Social Work & Child Neglect

Social workers often find that children who are chronically neglected are the most damaged and difficult to work with as they have absolutely no self worth. These children may have emotional difficulties which make them watchful and wary of adults and reluctant to express their complex feelings verbally. If neglect comes from parenting that overlooks the child's need to be held appropriately, both physically and emotionally, these children may not even recognise their basic need for affection and personalised human interaction and affirmation. Their distress may be acted out in problematic behaviours, or alternatively, in silent withdrawal.

Parents who neglect their children are usually people who have themselves suffered neglect and have not been given good role models during their own childhood. They therefore struggle to understand how to parent a child - unlike most parents who instinctively know what to do. They may claim to have loving feelings for their child but are not emotionally equipped to respond appropriately to their child's needs for care and support. Very often they are so preoccupied with their own needs and problems that they find it difficult to focus clearly on the child's needs and, as a consequence, may take insufficient account of the child's vulnerability.

An understanding of the neglected child is at the core of good social work practice. Chronic neglect is a major factor behind the ever-rising demand for services; many children who have been abused have also been subject to a degree of neglect. There are a range of different services that can be provided but social workers need to be very clear about why it is necessary for them to intervene and what is is they are trying to do.

Neglect presents social workers with many uncertainties. Current procedures in children's services are too focused on elaborate child in need assessments - which tend to lose sight of consideration of circumstances that might amount to child neglect. In some ways core abuse (physical and sexual) can appear easier to detect and prove than neglectful behaviour. Acts of omission are more difficult to recognise and record than acts of commission. Furthermore, the task of making interventions that achieve lasting change can be challenging. What level of risk is acceptable? When is neglect so significant that further action must be taken?

A major cause of confusion comes from the ideological assumption within the profession that child protection is invariably oppressive. Unfortunately, this can have a paralysing effect on some social workers. The family may be suffering from material poverty but something else may be going on in the family - that comes from the low level of input into important caring activities. There seems to be insufficient recognition that neglect represents a more fundamental undervaluing of the child - particularly if parents, for example, do not care that their children are dirty and smelly and ostracised at school. The cumulative effect of lack of parental concern about unmet needs is often under-estimated by social workers.

Of course, not all neglected children need social work help. Some have relatives in the wider family and other people in the community who understand their situation and provide support in whatever way they can. Referral to children's services usually only happens when the efforts of family, school and professionals to address problems have been unsuccessful. A common feature of neglect referrals is often that there is no particular incident that precipitates action - but standards in the family have deteriorated to the point where children are apparently being harmed. It is then assumed that social workers can engage the parents in constructive work to raise standards and reduce harm.

Social workers, being at the centre of many different pressures and influences, often struggle to strike an appropriate balance between respecting family autonomy and recognising the child's right to protection. There are particular challenges for social workers if the parents feel strongly about their need for privacy and resist outside intervention. Social workers therefore need managers who know how to push for decisive and authoritative action to protect the child when this seems necessary.

Early intervention is the guiding principle but there are often barriers to change if parents with psychological problems are stuck in their dysfunctional patterns of relating. Sometimes the apparent perversity of parents, struggling to care for their children, makes them reject whatever is offered - including the help of highly skilled professionals.

Social work training puts a strong emphasis on relationship-based work, counselling and family therapy, all of which have a continuing relevance, but when working with neglect practical help should be given more emphasis. A strong focus on the physical conditions in the home is as important as working with the emotional and relationship problems.

Social workers need good supervision to help them understand when concerns have reached the threshold of possible significant harm. However, there is always the risk that social workers simply become accustomed to the poor standards in the home. Another difficulty may arise when families become less co-operative over time, particularly if there are frequent changes of social worker. Some parents become expert in covering up their difficulties and going through the motions of co-operating with professionals.

An early response to neglect must include action to protect the child, particularly if there is a serious incident such as the following: a domestic incident, an accident where the child needs medical treatment, a young child out in the street alone and distressed, an older child self-harming or missing from home. The current organisational arrangements are not conducive to the development of consistently reliable decision-making in situations which may require a formal investigation. Line managers may need to take more responsibility for interpretation of what constitutes risk and arrange a timely response to situations indicating a child may be at risk of significant harm. There may be evidence that a section 47 enquiry should be carried out, possibly leading to a Child Protection Conference and a Child Protection Plan.

A Child Protection Plan would give the social worker, as key worker, the authority to speak directly to the family about concerns and say things that others have possibly felt unable to say, whilst also conveying a willingness to organise practical help. The initial task of tackling the dirty and unhygienic home conditions and inadequate physical care of children may mean that money has to be found to pay for such things as cleaning equipment, a new bed or bedding. Practical advice and help may be required to deal with: health and safety issues around the home, arranging for rubbish to be cleared, improving children's physical health and dental health, getting rid of dangerous dogs, redecorating etc. Additional support from family aides, for example, who can get alongside the family and provide help with the children, including getting them to school, can give parents a real boost.

When dealing with child neglect many social workers often feel powerless here. They are not powerless. They simply lack an understanding of the way an appropriate use of their legal powers can empower them.

Social work has a pivotal role in tackling neglect and in bringing standards of parenting up to an acceptable level so that children are better protected and supported within their own families. The quality of the service provided is dependent on the extent to which those at the top recognise skilled social work intervention and provide an organisational structure that supports it.

Hilary Searing