Mandatory reporting on child abuse and neglect: the consultation

I’ve just responded to the government consultation Reporting and acting on child abuse and neglect which closes on 13 October. It’s prompted some thoughts;

The challenge

Preventing children being harmed. Obviously.   But that’s a pretty broad remit. Local authorities and the agencies they work with have a statutory duty to ‘make arrangements for ensuring that their functions are discharged having regard to the need to safeguard and promote the welfare of children’ (s. 11 Children Act 2004). Basically they should have appropriate procedures in place. That prompted this comment from Eileen Munro in her Review of Child Protection;

‘…instead of “doing things right” (i.e. following procedures) the system needed to be focused on doing the right thing (i.e. checking whether children and young people are being helped)’ (Consultation document para 5)

Since the 2004 Children Act, safeguarding children seems to have had an increasingly high profile; promoting the welfare of children appears to have taken a back seat. Here’s how the current government sees it;

“…Safeguarding children – the action we take to promote the welfare of children and protect them from harm…”(para 2)

In other words the broad duty to promote the welfare of children – with all that that entails – now boils down to protecting children from abuse and neglect.  And the child protection system doesn’t always work. Numerous people have pointed out that no system can guarantee the protection of all children; we don’t have, and never will have, the resources to do that.

The nation has been, understandably, shocked to the core by accounts of the appalling abuse some children have suffered. The news that one child each week is killed on our roads and over 2000 a year are seriously injured in contrast barely makes the headlines; child protection isn’t just about abuse and neglect.  But children are abused and neglected and recent high profile cases have been shocking partly because they’ve highlighted clear failings in the child protection system. The reporting and acting consultation is part of the government’s response.

What the consultation proposes is that reporting and acting on suspected child abuse and neglect is made mandatory for people working in certain organisations. If they don’t report and take appropriate action, they could face serious sanctions. The people include not only those working directly with children but support staff and senior officers. As the consultation document points out, the possibility of sanctions introduces a significant risk of unintended and unwanted outcomes, such as unwarranted intrusion into family life and even more problems with recruitment and retention of social workers.

The evidence

On the face of it, mandatory reporting and acting looks as if it makes sense; if everyone reported and acted on their concerns, surely children would be much safer. But the evidence doesn’t support that reasoning. The evidence shows that when mandatory reporting is introduced the number of referrals increases dramatically (in Australia it doubled), but the proportion of substantiated cases is low (around 20% in several jurisdictions).   As the consultation document itself says:

‘Overall, the literature seems to show that “there remains some question about the efficacy of reporting laws in achieving their ultimate goal: protecting children from harm”’(Annex D p.22).

The causes

Not only does the evidence demonstrate that mandatory reporting doesn’t help, but reporting and acting per se don’t play a major role in the failures of the child protection system to protect children, either. Serious case review after serious case review identifies complex decisions to which there is no obvious right answer, and not following existing procedures properly, as key factors in the failure to protect children from harm. SCRs are littered with accounts of novice social workers being assigned to difficult cases, agency staff unfamiliar with cases, inadequate supervision, lack of understanding of the law and poor communication between agencies – all signs of services that don’t have the capacity to meet demand. In the vast majority of cases, the problem wasn’t that no one had reported their suspicions or failed to act on them.

Given the lack of evidence for the effectiveness of mandatory reporting and acting, and the fact that reporting and acting weren’t the main causal factors of failure, why is the consultation happening at all?

Why consult?

The consultation appears to be have been prompted by some recent high profile cases where abuse and neglect was known about but ignored; the consultation document cites Jimmy Savile’s activities and the sexual exploitation cases in Rotherham, Rochdale and Oxfordshire. Mandatory reporting and acting has been suggested by “MPs, MPs, Peers, campaign groups and members of the public” (consultation document Foreword). But MPs, Peers, campaign groups and members of the public might not be familiar with the evidence for the efficacy of their suggestion.   The way the child protection system is designed isn’t a matter of opinion, it’s a matter of the evidence for what’s effective.

The only reason for consulting that I can think of that is that it’s politically advantageous; the government is seen to be doing something. As the consultation document says “… it is crucial that we do all that we can to strengthen our arrangements to minimise the risks as far as possible” (para 14). Yes, it is, but there’s no evidence to suggest this is the way to do it.

If there are problems with a system, the only way to address them effectively is to identify the root causes of those problems.   SCRs provide a wealth of evidence for those root causes. We need to be looking at them, not quick fixes that we know won’t work and could make things worse.

brain development and social problems

Reading the final report of the Munro Review of child protection, my attention was caught by what turned out to be a minor typographical error. The last sentence of paragraph 5.8 appears to refer to reference 95, the Royal Society paper Brain Waves Module 2: Neuroscience: implications for education and lifelong learning, but in fact cites reference 94. Reference 94 is an independent report commissioned by the current UK coalition government, published in January 2011, written by Graham Allen, Labour MP for Nottingham North and entitled Early Intervention: The Next Steps.

Graham Allen MP

Early intervention is summed up as follows by the ‘Early Intervention Review Team’;

Early Intervention is an approach which offers our country a real opportunity to make lasting improvements in the lives of our children, to forestall many persistent social problems and end their transmission from one generation to the next, and to make long-term savings in public spending….” (p.vi)

In 2008, Graham Allen had written another paper on early intervention, this one co-authored with Iain Duncan Smith and entitled Early Intervention: Good Parents, Great Kids, Better Citizens published jointly by the Centre for Social Justice (CSJ) and the Smith Institute. Iain Duncan Smith is a former leader of the Conservative Party and currently Secretary of State for Work and Pensions. In 2004, he founded the Centre for Social Justice, a centre-right think tank, just after his period of party leadership ended. The Smith Institute is a left-leaning think tank set up in 1996 in memory of the former Labour Party leader, John Smith. Ed Balls, later to become the Labour government’s Secretary of State for Children, Schools and Families, worked for the Institute between 2004 and 2005.

Rt Hon Iain Duncan Smith, Secretary of State for Work and Pensions

In previous posts I’ve complained (at some length) that the model of child development being used by children’s services pays little attention to recent biological research. It would be unfair to suggest that biology is entirely absent however. There are many references to physical development in this literature, Aldgate et al’s book contains a chapter on genetic and biological influences and the Munro report cites the National Research Council’s From Neurons to Neighbourhoods: The Science of Early Childhood Development – chapter 8 contains a comprehensive summary of brain development. The second chapter of each of the two documents written by Graham Allen is also dedicated to brain development. It’s these two chapters I want to concentrate on in this post.

I’m not entirely clear why it was deemed necessary to refer to brain development in papers about early interventions intended to forestall social problems. After all, few people would want to see evidence from brain scans before they could be persuaded that sanitation, a balanced diet or education have good outcomes for individuals and for the population as a whole. And given the technical problems with brain scanning and the interpretation of the resulting images, there are other more reliable ways of measuring the effectiveness of interventions. Allen and Duncan Smith’s Early Intervention: Good Parents, Great Kids, Better Citizens justifies the inclusion of material on brain development as follows;

We make no apology for presenting, as laymen, a considerable body of medical evidence in this chapter. When economic resources are under intense pressure, and facing strong claims from well-established programmes and special interests, we believe that this medical evidence points overwhelmingly in favour of a shift to Early Intervention.” (Good Parents p.45)

What’s the evidence?

The first few pages of chapter 2 of Good Parents focus on results from three large-group, longitudinal studies purported to show that early adverse childhood experiences result in later health risks such as smoking, alcoholism, illicit drug use, obesity and high level promiscuity (Good Parents p.54). At first glance, the conclusions presented are persuasive, but when you look a little more carefully, the picture isn’t quite so clear-cut.

I’ve mentioned several other documents that in some cases refer to each other. To clarify how they are linked, I’ve mapped out the connections here:


Two of the studies, Farrington and West’s Cambridge Study in Delinquent Development, a Prospective Study of South London Males From Ages 8–32 and the Dunedin Multidisciplinary Health and Development Study are prospective – that is, they started with children and have periodically sampled their health, development and behaviour over many years.

According to Allen and Duncan Smith the Cambridge study showed that adult offending could be predicted in childhood (Good Parents p. 51). That’s not quite what the study records. The 2006 report, which tracked the participants up to the age of 48, found that there were predictive factors in childhood for adult offending. In other words, some factors were predictive of behaviour for a particular group, not for particular individuals. The highest correlation between childhood factors and persistent offending was for children having a convicted parent or sibling. What this means is that children with previous offenders in their families are more likely to offend, not that offending can reliably be predicted in individual children. A significant number of children from families with an offender didn’t commit crimes, whereas some children from non-offending families did.

The Dunedin study looked at the health and development of 1037 babies born in Dunedin, New Zealand, between 1972-73. Data from the Dunedin study has been used in over 1000 publications but I couldn’t find which one Allen and Duncan Smith were referring to. They claim that nurses’ assessments of which of a group of 3 year-olds were at risk, predicted criminal convictions, violent behaviour and domestic abuse at age 21. They conclude;

the fact is that children who are likely to have poor outcomes, including adult criminality, can be identified at age three when they are still riding their tricycles.” (Good Parents p.52)

Not exactly. As Allen and Duncan Smith themselves point out, not all of the at-risk children offended, and some of the not-at-risk children did – 18% exhibiting violent behaviour and almost 10 % abusing their partners (Good Parents p.51).

The third study, the Adverse Childhood Experiences (ACE) Study, by contrast, is retrospective; it relies on self-reports about childhood maltreatment, family dysfunction and health status, and therefore on that notoriously unreliable data source, human memory. You can read the questions that were posed to participants in Preventing child maltreatment: a guide to taking action and generating evidence. It’s published jointly by the World Health Organization and ISPCAN, The International Society for the Prevention of Childhood Abuse and Neglect. My curiousity about Preventing child maltreatment: a guide to taking action and generating evidence was initially piqued by the title. I have no problem with taking action against child maltreatment, but do have concerns about ‘generating evidence’. Evidence is usually ‘gathered’ or ‘found’ – implying that it’s already out there, researchers just have to go and look for it. ‘Generating evidence’ suggests that, like Bettelheim, your case might not actually have strong evidence behind it so you need to create some.

I was also concerned by a reference in the Foreword to the idea that

the traditional “privacy barrier” between the domestic and public spheres has inhibited the evolution of policies and legal instruments to prevent violence within the family and provide services for those affected by it.” (p.vi)

I’d predict that the prohibition of violence is as likely to be effective as the prohibition of alcohol consumption, but that violence might be lessened if its causes were to be addressed. Furthermore, the ‘traditional “privacy barrier”’ isn’t about “privacy” – a relatively recent development in human history – but about protecting the individual from the abuse of power by the state. I’m sure the author, who’s had extensive experience with the UN, is aware of that. But I digress.

I also had concerns about Box 1.1 (p.8). It’s entitled Child maltreatment and damage to the developing brain and is adapted from a pamphlet published in 2001 by the National Clearinghouse on Child Abuse and Neglect Information and the National Adoption Information Clearinghouse called In Focus: Understanding the Effects of Maltreatment on Early Brain Development. The pamphlet lists 31 references, 11 by Bruce Perry and one by Allen Schore. In 13 pages, Schore’s work is cited 17 times and Perry’s 40 times. These names crop up again in the papers by Allen and Duncan Smith.

My concerns about Box 1.1 and the In Focus pamphlet weren’t so much about what they said, as about their emphasis. Firstly, maltreatment and neglect of children is, by definition, harmful – that’s why they are called maltreatment and neglect. We already know that certain practices cause harm to children, at the time they happen, immediately afterwards, and, in some cases, throughout life. We don’t need evidence from brain scans to tell us that. But maltreatment and neglect are being presented as if pre-existing evidence of harm isn’t sufficient to persuade legislators that more stringent legislative measures are required to prevent maltreatment and neglect, so neurobiological findings are being recruited for this purpose. Secondly, although there is certainly evidence to suggest that maltreatment and neglect have a negative impact on brain development, they are only two of the factors that do so. In other words, you could predict with some confidence that maltreatment and neglect would result in ‘abnormal’ brain development, but you can’t assume that because someone’s brain has developed abnormally, that they were maltreated or neglected as a child. Thirdly, there’s an implicit assumption in the way the evidence is presented that maltreatment and neglect are the primary cause of ‘social problems’, when social scientists have been aware, for decades, that those causes are many, varied and have complex interactions.

In short, the evidence doesn’t appear to support the idea that the predominant cause of social problems is child maltreatment or neglect. Allen and Duncan Smith call for a study along the lines of the Dunedin study to be carried out in the UK “in order to provide definitive evidence on the benefits of Early Intervention” (Good Parents p.52). I can’t see why another study is necessary – the Cambridge study makes clear that the causes of antisocial behaviour are complex and that patterns of behaviour change significantly over the lifespan.

Update 13/12/16:  Thanks to @PaulWhiteleyPhD on Twitter for drawing attention to this article in Nature analysing the Dunedin study findings.

In the next post, I want to look at what Graham Allen and Iain Duncan Smith have to say about brain development.

Photographs of Graham Allen and Iain Duncan Smith from Early Intervention Early Intervention: Good Parents, Great Kids, Better Citizens.