Tackling child neglect in Scotland 2: rapid review of intervention literature

Emerging themes

17. Child neglect is a societal problem requiring systemic intervention addressed through collaborative partnerships between statutory and non-statutory sectors and community members with attention to contextual factors, including poverty (Chambers and Potter 2008; Hearn 2011). It may be that society needs intervention at different levels: p rimary (or universal) prevention or public health approaches are designed to prevent behaviours before they occur. Such approaches focus on reducing risk factors and enhancing protective factors; secondary (or selected) prevention focus on the early detection and treatment of existing problems, often targeting groups or individuals identified as at-risk; and t ertiary (or indicated) prevention approaches are designed to reduce the impact of existing problems (i.e., the re-occurrence of abusive behaviors). Thus, tertiary prevention programs focus on families in which abuse has already been identified (Hardiker 1991; Portwood 2006).

18. Several wide ranging factors are seen as potential contributors to child neglect, but only some may feature in a particular family at any one time (Garshater-Molko, Lutzker and Sherman 2002). In a recent article, Daniel (2013) neatly summarised the complex issues:

‘The evidence points to the need to build comprehensive packages of support that are clear, focused and address the issues at each ecological level. In particular, there is evidence that the provision of direct support for children is of especial value. Intervention also has to include attention to the processes underlying service use and change, and it can hinge on the quality of the relationship between the practitioner and the parent and/or child. Authoritative intervention combines understanding of the factors affecting parents with realism about parental capacity and willingness to change based on close observation of evidence about the child's experience of care (Tuck, 2012). And, crucially, intervention to support neglected children has to be provided on a long-term, not episodic basis, but, again, we have known this for a long time.’

[Daniel 2015, p.10]

19. To understand how we might have a greater impact with children, young people and families living with neglect, the body of evidence is universal in identifying that attention needs to be given to individual family members in the context of their lived experiences in the home and within the wider community. This review does not provide answers, but does identify some common core principles grouped under the following emerging themes:

• Building blocks of an intervention
• Working with individual children, young people and families
• Interventions and programmes
• Working with communities
• Relationships