Child Neglect: time to plan the way ahead

Four high-profile cases have focused attention on a form of abuse often underplayed – child neglect. But, asks Mark Ivory, at what point should protection workers intervene?

More children are on child protection plans because of neglect than for any other reason, yet this pervasive, ticking timebomb in the lives of many families remains one of the least understood aspects of social work. Serious case reviews (SCRs) repeatedly show professionals either underestimating the impact of child neglect or feeling powerless to do anything about it.

But the coalition government’s decision to publish SCRs in full has brought renewed hope of a solution. Child neglect is a recurring theme of reviews and publication in unexpurgated form will provide an unprecedented opportunity for children’s departments to tackle the problem systematically. Studies suggest that up to 10% of UK children suffer from neglect, characterised by lives in which poor hygiene, filthy clothes, meagre diet and domestic violence are the norm. When the first complete SCR was published in July, looking into the case of Khyra Ishaq, the seven year old Birmingham girl who starved to death at home, it questioned why professionals had not been more robust in assessing and intervening with her family.

Exactly the same question will be asked in three other high-profile SCRs, the complete versions of which are expected by the end of the year. They concern Shannon Matthews, the Dewsbury girl abducted by the uncle of her mother’s boyfriend; Baby Peter Connelly, who died in Haringey; and the two young Doncaster brothers who beat and tortured two other boys.

Domestic violence

Child neglect was implicated in all of these cases, as is evident from the SCR executive summaries already published. The Doncaster brothers’ family had been known to professionals since 1995 as one in which domestic violence and emotional and physical neglect were routine, but these problems were allowed to become “entrenched and extreme” by 2008. The Matthews family had been well known for its chronic neglect since 1996, but professionals reacted to periodic crises rather than undertake the long-term planning which might have lifted the family out of trouble.

“The message from research and serious case reviews is that agencies are poor at addressing the impact of chronic neglect and intervening at an early stage to prevent the problems escalating,” says Jane Stacey, UK director of operations for Barnardo’s. “Due to a fear of being vilified and the pressure to keep families together, social workers and legal staff are reluctant to make proactive judgments to remove children living in chronically neglectful circumstances.”

New research by Bristol University academics Elaine Farmer and Eleanor Lutman, however, has shown practitioners and their managers the way ahead. They found a tendency to play down abuse and neglect, and to take an “over-optimistic” view of the possibility of parental change “in the face of long histories suggesting the contrary”. Passive case management was noted in nearly a quarter of the 138 neglect cases they studied and decisive action usually depended on a trigger incident such as physical or sexual abuse, or severe domestic violence.

Farmer and Lutman make a cogent argument for earlier intervention, intensive work with parents, and greater clarity about how professionals can make a case in care proceedings where persistent neglect has been identified. It is an argument which has begun to get a hearing across social care.

Ray Jones, professor of social work at Kingston University, thinks that lessons should be learned from assertive outreach programmes in mental health, where people may be supervised to stay in the community and out of hospital subject to strict conditions about things like taking medication and attendance at a day centre.

“We could do something similar where child neglect is concerned, setting out clear rules as to what’s required if parents are to keep their children with them,” Jones says. “The parents would have to understand that social workers will initiate care proceedings, if the alternative is that chronic neglect continues and has a really detrimental impact on the child.”

Colin Green, who chairs the Association of Directors of Children’s Services safeguarding committee, admits that neglect is the biggest challenge, but points to the complex professional judgments that have to be made in assembling a case that will stand up to care proceedings.

“One of the difficulties with neglect is that the child’s condition and quality of care may go up and down over a considerable period of time, and it’s difficult to say when is the point to intervene,” Green says. “How many days does a child have to be grubby and unkempt for before it triggers a response?

“Many families go through a rough patch, perhaps when a parent leaves home, but we need to be able to identify when the situation isn’t going to improve, for example because of alcohol or drug abuse, domestic violence, or possibly the mother has significant learning disabilities and may be being exploited by a new partner.”

The Matthews, Ishaq and Connelly SCRs all say that professionals should have paid more attention to the mothers’ new boyfriends, either because the boyfriend’s influence was pernicious or because the mother began to put herself first. The SCR summary noted that Karen Matthews’s various short-lived relationships “interfered with her ability to concentrate on meeting her children’s needs and to prioritise them over her own needs”.

The most compelling reason for no-nonsense interventions is the trajectory of neglect towards even worse kinds of maltreatment: Farmer and Lutman’s research found that the majority of children they studied had suffered emotional, physical or sexual abuse.

Baby Peter became one more extreme example. His mother Tracey, the serious case review summary said, should have been “challenged and confronted” about her neglectful attitude towards her child. Notoriously she was not, but neglect is at last rising to the top of the professional priority list.

Bristol University research available at: