Recognizing and Helping the Neglected Child:-by Brigid Daniel and others

I must start this review by acknowledging that I have not read other recent texts on this subject, and I cannot therefore make an informed comparative judgement. I can, however, commend this book.The subject matter is of major importance in the protection of children. More children are placed on Child Protection Registers as being put at risk by neglect than other categories of abuse, and the subject causes major headaches for social workers. So many children are subject to a degree of neglect that they cannot all be removed from their families, and when is neglect so significant that action must be taken? The line taken by Professor Brigid Daniel and her co-authors has been to consider the research, to identify the soundest and most relevant and to sprinkle their findings liberally throughout the book. In all, 20,480 items were considered and 63 were finally selected as being sound, relevant and useful. This is commendable, and provides a strong basis for the authors’ conclusions and advice. The book works logically through six main themes, with a chapter on each: – understanding child neglect, – signs that parents need support, – signs that children’s needs are not being met, – responding to children whose needs are not being met, – helping the neglected child, and – preventing child neglect. For the most part this book is very thorough. Because it is based on such a wide range of evidence, it comes over as a mixture of an evaluation of the research suited to the needs of experienced professionals and a basic teach-in about neglect for social work students. This mixture does not detract from its usefulness to both groups of potential readers. The language is inevitably rather social-worky and at times a bit heavy. To break up the text and prevent it being too stodgy, there are items in boxes at intervals – either case studies or descriptions of key pieces of research. This is a good idea, but some of the boxes stretch over more than a page (e.g. pp. 122-124), which rather detracts from their impact as snappy bite-sized inserts. If anything, I would have liked to see a few more case examples. Having commended the book, let me focus on what appeared to me to be its failings. First, it seemed to me that there was insufficient recognition that neglect, as seen in poor home conditions and inadequate physical care of children, often actually implies a degree of emotional abuse. If parents do not care that their children are dirty and smell and are ostracised at school, for example, it shows a more fundamental undervaluing of the children. It is not just that the family happen to be suffering poverty. This is particularly true when neglect is long-term, and the cumulative impact of lack of parental concern is, I think, often under-estimated by social workers. There is some discussion (c. p. 63) of emotional neglect but, perhaps because of insufficient research on the subject, it does not in my view have the weight it merits. Both neglect and emotional abuse are, of course, ‘abuse by omission’, and are harder to substantiate if social workers need to prove a case for action. Secondly, I did not feel that the book gave practical advice to social workers to help them decide when to act. A distinction is made between the need to take action in the early stages and formal child protection, but I have come across cases where standards in families have sunk by degrees to the point where social workers realise that they should have taken formal action much earlier. This is a problem particularly if there is no incident which precipitates action; social workers seem to become inured to the poor standards in the home, perhaps feeling that the life-style is a matter of the clients’ choice. Allied with this problem is that of families who become less co-operative over time. There may be an assumption that people and families are constant, but they change, and if case files are read covering, say, a decade or more, it will be seen that clients often become more hostile, perhaps in part because of defensiveness in the face of criticism, or in part because of frequent changes of social worker. Some clients become expert in manipulating professionals and getting them to play their game. There are references to this (p.113 and the criticism of passive case management on p. 127) but it deserves more coverage. The point of all these observations is that texts of this sort need to alert social workers to the complexity of the issues and to give them handles for action. In this respect I felt this book fell short. Thirdly, the book focuses on the casework and relational aspects of dealing with neglect well, but there are very few references to practical action. Maybe social workers these days are only expected to talk about things and not actually do anything practical to help families suffering from neglect. But there are times when a depressed or overburdened parent needs a helping hand to get back on track. Cases in which I have been involved recently have included – help by social workers in cleaning houses and decorating, – the provision of daily family aides to make sure that the children get to school on time, – the provision of skips to help shift the rubbish which neglectful parents sometimes acquire, – a social worker getting down to floor level to play with the children, offering a model for the mother to join in when she did not know how to pay, – a teacher who helped a smelly child by providing a shower at school before the school day started, – the provision of small grants at crisis times, and – HomeStart advisers supporting parents (how can one write a book about neglect and fail to refer to HomeStart’s impact?). I am not denying the need to resolve the families relational and motivational problems, but some of the problems are primarily practical, and getting alongside clients can be a real morale boost for them. In particular, I was amazed to see absolutely no reference to the use of family rehabilitation centres as a valuable means of helping parents learn how to look after their children, budget, relate to each other, and cope with the whole range of issues which lead to neglect. The impact of these centres on the lives of families with multiple problems has in some cases been dramatic. I am aware that there is a strand of social work thinking that is opposed to any residential care, but to ignore this range of provision is a serious omission. The book ends with the proposal that neglect should be seen as a matter of public health. This is an interesting idea, but as neglect is the outcome of human behaviour and attitudes it is misleading to compare it with health problems that can be solved by vaccination. It is more akin to mental health and substance abuse problems, and to assume that it can be wiped out like smallpox is, in my view, overoptimistic. This warrants more debate; I would personally prefer a stronger community-based approach, as extended families and neighbours are the ones who often offer support or raise the alarm. Involving and strengthening these networks could support families better and reduce the need for statutory action. Finally, as an Editor, I noted half a dozen slips in spelling and grammar. (I quite liked the notion of abuse being ‘maletreatment’.) None rendered the text ambiguous, but a book of this sort should be error-free. In conclusion, though half of this review describes its shortfalls, it remains an excellent book. Indeed the comments made above essentially highlight the importance and complexity of the subject, and the authors rightly identify several areas as meriting more resarch. Jessica Kingsley are producing quite a flood of interesting texts at present, and they are to commended for publishing this book. Daniel, Brigid, Taylor, Juliet, Scott, Jane, Derbyshire, David and Neilson, Deanna (2011) Recognizing and helping the Neglected Child Jessica Kingsley, London ISBN 978 – 1 – 84905 – 093 – 7