CHRONIC NEGLECT : CHRONIC NEGLECT : TRIPLE JEOPARDYTRIPLE JEOPARDY

Johanna WatsonJohanna Watson

Kate FurstKate Furst

Sharon BurkeSharon Burke

NSW Centre for Parenting and Research

CHILD NEGLECTCHILD NEGLECT

DefinitionDefinition

Neglect is considered to have occurredNeglect is considered to have occurred

when a child’s basic developmental needswhen a child’s basic developmental needs

have not been met have not been met (Dubowitz, 2004).(Dubowitz, 2004).

PREVALENCEPREVALENCE

Neglect is the most common category of Neglect is the most common category of substantiated maltreatment in:substantiated maltreatment in: the United States - 61% the United States - 61% (USDHHS, 2005)(USDHHS, 2005) Canada – 40% Canada – 40% (Trocm(Trocméé et al., 2001) et al., 2001)

the United Kingdom – 42% the United Kingdom – 42% (DfES, 2004).(DfES, 2004).

In Australia it is the second most common In Australia it is the second most common after emotional abuse Australia – 28% after emotional abuse Australia – 28% (AIHW, 2006). (AIHW, 2006).

RATES REFLECT DEFINITIONRATES REFLECT DEFINITION

In the US, Canada and the UK over the past decade In the US, Canada and the UK over the past decade neglect has been the fastest growing category of neglect has been the fastest growing category of maltreatment.maltreatment.

This increase in rates may in part reflect the This increase in rates may in part reflect the broadening of the definition to include compromised broadening of the definition to include compromised developmental well-beingdevelopmental well-being..

NEGLECT IS HARMFULNEGLECT IS HARMFUL

Chronic neglect may carry more damaging Chronic neglect may carry more damaging long-term consequences than isolated long-term consequences than isolated incidences of physical abuse incidences of physical abuse (Sullivan, 2000).(Sullivan, 2000).

Half of maltreatment fatalities are Half of maltreatment fatalities are attributable to childhood neglect attributable to childhood neglect (Sullivan, 2000; (Sullivan, 2000;

NSW Ombudsman, 2005).NSW Ombudsman, 2005).

WHY TRIPLE JEOPARDY?WHY TRIPLE JEOPARDY?

Children are:

Neglected by their parents

Compared with other maltreatment neglected children also receive comparatively little attention from:

Service providers

Researchers.

AVOIDED BY RESEARCHERS?AVOIDED BY RESEARCHERS?

Of 3,888 articles published on child abuse Of 3,888 articles published on child abuse and neglect over a five year period, only and neglect over a five year period, only 57 were specifically about neglect57 were specifically about neglect..

A striking number of pages devoted to the A striking number of pages devoted to the difficulties of defining neglect.difficulties of defining neglect.

AVOIDED BY RESEARCHERS?AVOIDED BY RESEARCHERS?

DEFINITIONAL ISSUESDEFINITIONAL ISSUES

It is very difficult to research a concept until it It is very difficult to research a concept until it has been empirically defined.has been empirically defined.

What are basic developmental needs? – neglect is not a unitary concept eg supervisory,

physical, emotional, educational and medical neglect are measured differently.

– Acts of omission difficult to measure eg how much lack of nurturing has to occur to be emotionally neglectful.

AVOIDED BY RESEARCHERS?AVOIDED BY RESEARCHERS?

DEFINITIONAL ISSUES (cont..)DEFINITIONAL ISSUES (cont..)

Concept of neglect socially and culturally Concept of neglect socially and culturally dependent. Is it neglect if:dependent. Is it neglect if:– An 11 year old is unsupervised at home An 11 year old is unsupervised at home (Cawson, (Cawson,

et al., 2000)?et al., 2000)?

– An 8 year old looks after a toddler unsupervised An 8 year old looks after a toddler unsupervised ((Laos and Cambodia - Straus & Kantor, 2005)?Laos and Cambodia - Straus & Kantor, 2005)?

Does neglect have to be intended?Does neglect have to be intended?– Parent has developmental delay - 72% (Parent has developmental delay - 72% (Connell-Connell-

Carrick, 2003).Carrick, 2003).

AVOIDED BY RESEARCHERS?AVOIDED BY RESEARCHERS?

DEFINITIONAL ISSUES (cont..)DEFINITIONAL ISSUES (cont..)

Does it have to be persistent?Does it have to be persistent?

To what extent might outside To what extent might outside circumstances mitigate (eg high correlation circumstances mitigate (eg high correlation with poverty)?with poverty)?

..

DEFINITIONDEFINITION

Neglect occurs when a child’s basic needs, as Neglect occurs when a child’s basic needs, as defined by current social and cultural norms, are defined by current social and cultural norms, are not met by those responsible. not met by those responsible.

If basic needs are not met children are still If basic needs are not met children are still neglected regardless of the reason.neglected regardless of the reason.

Neglecting families may be difficult to engage in Neglecting families may be difficult to engage in research.research.

OVERLOOKED BY SERVICES?OVERLOOKED BY SERVICES?

Despite overseas experience that neglect is the Despite overseas experience that neglect is the hardest type of maltreatment to substantiate, in hardest type of maltreatment to substantiate, in NSW neglect was substantiated at a higher rate NSW neglect was substantiated at a higher rate than physical abuse. than physical abuse.

Service providers are likely to respond quickly to Service providers are likely to respond quickly to clear incidences of serious neglect (eg young clear incidences of serious neglect (eg young children at home alone).children at home alone).

OVERLOOKED BY SERVICES?OVERLOOKED BY SERVICES?

Children in families where the neglect is Children in families where the neglect is classified as low level but it is chronic are classified as low level but it is chronic are less likely to come to the attention of less likely to come to the attention of service providers (US and Canada). service providers (US and Canada).

Family reasonsFamily reasons– Characteristics of the parents Characteristics of the parents

Overwhelmed mothers do not take children to Overwhelmed mothers do not take children to services - eg to GPs and Baby Health Centres.services - eg to GPs and Baby Health Centres.

– Characteristics of the childCharacteristics of the child Withdrawn children are easily overlooked.Withdrawn children are easily overlooked.

OVERLOOKED BY SERVICES?OVERLOOKED BY SERVICES?

Service provider reasonsService provider reasonsEach incident may seem trivial - not a Each incident may seem trivial - not a concerning enough ‘trigger event’concerning enough ‘trigger event’ (Tanner and Turney, (Tanner and Turney,

2003).2003).

Reported events may be given low priority, those Reported events may be given low priority, those whose safety is at immediate risk receive priority whose safety is at immediate risk receive priority responseresponse (Little, 1995).(Little, 1995).

OVERLOOKED BY SERVICES?OVERLOOKED BY SERVICES?

Case drift - when involved with the family Case drift - when involved with the family for a long time, the level of dirt and lack of for a long time, the level of dirt and lack of care may seem ‘normal’ for that family.care may seem ‘normal’ for that family.

Focus on supporting parents - become Focus on supporting parents - become involved with supporting the parents, involved with supporting the parents, especially if struggling, and lose focus on especially if struggling, and lose focus on the child.the child.

OVERLOOKED BY SERVICES?OVERLOOKED BY SERVICES?

Cultural relativism - being overly mindful of Cultural relativism - being overly mindful of the influence of culture. the influence of culture.

Court evidence - it is more difficult to Court evidence - it is more difficult to persuade the court system that a child is persuade the court system that a child is at risk of harm from neglect that if the at risk of harm from neglect that if the maltreatment were physical or sexual maltreatment were physical or sexual (Sheehan, 2006).(Sheehan, 2006).

OVERLOOKED BY SERVICES?OVERLOOKED BY SERVICES?

Neglect known to be difficult - it is the most Neglect known to be difficult - it is the most resistant to treatment initiatives producing resistant to treatment initiatives producing lasting change in only 40% of neglecting lasting change in only 40% of neglecting families families (Salmelainen, 1996).(Salmelainen, 1996).

Grave consequences to the family so Grave consequences to the family so workers try to avoid incorrect classification workers try to avoid incorrect classification (Dept of Health, 1995).(Dept of Health, 1995).

RESEARCH IN AUSTRALIARESEARCH IN AUSTRALIA

Little is known about the picture of neglect Little is known about the picture of neglect in Australia.in Australia.

In the US particularly the welfare system is In the US particularly the welfare system is very different with a 5 year lifetime limit on very different with a 5 year lifetime limit on welfare welfare (Berry, Charleson & Dawson, 2003).(Berry, Charleson & Dawson, 2003).

Higher rate in the US may be associated Higher rate in the US may be associated with neglect through its strong link to with neglect through its strong link to poverty.poverty.

PROPOSED STUDYPROPOSED STUDY

STUDY HAS THREE COMPONENTSSTUDY HAS THREE COMPONENTS

Component 1 - Definitional Component 1 - Definitional

Component 2 - AssessmentComponent 2 - Assessment

Component 3 - InterventionComponent 3 - Intervention

PROPOSED STUDYPROPOSED STUDY

Component 1 - DefinitionComponent 1 - Definition

Aims to:Aims to:– identify the criteria to categorise neglectidentify the criteria to categorise neglect– identify criteria relating to severity and identify criteria relating to severity and

chronicity of neglectchronicity of neglect– identify social and familial risk and protective identify social and familial risk and protective

factors associated with substantiated neglect.factors associated with substantiated neglect.

PROPOSED STUDYPROPOSED STUDYMethod Method – Identify criteria used in decision-making Identify criteria used in decision-making

process through focus groups representing:process through focus groups representing: differing levels of expertisediffering levels of expertise

different stages of the assessment process.different stages of the assessment process.

– identify risk and protective factors related to identify risk and protective factors related to severity and chronicity of neglect through:severity and chronicity of neglect through:

500 case files of substantiated maltreatment500 case files of substantiated maltreatment

comparing with LSAC data.comparing with LSAC data.

– design a template to ‘guide’ decision-making design a template to ‘guide’ decision-making that takes risk factors, severity and chronicity that takes risk factors, severity and chronicity into account.into account.

PROPOSED STUDYPROPOSED STUDY

Component 2 - AssessmentComponent 2 - AssessmentExamine the psychometric properties and usefulness of this ‘guide’ in assisting with decision-making.

Component 3 - InterventionComponent 3 - InterventionExamine the effectiveness of parent vs child focussed interventions as a function of severity and chronicity of neglect.

FURTHER INFORMATIONFURTHER INFORMATION

Literature review can be found atLiterature review can be found at::

http://www.community.nsw.gov.au/http://www.community.nsw.gov.au/

documents/research_child_neglect.pdfdocuments/research_child_neglect.pdf

DoCS research site:DoCS research site:

www.community.nsw.gov.au/html/news_www.community.nsw.gov.au/html/news_

publications/research.htmpublications/research.htm