Cumulative harm in the child protection system: The Australian context

Cumulative harm is a major child protection concern, with significant consequences for child well‐being and development often into adult life. This systematic literature review examines how the construct of cumulative harm is understood and operationalized within current Australian child protection legislation, policy, and practice and situates this within an international context. Scholarly articles and grey literature were qualitatively analysed to explore two main research questions: How is cumulative harm to children identified, assessed, and ultimately incorporated into child protection and legal structures? And what are the most effective responses to cumulative harm identified for child protection practice? What was found was that although the construct of cumulative harm is increasingly incorporated into child protection practice and legislation, in practice, this remains crisis‐driven. Although the literature emphasized prevention and early intervention as responses to reducing the cumulative impact of adverse childhood experiences, there is negligible research on what constitutes an effective response to cases involving cumulative harm. They are cases which are less visible within the child protection paradigm; attention to the impact of risk of maltreatment and its influence on long‐term developmental outcomes is less well addressed creating uncertainty and ambiguity about effective responses for child protection.     

Equipping child protection practitioners to intervene to protect children from cumulative harm: legislation and policy in Victoria,Australia

Many children are repeatedly reported to statutory child protection services, but do not receive the protection they need. Many such children are suffering chronic maltreatment, which is likely to result in cumulative harm. Chronic maltreatment encompasses emotional abuse and chronic neglect. As a result, children can experience a range of cognitive, emotional, and behavioural problems that are more serious than those associated with other abuse types. This paper focuses on the Victorian statutory child protection system, and considers why cumulative harm is not receiving the attention the legislation intends. Under the Victorian legislation cumulative harm must be proven on grounds of emotional abuse and/or neglect. However, it is difficult for child protection practitioners to place before the court the necessary evidence to establish these grounds. The paper concludes that the legal definitions of emotional abuse and neglect should not require evidence of a link between the abusive actions of the parent and the poor outcomes for the child. The evidentiary focus should be on the actions of the parent. Furthermore, legislation should focus on abusive parental behaviours that are likely to result in cumulative harm, which are more concrete and measureable than emotional abuse and neglect, such as intimate partner violence and parental illicit drug use.     

Contextualizing case reviews: A methodology for developing systemic safeguarding practices

This paper introduces a systemic methodology for reviewing professional responses to abuse between young people. The approach, “contextual case reviewing,” draws upon constructivist structuralism to assess the extent to which safeguarding practices engage with the social and public contexts of abuse. The paper conceptually compares the methodologies of contextual case review and other serious case review methods before drawing upon findings from 2 studies, which used the contextual case review methodology to explore the extrafamilial nature of peer‐on‐peer abuse and the ability of child protection practices to engage with this dynamic. Thematic findings from these studies regarding the practical interpretation of “significant harm” and “capacity to safeguard,” as well as their use within child protection assessments, are used to challenge conclusions of other case reviews, which imply that child protection procedures are sufficient for safeguarding young people. Contextual case reviews suggest that safeguarding practices, and the legislation that underpins them, are culturally, procedurally, and organisationally wedded to the context of the home, whereas insufficiently engaged with extrafamilial contexts of significant harm. The application of these issues require interrogation if social work systems are to provide sufficient mechanisms for safeguarding young people and families at risk of significant harm.     

Repositioning prevention in child protection using performance indicators

ABSTRACT

Performance indicators have both technical and value dimensions, capable of providing data for monitoring and reporting in addition to framing policy problems and their solutions. This paper considers the performance indicators proposed in a recent child protection inquiry in Australia that recommended ‘decreasing the numbers of children in the child protection system’ as a primary policy objective. The paper examines the context in which the indicators were set, the values and theories they endorse, and how they position stakeholders. The analysis shows how the indicators communicate that child protection services should be only for the most serious cases of child maltreatment, and the reach of statutory services should be curtailed. Children who have been maltreated or who are at risk of harm from abuse or neglect should be diverted from the child protection system (positioned as bad) to the family support system (positioned as good), and at the same time from the state to the nongovernment sector. The shifting relations between government, service providers, and families signified by the indicators can be seen in a broader international context of tightening the boundaries around child protection and concurrently advancing concepts of compliance within family support.     

Parents' involvement in care order decisions: a cross‐country study of front‐line practice

This article examines parents' involvement in care order decision‐making in four countries at one particular point in the care order process, namely, when the child protection worker discusses with the parents his or her considerations regarding child removal. The countries represent different child welfare systems with Norway and Finland categorized as ‘family service systems’ and the USA as a ‘child protection system’, with England somewhere in between. The focus is on whether the forms and intensity of involvement are different in these four countries and whether the system orientation towards family services or child protection influences practice in the social welfare agencies with parents. Involvement is studied in terms of providing information to parents, collecting information from parents and ensuring inclusion in the decision‐making processes. A vignette method is employed in a survey with 768 responses from child protection workers in four countries. The findings do not show a consistent pattern of difference regarding parental involvement in care order preparations that align with the type of child welfare system in which staff work. The goal in each child welfare system is to include parents, but the precise ways in which it is carried out (or not) vary. Methodological suggestions are given for further studies.     

Chronic Child Abuse: The Characteristics and Careers of Children Caught in the Child Protection System

The introduction of the Quality Protects initiative in Englandand the focus on performance management has challenged socialservices departments to examine the systems, processes and outcomesfor children who have their name on a child protection register.Research indicates that approximately one-quarter of the situationsin which children are registered could be described as chronic—thatis, they remain on the child protection register for significantperiods of time, experience more than one period of registrationor suffer a further incident of significant harm whilst subjectto a child protection plan. In this article, the findings froma research study conducted into this group of vulnerable childrenare reported, focusing on the characteristics of the childrenand their families, and their careers in the child protectionsystem. The paper concludes with observations about the weakconceptualization of performance management and the need torecognize the complexity of the factors that influence children’scareers in the child protection system.     

Relating outcomes to objectives in child protection

With the introduction of the Children (Northern Ireland) Order 1995, Health and Social Care Trusts in Northern Ireland have been engaged in a refocusing of children's services, shifting resources and interventions towards supporting families at an earlier stage in order to reduce the likelihood of crisis, breakdown or abuse at a later stage. Alongside this development the Government wishes to see a clearer link between the objectives of the child protection system and the outcomes for children and their families. This paper critiques the current system of performance management in the child protection system. Using data from a study exploring the characteristics and careers of children in the children protection system in Northern Ireland it is argued that the current measurements of performance are too basic and are designed principally to monitor the operation of the system rather than the impact of services and interventions on the lives of children and their families.     

Children’s Participation in Child Protection Practice in Ghana: Practitioners’ Recommendations for Practice

Abstract

The United Nations Convention on the Rights of the Child (UNCRC) includes provisions to ensure that children and young people participate in decisions affecting their lives. Ghana ratified the convention in 1990 making a commitment to review its child protection policies and legislation in compliance with provisions in the UNCRC. Yet, national policies and legislation do not include practical guidelines to promote children’s participation in the child protection process. Thus, this qualitative study presents findings from in-depth interviews with 15 child protection practitioners on their views about some practical guidelines to promote children’s participation in child protection. Data from the interviews were subjected to constructivist grounded theory analysis. The study findings revealed the age of the child, separate room for children, creating a friendly environment and education as some important factors for practitioners to consider in promoting participatory practices for children. Child protection policies and legislation in Ghana should include these suggestions to ensure that children’s views are heard in the child protection process. To realize the overarching goal of achieving active child participation in child protection, further research may focus on the views of parents and children on how to develop culturally relevant strategies to promote child participation.     

Understanding child,family, environmental and agency risk factors: findings from an analysis of significant case reviews in Scotland

This paper presents the findings from an analysis of 56 significant case reviews (SCRs) in Scotland. In contrast to England and Wales where national analyses have been undertaken for many years, until this study was undertaken, the findings from SCRs had not previously been collated nationally. The paper discusses child, parent, environmental and agency factors that were identified in the SCRs and, whilst noting that the pathways to death or harm will be unique in individual cases, tries to further our understanding of the ways in which these different factors may interact to result in death or harm. A significant finding was the high number of SCRs that relate to the care and protection of children living in families whose lives are dominated by drug use and the associated issues this brings, including criminality and neighbourhood problems. Another challenging finding was the lack of suitable resources for the placement and support of troubled teenagers. Finally, a number of SCRs involved long‐term neglect and/or sexual abuse of school or nursery age children who had been known to statutory services for many years.     

Effective casework practice with adolescents: perspectives of statutory child protection practitioners

Many child protection practitioners struggle with the complexity of problems and the limited casework time for adolescent cases. However, there is little research on child protection practice or case management that can guide a practitioner working with adolescents in the child protection system. The aim of this study was to explore and describe the nature of effective child protection practice with adolescents from the perspective of statutory child protection practitioners in one state in Australia. Data were collected through focus group discussions and interviews with child protection practitioners and managers currently working with adolescents (n= 44). A grounded theory approach was used to identify the dominant themes or categories and form linkages and relationships through constant comparison techniques. Seven key categories emerged from this analysis: characteristics of the young person and their family; ‘walking it together’– the centrality of relationships; ‘looking back/looking forward’– practice strategies; practitioner attributes and skills; ‘walking a fine line’– working with the families of adolescents; ‘walking with services’– effective inter‐agency work; and organizational context in effective child protection practice with adolescents. Key implications for practice and areas for further research were discussed.     

Significant harm and children's experiences of domestic violence

This is the first of two papers concerning children and domestic violence, both of which draw on findings from a Department of Health commissioned study of children suffering or likely to suffer significant harm. This paper discusses the ways in which children appear to be harmed by witnessing violence between their parents or parental figures. A brief review is offered of the literature concerning the developmental and behavioural effects on children who have lived with domestic violence. Selected findings from the research study are then discussed. Out of a cohort of 105 maltreated or neglected children, 49 were discovered to be regularly witnessing violence between parents at home. The emotional, social and behavioural effects on 28 children who were studied in detail are presented, through three case studies. Examples are offered of the way in which professionals overlook, discount or downgrade the harm to the child from this hostility. The emotional impact on the child of living with domestic violence rarely forms part of the assessment of significant harm made at the child protection conference; nor does it feature in subsequent plans to protect the child.     

Risk and Public Protection: Responding to Involuntary and ‘Taboo’ Risk

Growing media, political and public concern with high‐risk offenders in the community has focused policy attention on the concept of ‘public protection’. A notion that the public has the right to be protected, particularly from ‘monstrous’ offenders such as predatory paedophiles, has infiltrated much recent legislation and penal policy. This article will explore the critical factors in the ‘public protection’ trend and the framing of risk and risky offenders that has ensued. In particular, attention will be given to the new surveillance and intervention mechanisms under the Multi‐Agency Public Protection Arrangements (MAPPA) and whether these arrangements manage risk or displace it. To what extent are they driven by the ‘precautionary principle’ and defensive responses to risks that are over‐inflated? To what extent does this result in ‘perverse incentives’ to over‐manage certain risks and to over‐concentrate on restrictive risk management techniques such as electronic tagging, satellite surveillance and curfews rather than treatment? Does the system represent effective risk management or a system for dealing with risk anxiety – both of the public(s) and of politicians?     

‘Like walking on eggshells’: service user views and expectations of the child protection system

This paper reports on a study of service users' views on Irish child protection services. Qualitative interviews were conducted with 67 service users, including young people between 13 and 23. The findings showed that despite refocusing and public service management reforms, service users still experience involvement with the services as intimidating and stressful and while they acknowledged opportunities to participate in the child protection process, they found the experience to be very difficult. Their definition of ‘needs’ was somewhat at odds with that suggested in official documentation, and they viewed the execution of a child protection plan more as a coercive requirement to comply with ‘tasks’ set by workers than a conjoint effort to enhance their children's welfare. As in previous studies, the data showed how the development of good relationships between workers and service users could compensate for the harsher aspects of involvement with child protection. In addition, this study demonstrated a high level of discernment on the part of service users, highlighting their expectation of quality standards in respect of courtesy, respect, accountability, transparency and practitioner expertise.     

Adoption and permanence planning in Scotland: Impact of the Adoption and Children (Scotland) Act 2007 on key processes and timescales

Adoption and permanence planning has been a key feature of Scotland's policy in relation to children and young people who are “looked after.” Although policy and law has significantly developed in recent years, there has been comparatively little research on permanence processes in Scotland. This paper outlines key findings from the first comprehensive study of permanence planning in Scotland. It examines the process for two cohorts of children where adoption or other types of permanence orders were made. The children were selected under the long standing Adoption (Scotland) Act 1978 and the more recent Adoption and Children (Scotland) Act 2007. In total, 300 cases were examined, analysing data from the children's first contact with services through to the order made by the Scottish Courts. This paper pays particular attention to the timescales found at key stages under the two sets of legislation and asks what difference the change in legislation has made.     

Child protection in China: threats and opportunities

Abstract

Since the inception of the Law on Protection of Minors in 1991, the Chinese government has increasingly emphasised child protection development by promulgating domestic legislation on children’s protection, and establishing policy and service delivery goals. This article critically appraises relevant academic literature, policy documents in relationship to the development of China’s child protection system. We found that although child protection policies exist, enforcement at local levels is characterised by sectorial fragmentation. There is a need to increase government-led initiatives in child protection, to strengthen the institution of family as a protective factor for children, to enhance professional competency and to develop innovative service delivery in partnership with civil society.     

Multi‐agency information practices in children's services: the metaphorical ‘jigsaw’ and professionals quest for a ‘full’ picture

As there are a number of high‐profile public inquiries into child death tragedies, ‘information sharing’ has now become a moral and political imperative across England and Wales for improving the welfare and protection of children. This paper discusses multi‐agency information practices, at the stage of referral, which were observed and documented in the day‐to‐day practice of child protection work. Drawing on transcribed, professional narrative accounts, a ‘jigsaw’ metaphor is used to describe the process of piecing information together to ascertain a ‘full’ picture of children and families lives. However, these accounts highlight that there is something of a mismatch between the jigsaw, as articulated in the conceptual abstract accounts, and jigsaw practices operating on the ground. It is argued that abstracting professional information practices from situated contexts creates impoverished understandings of these practices. Thus, reported findings in this paper highlight the inherent complexities of jigsaw practices in the ‘everyday’ of child protection work, which challenges objectivist assumptions about a stability of meaning, and further highlight that the ‘endpoint’ of reaching a ‘full’ picture of a child's life is not fixed, nor does it have the same meaning for all professionals, but rather it is a complex process involving sense‐making, translation in context and organizational relevance.     

Child safety in policy: Who is being kept safe and from what?

Keeping children safe from harm is a national policy priority in Australia. Extensive inquiries and reviews have highlighted institutions' persistent failures to respond ethically and appropriately to child abuse and its life-long impacts on survivors. Policy efforts now reflect considerable emphasis on safeguarding children, including through the development of ‘child safe’ organisations. The realisation of these policy aspirations requires close attention to how ‘child safe’ is conceptualised and operationalised in different organisational contexts. Drawing on an analysis of policy in Australia and other international jurisdictions, namely New Zealand, the United Kingdom and Ireland, this article engages critically with the notion of ‘child safe’ in policy, to explore who is to be safe, from what and how, in organisational settings. The findings suggest emergent discourses of ‘child safe’ are bound up with particular constructions of both children and safety, reflect current social and political understandings and agendas, and have implications for organisations' approaches to safety. Ensuring the safety of children in Australia and other jurisdictions requires continuing scrutiny of policy implementation to make sure current policy efforts are not reduced to compliance-based imperatives that protect organisations, but fail to create the cultural conditions that enhance children's wellbeing and safety.     

Linking illicit substance misuse during pregnancy and child abuse: what is the quality of the evidence?

In most Australian states, legislation makes provision for professionals to report their concerns about the future welfare of an unborn child to appropriate authorities. The legislation establishes guidance for the implementation of family supports to minimize future child protection involvement. Given the legislation and the potential benefits, empirical research linking substance misuse during pregnancy and child protection involvement is relatively limited. We review 21 original studies linking substance misuse during pregnancy with child protection outcomes and the potential generalizability of results to the Australian context. The majority of studies reviewed were conducted in the USA and were mostly retrospective. Other differences between studies include sample sizes, comparison groups, study setting, participants’ ethnicity and pattern of drug use. In the postnatal literature, it is well established that child abuse is associated with a complex array of factors including partner, as well as broader family factors and yet, the studies reviewed focus upon maternal substance abuse without including the wider context. Given the available evidence‐based literature, it is difficult to come to definitive conclusions that can assist clinicians involved in frontline decision‐making for early intervention. Well‐designed research, accessible by antenatal health‐care professionals, is needed to adopt an evidence‐based approach to risk assessment in the prenatal context.     

Social workers' attitudes towards family group conferences in Sweden and the UK

The New Zealand family group conference (FGC) approach to decision making in child welfare and protection has attracted strong interest among policy makers and professionals all over the world. While New Zealand’s legislation makes use of FGCs more or less mandatory in child protection, other countries permit social workers to refer families to an FGC at their own discretion. Knowledge about social workers’ attitudes towards the model is thus paramount if we want to understand implementation and evaluations of FGCs outside New Zealand. This study looks at attitudes towards and actual referrals to FGCs amongst 219 social workers from 18 local authorities in Sweden and the UK. Results reveal an overwhelmingly positive attitude towards FGCs in both countries. Given these attitudes it was striking that only 42% of the social workers had initiated at least one FGC over an 18‐month period. The number of implemented FGCs was almost exactly the same in Sweden and the UK, after adjusting for time and number of social workers. Possible explanations for this paradox are discussed, using data from the survey and child welfare literature.