequately identify and respond to the accumulation of adversity.Design/methodology/approachDrawing on practice experiences in Queensland Australia, the paper examines service delivery responses to cumulative harm in the context of the Intensive Family Support model of service delivery.FindingsWithin current frameworks for child protection service delivery, there is no method of assessing the diverse and cumulative effects of ongoing chronic child maltreatment and adversity, despite research confirming that cumulative harm very often co-occurs with other child protection concerns. To effectively and collaboratively intervene in matters of chronic and cumulative abuse and neglect, practitioners and stakeholders must be guided by frameworks and assessments that accurately recognise and acknowledge the impact of ongoing exposure to adverse experiences and maltreatment.Research limitations/implicationsThe need for a valid and reliable assessment method that draws together all elements contributing to the chronic maltreatment experience for a child and family: multiplicity, diversity and severity.Social implicationsPractice solutions tailored to each child’s specific cumulative experiences of adversity and maltreatment will promote better social, emotional and health outcomes across the lifespan.Originality/valueThis paper highlights a significant gap in assessment and practice frameworks and advances the impetus for cumulative harm to be proactively integrated into social care and service delivery.