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CHRONIC NEGLECT : TRIPLE JEOPARDY

CHRONIC NEGLECT : TRIPLE JEOPARDY. Johanna Watson Kate Furst Sharon Burke. NSW Centre for Parenting and Research. CHILD NEGLECT. Definition Neglect is considered to have occurred when a child’s basic developmental needs have not been met (Dubowitz, 2004). PREVALENCE.

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CHRONIC NEGLECT : TRIPLE JEOPARDY

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  1. CHRONIC NEGLECT : TRIPLE JEOPARDY Johanna Watson Kate Furst Sharon Burke NSW Centre for Parenting and Research

  2. CHILD NEGLECT Definition • Neglect is considered to have occurred when a child’s basic developmental needs have not been met (Dubowitz, 2004).

  3. PREVALENCE • Neglect is the most common category of substantiated maltreatment in: • the United States - 61% (USDHHS, 2005) • Canada – 40% (Trocmé et al., 2001) • the United Kingdom – 42% (DfES, 2004). • In Australia it is the second most common after emotional abuse Australia – 28% (AIHW, 2006).

  4. RATES REFLECT DEFINITION • In the US, Canada and the UK over the past decade neglect has been the fastest growing category of maltreatment. • This increase in rates may in part reflect the broadening of the definition to include compromised developmental well-being.

  5. NEGLECT IS HARMFUL • Chronic neglect may carry more damaging long-term consequences than isolated incidences of physical abuse (Sullivan, 2000). • Half of maltreatment fatalities are attributable to childhood neglect (Sullivan, 2000; NSW Ombudsman, 2005).

  6. WHY TRIPLE JEOPARDY? Children are: • Neglected by their parents Compared with other maltreatment neglected children also receive comparatively little attention from: • Service providers • Researchers.

  7. AVOIDED BY RESEARCHERS? • Of 3,888 articles published on child abuse and neglect over a five year period, only 57 were specifically about neglect. • A striking number of pages devoted to the difficulties of defining neglect.

  8. AVOIDED BY RESEARCHERS? DEFINITIONAL ISSUES • It is very difficult to research a concept until it 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.

  9. AVOIDED BY RESEARCHERS? DEFINITIONAL ISSUES (cont..) • Concept of neglect socially and culturally dependent. Is it neglect if: • An 11 year old is unsupervised at home (Cawson, et al., 2000)? • An 8 year old looks after a toddler unsupervised (Laos and Cambodia - Straus & Kantor, 2005)? • Does neglect have to be intended? • Parent has developmental delay - 72% (Connell-Carrick, 2003).

  10. AVOIDED BY RESEARCHERS? DEFINITIONAL ISSUES (cont..) • Does it have to be persistent? • To what extent might outside circumstances mitigate (eg high correlation with poverty)? .

  11. DEFINITION • Neglect occurs when a child’s basic needs, as defined by current social and cultural norms, are not met by those responsible. • If basic needs are not met children are still neglected regardless of the reason. • Neglecting families may be difficult to engage in research.

  12. OVERLOOKED BY SERVICES? • Despite overseas experience that neglect is the hardest type of maltreatment to substantiate, in NSW neglect was substantiated at a higher rate than physical abuse. • Service providers are likely to respond quickly to clear incidences of serious neglect (eg young children at home alone).

  13. OVERLOOKED BY SERVICES? • Children in families where the neglect is classified as low level but it is chronic are less likely to come to the attention of service providers (US and Canada). • Family reasons • Characteristics of the parents • Overwhelmed mothers do not take children to services - eg to GPs and Baby Health Centres. • Characteristics of the child • Withdrawn children are easily overlooked.

  14. OVERLOOKED BY SERVICES? Service provider reasons • Each incident may seem trivial - not a concerning enough ‘trigger event’(Tanner and Turney, 2003). • Reported events may be given low priority, those whose safety is at immediate risk receive priority response(Little, 1995).

  15. OVERLOOKED BY SERVICES? • Case drift - when involved with the family for a long time, the level of dirt and lack of care may seem ‘normal’ for that family. • Focus on supporting parents - become involved with supporting the parents, especially if struggling, and lose focus on the child.

  16. OVERLOOKED BY SERVICES? • Cultural relativism - being overly mindful of the influence of culture. • Court evidence - it is more difficult to persuade the court system that a child is at risk of harm from neglect that if the maltreatment were physical or sexual (Sheehan, 2006).

  17. OVERLOOKED BY SERVICES? • Neglect known to be difficult - it is the most resistant to treatment initiatives producing lasting change in only 40% of neglecting families (Salmelainen, 1996). • Grave consequences to the family so workers try to avoid incorrect classification (Dept of Health, 1995).

  18. RESEARCH IN AUSTRALIA • Little is known about the picture of neglect in Australia. • In the US particularly the welfare system is very different with a 5 year lifetime limit on welfare (Berry, Charleson & Dawson, 2003). • Higher rate in the US may be associated with neglect through its strong link to poverty.

  19. PROPOSED STUDY STUDY HAS THREE COMPONENTS • Component 1 - Definitional • Component 2 - Assessment • Component 3 - Intervention

  20. PROPOSED STUDY • Component 1 - Definition Aims to: • identify the criteria to categorise neglect • identify criteria relating to severity and chronicity of neglect • identify social and familial risk and protective factors associated with substantiated neglect.

  21. PROPOSED STUDY • Method • Identify criteria used in decision-making process through focus groups representing: • differing levels of expertise • different stages of the assessment process. • identify risk and protective factors related to severity and chronicity of neglect through: • 500 case files of substantiated maltreatment • comparing with LSAC data. • design a template to ‘guide’ decision-making that takes risk factors, severity and chronicity into account.

  22. PROPOSED STUDY Component 2 - Assessment • Examine the psychometric properties and usefulness of this ‘guide’ in assisting with decision-making. Component 3 - Intervention • Examine the effectiveness of parent vs child focussed interventions as a function of severity and chronicity of neglect.

  23. FURTHER INFORMATION Literature review can be found at: http://www.community.nsw.gov.au/ documents/research_child_neglect.pdf DoCS research site: www.community.nsw.gov.au/html/news_ publications/research.htm

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