protect children from experiencing abuse, neglect or harm;
avoid problems escalating;
reduce the need for safeguarding enquiries and interventions;
have long-term benefits for the child’s health and well-being.1
It is important therefore, that early help is offered to children that are identified as vulnerable to possible abuse and neglect and their families.2
Moreover, recent research by Public Health Wales has highlighted how Adverse Childhood Experiences (ACEs) can affect individuals throughout the life-course.
The ACEs include:
Living within a household where there are issues, such as domestic abuse, mental illness and drug and alcohol misuse;
Parental separation and family breakdown;
The researchers found those who had experienced four or more ACEs were more likely to have issues including, health-harming behaviours, poor mental health, chronic disease and wider social problems such as unemployment, lower socio-economic status and diminished social mobility. There is also increased risk of the child becoming involved with the criminal justice system.3
Bearing in mind the possible detrimental effects of abuse and neglect throughout the life course the most effective strategy is to prevent children from experiencing abuse, neglect and harm.
The tasks for practitioners in contact with children and their families who may be vulnerable to abuse and neglect are two-fold to:
and, if this is not effective:
When identifying possible emerging concerns about abuse and/or neglect practitioners should ask:
What are my concerns about the child/ren’s well-being that if not addressed could cause significant harm?
What is the evidence to support these concerns?
Am I concerned that parenting capacity and family and environmental factors, such as poverty, are impacting on the well-being of the child and their vulnerability to abuse and neglect?
They should also record these concerns and information obtained.
If at any point during their involvement with a child/family a practitioner becomes concerned that the child may be experiencing or at risk of experiencing abuse, neglect or harm they should discuss their concerns with their safeguarding lead. (See Duty to Report )
Practitioners who are in contact with children and their families are particularly well placed to identify emerging concerns about abuse and neglect. They include:
those working in education, such as teachers, classroom assistants, mentors, playground supervisors;
practitioners in housing and benefit services;
health practitioners including, GPs health visitors, school nurses, midwives, CAMHS, paediatricians;
those delivering services to parents or carers with adult-orientated issues such as drug and alcohol, mental health learning disabilities and domestic violence;
those in criminal justice settings such as police, probation and youth offending teams;
those providing services to specific age groups, such as nursery staff, youth workers;
community based practitioners.
N.B. this is not an exhaustive list.
It is essential that the child and family are actively engaged in determining the best way in which their needs can be met.
The child must be seen and listened to and their wishes and feelings considered, whatever their method of communication. Engaging with, and listening to, what children and young people say about what is happening to them should be the cornerstone of effective intervention and support.
Children and their parents/carers are most likely to engage with early help services if:
services are timely and accessible bearing in mind the specific needs of the family members;
time is spent by practitioners forming positive and trusting relationships with the family;
misconceptions about safeguarding services are dispelled;
information is shared openly and honestly.4
Interventions can take various forms:
information for example on child development, communicating with young babies;
general and/or specific advice for example on bed wetting, bedtime routines;
assistance for example, home visiting support programmes for vulnerable families, school-based programmes on internet safety, mentoring programmes for young people displaying risk-taking or challenging behaviours.
These interventions may be provided by practitioners from a diverse range of disciplines who are in contact with the child and their family.5 For example, health visitors may be best placed to provide advice about child development in early years.
When determining the most appropriate interventions consideration should be given to:
a holistic approach;
supporting and working with the family as equal partners to plan and deliver the intervention/s;
empowering the family considering how they can retain control over their day to day lives and achieve what matters to them;
producing innovative solutions for example through local networks and communities;
timely interventions delivered in the right place;
selecting a diverse range of services that consider the needs of individual family members. for example, parenting programmes and mentoring for a young person;
recognising interventions need to be flexible and recognise individual family needs and circumstances;
particular family members’ needs for example, age and stage of development, disability, communication;
ways in which any emerging or new needs will be addressed;
shared ownership and active contributions by all practitioners involved with the child and family.
The following questions are designed to identify and deliver appropriate interventions:
What do we (agencies and family) want to achieve?
How will we know when we have achieved these outcomes?
How can we build on family strengths?
How are we going to do it? (Think Information, Advice and Assistance)
Who is going to do what?
What are the timescales?
How will we monitor progress?
1 Early Intervention Foundation (EIF) (2018) About early intervention: why it matters
3 Public Health Wales https://phw.nhs.wales/topics/adverse-childhood-experiences/
4 Easton, C., Lamont, L., Smith, R. and Aston, H. (2013). ‘We Should Have Been Helped from Day One’: a Unique Perspective From Children, Families and Practitioners. Findings from LARC5. Slough: NFER www.nfer.ac.uk/publications/LRCF01