Child neglect: practitioners' perspectives
Summary of research and findings
By Bill Stone (August 1998)
Child neglect: practitioners' perspectives - summary of research and findings (PDF, 17KB)
Child neglect: the context
- Practice experience in social work and recent research findings on the child protection system have suggested that neglect has a low profile compared to other forms of child maltreatment. Some evidence suggests that social workers find it difficult to work with child neglect. Neglect also achieves much less public awareness than physical or sexual abuse.
- There is a question mark over whether neglected children should be conceptualised as children in need rather than in child protection terms, and whether this might offer a more constructive support to the children and their families.
Previous research on child neglect
- There is definitional confusion over neglect, with many competing approaches, none of which appear to have received general acceptance among practitioners.
- Medical and psychological approaches share an underlying commitment to the methods and language of the physical sciences and are grounded in concepts of disease and pathology. Medical and socio-medical studies concentrate on parental deficits, particularly maternal deficits. Psychological and socio-psychological studies more often conceptualise neglect in terms of disordered parent-child relationships. Some recent studies have moved towards a focus on the interaction between people and the environment in which they live.
- Sociological research evidence specifically addressing child neglect is scarce and diffuse. The studies of societal response to child maltreatment are particularly salient to neglect, which strongly impinges on cultural expectations about child rearing and the relationship between the family and the state.
- Studies of the social construction of child maltreatment focus on its perception and definition. These studies challenge the pathologising of parents, families and of particular social class or ethnic groups. They suggest that pathologising strategies are used to place problems of child maltreatment in the hands of medical or social work experts. This downplays responsibilities of the state for a social problem with economic and political aspects.
- Some research has focused more pragmatically on public and professional consensus over what constitutes neglect. This has tended to show relatively high consensus, regardless of profession, social class or ethnicity. Most of this work is American and there is little British material.
- Research on the child protection system has attempted to develop instruments to measure neglect and to examine the operation of child protection services in response to neglect. Results vary considerably, some studies suggesting limited consensus and few differences between neglected children and victims of abuse, while others found marked differences.
- The scarcity of British material on neglect is particularly marked. There is a lack of material developing a distinctively social work approach to understanding and defining neglect, and in consequence the scope for thoughtful, evidence based social work practice is severely limited.
Practitioners' definitions of neglect
- A research design was developed to examine the way in which families become defined by professionals as neglect cases. In the first stage, a workshop was held for 33 practitioners from agencies making up the Area Child Protection Committee in a Metropolitan borough. Participants included social workers, health visitors, teachers, police and probation officers. They completed individual exercises and took part in focus groups.
- In individual exercises, they were asked to construct their personal definition of neglect and to rate a series of 30 case scenarios of possible neglect. In the focus groups they were asked to assess children's needs, to identify significant features of neglect cases, and to describe their own feelings about working with child neglect.
- Results of the individual definition exercise identified consensus on physical and emotional neglect in which the primary focus was on the concepts of needs and care. Primary needs such as food, clothing, shelter and medical care, and emotional needs such as love, were prominent. Although protection from harm and safety were concerns, lack of supervision of children was not mentioned as a feature of neglect in any individual definitions.
- The case scenarios used had been developed in a study in the USA by Craft and Staudt (1991) and were adapted for language to the British scene. Respondents rated on two dimensions, whether a situation was considered dangerous and whether the child was to be referred for a child protection enquiry.
- Results showed higher consensus on which scenarios were dangerous than on which were safe, and large areas where there was little agreement either to refer or on dangerousness. All items on the supervision of children and leaving children alone led to marked division of opinion.
- There was relatively little relationship between the assessment of dangerousness and the decision to refer, showing the way in which a child protection enquiry could be used because of anxiety about the situation rather than because it was seen as immediately dangerous.
- There was little identification of the context of neglect in the individual exercises, but discussion of significant features of neglect cases included a perception that neglectful behaviour was associated with a cycle of inter-generational transmission. Neglecting families were seen as resistant to official agencies, and in the majority of groups significant features included poverty, deprivation, poor housing and unemployment.
- Practitioners' descriptions of their own feelings about working with child neglect were overwhelmingly negative, with almost all identifying sadness, despair, helplessness, anger and frustration.
Common themes in practitioners' assessment of neglect
- In the second stage of the research, 20 individual cases of young children recently placed on the child protection register on the grounds of neglect were selected. The key social workers were interviewed with a schedule based on issues from the group exercises.
- Key workers showed a high level of agreement with workshop participants on the significant features of neglect, and from a list of 35 features, identified more than 15 as present in 15 of the 20 cases. Three cases had more than 25 of the features.
- In contrast to workshop participants, key workers were guardedly optimistic about the outcome for the families that they were working with. Their level of optimism was related to the age of the child, with early intervention leading to greater optimism.
- Key workers' assessments supported the inter-generational transmission concept, and in 18 out of the 20 families, parents/carers were regarded as having been poorly parented themselves. Substance abuse, mental illness, learning disability, and domestic violence were also identified as significant features in a high proportion of the families.
- As in the individual and focus group exercises, lack of supervision was not seen as a particular issue by individual key workers. Economic deprivation was a major feature in the families, with 18 considered to have financial problems.
Child neglect - a time for reappraisal
- Results illustrated the complexity of child neglect, and the multiple difficulties which typified neglect cases. There appeared to be no one particular factor, which taken alone, could be used to define neglect. On some issues there is very limited professional consensus. A surprising finding was the apparent unimportance of lack of supervision to practitioners.
- Results showed that practitioners considered emotional and relational factors to be essential to a definition of neglect and that poor material care alone would not be considered sufficient. Relationship issues and family dysfunction are central to practitioners' understandings of how children become neglected.
- It was evident, however, that social factors connected with poverty and deprivation were important. Neglected children suffered from poverty both in their material and their emotional environments.
- This is a small study in one local area, giving a snapshot of a situation at a particular moment in time. However, the variety of methods used has enabled the concepts to be examined from several different angles, and identified a number of significant themes. It indicates the importance of addressing questions of professional consensus over neglect, and of articulating and examining differences in definition and judgement, if children are to be given consistent support and adequate protection.
References
Craft, J. L. and Staudt, M. (1991) Reporting and founding of child neglect in urban and rural communities. Child Welfare, 70(3): 359-70.
Full report:
Stone, B. (1998) Child neglect: practitioners' perspectives. London: NSPCC. [NSPCC Policy Practice Research Series].
ISBN: 0902498770
Available from NSPCC Publications
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