2 Protecting young children at risk of abuse and neglect The changing face of early childhood in the UK
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Authors
Jordan Rehill
Carey Oppenheim
2 Protecting
young children at risk
of abuse and neglect
The changing face
of early childhood
in the UKContents
Overview and summary 2
Scope and methodology 7
1 The impact of abuse and neglect in early childhood 11
2 Changing legislation, policy, and protection
for children at risk of abuse and harm 16
3 What do we know about children in the child
welfare and family justice systems, and how
has this changed over time? 23
4 What have we learned from the variation
within these systems? 29
5 Understanding the systems that support
children at risk of abuse and neglect 34
6 The impact of COVID-19 38
7 Conclusions 40
References 42
Annex: Policy and strategy milestones
in England and Wales 49
Acknowledgements 51
Protecting young children at risk of abuse and neglectThe Changing Face of Early Childhood series
The Changing Face of Early This review—the second in
Childhood is a new series of short the series—explores the evidence on
reviews, events and engagement the changing circumstances of young
that seeks to generate an informed children at risk of abuse and neglect.
debate on early childhood based on
what the collective evidence tells us. • Review 1 – How are the lives of families
The series draws on over 80 studies with young children changing?
funded by the Nuffield Foundation • Review 2 – Protecting children at risk
and undertaken by multidisciplinary of abuse and neglect
researchers working in universities, • Review 3 – The role of early education
research institutes, think tanks and and childcare provision in shaping
other organisations, as well as other life chances
key studies. The research is wide- • Review 4 – Changing patterns
ranging, reflecting the interests of poverty in early childhood
of the research community, as well • Review 5 – Are young children
as the Foundation’s priorities. healthier than they were
Our approach is designed two decades ago?
to be holistic, bringing together • Review 6 – Parents and the home
perspectives from different disciplines • Conclusion – Bringing up the next
and vantage points. We want to involve generation: priorities and next steps
researchers, policy makers, and
practitioners to help us explore the We value input and feedback on the series
issues and develop evidenced-informed as it progresses, and the responses we
recommendations, and to identify gaps receive will inform the concluding review.
in the evidence. The final report will draw You can provide feedback on this review
upon the insights provided by our readers via our website: www.nuffieldfoundation.
and contributors over the course org/contact/feedback-changing-face-of-
of the series. early-childhood-series
Nuffield Foundation Protecting young children at risk of abuse and neglectProtecting young 2
The changing face of early childhood in the UK
children at risk of
abuse and neglect
Overview and
summary
Aims
All children need protection and nurture • Highlight key insights from the work
to be able to develop and thrive, but the Nuffield Foundation has funded in
those under five require particular support. order to increase understanding of how
The love and care provided by parents outcomes for children at risk of abuse
and caregivers lays the foundations and neglect can be improved through
for all future emotional, cognitive, and changes to policy and practice.
physical development. Sadly, many • Explore the implications of current
children do not receive adequate care changes, including the impact
and support. Abuse and neglect in of COVID-19, on young children’s
the earliest years of a child’s life have lives now and in the future.
been shown to have severe detrimental • Set these new insights in the context
impacts on a child’s immediate well- of existing evidence—we do this by
being and development, as well as synthesising and critically appraising
their life chances and outcomes well a large and complex body of evidence,
into adulthood (Wilkinson and highlighting connections and tensions
Bowyer 2017). as well as gaps and uncertainties.
This review sets out to explore
changing patterns of abuse and We hope this review serves as a useful
neglect in early childhood over resource for policy makers, researchers,
the last two decades. Our aims are to: and practitioners.
Nuffield Foundation Protecting young children at risk of abuse and neglect3
Key learning
The changing face of early childhood in the UK
We know more about outcomes for neglect owing to, for example, increased
young children at risk of abuse and financial pressures on families, or reduced
neglect than we did 20 years ago, and fragmented preventative services—
but much is still unknown. or, more likely, a mixture of all of these factors
Outcomes for children in the child welfare (Trowler and Leigh 2018; Care Crisis Review
system are generally less favourable 2018; Hood et al. 2020; Curtis et al. 2019).
than for other children. These outcomes It remains unclear whether different
are often shaped by a combination or compounded risks are being identified,
of structural and societal factors or if the same behaviours are regarded as
(such as exposure to poverty and changing riskier to children than they would have
welfare systems) as well as child and been previously.
family-related issues.
However, we still know very little Reduction in preventative services.
about the early outcomes of children As budgets have tightened, services
under five in these systems, including designed to support families have been
early educational progress, and even cut (Britton, Farquharson, and Sibieta
less about their early social emotional 2019; Kelly et al. 2018; Social Care Wales
development compared to the wider 2020). Statutory and acute services
child population. National data is still not (such as provision for children in care)
collected on attendance at early years have been protected at the expense
settings by looked-after children. To many, of targeted preventative services
this may seem like an administrative or (National Audit Office (NAO) 2019).
technical issue. However, until information Overall, we see statutory services and
is collected on who is (and importantly, acute services for children at risk largely
who is not) attending early years settings, protected and a hollowing out of the
it is difficult to identify the true scale of the middle—the services that help identify
issue and design effective policy to help and support families and young children
address this (Mathers et al. 2016). who are under pressure and struggling.
While acute services are also taking up
Changing expectations and practice. larger proportions of children’s social
A larger and growing proportion of families care funding in Wales, cuts to spending
are being referred to services because on preventative services have been
of emotional abuse and neglect compared much less severe.
to 20 years ago. This raises important We have also seen a shift to
questions as to whether we are seeing ‘late intervention’ in the child welfare
increased awareness and more/better system—that is, a greater tendency
reporting and recording, risk-averse social to use child protection procedures and
work practice, or whether there has been care for a greater proportion of referrals
an actual increase in emotional abuse and (Hood et al. 2020).
Nuffield Foundation Protecting young children at risk of abuse and neglectMore young children and newborns courts apply the law relating to abuse 4
are in some form of state protection. and neglect (Harwin et al. 2019; Bilson
The changing face of early childhood in the UK
We now know that the rate of children ‘born 2018). While each local authority is
into care proceedings’ more than doubled unique, analysis has shown that more
in England and Wales between 2008 deprived local authorities have higher
and 2017 (Broadhurst et al. 2018; Alrouh levels of demand, and therefore tend
et al. 2019).1 to do more screening and rationing.
In 2016/17, some 2,500 newborn Less deprived local authorities tend to
babies were in care proceedings at birth have more resources relative to demand,
in England because they were thought and therefore use statutory interventions
to be at risk of significant harm. We know more readily (Hood et al. 2020).
this an intergenerational issue; around
half of these babies are born to mothers Fragmented wider support for young
who were themselves a teenager when children and their families.
they first became a mother, and around Research suggests that evidence-informed
half of the mothers will have had a child interventions at the right time in early
taken into care before. childhood can protect children and support
their families to help them thrive (Allen 2011;
Variation and disproportionality Molloy, Barton, and Simms 2017). When
in the child welfare system. offered as a holistic, ongoing package
The chance of experiencing a child welfare of support across agencies (e.g. across
intervention (becoming looked-after, or children’s social care and adult support
a child in need, or being on a protection services), early help has the power to
plan) is not experienced equally by all prevent abuse and neglect, or ameliorate
families. Socio-economic circumstances, its impact (Wilkinson and Bowyer 2017).
local area deprivation and ethnicity However, the diversification of early help
intersect to influence the likelihood funding and provision around children’s
of a child coming into state protection centres has meant that there is significant
(Bywaters et al. 2020). Children are more variation in local offers. The Family Hub
likely to be considered ‘at risk’ if they live initiative represents the latest attempt
in poorer areas. This relationship appears to coordinate local family, health, and
stronger for younger children. education support for children and their
However, we know that there are families. There is however limited national
large and significant differences in rates data on the effectiveness of existing
of intervention by ethnic groups—urgent family hubs, the services that they provide,
attention needs to be paid by policy makers how they are organised, and how families
and researchers to understand key issues use them (Lewing, Stanford, and
(e.g. what can we learn from communities Redmond 2020).
that have lower rates than others) and to We have also seen evidence that
identify areas requiring action (Bywaters universal and targeted support services
et al. 2019). often do not work together in a coherent
There are also significant variations way to ensure both offers are reaching
in the way different local authorities and the children and parents who need them
1 Infants subject to care proceedings at less than one week old.
Nuffield Foundation Protecting young children at risk of abuse and neglectthe most (Children’s Commissioner areas across England (National Lottery 5
for England 2020a). In an ideal system Community Fund 2020).
The changing face of early childhood in the UK
these services—health, social care,
wider social supports (e.g. the Troubled Increased pressures on children
Families Programme), and early childhood at risk and services during the
education and care—would be integrated. first (March 2020) lockdown.
In reality, however, the siloed approach Usual pathways for referring children
to service provision means that these to services were significantly disrupted
services are treated as independent during the first UK lockdown, meaning
bodies, and as a result many families children at risk of abuse and neglect
continue to fall through the gaps. may have been missed. These issues
To truly support children at risk appear to be even more acute for infants
a holistic cross-governmental framework and babies born in the pandemic, with
is needed—social work and family children’s centres closing and health and
justice are only one part of the solution. GP check-ups coming via video link or
Recent programmes, such as the Big telephone. Family court hearings and child
Lottery Fund’s Better Start initiatives, protection conferences moved to a remote
have attempted to coordinate services to or hybrid format, with professionals
better support families with young children and parents reporting concerns about
and are being delivered in a number of trial fairness and the ability to practice humanely.
Points for discussion
A large and growing number of young while administrative data relies on broad
children and newborns are known to categories of abuse and neglect, and
services and taken into care. Meanwhile, holds very little information about a child’s
a significant number of under-fives in wider circumstances (Nuffield FJO
vulnerable households are not known to 2020). Without more granular data, it is
the child welfare system. There is ongoing difficult to confidently estimate whether
debate as to whether too many children too many or too few children are known
are being taken into state protection, to these systems, let alone whether the
or whether too many are being missed. right children are known to them. To truly
Before any semblance of consensus understand who the children at risk are,
can be reached on this issue, individual- we need more research on maltreated
level data must be improved on child children in population-representative
need and maltreatment. Currently, cohort studies, rather than solely relying
estimates of abuse and neglect are on reports about officially registered cases,
taken from retrospective surveys or which are often a highly biased subset,
extrapolated from small-scale studies, and often only the tip of the iceberg.2
2 The Economic and Social Research Council (ESRC) has recently outlined plans for a new early life cohort
study, which will focus on ‘sub-groups, including those which are traditionally underrepresented in studies
of this kind and/or are harder to reach’ (ESRC 2020).
Nuffield Foundation Protecting young children at risk of abuse and neglectA natural consequence of blunt children and family outcomes? In addition 6
data, and variable practice and thresholds, to needing more data on child need
The changing face of early childhood in the UK
is that two children can have similar levels and maltreatment, we also need better
of need, but one will be in care and the information on how children and families
other will not. Conversely, two children experience these services—do they
in care who appear to be similar from the help solve the underlying problems?
data can actually have very different lives This raises more fundamental questions
and needs. about whether we are right as a society
As a society we are still stuck trying to focus on social work interventions
to answer the following question: when it as the main or only way to address the
comes to abuse and neglect, is the state increasing challenges to early childhood.
intervening too little or too much? The When we consider the outcomes
answer may be ultimately that it is doing for children who have experienced
both. Different state agencies appear to not maltreatment it is difficult not to
be doing enough for some children at risk, conclude that the current system
and too much for others—largely because of child protection and support may
of weaknesses in data, missed signals need to be reevaluated.
of risk, systematic risk aversion, and blunt Does the child welfare system
measures of overcompensation. focus too much on keeping a small cohort
Is this even the right question to of children alive, and not enough on helping
be posing? Should society and services them (and a wider group of vulnerable
instead be focusing on whether different children who do not reach the same
state agencies are intervening in the right thresholds) to be happy, do well in life,
way? Is the current model of protection the and make the transitions to succeeding
best way of preventing harm and promoting in adulthood?
Nuffield Foundation Protecting young children at risk of abuse and neglectScope and 7
The changing face of early childhood in the UK
methodology
This review seeks to explore the changing this area, including the Nuffield Family
circumstances of young children at risk Justice Observatory (Nuffield FJO).
of abuse and neglect. Other factors The Nuffield Foundation has
relevant to children’s well-being, such a UK-wide focus. However, the review
as poverty and child and parental mental concentrates on England and Wales,
health, will be explored in later reviews largely because the family justice system,
in this series. including the family courts, operates as
This review focuses on the main a single system across both countries.
systems designed to identify and support This said, as we note in the policy and
children at risk of abuse and neglect— strategy milestones (see annex), the
the child welfare and protection system ways in which the child welfare system
and the family justice system.3 Not all has developed in the last two decades
children will be known to these systems differs between these two countries.
because of abuse and neglect—some The Nuffield Foundation has also funded
will be known for other reasons such as important work on children’s social care
a disability, and/or a parent’s disability.4 in Scotland, such as the second phase
Others may be at risk but will not be of the Permanently Progressing project,
known to systems at all. The review which explores children’s perceptions
focuses on ‘early childhood’, which we as they move through the Scottish care
define as babies and children under system (Whincup et al. forthcoming).
the age of five. Understanding how children This review focuses predominantly
at risk of abuse and neglect are supported on children involved in the child welfare
in these systems, as well as the individual system and in the family justice system
and wider societal causes of maltreatment, via public law proceedings. For younger
has become an important area children in particular, debate has centred
of focus for the Nuffield Foundation. on the issues of adoption and moving
Over the past decade it has funded many children at particular risk away from
projects and organisations to provide their families permanently. However,
research evidence and innovation in due to constraints on space, we do not
3 For a full review of the data issues relating to children at risk of abuse and neglect see Bywaters et al. (2015)
and Children’s Commissioner for England (2020a).
4 Not all children will be experiencing abuse and neglect, though the majority of children under 18 have some
form of abuse recorded as an initial category of need. Other reasons for a child being in care include family
dysfunction or because their family is in acute distress. A small number of children will be in these systems
due to their disabilities (Department for Education (DfE) 2020a).
Nuffield Foundation Protecting young children at risk of abuse and neglectfocus on these issues in great detail of abuse and neglect (Hester 2011; Jay et al. 8
in this review.5 2019; Barnett 2020). Again, constraints
The changing face of early childhood in the UK
The Nuffield Foundation continues on space and scope mean we do not
to fund a great deal of work in relation to focus on children involved in private law
private law (Cusworth et al. 2020), and proceedings in this review.
private law proceedings remain a key The themes and areas of interest
focus area for Nuffield FJO. There is clear covered in this review include (but are
evidence that many children in private law not limited to) research funded by the
proceedings will have experienced forms Nuffield Foundation over the last eight
Figure 1: Systems designed to support children and families as described
by the Family Justice Review. Source: Norgrove (2011).
Early years
provision
Early help Family support
services
Children’s
Troubled
social care
DWP & Families
Judiciary services Cafcass
HMRC Programme
Legal aid Expert
agency witnesses
Health
services Schools
Courts
Children and families Lawyers
Police
Mediators
Advice
(third and
Family private sector)
Contact
Housing Justice
centres
Council
Family justice system
Sure start
CAMHS children’s
centres
Statutory and community
support services
Note: CAMHS stands for child and adolescent mental health services.
5 For further information on this see Neil, Gitsels, and Thoburn (2019) and Nuffield FJO (2020).
Nuffield Foundation Protecting young children at risk of abuse and neglectyears. The Nuffield Foundation-funded in this area. This narrative review was 9
research cited in this review is underlined, designed to be an informative (rather than
The changing face of early childhood in the UK
with full details provided in the reference all-encompassing) review of the literature
list. While not all of the work funded by the on abuse and neglect in early childhood.
Foundation in this area focuses directly Drawing on this review, alongside the
on children under five years old, many extensive knowledge and libraries of
of the findings and perspectives pertain our advisory group and colleagues, both
to them. themes and gaps in the wider literature
A targeted (also known as were identified. The review focused
a focused) literature review was on studies published in the UK from
undertaken to complement the existing 2010 onwards, and included both
body of work the Foundation has funded peer‑reviewed and grey literature.
Nuffield Foundation Protecting young children at risk of abuse and neglectKey terms
• Care proceedings are court require a social care response, as
proceedings issued by the social defined by current legislation and
services department of the local guidance. For further information about
authority where an application is made how the child protection system works,
for a care or supervision order in respect see the NSPCC summary available
of a child (Family Law Group 2020). at: https://learning.nspcc.org.uk/child-
• A care order is a court order that protection-system.
places a child under the care of the • Early help, also known as ‘early
local authority. This is otherwise known intervention’, early help is support
as a child ‘being in care’. This does not given to a family when a problem first
necessarily mean that the parent does emerges. It can be provided at any
not have parental responsibility, but stage in a child or young person’s life.
the parent’s wishes can be overridden • The family justice system is the legal
if the local authority believes it is in the machinery that applies to the regulation
best interests of the child. of disputes concerning the family or
• Child in need. A child may be designated between members of the family and
as ‘in need’ if they are ‘unlikely to reach the state. It encompasses both the
or maintain a satisfactory level of court system and wider ‘dispute
health or development, or their health resolution’ services such as lawyer
or development will be significantly negotiation, mediation, and the
impaired without the provision provision of advice.
of services, or the child is disabled’ • Public law puts in place systems and
(DfE 2020a). In Wales, legislation and processes in order to minimise the risk
recording changed in 2016. Children are of children coming to harm and lays out
now designated as ‘children receiving what action should be taken if children
care and support’ (CRCS). are at risk.
• Child protection plan. If the concerns • Private law deals with family
around a child are confirmed, but not proceedings such as divorce, contact,
serious enough to remove a child, the and financial arrangements.
child may be placed on a child protection • A supervision order is a court order,
plan (in Wales it is the child protection which means that the child remains
register). This is an agreement between where they are but that the local
the parents and local authority to authority then supervises the care
improve a child’s situation. of the child.
• Child welfare system. The definition • Toxic stress is a term used by
used in this review is derived from psychologists and developmental
Molloy, Barton, and Simms (2017), neurobiologists to describe the
and refers to statutory child protection kinds of experiences, particularly
services, interventions and practice in childhood, that can affect brain
with children and young people who architecture and brain chemistry.
Nuffield Foundation Protecting young children at risk of abuse and neglect1 The impact 11
The changing face of early childhood in the UK
of abuse and neglect
in early childhood
There is a large and growing body such as maltreatment or exposure
of research on the detrimental impact to domestic abuse, has built on an
of abuse and neglect in early established base of literature and collated
childhood (Belsky 1993; Widom, the evidence on the harmful effects that
Note to the reader: Weiler, and Cottler 1999; Radford these experiences have on well-being,
Inline references et al. 2013; Ashton et al. 2016; development in early childhood, and further
that are underlined
are those funded
Wilkinson and Bowyer 2017). outcomes throughout life (Felitti et al.
by the Nuffield Recent research on adverse 1998; Anda et al. 2006; Radford et al. 2013;
Foundation. childhood experiences (ACEs), Ashton et al. 2016).
Definitions of abuse and neglect
Official definitions differ between adults, or another child or children […]
England, Wales, Northern Ireland It may involve conveying to a child that
and Scotland, but all contain reference they are worthless or unloved, inadequate,
to physical, sexual and emotional or valued only insofar as they meet the
or psychological abuse, and neglect. needs of another person. It may include
We draw on the definition given in not giving the child opportunities to
Working Together to Safeguard Children express their views, deliberately silencing
(HM Government 2018, pp. 107–108). them or ‘making fun’ of what they say
or how they communicate. It may feature
‘Abuse: A form of maltreatment of age or developmentally inappropriate
a child. Somebody may abuse or neglect expectations being imposed on children.
a child by inflicting harm, or by failing to
act to prevent harm. Children may be Neglect: The persistent failure to
abused in a family or in an institutional meet a child’s basic physical and/or
or community setting by those known to psychological needs, likely to result
them or, more rarely, by others. Abuse can in the serious impairment of the child’s
take place wholly online, or technology health or development. Neglect may
may be used to facilitate offline abuse. occur during pregnancy as a result
Children may be abused by an adult or of maternal substance abuse.’
Nuffield Foundation Protecting young children at risk of abuse and neglectResearch on ACEs by the Early of UK child protection policy—and their 12
Intervention Foundation (EIF) makes clear findings confirm what is often reported
The changing face of early childhood in the UK
that there is a risk of oversimplification, by practitioners (Critchley 2020)—
and that there are major gaps in the samples studied have tended to be
the evidence on how to identify and small and highly biased. Moreover, most
support children most at risk. Research of the research is, and continues to be,
into the relationship between these observational and therefore cannot
experiences and short and medium-term attest that abuse and neglect actually
outcomes has used a variety of methods, cause poor later life outcomes. That is
with different degrees of robustness. The not to say that shaken baby syndrome
overall conclusions are not clear-cut and or a head injury from abuse do not harm
need careful interpretation (Asmussen, the brain, for example, but those are
Fischer, and McBride 2019). not the cases that have typically been
included in the research.
Our understanding of latent
1.1 Evidence from vulnerability, where maltreatment in
neurobiological research a child’s earliest years does not manifest
until later in childhood, is also beginning
Neurobiological research has formed to develop (McCrory, Gerin, and Viding
the core of recent developments in child 2017; McCrory et al. 2019). It should be
protection and wider early years policy. noted, however, that this research is still
Influential reports (Allen 2011; Brown and in its infancy and more data and analysis
Ward 2013; Leadsom et al. 2013) have is needed to provide further guidance on
drawn on supporting evidence from how and when services should intervene
neuroscience to suggest that the first three (Asmussen, Fischer, and McBride 2019).
years (or sometimes the first 18 months)
of a child’s life are critical in laying the
foundations of future well-being 1.2 Emerging evidence on the early
and development. and later life outcomes for children
in the family justice and child
‘The emphasis on the vulnerable welfare systems
infant brain has created a “now or
never” imperative to intervene early to We now know more about the associations
prevent irreversible damage to human between child maltreatment and
development’ (Critchley 2020, p. 896). outcomes in adolescence and in later life.
However, population-level data exploring
Research from the Center on the outcomes for this cohort is still limited
Developing Child at Harvard University (Gypen et al. 2017). Outcomes for these
has been influential in drawing together children are often shaped by a combination
data that indicates that environmental of structural and societal factors such as
neurotoxins, drug exposure, and chronic or exposure to poverty and changing welfare
‘toxic’ stress can harm the developing brain systems, as well as individual and family-
(Shonkoff and Phillips 2000; McCrory et al. related factors such as exposure to abuse
2011; Hein and Monk 2017). While these and neglect, and disrupted relationships
studies and others in this sphere have with birth parents (Howe 2005; Dozier
been influential in forming the backbone et al. 2007; Bywaters et al. 2015; Cleaver
Nuffield Foundation Protecting young children at risk of abuse and neglectet al. 2011; Burch, Daru, and Taylor 2018). consistently lower educational outcomes 13
These outcomes can be ameliorated than those with no intervention. The gap
The changing face of early childhood in the UK
or compounded by early help and the also increased with the severity of the
intervention of services (see Section 5). intervention (Figure 2).
Protective factors have perhaps As argued by Berridge et al. (2020),
not been researched as extensively given that in terms of volume social work
as risk factors. However, there appear is clearly dominated by children in need
to be certain types of support that services, and given the consistently poor
can help children recover from abuse educational outcomes of children in need,
and neglect in childhood. As noted more needs to be done to increase the
by Wilkinson and Bowyer (2017) in visibility of children and bring more parity
their review of the research evidence with children in care.
on maltreatment: For children in state care, instability
appears to be one of the largest drivers of
‘Individual children and young people’s poor attainment; children with multiple social
ability to cope with and rebound work interventions tended to have poorer
from adverse experiences is related educational outcomes than those with
to a number of characteristics and fewer interventions (Berridge et al. 2020).
supporting factors. These include factors Aligning with earlier work by Sebba et al.
such as their age and developmental (2015), being in care for over a year appears
stage, the presence of resilience to benefit children’s educational attainment.
promoting relationships in their lives However, a higher number of placement
and access to wider family support’ changes was linked to poorer attainment,
(Wilkinson and Bowyer 2017, p. 19). suggesting that the stable placements may
operate as a protective factor educationally.
Education outcomes. Though, as Figure 2 shows, looked-after
In England, data is limited on the educational children continue to have significantly
and social emotional progress of children poorer educational outcomes than those
known to the child welfare system prior to who are not in care.
school age (Mathers et al. 2016). There is Around one-third of children leaving
some evidence that looked-after children care re-enter within five years. Those older
have poorer early language development, at initial exit, White or mixed ethnicity
including pre-reading skills as they enter children, those returning to parents, and
primary school (Pears et al. 2011). children who had shorter placements, are
International research has also consistently more at risk of re-entry (Neil, Gitsels, and
shown gaps in early language development Thoburn 2019; McGrath-Lone et al. 2017).
between disadvantaged and advantaged
children more broadly (Waldfogel and Wider outcomes
Washbrook 2011; Matthews et al. 2017). In recent years more data and evidence
Researchers have often investigated has emerged on outcomes for children
the educational outcomes of children in who have been involved in the family
care. However, up until recently children justice system via public law proceedings.
in need have received very little attention. However, often the data does not
Research by Berridge et al. (2020) has distinguish between children who entered
shown that children at Key Stage 1 (aged 7) the system in early or later childhood
with a social work intervention had (Nuffield FJO 2020).
Nuffield Foundation Protecting young children at risk of abuse and neglectCompared to the wider population, children (aged 18–23) go on to university 14
we know that children who have been in each year, compared to 43% of all
The changing face of early childhood in the UK
the care system are more likely have 18 to 23-year-olds (Harrison 2017).
committed multiple offences in their We also know more about
teenage years (Forty and Sturrock 2017). the intergenerational impact of being
It is also estimated that around a quarter in the care system. Research by
of prisoners have been in care at some Broadhurst et al. (2017) exploring the
point in their formative years circumstances of mothers who had
(Full Fact 2012). successive children removed from their
According to recent estimates, care showed that a significant proportion
of the 19 to 21-year-old former looked- were previously in the care system
after children who stayed in touch with themselves. Between 2007 and 2014, 40%
councils in 2019, 39% were not in recorded of the mothers had been in foster care or
education, training, or employment. This children’s homes with a further 14% living in
compares to 11% of 19 to 21-year-olds private or informal relationships away from
in the general population (DfE 2020a). their parents. The study also revealed the
An estimated 12% of former looked-after high levels of abuse and neglect women
Figure 2: Mean attainment in English, maths and science at Key Stage 1
compared to children who had not received an intervention
during their school years. Source: Berridge et al. (2020).
Ever had Ever had
a child in need plan a child protection plan Ever been in care
-14%
-17%
-24%
Nuffield Foundation Protecting young children at risk of abuse and neglecthad suffered in their lives as children and neglect, placement stability, and 15
(Broadhurst et al. 2017) timing of removal.
The changing face of early childhood in the UK
• Children with social work interventions
(in need, on a protection plan or in
1.3 Points for discussion care) tend to have poorer educational
outcomes at Key Stage 1. While policy
• Research suggests that outcomes continues to focus on children in care,
for looked-after children are generally more needs to be done to increase
less favourable than for other children the visibility of children in need.
outside of the care system. However, • We still know very little about the
these negative outcomes are often early educational progress and
dependent on circumstances related social and emotional development
to the individual child including of children in the family justice and child
(but not limited to) exposure to abuse welfare systems.
Nuffield Foundation Protecting young children at risk of abuse and neglect2 Changing 16
The changing face of early childhood in the UK
legislation, policy,
and protection
for children at risk
of abuse and harm
2.1 A shift in the funding acute risk (Britton, Farquharson, and
of preventative and Sibieta 2019; Kelly et al. 2018; NAO 2019).
statutory services Data from Wales since 2014/15
shows a similar pattern. A greater
Since 2010 we have seen significant proportion of children’s social care budgets
changes in how local authority spending are being spent on looked-after children
on children’s services—moving away from and safeguarding children services
preventative services—has affected the than in previous years. And while there
ways children at risk are both identified and have been reductions in spending on
supported (Kelly et al. 2018; Curtis 2019). preventative services (e.g. family support
Analysis by the Institute for Fiscal Studies services), in contrast to England, spending
and the National Audit Office (NAO) has on these services has not been reduced
shown that overall spending on children’s quite so severely (Social Care Wales 2020).
services has remained largely consistent Alongside a reduction in
in England since 2010. However, statutory preventative spending, local authorities
and acute services, such as provision for in England have also seen a reduction
children in care, have been protected at the in the public health grant since 2015
expense of targeted preventative services, (Harris, Hodge, and Phillips 2019).
reducing early intervention and removing An illustrative example of where we have
vital safety nets for children at particularly seen the consequences of this shift is
Nuffield Foundation Protecting young children at risk of abuse and neglectFigure 3: Changes in spending on children’s services, England, 2011–2018. 17
Source: NAO (2019).
The changing face of early childhood in the UK
£ billion in 2017/2018 prices
10
9
8
7
6
5
4
3
2
1
0
2010/11 2011/12 2012/13 2013/14 2014/15 2015/16 2016/17 2017/18
Statutory (£) Preventative (£)
Note: Real terms, 2017/18 prices.
Nuffield Foundation Protecting young children at risk of abuse and neglectin relation to health visitors.6,7 Alongside introduction in 2016. However, in line with 18
their public health nursing role, health England, the number of FTE health visitors
The changing face of early childhood in the UK
visitors provide a valuable safeguarding has also declined since its peak in 2015
and early help service for children at risk (StatsWales 2020a).
(Peckover and Appleton 2019). NHS data
suggests the number of full-time equivalent
(FTE) health visitors has declined steadily 2.2 Changing social work practice
since its peak in 2015 (NHS Digital 2020).
(See Section 6 for recent changes in light Since the enactment of the 1989 Children
of COVID-19.) Act we have seen the introduction
In contrast, the comparable of a range of legislation, guidance, and
programme in Wales, Healthy Child Wales, policy across different administrations
has received consistent funding since its to both encourage integrated approaches
Figure 4: Health visitor FTE equivalent in NHS hospitals and community
health services, England, 2010–2020. Source: NHS Digital (2020).
FTE health visitors
12,000
10,257 10,144
10,000
9,087
7,963 8,926 8,172
7,846
8,000 7,588
8,029
7,697
6,828
6,000
4,000
2,000
0
2010 2011 2012 2013 2014 2015 2016 2017 2018 2019 2020
Note: Measured in March each year.
6 Health visitors support new parents and infants from birth until the child is two, advising on feeding and
growth, sleeping, vaccinations and development, and identifying parents who need mental health support.
All families are entitled to five checks, the first usually a home visit (Sherwood 2020).
7 The commissioning of public health services, including school nursing and health visiting was transferred
to local authorities by the end of 2015 (Royal College of Nursing 2019).
Nuffield Foundation Protecting young children at risk of abuse and neglectto family support and redesign services in England (and on the child protection 19
around the notion of early identification register in Wales) due to neglect and
The changing face of early childhood in the UK
of risk (Hood et al. 2020).8 These emotional abuse (DfE 2020b). This
policy developments have taken place raises important questions as to whether
against a backdrop of significant events, we are seeing increased awareness
which have increased the role of the and more/better reporting and recording,
state in vulnerable children’s lives and risk-averse social work practice, or whether
the organisation of these services, as there has been an actual increase in
well as the behaviour and practice of emotional abuse and neglect owing to,
professionals. The tragic and high-profile for example, increased financial pressures
deaths of Victoria Climbié and Peter on families, or reduced and fragmented
Connolly, together with their subsequent preventative services—or, more likely,
enquiries, have drastically changed how a mixture of all of these factors (Trowler
the state supports the children at risk and Leigh 2018; Care Crisis Review 2018;
of abuse and neglect. The reviews that Hood et al. 2020; Curtis et al. 2019).
followed, notably Laming (2003) and
Munro (2011), proposed radical changes
to the national and local structures for 2.3 Capacity and the ‘right’ level
children’s and family services to ensure of intervention
they are properly coordinated, accountable,
and managed effectively. Debates continue as to whether child
It remains unclear whether different welfare intervention rates are too high
risks are being identified, or if the same (i.e. whether the state intervenes too readily
behaviours are regarded as riskier to children in families’ lives) in England and Wales. It
than they would have been previously. appears that higher intervention rates are
According to some commentators and not driven by more referrals. Research
policy officials, we have witnessed a change has shown that while referrals to local
in what society is prepared to accept as authorities increased by 7% between
a standard of parenting it can tolerate, 2010/11 and 2017/18, local authorities
resulting in a greater number of children carried out 77% more child protection
referred to children’s services (Trowler assessments (NAO 2019). It is not clear,
and Leigh 2018; Curtis et al. 2019). however, if the disproportionate increase
The reasons behind the trend in assessments is because of lower risk
of increasing numbers of children going into thresholds applied by authorities, a change
the child welfare and family justice systems in the nature of referrals made, or other
are complex and contested. But they do factors (NAO 2019). Interviews with service
not reflect an increase in recorded physical managers carried out by Hood et al. (2020)
or sexual abuse. Instead, as Figure 5 suggest that demand, in terms of children
shows, we have seen a greater proportion requiring a child protection intervention,
of children under five on protection plans has increased.
8 Others have provided more comprehensive accounts of the ways in which the policy in this area has
transformed and developed (Association of Directors of Children’s Services (ADCS) 2018; Powell 2019;
NSPCC 2020). These policies and strategies have not all been directly aimed at children under five,
but all pertain to them. (A list of strategy and policy milestones can be found in the annex).
Nuffield Foundation Protecting young children at risk of abuse and neglectResearchers and commentators analysis by the Child Safeguarding Practice 20
suggest that high-profile and tragic deaths Review Panel for England revealed that
The changing face of early childhood in the UK
have caused local authorities and social 46% of children who died or were seriously
workers to become ‘risk-averse’ (Hood harmed in 2018/19 were not known to the
et al. 2020; Tickle 2018). However, this child welfare system (Child Safeguarding
has been in the form of ‘late intervention’, Practice Review Panel 2020).
or a greater tendency to use child These viewpoints are not
protection plans and care for a greater necessarily mutually exclusive. Not all
proportion of referrals (Hood et al. 2020). of these children in vulnerable families
Meanwhile, bodies such as the need to be on a child protection plan
Children’s Commissioner for England argue (or in Wales a child receiving care
that the scale of childhood vulnerability is and support plan). Instead, existing
much larger than is currently being dealt universal and targeted services, for
with, arguing that only a fraction of children example an expanded Troubled Families
at risk are actually identified (Children’s Programme, could potentially be
Commissioner for England 2020b). Recent sufficient in helping local authorities to
Figure 5: Initial factors identified in child protection plans of children aged 1–4,
England, 2011–2019. Source: DfE (2020b).
Children with protection plans
16,000
14,000
12,000
10,000
8,000
6,000
4,000
2,000
0
2011 2012 2013 2014 2015 2016 2017 2018 2019 2020
Multiple Sexual abuse Physical abuse Emotional abuse Neglect
Note: The ‘Multiple’ category refers to instances where there is more than one main category of abuse.
Children included in this category are not included in any other category of abuse, therefore a child is
counted only once overall.
Nuffield Foundation Protecting young children at risk of abuse and neglectsupport the welfare of young children and In 2016, the then President of the 21
their families. Family Division, Lord Justice Munby,
The changing face of early childhood in the UK
There are serious concerns and described the care system as being in
much uncertainty about whether the child a state of crisis. In response, the Nuffield
welfare and family justice systems can be Foundation funded the Care Commission
sustained with the current levels of demand to consider how to address this ‘care
and resourcing for care (Care Crisis Review crisis’, and to explore the factors that have
2018). Councils in England overspent on contributed to the number of children
children’s social care by £800 million in in care reaching the highest level since
2018/19 (Harris, Hodge, and Phillips 2019). the Children Act 1989 was enacted
Figure 6: Factors identified in children on the child protection register aged
1–4, Wales, 2001–2019. Source: StatsWales (2020b; 2020c).
Children on protection register
1,000
800
600
400
200
0
07
08
09
10
11
12
13
14
15
17
18
19
02
03
04
05
06
20
20
20
20
20
20
20
20
20
20
20
20
20
20
20
20
20
Multiple Sexual abuse Physical abuse Emotional abuse Neglect
Note: A number of data items are unavailable for 2015–16. The scope of the social services data collections was
reduced for 2015–16 in order to ease the burden on local authorities while they made preparations for the change
to data requirements for 2016–17, following the Social Services and Well-being (Wales) Act 2014 coming into force.
Nuffield Foundation Protecting young children at risk of abuse and neglect(Care Crisis Review 2018). (Section 3 share of funding allocated to 22
explores these trends in greater detail). statutory and acute rather than
The changing face of early childhood in the UK
preventative services.
‘Many in the system continue to be • There is ongoing debate as to whether
frustrated working in a sector that is too many young children and newborns
overstretched and overwhelmed and are being subject to care proceedings,
in which, too often, children and families or whether too many are being missed.
do not get the direct help they need early The answer may be due both to a lack
enough to prevent difficulties escalating’ of child protection support at the
(Care Crisis Review 2018, p. 4). right level and a system that does
not always take the right children
into care. Ultimately both appear to
2.4 Points for discussion be a consequence of failing to align
services against the distribution of
• There has been a shift in needs in the local population, which
the organisation and funding is a consequence of insufficient
of services for children at risk of data on the latter (and cuts to
abuse and neglect, with a greater preventative services).
Nuffield Foundation Protecting young children at risk of abuse and neglect3 What do we know 23
The changing face of early childhood in the UK
about children in
the child welfare
and family justice
systems, and how
has this changed
over time?
3.1 Estimating the number of young The ONS has started collating survey
children at risk data to estimate the proportion of the
population that has experienced abuse and
It is estimated that some half a million neglect. It estimates that one in five adults
children under five live in a household with (aged 18–74) has experienced some form
domestic abuse, parental mental health of abuse and neglect by the time they are
problems, or parental drug/alcohol abuse 16 (ONS 2020). (Section 6 outlines recent
(see box on page 24). Scarce evidence trends in light of the COVID-19 pandemic.)
exists on whether child maltreatment is However, robust assessment of the
increasing or decreasing over the long extent of maltreatment and whether this
term in England and Wales (Degli Esposti has changed over time remains limited due
et al. 2019; Gilbert et al. 2012). Research to a lack of regularly collected data.
by the NSPCC, which remains the most Moreover, the data used in both the NSPCC
robust to date, suggested in 2011 that and ONS analyses is based on
rates of child maltreatment reported retrospective recall of historic abuse. There
retrospectively by young adults aged is strong and ample evidence of both under
18–24 were lower in 2009 than in 1998, and overreporting in such studies. When
suggesting maltreatment may be becoming retrospective recall of child abuse and
less prevalent (Radford et al. 2013). neglect has been compared to prospective
There has not yet been a follow-up survey. data in the same cohort, there is shockingly
Nuffield Foundation Protecting young children at risk of abuse and neglectlittle overlap (Reuben et al. 2016; Baldwin parents—most often the mother—being 24
et al. 2019). categorised as ‘toxic’ and the main source
The changing face of early childhood in the UK
In the UK current practice in of risk. As a result, the term serves to further
children’s social care and protection stigmatise and does not illuminate fruitful
has been led by the influential review pathways to intervention (Hardy 2018).
of Cleaver et al. (2011). This has led to an
increased awareness of the risk factors
that affect the capacity of parents to 3.2 Children known to the child
adequately care for their child: mental welfare system
illness, learning disabilities, substance
misuse and domestic violence. In policy While less is known about trends in
documents these factors have been underlying prevalence of child abuse
reduced and referred to simply as the and neglect, much more is known about
‘toxic trio’ (Cleaver et al. 2011). Poverty the profile of children being supported
is also often seen as separate from these by child welfare and family justice systems,
risk factors, reduced to a secondary factor, and how this cohort has changed over time.
which may increase the risk to children.
This is despite considerable international Children in need
research evidence that suggests that Despite a growing number of children in care
the socio-economic conditions in which and on protection plans, the rate of children
parents operate exacerbates or mitigates in need has remained relatively stable for
these issues (Bywaters et al. 2016). all children under 18 in England. For children
In recent years there has been aged 1–4 the rate has actually decreased
growing concern around the use of such since 2009, while among children under the
terms because they often lead to the age of one it has increased (DfE 2020b).
According to official statistics and extrapolated survey data,
England, 2019
• 557,512 children under five lived in by unintentional and deliberate
a household with domestic abuse, injuries in children.
parental mental health problems, • 17,377 children under five had
or parental drug/alcohol abuse. an open child protection plan.
• 72,736 children under five were • 14,580 children under five were
children in need (but not looked after). looked after by a local authority.
• 41,210 children under five had • 2,890 children under five were
a hospital admission caused adopted after being taken into care.
Note: Some children may be included in multiple groups. For full information on data sources
see Children’s Commissioner for England (2020b). ADCS has also released national data for
all children under 18 (ADCS 2020).
Nuffield Foundation Protecting young children at risk of abuse and neglectFigure 7: Children in need per 10,000 children, 25
England, 2009–2018. Source: Authors’ analysis of DfE (2020b) data.
Rate per 10,000 children
350
335 334
300 308
305
282
250
249
200
150
2009 2010 2011 2012 2013 2014 2015 2016 2017 2018
All ages Aged 1–4 Aged under 1
Note: ‘Aged under 1’ excludes unborn children. Measured in March each year. Mid-year population estimates
taken from ONS.
Figure 8: Children on protection plans per 10,000 children,
England, 2001–2018. Source: Authors’ analysis of DfE (2020b).
Rate per 10,000 children
80
78
70
60
49
50
50
40 44
30 34
20 24
10
0
2
03
4
5
20 6
20 7
20 8
20 9
/10
/11
12
/13
/14
/15
/16
/17
18
/19
/0
1/0
/0
/0
/0
/0
/0
11/
17/
10
2/
16
14
12
13
15
18
09
07
06
04
05
03
08
0
20
20
20
20
0
20
20
20
20
20
20
20
20
20
20
Aged under 1 Aged 1–4 All ages
Note: ‘Aged under 1’ excludes unborn children. Measured in March each year. Mid-year population estimates
taken from ONS.
Nuffield Foundation Protecting young children at risk of abuse and neglectChildren on a protection plan (all children under 18) have been rising 26
The costliest activities in the child welfare in both England and Wales since the late
The changing face of early childhood in the UK
system—child protection assessments 1990s (DfE 2020b). Yet, until recently, little
and supporting children on child protection was known about the number of newborns
plans—have increased rapidly in the last coming into care proceedings.
two decades, suggesting a greater demand Analysis by Broadhurst et al.(2018)
on children’s services (DfE 2020b). found that just under one in four children
As Figure 8 shows, the rate of children in care proceedings in England is an
on a protection plan in England remains infant under one year old. Between
higher among children aged under four, 2007/08 and 2016/17, a greater proportion
and has risen since the early 2000s, of care proceedings concerning infants
though rates have stabilised since were issued for newborns. The likelihood
their peaks in 2013. of newborns in the general population
becoming subject to care proceedings
had also increased; ‘the incidence rate
3.3 Children in care proceedings more than doubled from 15 to 35 per
10,000 children’ (Broadhurst et al. 2018,
The number and rates of looked-after p. 18). Data suggests around half of these
children and children in care proceedings babies are born to mothers who were
Figure 9: Care proceedings per 10,000, England, 2008–2016.
Source: Broadhurst et al. (2018).
Rate per 10,000 children
81
80
70
60
51
50
40 35
30
20 15
20
10 19
13
10
0
2008 2009 2010 2011 2012 2013 2014 2015 2016
Aged under 1 Newborn Aged 1–4 All ages
Notes: ‘Newborns’ refers to the number of infants subject to s.31 proceedings within one week of birth
per calendar year (2008–2016), and the number of live births in England in each calendar year (2008–2016).
Mid‑year population estimates taken from ONS.
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