Defining vulnerability in children
Vulnerable is a term widely used in relation to children, but what does it actually mean?
Child in silhouette - Image credit: Arne Dedert/DPA/Press Association Images
Along with all three and four-year-olds, ‘vulnerable’ two-year-olds are eligible for 600 hours a year of free childcare, rising to 1,140 hours, or 30 hours a week, by 2020.
While ‘vulnerable’ is used as shorthand for this eligibility, in the case of free childcare for two-year-olds there is a very specific set of criteria that defines which children are eligible.
This includes children with parents in receipt of certain benefits such as Universal Credit, Income Support, Jobseeker’s Allowance, or child tax credits with income below a certain level, as well as children who are looked after.
But ‘vulnerability’ is used much more widely about children who may be at risk or families that need more support.
What does it mean to those working with those children, how do they define it and if at the age of just one, a baby such as Kirsty was vulnerable, how would they know?
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Kate Rocks, chief social work officer at East Renfrewshire Council and chair of the Children and Families Standing Committee for Social Work Scotland, says: “Vulnerability is a generic catch-all term that we would use to describe children that have had adverse life experiences.
It’s very unique to that particular child, so it’s very difficult to give a standard definition in terms of set criteria that are recognised across Scotland.
“That will very much be determined on some of the adversities, the strengths within a family, the level of resilience that a child may have, so the national practice model for GIRFEC is probably the most consistent tool in terms of the resilience matrix and in terms of how we do our assessments that would identify the likelihood of where that vulnerability sits.”
This is seconded by Lynne O’Brien, assistant director for West Scotland at Barnardo’s, who says: “We don’t have a strict definition, but we have a good understanding of the factors involved in what makes children vulnerable…there’s certain things you’d be looking out for rather than it being one single thing.
“So, you’ve got the national practice model, which sits within GIRFEC, which is an assessment tool which helps organisations speak to each other around the language of wellbeing, and I suppose the flipside of wellbeing then would be vulnerability.”
‘Getting it right for every child’, or GIRFEC, is the Scottish Government’s approach to improving the lives of children and young people.
Central to it is ‘wellbeing’. There are eight wellbeing indicators in GIRFEC, commonly referred to by the acronym SHANARRI, which ensures everyone has a common understanding of what wellbeing means.
Those eight indicators are: safe, healthy, achieving, nurtured, active, respected, responsible and included.
O’Brien says: “The good thing about GIRFEC is that common shared approach across organisations focusing on wellbeing…I’ve just come from a meeting in Inverclyde, and there’s a real shared understanding of wellbeing and vulnerability and nurture and all of those things that makes it easier for us all to work together, so I think that GIRFEC just gives that framework to do that.”
Claire Burns of CELCIS, the Centre for Excellence in Looked After Children in Scotland at the University of Strathclyde, suggests the difficulty is not actually in defining or recognising vulnerability, but it’s a question of what action to take.
She says: “If you think of a teacher who’s really concerned about a child in the class who maybe is not attending regularly or turning up late or seems sleepy or doesn’t seem to be fed properly, then their concern is not about whether they think that child is vulnerable or not.
“I think they often can assess vulnerability. Their issue is, ‘Is this serious enough for me to pass this on?’ and that seems to be their concern. Or, ‘What is the cumulation of concerns which means I need to pass this on?’
“And then what is the process for doing that? So, if I tell my headteacher, does that mean that that’s my responsibility gone? How does the headteacher then connect that in with, for example, social services?
“So, I think people have an understanding of vulnerability, but it’s actually their understanding of when is one concern too many [is the issue].
“And that’s because it feels quite nebulous for people…people find that a difficult call to make, and it’s a call they’re very often quite concerned about.”
All three agree that while poverty may be a contributing factor in vulnerability, a child is not automatically vulnerable simply because they are poor.
However, evidence shows poverty and the strains it brings can contribute to other factors in vulnerability such as domestic abuse in the home or parents with alcohol or drug misuse issues.
Burns says: “We’re clear that there’s a link between poverty and the rise in the number of cases we’re seeing and neglect because what neglect brings with it is often the attendant issues of alcohol, domestic abuse, mental health issues, so the kind of things that will impact on people’s ability to parent.
“Like poverty impacts on people’s ability to parent, and if it impacts on their ability to parent, then that is likely to compromise children’s development.”
What influences how they might decide if a child the age of Kirsty is vulnerable comes back to GIRFEC and also a professional’s knowledge of what normal development looks like.
Rocks says: “One of the things we have got quite right is ‘Getting it right for every child’, so the fact is for very small children that we have universal pathways…and the fact that we operate the same assessment parameters across the board, we use the same model across Scotland for health, education and social work allows us to identify what that vulnerability looks like much earlier on.
“So health visitors would probably be the first ones to identify the features of what that vulnerability might look like and the steps that might need to be taken to mitigate the level, the series of adversities for that child.”
According to Burns: “I think the evidence tells us enough now that even when children are not communicating with us verbally that there are signs, that we know what healthy development looks like, so I think we are quite aware of what development looks like when it’s compromised.
“I think there’s less of an issue of being able to identify it, so I think nursery teachers, education teachers, they are good at identifying where children are not meeting their developmental milestones.”
She adds that much of the evidence is now saying that a lot of work needs to be done with the family in the home and “what we need to maybe think twice about” is many services being provided outwith the home, such as free childcare, while a lot of the resources in local areas have been lost due to cuts.
As well as the difficulties for those in universal services such as teaching and healthcare knowing whether to escalate a concern, one of the real challenges in times of constrained budgets is how to support children and families who may be struggling, but are just about coping, and children about whom services have some concerns, but who have not reached the threshold for statutory intervention by social services.
Following on from Children in Scotland chief executive Jackie Brock’s 2014 report on safeguarding vulnerable children from abuse, CELCIS is working with three local authorities to look at best practice as well as gaps in dealing with neglect.
Burns says: “Part of the reason that we were funded to do a programme of work around neglect was in response to the Brock report – Jackie Brock’s report – which said we need to focus our concern around those children who are, what she called, ‘on the radar’, but not looked after.
“So, where they hadn’t reached the threshold for statutory services, for example, referral to children’s hearings, but where they were on the radar and a range of people, like teachers, were concerned about them.”
She continues: “So what the concern is [is] that in a time where we’ve got reduced resources, statutory services are having to make choices about who’s reaching the threshold and we’ve got a system whereby GIRFEC was set up so that the majority of welfare concerns would be dealt with by universal services, but both themselves and statutory services feel they can’t stretch any further than what they’re stretching.
“So we’ve got a bit of a gap between those children who we’ve got concerns about, and those children who are meeting the threshold for, for example, social work intervention…so that’s the vulnerability gap there.”
Burns mentions the issue not just of responsibility, but also of time for universal services, such as teachers and healthcare workers, to deal with these issues, citing an example of one teacher who had eight meetings in a week about a child.
She adds: “I think there is a concern that because of the reduced resources in social work that…they’re having to move their threshold of what is becoming a case and that can change throughout Scotland…so there are children who are very vulnerable and probably require a service, but are not getting it because they’re not as vulnerable as other children.”
Asked whether she thinks the balance is right between dealing with immediate cases and prevention, Rocks says she couldn’t comment for the whole of Scotland, but that it is a “postcode lottery”, with social workers directly employed by councils and without the same protections or standardised workload there is for, say, teachers or health visitors.
She expects this will be something that will be looked at in the independent care review.
She says: “I couldn’t even give you a ‘guessology’ of what that looks like nationally, but if you think about all the things that I said [with regards to increasing demand], and the fact is we’re in the greatest element of cuts in terms of the challenges for public spending for local authorities, there’s no safeguards for social workers within this.
“And it’s a matter of the political priorities of the council.”
Burns suggests there needs to be a shift in focus towards whole family approaches, which free childcare for two-year-olds will not do alone.
She says: “One of the things that’s coming up from our work is … that our system at the moment doesn’t actually support whole-family approaches.
“So, you often get workers who’re involved with, maybe addiction or mental health workers who’re from adults’ services and then children and family services are involved with the children and it often doesn’t feel like a totally integrated whole-family approach. So how are those all coordinated to align to what is required by the family?”
In terms of system change, she says: “It needs [something] like the lessons from the Christie Commission, it needs a shift away from failure demand into a focus on early invention and prevention, which is saying, how do we redivert some of our resources towards some of that identifying families at an earlier stage and putting in the kind of work in the family setting?
“So, for example, the education and nursery places for two-year-olds are a great resource, but some of the evidence is actually saying we need to support the family – that taking the child out might be helpful, but that needs to maybe sit alongside the work, that’s not going to be the panacea, there needs to be work that sits alongside the family.”
Although the work CELCIS is doing with the three councils is specifically to do with addressing neglect, she says: “What we’re finding is in order to address that effectively, you have to go back to how are our systems responding at an early stage when vulnerability’s highlighted. And families are also telling us that.
“Families are saying to us, ‘Why am I having to get to a point of crisis or where things get chronic before support services are provided?’”
O’Brien expresses the same view: “I think there’s a real challenge…in terms of providing whole-family support that’s not siloed in the way that somebody has to be this age or that age.
“One of my services can provide support across the age and stage continuum. If a family of three is in need, we can provide support for the children at the different stages.
“But I think there are real challenges around services that are themed – [it] is really important to have themes in specialist services; I’ve got ones on domestic abuse and parental substance misuse, they’re all great and very, very necessary – but it’s that challenge of how do you meet the needs of the whole family and not funding just for that issue, that age.
“I think that’s the challenge that we all face. And…I think there’s real challenges around families who are just coping.”
The consensus is that what is laid out in GIRFEC for dealing with vulnerability is good, but the challenge is in implementation.
Burns concludes: “I think what I’d want to emphasise is that in Scotland there’s no disagreement about the framework or the principles that we’ve got around ‘Getting it right for every child’ – everybody’s signed up to that.
“But what people are recognising is that we can be signed up to the principles but we haven’t implemented it with ‘full fidelity’ – for want of a better word – you know, as intended, fully implemented, and that’s some of the challenges for people.
“So, the actual principle of universal services intervening at an early stage where there’s early concerns and then as those concerns increase, statutory services moving in and that it’s been the team around the child, with education, health and everybody involved, all the relevant services involved in that, everybody’s signed up to the principle of that, but the full implementation of that is very difficult.”
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