Summary of the impact

The research addressed the lack of insight from research, policy and practice in relation to adolescents who are neglected within families. Findings have informed policy development at a national level, and were the basis of a guide to good practice, published and circulated widely by the (then) Department for Children Schools and Families ((DCSF), now the Department for Education (DfE)), and a guide for young people to increase their awareness of neglect, published and circulated by the National Society for the Prevention of Cruelty to Children (NSPCC). At a local level, researchers worked intensively over 18 months with the whole senior management tier from Children's Services in one local authority to enable understanding and refocusing so that adolescent neglect becomes a legitimate part of practice. Managers went on to enable the shift in practice with their teams, and adolescent neglect has been included in revised safeguarding screening tools approved by the Local Safeguarding Children Board (LSCB).

Underpinning research

The issue of adolescent neglect has received little policy attention in England and Wales, with a corresponding lack of centrality in practice. The DCSF and the Department of Health (DH) were aware of the gaps in the evidence base and commissioned a team of researchers, including Hicks, to address this, as part of the `Safeguarding Children Research Initiative' (SCRI), the purpose of which was to produce `a stronger evidence base for the development of policy and practice to improve the protection of children in England'. This was part of the government's response following the Inquiry after the death of Victoria Climbié and later, Peter Connelly. The conduit between researchers and national policy makers was integral to the projects supported; a DCSF/DH programme of seminars and workshops enabled an ongoing working dialogue.

In the UK, neglect is the most common initial reason for being the subject of a child protection plan, accounting for 41.9 per cent in the year ending 31 March 2012 (DfE, Children Looked After in England (including adoption and care leavers), Statistical First Release, 20/2012). Adolescent experience includes self-harm, mental illness, difficulties with eating, and in extreme cases, life is placed at risk. A quarter of all Serious Case Reviews focus on teenagers as victims, and 10 per cent of these young people are aged 16 or over (Rees et al., 2011). However, neglect remains an issue that receives relatively little attention from practitioners, researchers and policy makers.

The research was designed to promote government priorities in respect of safeguarding children and young people by raising awareness of adolescent neglect at the levels of research, policy and practice. It took place between 2007 and 2009, and was a collaborative study, initially involving three organisations, which became four during the course of the project, when Hicks moved to the University of Lincoln in 2008: the University of York (Mike Stein, Research Professor and Principal Investigator), the University of Lincoln (Leslie Hicks, Senior Lecturer, subsequently promoted to Reader, and lead on the qualitative research data collection, analysis and outputs); the National Society for the Prevention of Cruelty to Children (Sarah Gorin, Senior Research Officer and lead on the participation of young people); and The Children's Society (Gwyther Rees, Research Director and literature review). Fieldwork, analysis and writing took place at the University of Lincoln. The research project included:

• a literature review of definitional and conceptual issues, causal factors, evaluated interventions and outcomes;
• qualitative research with young people and multi-agency practitioners;
• two Advisory Groups comprising a) young people and b) policy makers, practitioners and academics;
• young people training as co-facilitators of the focus groups with adolescents.

The review provided evidence from research additional to specialist child protection sources, such as from studies of parenting, of disadvantaged and socially excluded young people and from clinical research in several disciplines. The framework from the review was taken forward into the qualitative research with young people and multi-agency professionals.

Findings

Core findings from the three stages of the project included:

• neglected young people initially come to the attention of professionals via a diverse range of systems, e.g. education, health and youth justice, as well as social care;
• successful multi-agency working is a pre-requisite for effectively meeting the needs of such young people, and this presents challenges (e.g. for those engaged in practice, in the development of policy, and for academics concerned with the well-being of youth);
• there is a need for a re-examination of current definitions of neglect in the light of age-related distinctions and perspectives;
• correspondingly, a fuller understanding is needed among practitioners, policy makers and researchers of the particular needs of adolescents who are experiencing neglect;
• there is a risk of persistent neglect becoming `normalised', with an ongoing corrosive effect on well-being, while not quite reaching accepted thresholds for intervention;
• the above risk may be heightened due to differences in professionals' conceptualisations of neglect for different age groups of children and young people;
• in relation to multi-agency practice, establishing frameworks and processes that aid communication and collaboration between professionals from different disciplines is vital;
• there is a lack of research about neglectful parenting and the behaviour of young people;
• there is limited knowledge about interventions with neglected adolescents.

References to the research

`Neglected Adolescents: review of research and preparation of guides for multi-disciplinary teams and for young people', Professor Mike Stein, PI. Department for Education and Skills/Department of Health: £146,816.

Details of the impact

There were three main levels of impact following on from the research. These involved:

1) Production of guides: a) for multi-agency practitioners and policy makers (Hicks and Stein, 2010); and b) for young people (NSPCC, 2010). Both were developed collaboratively by researchers and participants from the qualitative stages of the research, with practitioners and young people assisting in the structure, form and content of the guides. As is usual with outputs from government funded research, both guides were peer reviewed by academics, practitioners and civil servants in the DCSF Project Advisory Group.

The guide for young people won the Plain English Campaign 2010 `Plain English' annual award. The research findings and guides have been disseminated widely, with presentations by Stein (http://php.york.ac.uk/inst/spru/profiles/msC.php) and by Hicks, to policy, practice and academic audiences.

Recent examples include the invited keynote presentations and two workshops given by Hicks, commissioned by East Dunbarton Child Protection Committee, at the `GETTING IT RIGHT for Children and Young People [GIRFEC] in East Dunbartonshire' multi-agency training event held for practitioners in Glasgow, November 2012. GIRFEC is a new national initiative that promotes multi-agency working and accountability, and underpins all Scottish Government policies for children and young people.

2) National policy influence: the multi-agency guide, Neglect Matters, was published by DCSF (4,000 copies) and distributed to all local authorities, with downloadable links provided on the Every Child Matters website. The publication was launched at a Centre for Excellence and Outcomes in Children and Young People's Services (C4EO) event, alongside the launch of the 2010 edition of the extensive government guidance, Working Together to Safeguard Children: a guide to inter-agency working to safeguard and promote the welfare of children, in which the adolescent neglect project was cited.

In June 2010, the Secretary of State for Education commissioned a review of child protection, which heralds a radical shift from previous reforms (The Munro Review of Child Protection: Final Report — A child-centred system, Department for Education (2011)). Proposals enable professionals to make the best judgements about the help to give children, young people and families. Neglect Matters: A multi-agency guide for professionals working together on behalf of teenagers is referenced in the Munro review as evidence to support the importance of young people's participation and inclusion in child protection work.

3) Local practice and policy influence: building on this research, funding from the University of Lincoln, Faculty of Social Science Research Fund, supported Hicks and her (then) colleague, Flynn, in utilisation work with a whole tier of Children's Service managers in one LA from December 2010 to July 2012. Hicks and Flynn worked in partnership with eight multi-agency senior managers to consider the relevance of the research findings to their own settings, with the action research goal of implementing changes in local awareness, practice and policy. The LA District Management Team were keen to work with our innovative approach to service development, and agreed to the release of staff time with a view to establishing potential for change in participants' own practice and in local policy. Initially, five workshops were held with eight senior managers from the range of children's services. The sessions were based on a utilisation model developed by a regional hub of the national research dissemination/utilisation federation, Making Research Count, involving:

• fitting the research findings to participants' own areas of practice and policy, establishing the implications for individual agencies and for the LA in making changes to practice;
• identifying the potential for the development of practice and policy within participants' own jurisdiction, establishing goals for change;
• devising plans to enable change, implementing, monitoring and reviewing progress.

To create changes in practice and policy managers were enabled to develop short guides to adolescent neglect for staff working in different agencies, e.g. substance abuse and counselling. Safeguarding Screening Tools approved by the LSCB were revised to include adolescent neglect and are currently in use throughout the LA. Follow-up interviews with individual managers established the nature of changes in practice and policies, examples of which include: cultural shifts ensuing from the recognition of `adolescent neglect' as a term for use; the inclusion of neglect in assessments of older children and their families; and monitoring data on adolescent neglect being collected by the LA performance team.

Sources to corroborate the impact

Hicks, L. and Stein, M. (2010) Neglect Matters: A multi-agency guide for professionals working together on behalf of teenagers, London: DCSF.

NSPCC (2010) Neglect Matters, a guide for young people about neglect, London: NSPCC, www.nspcc.org.uk/inform/publications/neglect_matters_wda70741.html.

The research is used extensively in a variety of practice guides and resources, for example:

Research in Practice, the national organisation geared towards enabling evidence-informed practice in children's services, makes extensive use of the `neglected adolescents' study in their Evidence scope: models of adolescent care provision (2013) (see pages 9, 10 and 19). This was commissioned by the Association of Directors of Children's Services (ADCS) and published alongside the ADCS April 2013 Position Statement. Both documents can be found at: www.adcs.org.uk/news/whatiscarefor.html.

With Scotland (2012) The Neglect and Abuse of Young People: A resource for secondary school, work (see pages 3, 5, 6 and 7): withscotland.org/download/child-abuse-and-neglect-a-resource-for-secondary-schools.

Action for Children, a major campaigning national charity, made use of Neglect Matters in its national `Neglecting the Issue' campaign in 2011, details of which can be found in the report provided at: www.actionforchildren.org.uk/campaigns/child-neglect-in-2011/child-neglect-campaign/neglecting-the-issue. See, in particular, the section on page 12 about adolescence and adulthood.

Action for Children (2012) Action on Neglect: a leading resource pack, cites Neglect Matters, available at: www.actionforchildren.org.uk/our-services/for-professionals/resources. See pages 71 and 77.

Tameside SCB, Neglect Practice Guidance (2011) (see in particular pp. 14, 15, 17): www.tamesidesafeguardingchildren.org.uk/attachments/077_TSCB%20%20Neglect%20Practice% 20Guidance.pdf.

Buckinghamshire Safeguarding Children Board (SCB) provides the Neglect Matters guide for young people at: www.bucks-lscb.org.uk/neglect.

Isle of Wight SCB, advice for young people includes Neglect Matters: 4lscb.org.uk/isleofwight/children_and_young_people/areyouworried.aspx.

Leicester SCB includes Neglect Matters in their guidance for practitioners: www.lcitylscb.org/information-for-practitioners/safeguarding-topics/neglect-ad/.

N.B. All links accessed 20 October 2013