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Neglect

The experience of neglect during childhood can have significant, long lasting and pervasive consequences, affecting all aspects of a child’s development. These effects include cognitive and other physical development, educational achievement, children and young people’s emotional wellbeing, and behavioural difficulties.

It can also result in children and young people having difficulties making and keeping relationships, which can affect how they parent their own children and can perpetuate inter-generational cycles of neglect. Consideration needs to be taken into individual development and context, including social and economic factors such as poverty and deprivation, family, environment and community resources. In addition, practitioners should be aware that neglect is an area which can be open to personal and moral judgements.

Neglect is the most common type of abuse experienced by children and young people in England. 

Neglect is a serious form of harm. Both families and professionals can become overwhelmed and demoralised by issues of neglect. Children may experience repeated attempts by professionals to try and improve the situation.

Published case reviews highlight that professionals face a big challenge in identifying and taking timely action on neglect.

Source: Neglect: learning from case reviews | NSPCC Learning (December 2022) 

Please view this short recording from Andrew Freeman, Assistant Director, NSPCC South West and Channel Islands and Chair of the SSP Neglect Sub Group, which outlines what we are doing in Swindon to help reduce the impact of neglect on children.

The Swindon Neglect Strategy 2024-2027 sets out the strategic aims and objectives of Swindon’s approach to reducing the number of children who are experiencing neglect.

The information and resources included below will assist you in identifying, assessing and responding to neglect.

What is neglect? 

Neglect is the persistent failure to meet a child’s basic physical and/or psychological needs, likely to result in the serious impairment of the child’s health or development. This can be due to failure to give due care, attention or time to a child or through disregard or carelessness. 

Neglect may involve a parent or caregiver failing to provide adequate food, shelter and clothing, failing to protect a child from physical harm or danger, or failing to ensure access to appropriate medical care or treatment. It may also include neglect of, or unresponsiveness to, a child’s basic emotional needs. In addition neglect may occur during pregnancy as a result of maternal substance misuse.

Neglect differs from other forms of abuse because it is:

  • frequently passive
  • not always intentional
  • more likely to be a chronic condition rather than crisis led and therefore impacts on how we respond as agencies
  • often combined with other forms of maltreatment
  • often a revolving door syndrome where families require long-term support
  • often not clear-cut and may lack agreement between professionals on the threshold for intervention 
  • often fluctuate with periods of improvement following intervention and then declining when support is reduced

For further information see identification of neglect, what is neglect.

NSPCC statistics briefing - Neglect (PDF)

What to look for? 

The way in which we understand and define neglect can determine how we respond to it.

Neglect can be very difficult to notice as having one of the signs doesn’t mean that a child is experiencing neglect. In addition, it generally involves an omission and failure to do something rather than an intentional act and this can sometimes make it difficult for professionals to recognise neglectful parenting.

The standards of care against which neglect is measured are:

  • meeting the child’s basic physical needs
  • promoting their health
  • providing age-appropriate supervision, boundaries and guidance
  • providing emotional warmth and support and good family relationships
  • promoting the child’s educational development and achievement.

So you need to be alert to when there are signs that these standards are not being effectively met, such as:

  • poor physical appearance – a child who is dirty, hungry, has a lack of appropriate clothing, bad hygiene, not having access to medical care and treatment
  • poor home conditions – dirty or hazardous conditions, lack of a safe place to play, inadequate or unsuitable sleeping arrangements, young people excluded from the family home
  • behavioural signs – developmental delay, failure to thrive, poor self-esteem, aggression, withdrawal, social isolation, substance misuse, running away, non-attendance at school
  • absence of supervision/boundaries – a child who is put in danger or not protected from physical harm, use of inadequate care givers, chaotic family environment with no boundaries or routines. This may include no supervision or safety controls in relation to internet, social media, TV/ games use. A parent/carer may lack knowledge and skills about online safety.
  • failing to support their health and/or medical needs – missed health or dental appointments, failure to comply with medical advice and give medications or treatment appropriately, delayed or missed immunisations
  • considering Affluent Neglect - neglect experienced by children in wealthy families. This can be more difficult to spot, as the kind of neglect experienced by children in these circumstances is often emotional. There are a few risks that children from all walks of life face; being a child in an affluent family is often perceived to protect those children from some of these dangers. Children from wealthier, more “stable” families aren’t as sheltered from neglect as is often assumed. Excerpt from Neglect and Affluent Neglect - Merton Safeguarding Children Partnership (mertonscp.org.uk)  For further information about affluent neglect see identification of neglect, what is neglect.   

Knowing the signs of neglect can help to give a voice to children. Any child can suffer neglect, although some may be more vulnerable than others. Children who may be more vulnerable include those who are born prematurely, have a disability or have complex health needs, are in care, or are seeking asylum.

When families go through a tough time (e.g. experiencing relationship problems, financial hardship, poverty, mental health issues, addiction or bereavement), parents or carers may struggle to maintain the standards of care for their child. It is  important to have a conversation with them and to work with parents and carers to ensure they are getting the support they need in order to be able to care for their children. 

You can use some of the resources available on this webpage to facilitate this - see also the resources section. 

The following may assist your understanding:  

Why is this important?

Apart from being potentially fatal, neglect causes great distress to children and leads to poor outcomes in the short-and long-term. Possible consequences include an array of health and mental health problems, difficulties in forming attachment and relationships, lower educational achievements, an increased risk of substance misuse, higher risk of experiencing abuse as well as difficulties in assuming parenting responsibilities later on in life. The degree to which children are affected during their childhood and later in adulthood depends on the type, severity and frequency of the maltreatment and on what support mechanisms and coping strategies were available to the child.

Neglect was identified as a learning theme in two recent local Child Safeguarding Practice Reviews, Bella and Ben published in December 2022 related to the neglect of two young children. Alan, published in March 2023, highlighted adolescent neglect. The reports and learning leaflets can be accessed via the Local Child Safeguarding Practice Reviews and Case Learning leaflets - Swindon Safeguarding Partnership

Some common challenges highlighted include: 

  • subjectivity about what are good enough standards of care
  • professionals do not use the work ‘neglect’ 
  • the plan are not SMART, are not working and there still concerns for the child’s safety 
  • the family know what good parenting is but don’t do it consistently
  • lack of professional curiosity 
  • multi-agency communication 
  • parenting capacity and the use of the Mental Capacity Act/advocacy 
  • inconsistency in Core Group and Child in Need plan reviews
  • the family have significant financial difficulties and this makes it difficult to consistently meet the child’s needs

What to do? 

Although you may be worried about a child, it may not always be easy for professionals to identify neglect. There is often no single sign or incident that a child or family need help. It is more likely that there will be a series of concerns over a period of time that, taken together, demonstrate the child is at risk. If you think neglect is occurring in a family, household or for an individual child or young person don’t wait. 

Focus on the impact of the circumstances on the child and consider the following good practice principles: 

  • Voice of the child and their lived experience - see tops tips on capturing the voice of the child and capturing the voice of the child in records - Swindon Safeguarding Partnership
  • Look at the whole picture – not only what has happened to the child, but also the child’s health and development, and the wider family and environmental context. 
  • Be aware of the many factors that may affect a parent’s ability to care for a child, and that these can have an impact on children in many ways.
  • Build on families’ strengths, while addressing difficulties.
  • Guard against over optimism, adopt a balanced approach, and beware of overemphasising positives at the expense of negatives especially in situations where the standard of care fluctuates. 
  • Professionals must always show professional curiosity.
  • Make full use of existing sources of information, for example, own agency files and computer databases, others who know the child, the child protection plan, the family themselves.
  • Be creative in how you work with the family. Use a range of resources and techniques in communicating and working with them. See resources section below.
  • Be specific in relation to the changes you expect and clear about the timescales in which you expect the changes to be achieved. 
  • Discuss your concerns with the:
    • child, parent / carer and family members as appropriate
    • your colleagues, line manager/safeguarding lead and partner agencies
  • Consider 
    • What do you see on a daily basis/interaction that will contribute to any assessment? 
    • How can you express the voice of the child? See ‘Day in the life resources’

Responding to Neglect 

The SSP Neglect Framework and Practice Guidance provides further information on how you can identify neglect and what your response should be. See the section agencies roles and responsibilities.

There is an expectation that if professionals have concerns that a child is experiencing neglect they will use the Neglect Framework to make an early proactive assessment of the impact on the child. 

The Neglect Screening Tool is a resource which can help you articulate your concerns or when working with parents and carers to identify the strengths or areas requiring improvement.  

The Multi-Agency Threshold Guidance The Right Help at The Right Time will also assist in assessing the levels of need and identifying the most appropriate support. 

Further information can be found on the webpage The Right Help at the Right Time - Swindon’s Multi-Agency Threshold Guidance - Swindon Safeguarding Partnership.

Using the resources and the good practice principles listed in the section on this webpage ‘What to do’, will assist you with your decision making. 

Remember: If you are concerned that a child or young person has suffered harm, neglect or abuse, please contact Swindon Multi Agency Safeguarding Hub MASH. If a child is at immediate risk of harm, call the Police on 999.

The cycle of change

Prochaska & DiClemente’s model (1983) shows a variety of stages that one can expect to go through when modifying behaviour and highlights where someone may be at any given time during the process.  

This model applies to all types of desired change and individuals in their quest to stop or reduce unhealthy behaviours and adopt newer, healthier behaviours move through a series of five stages.  

It may be helpful to have an understanding of this model when assessing parental capacity to change.

See also SSP Practice Brief The Cycle of Change - Stages of Change.

Source: The Stages of Change (Prochaska & DiClemente) – Social Work Tech

Courageous conversations with parents/carers

Talking to parents/carers about neglect can often feel uncomfortable and challenging. 

Refer to the top tips on having courageous conversations with parents/carers. 

Motivational interviewing and communication skills 

Motivational Interviewing is an approach to being with people in conversations to support them to mobilise change to their behaviour. Further information can be found here: Motivational interviewing: what it is and how you can use it in social work.

Free face-to-face training is being delivered by professionals from the Family Nurse Partnership, SBC and some places are available to professionals from across the safeguarding partnership. 

Dates available: 

  • 19 January 2024 from 9.30am to 4.00pm
  • 19 April 2024 from 9.30am to 4.00pm
  • 12 July 2024 from 9.30am to 4.00pm

To book a place please go to the eventbrite website and select the date.

Adolescent neglect

The signs of neglect of older children may be more difficult to identify than signs of neglect in younger children. Older children may present with different risks, for example, they want to spend more time away from a neglectful home. Also, given their experience of neglect, they may be more vulnerable to risks such as going missing, offending behaviour or exploitation.

When older children who have experienced neglect come to the attention of agencies, the most obvious risks of, for example, exploitation or offending behaviour may elicit an appropriate response from professionals initially. But, without understanding and addressing the underlying impact of neglect, the effectiveness of any work to support these children will be limited.

Sometimes professionals and parents can view the presenting issues older children face as the problem. This is often an unconscious assumption however when a child’s presenting issues become the sole problem, professionals do not always consider their behaviour in the context of the impact of neglect on the child. As a result professionals may fail to take action with parents regarding any ongoing neglect.

The impact of neglect on older children can be significant and, in some cases, life-threatening. Neglect can lead to problems in adolescence and adulthood including, but not limited to:

  • poor mental and physical health
  • difficulties with interpersonal relationships
  • offending behaviour
  • substance misuse
  • a high propensity for risk-taking behaviour
  • suicide

Older children who suffer neglect may have been neglected for many years and can carry the legacy and impact of neglect at a younger age with them into adolescence. This means they are often not well equipped to cope with the many challenges that older childhood brings and may not get the support from parents to manage this transition. 

Neglect of older children may look very different to that of a young child or baby. Older children may also be skilled at hiding the impact of neglect by seeking support from places other than the family or by spending more time away from home, which in itself may put the child at more risk. They may appear ‘resilient’ and to be making choices about their lives, when in fact they are adopting behaviours and coping mechanisms that are unsafe. For example, they may look for support from inappropriate and dangerous adults or use alcohol and drugs as a form of escape.

Children themselves are not always sure that they are being neglected or abused. Research shows that children are least likely to recognise neglectful parenting compared with other forms of abuse.  When older children discuss their emotional abuse or neglect on online forums, it is common for them to question whether they are experiencing neglect (as a form of abuse) or not.

What older children require from their parents is also different to what younger children need. Older children face risks outside of the home in ways that younger children do not. Parents may not always be equipped to help their older children deal with increased risks outside the home. Alternatively, because their parents are neglecting them at home, older children may spend more time away from the home, which increases their risk of exposure to child sexual exploitation, criminal exploitation, gang-related activity or violence. These, then, are the problems that professionals first see when they encounter a neglected child and these may well be the issues they respond to. 

Unless all agencies work together to address the underlying neglect of older children who are experiencing multi-layered problems and risks, the experiences of these children are unlikely to improve. Dealing with the most immediate presenting risks first may be the correct response initially, for example by protecting the child from sexual exploitation. However, supporting and protecting older children is about addressing the risks both inside and outside the home. In cases where parents are neglecting their children’s needs, agencies must address this too.

Further information/guidance about adolescent neglect can be found in the relevant section of the Swindon Safeguarding Partnership Children’s Neglect Framework and Practice Guidance.

Additional resources on adolescent neglect:

See also section - A Day in my life child resources.

Further information can also be found in the following resources:

Disabled children and neglect 

Research indicates that disabled children are more at risk of being abused than non-disabled children. It is estimated that disabled children are over 3 to 4 times more likely to be abused or neglected. They are more likely to be abused by someone in their family, and the majority of disabled children are abused by someone who is known to them. 

This analysis covers a wide range of disabilities, including physical and sensory impairments, mental illness, mental or intellectual impairments, and long-term health problems.

Recognising signs of neglect and what to look for?

  • Carer does not recognise the identity of a child with a disability, and as a result is negative about the child
  • Carer does not ensure health needs relating to disability are met and leads to a deterioration in the child’s condition
  • Parents’ own issues impact on their ability to respond to urgent health needs of a disabled child
  • Carer is hostile when asked to seek help for the child and is hostile to any advice or support
  • A child with limited capacity located elsewhere other than their home with no knowledge of parents
  • Carer does not support child with the use of communication aids – not attending follow-up appointments or maintaining equipment
  • Carer not following dietician advice e.g. risk of aspiration by feeding orally
  • Carer overmedicating the child
  • Equipment to care for the child safely is not present in the home, despite recommendations from professionals
  • A change in behaviours that do not appear to be the norm for the child and may be indicative of harm from another e.g. acting out sexualised behaviours with toys. 

Further information can be found in this resource Neglect in Disabled Children - Hampshire SCP (2021).

A day in the life of the child 

Day in the Life Tools can help you to work with children and families to make sense of an individual’s lived experience. The model aims to help practitioners gain a better understanding of what is happening in families where neglect is an issue and what actions may lead to improved outcomes for children.

There are six versions of the “day in my life” tool, each specifically written for the following cohorts of children:
•    Day in my life – Unborn baby
•    Day in my life – Baby
•    Day in my life – Pre-school child
•    Day in my life – Primary school aged child
•    Day in my life – Adolescent
•    Day in my life – Child with disabilities

We have also produced this guide to give more information on how to use these tools.

Useful resources

7 minute and practice briefs

SSP procedures and guidance

Recordings

SSP webpages

SSP training

Other useful resources

Resources relating to the relationship between poverty and neglect

Resources relating to affluent neglect 

Professional response to child neglect in Swindon

Below we have some short clips from professionals working in Swindon who have provided some information on how they may identify, assess and work with neglect.

Dorset and Wiltshire Fire Service

Swindon health visitor services

This short video clip (duration 3:37 minutes) from a health visitor working in Swindon, provides information on their role, impact of neglect and working with children and families.

Further information can be found on the Health visitor services webpage.

If you would like to provide a recording on behalf of your agency or service, please contact the safeguarding partnership email: safeguardingpartnership@swindon.gov.uk

We would really like your feedback on the information and resources on this page and would appreciate you taking a couple of moments to let us know your views via this feedback form.