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Parental Substance Misuse and Entrenched Neglect. Gretchen Precey: Independent Social Worker. Neglect . Persistent failure to meet a child’s basic physical and/or psychological needs, resulting in serious impairment to the child’s health or development Faltering growth

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Parental Substance Misuse and Entrenched Neglect

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Parental Substance Misuse and Entrenched Neglect

Gretchen Precey: Independent Social Worker

neglect and substance misuse


  • Persistent failure to meet a child’s basic physical and/or psychological needs, resulting in serious impairment to the child’s health or development

  • Faltering growth

  • failure to provide adequate food, shelter, clothing, safety, health and education

neglect and substance misuse

neglect and substance misuse

Findings from Biennial Analysis of Serious Case Reviews

The children (189)

  • 2/3 under 5; ½ under 1

  • 60% of children died

  • 17% subject to child protection plans

  • 13% were on care orders or accommodated

  • 45% of families highly mobile

  • 50% of parents had criminal record

  • 75% affected by DV, mental illness, substance misuse

  • 75% did not cooperate with services

The professionals

  • Overwhelmed professionals/overwhelmed families

  • Lack of clarity about procedures and confidentiality

  • Assumptions about involvement of others

  • Over emphasis on strengths

  • Fixed thinking: neglect and ‘rough handling’

  • Dearth of information about fathers and men

  • Unrealistic expectations about capability of less experienced staff (CAF)

neglect and substance misuse

The chaotic behaviour in families was often mirrored in professional’s thinking and actions. Many families and professionals were overwhelmed by having too many problems to face and too much to achieve. These circumstances contributed to the child being lost or unseen. The capacity to understand the ways in which children are at risk of harm is complex and requires clear thinking. Practitioners who are overwhelmed, not just by the volume of work but also by its nature, may not be able to do simple things well.Brandon et al 2009

neglect and substance misuse

Overwhelmed, chaotic families, ‘negative’ support, drugs, violence, mental ill health, criminality

Fixed views about family

(e.g. men) fixed assessment

Views (e.g. neglect)

Invisible Children

Efforts not to be judgemental,

Whole picture missed, separate

‘specialisms’ offer support

Too much to achieve,

Low expectations, ‘success’

Is getting through the door,

muddle about confidentiality

neglect and substance misuse

Start Again Syndrome

  • Used as a defence by workers to overwhelming information and feelings of hopelessness

  • Each pregnancy or birth presented as a ‘fresh start’

  • Parents fail to engage with agencies/ agencies fail to engage with parents

  • Focus is on the present not on the family history, lack of progress not taken into account

  • Growing evidence base that short-term, behavioural approaches are not likely to succeed with families with long standing, complex problems

neglect and substance misuse

Emotional development and faltering growth in young children

  • The importance of feeding children; inter-relationship between the physical and emotional development of young children

  • It’s not just about weight gain, mechanics of feeding and developmental scales

    Practitioners need to be aware of the parent’s reactions to their child, and to specifically observe and reflect on the child’s responses to his or her caregivers. These are the foundations of emotional development and of attachment behaviour. What happens during feeding provides powerful clues to emotional development (Brandon et al pg 8)

neglect and substance misuse

neglect and substance misuse

Neurobiologists have explored the deep significance of attachment, affect regulation, and the quality of early parent-child relationships to the way the brain processes information and experience, particularly emotional experience in the context of attachment relationships, and how its hard-wiring, biochemistry and neurological organisation is shaped by those very experiences. (David Howe 2005)

neglect and substance misuse

Nature, Nurture & Resilience (Vizard 2010)

Effects on Brain Development(Schore, 1994; Perry, 1997, Glaser ,2000)

  • Babies of depressed mothers – 48% show reduced brain activity particularly in the left frontal cortex (which is associated with joy; interest; anger),

  • Early experiences of persistent neglect and/or trauma result in neurophysiologic changes in the brainstem and midbrain leading to: anxiety; impulsivity; poor affect regulation, and hyperactivity.

  • Deficits in cortical functions result in poorer problem-solving, and impoverished capacity for empathy. Such children become the delinquents and psychopaths of the future (Gerhardt et al., 2004).

neglect and substance misuse

Evidence from Brain Scans

2. Nature, Nurture & Resilience

neglect and substance misuse

2. Nature, Nurture & Resilience

neglect and substance misuse

2. Nature, Nurture & Resilience (Vizard 2010)

So.........studies show adverse effects on the

developing brain from abuse and neglect on:

  • Brain structure

  • Brain function

    But............there is also evidence of ‘catch up’

    with brain development when ‘nurture’ improves

    And...........child resilience moderates between

    nature and nurture

neglect and substance misuse

No, I knew they loved me but they just didnae care that I was there and I needed stuff as well. And I needed this and things and they were just away taking drugs and stuff Elaine 14 ( Barnard and Barlow 2003)

neglect and substance misuse

Problematic Substance Misuse and Parenting

Poor sensitivity

Unresponsiveness to children’s emotional cues

Heightened physical provocation and intrusiveness

Some ambivalence about having / keeping children

neglect and substance misuse

Assessing the quality of life of the child of substance misusing parents (Swadi 1994)

Procurement of substance: child left alone or exposed to violence/danger

Family’s social network: degree of contact with non-drug users, family support

Parental attitude to substance misuse: responsibility, denial, insight, recognition of effect on child, motivation to change

Child’s perceptions: feelings of responsibility for parent, fluctuations in quality of care, feel safe and protected

  • Home environment: financial and geographic security, visitors to the house

  • Provision of basic necessities: food and clothing, supervision, school

  • Pattern of parental substance misuse: type, frequency, needle disposal, presence of child, attempts at treatment

  • Effect on parental mental state: cognitive ability, judgement

neglect and substance misuse

Summary of adverse effects of maltreatment on child’s development and wellbeing (MacMillan 2009)

  • Infancy

    • Injury

    • Affect regulation

    • Attachment

    • Growth and developmental delay

  • Childhood

    • Anxiety disorders

    • Mood disorders disruptive behaviour

    • Academic failure

    • Poor peer relationships

  • Adolescence

    • Conduct disorder

    • Alcohol and drug abuse

    • Other risk taking behaviour

    • Recurrent victimisation

  • neglect and substance misuse

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