Neglect Awareness Training
The information on this page forms part of your training. Please ensure you read it thoroughly before attending the virtual event.
Welcome to the Neglect Training. On this page and in the accompanying virtual briefing we will be covering the following objectives:
- To have a better understanding of what we mean by neglect
- To understand the underlying factors and impact of neglect
- To have more confidence in how we recognise it
- To understand how to respond to concerns
You should undertake this training as directed by your line manager and be aware of your own well-being. If you are upset by anything in this module you should seek support from your manager or a colleague.
What is neglect?
Working Together 2018 identifies neglect as:
‘The persistent failure to meet a child’s basic physical and/or psychological needs, likely to result in the serious impairment of the child’s health or development. Neglect may occur during pregnancy as a result of maternal substance abuse.
Once a child is born, neglect may involve a parent or carer failing to:
– provide adequate food, clothing and shelter (including exclusion from home or abandonment)
– protect a child from physical and emotional harm or danger
– ensure adequate supervision (including the use of inadequate caregivers)
– ensure access to appropriate medical care or treatment
It may also include neglect of, or unresponsiveness to, a child’s basic emotional needs.
Categories of neglect
Neglect presents in a number or forms. A child may be suffering from one, or several of these forms of neglect.
– Physical neglect—not meeting a child’s basic needs, such as food, clothing or shelter.
– Lack of supervision and guidance – not supervising a child adequately or ensuring their safety, both when in carers presence or absence.
– Emotional neglect— not meeting a child’s needs for nurture and stimulation, for example by ignoring, humiliating, intimidating, or isolating them.
– Educational neglect— not ensuring a child receives an education.
– Medical neglect— not providing appropriate health care (including dental care), refusing care or ignoring medical recommendation.
We can use Maslows Hierarchy of Needs to understand what a child needs to live a healthy, stable life. It is important to recognise that all of these are equally as important. Whilst it is true that neglect will often be reflected in a child’s living conditions and provision of basic needs, and this is often the neglect first recognised by professionals, equally as important is the emotional warmth, the safety and the developmental needs of the child.
Why do parents neglect?
Neglect happens when parents or carers can’t or won’t meet a child’s needs. Sometimes this is because they don’t have the skills or support needed, and sometimes it’s due to other problems such as mental health issues, drug and alcohol problems or poverty.
Neglect is an inter-generational concern. A lot of parents we work with will have experienced neglect themselves as children. They may not recognise neglectful behaviour, and may neglect themselves as well as the child. This self-neglect is often seen as the child moves into adolescence, this might be recognised in lack of personal hygiene, inappropriate clothing, not eating properly and not responding to their own medical conditions. As these young people move into adulthood they take these neglectful behaviours with them.
When working with families we need to be aware of the care needed both at the ante-natal and post-natal points of pregnancy. Missing appointments and mum not taking care of herself whilst pregnant will have a detrimental effect on the baby.
Understanding someone’s background gives us better insight into their own parenting and helps us when trying to work with the family.
Impact of neglect
The impact of neglect varies depending on how long children have been neglected, the children’s age, and the multiplicity of neglectful behaviours children have been experiencing. Lag is a term we use for the delay between the neglect starting and the affect becoming evident. We don’t always see the impact of neglect straight away as children are often very resilient and learn to live with the situation.
However, studies on children have shown that severe deprivation or neglect can disrupt the way in which a child’s brain develops and processes information, increasing the risk for attentional, emotional, cognitive, and behavioural disorders.
It can alter the development of biological stress-response systems, leading to greater risk for anxiety, depression, cardiovascular problems, and other chronic health impairments later in life.
It has been shown to correlate with significant risk for emotional and interpersonal difficulties, including high levels of negativity, poor impulse control, and personality disorders, as well as low levels of enthusiasm, confidence, and assertiveness.
It is associated with learning difficulties and poor school achievement, low IQ scores, poor reading skills, and low rates of high school graduation.
The negative consequences of deprivation and neglect can be reversed or reduced through appropriate and timely interventions, but the longer the neglect continues the harder the recovery from that will be.
Adverse Childhood Experiences (ACEs)
ACEs refer to stressful or traumatic events that children and young people can be exposed to as they are growing up. Severe neglect is recognised as an ACE and has similar affect to Post Traumatic Stress Disorder. ACEs can have a negative impact on development in childhood and this can in turn give rise to harmful behaviours, social issues and health problems in adulthood. There is now a great deal of research demonstrating that ACEs can negatively affect lifelong mental and physical health by disrupting brain and organ development and by damaging the body’s system for defending against diseases. Research shows that there is a strong dose-response relationship between ACEs and poor physical and mental health, chronic disease (such as type II diabetes, chronic obstructive pulmonary disease; heart disease; cancer), increased levels of violence, and lower academic success both in childhood and adulthood. Other effects of ACEs can include: problems with drugs or alcohol; struggles with relationships; lower educational attainment, difficulties in communicating; anti-social behaviour, criminal behaviour; and death.
As children grow older and move into adolescence, they are likely to seek the attention they are not getting at home. In many cases this can lead to children being drawn into Child Exploitation, both criminal and sexual.
How would we recognise neglect?
For a lot of professionals, poor home conditions and lack of provision of appropriate clothing and hygiene are easier to see. However, we need to be cautious not to become complacent. A professional will have a ‘good enough’ level in terms of standards. This good enough level will often start to drop as they become de-sensitised to what they are seeing, or they may say ‘this is good compared to what it was’. In doing this they risk losing sight of what the child may be experiencing.
Below is a picture of a child’s bedroom from a case in Yorkshire where the parents were convicted of neglect. Anyone going into this environment would be shocked by what they are seeing, and would recognise this as an unhealthy environment for anyone to be living in.
Professionals need to also be aware of those cases where the home environment may be acceptable, but the child is suffering emotional neglect. This is much harder to see and sometimes relies on that ‘gut feeling’ that something is not quite right. It will often rely on recognition of the child’s behaviour and responses to situations.
Family A were first referred to services in July 2011 due to mum suffering post-natal depression and poor health. She came under the care of mental health services.
The family were assessed as Child In Need following referrals from various professionals concerned about mums mental health. As mum did not wish to be supported in Child In Need. The family were managed in TAF, with school identified as the lead professional. Additional support was offered by a friend who took on the role as private foster carer for the children to allow mum to have respite. Initially this plan appeared to impact positively on the family, however mum’s mental health would dip and result in referrals in and out of social care.
Being open to Early Help services and Social Care on a number of occasions, in 2017 a Graded Care Profile was completed with the family. The parent scored herself 1’s and 2’s and felt that she was able to parent effectively and that it was the children who were not responsive to her. The worker challenged the parents scores and scored the family 4/5 and referring through to Social Care. The worker continued to support the family, reviewing the Graded Care Profile several times.
Following continued concerns by professionals involved and escalation of concerns, a strategy meeting took place. The case finally moved into Child Protection.
Impact on the children
Mums mental health significantly impacted upon the children. Being low in mood meant mum took a time to respond, rarely giving eye contact to the children. There was little emotional warmth, with the older child frequently telling professionals that she wished for more time with her mum.
Mums often spoke negatively about the oldest child referring to her as ‘horrible’ and a ‘narcissist’. However school and other professionals involved saw her as a bright and happy child, who was talkative and responsive to peers and adults. In addition to this she took on a caring role in the family home, supporting her younger brother with homework, making meals for him, and getting him to school, with mum often staying in bed for most of the day.
The younger child was very quiet and rarely speaking, but displaying concerning behaviours often becoming extremely distressed both at home and in the community.
What to do if we have concern about a child.
Record any concerns immediately – this will ensure information is available for any referrals.
Assess the concerns – the Graded Care Profile (GCP) 2 is the agreed tool used in the Wirral to measure the level of neglect. It is set out in a way that allows professionals to recognise the type of neglect present, but also the level, from moderate to severe. This is a licensed tool and professionals must have undertaken the formal training to be able to complete the tool. If any professional is not trained in completion of the tool, they can seek support from a colleague who has been trained/ has a GCP2 license e.g. health visitor.
Seek support – time to reflect and supervision is essential to support professionals.
Making a referral
If a child or young person is at risk of harm, abuse or neglect please contact the Wirral Integrated Front Door Team who will be able to offer advice and support in any referrals:
Mon-Fri, 9:00am – 5.00pm Tel: 0151 606 2008
Outside of these hours Tel: 0151 677 6557
To see more information on the referral process click on the following link:
Narrated power point
Below is a narrated power point that covers the material above. Click on the picture to access the slide show.
To attend a virtual session, click on the link below of the session you wish to attend:
Please ensure you have registered for training before attempting to book a place. Each individual person requires their own registration – do not book places for other people, they will not be recorded as having attended and will not receive a certificate