Neglect and serious case reviews (PDF, 735KB) - nspcc

uising and rough handling
An understanding of child development is also important in interpreting the significance
of any bruising in children living with neglect who may be known to have less than
optimum supervision. These children are sometimes believed to bruise themselves
more often, but any bruise needs to be carefully considered and explained in relation
to the child’s age and developmental capability. A bruise also needs to be considered
in relation to the parent’s capacity to supervise in a way that is appropriate to the
child’s developmental needs. These issues are considered in more depth in our recent
small scale study of child development and serious case reviews (Brandon et al 2011,
2012). Any bruising on a pre-mobile baby has to be considered suspicious as prior to
around six months babies have very limited control of their own movements. Older
babies are more able to bruise themselves through falls and tumbles but where there are
pre-existing concerns about neglect and emotional development, for example faltering
growth and failure to thrive, workers are right to be worried about bruising, especially
facial bruising which needs specialist assessment by a paediatrician rather than a GP.
In some of these cases professionals had noted insensitive ‘rough handling’ of babies,
and parents being verbally aggressive and smacking a toddler, and other inappropriate
behaviours that imply physical aggression. In some families this rough handling was
frequent behaviour and formed part of the child’s everyday experience, while in others
it occurred in the build up to an incident of domestic violence or when the parent was
experiencing a bout of poor mental health.
professional confusion and downgrading of harm
In some of these cases the risks of physical harm alongside neglect had been acknowledged
to some degree, but professionals did not act with any urgency and were sometimes
said to be ‘going through the motions’ in carrying out an assessment or child
protection enquiry. In these cases there tended to be a gradual dilution and forgetting of
concerns about the risk of physical harm which would be overtaken by a ‘this is only
neglect’ mindset. This would mean that re-arranging missed appointments or ensuring a
proper medical examination of a child would no longer be seen as urgent as a sense of
urgency did not fit with this neglect mindset. The danger here is perhaps that in categorising
children as experiencing neglect (or any single form of harm) less attention is paid
to the other risks they face. In particular, neglect does not preclude physical abuse.
3.7 Suicide amoNg youNg people
3. A thematic analysis of neglect
When the child at the centre of a serious case review is an older young person he or she
will have carried with them the legacy of early experiences of care and nurture. These
experiences lay the foundation of their capacity to cope with or to fail to withstand the
stresses that come from outside influences and internal pressures. A number of UK
researchers have increased our awareness of the vulnerability of older young people who
have lived with maltreatment and how easy it is to regard them as resilient, primarily
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