No.1 Neglect

What is neglect?

Neglect is defined in ‘Working Together to Safeguard Children’ 2018 as ‘the persistent failure to meet a child’s basic physical, emotional and/or psychological needs, likely to result in the serious impairment of the child’s health or development.’ Nationally it is the most common form of maltreatment in England.

Neglect can be a challenge for professionals to identify as can often be passive and not always by commission but by omission; however that does not mean that neglect should not be addressed and challenged.

Neglect may involve:

• Physical neglect – lack of shelter, inappropriate clothing, food, cleanliness and/or living conditions.
• Medical neglect – the minimising or denial of a child’s illness or health needs (including dental health) and/or a failure to seek appropriate medical attention or administer medicine and treatment.
• Nutritional neglect* – not providing adequate calories or nutritional intake for normal growth (failure to thrive). This in extreme cases could be in the form of malnutrition or cases of obesity.
• Emotional neglect – lack of responsiveness to a child’s emotional needs, including a lack of affection, love and validation, lack of nurture and stimulation, or undermining a child’s self-esteem and sense of identity – potentially through ignoring, or isolating them.
• Educational neglect – failing to provide a stimulating environment or support a child in their school activities.  Failing to respond to any special needs, or failing to comply with state requirements about school attendance.
• Lack of supervision and guidance – failing to provide an adequate level of supervision (in or out of the home) and guidance to ensure a child’s safety and protection from harm e.g. lack of a stair gate, medication not put out of a child’s reach, child out in the community with no adult supervision.

Emotional neglect vs emotional abuse*

Most experts distinguish between emotional neglect and emotional abuse by intention: emotional abuse is intentionally inflicted, emotional neglect is an omission of care.

Who does it affect?

Neglect can happen at any age, sometimes even before a child is born, and can affect children of all ages. It tends to affect boys and girls equally.  Often when a young person is experiencing neglect there may be barriers to them or their families engaging with interventions and support offered or provided.

Neglect can have short and long-term effects on a child’s development such as:

• Brain development
• Physical development
• Physical health
• Mental health
• Relationships and attachment

It may also lead them to take risk taking behaviour or ignore safety guidance.

How is it different from other types of abuse?

Neglect differs from other forms of abuse in that there is rarely a single incident or crisis that draws attention to the family.  It is repeated, persistent, neglectful behaviour that causes incremental damage over a period of time.

How can school staff spot neglect?

Staff in education settings are likely to observe a range of signs that a child may be suffering neglect. These could include:

• A child may routinely present as unkempt, dirty or odorous
• The child may display poor coping abilities or attention needing behaviour, including acting out / aggression / impulsivity
• The child may display attachment seeking behaviour, with staff or peers
• There may be a notable lack of emotional warmth/engagement from the parent/carer
• The child may disclose that they are left ‘home alone’ or that they witness domestic violence/abuse on regular basis
• A child may be very underweight with no obvious medical cause and may take food from other children.  They may be obese
• There may be unexplained changes in the child, especially in their behaviour
• The child may repeatedly miss health appointments or treatments, or no appointments may be sought by the carer
• The child may be involved in low level criminal activity, going missing or sofa surfing
• The child may take a dip in their academic attainment or progress, or may always have been academically low, including poor language skills or poor problem-solving skills
• The child may low self-esteem and negative self-representations, present as withdrawn or have difficulty in making friends
• The child may be persistently absent from school or have a pattern of absence, including lateness if a child is fending for themselves
• You may receive reports of the child being out in the locality on their own, or presenting at other people’s houses (beyond what would be expected for their age)
• You may just have a ‘gut feeling’, something isn’t right

It is important to remember that schools’ systems such as analysing attendance, record keeping/chronologies, seeking medical appointment evidence, parent evenings etc. all have a part to play in identifying and evidencing those persistent or ongoing cases of neglect.

What should school staff do?

Staff should be encouraged to recognise that their personal values and attitudes could be a barrier in identifying cases of neglect.  Think about what you know about the child and what their life might be like, this can be overlooked if a child has always presented in a certain way (it is seen as normal for that family).  Talk to other professionals to see if they share your concerns.

If the support the school can offer is not achieving an acceptable standard of care for the child, consider what other agencies or services may be able to support the child (Multi-Agency Early Help).  The Early Help Co-ordination Centre will be able to advise on this.  Use resources such as the Neglect Toolkit, Graded Care Profile alongside the Levels of Need (or your LA threshold tool) to support professional decisions. However, if the risk escalates, or improvement is not seen for ongoing neglect cases, a Front Door Request for Support should be made, including a chronology of what has been tried and to what effect.

Further Information

RESOURCES

DSCP – Neglect Tool kit

DCC Levels of need tool

CONTACTS

Devon Front Door (formerly known as the Multi-Agency Safeguarding Hub or MASH):

Consultation line – 01392 388 428          

Main telephone including emergencies or Early Help – 0345 155 1071

E-mail – mashsecure@devon.gov.uk

Request for Support Form – DCC – Request for support (outsystemsenterprise.com)

Children’s Social Care Emergency Duty Team (out of hours): 0845 6000 388

Police (non-emergency): 101

READING

National Review: Arthur Labinjo-Hughes and Star Hobson

Please refer to your Local Authority Safeguarding Partnership for specific resources, threshold tools and assessment to support the identification of and the support provided for cases of Neglect.