Child Neglect and Abuse Prevention

The evidence-based decision-making (EBD) review service seeks to improve evidence, understanding and decision making in complex cases of neglect known to local authorities. The key findings are:

• The review can play a role in improving evidence, understanding and decision making. Helpful features include: the requirement to be evidence based; the challenge provided by an NSPCC social worker; increased time given to the family; the use of numerical scores and traffic light coded charts; and the focus on strengths as well as weaknesses.

• The review was not always used to improve evidence,
understanding and decision making. The social worker’s focus, capacity for critical reflection, writing skills, communication skills and workload influenced his or her ability to get the most out of the review. The impact of the EBD review could be limited when social workers already had good evidence and understanding prior to the review.

• The findings suggest a range of activities that the NSPCC could engage in to develop practice in assessment and decision making on neglect. These are: promoting use of the review; providing an assessment service; promoting a culture of challenge and a focus on long-term safety within social work practice; and campaigning for sufficient time to be spent on the assessment of neglect.

• This report describes the different ways in which the review was used and explains the reasons for this variation. It does not aim to quantify the ways in which the review’s scale tool was used. Nor does it aim to establish the impact of the review or the validity or reliability of the scale tool used in the review. The validity and reliability of the tool has been demonstrated elsewhere (Kirk, 2008; Kirk, 2012; Kirk and Martens, 2006; Pennel, 2008).

"Es importante construir otras formas de ejercer la crianza que proporcionen una visión de la infancia y adolescencia en tanto sujetos de derechos. Así, también, se busca insistir en un replanteamiento cultural de los modelos familiares porque las madres son las principales responsables de la crianza de sus hijas e hijos, del trabajo doméstico e inserción al contexto laboral. Es fundamental tipificar la negligencia infantil con perspectiva de género y derechos humanos para detener el abandono paterno y construir modelos libres de violencia".

Background: All health care professionals in Sweden are obliged to report children whom they suspect are subject to maltreatment to Social Services, but it has been shown that professional group affiliation is the most significant factor behind hospital personnel’s decisions not to make reports. This article explores the differences between professional groups’ work with child maltreatment and the different
conditions under which they have to perform such work.
Methods: 295 physicians, nurses, nurse assistants and hospital social workers at the four largest children’s university hospitals in Sweden responded to a questionnaire. The data was analyzed using descriptive statistics, chi-square tests and binary logistic regressions.
Results: The findings show great differences between the professional groups. Nurses and nurse assistants showed a lower level of knowledge of risk to children, the legalization and the available organizational support than physicians and hospital social workers. Nurses were characterized by feeling insecure in assessments and anxious about threats, while physicians tended to feel anxious about destroying the
relationship with parents. Hospital social workers were characterized by feeling confident and trying to solve the situation themselves. It was unusual for nurses and nurse assistants to have experience of reporting, and hospital social workers were the group with the most such experience. The analysis shows that the differences between the professional groups are based on the traditional medical hierarchy,
which is seen to have a strong influence on hospital staff’s work with child maltreatment.
Conclusion: The study argues that all professional groups need training, with the opportunity to become more involved in the assessment and reporting processes. This would reduce the insecurity in assessments and support the professional autonomy of health care professional groups. Strengthening multidisciplinary structures at the clinical level would also help children who are subjected to
maltreatment to be acknowledged and to receive support or protection.