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Launching our new national guidelines for responding to unexpected child deaths

one candle 4The unexpected death of an infant or child is a huge tragedy for any family, leaving them bewildered and grieving, and cutting across all their joys and hopes for their child. While much progress has been made in our understanding of the causes of such unexpected deaths and how to prevent them, sudden infant death syndrome (SIDS) remains the biggest cause of infant death after the first week of life, with over 200 babies per year dying this way in England and Wales. Whenever a child dies unexpectedly, there is a requirement for the coroner to investigate the death. These investigations can, however, further add to the parents’ distress. It is therefore crucially important that each unexpected child death is thoroughly investigated in a sensitive and supportive manner.

 

Every week at least four families in England and Wales experience the sudden, unexpected death of their child

 

Sudden unexpected death in infancy and childhood – Multi-agency guidelines for care and investigation

These new national guidelines have been published by a multi-agency working group convened by The Royal College of Pathologists and The Royal College of Paediatrics and Child Health. They provide guidelines for professionals responding to an unexpected child death which are both sensitive to the needs of grief-stricken parents and seek to help parents understand why their child has died.

The revised guidelines build on previous work published in 2004 and seek to outline best practice for the different professionals involved in responding to an unexpected death and to ensure that the response to such deaths is both sensitive and thorough.

I have been enormously privileged to have been part of the group writing these new guidelines, and also to have been involved in some of the research on which they are based. We have seen huge improvements in the ways police and health professionals respond to such deaths, but there is always more that we can learn. So I hope that the revised guidelines will be a stimulus for improving services across the country.

In my work with bereaved families, I have come across terrible situations where parents have been kept in the dark or made to feel like criminals, but also some great examples of how families have been supported through the days and weeks following their child’s death and how police and health professionals have worked together in a sensitive, thorough, and caring manner. Parents often tell me that what they want, above anything else, is to understand why their baby died, but also their hopes that by investigating their child’s death thoroughly, we can work to prevent other families having to go through a similar experience.

The guidelines are freely available for download from the Royal College of Pathologists. Click here to download the guidelines.

The Lullaby Trust

Lullaby TrustWhile so many families continue to face this awful tragedy, we must do everything we can to support those families and to prevent future child deaths. Particularly at this time of year, many parents will be feeling the grief so much more intensely. It has been really encouraging to be involved with the Lullaby Trust who continue to work to support families and professionals as well as supporting research and public health initiatives to further reduce the incidence of SIDS. This week, they are once again holding a fundraising challenge through The Big Give: From 12 midday on Tuesday 29 November to 12 midday on Friday 2 December donations made to us via The Big Give website will be matched pound-for-pound; this means a donation to us could go twice as far absolutely free of charge to you!

 

 

 

 

 

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International Day for the Elimination of Violence against Women

Today, 25th November, has been designated by the UN as an international day for the elimination of violence against women.

 

“Violence against women and girls is a human rights violation, public health pandemic and serious obstacle to sustainable development. It imposes large-scale costs on families, communities and economies. The world cannot afford to pay this price.” — Ban Ki-moon, UN Secretary-General

 

In my work in the field of child abuse, I have increasingly become aware of the huge tragedy of violence against women, the awful scars it causes to the women themselves, and to their children. It is also a scar across the whole of humanity – something Elaine Storkey has explored in her powerful book, Scars Across Humanity. We must do more to stop it.

 

Violence against women harms their children too.

In the three years from April 2011 to March 2014, Local Safeguarding Children Boards in England carried out a total of 293 Serious Case Reviews (SCRs) (1). Each one of these concerned a child or children who had died or been seriously harmed as a result of abuse or neglect. In a review of these SCRs, we found that in 54% of cases, there was documented evidence of domestic violence in the parents’ relationship. This included 70 children who had died within a context of domestic violence in the family.

It is now abundantly clear from research that living with domestic abuse is always harmful to children. This was emphasised in a recent special issue of the journal Child Abuse Review (2). At its extreme, this may result in the death of a child, the risks for which may continue even after separation. However, far more children continue to live in households where domestic violence is a part of ‘normal’ family life. The myth that because the children are in a different room and so don’t witness any actual violence, they aren’t harmed by it, has been very clearly shown to be a myth. Children pick up on the stress their parents feel; they experience the fear and terror when their mother is being hit or shouted at; they suffer from the controlling, threatening behaviour, the isolation and intimidation that are imposed on their mothers (for the reality is that, in most of these cases, it is the mother who is the victim).

Over the past few years, there has been huge progress in how we as a society, and as child welfare professionals, recognise and respond to domestic violence, including a growing recognition of the impact on children of living with domestic violence. However, there is still much to do. In our research we identified the importance of police, health and social care professionals carefully considering the needs of children in a family whenever there is evidence of domestic violence; of recognising that domestic violence should not be seen solely in terms of violent incidents, but also within the context of ongoing coercive control and the impact of this on the parent and children; and that controlling behaviour may continue to pose risks to mothers and children, even following separation.

By recognising these risks, and taking action to protect women and children from domestic violence, perhaps we could prevent some of those 70 deaths and many more of the cases of serious harm and children and women living in fear.

 

The full research report, Pathways to harm, pathways to protection, is freely available for download from Research in Practice: http://seriouscasereviews.rip.org.uk

The special issue of Child Abuse Review is available via the BASPCAN website: http://www.baspcan.org.uk/child-abuse-review/

 

 

 

 

  1. Sidebotham P, Brandon M, Bailey S, Belderson P, Dodsworth J, Garstang J, et al. Pathways to harm, pathways to protection: a triennial analysis of serious case reviews 2011 to 2014. London: Department for Education; 2016.
  2. Humphreys C, Bradbury-Jones C. Domestic Abuse and Safeguarding Children: Focus, Response and Intervention. Child Abuse Review. 2015;24(4):231-4.

 

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Evidence-informed Practice, Practice-informed Research

This Friday, 18th November, we are celebrating 25 years of the journal Child Abuse Review with a special anniversary conference in Birmingham.

To mark the occasion, we have launched a virtual issue of Child Abuse Review which is freely available to download from the journal website:

Child Abuse Review

Evidence-informed Practice, Practice-informed Research

In this virtual issue we have pulled together a selection of papers from across the 25 years of the journal’s publication within the four conference themes of neglect, child sexual exploitation, domestic violence, and research into practice. We include papers by each of our four keynote speakers, as well as papers by several of the other free-paper authors who are speaking at the conference.

Over the 25 years of the journal, we have seen an increasing emphasis on evidence-informed practice: ‘the application of appropriate evidence, combined with the experience of the practitioner and their responsiveness to the current context’ (Sidebotham, 2013). Equally important is the emphasis on research being informed by and relevant to practice.

 

Neglect

Neglect is one of the most prevalent and most challenging forms of child maltreatment. Our keynote speaker, Marian Brandon, is well known for her work on Serious Case Reviews, and has given a lot of thought to the role of neglect in child fatality and serious injury (Brandon, Bailey, Belderson, & Larsson, 2014). She points out that while neglect is rarely the direct cause of a child maltreatment fatality, it is a contributory factor in a much larger proportion of cases, and we need a more nuanced understanding of the different forms of neglect and their potential impact on the child. Given all that we know about the prevalence and impact of neglect, it is perhaps surprising that this topic is relatively under-represented in published research. One of our other conference speakers, Katherine Kloppen, undertook a systematic review of prevalence studies of child maltreatment in Nordic countries and found only one study reporting on the prevalence of neglect (Kloppen, Mæhle, Kvello, Haugland, & Breivik, 2015). Within Child Abuse Review, we have been able to publish a number of original research articles focusing specifically on neglect, including our 2014 special issue, from which we would particularly highlight the papers by Elaine Farmer, another conference speaker: (Farmer & Lutman, 2014).

 

Child Sexual Exploitation

Child sexual exploitation (CSE) has come to prominence more recently, although it is clearly not a new phenomenon, as was pointed out by Nina Biehal, another conference speaker, in her 1999 paper on the risks associated with going missing from substitute care (Biehal & Wade, 1999) and in a highly cited review of CSE by Elaine Chase and June Statham (Chase & Statham, 2005). Our conference keynote speaker on this theme, Jenny Pearce, has been a leading advocate for appropriate responses to dealing with the issues raised by sexual exploitation, as highlighted in an early discussion paper (J. Pearce, 2006) and a more recent review of how Safeguarding Children Boards work to protect children from sexual exploitation (J. J. Pearce, 2014).

 

Domestic Violence

Our awareness of the impact of domestic violence on children has similarly grown over the years, and it is now much more clearly recognised as always being harmful to children. Part of this has involved the recognition that children are harmed even if they are not directly involved in the violence, and that the ongoing context of coercive control may be as damaging to children (if not more so) as any physical incidents. In a landmark paper published earlier this year, Emma Katz explores these issues and considers how we as practitioners can respond more appropriately (Katz, 2016). Preventing and responding to domestic violence presents huge challenges to practitioners, particularly where children are involved. In a systematic review available online through our Early View function, William Turner and colleagues searched for evidence on the effectiveness of interventions to improve the response of professionals (Turner et al., 2015). They found good evidence of training interventions improving knowledge, attitudes and clinical competence, but less evidence around system level interventions. One of the biggest challenges in this area is how to work with fathers, and this is an issue which Stephanie Holt, our keynote conference speaker, has specifically explored in her research (Holt, 2015).

 

Research into Practice

Our fourth topic of research into practice is addressed by one of the former editors of Child Abuse Review, Kevin Browne. Kevin has been a leading advocate for child protection services, particularly in Eastern Europe, and his paper comparing institutional care and international adoption between Romania and Lithuania is published online through Early View (Chou & Browne, 2016). Translating research into practice isn’t always easy and the paper by Helen Buckley and colleagues exploring the factors that may influence practitioner uptake of research is well worth reading (Buckley, Tonmyr, Lewig, & Jack, 2013). They highlight particular ways in which practitioners can both access and use research evidence to inform their practice, and get involved in further study and research, thus promoting the full circle of evidence-informed practice and practice-informed research.

 

You can access all the papers from the 25th anniversary virtual issue by clicking on the link below:

Child Abuse Review 25th anniversary virtual issue

 

Content of the Child Abuse Review 25th Anniversary Virtual Issue

Neglect

The Role of Neglect in Child Fatality and Serious Injury
(Volume 23, Issue 4, 2014)
Marian Brandon, Sue Bailey, Pippa Belderson and Birgit Larsson

Prevalence of Intrafamilial Child Maltreatment in the Nordic countries: A Review
(Volume 24, Issue 1, 2015)
Kathrine Kloppen, Magne Mæhle, Øyvind Kvello, Siren Haugland and Kyrre Breivik

Working Effectively with Neglected Children and Their Families – What Needs To Change?
(Volume 23, Issue 4, 2014)
Elaine Farmer and Eleanor Lutman


Child Sexual Exploitation

Taking a Chance? The Risks Associated with Going Missing from Substitute Care
(Volume 8, Issue 6, 1999)
Nina Biehal and Jim Wade

Commercial and sexual exploitation of children and young people in the UK—a review
(Volume 14, Issue 1, 2005)
Elaine Chase and June Statham

Who needs to be involved in safeguarding sexually exploited young people?
(Volume 15, Issue 5, 2006)
Jenny Pearce

‘What’s Going On’ to Safeguard Children and Young People from Child Sexual Exploitation: A Review of Local Safeguarding Children Boards’ Work to Protect Children from Sexual Exploitation
(Volume 23, Issue 3, 2014)
Jenny J. Pearce


Domestic Violence

Beyond the Physical Incident Model: How Children Living with Domestic Violence are Harmed By and Resist Regimes of Coercive Control
(Volume 25, Issue 1, 2016)
Emma Katz

Interventions to Improve the Response of Professionals to Children Exposed to Domestic Violence and Abuse: A Systematic Review
Early View: First Published 29 June 2015
William Turner, Jonathan Broad, Jessica Drinkwater, Adam Firth, Marianne Hester, Nicky Stanley, Eszter Szilassy and Gene Feder

Post-separation Fathering and Domestic Abuse: Challenges and Contradictions
(Volume 24, Issue 3, 2015)
Stephanie Holt


Research into Practice

The Relationship over Time between International Adoption and Institutional Care in Romania and Lithuania
Early View: First Published 14 July 2015
Shihning Chou and Kevin D. Browne

Factors Influencing the Uptake of Research Evidence in Child Welfare: A Synthesis of Findings from Australia, Canada and Ireland
(Volume 23, Issue 1, 2014)
Helen Buckley, Lil Tonmyr, Kerry Lewig and Susan Jack

 

 

 

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Everyone loves a wedding


 

Britain may be leaving the EU; Donald Trump may be threatening to build a wall; New Zealand may be rocked by earthquakes and Delhi engulfed in smog. We may live in a crazy, messed up world. But where there is love, there is hope.

 

So, to brighten up your day, here are a few photos from Esther and Rob’s special day.

wedding-2 wedding-4

 

 

 

 

wedding-9 wedding-15

 

wedding-11

wedding-19 wedding-26 wedding-28

 

wedding-38

wedding-47

 

wedding-54 wedding-60 wedding-61

 

 

(There are another 390 or so on Rob’s Facebook page!)

All images (c) Matt & Esther Way Matt & Esther Photography http://mattandesther.co.uk/

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Re-reading Malachi: a sermon for Remembrance Sunday

 

 

We live in a messed up, hurting world.

 

Remembrance Sunday

Today is Remembrance Sunday on which we give thanks for those who gave their lives for the peace that we have enjoyed for the past 60 years; we remember the horror of war – the pointless loss of innocent lives; we pray for those who live with the ongoing reality of violent conflict; and we strive for greater peace and freedom.

In Bristol, 19,240 shrouded figurines were laid out in memory of the British soldiers who were killed on the first day of the Battle of the Somme, 1st July 1916.

college-greenjpg_jpg_size_custom_crop_1086x724

 

100 years later: from 9/11 to 11/9

As we commemorate 100 years from the Battle of the Somme, it is patently clear that we continue to live in a messed up, broken world. We just need to think of the events of this week with the US election; or the Brexit vote just 5 months ago; or the terrible reality of the terrorist attacks of 9/11 and all the ongoing terrorism since; or the living reality of the conflicts in Syria and elsewhere.

We seem to be surrounded by violence, intolerance, bigotry and greed: if anything such values seem to be more prominent, and it is easy to lose hope and sink into despondency.

 

Reading Malachi

The book of the prophet Malachi is the last book in the Old Testament. It was written around the time of Nehemiah and the re-settlement of Jerusalem after the exile.

burning-stubbleAnd it is a book of judgment:

See, the day is coming, burning like an oven, when all the arrogant and all evildoers will be stubble; the day that comes shall burn them up, says the Lord of hosts, so that it will leave them neither root nor branch (Malachi 4:1)

 

This makes it a really hard book to get to grips with and to reconcile with our understanding of God and the reality of the world we live in. It comes across as a book that incites religious bigotry and division.

 

A divided world

We like things to be simple, to make sense according to our sense of right and wrong. And so we tend to divide the world into two groups: the righteous and the evildoers; those who are in God’s kingdom and those who are not. And we like to believe that God loves the first group, but hates the others; that God will bless the righteous, but the evildoers will be destroyed.

That was perhaps how the Israelites saw things, and we can read Malachi from that perspective:

‘I have loved you,’ says the Lord. ‘Yet I have loved Jacob but I have hated Esau; I have made his hill country a desolation and his heritage a desert for jackals.’ (Malachi 1:2-3)

We can read Malachi in that light – divide the world into those who are good and those who are evil; those who are in the kingdom and those who are out.

 

Religious Bigotry

There are a number of problems with that:

  1. It doesn’t match reality. It is not the evil who suffer for their violence and greed, all too often it is their innocent victims: the young men sent to the trenches of WWI; the innocent civilians in Coventry, Dresden, or Hiroshima; the millions of Jews sent to the gas chambers; the families of those killed in action in Afghanistan or Iraq; the millions of refugees fleeing inconceivable horrors under Islamic State…
  2. Rather than leading to peace, it exacerbates the violence that separates. It is the crusader mentality that prompted those in the middle ages to march out against the infidels, and closer to home, was used by George Bush and Tony Blair to justify military action in Iraq – ‘we are right and God is on our side’. Donald Trump and his rhetoric in the election campaign; the racism that we saw in this country post-Brexit
  3. It infiltrates our churches so that we become exclusive and judgmental. Think about how we, as a church treat people who don’t necessarily conform to our beliefs or behaviour: Muslims, gay people…
  4. It blinds us to the reality that we are just as much to blame.

Are we really that different from those who perpetrate violence and injustice? We like to portray them as evildoers: child abusers, wife batterers, paedophiles, corrupt bankers and stock brokers, bigoted white Americans or Daily Mail readers… The reality may be that we are not that different.

 

An unfolding word: Re-reading Malachi in a different light

Psalm 119 gives a different perspective on how we can read the words of the prophet Malachi:

The unfolding of your words gives light (Psalm 119:130)

 

Perhaps, then, a crucial part of challenging religious and any other bigotry is being prepared to have our own prejudices and preconceptions challenged.

So perhaps, in the spirit of this ‘unfolding’ of God’s word, what we need to do is re-read Malachi, in a different light: in the light of Jesus, the Messiah, the sun of righteousness who has risen with healing in his wings; the one who came, not to build walls, but to break down the dividing wall of hostility that separates people; the Prince of Peace, who came to overcome violence and evil, not with yet more force and power, or with tactics of shock and awe, but in humility, non-violence and grace.

Perhaps we need to see the prophecy of Malachi, not so much as a condemnation of those who are different, the evildoers, those who are not in God’s kingdom, but rather as a reflection of the cry of God’s heart: God’s longing for justice and healing; God’s longing for all to know that they are loved and accepted; and God’s longing for all to accept the cleansing and healing that he offers.

If we do that, we will find that most of the words of judgment spoken in the book of Malachi are, in fact, spoken against those who are ‘in’: the people of Israel, God’s chosen people; and particularly against those who claimed to be religious.

 

A message of hope: the sun of righteousness

We will find also that it is a message of hope: of the sun of righteousness coming with healing on its wings – extending healing to all those who are abused, persecuted or oppressed; those who are hurt by the violence and greed of this broken world; those hurt by the judgments of us who claim to be part of God’s kingdom.

mountains sunriseFor you who revere my name the sun of righteousness shall rise, with healing in its wings. (Malachi 4: 2)

 

 

 

This is not some soft, wishy-washy message of bland acceptance, ignoring the reality of injustice, violence and greed that is in each one of us. God will bring judgment, and it will be like a fire. But it will be like the fire that burns up chaff and stubble in a harvested field, or like the refiner’s fire that burns up impurities in silver or gold. The farmer will only burn up the chaff and stubble in a field that he cares for, the refiner will only put precious metals in the fire. It is not a fire of torment or destruction, it is a purifying fire and one that leads to justice, to healing, to peace, to joy.

So, if the prophet Malachi were to come to our churches today, what do you think he might see? What might he be challenging us to? Where might he be confronting some of our bigotry, complacency or preconceptions?

 

 

 

 

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Children and Families and the Care System

The latest issue of Child Abuse Review is now available online, with an editorial by my co-editor, Jane Appleton in which she explores some of the complex issues of working with these children and young people, and the huge challenges they may face:

 

 

 

 

 

 

 

 

The papers in this issue revisit the very important subject of children in public
care, which Child Abuse Review most recently examined in a themed issue in
2014 (Appleton and Sidebotham, 2014). Significantly, the latest statistics on
children looked after in England show a steady rise in the numbers of children
in care since 2009, with 69 540 children being ‘looked after’ at 31 March 2015,
‘an increase of 6% compared to 31 March 2011’ (Department for Education,
2015, p. 1). While this trend is not mirrored in Scotland or Wales, children
in the public care system are recognised as being some of the most vulnerable
in society with high levels of need, particularly around emotional wellbeing
and mental health (Bentley et al., 2016). In the UK, most children are placed
with foster families, with other placements including children’s homes, secure
units, hostels and with their parents under social care supervision. Children and
young people enter the care system for different reasons, but for many it is as a
result of abuse and neglect. The experience of being in care, as DEMOS (2010,
p. 11) has noted, ‘clearly serves some g roups of children better than others’ and
there is considerable interest in the outcomes of young people’s care
experiences.
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Children in the public care system are recognised as being some of the most vulnerable

in society with high levels of need, particularly around emotional wellbeing
and mental health
You can read the full editorial, which is freely available online, here.
 .
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Table of Contents

Children and Families and the Care System (pages 247–250)

Jane V. Appleton

 

Out-of-Home Care versus In-home Care for Children Who Have Been Maltreated: A Systematic Review of Health and Wellbeing Outcomes (pages 251–272)

Miriam J. Maclean, Scott Sims, Melissa O’Donnell and Ruth Gilbert

 

A Life Less Ordinary: Foster Carers’ Views and Experiences of Negative Peer Interactions in Fostering Households (pages 273–286)

Christine Barter and Eleanor Lutman

 

Applications of the Dynamic-Maturational Model of Attachment with Children Involved in Care and Family Proceedings (pages 287–299)

Daniel T. Wilcox and Clark Baim

 

Maternal Borderline Personality Disorder and Risk of Child Maltreatment (pages 300–313)

Sarah Laulik, Jayne Allam and Kevin Browne

 

‘Teachers Matter’: The Impact of Mandatory Reporting on Teacher Education in Ireland (pages 314–324)

Ashling Bourke and Catherine Maunsell

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Evidence – Informed Practice, Practice – Informed Research

Celebrating 25 years of BASPCAN’s Journal

‘Child Abuse Review’

Royal Angus Hotel, Birmingham

Friday 18 November 2016

 

 

25th anniversary issue 1 coverAs one of the editors of Child Abuse Review, I would really like to invite you to join us on the 18th November in Birmingham for our 25th Anniversary conference. It promises to be an exciting and challenging programme, with some great guest speakers and inspiring free papers.

 

 

 

 

The day will include:

An optional pre-conference breakfast meeting for delegates on how to get published in Child Abuse Review

 

An opening plenary session setting the theme, with four parallel sessions on the themes:

  • Child Sexual Exploitation and Sexual Abuse
  • Domestic Violence and Parenting Issues
  • Translating Research into Practice
  • Neglect

Each parallel session will include a keynote lecture, a number of short presentations from submitted abstracts, and a plenary discussion.

Interactive poster presentations will be held at morning coffee and lunchtime. The posters will be up for viewing all day from 9am until 4.30pm

A closing plenary and celebration of 25 years of Child Abuse Review.

 

Book online at http://www.baspcan.org.uk/booking.php

 

To see the full programme, click here

4-page-programme-25th-anniversary-flier

 

 

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Camino reflections: Portuguese hospitality

  The taxi driver assured us he knew the way to Mosteiró and the start of our Camino.

Leaving the airport, we passed through the inevitable industrial estates on the outskirts of Porto, then on through increasingly rural spaces: small fields of maize dotted between the warehouses and factories, until finally we were bumping over cobbled streets through elderly Portuguese villages.

 

 

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Eventually he abandoned us on a quiet street corner and pointed to a run-down café on the other side of the road, confidently telling us that this was Mosteiró. There was no sign of the Camino; no friendly yellow arrows pointing us towards Santiago de Compostela. Just a silent Portuguese street, miles from anywhere.

In the café a few elderly men were passing the time of day over tiny cups of sweet, black coffee. We asked if this was Mosteiró, where the start of the Camino was, and whether we could get a sandwich or a bowl of soup to start us on our way.

After eyeing us up and down, one of the men volunteered that this was not Mosteiró, that we would find the Camino a few kilometres back down the road on which we had just come, and that the café sold coffee only, and no food.

Then, recognising our disheartened faces, he broke into a smile, bundled us into tiny car, our backpacks and walking poles crammed into the boot, and drove us back to Mosteiró and the start of our Camino. He dropped us by a warm and friendly café where hordes of farm labourers were tucking into bowls of soup, washed down by carafes of vinho tinto, and pointed out the bright yellow arrows that would set us, refreshed and energised, on our way.

img_2091That simple, generous hospitality to strangers was a feature of our Camino: from the owners of the Albergues and Casas who welcomed us into their homes; the elderly couple who plied us with green figs they had just been picking from their tree; the two old men who daily came down to a river to feed the ducks; the friendly gestures of people we met on the way; and the cheerful waves and ‘Bon Camino’s that greeted us as we tramped our way.

 

Portugal is not a wealthy country, and much of the area we walked through seemed caught in a previous century.

Perhaps, though, the very presence of pilgrims, walking those paths over so many centuries, has endowed the culture with a sense of hospitality: to welcome the pilgrim and the stranger.