An exploration of factors influencing professionals and families understanding and experiences of child neglect

Abstract

This study explores commonalities and differences between families and professionals’ understandings of neglect, professional confidence in identifying and working with neglect, utilising contextual data exploring relationships between community factors and the scale and spread of neglect to strengthen the depth of the findings. Organisational data confirms that child neglect remains a prevalent and pressing issue across Scotland. The scoping review of the literature highlights that both identification and working with neglect continue to be challenging for professionals. However, recent changes to the definition of child neglect within the Scottish national guidance emphasise the relationship between neglect and systemic stresses including poverty, offering an opportunity to deepen holistic understanding of neglect. Mapping of secondary data confirms local relationships between poverty and neglect, highlighting the importance of context and ‘causes of the causes’ underlying neglect. To challenge these issues, an ecological systems approach to reducing inequalities at community and structural level is important. Therefore, consistent investment in public health approaches to reduce inequalities and child poverty offering a more equitable foundation for individual intervention to address neglect is advocated. Questionnaire findings demonstrated that while professionals reported confidence in recognising neglect, they expressed significantly less confidence in decision making and intervention following identification. Thematic analysis of the questionnaire findings revealed three overarching influences on professional responses environmental, professional, and caregiver factors with poverty emerging as a dominant theme. IPA interviews with professionals, families, and young people generated a series of experiential themes, including the “revolving door effect,” professional anxiety (“Should I open the can of worms?”), feelings of powerlessness, and a shared desire for collaborative sense making. Families described feeling misunderstood, judged, and disconnected from decision making processes, particularly when the term neglect was used. The study argues for a reconceptualisation of neglect as a continuum rather than a binary classification, distinguishing between neglect arising from social stresses and neglect involving deliberate parental omission or commission. This continuum approach aligns with the updated Scottish definition of neglect and supports proportionate, context sensitive assessment. The findings also demonstrate that the term neglect is understood by families as a stigmatising label that undermines therapeutic relationships and inhibits partnership working. The study findings highlight how language shapes perceptions of risk, responsibility, and parental identity, and calls for the adoption of alternative, non judgemental terminology, particularly in cases where structural factors underpin unmet needs. Overall, the study findings offer new insights into how professionals and families navigate the complexities of neglect and identifies opportunities for policy and practice reform. Recommendations include adopting a continuum based model to support assessment of neglect, embedding shared sense-making, strengthening reflective and peer based support structures, and reframing language to reduce stigma and enhance engagement. These recommendations offer evidence-based opportunities to embed a rights-based, compassionate, equitable, and effective response to child neglect.