National guidance for child protection in Scotland - Scottish ...

High Risk Families
High Risk Families
Although child abuse and neglect can occur in any family, it is concentrated in
particular sectors of society where families may be vulnerable to a combination of
complex risk factors. Many of the risk factors for physical abuse are multiple, for
example, domestic abuse; alcohol and drug (mis)use; and mental health issues.
What is important to remember is that ‘multiples matter’ (Spratt, 2011) and that it
is usually the accumulation of risk rather than the presence of any single risk
factor that affects outcomes. Certainly the ‘toxic trio’ of domestic abuse,
substance misuse and parental mental ill health provide a milieu of most risk, but
we do not know enough about the relative weightings of each and there is a need
to separate alcohol and substance dependencies. Beginning to identify risk
factors, though, is not the same as being able to predict which families may harm
their children (Taylor, Baldwin, & Spencer, 2008).
In the most recent analysis of SCRs (Brandon, Bailey, Belderson, Gardner,
Sidebotham, Dodsworth et al., 2009), over half the children lived with current or
past domestic abuse (DA), almost two thirds lived in a household where a parent
or carer had a mental illness, and a substantial number of parents were misusing
drugs or alcohol. Nearly three quarters of the children had lived with current or
past domestic violence and/or parental mental ill health and/or substance
misuse. The combination of the three problems can produce a toxic caregiving
environment for the child.
Poverty
Although significant attempts have been taken to end child poverty in the UK, the
proportion of children living in poverty in the UK is higher as compared to a
generation ago and higher than the level experienced by most European
countries (Hooper, Gorin, Cabral, & Dyson, 2007). Children living in poverty are
at a higher risk of a wide range of adverse experiences and unfavourable
outcomes, including maltreatment and most notably physical abuse and neglect
by parents (Coulton, Korbin, Su, & Chow, 1995; Garbarino & Kostelny, 1992;
Waldfogel, 2007).
The main influence of poverty on parenting appears to be the stress it causes,
which in turn disrupts parenting practices and styles (Katz, 2007), though this
relationship is far from straightforward. Stressed parents are more likely to use
harsh parenting practices and therefore increasing negative outcomes for
children (Webster-Stratton, 1990).
Cycles of Abuse
Literature on the intergenerational transmission of child physical abuse suggests
that individuals physically abused in childhood are at increased risk for physically
abusing their own children (Coohey & Braun, 1997; Milner, Robertson, & Rogers,
1990). Individuals (and especially women) with a history of childhood physical
abuse had significantly higher rates of anxiety disorders, major depression,
alcoholic dependence, illicit drug use, antisocial behaviour and were more likely
to have one or more such disorders than those without such a history (MacMillan,
Fleming, Streiner, Lin, Boyle, Jamieson et al., 2001).
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