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Supervisory Neglect: Is there a workable definition

Supervisory Neglect: Is there a workable definition. Debbie Scott (AIFS) Daryl Higgins (AIFS) Ruth Walker (UQ) Richard Franklin (JCU) Commission for Children and Young People and Child Guardian. Disclaimer.

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Supervisory Neglect: Is there a workable definition

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  1. Supervisory Neglect: Is there a workable definition Debbie Scott (AIFS) Daryl Higgins (AIFS) Ruth Walker (UQ) Richard Franklin (JCU) Commission for Children and Young People and Child Guardian

  2. Disclaimer The Australian Institute of Family Studies (AIFS) is committed to the creation and dissemination of research-based information on family functioning and wellbeing. Views expressed here are those of individual authors and may not reflect those of the Australian Institute of Family Studies or the Australian Government.

  3. Injury • Injury leading cause of death in 1-44 year olds • Children: transport, drowning, assault/homicide • Role of ‘Intent’ • Accidental

  4. Injury • Child injury leading cause of death in 1-44 year olds • Children: transport, drowning, assault/homicide • Role of ‘Intent’ • Unintentional • Intentional

  5. Injury Prevention • Preventable • Interventions • Environmental – pool fencing • Legislation – use of car restraints • Education – safe sleeping techniques • Engineering – reversing sensors in cars • Behaviour – wearing of mouth guards • SUPERVISION

  6. Supervision • Injury prevention strategy? • Ideal world vs real world • Adequate supervision • Risk recognition • Capacity to intervene • Environment • Activity • Personality

  7. Neglect • Australia 2010-2011 = 29% of substantiated maltreatment • Failure to provide • Difficult to identify behaviour or incident • Lack of parental control over some risk factors • Poverty

  8. Muddy waters • Different types of abuse = different considerations • severity • chronicity • measurement affected • criminal prosecution varies • Sexual abuse vs emotional neglect • supervisory neglect very murky

  9. Supervisory neglect • Variability • child factors • activity • time – length, time of day • access to support • environment • parent/family factors • chronicity • immediate context

  10. This study: • AIM: to understand definitional differences in supervisory neglect develop a ‘workable’ definition • DATA: 100 randomly selected scenarios of deaths of Queensland children under 18 years provided by CCYPCG • METHODS: blind review and classification by 5 professionals with experience in child protection, public health, injury prevention, law and child death review

  11. Sample (n=100) • 62% male • Largest proportion under 12 months (36%), smallest 5-12 years (12%) • 20% Aboriginal or Torres Strait Islander • 7% CALD • 65% not known to child protection authorities at time of death

  12. Causes of death research category * Sudden infant death syndrome or Sudden unexplained death of an infant

  13. Classifications • Possible: • Definitely not/not supervisory neglect • Possible supervisory neglect • Probable supervisory neglect • Insufficient information • Logic behind each decision

  14. Results

  15. Medical neglect • Agreement • Risk Factor • Lack of assertiveness • Unclear professional advice • Lack of support for parents to ask question • Protective • Med care sought • Disagreement • Risk Factor • Condition worsening and no help sought • Did not follow medical advice • Protective • Med care sought but too late • Condition of child not obviously life threatening

  16. Safe Sleeping • Agreement • Risk • Co-sleeping • Alcohol or drug • Sleep position • Protective • Fell asleep with bub • No evidence alcohol • Disagreement • Risk • Co-sleeping • Alcohol or drugs • Sleep position • Length of time • Family history • Protective • Sleep position • Own bed • No evidence alcohol

  17. Adolescent Independence • Agreement • Risk factors • Time of day • Activity type • Length of time • Illegal/risky behaviour • Protective • Age appropriate • Parent ‘permission’ • Disagreement • Risk factors • Peers • Illegal/risky behaviour • Parent knowledge of previous risky behaviour • Protective • Age (older) • Time • Use of protective equipment • Sport

  18. Summary • Balance of risk and protective factors • Layers of protection Reason, J. BMJ;320:768-770

  19. Conclusion • Child death review/Public health • More weight to risk factors • Low burden of proof • Focus – primary/ prevention • Law/Child protection • More weight to protective factors • High burden of proof • Focus – tertiary/response

  20. Thank you deborah.scott@aifs.gov.au

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