Working with parents where neglect is an issue

Acting with urgency: responding to child neglect


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Parents who neglect their children are often experiencing a range of stressors, which impact upon their capacity to care for their children. Parents may not be aware of how their behaviour effects their children’s lives. Your work should focus on understanding all of the issues which are contributing to the neglect of a child and helping parents understand how their behaviour impacts upon their children. Talking to parents about their daily experiences helps us to identify why neglect may be occurring and what needs to change in order to ensure that the children are safe. 


What do parents think neglect is? 

Parental understanding of neglect varies based upon cultural, community and societal factors and so no common understanding amongst parents of a definition of neglect. Parents may not understand that neglect can have different impacts across a child’s development and may disagree with a practitioner’s assessment that their child has been neglected. Where parents do not agree with an assessment of neglect, practitioners need to try to build parents’ understanding about the impacts of neglect upon the child. 


How do neglectful parents perceive themselves?

Recognising they are neglecting their child can be very damaging to parents’ sense of self. Parents may not view themselves as neglectful and may resist the label of being ‘neglectful’. They may draw distinctions between themselves and ‘bad’ parents and may provide examples of why their parenting is not a problem. This resistance is more likely amongst neglectful parents where the impacts of maltreatment are not easily visible. 

 When parents resist the label of being neglectful they may also initially appear reluctant to change, or to work with child protection workers.  These are normal reactions and do not always demonstrate a lack of insight. Parents may have had ongoing interactions with child protection and may be wary of talking to practitioners. In cases where parents do not acknowledge that neglect has occurred, rather than labeling parents as neglectful, it may be useful re-frame them as being in need of help and support to improve their capacity to create a functional family. 


What are the personal experiences of neglectful parents? 

Parents who have very limited parenting skills are often attempting to meet the needs of their child in a context that even the most competent parents would find challenging

Neglectful parents are often dealing with a range of factors, which can hamper their ability to parent their children safely. They may be struggling with: 

  • mental health issues
  • substance abuse issues 
  • housing instability
  • domestic violence, or
  • intellectual disability.

Although many parents living in poverty do not neglect their children, there is often relationship between poverty, disadvantage and neglect. Issues facing many parents living in poverty; such as insecure housing, low income, and the lack of educational and employment opportunities; compound the difficulties experienced by parents. Disadvantage therefore makes it more difficult for parents to keep their children safe. An individual must have extraordinary levels of both organisation and determination to manage to parent effectively in the context of these challenges. 

Many parents may be dealing with the legacy of harm caused by their own experiences of being abused or neglected in childhood.


What are parents’ perspectives of working with child protection?

 The presence of multiple problems can contribute to parents feeling vulnerable, stressed and desperate. They may feel overwhelmed by the challenge of managing their own problems which may overshadow the importance of responding to their child’s health and development needs. 

Parents may be reluctant to work with child protection staff for a number of reasons. They may: 

  • feel embarrassed about the involvement of child protection authorities 
  • feel disempowered and ashamed at being labeled as neglectful or at involvement of  child protection
  • find it difficult to trust workers, particularly if they have had past negative experiences with child protection workers 
  • be afraid that they will have their children taken away 
  • have had longstanding interactions with child protection workers and feel frustrated that they need to form relationships with new workers and respond to new concerns 
  • feel disrespected by workers who do not recognise their capacity for change.

If a child’s needs are not being met because a mother or carer is being abused by her partner, it is important to remember that a women’s ability and motivation to provide care may be compromised because of her violent partner’s efforts to undermine her and her constant efforts to resist and shield children from the violence. 

Despite struggling with a range of issues, parents may not feel comfortable speaking about the impact of these challenges on their parenting. They may be embarrassed by the stigma associated with these problems; not make the connection between their behaviour and the impact on their child; or be fearful of drawing attention to additional problems. 


How parents seek help / signal for assistance

We know that parents find it difficult to ask for help. They may feel ashamed, afraid or worried about what will happen next or about losing control over the process. Acknowledging these concerns can help practitioners’ recognise and understand why parents may be reticent to talk.  

Many neglectful parents come to the attention of child protection agencies through their interaction with other agencies. They may approach agencies for support to cope with financial problems, housing instability, or as a result of criminal involvement, substance abuse, domestic violence or mental health issues. When parents approach services for help, they have often been struggling for a long time and have a high level of need. Parents may recognise that they need some help, but do not identify as being neglectful. Being reported for neglect may be unexpected and confronting. Practitioners may need to work with parents to develop their understanding about what being neglectful means, including recognising the impacts of their behaviour on their child. 


The Horwath Model

Improving outcomes for children requires practitioners to have a detailed understanding of the reasons why neglect is occurring. The Horwath model aims to help practitioners gain a better understanding of what is happening in families where neglect is an issue and to try to identify what actions may lead to improved outcomes for children. The model makes the experiences of each neglected children visible.

 As indicated by the diagram, the model requires workers to talk with children and parents about what a regular day is like across a 24 hour cycle. By talking to each family member and cross-referencing their experiences of the same day, practitioners are able to develop an understanding of what a full day is like in the life of each and every child and carer in the family. 


Making sense of the lived experience

‘The mother said she’d never really thought about what life was like for her child. She said for the first time she realised why things needed to change’

By comparing and contrasting the lived experience of each family member, practitioners can begin to understand what it means for a child. You can begin to understand why neglect is taking place, what is likely to happen if things do not change within the home, and what actions are required to improve outcomes for the children. 

This information should be useful to inform case plans and your work with families and to enable parents and practitioners to measure change in parenting behaviour in terms of the quality of the child’s lived experience. 

The traffic lights tool can support practitioners talk to parents about: 

  • how their behaviours are impacting upon their child, 
  • what needs to change in order to ensure the children are safe, and 
  • to prioritise the changes needed in relation to the impact upon the child. 

As outlined below, each parenting concern is categorised as either red, yellow or green. 

 Red concerns need to be worked on as a priority. The child’s needs are not being met and there is a likelihood that significant harm will be caused. 

Yellow indicates areas of parenting concern which need to be improved but are not an immediate priority. The child’s health and development is likely to be impaired without the provision of services to address this area of concern. 

Green highlights areas of good parenting. The child’s needs are being met and the parents should be encouraged to keep up their work in this area. In cases of chronic child neglect, there may be few examples of good parenting. Wherever possible, practitioners should take a strength based approach and try to identify and build upon any parenting strengths, however small they appear. 

After talking with parents, the concerns which have been identified as a priority should be incorporated into interventions. The following questions may be useful in guiding this process: 

  • What current aspects of the daily lived experience of the child are you worried are unsafe or causing harm?
  • When the child is safe from harm, how will their daily lived experience be different? What will their new lived experience look like? 
  • What aspects of the daily lived experience of the parent(s), parenting issues, family and environmental factors  may positively influence the ability of parent(s) to meet the needs of the child? 
  • What will the parent(s) need to do to ensure the child is protected from harm and the child’s lived experience improves? 
  • How can we achieve this? What are the first steps? Who can support these changes? Who needs to do what? What are the acceptable timeframes for change? 

Implications for Practice 

Assessment & understanding why parents are neglectful

  • There is a need for clear and comprehensive assessments in neglect cases. Without a clear understanding of the problem, interventions are likely to be inappropriate or ineffective. Understanding the lived experience of all family members will help to highlight why parents may be neglectful.
  • Neglectful parents may feel vulnerable, stressed and desperate. Neglectful parenting often occurs against a backdrop of poverty and disadvantage and parents may be experiencing a range of others stressors in their lives. Practitioners need to understand how parental capacity is influenced by these daily challenges. 
  • Neglectful parents have often experienced past trauma, including their own child protection history. Assessment of neglectful parenting should always consider the parent’s history and how this affects their day-to-day functioning and parenting capacity. Practitioners should pay particular attention to the accumulation of stressors in parents’ lives. If parents are struggling with multiple stressors, they may need support to address each of them individually. 
  • Assessments should include whether there are any characteristics of the child or other children in the family (such as disability, medical concerns or behavioural problems), which make it hard for the parent to meet the needs of their children.
  • As with other forms of child maltreatment, practitioners play a crucial role in assessing parents’ motivation and capacity to change how they care for their children. Practitioners must maintain the balance between offering support for parents and being realistic about their capacity to change. This is particularly relevant in relation to chronic neglect, where cases may have drifted with very little improvement or change over an extended period. 
  • There may be many reasons why maintaining change can be difficult for neglectful parents. It is important not to be over-optimistic about parental capacity in difficult circumstances. The desire to change neglectful parenting does not mean that parents have the capacity to change. Assessing a parent’s capacity to change requires evidence of commitment and consistent evidence of changed behaviour.
  • Changes in parenting may be incremental. Practitioners need to assess parental capacity for change and recognise the signs of improvements. (i.e. where there are issues of parental drug use, the re-emergence of some routine may indicate that the parents’ primary focus has moved away from drug use). Subtle changes can be effectively measured through intermittent use of the Horwath model.  

Helping parents to understand the impact of their behaviour on their children

  • For parents, understanding that they may be neglectful can be a very threatening process. It can impact upon their sense of self and self-identity. 
  • Neglect may have been normalized in their home and in their community. We may need to work with parents to help them recognise the cumulative harm caused by neglect. 
  • When parents make comparisons to other families and forms of maltreatment, help them recognise the cumulative harm caused by the neglect of their children. Talk about the impact of neglect on the child and where appropriate draw upon descriptions of the daily lived experience provided by the child themselves. 
  • Practitioners should draw upon their knowledge of the lived experience of each family member to talk to parents about how their behaviour may impact each individual child within the household differently. 
  • Neglectful parents may not have appropriate understanding and appreciation of what is developmentally appropriate for each child. Parents may need support to understand what normal development for their child looks like. Practitioners may find it useful to provide clear and simple descriptions of normal development as well as of the developmental signs of neglect at their child’s specific developmental stage. Use of charts or diagrams may be useful.
  • In cases of chronic neglect, practitioners may become desensitised to the impacts upon the child. Practitioners should try to be honest and clear with parents about expectations, without creating hostility, and be empathic without colluding with unacceptable behaviour. 

Helping parents improve their parenting

  • In cases of chronic neglect, families may have had longstanding interactions with child protection workers. Parents may be wary of talking to workers and practitioners must work hard to display persistent relationship based practice. 
  • Be reliable and professional and aim to provide educative, supportive and timely assistance which addresses the specific and unique needs of each parent. 
  • Work closely with parents to address the stressors in their life that impact upon their parenting. Casework with parents should include interventions which address the causes of neglect. These interventions must also be clearly linked to specific improvements in the lives of children. 
  • Casework should always remain child focused. Parents should be encouraged to see what these improvements would look like in relation to changes in the daily lived experiences of children.  
  • Avoid developing case plans which measure success as the completion of tasks (i.e. cleaning up the house, purchasing a new washing machine).  Interventions should be linked to observable changes in outcomes for children (i.e. child has a bath every day, has a clean uniform to wear to school and shows no signs of skin irritations). 
  • In assessing parental capacity, always consider the role of the father in the family. 
  • Work with families to develop case plans which provide parents with examples of how changes in their behaviour will result in improvements in their child’s lived experience. 
  • When developing case plans which are focused on changes to the quality of life for the child, think about: 
    • What are the current aspects of the daily lived experience of the child which I am worried are unsafe or causing harm? 
    • How will the daily lived experience of the child be different when the child is safe from harm?
    • What aspects of the daily lived experience of the parent(s), parenting issues, family and environmental factors may positively and negatively influence the ability of the parent(s) to meet the needs of the child? 
    • What will the parent(s) need to do differently to ensure the child is protected from harm and the child’s lived experience improves? 
    • How can we achieve this change? What are the first steps? Who needs to do what? To what timescales? 

Videos

To learn more working with parents where neglect is an issue watch Emeritus Professor Jan Horwath’s presentation at the Research to Practice seminar. 


References 

Burgess, C., Daniel, B., Scott, J., Dobbin, H., Mulley, K. & Whitfield, E. (2014) Preventing child neglect in the UK: what makes services accessible to children and families? Action for Children & the University of Stirling, UK

Horwath, J. (2016) ‘Chapter 3. Making a difference to the neglected child’s lived experience’ in R. Gardner (ed.) Tackling Child Neglect. Research, Policy and Practice. London: Jessica Kingsley Publishers. 

Horwath, J. (2017) Under the microscope: the lived experience of neglectful families. Video recording presented at FACS Research to Practice seminar – Act with urgency: responding to neglect. Sydney, 9 May 2017.