Research: Adolescent neglect in child protection work

 There is a need for a workable, shared definition of neglect in the context of multi-agency working with adolescents

The ‘incident focus’ of child protection has served teenagers poorly. Susannah Bowyer examines a literature review of adolescent neglect and finds the field sparse

THE RESEARCH

KEY WORDS: Teenager ❙ Adolescent ❙ Neglect ❙ Maltreatment

Authors: Mike Stein (Social Policy Research Unit, University of York), Gwyther Rees (Children’s Society), Leslie Hicks (University of Lincoln), Sarah Gorin (NSPCC)

Title: Neglected Adolescents – Literature Review, 2009, Department for Children, Schools and Families http://php.york.ac.uk/inst/spru/pubs/1191

Aim: To deliver an accessible summary of the relevant literature on adolescent neglect which informed the development of two practice guides – one for multi-disciplinary teams and one for young people.

Methodology: A literature review of international and UK research (published 1997-2006) focusing on practice, policy and research implications.

Conclusion: There is a lack of research and practice attention to adolescent neglect. Child protection systems are very “incident-focused” and no interventions aimed specifically at this issue were identified. Background factors are poorly understood.

Objectives

This project was one of 11 research studies in the Safeguarding Children Research Initiative funded by the UK government, after Lord Laming’s report of the Victoria Climbié inquiry in 2003. It was designed to support improved recognition and intervention to protect children from maltreatment.

The review responds to two overlapping gaps in both policy and research in the UK and internationally. There has been little research attention to either the maltreatment of adolescents or to neglect as a specific category of maltreatment. One might see the research community as mirroring the practice world in adopting an incident-focused approach to the study of maltreatment, which has resulted in a widespread “neglect of neglect” in international research reviews on maltreatment.

Neglect on the part of agencies and professionals is also acknowledged to be a concern in this context. A government-­commissioned analysis of serious case reviews from 2008 identified that a quarter of SCRs related to young people aged over 11. Most of these cases involved “hard to help” young people who had a history of involvement with social care and other specialist agencies, including periods of being looked after.

However, by the time of the serious incident “little or no help was being offered because agencies appeared to have run out of helping strategies”.

Neglect is the most common form of maltreatment across all age groups. The latest statistical release for children subject to child protection plans (CPPs) in 2009-10 in England shows that neglect remains the largest category, accounting for 19,300 new CPPs (44%), with emotional abuse a further 12,300 (28%) of CPPs.

Just over a quarter of all new CPPs involved children in the 10-15 age group, while there are also nearly 800 young people over 16 on protection plans.

Overall, there has been a 17% increase in CPPs, with a sharp rise in the number of young people over 16 on CPPs in many areas. Research commissioned by the Association of Directors of Children’s Services (Brookes and Brocklehurst 2010) suggests that this increase is directly related to an “increased awareness of the specific needs and vulnerabilities of this age group as local authorities consider their response to the Southwark judgement [obliging councils to house homeless 16- and 17-year-olds] and their service to older teens in general”.

Findings

The literature review identified little research that focused on adolescent neglect. As a result, the review drew on the wider literature on child neglect, adolescent maltreatment, parenting and other material on “problems faced by teenagers which may inform thinking on adolescent neglect”.

There is clear evidence to show that a range of negative outcomes among young people is associated with adolescent experience of neglect, while not necessarily being proven as directly caused by neglect.

These are summarised by the authors under the Every Child Matters outcomes headings and include negative health and mental health outcomes, educational disengagement, the risk of running away, bullying, and an association between neglect and anti-social behaviour.

The report identifies the need for a workable, shared definition of neglect in the context of multi-agency working with adolescents. The increased independence of teenagers makes defining neglect harder to pin down than it is for, say, highly dependent infants.

The multi-agency guidance informed by the literature review usefully identifies key themes from the research literature regarding neglected adolescents.

For instance, neglect of children is often defined as “an act of omission” – what parents or carers are not doing to meet a child’s needs. In adolescence, neglect may also encompass “acts of commission”, such as forcing a young person to leave home.

Acute neglect may become evident at a point of crisis in a young person’s life, and teachers are well placed to notice such changes and offer help to children and young people. However, neglect is often characterised by a cumulative pattern of harm over time. If neglect is chronic, an adolescent may underestimate the harm they experience, having been used to an absence of care throughout their young lives.

It is important that practitioners do not themselves become desensitised to young people’s experiences. Furthermore, professionals should not place undue emphasis in assessment on the idea that cultural factors might influence different standards of parental care.

The guidance instead recommends maintaining close reference to robust tools and measures to support the assessment of a young person’s development.

The authors remind practitioners of the core assessment records produced to support the implementation of the common assessment framework, which provide guidance for assessing developmental needs and parenting capacity appropriate to specific age ranges of children and young people.

Recommendations

The review did not find any interventions aimed specifically at adolescent neglect, which does not mean that there is not ­effective work taking place, but that there is a lack of robust research accompanying positive interventions that may be happening on the ground.

The review supports the use of the ­ecological approach to understanding neglect, as supported by the assessment framework. However, background factors associated with adolescent neglect are not well understood.

Critique

The published research brief does not provide a great deal of detail on the full literature review. However, the guide to multi-agency practice is usefully laid out, with questions in each section designed to support the review of local practice.

PRACTICE IMPLICATIONS

For children’s services:

● The review suggests the need to raise awareness about neglect among young people in order to support their ability to seek appropriate support. An NSPCC guide for young people was produced from one of the outputs of this project and is available at nspcc.org.uk

For frontline practitioners:

● Young people’s sense of privacy, acceptance of their parents’ behaviour and loyalty to their families is likely to inhibit their ability to seek help. It is vital that there is continuity of practice in order to develop working relationships of trust with young people.

For multi-agency workers:

● The guidance provides questions to support the review of local practice and policy to ensure it is sufficiently focused on adolescent neglect.

For managers:

● There is “a need for additional documentation to support age-specific assessments in cases of potential neglect”.

What is cumulative harm?

Cumulative harm is a concept adopted in child protection law in the Australian state of Victoria. It refers to “the effects of multiple adverse circumstances and events in a child’s life” and offers a useful means of analysis for the effects of chronic neglect over time, something that is arguably lacking in the incident-focused child protection system in England.

Further reading

● Mike Stein and Lesley Hicks (2010), Neglect Matters: a multi-agency guide for professionals working together on behalf of teenagers, London, Department of Children, Schools and Families.

● Carole Brooks and Philip Brocklehurst (2009), Safeguarding Pressures Project Phase 2, ADCS.

● Leah Bromfield and Robyn Miller (2007), Cumulative Harm: Specialist Practice Guide, Victoria, Department of Human Services.

Susannah Bowyer is a research officer at Research in Practice

This article is published in the 24 March 2011 edition of Community Care under the headline “A history of neglect around adolescent mistreatment”