Scourfield (2000) notes that two influential and contrasting professional dis-courses operate within teams working with child neglect. He argues that practice will be determined by the discourse that dominates team practice. The first discourse is that taken by the Bridge Childcare Consultancy, an independ-ent organization who have prepared a number of case reviews following deaths of children from neglect (Bridge Childcare Consultancy 1995). Scourfield argues the emphasis is on the physical care of the child ‘servicing the child’s body’, recognizing that dirty, smelly children may be suffering maltreatment.
The other discourse is that emphasized through the Department of Health’s publication (1995) with a focus not on the physical care provided by the parent but on the emotional impact of parenting on the child. Scourfield, in his ethnographic study of a social work team, found that social workers con-structed child neglect by concentrating on the ‘children’s bodies and parental body maintenance for children’. He noted that social workers made judge-ments about the emotional climate within the home but that if this was positive but the standards of physical care were unacceptable then the family was still seen as a cause of concern. However, Stone (1998) interviewed social workers
in a metropolitan borough in England about their work with neglected children on the child protection register. He found that these practitioners con-sidered relationship issues and family dysfunction to be central to their under-standing of how children become neglected. This could be seen to support Scourfield’s argument that the organization and team play a crucial role in shaping practitioners’ perception of neglect.
Turning to the Irish study, there was general agreement amongst those that attended the focus groups that perceptions of child neglect vary from worker to worker and the responses to the questionnaire would seem to bear this out.
However the review of the case files completed as part of the study indicated that the perceptions of child neglect varied depending partly on the location of the worker. That is, workers in the different comunity care areas tended to assess child neglect in different ways. This was influenced by the context in which the teams operated. For example, the systems, resources available and workloads. As a result of this, in one area with clear established systems for pro-cessing cases of child maltreatment the focus when defining neglect tended to be on the incident that could pose an immediate risk of harm to a child. The cases were thoroughly investigated with this focus. For example, if a child was left home alone, the assessment focused on the act of leaving a young child at home alone. In a second community care area the focus of both assessments and interventions were more varied. Some cases records indicated the focus was on keeping children safe and meeting their needs, whilst other records showed workers attempting to do this as well as improving parenting capacity.
However, the records on the files indicated that pressure of work resulted in short term interventions Finally, in the third area that had services available to families that were not available in the other areas the workers were able to focus not only on the impact of maltreatment on the child, they were also addressing issues related to parenting capacity and the parenting environment. In addition, the threshold for intervention was lower in this area than in the other two areas.
The way in which the social work professionals define child neglect has a direct influence on the assessment process. In the case audit included in the Irish study, 48 out of the 82 reasons for referral (referrers often cited more than one cause of concern) focused on a specific incident such as children being left alone or the parents being seen drunk whilst caring for the children (Table 5.1).
When completing assessments in response to these referrals notable differ-ences were recorded on case files based on team response. In 20 cases predomi-nantly from one community care area, social workers dealing with the referrals appeared to focus on the incidents of possible neglect rather than considering the impact of neglect on the child. In a further 18 cases, mainly from a second team, there was a generalized assessment of the children’s needs. This included eight cases where information was obtained from other professionals with no discussion with families recorded and ten cases where the information was based on contact with the family and professionals. The records included
Table 5.1 Reasons for referral
Nature of referrers’ concerns Frequency and percentage
Alcohol use by carer 8 (9.8%) single source of referral 11 (13.4%) combination Children left unattended 7 (8.5%) single source of referral
6 (7.3%) combination
Home conditions 2 (2.4%) single source of referral 3 (3.7%) combination
Drug use 3 (3.7%) single source of referral
2 (2.4%) combination
Suspected child sexual abuse 1 (1.2%) single source of referral 3 (3.7%) combination
Children hungry 4 (4.9%) combination
Lack of supervision 4 (4.9%) single source of referral Inappropriate carers 3 (3.7%) single source of referral Children witnessing domestic violence 3 (3.7%) combination
Carer’s ability to care 2 (2.4%) single source of referral 2 (2.4%) combination
Non-attendance at clinics 2 (2.4%) single source of referral 1 (1.2%) combination
Non-school attendance 1 (1.2%) single source of referral 2 (2.4%) combination
Carer’s mental health 1 (1.2%) single source of referral 1 (1.2%) combination
Child begging 1 (1.2%) combination
Carer gambling 1 (1.2%) combination
Carer’s company 1 (1.2%) combination
Homelessness 1 (1.2%) combination
Lack of stimulation 1 (1.2%) single source of referral
Carer’s aggression 1 (1.2%) combination
Vulnerable adolescent 1 (1.2%) single source of referral Carer’s lifestyle 1 (1.2%) single source of referral
Physical abuse 2 (2.4%) combination
generalized descriptions, for example ‘the child is well though her weight remains a problem’. In these cases, it was difficult to establish what was the cause of concern. For example, was the weight a problem because the child was under or over weight? In 18 cases largely from a third team, the initial assess-ments explored the specific needs of the child and the carer’s ability to meet these needs. The analysis of case files would seem to indicate that workers and managers take one of three different perspectives towards the assessment process:
· to confirm whether child neglect has occurred
· to assess whether the child has suffered or is likely to suffer harm as a result of the perceived neglect
· to assess both for harm and the impact of the harm caused by neglect on the well-being of the child.
Rose (2001) notes that any assessment of a child that aims to understand what is happening to the child has to take account of a child’s developmental needs, the parenting capacity to meet these needs and the wider community in which he/she lives. Yet, the review of the case files highlighted that in many cases these factors were not considered in detail.
The review of case material indicated that the interventions planned for the children in many ways mirrored the assessment, that is, perceptions of neglect and its impact on the child influences the approach to interventions. Interven-tions could be seen to operate at three levels each having a different purpose:
protecting the child from the presenting concern; protecting the child and pro-moting the child’s welfare; or safeguarding and propro-moting the welfare of the child and working to improve parenting capacity. The suggested interventions in response to a questionnaire scenario about a family where increasing concerns about neglect were described. Some respondents focused on the abuse the children were suffering and considered care proceedings as a means of keeping the children safe. Others focused on ways in which the children could be protected and have their needs met. Suggestions included regular medical checks, respite care, daycare and monitoring. Other respondents con-sidered ways of influencing parenting capacity through parenting courses, alcohol counselling and treatment for the mother’s depression. It appears that different services are offered depending on the attitude towards not only the assessment but also the perceived purpose of intervention.
If teams are incident focused and view child neglect as failure to service children’s bodies then, as Minty and Pattinson (1994) comment, social workers can under-estimate the seriousness of child neglect believing it is either a con-sequence of maternal poverty or a matter of ‘dirty children in dirty homes’. That is, social workers can be ‘under-whelmed’ to the point where practitioners nor-malize the neglect (Graham 1998, cited in Buckley 2002). However in teams
that take a broader holistic approach towards child neglect and consider rela-tionship issues and family dysfunction in addition to poverty and physical neglect workers may feel ‘over-whelmed’ by the complexity of the case.
The role of the supervisor
If, as would seem to be the case in the Irish study, teams respond differently to cases of child neglect then this raises questions about the role of the team manager. Practitioners and managers in the study were asked to respond to the statement ‘the criteria for triggering child protection procedures can vary depending on which manager is involved’. Seven of the nine managers agreed with this; however, only 53% of practitioners agreed. If team managers recognize different approaches while a large number of practitioners do not it would appear that many practitioners are unaware of the differences in practice between the com-munity care areas accepting their team approach as ‘normal’. It may be that some team members are unaware of the influence of the manager in setting thresholds and the focus for assessments and interventions. In addition, the respondents in the focus groups believed that team members played a signifi-cant role in supporting fellow team members and acting as a sounding board when exploring concerns about children and families. It would seem the team members play a part in reinforcing the standards set by the manager.