Perspectives of Neglect

Abstract

Child Abuse ReviewVolume 21, Issue 2 p. 77-80 EditorialFree Access Perspectives of Neglect First published: 26 March 2012 https://doi.org/10.1002/car.2208Citations: 3AboutSectionsPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinked InRedditWechat Neglect is a common, yet under-recognised form of child maltreatment (Glaser, 2002). In the UK, neglect is the most common category of abuse for children who are the subject of a child protection plan and its damaging effects on children and young people's health and wellbeing have been highlighted in two recent high-profile reports (Burgess et al., 2012; Daniel et al., 2011). Neglect is a significant public health issue, it is an underlying feature in many serious case reviews (reviews of non-accidental child deaths) and in extreme cases may be the direct cause of death (Brandon et al., 2010). Neglect rarely comes to light as a result of a specific incident (Hildyard and Wolfe, 2002) and often relies on practitioners making a judgement about the adequacy of ongoing care within a child and family context. Daniel (2005, p. 15) has described how a definition of neglect ‘must always be accompanied by careful delineation of the circumstances within which the child is living, the current and likely future physical and emotional impact and an analysis of the parental context’. It is the persistent failure to meet a child's needs and provide adequate care which is often significant, with its cumulative negative effects being detrimental to the child over a considerable period of time (Powell, 2007). ‘An underlying feature in many serious case reviews and in extreme cases may be the direct cause of death’ Yet, defining and identifying the presenting features of neglect are difficult and it is widely recognised as challenging for practitioners and researchers (Daniel et al., 2011; Taylor et al., 2005). The first paper in this issue describes how one borough council in the UK, Blackburn with Darwen, implemented a strategic approach to address the challenge of what constitutes adequate care. This council introduced multi-agency training workshops with 200 staff and appreciative working practices, to support the introduction of the Graded Care Profile (GCP) tool for supporting professional judgements about child neglect. Bernie Carter (2012) describes an evaluation study which took place alongside the initiative to investigate what was working well within child neglect practice and what changes occurred following implementation of the GCP. Despite initial reservations about the new model of working, over the course of the project there was a shift in the discourse of practitioners implementing the GCP from a focus on ‘neglect’ to a consideration of ‘quality of care’. Carter (2012, p. 95) reports how use of the GCP added ‘greater criticality’ to the professionals' observations of cases of neglect, ‘helped practitioners to have more positive conversations with parents’ and was helpful for less experienced practitioners. ‘A strategic approach to address the challenge of what constitutes adequate care’ In the second paper, June Slee (2012) outlines how in the Northern Territory of Australia failure to send children to school is classified as neglect by the Department of Health and Families. Slee describes how Indigenous children in Australia's remote Northern Territory have the poorest literacy and numeracy outcomes in Australia, as well as the highest rates of school non-attendance. In her informative paper, she contends that because authorities do not insist on children attending school and therefore fail to provide them with learning opportunities, that this is a form of systemic neglect. The paper examines some of the reasons for students' low school attendance, including the transient movement of Indigenous populations living in very remote areas and some children and families not seeing the value of education. Slee (2012, p. 111) argues that the key to addressing systemic neglect of school non-attendance and poor school performance is to attract and prepare Indigenous teachers to work at all levels, who can provide ‘culturally appropriate curricula’ as well as developing culturally responsive teaching amongst non-Indigenous staff. ‘Authorities do not insist on children attending school and therefore fail to provide them with learning opportunities’ Continuing the international focus on Australia, Shanti Raman and colleagues (2012) report on a research study which sought to examine whether front-line clinicians in general practice and hospital settings are equipped with the ability and confidence to address child abuse and neglect. Their survey, conducted in south west Sydney, involved general practitioners (GPs) and practice nurses working in primary care and emergency department (ED) doctors and nurses. These researchers found that while the majority of respondents understood their statutory and professional responsibilities to report suspected abuse or neglect, confidence levels in identifying abuse and neglect varied significantly between the two groups, with emergency doctors being the most consistent and practice nurses the least. The clinicians reported being most confident identifying physical abuse and neglect and less confident identifying emotional and sexual abuse. Of the 80 per cent of clinicians who had received some prior training in child abuse and neglect, 70 per cent of ED nurses, practice nurses and GPs reported their training to be inadequate, in comparison to 19 per cent of the ED doctors. These researchers conclude that there are significant differences between the confidence and reporting behaviour between front-line clinicians working in EDs and those working in primary care, and recommend targeted child protection training for front-line clinicians working in general practice. ‘Confidence levels in identifying abuse and neglect varied significantly between the two groups’ In a short report in this issue, Colette Selebo and colleagues (2012) describe an evaluation of a new specialist training programme developed in conjunction with the Royal College of Paediatrics and Child Health for paediatricians involved in legal processes. The two-day course on court skills training, delivered in a court setting, focused on family courts and criminal proceedings and explored the different orders available to the courts in child protection proceedings. The course provided participants with an opportunity to present evidence in mock trial sessions and to be cross-examined by two barristers. Evaluation feedback was received from 13 out of 15 students who participated in the course. All found the course highly relevant, with students being extremely positive about the value of preparing and presenting evidence in a mock trial. Following the two-day training course, seven participants had an opportunity to observe judges and barristers in a total of 14 cases representing a mixture of family, civil and criminal proceedings, including two cases of alleged neglect. The authors conclude that the success of the training is linked to the high staff-student ratio, and that such training is extremely important in improving the confidence of paediatricians when presenting evidence in court. ‘The course provided participants with an opportunity to present evidence in mock trial sessions’ Daryl Dugdale and Carol Wells (2012) in the final article of this issue address the subject of interprofessional training in the field of safeguarding children. These authors describe the development of a process and tool in which those responsible for inter-agency child protection training could be supported to audit and review the conditions in which training programmes were being delivered. The authors describe the three phases of the development of the audit tool, which included: (i) a review of the existing research and literature to identify key standards; (ii) adaptation of an existing model ‘to audit the conditions for delivery of effective inter-agency training’ (Dugdale and Wells, 2012, p. 143) and measure against existing standards; and (iii) testing of the tool with a number of Local Safeguarding Children Boards (LSCBs) and an interactive presentation with 70 interprofessional trainers who had an opportunity to try out the tool and provide feedback, which led to further development of the audit tool. The ‘Make a Difference’ tool is the outcome of the project. The authors report that the review tool is divided into three key areas of provision, participants and practice systems, which provide a framework to ‘demonstrate the training function's strengths and weakness’ (Dugdale and Wells, 2012, p. 148). Dugdale and Wells argue that the review tool's requirement to evidence responses results in a plan that can be owned and actions prioritised by the LSCB. ‘70 interprofessional trainers who had an opportunity to try out the tool and provide feedback, which led to further development of the audit tool’ The book review in this issue is by Jo Hebb (2012) who reviews Daniel Wilcox's authoritative and multi-authored practitioner's guide to the use of the polygraph in assessing, treating and supervising sex offenders. References Brandon M, Bailey S, Belderson P. 2010. Building on the Learning from Serious Case Reviews: A Two-year Analysis of Child Protection Database Notifications 2007–2009. Department for Education: London. Google Scholar Burgess C, Daniel B, Scott J, Mulley K, Derbyshire D, Downie M. 2012. Child neglect in 2011. First annual report on child neglect from Action for Children and the University of Stirling: Watford. Google Scholar Carter B. 2012. Developing and implementing an appreciative ‘quality of care’ approach to child neglect practice. Child Abuse Review 21: 81– 98. DOI: 10.1002/car.1198 Wiley Online LibraryWeb of Science®Google Scholar Daniel B. 2005. Introduction to issues for health and social care in neglect. In Child Neglect: Practice Issues for Health and Social Care, J Taylor, B Daniel, O Stevenson (eds). Jessica Kingsley Publishers: London. Google Scholar Daniel B, Taylor J, Scott J, Derbyshire D, Neilson D. 2011. Recognizing and Helping the Neglected Child. Evidence-Based Practice Assessment and Intervention. Jessica Kingsley Publishers: London. Google Scholar Dugdale D, Wells C. 2012. The Development of an Auditing tool to Support the Delivery of Inter-professional Training within the Field of Safeguarding Children. Child Abuse Review 21: 141– 150. DOI: 10.1002/car.1157 Wiley Online LibraryWeb of Science®Google Scholar Glaser D. 2002. Emotional abuse and neglect (psychological maltreatment): a conceptual frameowork. Child Abuse & Neglect 26: 697– 714. CrossrefPubMedWeb of Science®Google Scholar Gough D, Stanley N. 2007. Policy, Practice and Decision Making in Child Neglect. Child Abuse Review 16: 71– 73. DOI: 10.1002/car.985 Wiley Online LibraryGoogle Scholar Hebb J. 2012. Book review of The Use of the Polygraph in Assessing, Treating and Supervising Sex Offenders. A Practitioner's Guide edited by D. T. Wilcox. Child Abuse Review 21: 151– 152. DOI: 10.1002/car.1147 Wiley Online LibraryWeb of Science®Google Scholar Hildyard KL, Wolfe DA. 2002. Child neglect: developmental issues and outcomes. Child Abuse & Neglect 26: 679– 695. CrossrefPubMedWeb of Science®Google Scholar Powell C. 2007. Safeguarding Children and Young People. A Guide for Nurses and Midwives. Open University Press: Maidenhead. Google Scholar Raman S, Holdgate A, Torrens R. 2012. Are our Frontline Clinicians Equipped with the Ability and Confidence to Address Child Abuse and Neglect? Child Abuse Review 21: 114– 130. DOI: 10.1002/car1180 Wiley Online LibraryWeb of Science®Google Scholar Slee J. 2012. Addressing systemic neglect of young indigenous children's rights to attend school in the Northern Territory, Australia. Child Abuse Review 21: 99– 113. DOI: 10.1002/car1166 Wiley Online LibraryWeb of Science®Google Scholar Solebo C, Sidebotham P, Watson C. 2012. Preparing Paediatricians for Court: Evaluation of A Court Skills Training Programme. Child Abuse Review 21: 131– 140. DOI: 10.1002/car1161 Wiley Online LibraryWeb of Science®Google Scholar Taylor J, Daniel B, Stevenson O. 2005. Child Neglect: Practice Issues for Health and Social Care. Jessica Kingsley Publishers: London. Google Scholar Citing Literature Volume21, Issue2March/April 2012Pages 77-80 ReferencesRelatedInformation