Tackling child neglect: David Howe explains the importance of understanding child development

Fully understanding the development needs of young children can alert us to the damaging risk of neglect. David Howe talks to Graham Hopkins

As the most widespread form of abuse, research repeatedly tells us neglect has a damaging and irreparable effect on a child’s development.

“From a developmental point of view babies are particularly vulnerable and dependent,” says Professor David Howe, University of East Anglia. “Taking the evolutionary line, the child has built-in mechanisms to try and ensure that whenever he or she feels anxious, distressed, confused or, in particular, abandoned (be that physically, emotionally or psychologically) that preludes ‘danger’. Human babies cannot survive without close protective involvement of their primary care-givers – which in most cases will be mum and possibly dad and other family members.”

Howe believes that sense of being alone – of not being in your parents’ mind – is almost a definition of neglect. “That your parent is not mindful of you as a young child, that they’re physically unaware that you are playing with a light socket or are in the garden with a rusty nail, is a very distressing experience both biologically and psychologically. And that has long-term developmental consequences for children.”

Naturally, not all neglect is deliberate. Often one or both parents are under a lot of stress due to poverty, poor housing, domestic violence, mental health or addiction problems. “Of course there are a lot of cases where the parents themselves have been in pretty poor relationships as a child, adolescent or adult. There a number of factors or ‘transactions’ interacting at a point in time – and over time – that may not leave you enough mental energy to have your kids in mind.”

Howe believes that early intervention is “absolutely key” in these cases. But because people don’t understand these so-called “transactional dynamics” they wait for the evidence to build up – particularly if they intend going to court. Thus neglect is seen as cumulative – and as such takes time to collect. “But the whole point about children’s development is you can’t wait,” says Howe. “The first two or three years are crucial – so it’s important for people to get in early. And you can spot a lot of these risk factors early on – if you understand.”

Health visitors and midwives are wellplaced to spot those risk factors. “They can play a key part in working with social services and social workers,” says Howe.

He continues: “Midwives can spot things even in hospital – is mum distracted? Does she seem not with it? Has the partner visited or is mum on her own? They could discuss their concerns with the health visitor. GPs probably have a role to play. If here are good links with social services you can then get a multi-disciplinary perspective on this that can anticipate things going downhill. But, of course, that’s not the way the world has always worked so far.”

And there is the rub – could the world ever work that way? “I’ve no illusions that  the reality of everyday life in large organisations isn’t conducive to the early intervention or preventive practice but that is what the whole thing shouts out for. And 30 years of research evidence says basically that for every pound you spend today on prevention, you save £8-£10 over the childhood lifetime of that individual.”

● For more information read Child Abuse and Neglect: Attachment, Development and Intervention by David Howe.

What is neglect
“Child neglect is 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. It may involve a parent or carer failing to provide adequate food, shelter and clothing, failing to protect a child from physical harm or danger, or the failure to ensure access to appropriate medical care or treatment. It may also include neglect of, or unresponsiveness to, a child’s basic emotional needs.”

Working Together to Safeguard Children

Practice pointers
● All health and welfare care workers need to get a clear understanding of children’s early development.
● This knowledge should be introduced in social work qualifications but should feature in post-qualifying training.
● All the involved professions need to share the same agenda and knowledge base. “This requires speaking the same language and understanding the same developmental perspective.”
● With this understanding assessments will be made more accurately and earlier which can then lead to good preventive measures.
● Good management and peer supervision is essential. “You need help to handle the emotional impact these cases have on you.”

Contact the author
Graham Hopkins

This article appeared in the 29 March issue under the headline "Earlier the better"