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Child abuseA guide for donors and funders

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Not seenand not heardChild abuseA guide for donors and funders

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Other publicationsCommunity

• A long way to go: Young refugees and asylum seekers in the UK (2007)

• Home truths: Adult refugees and asylum seekers (2006)

• Inside and out: People in prison and life after release (2005)

• Grey matters: Growing older in deprived areas (2004)

• Side by side: Young people in divided communities (2004)

• Local action changing lives: Community organisations tackling poverty and social exclusion (2004)

• Charity begins at home: Domestic violence (2003)

Education

• Lean on me: Mentoring for young people at risk (2007)

• Read on: Literacy skills of young people (2007)

• On your marks: Young people in education (2006)

• What next?: Careers education and guidance for young people (2005)

• School’s out?: Truancy and exclusion (2005)

• Making sense of SEN: Special educational needs (2004)

Health and disability

• Don’t mind me: Adults with mental health problems (2006)

• Valuing short lives: Children with terminal conditions (2005)

• Ordinary lives: Disabled children and their families (2005)

• Out of the shadows: HIV/AIDS in Burundi, Democratic Republic of Congo and Rwanda (2005)

• The hidden assassin: Cancer in the UK (2004)

• Caring about dying: Palliative care and support for the terminally ill (2004)

• Rhetoric to action: HIV/AIDS in South Africa (2003)

Cross-cutting research

• Striking a chord: Using music to change lives (2006)

Improving the voluntary sector

• Funding success: NPC’s approach to analysing charities (2005)

• Surer Funding: Improving government funding of the voluntary sector (2004, published by acevo)

• Full cost recovery: a guide and toolkit on cost allocation (2004 published by NPC and acevo)

• Just the ticket: Understanding charity fundraising events (2003)

• Funding our future II: A manual to understand and allocate costs (2002, published by acevo)

Forthcoming research

• Autism (2007)

• Environment overview (2007)

• Out of school hours learning (2007)

• Violence against women (2007)

• Financial exclusion (2007)

• How to fund (2007)

• Advocacy and systemic change (2007-08)

• Homelessness and housing (2007-08)

• Mental health of children and young people (2008)

• Substance abuse (2008)

This report is available to download free of charge from our website www.philanthropycapital.orgTo purchase a hard copy, please call Central Books: 0845 458 9910.

This report was funded by Lloyds TSB Foundation for Scotland and an anonymous individual

Cover photograph supplied by Kristian Buus


SummaryWhy children need protectionChild abuse in the UK is more widespreadthan most of us realise. Research showsthat at least one in nine children is thevictim of serious abuse. NPC estimatesvery conservatively that at least 80,000children are abused each year, involvingemotional, physical, sexual abuse and/orneglect. Abuse can have devastatingconsequences—including death. In theshort term, research has shown that abusecan damage the developing brain and resultin withdrawn or aggressive behaviour. In thelonger term, victims of abuse are more likelyto suffer from mental health problems andto fall victim to further abuse.

Given the sheer number of children whoare abused, the often hidden nature of theirproblems and the widespread, long-termeffects, there is an urgent need for action.Children need protection: from becomingthe victims of abuse in the first place; fromsuffering its consequences; and from livingwith the after-effects as adult survivors.This report will show that donors canchange lives—and even save lives—withtheir support.

The child protection systemIn order to provide context for the work ofthe charities in this field, which spend anestimated £1.1bn per annum on tacklingchild abuse, this section outlines the detailsof the child protection system. Centralgovernment is responsible for the currentsystem, which identifies, reports and dealswith cases of abuse through localgovernment and charities. Localgovernment itself is the major funder ofcharities dealing with child abuse.

Charities sometimes act as part of thissystem: they help to reach more children;they also monitor and suggestimprovements. But charities’ work is alsoconstrained by the system. Without asystem in place that works effectively for allabused children, many thousands ofchildren are missing out on the childhoodthey deserve.

The homeChildren are at greatest risk of abuse intheir own home. They are most likely to beseriously injured or to die at the hands oftheir parents or carers. What is less clear iswhy children are abused. Understandingthis offers a vital step towards tackling thecauses of the problem.

However, there is little consensus on thecauses of abuse. Even where causes canbe identified, they are part of a list ofcontributing risk factors rather than singlecauses, making it difficult to highlight anyone particular causal factor.

Many charities, often in partnership withlocal authorities, offer a package ofservices aimed at reducing the risk of harmto children. Some of the key factors aredescribed in this section, offering donorsthe opportunity to make their own choiceabout where to focus their giving.

Away from homeChildren who have been abused are morelikely to fall victim to further abuse. Theycan end up running away from home,being removed from home, or being forcedto leave. Children may leave home forother reasons, but once they have left, theyare at high risk of abuse. These are someof society’s most vulnerable children.

In the longer term, these children risk theworst forms of social exclusion: fromsubstance abuse to homelessness andprison. Charities are at the forefront ofworking with these children, yet they sufferfrom a serious lack of funding.

Sexual abuseThe sexual abuse of children generates muchheated media attention. But the reality is thatpredatory strangers are not the greatestthreat to children. Four out of five offendersare known to the child, while childrencommit one in three sexual offences.

Effective work to prevent sexual abusemust focus on perpetrators, as well asworking with children, their families and thecommunity—to prevent them from abusingin the first place and deal with them oncethey have been identified. However,resources for both areas are scarce, anddonors’ support is urgently needed.

SchoolSchool can offer a safe haven for childrenand young people. For some, it provideswelcome respite from issues affecting themelsewhere. It is also a place where abusecan be identified and children supported,whether that abuse is happening in thehome or elsewhere. Children can be taughtabout danger, and attitudes andbehaviours can be tackled, potentiallypreventing abuse.

Abuse, however, happens in schools too.Half of all primary schoolchildren and onequarter of secondary schoolchildren reportbeing bullied in the last year. Charities havebeen instrumental in highlighting suchpeer-on-peer abuse, and continue to bevery active in tackling bullying.

Adult survivorsThe majority of abused children do notreceive the support and treatment theyneed to overcome the potential damagecaused by abuse. Most children do notreport their abuse at the time it ishappening. Most children fall through thenet of the child protection system. Thismeans that there are many more adultsurvivors of abuse than children beingabused at any one time. NPC estimatesthat there could be as many as five-and-a-half million survivors in the UK alone.

Not all survivors of abuse want support, oractively seek it. However, the number oforganisations that have sprung up to offera listening ear or more formal counsellingfor survivors suggests that many do wanthelp. These groups do little advertising oftheir work; demand could massivelyoutstrip their capacity if all survivors wereaware that support was available.

SocietyBroader changes in attitudes andbehaviours are required across the countryin order to tackle child abuse head on.Work that aims to create change acrosssociety as a whole may be the mostfamiliar area of this field to donors. The FullStop campaign by the National Society forthe Prevention of Cruelty to Children(NSPCC) is by far the most visibleelement of charities’ recent efforts to tacklechild abuse.

But public attitude campaigns alonecannot stop child abuse. There are anumber of ways in which charities can helpto change society’s attitudes and ensurethat direct approaches to tackling abusecan work effectively. These steps are allnecessary if we are even to hope that childabuse can be totally prevented.

ConclusionsBy supporting charities in this field, donorscan play a significant role in helping toachieve change—and in protecting futuregenerations of children from harm.

Every night and every morn some to misery are born.

Every morn and every night,

Some are born to sweet delight, some are born toendless night.

Extract from Auguries of Innocence,William Blake

Contents

3

Introduction 4The report begins by outlining the key priorities for donors interested in tackling child abuse.

Section 1: Why children need protection 7The first section reveals the size of the problem and its devastating impact. It looks at the important role

charities play as well as some of the knowledge gaps in the field.

Section 2: The child protection system 14The second section provides important context for the rest of the report. The state delivers the majority of child

protection services, but many children are slipping through the net.

Section 3: The home 32The third section discusses the fact that children are most at risk of abuse in the home, at the hands of parents or

carers. It explores some of the many risk factors associated with child abuse.

Section 4: Away from home 48The fourth section looks at the forgotten elements of child abuse, such as running away and sexual exploitation.

These typically involve children who have tried to escape abuse but end up in situations where they are all themore vulnerable.

Section 5: Sexual abuse 59The fifth section highlights some of the treatment work for sexual offenders. This is unpopular work,

yet critical if child sexual abuse is to be prevented.

Section 6: School 72The sixth section identifies school as a place where abuse can be picked up and dealt with. It can also be

an abusive place: bullying is often cited by children as their number one concern.

Section 7: Adult survivors 78The seventh section demonstrates the needs of the many millions of adult survivors being helped by

charities to overcome the damaging legacy of childhood abuse.

Section 8: Society 84The eighth section explains the wide-ranging role society and culture have to play in the abuse of children,

and the importance of challenging attitudes and behaviours.

Conclusions and recommendations 93The report concludes with a summary of where funding can have the greatest impact, and how this funding

should be prioritised.

Appendices 95

Acknowledgements 103

References 105

IntroductionThis report is a guide for donors who want totackle child abuse. It sets the context for, andoutlines the vital work of charities in this field. Italso describes the results they achieve, andsuggests how donors can prioritise theirfunding based on these results.

Tackling a difficult issueChild abuse is a difficult area to research, forseveral reasons. These are reflected in thestructure and content of this guide. First,abuse takes many forms—from physical abuseto neglect. Second, causes are hard to isolate,and charities must work on many fronts totackle multiple causes. Third, we actually knowlittle about child abuse because it is oftenhidden, and because not enough research hasbeen done. And finally, preconceptions aboutabuse based on unbalanced media reportingcan colour our views.

This report has been structured primarilyaround the different settings where abuseoccurs and can be tackled:

• the home;

• away from home;

• in school; and

• across society in general.

Sexual abuse is discussed separately fromother forms of abuse, as its causes aredifferent, as are effective approaches totackling it.

In this report, we describe the scale of childabuse, the massive cost to both individualsand society, and some of the many ways inwhich charities can tackle abuse. Charitieswork to prevent abuse from occurring and,where it does occur, they work to protectchildren from harm, identifying, reporting anddealing with abuse. They help children torecover from what has happened to them;help families to provide a warm, stableenvironment; and help perpetrators to confrontand deal with the abuse they have committed.Charities also help those children who fallthrough the net to recover as adults.

As a guide for donors, this report provides atool that helps one to think about where togive. But prioritising is hard because we do

not know enough about the effectiveness ofdifferent approaches, from telephone helplinesto attitude-changing campaigns. However, ifwe start with what we do know, it is possibleto build the basis of a prioritising tool. This ispresented at the end of report, in Appendix 4.Our approach to prioritisation centres onresults—each section of this report concludesby summarising what we know, and what wedo not, about the results of charities’ work.

At times, this report will go into the detail ofefforts to tackle abuse, both by charities andby central and local government. This detail isneeded to fully explore the key issues, butmight appear overwhelming at times. Donorsmay want to dip into the detailed sections thatparticularly interest them in order to flesh outthe recommendations given here.

Focusing on prioritisation creates a lensthrough which a donor can read and absorbeverything presented here. When the reportgoes into detail, the reader may use thequestions posed in the prioritisation tool todraw conclusions:

• How many people does this affect?

• What are the potential results of thisapproach?

• How confident are we that these results willbe achieved?

• What are the risks of this approach?

• Based on these factors, is this area apriority for my giving?

Many different options for donorsThere are many options for donors wanting totackle abuse. To a certain extent, the choicewill be a personal one, based on the areas ofwork a donor is most interested in. But NPC’sresearch should help to inform that choice.Funding options can be prioritised based onthe combination of personal interest andlogical reasoning.

Providing a context for making that decision, itis worth noting that NPC estimates thecharitable sector spends £1.1bn per annumon tackling child abuse; £500m of this comesfrom the general public, while £640m isprovided by government (see Figure 1).

4

Some areas that a donor might choose tosupport are well funded by government, whileothers are primarily funded by donations fromthe public (as illustrated in Figure 2).

Much of the charitable activity in this field ismade up of large national charities, and thedetail of this report will necessarily draw onmany examples from organisations like theNational Society for the Prevention of Crueltyto Children (NSPCC), Barnardo’s, CHILDREN1

stand The Children’s Society. These are

broad and complex organisations, whose workcannot fully be explored within the confines ofthis report. NPC plans to return to the work ofsuch large children’s charities later in 2007.

Providing preliminary background to thisreport, the diagram below provides an outlineof the major areas of activity aiming to tacklechild abuse, across both the public sector andcharities. This has been colour coded to showthe areas in which NPC believes the greatestfunding gaps and opportunities for privatedonors lie, and conversely where governmentfunding tends to dominate.

5

Not seen and not heard Introduction

0

200

400

600

800

1000

1200

1400

1600

1800

2000

Expe

nditu

re /

£mGovernment

£1,187m

£643m

£643m

£499m

Charities

Voluntary income

Direct government spending

Government spending through charities

PRE-ABUSE

SEQU

ENCE

OF

EVEN

TSOP

TION

S FO

R DO

NORS

DURING ABUSE POST ABUSE

Abuse continues/no support

Abuse stops

Improving identificationand reporting

At least one third of casesnot picked up

Activities to stop abuseand prevent it recurring

Almost no treatment for abusers

Therapy for children

At least one third receive no support

Key service/funding gaps

Largely government funded

Support forsurvivors

Activities reducing the risk to children

Short-term impact

• Developmental delay

• Child’s (mental) well-being

Long-term impact

• Mental health problems

• Further abuse

Confidential sources of advice and support

Research (eg, into prevalence, causes and effectiveness of interventions)

Risk factors for abuseA number of distinct issues are linked to child abuse in

the home, including:

• Poverty• Domestic violence• Substance abuse

For sexual abuse, risk factor is untreated perpetrators

Child is abusedPhysical

EmotionalNeglectSexual

Child runs away/is sexually exploited

Figure 1: Government and charitable spending on child abuse

Figure 2: A map of approaches and options for donors

The scale of the challenge is huge, but manyof the options outlined here have the potentialto benefit large numbers of children—childrenlike eight-year-old Victoria Climbié, who diedfrom horrific injuries inflicted by her aunt (seeBox 3); or two-year-old Derek Dohan, whodied after drinking the heroin-substitutemethadone at his home in East Lothian.Donors interested in supporting this work areencouraged to contact NPC, as we believe

that the best results can be achieved bybuilding a balanced portfolio of funding acrossthese options, based on a donor’s individualpreferences. A donor can also arrive at such aportfolio by using the tool presented here toprioritise their areas of interest. Such aportfolio is described at the end of the report,in Conclusions and Recommendations, and isalso presented here as an introduction toNPC’s recommendations for donors.

6

Not seen and not heard Introduction

Figure 3: A portfolio of approaches tackling child abuse

Prevention

Empowering children• Confidential spaces

• Education/awareness

• Children’s rights

Exploring roots of violence• New approaches to violenceand empathy

Sexual abuse• Helplines and advice

Protection

Child protection

• Family resilience andwhole family work

• Volunteers to support families

Tackling risk factors• See other NPC reportson these subjects

Away from home• Sexual exploitation

• Runaways

Treatment

For children• Lobbying for increased government funding

For sexual abusers• Treatment programmes

• Support/monitoring groups

Survivors

Survivors’ groups• Local groups

Sector coordination• Umbrella body to supportand raise awareness of sector

7

1Why children need protectionChild abuse in the UK is more widespreadthan most of us realise. Research showsthat at least one in nine children is thevictim of serious abuse. NPC estimates veryconservatively that at least 80,000 childrenare abused each year, involving emotional,physical, sexual abuse and/or neglect.Abuse can have devastatingconsequences—including death. In theshort term, research has shown that abusecan damage the developing brain and resultin withdrawn or aggressive behaviour. In thelonger term, victims of abuse are more likelyto suffer from mental health problems andto fall victim to further abuse.

Given the sheer number of children who areabused, the often hidden nature of theirproblems and the widespread, long-termeffects, there is an urgent need for action.Children need protection: from becomingthe victims of abuse in the first place; fromsuffering its consequences; and from livingwith the after-effects as adult survivors.This report will show that donors canchange lives—and even save lives—withtheir support.

Today there is almost universal agreement thatchild abuse is wrong, and should be stopped.But not everyone agrees on the definition ofchild abuse. People most often think of child

abuse as physical or sexual abuse—yetneglect and emotional abuse can have equallyserious long-term effects.

54Fewer people still

would be able to say how many children areabused. Knowing the answers to thesequestions is the first step to effectively tacklingthe problem.

In the next section, we will look at how manychildren are affected and what impact it has.

What is abuse and how manychildren are affected?Sceptics sometimes argue that the extent ofchild abuse is exaggerated, inflated bycampaigners who are overly eager to regulatethe normal rough and tumble of family life.

It is certainly difficult to define abuse. Childabuse occurs on a continuum—drawing theline depends on value judgements. For some,smacking and bullying are both forms ofabuse; for others they are not. This is less of aproblem with harsh physical or sexual abuse:nine out of ten agree on what it is.

55But there

is room for debate when it comes to assessingmany incidents. Is harm defined by what wasdone to the child? Or by the harm’s impact?For example, shaking a teenager out offrustration is unlikely to cause significant harm.Shaking a baby can result in death.

Types of abuse Definition of serious abuse Likelihood of under-18s experiencingabuse

Emotional abuse Experience of four out of the following seven indicators:

• psychological control and domination;

• physical control and domination;

• humiliation or degradation;

• withdrawal;

• antipathy;

• terrorising; or

• proxy attacks (ie, killing a pet).

6%

Physical abuse When violent actions by parents or carers either causeinjuries or continue over many years, causing marks, pain orsoreness lasting until the next day or longer.

7%

Neglect Absence of basic physical care, for example, frequentlygoing hungry, not being taken to the doctor when ill, beingabandoned or deserted.

6%*

Sexual abuse Non-consensual sexual activity or sexual activity whenunder the age of 12 with someone five or more years older.

11%

Table 1: Definitions of abuse and prevalence

* The NSPCC used two separate definitions for physical neglect: absence of adequate parental care (6%) and supervision (5%). The two cannot be aggregated, as we do not know whatoverlap there is between the types of abuse, so here we use the highest proportion.

Researchers have tried to get round thisambiguity by devising clear, concrete criteriafor each of the four types of abuse. Table 1shows the results of the most comprehensiveUK prevalence study to date, published by theNSPCC in 2000. Young adults were askedabout their experiences as children. Theirresponses were analysed against criteria forfour types of abuse: emotional, physical,sexual abuse and neglect.

There is significant overlap between differenttypes of abuse. One study found that only 5%of cases involve just one type of abuse.

56For

example, ‘some level of emotional abuse isinvolved in all types of maltreatment of a child,though it may occur alone’.

27

As such, arriving at an aggregate number isproblematic. The NSPCC study did notattempt to give a total figure of those abused.To avoid double counting, we have used thecategory of abuse that has the highestproportion of the population affected,according to the NSPCC criteria. This is 11%,for sexual abuse involving contact (ie, notincluding exposure, taking pornographicvideos or photos of children, or making themwatch other people having intercourse, whichaffected a further 5%). But we can explore thenumbers to get a better idea of how big theproblem might be.

Figure 4 shows what we know, and what wedo not know, about the prevalence of abuse.

These numbers are shocking. What they showis that a minimum of 11% of children suffersome form of serious abuse; the number couldbe as high as 24%. That means a minimum of80,000 children are abused each year; andthat number could be as high as 175,000each year. The true number is unlikely to beeither of these extremes—we know that thereis overlap between types of abuse but notcomplete overlap—so NPC has used thelowest figure to remain conservative.

Far from being exaggerated, as scepticssuggest, there are further reasons why thefigures used by NPC are likely to be anunderstatement. For each type of abusecaptured in the NSPCC’s prevalence survey,there was an additional significant minoritywho had experienced sufficient abuse tocause concern. Furthermore, the respondentswere young adults. They are unlikely toremember incidents in early childhood, and yetstudies of parental behaviour show that mostphysical punishment happens when the childis under seven years old.

55

The figures also mask important differencesbetween groups. For example, contact sexualabuse affects 16% of girls and 7% of boys,which averages out at 11% of children. Thereare far more female victims of sexual abuse,and therefore more adult female survivorsthan male.

55

The 2000 NSPCC study is the mostcomprehensive available data, and until thenext one is undertaken (forecast for 2010) wehave no way of telling whether prevalence isrising or falling. Given the high political profileof child abuse, it is surprising that there is notgreater commitment to more regularmeasurement of prevalence.

What these figures do tell us is that childabuse is extensive; with at least 80,000children affected each year. The total numberof adult survivors of childhood abuse must bemany times greater, in the region of five-and-a-half million (see Appendix 1 for calculations).

These numbers will be useful later when wethink about prioritising funding in this field, asthey show the relative scale of the problemsfacing children and adult survivors.

The need for better dataIt is disappointing that the best data we haveto go on dates from seven years ago. It mustbe remembered that the study used 18–24year olds, so the study is arguably morereflective of children’s experiences in the1980s and 1990s than today.

8

Not seen and not heard Why children need protection

Figure 4: How many children might be affected by abuse?

Emotional6% of

children

Physical7% of

children

Maximum: no overlap between physical, neglect and sexual abuse; emotional abuse present in (ie, overlaps with) almost all cases

Minimum: complete overlap between all types

Neglect6% of

children

Total24% of children

Total11% of children

Sexual11% ofchildren

Physical

Neglect

Sexual

These numbersare shocking.What they showis that aminimum of11% of childrensuffer someform of seriousabuse; thenumber couldbe as high as24%.

Box 1: Definition of a child

A child is defined as ‘anyone who has not yet reached their 18th birthday […] The factthat a child has become sixteen years of age, is living independently or is in FurtherEducation, or is a member of the Armed Forces, or is in hospital, or in prison or a youngoffenders institution does not change their status or their entitlement to services orprotection under the Children Act 1989.’ 27

A quick glance at the references at the back ofthis report highlights the wide range ofresearch on offer, particularly the role charitieshave to play in generating evidence in thisfield. NPC would not have been able toproduce this report without such research, yetresearchers report great difficulty gettingfunding for research projects. Much primaryresearch consists of small-scale and short-term projects. Only a small proportion issubject to rigorous peer review.

NPC believes there is great opportunity fordonors to support research in this area. DuringNPC’s own research into the field, it has beensuggested that there may be a role for acoordinating research body, perhaps similar tothe National Cancer Research Institute (NCRI)in the field of cancer. The NCRI coordinatesresearch, identifying gaps and avoidingduplication of efforts. Research into childabuse is nowhere near as developed (ie, well-funded) as cancer research, but some kind ofindependent strategic body could helpgovernment and charities alike to focus theirefforts effectively on tackling abuse.

To illustrate the value of such a body, considerthe fact that much has changed in terms ofapproaches to tackling abuse over the pastdecade. Increased information-sharingbetween relevant organisations; newcampaigns to change attitudes to abuse; andawareness-raising campaigns among childrenshould all have had some effect on prevalencerates of abuse. But without current data, thereis no way of knowing their impact.

In Scotland, an informal research network isdeveloping out of the University of Dundee.The Scottish Childcare and Protection Networkaims to develop an improved, more consistentapproach to evaluation and to generate betterevidence for a variety of child protectionpractices. In England, there has beenwidespread support for the government’sproposal of a national centre for excellence inchildren and family services that would ensuresystematic sharing of good practice.

This should not mean duplication of existingwork. Professional bodies such as the BritishAssociation for the Study and Prevention ofChild Abuse and Neglect produce qualityresearch in the form of the academic journal,Child Abuse Review, but they have limitedresources. Some kind of strategic researchbody might be able to focus efforts on bringingin funding for further research, and coordinateexisting efforts.

NPC does not recommend that donorsconsider establishing an independentresearch organisation themselves. Rather,we emphasise the value of funding researchwithin specific charities in the field, and also offunding independent research where thisis possible.

What is the impact of child abuse?Abuse matters because it causes childrenmisery, threatens their safety and can ruin theirlife chances. The most visible consequence—for a few high-profile cases—is death. Butthere are a whole range of less visible and verydamaging consequences.*

Abuse causes injury and deathThere were 58 reported child murders in2004/2005.

57Sadly, children most often die at

the hands of their own parents or carers.Figures are disputed given the ambiguitysurrounding Sudden Death Syndrome andsome domestic accidents.

Children under the age of one are at highest riskof serious injury or death.

58This may not only be

because younger children are more physicallyvulnerable, but possibly because they are abusedmore. A 1997 survey of corporal punishment inthe home found that the younger the child, themore likely they were to be hit at least weekly.Over half of the one year olds were hit once aweek or more by either or both parents,compared with one in ten 11 year olds.

59The

links between all forms of corporal punishment(eg, smacking) and serious abuse are not clear,but there is a correlation between the two.

Abuse can damage thedevelopment of the young brainThe pain, fear and loneliness experienced byabused children can make a physical imprintthat will affect every aspect of their future,damaging the very development of the brain.Cognitive and linguistic delays have beenfound in abused children.

60Researchers are

looking at the effects of abuse on thedeveloping infant’s brain. The hormone cortisolis produced under stress and is thought tohave toxic effects on the developing brain,particularly the limbic system that governsemotions. This can result in hyperactivity,anxiety and impulsive behaviour.

61

9


* There is a vast amount of research on the impact of abuse. Drawing generalisations from it is problematic. For example, much research is focused on sexual abuse. Establishing causalrelations is even more difficult, as a lot of research is from the perspective of adult (usually female) survivors. Long-term outcomes could be the result of any number of things that havehappened since the abuse, rather than the abuse itself. Nonetheless, there is a sufficient body of evidence to paint a picture of the possible impact of abuse.

Abuse can damage a child’sability to form relationshipsIn the medium term, the ability of abusedchildren to form relationships can suffer. Theymay become withdrawn or develop aggressivebehaviours. A study, mainly based on evidencefrom the US, found that abuse in the first fiveyears of life nearly tripled a child’s likelihood ofhaving multiple physiological, behavioural andacademic problems at school. The earlier theabuse occurred, the higher the likelihood thatthe child would experience such problems.

60

Abuse can have a profound impact on anindividual’s ability to bond, including with theirown children.

58It is not clear whether this goes

so far as to increase an individual’s likelihoodof abusing their own children (see Box 2). Formost of us, our prime example of parentingcomes from our own parents. Some make aneffort not to parent as they were parented, butmore often than not we mimic our parentswhen bringing up our own children.

Abuse causes long-term mentalhealth problemsThe effects mentioned above can themselvescreate long-term consequences. One of thestrongest correlations appears to be betweenchildhood abuse and mental health problemsas an adult; research shows that around 50%of people receiving mental health servicesreport abuse as children. For example, onereview of the prolific literature on the topicfound that ‘on careful questioning, 50-60% ofpsychiatric inpatients and 40-60% ofoutpatients report childhood histories ofphysical or sexual abuse or both.’

62Others

have concluded that ‘child abuse may have acausative role in the most severe psychiatricconditions.’

62A Swedish study of over one

Researchshows thataround 50% ofpeople receivingmental healthservices reportabuse aschildren.

million adults found that former child welfareclients were four to five times more likely tohave been hospitalised as a result of suicideattempts.

63Fatal effects of child abuse are not,

therefore, limited to the short term.

There is also a strong link between abuse andlater offending. One UK study found that 72%of young offenders incarcerated for a ‘gravecrime’ reported some form of childhoodabuse.

60It is not clear whether such patterns

of behaviour are linked to the abuse itself,other factors associated with abuse (such asdeprivation) or the toxic effect of abuse on thebrain, resulting in impulsive behaviour.

Abused children have an increased chance offalling victim to further abusers. Physicallyabused children are three times as likely to bebullied as their peers, while women who werephysically or sexually abused in childhood aremore likely to be raped or to become a victimof domestic violence in adulthood.

64, 65

Research on the prevalence of sexual violencein Ireland found that penetrative child sexualabuse increased the risk of adult penetrativesexual abuse 16-fold, for both men andwomen.

66

Costs of abuseIn addition to the terrible physical andemotional costs for individual children, there isa financial cost to society. A governmentreview in 1996 conservatively estimated thatchild abuse costs society £1bn each year.

9

This sum underestimates the true cost. Thestudy did not include disability, decreasedquality of life, premature death, apprehendingand prosecuting offenders, investigation ofchild abuse reports by social welfareorganisations, foster care and costs to theemployment sector due to absenteeism andlow productivity.

58All present an enormous bill

to the taxpayer.

NPC estimates conservatively that the statespends at least £1.8bn on children’s servicesrelating to child abuse each year in Englandalone.* There are indications that the true costto society of child abuse could be many timesgreater. Research in the US conservativelyestimated the cost of child abuse nationally tobe $98bn each year.

69

Furthermore, if approximately 50% of mentalhealth service users are found to haveexperienced childhood abuse, it is reasonableto assume that the cost of these servicescould be reduced if the prevalence of childabuse were to decrease. A 10% decrease inthe need for mental health services wouldequate to a saving of £1.8bn.

Donors wanting to fund work in this area maytake these figures as a very conservativeindication of the huge benefits that could berealised by tackling abuse.

10


Box 2: ‘And do I abuse my children? No!’23

The majority of people who are sexually abused do not go on to sexually abuse others.The majority of victims are female, whilst the majority of perpetrators are male. Althoughthere is a relationship between childhood sexual abuse of males and subsequent sexualoffending, being a victim of sexual abuse does not necessarily predict subsequent abusivebehaviour. Rather, family factors are implicated in subsequent sexual offending.38 Riskfactors include neglect, sexual abuse by a female and being witness to frequent seriousviolence within the family.43

‘Retrospective research has shown that the majority of young people who display sexuallyabusive behaviours have themselves been abused, however, while attention is oftenpaid to the cycle of abuse, the majority of young people who have been abused do notgo on to abuse.’ 50

This is perhaps less clear for victims of other types of abuse. One study of families involvedin the child protection system (see Section 2) found that one in seven of the parentshad a history of abuse.44 As with any longer-term results, it is not clear whether the historicalabuse or other factors were the cause of the current abuse.

‘While experience of abuse as a child leaves parents at considerably greater risk of havingparenting problems with their children, the relationship between the two is far frominevitable […] It is the combination of childhood abuse and continued poor life experiences[…] which increases the chances an individual becoming an abusive parent.’ 53

* This figure is based on government spending on children’s services in 2005 (total £4.4bn),67

broken down by categories of children in need (of which 35% relate to abuse or neglect).68

Charities play a key role inprotecting childrenThe potential impact of abuse is devastating,particularly for babies and infants. The childprotection system aims to intervene early withyoung children, and donors might wish tofollow similar lines with their giving. We havealso seen, however, that the impact of abuseis not just felt in the short term. The negativeeffects often continue for years, over a wholelifetime. They can even affect the nextgeneration. Therefore, there is significantscope for taking action, at various points overa victim’s life, to tackle the pervasive effects ofchild abuse.

Charities play a huge role in tackling childabuse, including:

• researching the scale and nature of theproblem;

• raising the issue as a problem among boththe general public and government;

• informing children about their right toprotection from all forms of violence;

• providing extra capacity for governmentwhen it comes to intervening directly toprotect children;

• increasing the resilience of children whohave been abused;

• reaching particularly vulnerable groups; and

• developing innovative ways of tacklingthe problem.

Before moving on to explore the wide range ofways charities are tackling abuse, it is worthdrawing attention to some of the difficultiesthat they face. These problems threaten toundermine efforts to make sure that suchaction is effective.

Taking action is problematicbut vitalChild abuse is a subject that motivates peopleto act, whether this involves writing letters tonewspapers and MPs or donating to charity.NPC estimates that around £500m is donatedby the public each year to charities involved inprotecting children.*

However, efforts to tackle child abuse arefraught with practical difficulties, as it is hard toknow the best course of action to minimise theharm to children. There is not enoughevidence to prove what works in terms ofpreventing and intervening to stop abuse. Thisis frustrating for donors, as it makes it hard todirect funding effectively.

Nevertheless, failing to act means that societyis failing our most vulnerable children, anddonors’ support for charities attempting totackle abuse is vital.

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The state spendsat least £1.8bnon children’sservices relatingto child abuseeach year inEngland alone.

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* This figure is based on a detailed analysis of voluntary income to charities involved in child protection and tackling child abuse.70

Some of the practical difficulties of working inthis field include the following:

Many people are unsure what child abuse is.

• If they do suspect a particular case ofabuse, they are not always clear on whenor how to report it.

• If abuse, or the risk of abuse, is identifiedand reported, establishing the best courseof action is difficult.

Difficult judgements need to be made, whethertrying to prevent abuse, intervening to stop it,or treating a victim of abuse. Not intervening totry to stop abuse can allow it to continue. Buttaking action can also have negative effects.Poor handling by police and social servicescan result in increased trauma in the shortterm.

7Either course of action might be wrong,

resulting in fallout for the family (non-abusingparents or siblings) and third parties (eg,neighbours, teachers, doctors), as well aswhoever took action (whether a member of thepublic or a professional).

71

These difficulties are reflected in assessing theresults of any work trying to tackle abuse.Assessing whether taking action was the rightdecision is problematic, let alone whether whatwas done was right, and at what stage effectsshould be measured. Are results to bemeasured in the short, medium or long term?What should be measured? How does onemeasure harm, risk, need or ‘resilience’?Following up action many years later mayestablish answers, but this is very difficultin practice.

Despite these difficulties, acting upon theknowledge that a child is being abused, or isat risk of being abused, is important.Intervening may save a life, or reduce thenegative effects outlined earlier in this section.

Building resilience achievesresults, regardless of theuncertaintiesGiven the difficulty of acting effectively totackle abuse, it is important that everythingpossible is done to strengthen and support theprotective factors that are known to reduce thenegative impacts of abuse. The ongoing familyenvironment, for example, is thought to be agreater predictor of later outcomes thanseverity of injury.

72Three broad sets of

variables have been identified that bolsterresilience. These are:

• individual attributes (eg, self-esteem,academic motivation);

• family characteristics(eg, stable and supportive);

We still lack astrong body ofinformationabout whichpreventivemeasures,whichinterventionstrategies andwhich treatmentinitiatives workand which donot.

Academic7

• wider social environment (eg, successin school).

73

NPC encourages donors to support charitiesthat work to bolster these protective factors.These charities may not explicitly presentthemselves as tackling abuse; rather they willoften apply an approach to children with arange of issues and needs. Examples wouldinclude mentoring programmes, peer support,recreational activities aiming to boost self-esteem, and educational support.

In other words, while we cannot identify themost effective ways of tackling abuse, we doknow that building resilience can help a childto overcome the effects of abuse. Given theuncertainty in the field, this can help donors toensure their funding achieves results.

More must be done to find themost effective ways to tackleabuseThe difficulties in establishing whether and howto take action to stop abuse are compoundedby the fact that there is a lack of satisfactoryresearch on results in this field. Acomprehensive literature review concluded:

‘We still lack a strong body of informationabout which preventive measures, whichintervention strategies and which treatmentinitiatives work and which do not.’

7

This worrying conclusion relates to allapproaches, from prevention to earlyintervention to reaction, whether involvingparents, children or both. As one frustratedacademic wrote of the lack of empiricallytested treatment programmes for child victims,‘this is clearly a case of child neglect.’

74

There is no doubt that donors and funders(including government) and service providers(including charities) are partly to blame for thelack of robust evidence supporting activities inthis field. Despite the challenges, a number ofcharities now have an emerging evidencebase, or are at least attempting to evaluatetheir work, and these organisations deservesupport. This report focuses on thoseapproaches wherever possible, looking forpractice that is based on evidence or thatseeks to establish evidence.

The larger charities, and funders focusing onthis field, can play a major part in acting asrole models for the sector by developing andsharing research and evidence-based practice.Although results can be difficult to measure,more has to be done to evaluate theeffectiveness of interventions in this field.

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NPC’s experience has shown that a great dealcan be achieved by taking small steps forwardin measuring results. A charity that works withfamilies where abuse is present may not beable to follow that family over many years tosee that its work had positive results. But itcan ask that family directly at the time ofworking with them whether the charity’sservices have improved the situation. And itcan track who uses these services, to seewhich families need to come back for supportand which do not. These small steps can helpthe charity to refine its work and increase itseffectiveness, and help the charity to report todonors the results of supporting its work.

This report discusses, in varying amounts ofdetail, a broad range of issues that areconnected with child abuse, from poverty to

running away. Where donors choose to focustheir giving is to some extent a personalchoice. But NPC believes that donors canmaximise the impact of their giving by ensuringthat they think about results when choosingwhat to support. This may also require beingprepared to fund evaluations in addition todirect work, to build the evidence baseneeded to ensure that work is effective.

At the end of this report, NPC provides a tool tohelp donors prioritise where to give. This tooloutlines the potential results of a particularapproach (eg, campaigns to change attitudes),as well as the level of confidence NPC has inthese results based on the evidence available tous. We believe this can form an integral part of adonor’s decision on where to give their supportto tackle the pernicious problem of child abuse.

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2The child protection systemIn order to provide context for the work ofthe charities in this field, which spend anestimated £1.1bn per annum on tacklingchild abuse, this section outlines the detailsof the child protection system. Centralgovernment is responsible for the currentsystem, which identifies, reports and dealswith cases of abuse through localgovernment and charities. Localgovernment itself is the major funder ofcharities dealing with child abuse.

Charities sometimes act as part of thissystem: they help to reach more children;they also monitor and suggestimprovements. But charities’ work is alsoconstrained by the system. Without asystem in place that works effectively forall abused children, many thousands ofchildren are missing out on the childhoodthey deserve.

The government’s fundamental obligations tochildren are set out in the form of humanrights. The UK is a signatory to the UnitedNations Convention on the Rights of the Child,which requires it ‘to ensure the child suchprotection and care as is necessary for his orher well-being’ and to give ‘protection from allforms of maltreatment perpetrated by parentsor caretakers.’

Sadly, despite its obligations under internationallaw, the UK performs badly on its commitmentto children’s human rights. The last UNCommittee report (2002) on how well the UKwas adhering to the Convention was extremelycritical of the UK’s children’s rights record. Mostnotable is its failure to offer children equal legalprotection, despite their increased vulnerabilityand reliance on adults.

57, 75

Further damning evidence comes fromUNICEF’s 2007 report on children’s well-being. The UK came bottom of a league tableof 18 rich countries on the well-being of itschildren. It scored lowest on measures suchas family and peer relationships, behavioursand risks (including bullying) and subjectivewell-being, where children were asked to ratetheir ‘life satisfaction’.

76

There is nonetheless considerable domesticlegislation outlining governmental obligations toprotect children. Local authorities have a dutyto protect children’s welfare, and the criminaljustice system has a duty to prosecute abuse

14

Donors’ supportis vital—both tostop childrenfalling throughthe net and toattempt toaddress thesystem’s flaws.

where it is a criminal offence. Centralgovernment sets performance standards forlocal authorities against which children’s well-being is assessed. But there are limits to whatthe state can and does achieve. This isexplored further in Section 8.

As such, although children’s services areundergoing reform, there are a number ofproblems with the child protection system thatare likely to persist in the short-to medium-term at least (see Box 4). These are the focusof the following section.

Setting the context for donorsThis section looks at statutory responsibilitiesfor children’s welfare and how the state acts toprotect children from abuse.* First, it looks atsome of the overall problems with the childprotection system. This provides importantcontext for donors, as it suggests that there issignificant scope for improvement. Whatindividual donors can do about thesewidespread problems is arguably limited, butthey still raise important questions for donorsconsidering where to put their funds.

Second, this section outlines how the childprotection system works in practice (the childprotection process), from identification ofthrough to treatment for, abused children.Within this process, there are several optionsfor donors. Many of the options presentedpromise very positive results. However, theymust be viewed within the context of the widerproblems with the system. Withoutconsiderable new funding being brought tobear, donors’ support is unlikely to lead tosignificant change in the system. But donors’support is still vital—both to stop childrenfalling through the net and to attempt toaddress the system’s flaws.

The purpose of the child protection system isto prevent children coming to harm, or tominimise the effects if harm has occurred,through policies and procedures that guide theactions of all public sector staff who havecontact with children. After recent reforms (seesection on next page) the child protectionsystem is moving towards ‘safeguarding’rather than just protection. Safeguardingrepresents the aim of promoting children’swelfare in general, rather than just focusing onpreventing harm.

* This report focuses on England and Scotland. This section uses English terminology in the main, including key differences in Scotland where appropriate for donors. Appendix 3 containsmore detail on both English and Scottish child protection systems.

Options for donorsAs this section will show, donors have anumber of options to support charities workingin and around the child protection system.These fall under two main areas:

• Reaching children not helped within thesystem (for example, those not identifiedby the child protection system at all).Examples might include funding helplinesand confidential spaces for children andadults to discuss problems and get advice.Given that most children are unknown tothe system, charities working in this areaare in high demand and private funding isoften critical.

• Improving the system by addressingsome of its flaws and biases (to helpchildren more effectively in the medium-tolong-term). For example, supporting newand effective ways of working with thosechildren already known to social services,or ways of reaching out to overlookedgroups. Although there are fewer optionsfor donors in this category, these couldnevertheless inform wider practice.

Donors may want to think about whether theyprefer to focus on more certain, short-termresults (eg, reaching children not helped by thesystem) or longer-term results that mayeventually affect more children (eg, improvingthe system).

The reader may find it useful to apply theseoptions to the tool included at the end of thissection and in Appendix 4 in order to thinkabout where he or she might want to directtheir funding.

Three different responses tochild abusePhysical or sexual abuse of children is a crime,and local authorities have a legal obligation toprotect children. In practice, three differentpathways can be pursued when reportingsuspected child abuse to the authorities.These may be pursued simultaneously, and,more often than not, are undertaken jointly:

• Child protection investigation:undertaken by social services to determinewhether a child is safe where they are, orwhether they need to be removed into localauthority care for their own protection.

• Assessment of the needs of the child(and family): also undertaken by socialservices with a view to providing localauthority support services to reduce the riskor counter the negative effects of abuse.

• Criminal investigation: carried out by thepolice and criminal justice system to gatherevidence with which to prosecute theperpetrator(s).

Although most cases of child abuse constitutea criminal offence—from infanticide to‘grooming’ a child with the intention of abusingthem—and police are often involved in childprotection enquiries, few perpetrators aresuccessfully prosecuted. There were fewer than1,500 convictions for child abuse in 2005. Thisrepresents less than 2% of the estimated80,000 cases of child abuse each year.

In some cases, this discrepancy betweenincidence and convictions for abuse isexplained by the fact that parents or carers areimplicated. In such cases, support is morelikely to be offered than punishment, becausethis is often judged to be in the best interestsof the child. A supportive and stable familyenvironment is a key protective factor to avoidlong-term harm to the child.

In other cases, however, prosecution of theperpetrator of abuse is judged to be in thebest interests of the child. There is significantscope for improvement in the system toincrease levels of prosecution where thisis appropriate.

The latter part of this section (Supporting childvictims through criminal proceedings) looks atefforts to increase successful prosecution ofperpetrators, while Section 5 looks at theresponse of the criminal justice system tosexual offenders in particular.

Reforming children’s servicesThe system has to be set within the widercontext of children’s services. In England,these are undergoing great change as a resultof the Every Child Matters: Change forChildren agenda (see Appendix 2). This reformwas catalysed by the high-profile death ofVictoria Climbié in 2000 (see Box 3), which hasresulted in change for both the child protectionsystem, and for the structure of children’sservices as a whole. Reform is also underwayin Scotland, similarly catalysed by an inquiryinto the death of three-year-old KennedyMcFarlane, in 2000.

15

Not seen and not heard The child protection system

Box 3: Victoria Climbié

There have been numerous cases of local authorities’ failure to intervene as they should.Victoria Climbié was one of the more recent, high-profile cases in England. She hadbeen subjected to horrendous abuse at the hands of her aunt and her aunt’s partner.Despite coming into contact with four separate social services teams, severalmembers of the local community and having been taken to two separate hospitals priorto the final 24 hours of her life, Victoria spent her last few months tied up in a plasticbag in a bath. She died in hospital in February 2000, where it was found that she had128 separate injuries to her body. She was just eight years old. The inquiry into Victoria’spreventable death was the catalyst for the Every Child Matters: Change for Childrenagenda, resulting in legislative change laid down in the Children Act (2004) requiringservices to work together and share information.

In one case ofsuspectedneglect/abuse itwas reportedseveral timesand nothing wasdone. Ieventuallyreported it to anon-duty socialworker whodealt with it, butthere was a timelapse of 12–18months.

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The sweeping changes set out in thisprogramme of reform (from workforce reformto forcing different agencies to work togetherand share information) are largely welcome.They are being implemented between 2006and 2009, and, as such, it is too early to tellwhat the results will be for children andfamilies. The child protection process, asdescribed above, continues to follow existinglegislation in the main (the Children Act (1989)and the Children Act (Scotland) 1995).

The last decade has seen a shift fromprotecting children to also promoting theirwelfare, seen as ‘two sides of the same coin.’

77

This idea of promoting children’s welfarealongside protecting them means there hasbeen a shift since the mid-1990s from theabuse itself as a focal point to working withthe wider family to ensure better results.

7The

family focus has arisen from the recognitionthat, in many cases of child protection, thereare a number of problems in the family. This is

We can have allthe multi-agencymeetings in theworld, if youcan’t deliver iton the ground,we might aswell pack upand go home.

Practitioner working withsexually exploited children11

discussed further in Section 3. It also reflectswider government priorities, for example, childpoverty. As such, child abuse is seen as justone aspect of a range of social problems thatmay blight children’s prospects.

78

Generally speaking, there is a strong (andincreasing) commitment to safeguardingchildren across government agencies. A 2005joint inspection of the state of safeguardingchildren across government services foundthat since the previous report in 2003 ‘prioritygiven to safeguarding children across agencieshas increased and children are being listenedto and consulted better. Agencies are alsoworking better together to identify and act onwelfare concerns.’

79

However, a number of problems with thesystem remain, which are discussed below.The importance of these points to donors isthat charities working in and around thechild protection system can be subject to thesame problems.

Yet equally, charities (and therefore donors)can provide a counterbalance to the problemsof the system. For example, a charity canfocus on working with fathers. But in order todo this, the charity will require private funding,as it is unlikely to be provided by central orlocal government.

Problems with the childprotection system

Many abused children are notsupported by the systemNPC estimates that between 35% and 70% ofchildren who suffer serious abuse are notmonitored or supported by the system (seeTable 2). These figures show that manychildren who are abused fall through the net ofthe child protection system. To provide thecapacity to support those who are failed bythe system, a significant injection of additionalfunding would be necessary. Based on NPC’sestimates, government spending would needto increase by between £500m and £1.2bn;voluntary giving would need to increase bybetween £150m and £1.6bn.

One of the results of children falling throughthe government’s child protection net is thatthe harmful effects of abuse continue, to thepoint that some children end up in even moredanger. Running away, sexual exploitation, re-victimisation and offending have all beenshown to be potential consequences of childabuse. Section 4 covers the plight of childrenaway from home in more detail. Charities suchas Kids Company (see Box 5) pick up these

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Prevalenceestimate

Proportion ofunder-18 yearoldsexperiencingserious abuse

Numbersaffected eachyear based onNSPCCprevalencestudy (Englandonly)

Number ofchildrenreceivingservicesbecause ofabuse (as ofFeb 2005)*

Proportion ofabusedchildrenreceiving noservices

Minimum 11% 67,000 43,450 35%

Maximum 24% 146,000 43,450 70%

Table 2: Comparing prevalence with numbers of children receivingservices in England80,55

* The total number of children recorded as children in need as a result of abuse or neglect in the February 2005 census was 86,900. The census does not tell us how many were registered inthat year. It is estimated that 50% of these children were placed on the register in 2005.

Box 4: Problems facing the child protection system

• We do not know how many children are abused each year. Given the priority attachedto protecting children from harm, it is surprising that more is not done to measurehow many children are abused. The best data we have is now seven years old.

• We know that the system supports a maximum of two thirds of children who areabused. It may support as few as one third. This means that much of the harm causedby abuse is never addressed.

• We do not know the most effective ways of tackling abuse. This means that, evenfor the children lucky enough to get help, nothing guarantees that this help will beeffective.

• We think that the system is not child-friendly. This means that children may be afraidof the system, and that their opinions are rarely genuinely taken into account.

• We know that there are not enough resources to provide treatment and support forall those children that the system does identify. This means that many children willgo without the support they require at the moment. If the system became more effectiveat identifying cases of abuse, resources would be even more stretched. Such resourceconstraints can create perverse incentives, inhibiting the reporting of abuse.

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children, sometimes several years down theline when problems are deeply entrenched,and support them in a way that no otheragencies can or do.

The system tends to overlookcertain groups

Focus on lower socio-economic groupsThe child protection system focuses on lowersocio-economic groups, and may thereforeoverlook abuse that occurs in more affluenthouseholds. Based on the evidence available,we can identify a number of factors leading tothis focus.

We know the following:

• Public sector services (social services,benefits, housing) traditionally work withlower socio-economic groups and so aremore likely to uncover abuse here.7

• Some types of abuse, such as neglect andphysical abuse, are more common in lowersocio-economic groups,7, 55 as are some ofthe problems that may be factors leading toabuse (eg, substance abuse).

Recognising links between poverty and abusedoes not mean that one necessarily leads tothe other, nor that abuse does not occuracross all socio-economic groups.Unfortunately, official statistics do not tell usenough to know how prevalence really variesacross socio-economic groups.

We do not know, therefore, whether thosefrom higher socio-economic groups aremore adept at masking abuse,

1and whether

the child protection system is overlookingthese groups.

Emerging evidence seems to show that certaintypes of abuse are just as common across allgroups. For example, technology seems to befuelling the numbers of men accessing onlinechild abuse images, and also theiridentification. New data suggests that allmanner of people are involved, across allsocio-economic groups. This is examined inmore detail in Section 5. Improving theidentification and reporting among the generalpopulation, as detailed later in this section,should go some way to reducing this gap.

Fathers, whether abusing or non-abusing, are not involvedSocial services are traditionally used to dealingwith some groups more than others. Thegender-neutral terms ‘parenting’ and ‘family’mask the fact that women are the main carersof children. Child protection workers rarelywork with fathers and male carers.

81The

majority of research and activities in this area isfocused on mothers.

10, 81Yet men are much

more likely to cause serious harm or death.7

The focus on mothers extends to punitivemethods as well as support. Parenting ordersare compulsory orders to attend courses givento parents when their children truant or behavein an anti-social way. They ‘are overwhelminglyimposed on mothers as the only accessibleparent, even though “the absent parentoften had a profound effect on familydynamics … especially where there had beendomestic violence.”’

82

Services should make clear the distinctionbetween abusing and non-abusing parents,and offer appropriate support. Where men areabusers, punitive measures should apply tothem rather than non-abusing mothers.However, as illustrated by the quote above,the mother may be the only ‘accessible’parent, and so it may not be possible to workwith the father at all.

There are very few programmes for violentmen, as discussed in the context of domesticviolence in Section 3. For non-abusing fathers,there is similarly very little support available.Less than 1% of family support services havespecialist services for fathers.

83A report on

support for fathers found ‘the regional andnational organisation of the work is disjointed,its development uneven, and projects tend tobe little known outside the direct setting inwhich they work.’

82Sure Start programmes

also report generally low take-up of servicesby fathers, which in places has been improvedby offering targeted, single sex services.

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Less than 1% offamily supportservices havespecialistservices forfathers.

Box 5: Kids Company

Kids Company is a unique charity, committed to promoting and supporting the well-being of ‘exceptionally traumatised and disaffected individuals who have failed to engagewith statutory provisions, invariably leading to fragmentation of life.’ This support isprovided via three main services, which in 2005/2006 were estimated to have reached11,000 children on a budget of £3.4m:

• Arches II: This drop-in centre for children and young people based in South EastLondon is the best known of the charity’s services, and acts as a base for a rangeof supportive work.

• Schools service: Therapeutic teams work in 32 schools across London.

• Urban Academy: Primarily an educational centre, offering training and life skills, aswell as support through placements at other colleges, to young people from variousLondon boroughs.

All three services are characterised by the recognition that behavioural difficulties area symptom of emotional hurt and that children need loving care and safety in order tothrive. The charity’s commitment is first and foremost to the child.

Kids Company has case notes on the individual children who access its services, andanecdotal evidence is largely positive. All Kids Company programmes have been subjectedto an evaluation over the last three years by London University. The results of whichwill be known in early 2008. These evaluations will need to be rigorous andcomprehensive in order to provide a meaningful assessment.

The gender bias found in the child protectionsystem means that there is a clear need formore support for fathers—support thatdistinguishes between abusive and non-abusive males and provides appropriate,effective services. NPC has come across feworganisations providing direct support forfathers. When considering where to focus theirfunding, donors might like to think about howwell charities respond to the needs of non-abusing fathers.

The system’s effectivenessis unclearAs noted earlier, the purpose of the childprotection system is to prevent harm comingto a child, and to minimise the effects if harmhas occurred. Its effectiveness in fulfilling thispurpose is unclear.

This is partly due to the difficulties of measuringresults in this field, as discussed previously. Thecurrent system focuses on what is easilymeasurable, not on effectiveness.

We know how many cases are assessed andreviewed, but it is not clear what actuallyhappens to the thousands of children andfamilies that filter through this system. Recentaudits, prompted by the deaths of childrenwho were known to the child protectionsystem, have been far from reassuring.

Charities are not immune from such failings. Anumber of high profile cases have involvedfamilies that were in contact with charities. Forexample, Victoria Climbié was referred to theNSPCC centre in Haringey, which failed toundertake a timely assessment.

A bewildering array of targets and inspectionshas been put in place as part of the changesto children’s services. This reform is ongoing,but the Department for Education and Skills(DfES) and Scottish Executive have yet toestablish a workable set of measures for

children on the child protection register.Current key performance indicators (KPIs)include how long a child stays on the register,which tells us little or nothing about whetherabuse has been stopped, and the effects onthe child. (See also later in this section: Thechild protection process—Investigation—Targets and inspections.)

The DfES has commissioned the NSPCC toconduct a study on what measures might beused in this area to form the basis of a targetfor public services (ie, a Public ServiceAgreement or PSA). This is a welcome step.

However, from the initial documentation seenby NPC,

85it appears that the measures put

forward are too constrained by practicality (ie,what is already measured) to constitute a fullpicture of prevalence and trends in abuse. Thestudy suggests surveying children only onsome subjects (eg, bullying). But surveys ofchildren could be used much more widely asprimary indicators of the prevalence of abuseof all forms. NPC does not believe that theproposed measures are robust or completeenough to give private donors and charities aview of how effectively they are helping totackle abuse.

Wherever possible, this report focuses oneffectiveness—on the real changes in people’slives resulting from charities taking action. NPCwould urge donors to ask charities whatmechanisms they have in place to measurethe results of their activities, and to considerfunding those that are attempting to do so.Examples of such mechanisms could includesurveys to ask children about their well-beingbefore and after the charity’s intervention;arrangements with local authorities to followup what happened to families in the long termor with schools to follow the educationalprogress of children affected by abuse.

A crisis of confidence? Although it is unclear what donors can do toimprove this situation, it is worth noting thatthere are problems in the recruitment andretention of skilled social workers in this field.The ability to deliver good results for childrenand families relies on ‘a high level of skill andprofessional judgement.’

10, 77, 86Yet there are

vacancy rates of 11% in social services.87

The audit of the child protection system inScotland in 2003 found that social workvacancy rates were affected by ‘theunattractive nature of working with children andfamilies in a hostile public and press climate.’

86

Public confidence in the system has beenweakened by a series of high-profile cases inwhich social services have been deemed tohave got it wrong; whether through too muchor too little intervention. The result of too little

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Box 6: ‘Damned if they do, damned if they don’t’ 3

Just as there have been many cases of under-intervention (see Box 3), there have beennumerous cases of over-intervention over the years. These are not always so high profile,as children do not die as a result. However, too much intervention can be very damagingto families.

One recent case involved a five-month-old boy whose rib fractures while in the care ofhis parents led to him being placed on the child protection register. This was followedby an interim care order placing him with foster parents. The parents maintained theirinnocence; it was later found in court that the boy suffered from brittle bone disease,indicating the injuries were likely to have been sustained accidentally. Nearly one yearafter the original incident, the child was returned to his mother. In the meantime, theparents had suffered trauma and shock, resulting in their separation and the mother’sdepression. She was unable to sue the local authority as the court ruled, as is often thecase, that ‘professionals charged with questions of child protection and the investigationof child abuse must be free to exercise their professional functions without having atthe back of their minds a fear of potential legal action by distressed parents.’ 3

Children are livingthe experienceand can give amore accuratepicture of whatlife is like in afamily than anyassessmentmade by aprofessional.

Academic14

ʻ

ʻ

intervention can be death, as seen in the caseof Victoria Climbié (see Box 3), while too muchintervention can leave families in utter disarray,and with little recourse to compensation(see Box 6).

As one think tank has noted, ‘the childprotection system is probably the least well-regarded and most criticised aspect of publicwelfare provision.’

71

There is little that charities can do to improvepublic perception of the workforce, althoughworkforce reform should go some way tobreaking the vicious circle that seems to havedeveloped. The Care Standards Act (2000) inEngland introduced measures to raise thestatus of social care. The profession is nowsubject to regulation and registration.

The poor perception of the child protectionsystem could in fact be seen as beneficial tocharities. The high level of ex-social workersNPC met when visiting charities was striking.The Scottish child protection audit concludedthat vacancy rates were affected by ‘themigration of children’s social workers to thevoluntary sector or new projects such as newcommunity schools.’

86

More positively, many of the charities visitedand experts consulted by NPC felt that familiesunder stress found charities moreapproachable than social services and otherprofessionals. This is very important, as themore approachable the service is, the morelikely children and families are to come forwardfor help, and the more likely children are to beprotected from harm.

Working in such a sensitive field, there is a fineline to be walked by both public sector andcharitable workers ‘between approachabilityand effectiveness and willingness tointervene.’88 In a number of high-profile childabuse cases, workers did not sufficientlychallenge parents or carers. Donors should beaware that, when charities present feedbackfrom parents and carers as evidence of results,particularly where there are child protectionconcerns, this may not present a full picture.Feedback from children would be preferable,but this is not always available or even sought.

The system is not child-friendlyCharities have a clear role to play in ensuringthat children can access the services designedto protect them. One factor that may contributeto the discrepancy between actual rates ofabuse and the numbers on the child protectionregister is that few children approach thesystem for help. We do not know how manyreferrals to the child protection system comefrom children themselves. But there is goodreason to believe that children may begenuinely fearful of the system.

Even in the child protection system, in whichthe relevant person is the child according togovernment guidance, ‘most activity andthought is focused on the adults rather thanthe child.’

71There is little research available on

children’s perspectives of the system. TheDirector of Children’s Rights for England hasresponsibility for representing children in careand their views. But 99% of children who filterthrough the child protection system do notend up in care; the voices of these children aresadly just not being heard.

Children’s perspectivesOne aspect of the reform of children’s servicesis for children and young people ‘to have moreopportunities to get involved in the design,provision and evaluation of policies andservices that affect them or which they use.’

89

This is a welcome step, but there have beenteething problems. An evaluation of children’sand families’ participation in children’s servicesin 2006 found the need to clarify‘participation’, and move from a ‘tokenistic andad hoc’ involvement of children and families tomore active engagement. The researchersnoted that ‘the voluntary and communitysector have an important part to play insupporting and representing groups of userswho find it difficult to interact with officialbodies.’

90

In some instances, the system can begenuinely hostile to children. The court system,for example, can be terrifying. It is notimprobable that the low rate of conviction is atleast in part linked to the lack of a child-friendlyjudicial system. Twenty years ago, childrenwere seen as such unreliable witnesses byjudges and lawyers that the judge would warnthe jury to be wary of any evidence given bychildren that was uncorroborated.

91The legacy

of this is still evident. The court system iscovered in more detail later in this section.

NPC came across a number of charities thatwere trying to represent the interests ofchildren at various points in the legal process.These are highlighted throughout the report.Examples include the Children’s RightsAlliance for England, Eighteen and Under,and NSPCC’s child witness programme.

NPC would urge donors to considersupporting research that includes children’sperspectives on the child protection system,wherever possible.

19


Families understress findcharities moreapproachablethan socialservices andother childprotectionagencies.

Dealing with the child protectionsystem’s flawsAs this section has demonstrated, there are anumber of problems in the child protectionsystem. These are important for donors andfunders to know, because charities work withinand alongside the government system.Therefore, charities that have a high level ofcontract-based funding from local authorities,for example, are often subject to the sameproblems as the system itself, as they arecontracted to deliver to the system’srequirements. Having said that, the bestcharities use their independence to improveaccess for certain groups, and developinnovative ways of improving the system,whether at local or national level.

For donors, there are two key messages. Onthe one hand, they should accept thatcharities are subject to the same problems asthe system, if they work within it. On the otherhand, they may be able to help charitiesaddress some of the problems by fundinglong-term work that redresses the balance ofthe various systemic biases.

The child protection processWe now turn to the process itself. Charities areinvolved at each stage of the child protectionprocess, whether with the aim of improving thecurrent system or adding extra capacity:

• identification;

• reporting;

• investigation;

• prosecution;

• support; and

• treatment.

The system is largely reactive. Local authoritiesgenerally do not go out looking for abuse,although increasingly they are being taskedwith doing so (see Appendix 2). They largelyrely on referrals from members of the publicand professionals working with children.

Given the large number of children affected, itis possible that many members of society willat some point come into contact with a childor young person who is being abused. Forprofessionals working with children, this ismore likely.

Both the English and Scottish governmentsargue that safeguarding children is everyone’sresponsibility, as reflected in the titles of tworecent publications: HM Government’s MakingSafeguarding Children Everyone’s Business(2006) and the Scottish Executive’s It’sEveryone’s Job to Make Sure I’m Alright(2003).

To be able to protect children, the veryminimum required is that people can:

• recognise that abuse is a problem;

• understand what counts as abuse and howto spot it; and

• know where and how to refer if theysuspect abuse is occurring.

There are a number of barriers at each step.These, along with some of the possiblesolutions, are set out below.

Recognising abuse when ithappensA pilot awareness-raising campaign inScotland in 2005 measured national attitudestowards child abuse. Nearly all adults believedthat it is everyone’s responsibility to helpprotect children. But four out of five admitted itwas difficult to know whether a child was atrisk of or subject to abuse or neglect, with twoout of three wanting more information.

92

The way questions were asked in that studymay mask misunderstandings about whatchild abuse or neglect is. A more recentScottish study of perceptions of abuse in blackand minority ethnic communities found that

20


The majority ofthose whosuspect abusedo not report it.This shows thegap betweenwhat people saythey would doand what theyactually do.

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there was a ‘severe lack of knowledge as towhat actually constitutes abuse.’ Similar levels,as in the national study, were unclear aboutwhat to look for to identify abuse or neglect,with many requesting more information.

93

There is a gap, therefore, between willingnessand ability in identifying abuse among thegeneral public. There has been nogovernment-led awareness raising in England.

The NSPCC, as part of its Full Stop campaign(see Section 8), is trying to encourage thepublic to identify and report abuse throughhigh-profile campaigns. On a very practicallevel, the NSPCC has developed a simpledistance learning programme called‘Educare’. It is designed to help peopledevelop skills and confidence in safeguardingchildren. Over 100,000 people havecompleted the course to date. Four-modulecourses are available for only £22.50, from ageneral course to tailored courses for sports,education and health.

94The impact on

identification and reporting rates is unknown.

Reporting abuse once identifiedor suspectedIf signs of abuse are suspected, individuals areencouraged to report abuse. Reporting abuseis not mandatory in the UK, but officialguidance states that professionals have a dutyto do so. Social services take leadresponsibility for child protection matters, withreferrals directed to local authorities. Membersof the general public can refer directly to theirlocal social services, whose phone numbershould be available through the local authority.

The Scottish research mentioned earlierregarding awareness of abuse showed that,although most people would struggle toidentify abuse or neglect, nine out of ten wouldreport abuse if they suspected it. People aremost likely to refer to social services.

A study by the NSPCC in the same year,2005, found lower figures for those willing toreport. Of 10,000 adults polled across the UK,one in nine had suspected abuse. The majority(around 600 of the 1,100 who had suspectedabuse) had not reported it. This shows the gapbetween what people say they would do andwhat they actually do. Barriers to reportingincluded not knowing what to do nor whatwould happen to the child.

95

Despite the high level of reporting confidencein Scotland, the government pilot there trialleda series of radio, press and poster adverts.These were designed to raise awareness ofabuse; stress community responsibility;encourage early reporting; and offer reportingroutes. The impact on awareness wasnegligible, given high levels to begin with. Thecampaign managed to reduce the confidenceof individuals in both recognising abuse andknowing who to report it to.

92This might be

because the campaign was attempting to putacross too many messages. It highlights thedifficulties in communicating child protectionmessages to the public and to moving peoplefrom saying they would do something toactually doing it.

National sampling masks differences withinparticular communities. A report by the charityRoshni found that individuals from black andminority ethnic communities in Scotland, evenif they could spot abuse, were unlikely toreport it. Of those surveyed, 16% admittedthat, if they did know of abuse, they would notreport it. Those who would report it would bemore likely to deal with it ‘in house’ thanreferring to the authorities. Barriers included:

• fear of backlash from the community forboth the reporter and the victim;

• the perception of service providers. Forexample, major child protection charitieswere deemed to be for ‘white kids’; and

• a mistrust of translation services, as theablity to interpret what was beingexpressed was felt to be inadequate orsimply wrong.

Further evidence was provided by an NSPCCsurvey of British Asians that found two thirdsthink that reporting child abuse would have anegative effect on the honour of a child’sfamily. As one commentator responded, ittakes ‘enormous courage’ to go against thebarriers in place:

‘So a victim of abuse will be hit with a triplewhammy. First, a family desperate to preserveits izzat [honour] that closes ranks against aninvestigation. Second, a community that seeksto sweep the unpleasantness under thecarpet. And third, investigating authorities suchas social services and the police that arehampered in their ability to protect by politicalcorrectness.’96

Sadly, the NSPCC survey confirmed that suchbeliefs do translate into inaction. The surveyalso revealed that 37% of the sample hadsuspected a child was being abused, yet 42%of those did nothing about their concerns. Ofthose who did, fewer than 4% reported theabuse to the police and only 3% reported it tosocial services. Most chose to deal with theirconcerns themselves, by confronting thealleged abuser, telling a member of the child’sfamily or talking directly to the child involved.

97

In Section 8, we return to the issue of culturalbarriers to reporting abuse.

21


Children’s fear ofthe childprotectionsystem indicatesthat child-friendlyways for childrento explore theirconcerns andfears aredesperatelyneeded.

Who reports abuse?We do not know who currently reports abuse.Official statistics do not capture referral routes.A 1995 study indicated that around half oflocal authority child protection inquiries beganwith a child or other member of the familydisclosing his or her concerns to aprofessional. In two fifths of cases,professionals already working with the familyidentified the abuse. The remainder of caseswere picked up through unrelated events,such as home visits or arrests.

44

In an attempt to make reporting abuse easier,the NSPCC began a national childprotection helpline in 1991 for anyoneconcerned about a child. The helpline isstaffed by trained professionals who makereferrals to social services where appropriate.Around 10% of calls result in referrals to socialservices. A follow-up survey of the referralsshowed that social workers found them to be,by and large, clear and helpful. Three out offive cases referred were already known tosocial services, but the evaluation suggests anunintended benefit in that the helpline datainformed the monitoring and decisions madeon those cases.

18

If necessary, the helpline operatives can refercases to the police when the conversationfinishes, so that the police can trace the call,and intervene in situations where a child isbelieved to be at risk of significant harm (seeBox 7). When NPC visited the Manchesterservice in February 2006, around four callswere being traced each week.

98

Scotland does not currently have a childprotection helpline. The Scottish pilotmentioned above included a helpline, in theGrampian area. Only 45 calls were receivedover the three-month pilot.

99This could have

been due to the difficulty the campaign had ingetting across a clear message. Alternatively,there may have been a lack of awarenessabout the helpline. It may also reflect thedifference between what people say theywould do, and what they actually do.

Increasing the general population’s awarenessof abuse will not by itself prevent abuse. As wehave seen, attitudes have to be translated into

Increasing thegeneralpopulation’sawareness ofabuse by itselfwill not preventabuse. As wehave seen,attitudes haveto be translatedinto behaviour.

actions, something that the NSPCC is hopingwill happen through its Full Stop campaign(see Section 8). And even if attitudes can betranslated into behaviour, there has to beconfidence in the system. As suggested by theRoshni study of black and minority ethnicgroups in Scotland, and has been suggestedby many of those whom NPC has met, thepublic does not always trust the system that isset up to protect its children.

Referrals from professionalsWorryingly, an unwillingness to report is foundamong professionals as well as the generalpublic. According to a survey of medicalprofessionals, 60% had seen cases ofsuspected abuse but only 47% had reportedtheir concerns.

100The survey identified the

following barriers:

• worries as to what would happen to thechild and family concerned;

• concerns over what reporting might do totheir relationship with the family concerned;and

• high thresholds for accessing childprotection services.

100

These fears are not unique to the healthservice. Other public sector workers in contactwith children do not refer as a result of highthresholds. A joint inspection of children’sservices in 2005 found:

‘Because some social services are unable torespond to families requiring support, otheragencies do not refer children when concernsabout their welfare first emerge. This meansthat some families are subject to avoidable

22


Box 7: NSPCC child protection helpline

There are four helpline teams at present, two of which provide a 24-hour service. Theservice is available in Welsh and a number of Asian languages, with separate textphoneand email services. Three-quarters of calls come from members of the public, theremainder coming from families or professionals.18

Despite its clear contribution to facilitating child protection referrals, the NSPCC receivesno government funding for the helpline, which costs £3.5m per annum to run. It is lobbyinggovernment with a view to recovering at least some of the costs from governmentsources.32

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pressure, children may experience preventableabuse or neglect and relationships betweensocial services and other agencies maybecome strained.’

79

It is difficult to see what charities can do toalleviate this problem, other than simply addingextra capacity to the system.

There is evidence to suggest that reforms tochildren’s services are making a difference,however. In 2005 a joint inspection by theeight different inspection bodies of variouschildren’s services found that, as a result ofagencies working together better, fewerunnecessary referrals were being made thanthree years previously. Not only does this freeup child protection teams to focus on genuinecases of abuse, it should hopefully increasethe confidence of those making referrals, bothin knowing when to report and in the childprotection system itself.

This will not overcome every barrier. High-profile media cases where professionals havegiven evidence in court are also thought to beaffecting recruitment and retention in children’sservices work other than social work. Worriesabout giving evidence, or more precisely thepossibility of getting it wrong, are thought tobe discouraging professionals from reportingconcerns and even going into child protectionwork in the first place.

101, 102

Referrals from children Charities do have a role to play in encouragingchildren to report abuse. It is generally thoughtthat most children do not report abuse at thetime it happens.

86In fact, they are more likely

to tell no one at all. The NSPCC found thatonly one in four sexually abused children tellsomeone about the abuse at the time. Onethird of young adults had never told anyoneabout the abuse they experienced as a child.

55

The disparity between numbers on the childprotection register and those thought to beabused each year is perhaps partly becausesome children never disclose abuse. Somedo tell somebody, but they are not believedor adults do not report the abuse tothe authorities.

The NSPCC undertook a survey of childrenwho were known to have been abused as partof its Talk ’til it stops campaign in 2005.Three out of four had been worried that, if theyreported, no one would understand or helpthem. The average time before they had toldanyone was two years and four months. Theyspoke to an average of three people beforeanyone helped them.

103Other research

suggests that disclosing at a younger age ispredictive of less supportive reactions thantelling when older.

104

Reasons why children do not report abuseinclude:

• they may be scared of what might happen,both at the hands of the abuser and as aresult of social services being involved;

• they (are led to) believe they deserve theabuse; and

• they may compare their experiences withothers they feel are worse off, and feelcomparatively that they are not beingabused.

58

23


Box 8: Confidential spaces

ChildLine provides a free and confidential helpline for children and young people. Itbegan in 1986, launched with a special BBC programme hosted by Esther Rantzen onchild abuse. The charity was the first of its kind; 50,000 children tried to call in thefollowing 24 hours. The service remains something of a pioneer, and is very popular.Around 4,500 calls are attempted each day, yet trained helpline volunteers can onlyanswer just over half of those at present. The helpline is run from ten centres aroundthe UK, with callers routed to the nearest, in recognition of differing regional legal situationsand sensitivity to local cultures and accents. ChildLine’s emphasis is on hearing whatthe child says, rather than focusing on what would seem most important to find outfrom an adult perspective by pursuing a line of questioning. This approach is uniquein child protection work, and goes some way to explaining the popularity of the helplinewith children and young people. Many children are repeat callers; in 2005, ChildLineoffered in-depth counselling to 140,000 children and young people. ChildLine receiveshundreds of thank you letters each month, which would suggest that children and youngpeople have felt the service to be of real benefit.

there4me is a younger, interactive online service. It provides information, advice andsupport aimed at young people aged 12–16. The service is designed to give youngpeople a safe space in which to disclose abuse. In order to encourage young peopleto access the website and not be put off by the stigma of it focusing on child protectionand child abuse, it presents itself as a broader information and advice service on awide range of topics. Services range from an agony aunt feature to a one-to-one livechat facility in which young people can speak with skilled advisers. Since its launchin 2002, 38,000 new users have created an account on the site. It is being adapted sothat disabled children can access it more easily, and representation from black andminority ethnic users is good, although the service is only available in English at present.The service is not currently advertised nationally, as capacity is limited. There are currently24 advisers, based at three sites in the North West of England and one in Northern Ireland.

Both services are run by the NSPCC (except in Scotland, where CHILDREN 1st runsthe ChildLine service). The newly combined listening services have jointly engaged ina mobile phone texting pilot called Speechless, which ran for one month in one ruraland one urban area of Bradford in 2006. Young people were involved in developing,running and evaluating the pilot. 1.5% of the 11–16 year olds in the area used the service,sending an average of 8.4 texts each. Scaled up to national level this would mean around70,400 children would access the service if available.48 The outcomes of the serviceare less clear, but the fact that 75 children in the pilot went on to have one-to-one textconversations with advisors, all of which were of a serious nature, suggests these childrenhad nowhere else to turn.

The NSPCC is now looking at how to develop the service in line with there4meand ChildLine.

Market research following the pilot found a high awareness of the service, in the topthree services young people were aware of, with 46% saying they would use the serviceand a further 39% saying they might. A focus group with deaf and hard of hearing youngpeople also had a positive response to the service.

Abuse is an imbalance of power that thrives onsecrecy. To keep it secret, threats andmanipulation may be used, further reasons whychildren do not readily report abuse. Referringto a faceless, nameless authority is not easy forchildren, whose sum knowledge of socialservices may be that they ‘take children away.’In reality, very few children are removed fromtheir families in cases of abuse. Of those casesreferred to social services on suspicion ofabuse, less than 1% are taken into care, andby far the majority of these are on a temporaryrather than permanent basis.

105Yet the

prevalence of this fear indicates that child-friendly ways are needed for children to exploretheir concerns and fears.

The NSPCC’s ChildLine offers such a service,as does the charity’s there4me online service(see Box 8). Both services have a clearconfidentiality system in place. It is explainedto children that, if they disclose any identifyingdetails, and are deemed to be at risk ofsignificant harm, their case will be reported tothe appropriate authorities. Whether or not thishappens is up to the child; he or she chooseswhether to disclose those details. Theconfidential space gives choice and power toabused children, something they are likely tobe lacking in the abusive relationship they areexperiencing. The service is a success withchildren: they are much more likely tocontact ChildLine than local authority childprotection teams.

There have been calls for the principle ofconfidential spaces, with high but not absoluteconfidentiality, to be extended to the childprotection system. The powerlessness thatchildren can feel once abuse is disclosed and

Charities aremore involved inprovidingsupport onceabuse has beenidentified than atthe investigativestage.

the child protection system descends canresult in additional harm. ‘After children hadtalked about the abuse they often feltresponsible for the effect this had on thefamily. Indeed, they were often heldresponsible by family members. Theyharboured strong feelings of self-blame andoften viewed the expulsion of the abuser withguilt and their own separation aspunishment.’

44

Of course, these consequences must beweighed up against the potentially fatalconsequences of not disclosing abuse. Itnonetheless highlights some of the difficultiesthat disclosure brings for children; even if theydo overcome them and report, support is mostcertainly needed after disclosure.

A report published in 2003 by the think tankDemos argued that both children and adultsshould be offered counselling and support,without the fear of the full weight of the childprotection system bearing down.

71A debate

on how well current confidentiality policiesprotect children is long overdue.

Whatever the details of such debates overconfidentiality, it is clear that confidentialspaces are a critical element of efforts totackle abuse by increasing reporting. Donorscan be certain that supporting such spaceswill lead to greater numbers of abused childrenseeking help, and being able to officiallydisclose their abuse if they choose to do so.

InvestigationOnce abuse is reported to a local authority, astandard process then begins. Social servicestypically have overall responsibility for thisprocess. Charities have less of a role to play inthis, although some do add extra capacity atthis stage. Many of the larger children’scharities mentioned below have been activelyfulfilling parts of this process for over a century,before the existence of the welfare state. Theyhave developed a wealth of knowledge, whichthe public sector can and does draw on.

The NSPCC is the only charity with the powerto apply for a court order to remove a childfrom danger, reflecting its historical dominancein the child protection field.

106Its Scottish

equivalent, CHILDREN 1st (formerly known asthe Royal Scottish Society for the Preventionof Cruelty to Children) lost this power in theSocial Work (Scotland) Act (1968).

107Up until

the 1980s the NSPCC directly managed childprotection assessments and registers in someareas. It has since moved away from suchwork, although it still has nine specialinvestigation service (SIS) teams, whichundertake assessments alongside police andlocal authorities (see Box 9). The teams areoften brought in for more complex cases,reflecting their specialist knowledge.

24


Box 9: NSPCC Special Investigation Services

The NSPCC has nine special investigation services (SIS) teams, manned by trained socialworkers specialising in child protection.

NPC visited an SIS team, based in Manchester, that worked all over the UK. Nearly allof the team’s work consisted of risk assessments where children were judged to besuffering, or at risk of, significant harm, and care proceedings were under way. Theteam had no ongoing contractual obligations to any particular local authority, to ensureit is non-partisan. The team of six can therefore choose which cases it takes on, oftendealing with very complex, long-term cases (running to three months). On average,they take on 30 cases per year. Referrals usually come from the lead solicitor, and innine out of ten cases, the child has already been removed by the time the SIS team isinvolved. Given the reputation of both the NSPCC and the team, courts more often thannot accept its assessment. The team has at times been involved in setting legal precedent.What services the child and family then receive is up to the court and local authority.

The team charges a flat fee of £2,995, usually to the local authority or court, regardlessof numbers involved or length of case. This reflects around 30% of the true cost—70% is covered by the NSPCC. This gap (funded largely by donations from the generalpublic) reflects the NSPCC’s commitment to delivering the highest possible quality service,despite the fact that local authorities are not prepared to pay for this. This is a problemseen across the sector, and one which the government’s commitment to full cost recoveryshould have stamped out.

NCH has a consultancy called The Bridge,which offers a range of services, from forensicconsultancy to training audits, for bothgovernment agencies and charities. TheBridge is perhaps best known for its seriouscase reviews, which are undertaken orcommissioned by Local SafeguardingChildren’s Boards when a child has been killedor seriously harmed (see Appendix 2).

It is not clear from official statistics how manychild protection cases involve charities. Fromthe services that NPC has visited, it seemsthat charities are more involved in providingsupport once abuse has been identified(discussed in more detail later in this section)than at the investigative stage. Overall,establishing what exactly happens to childrenand families as they go through the childprotection process is not easy.

The process is worth reflecting on. Asindicated above, the system is not without itsproblems. These problems indicate some ofthe general difficulties of working to protectchildren from harm. They also perhaps explainwhy only one in three seriously abusedchildren is helped, despite the commitmentfrom central government to doing so and theclear responsibility of local authorities tosafeguard children at a local level. Thereremains significant scope for improvement,which is where private funding can help.

Section 47 enquiryA child protection inquiry is named afterSection 47 of the Children Act (1989), whichsets out the duty of local authorities. Figure 5is a simplified flow-chart of the process fromreferral; the process is described in more detailin Appendix 3. It indicates the large number ofchildren who are filtered through the system,but that little is known about what happens tothose who are filtered in or out, or why.

Figure 5 is a simplification of what is acomplicated and bureaucratic system (thereferral process checklist in the most recentgovernment guidance runs to five separatedetailed flow charts).

27The checks, measures

and targets that are in place reflect theseriousness of the work and the importance ofaccountability. But they do not necessarily reflectthe quality of the judgements made at eachstage of the process. Structures and processesare not the same as skilled judgement.

As indicated earlier, identifying abuse is noteasy, either for members of the public or forprofessionals (see Box 10). As one academichas noted, ‘many of the children coming tothe attention of the child protection agenciesare in the grey area, which means that thequestion of whether abuse has occurred is adebatable one.’

109

Limited time and resourcesProfessionals have a limited time frame inwhich to make difficult decisions about whatconstitutes child abuse. Once an initial referralis made, whatever the cause for referral, socialservices have just 24 hours in which to decidewhether to carry out an initial assessment ornot.

27Just under 50% of children are filtered

out at this stage.105

How many of these arechild protection cases is not clear.

Professionals also have finite resources. Asmentioned earlier, there are high vacancyrates. This must have an impact on quality.Some local authorities are applying‘inappropriately high thresholds in respondingto child protection referrals and in taking actionto protect children.’

79Research indicates that

professionals are as likely to use caseconferences, at which key child protectiondecisions are taken, to filter out cases as toaccept them, ‘a state of affairs resulting fromtheir need to realistically manage the amountof work coming to them.’

7

Donors and funders may question why theyshould put money into an area where there issuch clear statutory responsibility; particularlyone that has received increased investmentover the past ten years. The question is avalid one. However, more money is notnecessarily the answer, and even if it were,there is not enough government funding tomeet current need.

25


Despite thegovernment’scommitment topreventativeservices,‘councils arefocusing onservices forthose with thehighest and mostcomplex needs.’For children, thismeans they gethelp only whenthey havereached thestage of being atcontinuing risk ofsignificant harm.

Figure 5: Child protection process (England only)105,108

Referrals to social services 552,000

Initial assessment290,300

Coreassessment

74,100

Child protection enquiry 68,500

Children in needassessment

24 hours

Child at continuing riskof significant harm

Child protection conference 37,400

Child protection register 30,700

Taken into care4,100

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A common criticism of the reform programmeis that the far-reaching changes are expectedto be implemented with only limited extraresources. However, the overall budget forchildren’s services has increased over the lastfew years. In 2007/2008, local authorities willhave combined funding for children’s servicesfrom the DfES of £2.9bn, an increase ofalmost 9% from the previous year. Thisincludes a rise in funding given specifically toimplement the reforms demanded by EveryChild Matters from £22.5m to £63m.

110

However, local authorities are bothexperiencing greater demand for services andare expected to make efficiency savings,thought to be in the region of £220m acrosscouncils for the financial year 2006/2007.Children’s services were expected to go£100m over budget in 2005/2006; two thirdsof local authorities are facing financialproblems as a result of growing demand.

111

The comprehensive spending review,published after this report went to print in2007, is likely to require slower growth insocial care spending.

Despite the government’s commitment topreventative services, ‘councils are focusing onservices for those with the highest and mostcomplex needs.’

112For children, this means

they are increasingly likely to get help onlywhen they have reached the stage of being atcontinuing risk of significant harm, or sufferingsignificant harm.

Gatekeeping and thresholdsFigure 6 indicates the different ‘thresholds’ thatact as gatekeeping mechanisms and thecompeting pressures on those thresholds.

It is highly likely that thresholds vary locally.Official figures from 2005 show that there were19 child protection enquiries per 10,000children in Bath and North East Somerset,compared with 261 per 10,000 children inHartlepool. This variation between localauthorities fluctuates at each different stage ofthe process (see Figure 6). There are a numberof reasons for this, not least differences in datacollection and in interpretation of theguidance.

105However, it does further

strengthen the argument that official figures donot reflect actual prevalence, nor are they agood guide to how effective the system is.

A 2007 children’s services inspection reportbased on 130 council and 37 children’sservices inspections found ‘thresholdsgoverning access to social care services areset too high, with no shared understanding oftheir purpose and application.’

113

26


Box 10: Significant harm

Harm is defined in the Children Act (1989) as ill-treatment or impairment ofdevelopment or health. This was extended in the Adoption and Children Act (2002) toinclude situations where a child has ‘suffered from seeing or hearing the ill-treatmentof another’. This has obvious implications for families where there is domestic violence,but despite coming into effect nearly two years ago there has been little impact.25

As we have seen, what constitutes harm depends on a number of factors, from culturalcontext to impact on the child. As for whether harm or not is significant, section 31,part 10 of the Children Act (1989) states that ‘where the question of whether harmsuffered by the child is significant turns on the child’s health or development, his healthor development shall be compared with that which could reasonably be expected ofa similar child.’ Given the different ways in which children are brought up, this approachraises ‘incredible spectres of class, cultural, racial, religious and ethnic considerations.’40

Professionals are not always able to establish whether maltreatment has or has notoccurred, resulting in considerable ambiguity.44

Figure 6: Thresholds for accessing child protection services, adapted from ChildProtection: Messages from Research, Department of Health

44

Thresholdswhen to:

• define something as abusive

• intervene

• confront or raise the issue with

parents

• call a protection conference

• remove a child

Notmaltreated

Maltreated

Moral and legal

questions

Outcom

es

evide

nce

Prag

matic

conc

erns

Concerns of

parents and children

Targets and inspectionsIn England, the key measure of thegovernment’s ‘staying safe’ outcome (seeAppendix 1) is related to numbers on the childprotection register. Three of social care’sperformance measures are:

• proportion of children re-registered on thechild protection register;

• length of time spent on the child protectionregister; and

• proportion of child protection cases thatwere reviewed within the specifiedtimeframe.

114

The government makes clear that thesemeasures are proxy measures for theeffectiveness of the system, but none of thesemeasures reflects the quality of social carejudgements nor the outcomes for the childrenand families involved (eg, preventing childrenfrom coming to harm; minimising the effect ofharm that has occurred).

There are genuine difficulties with measuringresults in this field, as seen at the end ofSection 1. Detailed case notes are taken onevery single child who is subject to a childprotection plan, in line with the Framework forAssessment (see Appendix 3).

The government continues to grapple withhow to collate such information in a way thatindicates the effectiveness of its services. NewJoint Area Reviews (JARs) bring together teninspection bodies which scrutinise frontlinepractice in local areas through the analysis ofindividual cases and feedback from childrenand their families. In the words of theinspectors, this is leading to a ‘less favourablepicture’. Of 37 children’s services inspected in2006, none was deemed to be ‘outstanding.’Seven were judged to be ‘inadequate.’

113

Supporting child victims throughcriminal proceedingsMany forms of child abuse are crimes. Asmost abuse occurs within the home, and giventhe importance of the ongoing familyenvironment in minimising the harm caused byabuse, the child protection system emphasisessupport rather than prosecution. In addition,the system focuses on reducing future harm;most past abuse is not recorded.

58It is unclear

what this means for prosecution. In somecases prosecution is necessary, but on thewhole, it is rare.

Soliciting disclosures from children with thepromise that the perpetrator will be punishedcan be misleading, and damaging if theperpetrator escapes punishment.

44Over ten

years ago the National Commission of Inquiryinto the Prevention of Child Abuse reported:

‘The way the court system operates can itselfbe so damaging to children that, in thechildren’s own interests, even when the mostblatant instances of abuse are involved,abusers escape prosecution […] If the abusedchild has to suffer, through the legal process,an experience which can be as damaging asthe original abuse itself, the purpose of justiceis defeated.’

15

Since 1988 changes have been graduallyintroduced to support child witnesses. Asnoted earlier, prior to this there was greatmistrust of children’s evidence. From 1988onwards, this position has shifted. Childrenshould now be helped to give their own story.Special measures, to be used frominvestigation to trial and beyond, include:

• screens, so the child does not have to facethe court room;

• pre-recorded video evidence, to be used incourt (for all sexual offences, abduction orcases involving violence and/or neglect);

• live television link (again, recommended forall sexual offences, abduction or casesinvolving violence and/or neglect);

• clearing the public gallery of the court; and

• removal of court wigs and gowns.91

These measures are set down in the YouthJustice and Criminal Evidence Act (1999). Arange of other good practice measures arerecommended but not included in thelegislation. These include familiarisation with thecourt prior to the trial, having a liaison officerand separate waiting areas. The ultimate aim ofthese policies is to increase the likelihood ofvulnerable witnesses testifying, help them givethe best evidence possible, and reduce thestress and trauma of giving evidence.

The treatment of child witnesses has improvedas a result, but remains inconsistent. AnNSPCC report in 2004, based on interviewswith 50 child witnesses, found a ‘chasm’between policy and reality. Children reportedlittle choice as to how, where and when theygave evidence.

115

27


The way thecourt systemoperates canitself be sodamaging tochildren that, inthe children’sown interests,even when themost blatantinstances ofabuse areinvolved,abusers escapeprosecution.

National Commission ofInquiry into the Prevention

of Child Abuse15

Box 11: NSPCC’s child witness support programme

The NSPCC currently runs six programmes for young witnesses called to give evidencein the criminal courts. Support workers aim to reduce the distress that giving evidencecan cause, helping them to give the best evidence possible. Children wait on averageone year between a defendant being charged and the trial taking place. While waiting,the support worker helps the child understand as much as possible about giving evidence.They may take them to visit the courtroom in advance.

During the trial the support worker will sit with or near the child, depending on whatthe court allows, to help keep him or her calm. After the trial, children can need helpunderstanding what has happened and the outcome of the trial. If possible, childrenmay be helped to access therapy.31

ʻʻ

A Home Office report two years later foundthat special measures were used in a minorityof cases. Video recordings, for example, wereused for around one quarter of childwitnesses. This was more likely to be becauseof an a priori judgement of the ability of thewitness to give evidence, which can happenwhen witnesses are older, or of a similar ageto their attacker, than because facilities werelacking.

91Indeed, unless children were victims

of sexual violence, they were not alwaysidentified as vulnerable and intimidatedwitnesses. As a result, special measures forgiving evidence did not apply. Yet videorecording is effective, increasing the accuracyand completeness of evidence.

91

Television links were also found to be used in aminority of cases, for fears of prejudicing theparity between victim and defendant. This wasparticularly pertinent when the victim anddefendant were both children.

91

The NSPCC developed child witness supportpackages in 1999 to improve their treatment incriminal courts (see Box 11). In addition todirectly supporting child witnesses, the charityis campaigning on the issue.

The Cross Government Action Plan on SexualViolence and Abuse published in April 2007promised the national roll out of intermediariesto help vulnerable witnesses in court.Guidance for local authorities in setting upchild witness support schemes is also beingdrawn up.

116

Direct forms oftreatment ortherapy [forchildren] havebeen found tobe lacking,often becausethe focus is onworking withparents toensure that theyare moreresponsive totheir children’sneeds.

Academic7

Support for families‘Support’ is an extremely vague and broadcategory. We use it because once abuse, orthe risk of abuse is identified, there is a hugerange of services that might be offered tofamilies, the majority of which are likely to besupportive rather than punitive. Althoughsome types of child abuse are crimes,punishment is not always seen as the mostappropriate response.

As seen earlier, the child protection system islargely focused on the home. The Children Act(1989) makes it clear that children are bestcared for by their parents, but that parentsmay sometimes need help in bringing up theirchildren. As such, children are rarely removedfrom the home. Instead, agencies work withthe parents to help protect the child. There is along list of reasons put forward for why abuseoccurs. Identifying why abuse is happening isimportant, because it offers avenues for bothstopping it and preventing it happening again.

Intervening to provide support for families is farfrom straightforward. In the majority of casesthat end up on the child protection registerthere are multiple problems in the family.

7, 44

One practitioner concluded that ‘there notonly appears to be no single cause of childmaltreatment, but no necessary orsufficient cause.’

117

Nonetheless, there are a number of identifiablefactors that can be worked on to both protectchildren and promote their welfare in cases ofabuse. Section 3 outlines what can be done toprotect children in the home, as well asexploring the detail of family support work andits results.

Meanwhile, it is worth noting one innovativeproject, Community Service Volunteer’s(CSV) Volunteers in Child ProtectionScheme, which is using volunteers to helpprotect children who are on the childprotection register. Its activities are describedin Box 12.

Treatment for childrenThe wide variety of ‘support’ on offer largelyappears to be for parents of abused children,with a view to stopping the abuse andpreventing it from happening again.

Many children will need specialist, ongoingsupport themselves. Children are entitled tolocal authority support, not just indirectlythrough support for their parents, but directly,for their ongoing well-being.

There is a strong link between abuse andsubsequent mental health problems. There issome evidence to suggest that any therapy is

28


Box 12: CSV’s Volunteers in Child Protection Scheme

In May 2003, the charity Community Service Volunteers (CSV) began pilot projects inBromley and Sunderland, testing how volunteers could be used to reduce pressure onsocial services. This has never been done before in the UK. The project aims not onlyto increase children’s well-being, but also to reduce pressure on social services byshifting some of it to the community. The project is nonetheless rooted in the localauthority’s child protection team; the project manager is based within the team andvolunteers are in constant contact.

A brief example of one match is that of Lynsey, 23, working with a single mum in her40s with four children (in addition to three older children), all registered for neglect.The family lives in poverty and social isolation. The mother suffers from low self-esteemand depression and the family has little community involvement as a result of localbullies. Lynsey works with the family to extend the children’s social contact in thecommunity, to help them develop their independence and to help them in the pursuitof their interests. Lynsey, the children and professionals are enthusiastic about whatis happening. All the children have grown in confidence, and have been able to developnew friendships.

Ultimately, the hope is that local authorities take up the project costs, which are around£60,000 per area each year. The programme is cost-effective, given the use of volunteers.It has expanded the capacity of child protection teams while also helping potential recruitsfrom the community gain valuable experience. CSV would like to extend this modelelsewhere.

ʻ

ʻ

better than none in helping reduce the ongoingnegative impact of abuse,

7but it is thought

that few receive such services. An estimated90% of sexual abuse victims do not receiveany service.

118

The system’s lack of transparency makes ithard to know who is receiving which services.However, one practitioner NPC spoke to withconsiderable expertise in the field had foundthat support for children beyond theassessment period was very limited.

1

Furthermore, a study of a small sample ofsexual abuse cases in the 1990s found:

‘As far as the children were concerned, only afew offers of therapeutic help either in the formof group or individual work were made, and byno means all of these were taken up. Selectionfor, and allocation of, therapeutic help was avery hit-and-miss affair, depending on theavailability of resources, knowledge of them bysocial workers and openness to them by bothchildren and parents.’

7

The picture is perhaps worse for victims ofother forms of abuse, ‘where direct forms oftreatment or therapy have been found to belacking, often because the focus is on workingwith parents to ensure that they are moreresponsive to their children’s needs.’

7A recent

NSPCC survey found that more than four outof five respondents (most of whom workedwith children) felt there was not enoughsupport available to help families overcome theeffects of emotional abuse.

119

Given the impact that abuse has on mentalhealth and well-being, the government’s childand adolescent mental health service (CAMHS)may work with children who have beenabused. But CAMHS is dealing with a widerange of mental health problems and there is ahigh level of need. Waiting lists are long, andthe service may not always be appropriate.The medical model may not be suitable ornecessary. CAMHS will only become involvedif there is a diagnosable mental healthproblem, which may not be the case withmany children.

118

NPC has come across a handful of charitiesdelivering therapeutic support for children tominimise the ongoing harm caused by abuse.On the whole these charities are the majorplayers in the field, which can afford to fundelements of these services themselves.Typically, local authorities are prepared topay for only a fraction of what the serviceactually costs.

The NSPCC runs 34 therapeutic services forabused children (see Box 13). A campaigningpriority for the charity is to persuade thefunding for every abused child to accesstherapy. As part of this, the NSPCC ismapping what services are currently availablefor abused children.

120

CHILDREN 1st runs seven abuse recoveryservices in Scotland, which work with around40 children each. NPC visited the Ettrickcentre, in the Scottish Borders. Therapistswork with the child, one-on-one, but also offersupport and advice to parents to help themcope with the ongoing fallout of abuse.CHILDREN 1st was the only organisationoffering therapy for abused children in thearea, where some 23,000 children live.

121The

local child and adolescent mental healthservice no longer had the capacity to workwith this group. As a result, the service had awaiting list of six months, despite working withthree times the number of children and familiesit is funded to work with.

122

Abuse recovery is currently the main theme ofthe charity’s awareness-raising campaign.CHILDREN 1st is trying to persuadegovernment that the commitment to childprotection must also include ongoingtreatment for victims of abuse.

Barnardo’s also runs 13 therapeutic servicesfor abused children. NPC visited services inBirmingham and Dundee. The latter servicecaters for children who have been abused aswell as children who display sexually harmfulbehaviour. As Section 5 discusses, there issignificant overlap between children who havebeen sexually abused and those who sexuallyabuse in turn.

29


There is a lack ofresearch on theeffectiveness oftherapy. A reviewof treatmentprogrammesfound few hadrobustevaluations.However, thesame reviewfound that mosttherapy seemedto be of benefit.

Box 13: NSPCC’s therapeutic and treatment services for abused children

NSPCC’s treatment services for abused children are flexible, designed to meet the needsof specific children. An internal evaluation in 2004 found that changes were observed,both within the therapeutic relationship and in the child’s external situation.22

Until recently, there was little consistency in practice in the therapeutic services. Aninternal evaluation in 2004 found that individual practitioners devised their ownassessment systems in some cases, usually in an effort to make the process as child-centred as possible. Some set goals as part of the service; others preferred using ‘themes’or ‘challenges’. This variation is not a bad thing; practitioners often tailor their approachto their clients.22 But a lack of consistency makes it difficult to assess the overall impactof the services.

To overcome this, the charity is implementing a measurement tool called the TraumaSymptom Checklist (developed in the US) in all of the charity’s therapeutic services.It is also running a long-term evaluation with a sample of children. These should providea strong body of evidence for the effectiveness of therapy for abused children, whichshould add significant weight to the case being put to government.

The length of the therapeutic relationship varies from child to child. The service costsroughly £3,750 per child per year. The proportion of those paid for by local authoritiesdepends from service to service; in some areas, the NSPCC fully subsidises the service,in others it receives up to one half of the cost of the project. Funding for CHILDREN1st’s Abuse Recovery projects in Scotland is equally patchy. Per child, per year, thecost is around £3,000. The charity finds the service is one of its hardest to fund. Persuadinglocal authorities to (fully) fund services once they are up and running is no easy task.

In addition, there are a number of localorganisations supporting survivors of rape andsexual abuse around the UK. Some of theseorganisations will have specialist services forchildren. They also tend to have a highnumber of adult survivors of abuse accessingtheir services. Adult survivors of abuse arecovered in more detail in Section 7.

As an internal evaluation of the NSPCC’stherapeutic services concluded, ‘effectivenessand evidence remain contested concepts withregard to therapeutic work.’

22Arguably, there

is no ‘best’ model of therapy for abusedchildren. Abused children’s experiences andcircumstances will vary greatly, as will theirresponses to the trauma they haveexperienced.

As in other child abuse services, there is a lackof research on the effectiveness of therapy,and the research that exists focuses on victimsof sexual abuse. A review of treatmentprogrammes for victims of sexual abuse foundthat few had sufficiently robust evaluations toconclusively determine their effectiveness.

123

However, the same review found that mosttherapy seemed to be of benefit.

123There is

little difference, for example, between theoutcomes of individual and group therapy.

7

The most important factor linked toeffectiveness is that the child is protected.

14

Once the child is protected and no longer atrisk of abuse, talking about the abusiveexperience(s) directly is thought to beconstructive. Doing so helps counter thesecrecy and silence surrounding the abusiveexperience, as long as it happens in astructured and supportive environment.

123

Greater research is needed into cognitivebehavioural therapy (CBT), as it has proveneffective for adult survivors of trauma (seeSection 7).

123CBT works by changing people’s

behaviour, usually over a short period of time.Trials have shown CBT to reduce thesymptoms of many mental health problems.

124

Finally, several studies have suggested thatsupport for both non-abusing parents andchildren seems to work better than supportfocusing on only one or the other.

7, 14, 74

There is a lackof research ontheeffectiveness oftherapy. Areview oftreatmentprogrammesfound few hadrobustevaluations.However, thesame reviewfound that mosttherapy seemedto be of benefit.

ConclusionsThis section has set out in some detail thesignificant problems that face the childprotection system and charities working withinand around this system. These include: thesystem’s failure to support as many as twothirds of those children who are abused; thebroad lack of evidence on effectiveness; thesystem’s unfriendliness to children, and itsoverall resource constraints.

This section has also described the process ofchild protection, including identification,reporting, investigation, support and treatment.

The child protection system, then, sets thecontext for donors to understand the work ofcharities in this field. They often face the sameproblems. For example, a donor fundingefforts to increase identification and reportingcan consider the system’s failure to engagewith those who have been sexually abused,resources for subsequent support andtreatment. Both these factors will influence thesuccess of the donor’s funding.

Given the sheer numbers involved, privatefunding for direct service delivery is unlikely tobe the solution to meeting demand.Furthermore, local authorities have a duty tosafeguard children living in their areas,including attending to the ongoing well-beingof children in need.

Therefore, donors should consider prioritisingfunding lobbying work ahead of servicedelivery in this area. For the work of charities inchild protection to be effective, increasedfunding is also required from government. Toachieve this, charities must lobby for morefunds where they are needed. For example,both the NSPCC and CHILDREN 1st arecurrently lobbying government for moreresources for therapeutic treatment servicesfor abused children.

The government’s stated commitment totackling child abuse must be backed up byfunding—private donors are unlikely to be ableto bring to bear adequate funds themselves.Nor, arguably, should they subsidise publicservices—a situation that is widespread in theprovision of therapeutic services.

To conclude, donors’ options for funding childprotection can be summarised under threemain headings.

30


Reach children not helpedwithin the systemIn this category, priorities for funding include:

• Mechanisms for increasing theidentification and reporting of abuse.These include helplines and confidentialspaces, which are needed for both childrenand adults to discuss their concerns, getadvice and disclose abuse.

• Support and treatment for childrenbeyond the system’s focus. This includestreatment for those who have been abusedbut are not at risk of immediate harm. Thesystem focuses on dealing with immediaterisk of harm. Yet the impact of abuse goesbeyond this immediate harm. The emotionalimpact of abuse will continue withoutappropriate treatment and support.

Given that the majority of children who havebeen abused are unknown to the system,charities working in this area are in highdemand and private funding is often critical.Ideally, both would receive greater governmentfunding given the clear commitment tosafeguarding children.

Add capacity to an over-stretched systemIn this area, donors can fund any area of thechild protection process itself. Areas in whichcharities are most active include identification(through helplines and outreach), specialistinvestigation work, support for childrenthrough the court system, family supportand therapeutic treatment.

Donors who choose to fund in this area mustaccept the constraints that the system’s flawscreate, or commit to long-term funding forcharities trying to fix them. Adding capacitymay be reactive and expensive, but it has adirect positive impact.

NPC does not believe this should be a priorityarea for private donors. Local authorities havea duty to protect all children in their area.Donors should ask serious questions ofcharities seeking funding for subsidisingservices provided for local authorities.

There should be a clear argument providedfor why the local authority is not fully fundingthe service.

Improve the system byaddressing some of its flawsand biasesThere are fewer options available for donors inthis category, but the few that exist couldinform wider practice. Funding prioritiesinclude:

• research and evaluation to establisheffective ways to act; and

• listening to children’s views on the systemand involving them in changing it.

NPC highlights these two options as elementsthat should be integrated into the work ofcharities working within and around the childprotection system. While there may be ways tofund work focusing specifically on theseapproaches, it is more valuable for donors tolook for signs that they are deeply ingrained inthe more general work they support.

Prioritising fundingUntil government funding increases, charitiesworking in and around the child protectionsystem will continue to need private funding tocover their costs. Donors should considerprioritising lobbying if they wish to fund work inthis area, as this could ultimately lead togreater commitment from government.

In general, NPC would not recommend thatprivate donors focus their giving on charitiesworking within and around the child protectionsystem. This is clearly primarily an area ofstatutory responsibility, and private funding isunlikely ever to be able to close the gapbetween capacity and demand. Privatefunding can have greater impact in other areashighlighted throughout this report.

31


Donors shouldconsiderprioritisinglobbying if theywish to fund workin this area.

3The homeChildren are at greatest risk of abuse intheir own home. They are most likely to beseriously injured or to die at the hands oftheir parents or carers. What is less clear iswhy children are abused. Understandingthis offers a vital step towards tackling thecauses of the problem.

However, there is little consensus on thecauses of abuse. Even where causes canbe identified, they are part of a list ofcontributing risk factors rather than singlecauses, making it difficult to highlight anyone particular causal factor.

This section concludes by drawing togetherwhat we know, and what we do not, about theresults of work tackling abuse in the home.This provides the basis for donors to prioritisetheir giving, focusing on the types of resultsthat are most attractive to them.

Because the child protection system focuseson abuse in the home, some of what isdiscussed in this section overlaps with theprevious section. But here, the focus is on theservices and support provided to families andchildren where abuse has been identified,whereas Section 2 focused on the wholesystem, from identification through totreatment and support.

The role of parents and carers A great deal of parental and societal anxietyabout child abuse stems from the belief thatabuse occurs at the hands of predatorystrangers. In fact, abuse by strangersaccounts for fewer than one in five knowncases of contact sexual abuse.

55The majority

of abuse—neglect, physical and emotionalabuse—occurs at the hands of parents orcarers.

125

This is a surprising and counterintuitive finding.The vast majority of parents love their childrenand want the best for them. Very few peopledeliberately set out to abuse their own sonsand daughters.

Why then is it that parents are the mainabusers? Frustratingly for donors, availableresearch on the causes of child abuse doesnot offer much of a consensus. ‘There notonly appears to be no single cause ofchild maltreatment, but no necessary orsufficient cause.’

117

A circumstantial answer is that it is parentswho spend the most time with their children. Itis parents who carry the physical and

emotional responsibility of meeting children’sneeds—predominantly in the home. There is aspectrum of acceptable ways of parenting andthe grey area between a stressed parent andan abuser is not always easy to navigate.

It is worth noting also that children arecommonly seen as the property of theirparents, rather than individuals who haverights of their own. There remains vociferousopposition in some quarters to anything thatthreatens to interfere with the family and theright of parents to treat their children as theysee fit.

More profound answers move to looking at therisk factors that contribute to abuse. Throughthis lens, many parents are potentially capableof engaging in abusive behaviour. Whether ornot they do so is at least in part aconsequence of the complex interaction ofother factors—be it poverty, use of drugs ormental illness.

There are cases of undeniably awful andinexcusable behaviour, which often end upbeing the focus of extended reporting in thepress. A more useful starting point is tounderstand that ‘much abuse is committedby ordinary people under extraordinarypressures.’20

Table 3 is adapted from a literature review ofrisk factors associated with abuse, from thecharity Barnardo’s.

74The large number of

factors are categorised into different groups. Inmany cases of abuse, these interact, tocumulative effect. What could be described asa dormant factor, such as a parent’s ownexperience of abuse, may combine with amore immediate one, such as a child’sbehaviour, to create a higher-risk environment.In other words, the previous experience ofabuse may come together with frustrationsabout the child’s behaviour to push the parentover the edge, into reacting abusively.

An emphasis on risk factors is potentiallyfruitful for donors interested in tackling abuse.That is because it gives concrete issues fordonors to focus on that may in part causeabuse, rather than just managing some of itssymptoms. It may also allow donors toprevent abuse in the first place, becauseaddressing risk factors reduces the likelihoodof abuse occurring.

NPC’s analysis suggests two kinds ofapproach for donors interested in tacklingabuse in the home.

32

Much abuse iscommitted byordinary peopleunderextraordinarypressures.

National Commission ofInquiry into the Prevention of

Child Abuse20

ʻʻ

Options for donorsThe first option for donors is to supportprogrammes tackling individual adult riskfactors, linked to child abuse (for example,substance abuse or parental mental health).This approach has an intensive focus andsometimes produces measurable results(eg, reduced levels of substance abuse).There are high levels of funding need in manysuch areas.

A second option is to fund more general supportprogrammes, which attempt to tackle a range ofissues including several risk factors (for example,family support that works in areas where poverty,substance abuse and domestic violence areprevalent). A broader approach may have lessclear results, but matches the reality of families’needs more clearly. However, government is themajor funder of much of this work, which oftenfalls under the broad heading of the childprotection system (discussed in Section 2).

33

Not seen and not heard The home

Table 3: Risk factors associated with child abuse

It may be moredifficult toaddress rootcauses, buteventually this iswhere thegreatest resultsare to be foundin the long-term.

Influences Factors

Sociological Cultural and social values

Racism

Social and educational resources

Legislation

Social systems for identifying and managing abuse

Social environment Poverty

Housing

Employment

Parental status

Social isolation

Stress

Family environment Parent/child interactions

Discord between carers

Child behaviour

Family history

Stress

Genetic Gender

Temperament of child

Disability or illness of child or parent

Biological Prematurity or low birth weight of child

Developmental delay of child

Aggression of parent or child

Substance misuse of parent

Psychological Developmental history (prior abuse or early separation)

Attachment between parents and child

Parental perceptions/expectations of child

Parental attributions of children’s behaviour

Parental empathy and self-esteem

Child management skills

Conflict resolution skills

The choice that donors make can be informedby whether they prefer to focus on treating adefined problem (ie, child abuse itself) and itssymptoms or to tackle root causes (ie, the riskfactors linked to abuse such as substanceabuse). Both areas of work are necessary. Itmay be more difficult to address root causes,but this is where the greatest results are to befound in the long term.

The rest of this section examines these twooptions in more detail.

In relation to the first, the number of potentialrisk factors is very large. NPC has focused onthose areas that, according to research, maybe influential in the context of child abuse:

• substance abuse;

• domestic violence;

• lack of empathy;

• harsh discipline;

• parental mental health;

• poverty; and

• lone- or teen-parenthood.

These risk factors have also been selectedhere because there are interesting charitiesoperating in the field that, crucially, workdirectly with children as well as adults. Awide range of existing and forthcoming NPCreports offer further information about many ofthe issues here and the charities tackling them.However, these organisations focus generallyon working with adults alone.

The final point donors should bear in mind isthat both approaches include preventative andreactive facets. In practice, a lot of existing

Efforts to endchild abusecompletely arehighly unlikely tosucceed unlessthey also tacklethese complexand interrelatedcauses.

provision in relation to child abuse tends to bedirected at families where problems havealready emerged; ie, it is reactive. But suchwork, reacting to known substance abuse, forexample, can prevent child abuse if substanceabuse is contributing to the occurrence ofchild abuse.

Figure 7 illustrates some of what we knowabout the overlap between different riskfactors and child abuse. It is illustrative only—the overlaps between all the different riskfactors cannot be represented accurately in asingle diagram. What it does indicate is thatthere is significant overlap between abuse andall of these factors.

126Efforts to end child

abuse completely are highly unlikely tosucceed unless they also tackle thesecomplex and interrelated causes.

Unfortunately, not enough data exists for us tobe able to see exactly how each of these riskfactors interrelates, and where activity couldbe most effectively focused. For example,work on substance abuse might be found tobe less effective than work tackling bothsubstance abuse and poverty at the sametime, if poverty is causally related to substanceabuse. Unless significant new research iscarried out, our knowledge of how to tacklethese complex causes is likely to emerge onlyslowly from the practical work of charities andstate-run programmes.

Substance abuseThe first area donors may wish to considerfunding is charities that tackle drug andalcohol abuse. Substance abuse has beenfound to be closely correlated with childabuse, and is therefore a compelling factor fordonors to address. For instance:

• Parents being incapacitated as a result ofsubstance abuse was the single biggestcause of neglect in the NSPCCprevalence study.

55

• One study of three London boroughs foundthat, in 60% of child protection casesknown to the authorities, parentalsubstance abuse was a key issue.

127

• In Scotland, the report of the ChildProtection Reform Team found that 40% ofcases in a sample taken from the childprotection register involved substanceabuse: ‘Health visitors or social workersfound parents incapable in the house whenthey visited and young children at risk fromfires or other household appliances. Someparents tried to protect their children fromknowledge of their drug use and frompossible harm by locking them in theirbedrooms for long periods of the day ornight. This solution created its own abusiveproblems, not least children urinating andsoiling in their bedrooms.’

86

34


Figure 7: Risk factors overlap with each other and with child abuse

Domestic violence is identified in 25–60% of cases of child abuse

Substance abuseis thought to be present in approximately 50% of cases of child abuse

Poverty is ‘strongly associated’ with child abuse

As many as 20% of children may be hit with an object: up to 35% experience ‘severe’ punishment

As many as 35% of child deaths involve parental mental illness

DOMESTIC VIOLENCE

MENTALHEALTH

LACK OF EMPATHY

HARSH DISCIPLINE

SINGLE OR TEEN-

PARENTHOODPOVERTY

SUBSTANCEABUSE

CHILDABUSE

and where there may be parental reluctance toengage with official agencies for fear ofchildren being removed. Children and youngpeople themselves often feel more able toaccess the support they need from a voluntaryorganisation.’

130

It should also be noted, however, that charitiesdelivering public services may not hold thesame privileged relationship with children andfamilies. If they are perceived as being part ofthe ‘system’, the same fears may apply tocharities and ‘official agencies’.

Practitioners speak of the difficulties substanceabusers have in accessing governmentservices. Parents in particular are often fearfulof contacting Social Services, so they try andcope alone, but cannot and reach crisispoint.

41At this point the child protection

process may kick in. The system is flawed ifparents can only get help once their child isregistered as a result of abuse.

28

The Scottish Executive’s response to HiddenHarm pledges support for charities, particularlyin terms of working in partnership withgovernment agencies, yet recognises few areengaged in this field.

35


How big a problem is parental substanceabuse for children in the UK? The availableevidence suggests it is a large one:

• For Class A drugs like heroin and crackcocaine, the official UK advisory bodyestimates in a major report, Hidden Harm,that 2–3% of the under-16 population inEngland and Wales is affected by problemparental use. Twice that percentage (4–6%)is affected in Scotland. This equates tobetween 250,000 and 350,000 childrenacross the UK.

128Drug abuse is predicted

to triple in the next twenty years.129

• Parental alcohol abuse is a morewidespread problem still. The charityTurning Point published a report this yearclaiming that 1.3 million children in the UKare living with parental alcohol abuse. InScotland alone, there are an estimated80,000 to 100,000 children affected, nearlytwice the number thought to be affected byparental substance abuse.

130

It is not always clearly recognised in publicdebate, but alcohol abuse can be as harmfulas drug abuse. Recent research by the Prioryclinic found that the development of childrenraised in alcoholic families is adverselyaffected, which in turn affects their ability toform relationships as adults and theiremployment prospects.

131

What are government and charities doing totackle substance abuse?

In relation to alcohol, the report by TurningPoint was part of a campaign aimed atgovernment, which demanded a nationalinquiry, the development of new services andsupport for those affected.

132

The issue has a higher profile in Scotland. Agreater proportion of children are thought tobe affected and change has been catalysed byhigh-profile deaths of children due to parentalsubstance abuse (see Box 14).

In relation to substance abuse generally,some action has been prompted by theAdvisory Council’s Hidden Harm report(mentioned above). The Scottish Executivepublished plans in 2006 to safeguard childrenof parents with a substance abuse problem.Proposals include ensuring that information onchildren with substance abusing parents isrecorded on the Scottish Drug MisuseDatabase, which records details of adultspresenting for treatment.

130

Importantly for donors, the report recognisesthe potential for charities to deliver support:

‘The voluntary sector is often very effective atreaching families where there is potential risk

Box 14: Child deaths related to substance abuse

There have been a number of deaths of young children and babies as a result of parentalsubstance abuse in recent years in Scotland. The deaths highlight the reactive natureof policy change, which is equally apparent in England and Wales.

Danielle Reid was murdered by her mother’s partner in 2002. The five-year-old girl hadbeen moved around by her mother, from Elgin to Dundee to Inverness. Despite pleasby the girl’s grandmother, who suspected neglect, the girl was never placed on the childprotection register and was able to drop out of school without alerting the authorities.Her mother was a heavy user of alcohol and amphetamines, as was her partner. WhenDanielle’s mother returned home to find her daughter heavily beaten but still alive, shefailed to call an ambulance. Instead, later on, her partner and his younger brother placedthe girl’s dead body in a bag, weighed it down with tiles and bricks and threw it intothe river. The body was recovered several months later when the younger brother admittedto a friend what had happened.33 Schools now have to report a child missing if they failto attend school with no explanation for ten days or more.

Eleven-week-old Caleb Ness died in hospital, following violent shaking by his father.The autopsy revealed fourteen rib fractures, thought to have occurred on at least threeseparate occasions. His father had sustained brain injuries a few months before Caleb’sbirth, so the court accepted diminished responsibility. The father had a history of substanceabuse and criminal convictions for serious assault. His mother was involved in prostitutionand had a heroin addiction. Although Caleb was placed on the child protection registersoon after his birth, the death was deemed avoidable as the baby was allowed to returnhome with the mother and it was well known that his father would be visiting often,although he was not actually living with the mother. No further decision or formal reviewof risk took place before the baby died.47 Following the inquiry, the First Minister announceda number of changes to the system, including £600,000 to train 300 social workers towork with children whose parents abuse drugs or alcohol.51

More recently, a review of the methadone programme has been announced in Scotlandfollowing the death of two-year-old Derek Doran. He died after drinking the heroin-substitute methadone in his home in East Lothian.52

2–3% of theunder-16population inEngland andWales isaffected byproblemparental use ofclass A drugs.Parental alcoholabuse is morewidespread still.

36


One exception to the rule, and an organisationthat donors might consider backing, isAberlour. It has worked with children ofsubstance abusing parents for many years inScotland. NPC visited one of its projects inDundee (Box 15). Aberlour convened a thinktank of experts to discuss parental substanceabuse in May 2006, to coincide with thepublication of the Scottish Executive’sresponse to Hidden Harm. It focused on thequestion, ‘what are the circumstances thatshould require the removal of children fromhome?’, and provides guiding principles forprofessionals that, it is hoped, will bereplicated in government guidance. Aberlour’sprojects are helping people kick theiraddictions, which keeps them focused on theirchildren. NPC has not yet identified similarwork in England, but will do so as part of itsforthcoming report on substance abuse.

The Scottish Executive has worked inpartnership with the Lloyds TSB Foundationfor Scotland and Atlantic Philanthropies in theUK since 2001 to fund charities working withchildren of substance abusing parents. ThePartnership Drugs Initiative (PDI) has fundeda number of projects, many of which havedifficulty in satisfying demand.

133

Domestic violenceA second key risk factor is domestic violence.*Like substance abuse, it is closely linked tochild abuse, so again presents a relativelyfocused approach for donors seeking to tackle

Box 15: Aberlour

Aberlour is a children’s charity that runs a number of childcare projects in Scotland. Ithas been working with families in which there is substance abuse for around 20 years.It currently runs two residential rehabilitation centres in Glasgow and one in Edinburgh,which house five to six families each at any one time. These services are not beingadvertised given the high levels of demand.

The charity also runs drug outreach services in Glasgow, Edinburgh and Dundee. NPCvisited one project in Dundee, a city with one of the highest levels of substance abusein Scotland. Half of the child protection registrations are thought to involve parentalsubstance abuse.28

The Aberlour Drug Outreach Team in Dundee has been running since 2001. It takes upto 30 families at any one time, and has worked with over 200 since it started. The projecthas strong links with health and social work teams from which referrals are also made.Around one in 20 referrals are self-referrals. These are prioritised by the team, as it indicatesmotivation is high.

The first step post-referral is to undertake an assessment of the motivation andcommitment of the parents, as well as the risk to the children, the children’s needs,and parenting capacity, which takes around six weeks. A care plan is then drawn up.It may offer parenting support, individual child support or family rehabilitation. The familyagrees what has to change, and then works towards that point with the support of theoutreach team. Research suggests that it takes on average 20 attempts before substanceabusers can kick their habit, so progress can be slow. The programme costs around£5,400 per family per year, which the charity has difficulty in fully funding.41 Around90% of the programme funding comes from government.

The project has linked up with Dundee Women’s Aid, as domestic violence is anothermajor issue facing those who use the service.

* Domestic violence is not confined to physical violence. It also covers ‘sexual, psychological or financial violence that takes place within an intimate or family-type relationship and that forms apattern of coercive and controlling behaviour.’

134

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the causes of abuse. The following figures areuncertain because much domestic violenceremains hidden, but give an indication of thescale of the problem:

• A study of nearly 2,000 child protectionreferrals across seven London boroughsfound 27% of cases involved domesticviolence. A study of child protection registercases that asked specific questions aboutdomestic violence discovered twice asmany cases by the end of the study as atthe beginning, uncovering domesticviolence in 59% of cases.

135

• One in 20 children is witness to frequentphysical violence between parents.

55

Domestic violence matters profoundly to thewelfare of children because it places them notonly at risk of immediate physical harm butalso threatens their development. The potentialdamage is worth spelling out, as the effectshave only relatively recently begun to seep intothe public consciousness. They include:

• Direct physical harm. Blows to a pregnantwoman are frequently aimed at her womb.Children may be harmed as they try tointervene in attacks, and they are oftenused by perpetrators to manipulate, controland abuse their partners.

• Parenting. Domestic violence affectsvictims’ self-esteem and emotions, to whichchildren are attuned. This can affect child-parent attachment and result in emotionaldamage for the child. Witnessing harm cancause serious trauma.

• Domestic violence can exacerbatechildren’s poverty and isolation. Not onlycan property and possessions be damagedin attacks, relationships with friends andfamily frequently suffer.

• Weaker child protection. Adults may bemore likely to withhold information for fearof the child being removed, or professionalsmay be less likely to visit, or visit lessfrequently, or avoid broaching sensitivesubjects, if the home is violent and abusive.Although partnerships between differentofficial agencies are improving, theseparation of services for children andadults, combined with a lack ofunderstanding of different perspectives,may hamper coordinated work with thewhole family.136

So how can children be protected? Despitethe government’s stated commitment totackling both child abuse and domesticviolence, actual practice does not alwaysreflect this high priority.

For instance, because of the stigma attachedto domestic violence, cases often only cometo light when specific questions about it areasked in child protection enquiries. However, itis not clear that such questions are alwaysasked. Domestic violence remains an electivemodule in the training of social workers.

137, 138

This is despite the change in the Adoption andChildren Act (2002) that extends the definitionof ‘harm’ to cover instances where a child has‘suffered from seeing or hearing the ill-treatment of another’. This came into force inearly 2005, and has obvious implications forfamilies where there is domestic violence. Todate, it seems to have led to little change.

25

In relation to what charities do, NPC’s report,Charity begins at home, recommends a rangeof organisations that make alternative provisionfor parents forced to leave where they live andthat also help abused parents and theirchildren stay in the home. This report will beupdated and extended in a forthcoming NPCpublication on violence against women.

The latter approach typically involves ‘individualadvocacy’—early stage legal and practicalsupport for abused parents to protect them fromtheir partner and to pursue convictions. This is agood approach for the abused partner becauseit potentially minimises disruption to her (mostvictims are female) life. And it is an attractiveoption for donors because it is highly cost-effective. However, it is not considered in detailhere because it tends to work exclusively withthe parent, and is well covered in NPC’s existingreport, Charity begins at home, as well as in theforthcoming report on violence against women.

37


Box 16: Talking to my mum

A scheme has been developed by the NSPCC and a handful of refuges, funded by theBig Lottery Fund and evaluated by the University of Warwick. It uses a mother and childactivity pack to help victims of domestic violence talk about their experiences andstrengthen the relationship with their child(ren). The programme was most effectivewhen the mother and children had had time to settle, away from the abusive situation.Often in abusive relationships, the mother is manipulated into putting the abusive partnerfirst, or she simply does not have the emotional stock required to fully attend to herchildren’s needs. Time away from the abusive relationship gives her the chance to re-priotise her child(ren). Women also need to recognise the effect of the abuse on theirchildren, which is a painful first step to make, arousing strong feelings of guilt.

Mothers reported that the scheme improved their relationship, while childrencommonly said that they liked the opportunity to spend time with mum.

‘You’ve got to learn to talk to your children. They are young people but they fullyunderstand. You’ve got to explain to them what’s going on. That’s what I’ve learnt fromJamie.’ (Jamie’s mum)39

The action research project has now come to an end, but the pack is available to buy(£20) and training is available (at cost) by the researchers who developed the package,based at the University of Warwick.42 There is great scope for applying this work, giventhe prevalence of domestic violence.

Domesticviolence mattersprofoundly to thewelfare ofchildren becauseit places themnot only at risk ofimmediatephysical harmbut alsothreatens theirdevelopment.

In practice, at the moment, most work directlyinvolving children comprises protecting themonce they have been forced to leave thehome, via the use of refuges. A refuge is asafe house which women and children whoare experiencing domestic violence canescape to. Some have children’s workers anda range of services for children. A keyprinciple is offering a confidential space forchildren in which they can work through thetrauma they have witnessed and experienced.This may take the form of therapeutic play,and may involve non-abusing parents andfamily if appropriate.

25

There are several reasons donors may wish toconsider supporting refuges:

• Children make up roughly two thirds of thepeople staying in them. According to thecharity Women’s Aid, just under 25,000children stayed in refuges in 2005.

• Children’s services in refuges are badlyunder-funded in England and Wales. Arecent study of London boroughs foundthat only six out of 33 projects have anygovernment funding for children’s work.Only one was fully funded.

25

• Some interesting programmes are beingdeveloped within refuges. One suchprogramme is challenging the ‘conspiracyof silence’, a common legacy of domesticviolence fostered by a history of secrecyand fear. Often both mother and child(ren)seek to protect each other by not talkingabout painful memories, yet talking canhelp speed recovery. Traditionally, fewservices address the joint relationshipbetween mother and child.

39Box 16

indicates a recently developed supportpack, Talking to my mum, that helpsmother and child discuss their experiences.This approach should be cheap and easyto implement in domestic violence projectsaround the UK.

A final area for donors to consider relates tothe fact that, depressingly, a large number of

women remain in abusive relationships, as dotheir children. Respect is a membershipcharity that has drawn up minimum standardsfor programmes working with perpetrators ofdomestic violence in the community. Furtheroptions for donors in this area will be looked atin NPC’s forthcoming report on violenceagainst women.

With the exception of educational resources(more detail on which is found in Section 6),NPC has come across very few specificallychild-focused preventative or early interventionservices that tackle negative attitudes towardswomen. One notable exception is theWomen’s Aid’s Hideout, an educationalwebsite for children that helps them explorewhether they or someone they know is avictim of domestic violence. For those who doidentify with domestic violence, it providespractical safety tips for children.

Lack of empathyHaving considered substance abuse anddomestic violence, donors can consider athird, rather different, kind of risk factor forabuse. Some charities and analysts argue thatlack of empathy is the crucial element sharedacross different kinds of abusive behaviour.

On this analysis, an emphasis on domesticviolence or drug use focuses on the externalmanifestations of parental behaviour. As such,it does not adequately address the internalpsychological factors that might lead people toabuse their children.

The main research focusing on this area in theUK was published by The WorldwideAlternatives to Violence (Wave) Trust, acharity, in 2005. It suggests that the realproblem (and best avenue for potentialintervention) is an individual’s propensityfor violence.

Its report recognises that there are externalfactors that influence violent behaviour—forexample, poverty and substance abuse—butmaintains that these are simply triggers.Rather, the real determinant is how likely anindividual is to be violent, a capacity often setin early childhood. As such, much of the workthat claims to be preventative misses thepoint, as it fails to tackle the root causes.

The report suggests that empathy is the singlegreatest inhibitor of an individual’s propensityto violence—that a parent is less likely toabuse his or her child if he or she has a well-developed sense of empathy that stops eventstriggering violent reactions. It also argues thatempathy is created by ‘attunement’ betweenthe child and its primary carer, up to the age ofthree. Children’s emotions develop in tune withtheir parents. Lack of attunement, whencoupled with harsh discipline, ‘is a recipe forviolent, antisocial offspring’.

61

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Box 17: First Steps in Parenting

Antenatal and postnatal classes traditionally focus on developing physical skills forcoping with birth and caring for a child and neglect the emotional and psychologicalneeds of new families. First Steps in Parenting addresses this gap by meeting the needsfamilies may have in the transition to parenthood. The course, available in a variety ofsettings around the UK, recognises that maintaining a healthy relationship betweenparents at this sensitive time is crucial, with the needs of fathers addressed in additionto those of mothers.

Each new family receives 35 hours of support, from pregnancy up to four months afterthe birth. Research has shown that, compared with parents who did not attend theprogramme, parents who attended classes were less anxious and vulnerable todepression, more child-centred in their attitudes and more satisfied with theirrelationships with both their baby and partner. The long-term effects on the childrenare less well documented.

Traditionally, fewdomesticviolence servicesaddress the jointrelationshipbetween motherand child.

The Wave Trust concludes that violence canbe stopped by ensuring that empathy inchildren is fostered. It researched andevaluated over 400 international projects thatreduce violence and child abuse. The projectswere rated on the strength of the evidenceproving that they reduced violence and childabuse or neglect, with programmes thatfostered empathy and attunement rated morehighly. Four projects stood out, one of which isFirst Steps in Parenting, based in the UK(see Box 17).

Some commentators argue that Wave’sfindings seem to ‘write off’ children who donot develop attunement with their parents(parents, particularly mothers, who may beunavailable for any number of reasons, frompost-natal depression to domestic violence).Wave would emphasise that the programmesit recommends are also effective with school-age children.

The approach may be interesting to donorsbecause of its commitment to identifying andtackling root causes. However, turning thetheory into action is not without its problems.Any results will be long term and difficult toattribute to the handful of methods suggestedby the Wave Trust.

The charity is calling on government toincrease its expenditure on early intervention,focusing on the programmes it picked out aseffective in fostering attunement and empathy.Of course the government’s Sure Start

programme (see Appendix 2) has alreadyprovided a massive increase in spending onearly intervention, but it does not workdirectly on fostering empathy. Its results havebeen mixed.

More daringly, the Wave Trust recommendspiloting the approaches suggested in one areaover time to monitor the effects. This would bea very ambitious and costly long-termprogramme, with early costings suggestingaround £2m each year. However, thepotential long-term savings would far outweighthese costs.

The charity has a growing band of enthusiasticadvocates, including a number of policeauthorities in both England and Scotland.

Donors interested in an ambitious yet riskyapproach might want to consider supportingthis organisation.

Harsh disciplineA fourth factor that donors could choose tofocus on, and one that can closely relate tohow some children develop empathy, isharsh discipline.

Nearly 40 years ago, it was noted that‘physical abuse was often discipline gone toofar’.

139Most charities and professionals today

subscribe to the view that:

• attitudes to and law on physicalpunishment can lead directly to the abuseof individual children; and

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Some charitiesand analystsargue that lackof empathy isthe crucialelement sharedacross differentkinds of abusivebehaviour.

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• attitudes and law reinforce a culture inwhich it is easier than it otherwise might befor abuse of children to occur and it is hardto get across messages of alternative,positive discipline.

Accordingly charities campaign for a ban oncorporal punishment. This is in opposition toprevailing public support for the law.

140

This is clearly a controversial area, and apolarised debate. On balance, NPC’s analysisagrees with the views of charities andprofessionals. Child abuse occurs on acontinuum, and while smacking may not beseen by all as a form of child abuse, it existson a spectrum along with more severe andserious ‘punishments’. Donors decidingwhether or not to support work in this area areencouraged to consider the evidence andmake up their own minds.

Several studies support the idea that physicalpunishment is over-used and can have harmfuleffects. A study that asked parents rather thanchildren (who may not remember early physicaldiscipline) found:

• The younger the child, the more likely theywere to be hit.

• Babies were particularly vulnerable; three infour babies (aged up to one year) had beensmacked by their mothers.

• Half of one year olds were smacked weeklyor more often by their parents.

• Around 20% of the children had been hitwith an implement, with just over one thirdhaving experienced ‘severe’ punishment.59

A recent literature review found that regularphysical punishment was associated with tennegative possible effects, such as aggressiontowards others. Only one positive was found:immediate compliance.

140

Another piece of the jigsaw that donors maywish to consider is that children’s perspectivesare rarely included in the debate. One reportinterviewed five- to seven-year-old children,who were clear that smacking hurt, with thevast majority believing it to be wrong.

141

Why are some reluctant to bancorporal punishment?Common criticisms of moves to crack downon physical punishment include:

• that the state should not meddle in howparents choose to bring up their children;

• fears that parents will be imprisoned forminor transgressions of the law;

• worries that children will be spoilt and/orbecome unmanageable and antisocialbeings (‘spare the rod and spoil thechild’);140 and

• that a ban could be unenforceable in practice.

A review of the evidence in countries that havebanned corporal punishment found that thesefears were largely unfounded.

140An often used

example is that of Sweden, which was the firstcountry to ban corporal punishment back in1979. The government there aimed to alterpublic attitudes alongside increasing earlyidentification of children at risk of abuse andpromoting earlier and more supportiveintervention to families. A Canadian academicreviewed the success of the programme in1999 using publicly available data, concludingthat the aims had been successfully met.‘Public support for corporal punishment hasdeclined, identification of children at risk hasincreased, child abuse mortality is rare,prosecution rates have remained steady, andsocial service intervention has becomeincreasingly supportive and preventative.’

142

It is important for donors to note that a causallink cannot be established between thelegislative change in 1979 and the differencenoted 20 years later. As the study notes, ‘thelaw’s implementation and the attitude shift thataccompanied it cannot be viewed in isolationfrom the social context in which it developed.’

142

It is also not clear whether a ban on corporalpunishment in the UK, if implemented with thesame aims and programmes as in Sweden,would produce the same results.

However, the available evidence doessuggest that attitudes and behaviour canchange and that altering the law can be partof that process.

It seems likely that the English and Scottishgovernments will remain under internationalpressure to ban corporal punishment as theyare signatories to the UN Convention on theRights of the Child, among other legislation,which requires the prohibition of all corporalpunishment, including in the family.

In the meantime, the Children areUnbeatable! Alliance, an alliance of some500 professional and charitable organisations,continues to monitor and campaign on thehuman rights issue of equal protection forchildren. Donors wishing to support charitieslobbying to change the law can help byfunding this charity.

Parental mental health problemsA fifth risk factor for child abuse is parentalmental health. Again, there is some evidenceshowing a relationship with child abuse.For instance, a study of child deaths in 1996by the Department of Health found that,in one third of cases, there were parentalmental health problems including psychosisand depression.

143

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Charitiescampaign for aban on corporalpunishment. Thisis in opposition toprevailing publicsupport for thelaw. Donorsdeciding whetheror not to supportwork in this areaare encouragedto consider theevidence andmake up theirown minds.

However, one should not conclude from thisthat the children of parents with mental healthproblems are automatically at great risk ofabuse. As with other risk factors, most parentswith mental health problems do not harm theirchildren. It does suggest, however, that therisk to the child must be carefully assessed.

Yet this rarely happens. A key problem inrelation to parents with mental health problemsand child abuse is that diagnostic and supportservices tend to focus either on children or onadults, but very rarely on both together.

In addition, experts have long recommendedthat a distinction be made between anassessment of the adult’s mental health andthe assessment of his or her parentingcapacity. This would preferably be undertakenby a child psychiatrist to ensure it was donefrom the child’s perspective.

143The diagnosis

on its own does not imply anything about theindividual’s parenting capacity; it is the parent’sbehaviour that is important.

144In practice,

however, this seldom happens.

What can donors do to help prevent abusethrough tackling mental health problems?

NPC’s report on adult mental health, Don’tmind me, identified Family WelfareAssociation’s Building Bridges project as aneffective way of bridging the gap betweenadult and child services. In ten centres acrossEngland, staff provide emotional and practicalsupport to help parents carry out theirparenting role. Most importantly, they alsosupport the healthy emotional development ofchildren. This can be through counselling orpractical help such as putting in place simpleroutines for breakfast in the morning, bath-time and bed-time.

124Its internal evaluations

show that 79% of parents demonstrate animprovement in their mental health and 50% ofparents experience less stress in parenting—allat a modest cost of £1,375 to service onefamily for a year. Donors could considerfunding this organisation to expand its work;NPC has come across no other charity offeringthis type of service.

Situational risk factorsThe final two risk factors that donors maywish to consider are about ongoing situationsthat parents find themselves in, rather thanspecific parental behaviour: poverty and lone-or teen-parenthood.

They differ from other factors that have beendiscussed here because, although they appearto be correlated with incidence of child abuse,the relationship is weaker than with directlycausal factors such as domestic violence orsubstance abuse. Relative to, say, families inwhich there is domestic violence, only a smallsubset of parents living in poverty, or loneparents, will abuse their children.

PovertyAt the beginning of NPC’s research into childabuse, data showed that one in four childrenin the UK is poor. Recently released figuresshow that, while child poverty has been fallingin recent years, it rose again by 100,000 in2005/2006.

145This is despite the government’s

commitment to reducing child poverty, and taxcredits designed to do exactly that. Thisstatistic is based on a standard measure ofpoverty: that of relative income. It judges thosehouseholds on 60% or less of the medianhousehold income to be poor.

146

Some people are sceptical of notions ofrelative poverty, arguing that in absolute termsmost children are well off. But surveys suggestchildren in families on low incomes aredeprived of essential things. A survey in 1999by the Joseph Rowntree Foundation foundone third of children went without at least oneof the things they needed as a result ofpoverty: three meals a day, toys, out of schoolactivities or adequate clothing. One in fivechildren went without two or more items oractivities defined as necessities by the majorityof people.

147

Poverty is clearly partly a relative concept.Parents and children without enough incometo enjoy the possessions and activities normalto the people they interact with (at school orwork, on TV or in their local area) feel unhappy,isolated and powerless. Evidence suggeststhat they suffer psychological anddevelopmental consequences arising from lowstatus, including low skills, ill health and riskybehaviour. It is perhaps not surprising,therefore, that there is a correlation betweenpoverty and neglect, and poverty and certaintypes of physical abuse.

‘Whilst most poor parents do not maltreat theirchildren, poverty is nonetheless stronglyassociated with maltreatment. Prevention ofchild abuse and neglect therefore requireseconomic and social reforms which target theroot causes of poverty.’74

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A key problemin relation toparents withmental healthproblems andchild abuse isthat servicestend to focuseither onchildren or onadults, but veryrarely on bothtogether.

Parents and their children at a Family Welfare Association service

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It could be that poor families are over-represented in certain types of abuse becauseof high levels of social isolation.

74More than

two fifths of families accessing family centres,which most commonly offer support tofamilies known to social services (see later inthis section), had no support from friendsor family.

148

It could also be that poverty is closelyassociated with child abuse because it is acausal factor underlying several of the otherrisk factors mentioned earlier. There arecorrelations, for example, between poverty andsubstance abuse, and poverty and domesticviolence.

126We should not be surprised,

therefore, to see a correlation between povertyand child abuse, even if direct causalmechanisms cannot be discovered.

Support networks are vital in all fields of socialwelfare. People seeking advice or supporttypically look first to friends, family andneighbours. Only when support from thesesources is insufficient or unavailable do peopletend to look for further support, frominstitutions like charities rather than fromindividuals. Support networks are alsoimportant to lone- and teenage-parent families(see below).

Since 1997, the government has publiclystated many times its commitment to tacklingchild poverty. Tony Blair announced in 1999that the government was committed tohalving child poverty by 2010 and abolishing it(since defined as reducing it to 5–10%) by2020. While some progress was made initially,it is clear from the latest figures that thesetargets (certainly the 2010 target) are unlikelyto be met.

Barnardo’s Chief Executive, Martin Narey,called the recent increase in child poverty a‘moral disgrace’ and claimed that thegovernment ‘intended, not to halve childpoverty by 2010, but to reduce it a bit.’149

In addition, commentators have questionedwhether policies that have succeeded so far,such as moving parents from welfare intowork, are sufficient for the very poorest.

146This

is reflected in the data. The poorest 10% ofchildren have seen their families’ incomesdecline in absolute terms since 1999. Despitebillions being spent on tax credits, they havebecome absolutely poorer. The reasons for thisare unclear but may include low incomesamong self-employed people.

Donors interested in supporting charities totackle abuse through reducing poverty cangive money to organisations that work directlywith children, or fund lobbying work toencourage government to continue andimprove its efforts.

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Campaigning organisations such as the ChildPoverty Action Group and the campaign toEnd Child Poverty have struggled to attractfunding since the government announced itsintention to eradicate child poverty. However,their efforts may still be needed. A number ofcharities, such as Barnardo’s, both lobbygovernment and work directly with children.Reducing poverty, in all its forms, should havea knock-on effect on rates of child abuse.

Lone- or teenage-parent familiesThe final risk factor that donors may wish toconsider focusing on is lone- or teenage-parent families.

Lone parents are over-represented in cases ofall types of abuse and neglect. One studyfound lone parents, predominantly mothers,more likely to have:

• moved three or more times in the past fiveyears, suggesting breaks in supportnetworks; and

• experienced violence, both as an adult andas a child.12

Parents whose first child had been born whenthey were a teenager were much more likely tohave conflicting or unsupportive familyrelationships, along with higher stress levelsand health problems.

12

Researchers suggest that the link betweenlone-parent families and child abuse is due tohigher levels of stress and poverty in thosefamilies. It could also be that lone-parentfamilies are more exposed to ‘statesurveillance’, and therefore abuse is morereadily picked up in such families.

7

There are charities that work with lone parentsto help them cope. In practice, however, manyof them offer general family support of the kindexamined in the next section. That is becauselone parents are often on low incomes and aremore likely than two-parent households to bein touch with the child protection system.

Family supportAt the start of this section, two possibleapproaches to tackling abuse in the homewere put forward. Thus far, charities deliveringprogrammes that tackle single factors havebeen highlighted. The alternative approach ismore general family support. This includesfunding family centres and lobbying for thewider use of techniques like family groupconferencing (see below for more detail). Suchwork will be less focused on particularproblems and more focused on promotinggood parenting. There are several advantagesfor donors of funding general family support:

Most authorsconclude thatfamily supportcan improveparents’resilience tostressors andability to counterthem, even ifexternal stresscannot all beremoved.

Internal evaluation of theNSPCC’s parenting andfamily support services12

ʻ

ʻ

• It tends to approach family life as a wholeso is, in theory at least, effective at seeingthe links between different problems.

• It can help reduce stress factors withinfamilies even where environmental factorslike those discussed above cannot besolved. This reduces the risk of childrenbeing abused.

• Family support can improve the ‘resilience’of parents as well as children.

12

• Schemes are often very localised for donorswho want to fund something in a particulargeographic area.

• Innovative approaches like family groupconferencing present an excitingopportunity for donors to create change inthe system (see below).

Alongside these advantages, there areimportant structural features of the familysupport sector that may make it lesscompelling for donors.

In particular:

• Much family support work is currentlydriven by central or local governmentfunding. Family centres, for instance, mightbe run by charities but would usually getsome or all of their funding from localauthorities or central government in returnfor fulfilling contractual obligations. This alsomeans that centres are likely to suffer fromthe flaws and biases of the governmentsystem that funds them.

• Linked to the above, family centres are ingeneral less under-funded than other areasof charities’ work around child abuse.

Parenting will be covered in depth in a futureNPC report. Here, we highlight a range ofactivities that aim to reduce both the risk ofharm to children and the incidence of abuse.We also suggest some questions donorsshould ask charities before funding familysupport schemes.

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What is available to families under stress?

As suggested above, the starting point fordonors is that there is already a lot of work outthere. The most recent mapping exercise offamily services available, from 2001, foundmost were focused on the under-fives. It alsofound that 40% of services were less thanfive years old, perhaps reflecting theirprioritisation by the 1997 Labour government(see Appendix 2 on the government’s SureStart programme).

Family centresFamily centres are run by charities, the privatesector or local authorities, to provide a broadrange of services. They are mainly funded bylocal or national government. There are threemain models employed by such centres:

• Community development model. Accessibleto all local people, often actively engagingthem. This may take the form of havingparents on the board.

• Neighbourhood model. Attended by amix of families who attend voluntarily andthose referred by professionals due toidentified problems.

• Client-focused model. Staffed by specialistswho primarily see referred families.82

The academic who categorised the threemodels pointed to some potential advantagesof the first model, which requires‘neighbourhoods composed of residents whotake upon themselves the responsibilities andpower to promote a locality that cares for itsown, helped by statutory services which existfor the sake of the residents’.

82NPC believes

that all three models have their ownadvantages, but agrees that, in theory at least,it would seem that a community model couldencourage earlier self-referral and be moreresponsive to local need. It would also,however, require greater commitment from thelocal community. These issues are explored inmore detail in NPC’s report on localcommunity organisations, Local actionchanging lives. Nevertheless, there is room inthe sector for all three approaches.

A study of over 400 family centres in 2001found that most centres followed the secondor third model described above. The majoritydescribed themselves as open access,working to prevent, intervene early and reactto family problems, but in reality three out offive were closed access, with most of theirreferrals coming from social services andrelating to children in need or child protectionreferrals. Only one third took referrals fromfamilies themselves, while another third tookreferrals exclusively from social services.Despite the fact that the latter route is morestigmatising and reflects a later rather thanearlier intervention, ‘the push was towardsmore specialisation and services to familieswith intractable problems.’

148

The growth of Sure Start since that study wasundertaken is likely to have changed thelandscape (see Appendix 2). Sure Start wasclearly based on the community developmentmodel outlined above. It has since shiftedaway from being community-led, and centresare beginning to look like the neighbourhoodmodel. They may move further over to theclient-focused model as a recent report foundthat Sure Start is still not reaching the mostdisadvantaged, who are over-represented onchild protection registers.

An internal evaluation of the NSPCC’s ownmodel for family centres—Quality Parentingand Family Support—would suggest thatthey have managed to remain open access yetfocused on families where there are quiteconsiderable problems (see Box 18).

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Box 18: NSPCC’s Quality Parenting and Family Support (QPFS)

QPFS programmes are a core part of the NSPCC’s preventative work. There are around40 family and children’s centres run by the NSPCC, offering a wide range of services,including drop-in, one-to-one counselling or advice, home visits, group work, coursesand outings.12

NPC visited a family centre in Leeds, a city where the NSPCC has worked for many years.The charity’s strategic review in the late 1990s shifted focus away from risk assessmentsand to more preventative work. Around this time, the Leeds branch moved out of the citycentre to the suburb of Bramley, where it set up a Quality Parenting and Family Supportcentre. The centre delivers a range of projects, many developed in response to local need.When NPC visited in March 2006, the centre was contracted by the local authority to deliverrehabilitation work for foster children who were about to return to their birth families. Italso ran a post-natal depression group; a group for women and children who haveexperienced domestic violence; and parenting skills classes. The centre worked closelywith other children’s services, notably police, as the centre has a special video recordingsuite in which children can give evidence rather than go to court (see Box 11). The suitewas also used to record parents to help them develop their parenting skills.

A 2005 evaluation of 18 NSPCC family support projects, covering some 1,225 families,found that nearly 70% of service users self-referred. This would suggest that servicesare fulfilling their early intervention brief, rather than simply receiving referrals fromsocial services, once problems have escalated. Most of those who approached the service(mainly single mothers) wanted help because of relationship difficulties with other adultsin the family, but health problems, practical difficulties related to childcare and housingand problems with children also featured. Many experienced abuse either as a child oras an adult, or both.12

The behaviour and well-being of children was monitored using the Goodman Strengthsand Difficulties Questionnaire (SDQ), a relatively easy and practical assessment tool toimplement, yet used by only a handful of charities. At initial assessment, the evaluationfound that the behavioural difficulties of children attending the family centres were twoto three times the frequency found in disadvantaged communities, suggesting the projectwas being accessed by those who needed it most.

After a year, interviews found that around half of parents were measurably less stressed.The evaluation acknowledges the difficulty of attributing change directly to the QPFSprogramme, but parents believed the service had made the difference. Around 50% ofthose in the original monitoring exercise were no longer accessing the service so couldnot be interviewed; what happened to these families is unknown. Nearly one third ofchildren whose original SDQ scores placed them above the threshold for clinical helpwere no longer a cause for concern. Over half had improved their score.12

The stigma ofasking for helpas a parent actsas a barrier toaccessingsupport. Yetfamily supportplays a crucialrole in childprotection.

The major advantage of family centres fordonors is that they are often highly localised sopresent an opportunity to ‘give somethingback’. A potential disadvantage, however, isthat, relative to other areas of need, familycentres are relatively well funded. Few thatNPC has come across rely exclusively ormainly on private donors.

Family group conferencingAn alternative option for donors is to supportthe wider use of Family Group Conferencing(FGC) by local authorities in Scotland,something being championed by the charityCHILDREN 1st. FGC is a tool used when thereis a family crisis. It looks beyond theimmediate family (parents) to wider, safesupport networks, whether relatives, friends orcommunity members, in an attempt to avoidchildren being taken into care. FGC may beused when social workers have to decide whatshould happen to the children in a family whenthere is a serious child protection concern.

Placing children in care, although only anoption if the child is at serious risk of harm, isboth expensive and leads to poor long-termresults for children and young people. Enablingchildren to stay within the family safely is bothmore cost-effective and leads to betteroutcomes for children. The family groupconferencing model was developed in NewZealand, and has now been adopted acrossthe country. The number of children beingplaced in care in New Zealand has droppedby 70%.

FGC differs from traditional child protectionpractice in a number of ways:

• The focus is on collaboration andpartnership. It recognises that familymembers are experts on themselves, ratherthan child protection professionals beingthe expert on them.

• Positive relationships and family strengthsare emphasised, rather than problemsand deficits.

• We have seen that the system leans heavilyon mothers. FGC looks at the widernetwork—relatives, friends or communitymembers, who may have a strong role toplay in safeguarding children.

• Families involved in the child protectionprocess have little say over what happensand how. The resulting feelings ofpowerlessness can detract from themtaking responsibility. By allowing time andspace for parents to participate more in theprocess, reaching an understanding ofwhat works for that particular family ismore likely.

150

Not only are children less likely to be taken intocare, families (including children) are morelikely to report satisfaction and agreement withthe outcomes of the process for the child thanwith other forms of child protection. Involvingthe wider network erodes the secrecy that sooften surrounds abuse. When people knowthat a child is at risk, they are more likely to actto safeguard them.

More importantly, there is evidence to suggestthat children are better protected as a result ofFGC than other forms of child protectionpractice. In one study, the approach wasjudged by social workers to work better in twothirds of cases, and as well in the final third.The same study found that re-abuse rateswere around one third reduced for families thathad used FGC. These positive results aresustained; another study found that four out offive professionals thought FGC child protectionplans were successful two years on.

150

From 1999–2005, CHILDREN 1st delivered 350FGCs. An audit of these found feedback fromall of those involved to be overwhelminglypositive.

151The charity has developed from its

practice-evidence base, and is trying to raisethe profile of FGC across Scotland. To date,the work is being delivered in partnership with12 local councils.

Supporting the implementation of FGC bybacking CHILDREN 1st is one clear option fordonors who wish to try and improve the childprotection system. FGC is not unique toScotland, but CHILDREN 1st is the only charityNPC has come across that is clearly focusedon promoting the uptake of the programmeamong local authorities.

FGC seems to be developing on a more adhoc basis in England, but the consultationresponse to the government’s Green Paper onchildren in care (see Section 4) highlightedwidespread support for its greater use. Onerespondent commented:

‘Social services should ask every single personin my family if they could look after me butthey only asked my Nan and it really p***edme off.’152

Studies of the effectiveness of FGC aregenerally positive and it has the potential toovercome some of the problems dogging thechild protection system, such as therecurrence of abuse once children are knownto the authorities, and the pressure onmothers. As the model is culturally sensitive(it was developed in New Zealand with Maoripeople), it has been suggested that it maybe even more useful for black and minorityethnic groups, although this has not beentested to date.

109, 153

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Family groupconferencing inNew Zealandhas reduced thenumber ofchildren beingplaced in careby 70%.

How effective is family support?Frustratingly for donors, there is a lack ofevidence on results for children and familiesreceiving family support. The body of evidenceis growing, but there are difficulties intransferring what seems to work in clinicalstudies to practice in the community. Isolatingthe few features that make the difference outof the many is also very difficult. There is littleevidence as to what does not work either,which is just as valuable in terms of learning.

The frustrating lack of clarity regarding effectivefamily support services was noted in thegovernment’s Green Paper, Care Matters:Transforming the Lives of Children and YoungPeople in Care. In it, the government proposesa national centre of excellence in children’sand family services that would ‘deliver asystematic approach to sharing best practiceacross children’s services’.

127Specifically, the

centre would:

• ‘Gather and review emerging research […]both nationally and internationally, maintaina database of effective practice, andcommission new research in key areas;

• disseminate the knowledge it obtains tocommissioners to ensure that they are ableto focus resources on programmes andpractice with a track record ofeffectiveness; and

• disseminate knowledge to practitioners tobuild evidence-based practice which isresponsive to the needs of and improvesoutcomes for children and families.’127

The development of such a centre ofexcellence would be a very welcome step.

At present, where results are measured, whatis measured is the work with parents. This isbecause the majority of family support work isfocused on parents, as an indirect way ofsupporting children. Where possible, theresults for the child should be measured, asthe aim of working with the parents is usuallyto improve results for the child. Although thereare ethical issues raised by involving children inevaluation (methods may be intrusive orinappropriate), there are ways of measuringchildren’s resilience (see Box 18—theGoodman Strengths and DifficultiesQuestionnaire). Generally speaking, however,the views of children ‘are curiously missing inresearch on family support’.

10

Should donors fundfamily support?There are hundreds of family support centresin the UK, which engage with their clients in aseemingly inexhaustible variety of ways. Manyreceive some funding from local governmentsources, but top up their funds with supportfrom grant making trusts or local donations.

If donors are interested in supporting their localfamily support services, they should thinkabout the following issues:

• What is the service doing to try andmeasure the results of its work? Is theprogress of children monitored?

• Is the service easily accessible to localpeople? Are they involved in developingand delivering services?

• What services are available for particulargroups in the local community, for example,non-abusing fathers, children withdisabilities, traveller groups, black andminority ethnic groups?

• How fairly are centres funded by localauthorities? If they are able to charge the fullcost of their services (including fairproportions of the charity’s overheads anddevelopment costs), there may not be aclear role for private donors to support them.If they are unable to recoup the full costs oftheir services, it could be argued that privatedonors should not have to subsidise what isessentially a public service.

Given the paucity of information on results, it isdifficult to compare services. Even comparingthe results of public services with charities isnot really possible. Given the number of issuesfaced by most families involved in the childprotection system, a number of organisationswill be involved. Attributing results to anyindividual organisation’s work is difficult.

The overwhelming message in favour ofcharities, however, is that they are moreapproachable than government services. Asmentioned previously, this must be balancedagainst services’ ability to challenge and reallycreate change in families.

The reality of this will of course vary from areato area and service to service, but the valuethat independent services bring should not beunderestimated. The majority of abuse is notreported; any service that enables people toask for help should be encouraged.

46


The majority ofabuse is notreported; anyservice thatenables peopleto ask for helpshould beencouraged.

[The views ofchildren] arecuriouslymissing inresearch onfamily support.

Department for Educationand Skils10

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ConclusionsThis section has taken the reader through awide range of approaches that charities taketo tackling abuse in the home. Theseapproaches fall into two groups, eitherfocusing on specific risk factors (such asdomestic violence) or on general support forfamilies facing problems.

We have seen how the complex array ofproblems that can face children and familiesoverlap, interact and together can becontributing factors that cause child abuse.This makes tackling them difficult. Workfocusing on just one factor (eg, substanceabuse) may tackle that effectively, but may failto reduce the incidence of child abuse unlessit also tackles other contributing factors.

There is, therefore, a tension for donorsbetween focusing on specifics (and tacklingthem well but not guaranteeing impact onchild abuse) and casting a wider net(providing general family support that can dealwith abuse but not tackle the underlyingcausal factors).

We have also seen that the role for privatefunding may be more limited in general familysupport than it is in tackling the risk factorscontributing to abuse, because this is thefocus of large government programmes suchas Sure Start, and the target of much ofgovernment funding in this area.

Prioritising fundingIt is beyond the scope of this report to providedonors with specific recommendations forwork tackling these risk factors. This is notbecause the areas are not important; in factthe opposite is true. But these are all broadareas that require detailed researchthemselves. Donors interested in tackling therisk factors underlying abuse should refer toNPC’s forthcoming reports on violence againstwomen and substance abuse in particular, andto Don’t mind me, NPC’s report on mentalhealth. These cover the issues in-depth, andoffer a number of funding options forinterested donors.

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4Away from homeChildren who have been abused are morelikely to fall victim to further abuse. Theycan end up running away from home, beingremoved from home, or being forced toleave. Children may leave home for otherreasons, but once they have left, they areat high risk of abuse. These are some ofsociety’s most vulnerable children.

In the longer term, these children risk theworst forms of social exclusion: fromsubstance abuse to homelessness andprison. Charities are at the forefront ofworking with these children, yet they sufferfrom a serious lack of funding.

This section looks at children who have runaway from home; those at risk of sexualexploitation; children in local authority care(known as ‘looked after children’); refugee andasylum-seeking children; and children in penalcustody. Many of these children are largelyinvisible to society, and their abuse does notreceive the same level of attention given toother abused children. In fact, without theefforts of charities, we would know next tonothing about the problems they face. Theirrelative lack of visibility may be because theyare usually older (in their teens) and thereforeare less likely to be the subject of interventionby the state, or serious case reviews thatoccur in the case of child deaths (primarilyhappening to very young children). They are,however, at risk of serious harm.

This section focuses mainly on runaways andchildren who are sexually exploited. Lookedafter children will be the subject of a futureNPC report, as will young offenders, whileNPC’s recent report, A long way to go,provides a guide for donors interested insupporting child refugees and asylum seekers.

Options for donorsThere are a number of compelling reasons whydonors may choose to fund charities workingin this area:

• Donors can help charities to offer a vitalsafety net to some of the most vulnerableand neglected children in the UK.

• This is an under-funded area, and donorscan therefore make a significant impact.

• The children affected tend to be older thanthose who face abuse in the home, anddonors may have a particular interest infunding work with this age group.

Charities play a unique role in working withthese children, as they are much more likely tobe able to reach out to them and win theirtrust than statutory agencies.

If donors are interested in funding work in thisarea, some of their main options include:

• helping children on return after runningaway to their parents or carers, throughwork with children and with parents andcarers;

• refuges and emergency accommodation toprovide a safe place to stay, and support toreduce the risk of running away again;

• outreach work to identify children at riskand engage them in support, through thesmall number of existing ‘streetwork’ teamsin the UK; and

• research and campaigning to raiseawareness of the risks these childrenface and political/social will to tacklethe problem.

These options are explored in more detail inthe rest of this section, which concludes with asummary of the results of working to protectchildren from abuse away from the home, andan outline of how donors may think aboutprioritising their funding.

RunawaysRunning away is included in this report as it isboth a potential cause and a potential effect ofabuse. According to an analysis of calls toChildLine, around one third of boys and twothirds of girls who called about running awayor being homeless also spoke of beingphysically or sexually abused.

154

Much of what we know about runawayscomes from research by The Children’sSociety, a charity widely recognised as theleading expert on the problem. Its 1999 report,Still Running, was the first to map the scale ofthe problem in the UK. It reported that over100,000 children run away overnight eachyear. More than three quarters do so for thefirst time.

155This means that around one in 10

children in the UK run away overnight at leastonce before they reach 16.

155, 156

One quarter of runaways first begin runningaway before the age of 11.

156Those under the

age of 11 are most likely to be running awayfrom physical abuse, and are the most likely tobecome repeat runaways. Girls are more likely

48

to run away than boys. Young people in careare particularly over-represented, especiallythose in residential care. Children withlearning difficulties are more likely to run away,as are gay and lesbian children. There arehigher rates of runaways in lone parent andstepfamilies.

Why do children run away?Running away from home is a last option, asign of desperation. A survey of children whohad run away from care found that most didso because they were unhappy.

157Running

away is associated with problems in the home,or at school, and is linked to offending andsubstance abuse.

158

Some children choose to run away, but anestimated one in 50 children in the UK areforced to leave home before the age of 16.

155

There are particular gaps in provision for thoseforced to leave home. They are unlikely to bereported missing, and are therefore unlikely toreceive services, because nearly two thirds ofyoung people referred to runaway projectscome through police missing person reports.

156

What happens to runaways?Running away is rarely a positive choice. Manyrunaways end up at greater risk of harm. Onein six overnight runaways ends up sleepingrough.

156One in seven is hurt or harmed while

away.158

Almost one in nine is sexuallyassaulted.

21

Running away places children at risk of abuse,homelessness and sexual exploitation.

158In

fact, the problem remains largely hidden.Runaways are a diverse group and aredifficult to spot. As many are not reportedmissing they are unlikely to come to theattention of the authorities charged withsafeguarding children.

159

What services are offered to a runaway childlargely depends on where that child lives. Intheory, a child who runs away should bereported missing, at which point the policetake up the search. When the child is found,he or she is taken back to their parents orcarers. Even if the child returns of his or herown accord, the police must undertake a‘safe and well’ check. But an estimated twothirds of overnight runaways are notreported missing.

156

The Children’s Society report, Still Running,was followed by an investigation by thegovernment’s now defunct Social ExclusionUnit. Its recommendations were published in2002, alongside Department of Healthguidance stipulating that local authorities must(among other things):

• set up cross-agency protocols for dealingwith runaways;

• conduct an assessment of the needs ofrunaways in the area; and

• ensure that cases where missing childrenreturn are followed up with enquiries bythe police.

160

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Not seen and not heard Away from home

No one takestime to listen.You’re trying toexplainsomething tothem and all ofa sudden theywalk away anddon’t take thetime to listen.

Young runaway5

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It also made clear that children should haveaccess to an independent interviewer (forexample, a charity worker) to ensure the childis able to get his or her story across to makedoubly sure there are no child protectionissues. As seen previously, very few childrendisclose abuse themselves. At the same time,charities are seen as more approachable,therefore this guidance is welcome. But it isnot clear how many children have anindependent interview.

The Children’s Society, as part of its Safeand Sound campaign, is monitoring localauthorities on their implementation ofgovernment guidance. By the beginning of2007, 90 out of the 150 local authorities wereimplementing basic government guidance, upfrom fewer than one in twenty in 2004.

21, 161To

help local authorities, the charity has launcheda Safe and Sound Task Force, offering everylocal authority access to training, support andconsultancy, in addition to learning seminarsand groups, and research and evaluation.

This sustained pressure is critical, as numbersof runaways have hardly changed since 1999,when Still Running was published. TheChildren’s Society repeated the research in2005, finding that 100,000 children still runaway each year and that the needs remainthe same.

156

Perhaps change is slow in coming becausethe issue remains low on the public agenda.Although overall numbers are large, thenumber of runaways in any one local authorityis relatively small, and, as discussed in theprevious section, children’s services are busywith abuse identified in the home.

Tackling runaways can save money, however.Although numbers in any one local authorityare small, expenditure on runaways is high.When the Lancashire police authority analysedits missing person investigations over one year,it found that half of the 6,200 missing personinvestigations concerned repeat runaways(with individuals running away up to 70 timeseach year). Each local authority care home intheir area reported up to 200 cases. Thepolice service estimated chasing up referralscost around £1,000 per case. Its study alsohighlighted the complexity of the lives of repeatrunaways; a study of six children’s policerecords found that between them they had201 missing persons investigations, 78 arrests,60 offences and nine recorded cases of beingthe victim of violent crime. Offences involveddrugs, prostitution and firearms.

162And these

are only the cases known to and recordedby police.

When the burden of runaways falls on thepolice like this, the expenditure is largelywasted. The police are not solely responsiblefor runaways, nor can the service they offer beexpected to tackle the underlying problemsand stop children from running away again.Other agencies have a role to play in:

• preventing children running away in thefirst place;

• helping them when they are away fromhome; and

• helping them upon return to their parentsor carers.

There remains a clear need for specialistservices, many of which have been developedby charities. Having said this, The Children’sSociety believes there to be only 21 (typicallysmall) charities working in this area across theUK. Many work on a local basis, yet there arenearly 200 local authorities around the UK.

PreventionGiven the links with child abuse, strategies thataim to prevent child abuse should indirectlyhave an effect on those children who run awayas a result of abuse.

Ideally, children should never be in a positionwhere they feel that running away is their onlychoice. The ‘confidential spaces’ mentionedpreviously are used by children to explore theirfears, worries and options. Such services mayprovide sufficient support to prevent problemsfrom escalating to the point that children runaway in the first place.

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Box 19: Alternative Solutions to Running Away (ASTRA)

ASTRA began in Gloucestershire after the police realised that 650 young people hadbeen reported missing over two years, 50% of whom were repeat runaways. Theprogramme has been running since 1997, funded by youth and social services, thepolice and the charity The Railway Children. The initiative has a steering group madeup of a number of local children’s services, with protocols established with social servicesand police. It is routinely held up as a model of good practice, but to date the projecthas not been replicated elsewhere.29

One project coordinator supports two full-time and two part-time support workers. Theseworkers support whole families, to improve relationships between young people andtheir carers so that children can remain in the home or, if this is not possible, developand maintain the child-parent relationship. Meetings are weekly, lasting one to twohours, with telephone support available in times of crisis. The family receives supportfor as long as is deemed necessary. Workers have found that exploring parents’ ownupbringing and parenting skills is vital. Around 50% of the work is parenting advice,such as understanding young people’s stages of development and developing differentparenting strategies to deal with conflict. The scheme is flexible, dealing with eachfamily as a unique case, but negotiation and mediation often form the bedrock of theprogramme.

Evidence of change is anecdotal, and comes from the family support worker. A 2003evaluation found that, out of 14 cases, six had changed for the better, in terms of parentingskills, relationships, or help from other agencies. In a further four cases, there wasevidence of some positive change. Two had deteriorated, although not noticeably asa result of the programme. Positive change only occurred where there was no currentabuse or violence in the home, and did not happen where relationships had brokendown.45 Local police estimate that the scheme has resulted in a two thirds reductionin running away, and that the rate of arrests among runaways has reduced by 21%.49

If abuse as a result of running away is to bestopped, it is vital that children should beidentified quickly, and safeguarded. This maybe through helping them return to their parentsor carers.

Helping children on return totheir parents or carersRunning away is a symptom of otherproblems. It is therefore a clear signal thatsomething is wrong, presenting an opportunityto intervene, for good. If the underlyingproblems are not tackled, the child may runaway again. Individual local authorities aredeveloping protocols between police andsocial services to try and prevent children frombecoming repeat runaways. Working togetherin this way is crucial, and is the cornerstone ofthe Every Child Matters agenda. As such,ongoing reform should help increase theidentification and protection of runaways.

Yet there are no clear performance indicatorsfor runaways, either for the police or otherservices. In Lancashire, the realisation of thefinancial burden on the police force of repeatrunaways acted as a catalyst for improvement.The police authority adopted a ‘three strikesand you’re in’ approach. Three investigationsmeant that children would be tracked andmanaged, in partnership with the localchildren’s homes, which were found to be theroot of much of the problem. Reward schemeswere introduced, and independent interviewswith the young people were conducted beforethey were returned.

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The system has resulted in a one thirdreduction in running away incidents, hopefullyan indication of improved care for the childrenconcerned. The police force estimates theprogramme has saved it £583,000 ininvestigating cases.

163

Box 19 contains a further example of asuccessful scheme that is reducing numbersof runaways. ASTRA, based inGloucestershire, also developed as a result ofa local police force realising how much time itwas spending on dealing with (repeat)runaways. ASTRA is a local authority-runprogramme, as is the Lancashire project, butmany of the others that are held up as goodpractice are run by charities. The SocialExclusion Unit report in 2002 led to 27 pilotprojects run between 2003 and 2004, 19 ofwhich were evaluated by The Children’sSociety. Eleven of the projects were run bycharities. A further four were partnershipsbetween charities and social services. Theselatter projects were funded for one year by theDfES, and on a small scale (typically coveringthe costs of one worker).

159

Many were relatively short-term crisisintervention work, involving taking referralsprimarily from police and working normal office

hours. Over 250 cases became ongoing cases,which represents around one in five of the initialreferrals. The work consisted of face-to-faceand telephone contact, mostly with the youngperson in question but also with those aroundhim or her, such as carers and other agencies.Here, as elsewhere in work with young people,many involved in the evaluation felt ‘perceivedindependence from statutory services was animportant ingredient in engaging successfullywith young runaways.’

159

Overall, the projects were felt to have achievedpositive change in 42% of cases. They weremore successful with children who were first-time runaways. They were less successful withthose who had stayed away withoutpermission. The projects had fewer referralsfrom children who had been thrown out, asthese children were rarely reported missing. Inaddition, achieving significant change with thisgroup of children was extremely hard given thelack of accommodation options.

159

RefugesRefuges provide emergency accommodationfor children who have run away. The refuge hasto get permission for children to stay from eithersocial services or police, to ensure thatproviders stay on the right side of the law.Children remain under the care of their legalguardian, and therefore cannot be harboured byothers without permission from their parents orcarers. However, Section 51 of the Children Act(1989) allows for certain charities, registeredchildren’s homes and foster parents to providerefuge for children who have run away fromcare or who are under police protection.

The Refuges (Children’s Home and FosterPlacement) Regulations (1991) require that,within 24 hours of a child being admitted to arefuge, the person providing the refuge shouldnotify the police. He or she must provide thechild’s name and last known address. Thepolice then contact the carer responsible forthe child, if possible, informing him or her thatthe child is in refuge accommodation butwithout giving the address.

164Refuge

accommodation can only be provided for amaximum continuous period of 14 days, or atotal of 21 days in any three months.

164

The tight guidelines, combined with the highcost of providing overnight accommodationand lack of government funding, mean thatthere are only three refuges in the UK. All arerun by charities.

156Together they provide just

nine beds. This represents fewer than one bedper five children who, every night, end upsleeping rough. Aberlour Running OtherChoices (ROC) is in Glasgow. There is also St.Christopher’s and NSPCC’s joint partnership,the London Refuge for Runaways, while TheChildren’s Society runs a ‘crash pad’ calledCheck Point in Torquay.

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There are onlythree children’srefuges in theUK. All are run bycharities.Together theyprovide just ninebeds.

In its first year, ROC refuge in Glasgowreceived 111 initial requests for help and wereable to provide refuge in 62 cases, for anaverage of one week. Most of these childrenhad referred themselves, and in over twothirds of cases, they were running from home.The majority returned to the place they hadrun from, with a significant minority going intorespite or longer-term local authority care. Ahandful left on an unplanned basis.

165

Refuges are expensive to run. Several haveclosed over the past two decades, largely as aresult of funding difficulties.The ROC refuge inGlasgow was set up in 2004 on a flexiblestaffing model. Staff are drafted in whenneeded, as opposed to working in the refugefull-time. When NPC visited the project inMarch 2006, six staff members were workingfor 30 hours a week, a further two for 22hours.

It costs £322,000 per year to run the ROCrefuge in Glasgow, roughly half the cost of thefirst refuge, which used a fixed-staffing modelin Leeds that proved unsustainable.Nonetheless, it remains expensive, at over£300 per bed per night. 40% of the costscome from the Scottish Executive, with asimilar proportion funded by local authoritiesand charitable trusts. The remainder is fundedby Aberlour, the parent charity.

166

Assessing outcomes is difficult given thecomplexity of the cases, but children using theROC refuge felt safe, supported and said thattheir behaviour had changed. The project islinked to an outreach programme, whichbegan before the refuge, so although theaverage refuge stay is one week, the outreachproject will have, on average, a further 12weeks of contact with the young person.One young person has been supported fortwo years.

The aim is to stabilise the young person’shome life and reduce the risk of themrepeatedly running away. The outreach workerengages with parents or carers if the childwants, but this is intensive work. If fundingbecame available, the project would be keento hire a specialist parent worker.

Flexible emergencyaccommodationRefuges are not the only accommodationoption. In Durham, social services run a 24-hour Emergency Duty Team for all out-of-hoursstatutory services. This works in tandem with achildren’s home, 1 Orchard Lane, thatprovides time-limited accommodation to anumber of children in need, but specifically torunaways. In an effort to raise awareness, theteam provides information to around 650young people in the area each month, via aDVD and theatre piece. The service has beenpraised by the Commission for Social Care

It was the firsttime anyoneasked meproperly why Iwas runningaway. Everyonegot togetherand we had abig meetingabout what waswrong … Meand my stepdadagreed to try toget on better.

Anna, 13, helped by TheChildren’s Society’s Check

Point refuge

Inspection for being a proactive and innovativesystem that is reducing the number of childrengoing into care. Again, the programme isexpensive and is currently receiving centralgovernment funding to keep it going.

167

The Children’s Society, with the support ofother children’s charities, has long campaignedfor safe spaces for runaway children to stay. Itrecognises central government as the mostlikely, and sustainable, source of funds. Thedifficulty is that central government is busydevolving funds to local authorities, which areexpected to identify local needs and planservices accordingly. Given that numbers ofrunaways in any one area are unlikely to reachthe critical mass required to dedicate six figuresums to refuges, individual local authorities arehighly unlikely to fund such work. It is a viciouscircle. In the meantime, the three refugesrequire ongoing support from private donors tokeep them afloat.

NPC advises donors interested in supportingsuch refuges and emergency accommodationto question charities about their prospects ofobtaining government funding, and their plansto develop alternative sources of funding.Otherwise, donors could find themselvessupporting projects that are unsustainable inthe long term. Nevertheless, this is a thornyissue, because the need is as great as ever,and refuges should not be allowed to fold.

OutreachEmergency accommodation is especiallycritical for those children who cannot easilyreturn home. It was noted above, in thesection on helping children on their return fromrunning away, that the pilot projects funded bythe DfES were not so successful in workingwith children who had been forced to leavehome. These children, along with those whogo missing but do not receive timely andeffective support, are at great risk of becoming‘detached’.

‘Detached’ young people are at greatest riskof becoming homeless, taking drugs or sellingtheir bodies. They are the hardest to engagewith and help. These children often run awayrepeatedly, and are on the streets forcontinuous periods of four weeks or more.

168

Around 1% of runaways (roughly 1,000children) had run away for more than fourweeks the last time they ran away, accordingto The Children’s Society’s most recentresearch.

156A detailed study of this group

found that only five out of 23 had receivedformal help.

168It seems that it is disturbingly

easy to become detached. Most of thesestreet children, if they do report receivingsupport, receive it through informal networks.These informal networks can result in harm aswell as support. Rather than being‘streetwise’, children can engage in extremelyrisky behaviour, as they often have a poor

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A reportfocusing onsexualexploitation inLondonestimated that1,000 childrenin London aloneare affected.

ʻ

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grasp of risk and danger.162

Some of thechildren interviewed had lived through extremesituations:

‘One young person ran away from home and,after being away for two to three months, wasabducted and locked up in a drug dealer’s flatfor four months […] One young person wholived on the streets for a long period of timedescribed how he had seen “all sorts” andcited, as an example, having witnessed a manbeing shot in the head. […] One youngperson, who was abused by the older adultshe was staying with, self-harmed to expressthe fear he felt and eventually attemptedsuicide by drinking bleach and painkillers. Hewas diagnosed as being mentally ill andsectioned for six months.’

168

Once children become ‘detached’, outreach orstreetwork seems the best method of findingthem. Some are picked up through sexualexploitation projects (discussed later in thissection). The children interviewed felt theywould have been helped by having someoneto talk to, family support and mediation, anddrop-in centres where they could go anddiscuss their options. Only 9% of referrals torunaway projects come from young peoplethemselves, suggesting that, sadly, we are veryfar from this scenario.

159

There are a handful of streetwork projectsaround the UK, many of which also work withsexually exploited young people (see later inthis section). Work with this group requires acareful balance between building trust throughmaintaining confidentiality and keeping youngpeople safe.

168

HelplinesASTRA, the local authority programme inGloucestershire (see Box 19), ran a local out-of-hours helpline as part of the DfES-fundedpilots in 2003 and 2004. The service receivedinsufficient calls for it to be viable in the longerterm; there were only three calls per week overthe year. However, the service only covered asingle local authority area, and was not widelymarketed. As with other areas of work withrunaways, numbers are often too small in eachlocal area to form the critical mass needed fora viable service.

158, 169A national helpline,

running around the clock, linked to localservice provision would seem to make themost sense.

The National Missing Person’s Helplinecurrently runs a special runaways helpline,staffed by volunteers. The helpline isconfidential, although if children want, theircalls can be referred to police, social servicesor another agency such as the NSPCC’sChildLine or its child protection line. Thehelpline is designed to let callers identify theiroptions. Children and young people can usethe service to leave a message for friends or

family to let them know they are safe. Theservice is open 24 hours a day, all year round.It receives up to 8,000 calls every month, mostof which it is able to answer.

The National Missing Person’s Helpline had forsome years struggled to meet its runningcosts, and faced a financial crisis in2004/2005. However, emergency appeals forfunding were answered by a number of majortrusts, and a new Chief Executive wasappointed. The charity would appear to haveweathered the storm, and is in a morefinancially stable position going forward.

At the moment, however, runaways are mostlyreferred to the service once they have beenmissing for some time—according to one localprotocol, children are to be reported once theyhave been missing for seven days. In addition,the lack of local authority services (particularlyout of hours) means that the service haslimited options when it comes to referringchildren on.

The NSPCC’s ChildLine receives some callsat crisis points. Many of the service’s night-time calls are from children who have run awayor been kicked out. This need for out-of-hourshelp is critical, but costly. NPC visited a servicefor looked after children in Perth, run by NCH.It had been funded by the local authority to runan out-of-hours service, in which it could pickup calls from runaways and deal with themimmediately, offering emergencyaccommodation if needed. The service had

53


These so-calledpals turned outto be older menwho would offerDan a bed forthe night, supplyhim with ‘E’s andalcohol.Eventually Dandisclosed thatthe men weremaking requestsfor him to providesexual favours forthese “treats” tocontinue. Whenhe refused, hewas threatenedwith violence.

Barnardo’s project worker11

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recently had its budget cut, however, meaningthat it was no longer available. Children inPerth now have nowhere to go if they runaway overnight, unless they can somehowmake it to Glasgow (the other side ofScotland), and be referred to one of the threeavailable refuge beds in Scotland.

What can donors do?To conclude, services for runaways across theUK fall well short of what is needed. As thingsstand, tonight:

• around 270 children will run away overnight;

• 45 of these children will sleep rough;

• 40 will be hurt or harmed; and

• 30 will be sexually assaulted.

The immediate harm that these children maysuffer is not the only reason for taking action.All runaways are likely to be running away fromserious issues that threaten their well-being, asit is a symptom of other causes.

If donors are interested in making a realdifference in this field, they should considersupporting the work of The Children’sSociety, which is campaigning on the matter.They should also consider supporting the workof Aberlour in Scotland, which in addition torunning the Glasgow refuge, is leading aninformal network to raise the profile of theproblem and ensure that runaway children getthe support they so desperately need.

Sexual exploitationThe charity Barnardo’s has developed astrong body of knowledge about the sexualexploitation of children and young people,another under-reported and under-resourcedarea. Despite the high profile of sexual abuse,the child protection system is less likely to pickup on this type of abuse. Children who aresexually exploited are a particularly complexgroup, and not easy to spot. Much of theactivity is ‘off street’.

As with other forms of abuse, sexualexploitation is best explained as a spectrum ofbehaviour and practices. Abuse andexploitation can be used interchangeably.Here, sexual exploitation is taken to covercoercive and manipulative influences‘attracting young people towards activities andrelationships which are more or less likely tobe regarded by professionals asexploitative.’

170

Sexual exploitation of young people can bedefined as:

• abuse through prostitution (both on thestreet and, more usually, hidden);

• abuse through involvement in pornography;and

• the trafficking of children and young peoplefor the purposes of sexual exploitation.

171

The following section covers children who areexploited through prostitution, whether formalor informal.

The role for donors in supporting childrenexploited through pornography is limited, butis covered in Section 5. The trafficking ofchildren is briefly covered in NPC’s report onrefugee and asylum-seeking children, A longway to go.

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Box 20: Barnardo’s reducing the risk

Barnardo’s published a two-year evaluation of its services for sexually exploited childrenin 2005, entitled Reducing the risk. The charity was the first to work with sexually exploitedchildren and young people, beginning in Bradford in 1995. It now has 16 services solelyfocused on sexual exploitation around the UK. Another four are in development, andeight working with missing children who are at risk of sexual exploitation. The establishedservices focused solely on sexual exploitation provide intensive support to around 167children per year each. Barnardo’s model of practice is centred on:

• Access. Children can self-refer or be referred, with each service carefully designedto make sure it is safe, attractive and accessible. Each service has developed protocolsin its area to ensure it is working in partnership with local authorities to increaseidentification of children at risk.

• Attention. The service aims to replace the attention these needy children receivefrom abusers with a protective and supportive relationship with project workers.This takes considerable time and effort.

• Assertive outreach. Linked to the above, project workers have to be extremely persistentif they are to engage children and start to replace exploitative relationships withtrusting ones. They hang out where the children do, communicating via regular texting,calling and cards.

• Advocacy. More often than not, children need advocates to access the services theyare entitled to. Many have been failed by services and do not trust professionalslike social workers. Project workers liaise with the various local authority agenciesto ensure that children do not ‘slip through the net’.

Between the services’ initial assessment of children and exit review, project workersaim to reduce the following risk factors: running away, accommodation needs, relationshipwith carers, rights and risk awareness, engagement with services and engagementwith education. The evaluation of ten of these services found that, on exit, risk factorswere reduced across five of these factors. Reductions in running away and being sexuallyexploited were particular significant: 74% of children showed a reduced level ofexploitation. Of these, one third were ‘stable’ on exiting the service and no longer inan exploitative relationship.

Despite such good results, the services continue to suffer from insecure funding. Eachteam is forced to work only with the highest risk group because of a lack of funding,and therefore project workers. Ideally, the schemes would engage with far more children,and act earlier. Barnardo’s attempts to obtain at least 50% of its funding for servicesfrom local authorities; the remainder has to be found elsewhere. This hampers the abilityto meet demand as well as plan for the long term.

How many children areexploited, and why?It is not clear how many children are involvedin sexual exploitation around the UK. Onesurvey of Area Child Protection Committees(now called Local Safeguarding Children’sBoards) estimated that an average of 19 girlsand 3 boys were known to each committee,which equates to just over 3,200 children andyoung people across England.

172This is

believed to be a significant under-estimate, asmany more will not be known to localauthorities. A subsequent report focusing onsexual exploitation in London estimated thatonly half of cases are known to localauthorities, and that 1,000 children in Londonalone are affected.

170

A survey of children known to Barnardo’ssexual exploitation projects (see Box 20)showed that four out of five were female. Ofthose under 18, the mean age was 15 (14 forboys). Children as young as ten were knownto the project, with a big jump in numbersonce children reached 13.

11

Those involved are extremely vulnerable. Nineout of ten children in the sample study had ahistory of abuse or neglect; two thirds hadbeen sexually abused within the family. Nearlyhalf had been involved in the care system atsome point. Just under one in three reporteddomestic violence in the home, or parentalsubstance abuse.

11Sadly, there are a number

of people (predominantly men) who are onlytoo willing to exploit such vulnerability for theirown gain, whether sexual or financial.

What can be done to preventsexual exploitation?Because child abuse is one of the primaryreasons why children run away from home,donors who choose to support any initiativestackling child abuse (outlined in the previoussections) might be able to help preventchildren from being sexually exploited. Moreimmediate causal factors leading to sexualexploitation include running away,homelessness and involvement with ‘risky’adults.

11Therefore, donors can also help

prevent sexual exploitation quite directly byfunding work with runaways.

Raising children’s awareness of the dangers isanother preventative option. Several trainingpacks for use in schools and other youthservices have been developed by charities.Barnardo’s published the educational resourcepacks Nae Danger in 2005 and Protecting Selfin 2006. Its project workers often go in tolocal schools to highlight the dangers andwarning signs.

Other organisations are similarly linkingeducational work in with their direct serviceprovision. For example, NPC has come across

one local charity, Walsall Street Teams, whichhas developed an education pack out of itsdirect work with sexually exploited childrenin Walsall.

Evaluating the impact of such schemes isproblematic; children certainly have greaterknowledge as a result but whether or not thisknowledge actually prevents children gettinginvolved in sexual exploitation is unknown. Atthe very least, it helps professionals such asteachers and children’s peers to identify thewarning signs, enabling them to refer particularchildren to specialist schemes.

There remains a need for specialist schemesworking with children at immediate risk. Thefact that they often have multiple problemsmakes stopping the exploitation particularlydifficult. As one 14-year-old boy explained:

‘Well, do you think I just woke up one day andthought “I know I’ll be a rent boy today?”Thousands of things have happened to me toget me here—mum leaving, no one at home,hanging round the pub late and waiting to gohome with dad, having blokes try to touch usup, seeing boys do tricks and getting cashand fags. If you want to change me, you’reprobably going to have to do thousands ofthings too, to balance it out.’

173

One of the biggest challenges is that childrenand young people are often unaware orunwilling to admit that what is happening isabusive, particularly in the early stages. As aresult of the types of problems indicatedabove, many of these children are very needy,which abusers readily exploit.

‘They have little if any experience of reliable,supportive adults, distrust professionals andare convinced that they are best served byleaving childhood behind and looking aftertheir own interests.’

11

As a result, engaging with these children andyoung people is very challenging. Work withsexually exploited children takes muchcommitment, time and effort.

It is not clear how many local authority areashave specialist services for children and youngpeople involved in sexual exploitation. NPChas come across only a handful of charitiesengaged in this type of work, and these aretypically leading local authorities on the matterrather than the other way round.

In fact, it is only relatively recently that policehave begun to move away from viewingchildren and young people involved in sexualexploitation as young prostitutes, who wereopen to prosecution. Such attitudes have left alasting legacy in terms of local authoritiyprovision. It also means that children andyoung people are less likely to come forwardfor help and support, as they do not trustlocal authorities.

171

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Services forsexually exploitedchildren remainpatchy. Schools,health servicesand youngoffending teamsare thought to beparticularly poorat recognisingand reacting tosexualexploitation.

Very worryingly, research by Barnardo’s in2005 suggested that sexually exploited youngwomen were being locked up in SecureAccommodation (for young offenders) when atrisk. This is interpreted by young women aspunishment rather than protection. As onecase study picked out:

‘I don’t think she’d have seen it as prostitution,but gradually she got involved in a group ofpeople where she was definitely being sexuallyexploited. She ran away one night from theunit and was raped and she was then sent tosecure [accommodation]. It was for herprotection but she interpreted it as, “I ranaway, I was raped, I have been locked upbecause of it.”’

174

This is not the intention of local authorities;rather, the young person’s safety is of primaryimportance. But provision of this sort is clearlyfar from ideal, and Barnardo’s research bringshome the necessity for alternatives.

Legislation, at least, has vastly improved overthe last few years. Since 2000, local authoritieshave been tasked with proactively preventingand stopping sexual exploitation. This involvesboth safeguarding children and investigatingand prosecuting adults.

175This guidance was

being updated as this report went to print,following the publication of the government’sCoordinated Prostitution Strategy in 2006.

176

Meanwhile, since 2006 Local SafeguardingChildren’s Boards (LSCBs) have a statutoryresponsibility to work together proactively totackle sexual exploitation, as those involvedare clearly at risk of significant harm. However,LSCBs have a huge task to undertake, withprecious little resources (see Appendix 2 formore details). As such, services for sexuallyexploited children remain patchy. Schools,health services and young offending teams arethought to be particularly poor at recognisingand reacting to sexual exploitation.

11

There appears to be insufficient communicationbetween those responsible for safeguardingchildren and those prosecuting adults whosexually exploit children. In the studymentioned above, only ten local authorities,less than 1%, were able to identify successfulprosecutions of offenders in 2001.

171Since

then, the Sexual Offences Act (2003) has comeinto force, making it easier to convict sexualabusers. Convictions in this area do not seemto have increased however. In 2005 there wereonly eight convictions for child pornography orprostitution, and three cautions.

177

The prosecution of sexual offenders is not aHome Office target (see Section 5 for moredetail on child sex offenders) and thecooperation of victims is arguably harder withthis group than with other victims of sexualcrime: there are high levels of coercion andmanipulation, and the victims are extremely

Results foryoung people incare are dismalin the UK; only11% of childrenin care attainfive goodGCSEscompared withover half of allchildren not incare.

vulnerable. As noted above, the first hurdle isgetting children to identify that what ishappening to them is exploitation.

There are successful examples of localauthority-led work, many of which seem todepend on a strong commitment from thepolice service. The commitment to multi-agency working has been strengthened by theEvery Child Matters agenda, which shouldimprove cross-departmental working. Thereare no police force national performanceindicators for child protection, althoughgovernment and the Association of ChiefPolice Officers are in discussions regardingwhat these might look like.

Meanwhile, donors interested in tackling childsexual exploitation should consider fundingcharities such as Barnardo’s (see Box 20).The charity has a proven track record inengaging children who are being sexuallyexploited and reducing that risk. Its specialistknowledge is of value to both centralgovernment and local authorities; its newbriefings for professionals are just one way ofkeeping the issue on the agenda of localauthorities, which have a clear duty to supportsuch children, if they do not always have theskills. In addition, the charity is often called into deliver consultancy or training support tolocal authorities. Finally, Barnardo’s campaignsover the years have helped to shape the waylocal authorities respond to sexually exploitedchildren, and should continue to do so.

Looked after childrenNearly two thirds of the 60,000 children in carein England are in that situation because ofabuse or neglect.

127

Results for young people in care are poor inthe UK: only 11% of children in care attain fivegood GCSEs compared with over half of allchildren not in care. They are also over-represented among those children who are notin education, employment or training; they aremore likely to be young offenders; and to faceissues including substance abuse.

127

The government announced its decision to dosomething about looked after children in itsGreen Paper, Care Matters: Transforming theLives of Children and Young People in Care in2006. The paper bemoans the state ofprovision for this group of children whose‘childhood and adolescence are oftencharacterised by insecurity, ill health and lackof fulfilment.’

127

Yet there is little research to suggest whetherthis is due to past problems, such as theabuse or neglect they suffered that led to thechild going into care, or to the ‘failure’ of thecare system itself. A 20-year follow-up study ofchildren who had been abused or neglected(to the extent that they were ‘under-

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Identifying [childrefugees andasylumseekers’]needs is fraughtwith difficulties.Immigrationofficials do nothave a duty toregard thewelfare ofchildren underthe ChildrenAct.

developed’) found that those who had beenplaced in stable long-term care followingunsuccessful intervention had far better long-term outcomes than those who remained athome where there was only limited change.

178

Before rushing headlong into an overhaul ofthe care system, further research into thedifference in outcomes for abused childrenwho stay in the home and those placed incare would be beneficial. Meanwhile, thegovernment Green Paper makes a number ofsuggestions that could benefit child protectionas well as the wider care system.

It recognises the lack of research into effectivefamily support, and reinforces thegovernment’s commitment to increasing thequality and quantity of parenting programmes.To this end, as mentioned previously, anational centre of excellence in children’s andfamily services is to be created that will ‘delivera systematic approach to sharing bestpractice across children’s services.’

127

NPC has not yet researched in detail the workof charities specifically supporting looked afterchildren. We plan to do this for a forthcomingreport on the subject. To an extent, theservices they need to access are the same asthose for children living at home. An exceptionis that they may need the help of independentadvocates to access the services and supportthey need, and to ensure their concerns arelistened to.

Child refugees and asylum seekersChild refugees and asylum seekers areextremely vulnerable. Once child protectionneeds are recognised among this group, thereis little to suggest that they are treated less wellthan other children. But identifying their needsin the first place is fraught with difficulties.

Just under 3,000 children arrive in the UKeach year on their own to seek asylum.

179

Asylum-seeking children who are separatedfrom their families are likely to be placed insemi-independent accommodation, with manyreceiving no support from anyone other thantheir social worker. Those living with families orother carers may only be known toimmigration officials, rather than socialworkers. Immigration officials do not have aduty to regard the welfare of children under theChildren Act (2004).

179

If they are known to the authorities, there areproblems with identifying the true age of aseparated asylum seeker because of lack ofpaperwork. Officials may refuse to accept thata child is under the age of 18, meaning thatthey will not receive the services to which theyare entitled. Even if they are identified aschildren, some child protection issuesparticularly pertinent to asylum seekers, suchas trafficking for sexual exploitation or forcedmarriage, may not be identified due to lack ofspecialist knowledge. Asylum-seeking childrencan also suffer further trauma when removedfor detention—some 2,000 children in familiesare detained each year—sometimes from afamiliar environment where they have lived forseveral years, which often happens at shortnotice.

79Detention centres are not known for

their educational provision, nor for theirattention to the welfare of those detainedwithin them.

For more information and options for fundingto support these children, see NPC’s report onunaccompanied refugees and asylum seekers,A long way to go.

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Charities workingin all these areassuffer frominsecure andinadequatefunding, and thesupport of privatedonors can makea markeddifference.

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Children in penal custodySince 1993, the number of 15 to 17 year oldsin custody has risen by 90%. The number ofchildren under the age of 14 who are detainedin Her Majesty’s care has gone up 800%.

180

These high numbers have been criticised.75

Many now question whether custody is thebest place for children who are often veryvulnerable. We saw in Section 1 the highproportion of prisoners reporting childhoodabuse. Many of those in custody come fromdeprived and troubled backgrounds.

Yet the treatment of children once in custodygives rise to even greater cause for concern.The Howard League for Penal Reform set up anindependent inquiry, led by Lord Carlile, into thetreatment of children in custody. Its findings,published in early 2006, were shocking.

‘We found that some of the treatment childrenin custody experience would in another settingbe considered abusive and could trigger achild protection investigation.’181

Physical restraint methods were regularly used,and continue to be used, despite the fact thatone in five was found to lead to injury for thechild or staff member.

182One fifteen-year-old

boy died as a result of choking on his ownvomit while being restrained by three membersof staff (using a method now withdrawn fromuse) in a secure training centre in 2004.

The government has repeatedly refused tohold a public inquiry into the death of anotherboy, Joseph Scholes. Despite his history ofserious self-harm, following a childhood ofsexual abuse, parental separation, being takeninto care, alcohol abuse and depression, hewas sent to a young offender unit following astreet robbery. He hanged himself nine daysinto his sentence.

180

NPC will come back to the issue of youngoffenders in a future report, but it is worthnoting here because the mounting concernsabout the abusive treatment (including neglect)of children in custody illustrates that thegovernment does not seem to fully sign up toits own policy, Every Child Matters. Furtherdiscussion of this is found in Section 8.

ConclusionsThis section has given an overview of theexperiences of some of the most vulnerablechildren in the UK. Runaways, who have oftenleft home because of abuse they sufferedthere, face significant harm and are unlikely toreceive any support because so little exists.They, and others, may be at risk of sexualexploitation while away from home.

Looked after children, who are often in carebecause they have suffered abuse, have poorlong-term prospects and may suffer furtherharm. Unaccompanied child refugees andasylum seekers may be at particular risk ofabuse because they may inadvertently behoused with adults, and may have littlecontact with anyone who can protect themfrom harm. Finally, children in penal custodyare subject to abusive practices sanctioned bythe same state that claims it is committed tosafeguarding all children.

There is less public attention on, and thereforeless funding available for, children on thestreets. Yet these children are particularlyvulnerable to abuse. Local authorities have aclear duty towards these children, but do notalways have the time, resources or expertiseto fulfil this duty. As a result, children who haverun away, or who are being sexually exploited,are subject to a postcode lottery when itcomes to being protected from harm.

Donors can make a significant impact on thelives of these young people by fundingcharities working in this area, which suffer frominsecure and inadequate funding. The supportof private donors can make a markeddifference to the prospects of many of thecharities and projects involved in the field.

Prioritising fundingCharities such as The Children’s Societyand Barnardo’s have developed proveneffective practice and spearheaded campaignstackling these issues. Charities are more oftenthan not able to engage with children whohave been failed by other services. Suchchildren are not easy to work with. But anumber of evaluations demonstrate the abilityof project workers to persist in developingtrusting relationships, giving these childrenanother chance.

They can only do this if they have sufficientfunding to both maintain existing service levelsand to be able to plan for the future.

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59

5Sexual abuseThe sexual abuse of children generates muchheated media attention. But the reality is thatpredatory strangers are not the greatestthreat to children. Four out of five offendersare known to the child, while children commitone in three sexual offences.

Effective work to prevent sexual abusemust focus on perpetrators, as well asworking with children, their families and thecommunity—to prevent them from abusingin the first place and deal with them oncethey have been identified. However,resources for both areas are scarce, anddonors’ support is urgently needed.

Setting the context for donorsTabloid press coverage of sexual abusesometimes suggests that the issue can bedealt with by monitoring known sex offenders.A number of high-profile campaigns againstsex offenders in the tabloids have led to somevery black and white public perceptions ofthe problem.

Yet most sexual abusers are unknown toauthorities, and between one quarter and onethird of sexual abuse is perpetrated by under-18s—neither case fits the stereotypical model.Working in this area requires difficult decisions:to work with perpetrators; to acknowledge thatchildren can be both abused and abuser; tohave a balanced debate rather than stigmatiseall abusers as ‘paedophiles’.

These points are important for donors in thisfield to consider, as they fundamentally affectcharities’ approaches to tackling sexual abuse,and significantly constrain the resourcesavailable to charities. This is a very unpopularfield for charities to work in. Those that workdirectly with sexual abusers are likely to facehigh levels of public antipathy to their work,despite its aims to protect children.

In this section we look at two key strands toprotecting children from sexual abuse:

• preventing perpetrators from abusingchildren, whether in the home, throughcommunity groups or over the internet; and

• dealing with perpetrators once they areidentified.

These two approaches are alsocomplemented by work that equips children toidentify abuse, and empowers them to act toprevent and report harm occurring tothemselves (known as increasing victimresistance). This is covered in the next sectionon work in schools.

This section starts with an overview of theprocess through which child sex offenders areidentified, prosecuted and treated, as thisestablishes the context for much of charities’work with abusers.

Options for donorsDonors wishing to tackle sexual abuse havethree main options:

• Funding work supporting children who arevictims of abuse and their families. Thiswork is likely to follow the models ofsupporting children described in earliersections.

• Funding work treating perpetrators ofsexual abuse or those who pose a risk tochildren, to prevent them offending.

• Protecting children online from grooming,and tackling the production and sharing ofchild abuse images.

This section will explore a number of promisingareas of work in the second area, including:

• Schemes that equip community groupswith child protection training.

• Monitoring and supporting offenders in thecommunity, to prevent reoffending.

• Treatment for abusers, particularly youngabusers. Early intervention is critical toprevent long-term offending patterns.

• Helping members of the public andprofessionals recognise and respond toabusive behaviour, for example, throughhelplines that advise those concernedabout someone’s behaviour (includingpeople concerned about their ownbehaviour).

This section will also examine work by charitiestrying to protect children online.

Working with abusersDonors may legitimately question why moneyshould be spent on abusers rather thanvictims. The answer is that work with bothgroups is necessary. Treatment programmesfor victims of sexual abuse, as seen in Section2, are needed if the corrosive effects of abuseare to be reduced. But if we are to preventchildren from being abused in the first place,effective treatment for abusers (and potentialabusers) is vital. At present, services for victimsand abusers and their families are woeful.

Sexual abusethrives onsecrecy and aclimate of fearonlyperpetuates thatsecrecy.

Circles of Support andAccountability6

ʻʻ

The reality isthat sexuallyabusivebehaviours areperpetrated bya very widerange ofdifferent typesof people whopresent verydifferent levelsof risk.

The Lucy FaithfullFoundation4

It is estimated that fewer than one in fifty childabuse cases results in conviction.Nonetheless, one in 140 men over the age of20 has a conviction for a sexual offenceagainst a child.

8The UK’s track record on

bringing the perpetrators of child sexual abuseto justice is poor. For example, recordedoffences of gross indecency with a child morethan doubled between 1985 and 2001 butconvictions decreased from 42% to 19%.

8

What does the picture look like five years on?It is possible to compare numbers forreporting, criminal proceedings andconvictions for a number of offences, includinginfanticide; gross indecency; cruelty to orneglect of children; and abuse of childrenthrough prostitution and pornography, to namebut a few.

In 2005, in more than nine out of ten cases,individuals who stood trial for gross indecencywere convicted. The figure is lower for othercrimes. Just 40% of those who stood trial forsexual activity with a child under 13 wereconvicted. The figure goes down further to justunder one in four for child pornography andprostitution, although the figures are very smallfor this crime so are likely to fluctuate greatly.

Comparing these figures with the numbers onthe child protection register, it is clear that thecriminal justice system works with sexualabuse far more than with other types of abuse.In 2005, 2,600 cases of sexual abuse wererecorded on the register, compared to 1,395(54% of the number on the register) criminalproceedings for this category. Meanwhile,25,500 cases of other types of abuse wererecorded on the register, compared to only981 (4% of the number on the register)criminal proceedings.

Some of the offences included in these figures,such as sexual activity with a child under 13and grooming, were introduced in the SexualOffences Act (2003). Changes were introducedto ensure a clearer legal framework for tacklingsexual offending, as the laws prior to that hadnot been changed since 1956. The changeshave led to increases in reported crime. Forexample, in 2004/2005 there were 185 casesof meeting a child following grooming, whichwas not previously an offence.

185

A review of the effectiveness of the Act in2006 found that, although it is still early dayssince the changes, there is little evidence ofincreasing convictions. The review concludedthat awareness of the Act among professionalswas not as high as it should be, caused bydeficiencies in the training of criminal justiceprofessionals and the low priority of sexualoffending.

185The Cross Government Action

Plan on Sexual Violence and Rape seeks torectify these problems.

116

60

Not seen and not heard Sexual abuse

Given the high level of media coverage theissue receives, donors may be surprised atthis. In truth, the hysteria surrounding sexoffenders is counter-productive. It distorts thereality of risk in its focus on known sexualoffenders. As one journalist recently wrote, theensuing ‘widespread paranoia and anxiety’creates a climate in which ‘it is almostimpossible to have a balanced and openpolitical discussion about how these peopleshould be managed’.

46

Even if the probation and police services hadthe time and resources to adequately monitorthose sexual abusers that are known to them,they could not eliminate risk.

Services are inadequate for the numbersinvolved, and this is likely to get worse asmore individuals are identified. At present, theblack and white portrayal of the problem isreducing public confidence in the system and,arguably, increasing the risk to children. Asone charity notes:

‘The media portrayal of a “monster” image ofthe “typical” sexual abuser discourages peoplefrom seeking help about their own behaviouror about those close to them. The reality isthat sexually abusive behaviours areperpetrated by a very wide range of differenttypes of people who present very differentlevels of risk.’

4

A broad spectrum of thoughts and behavioursexist in child sexual abuse. The label‘paedophile’ is (mis)used far too frequently.Paedophilia is defined as a ‘disorder of sexualpreference,’ a category itself classed as a‘disorder of adult personality and behaviour.’

183

Even if an individual is a diagnosed paedophile,he (the majority are male) may not act on hispreferences.

184There is a difference between

someone who fantasises about children andsomeone who attacks a child. The currentclimate does not allow for such distinctions.

It is high time for a measured and open debateon child sexual abuse. In the meantime, thereare a number of very interesting and valuabledevelopments occuring at both governmentand local authority level. Many have beeninformed by the innovative work of charities. Ifdonors and funders are committed topreventing child sexual abuse, they shouldseriously consider supporting charities that workwith perpetrators, their friends and families.

Most sexual abusers are unknownto the authoritiesIt is likely that most sexual abusers have neverbeen caught or prosecuted for their crimes.Conviction rates for sex offenders areextremely low, although significantly higherthan for other forms of child abuse.

ʻ

ʻ

Although most sexual offenders are not knownto the authorities, a great deal of effort is spenton discussing how to monitor those who docome to the attention of the authorities.Monitoring offenders who are known to theauthorities is of course important, as isensuring that adults who pose a known riskare not able to work with children.

Much of the following data taken fromgovernment sources applies to all sexoffenders, not just those who have abusedchildren. The number of those on the registerwith offences against children is not availableand official reports are hazy on specificservices for child sex offenders. This is despitecalls from the NSPCC for an annual report onthe monitoring and supervision of child sexoffenders, which would help our understandingof both the size and nature of the problem.

Those who are known toauthorities still pose a riskThere has been much scrutiny of themanagement of child sex offenders, mosthighly critical. The Home Secretary ordered areview of the management of child sexoffenders in June 2006. This report went toprint before the review was published. Itseems unlikely from early reports that thereview will fix the many problems that dogthe system.

186

Treatment servicesTreatment came under the jurisdiction of thecriminal justice system in England (but not inScotland) with the National TreatmentProgramme for Sexual Offenders in Prison(1991). Treatment is insufficient, both withinprison and once offenders are released intothe community.

The report of the chief inspectors of probationand police services in 2005 found demand forsex offender programmes ‘exceeded supplythat led to unacceptable delays. Consequently,case managers had to ensure that sexoffenders remained motivated for long periodsof time before starting their programme, whichwas sometimes difficult.’

187

Not all prisons offer treatment programmes;one unannounced prison inspection in 2005found that 20% of prisoners were housed inthe vulnerable prisoner wing, mainly consistingof sex offenders. The prison offered notreatment programme. ‘Many sex offenderswere in denial and nothing was being done toreduce their risk to the public after release.’

188

Around one third of sex offenders are not eligiblefor treatment, because they are sentenced forless than two years. This leaves insufficient timeto complete the course, whether in custody oron licence in the community.

116

Effectiveness of treatmentThere are currently three accreditedprogrammes for use with sex offenders inprobation and prison services. A recenteditorial in the British Medical Journalconcluded that there was incomplete evidenceon the effectiveness of treatment programmes,recognising that, although completion oftreatment programmes was associated with alower rate of recidivism, ‘psychologicaltreatment for adult sex offenders can reducereoffending rates but does not provide a cure.’It also pointed out that ‘there is enormouspolitical and institutional pressure to prove thattreatment works’.

189

There has only ever been one residentialspecialist centre in the UK for high-risk childsex offenders, run by a charity called the LucyFaithfull Foundation, with places funded bythe Home Office. The Wolvercote clinic ranfrom 1995 until 2002. A study following theclosure of the centre showed that the overallreconviction rate was only 10%. Of thosedeemed to be ‘treated’, none was reconvicted;and 86% of those who had not completedtheir treatment on exit were also notreconvicted. The programme led to change in20% of high deviance offenders for whomprevious treatment had been unsuccessful,although this could be due to a cumulativeeffect.

190A 1998 Home Office report suggests

that the programme was twice as effective forhigh deviance offenders as the shorter-termprison treatment programme of the time.

191

The residential centre was forced to close in2002, and has been unable to find anothersuitable location due to local opposition. Theopposition of local residents, no doubt fuelledby sensationalised press coverage, is just oneexample of how the current climate canarguably indirectly threaten rather than protectchildren. Setting up a new centre is a priorityfor the charity.

61


There has onlyever been oneresidentialspecialist centrein the UK forhigh-risk childsex offenders. Itwas anunequivocalsuccess, butwas forced toclose due tolocal opposition.

Box 21: What stops abusers offending?

The American academic David Finkelhor has identified four pre-conditions to offending:

• motivation to sexually offend;

• overcome internal inhibitor (eg, conscience);

• overcome external inhibitors (eg, getting past adults in order to access children);and

• overcome victim resistance.26

Stopping sexual abuse therefore requires barriers at each of these stages. Preventingindividuals from looking at child abuse images, for example, might reduce the motivationto offend. Prohibiting individuals from accessing children, which many SexualOffending Orders do, is one way of increasing external inhibitors. Ensuring that childrenknow what is and is not acceptable and what to do about it, as Eighteen and Underdoes (see Section 6), is one way of increasing victim resistance.

Treatmentarrangements forsex offenders fallwell short of whatis needed.

Report on safeguards forchildren21

ʻʻ

Vetting and barringIn 2006 there was considerable furore over thelack of a central list identifying all those whoposed a risk to children and vulnerable adults.It was prompted by the news that a registeredsex offender had been cleared by the DfES towork as a teacher. This hurried along changesthat had been recommended in the Bichardinquiry following the Soham murders. IanHuntley, who killed two girls he knew from theschool where he was a caretaker, hadpreviously been known to police for allegedsexual offences.

Regulation has a cost. Implementing a centralregister has been delayed because of highestimated costs, thought to be in the region of£22m each year, falling to £19m as thesystem settles.

192

This is not the only cost. There is a risk thatputting such emphasis on criminal recordsdeflects attention from bigger problems.Criminal records checks can never replacegood child protection practice and skilledassessment of risk, not least since the majorityof offenders are not known to the criminaljustice system.

Monitoring child sex offendersDespite recent and significant improvements inthe management of child sex offenders, manycontinue to pose a risk to children. Indeed, ‘itwill never be possible to eliminate risk when anoffender is being managed in the community’.

193

A focus onprevention isneeded,includingprogrammes tooffer help toabusers andtheir families toaddress thebehaviour at anearly stage.

Report by JosephRowntree Foundation8

Many will not have received treatment while inprison. Accredited programmes for thosereleased in the community only came intobeing in 2003, with currently around one infive accessing treatment. To be fair, not all ofthose released are deemed suitable fortreatment, nor are all supervised offendersrequired to attend treatment,

194but there is

also a lack of services.

The Sex Offenders Act (1997) requiredconvicted offenders to register within threedays of their arrest or conviction with thepolice and keep them informed of theirwhereabouts. Those with sentences of morethan 30 months are placed on the listindefinitely, but the registrations of those withshorter sentences are time-limited.

195

The 1997 Act only required offendersconvicted from the point it came into force toregister, thereby not covering an estimated100,000 offenders convicted prior to thatpoint.

196The Crime and Disorder Act (1998)

attempted to rectify this, allowing police toapply for Sex Offender orders (requiringindividuals to register and inform police of theirwhereabouts) for those not covered by the1997 Act, but who were considered a danger.The Sexual Offences Act (2003) introducedfurther measures to monitor the movements ofconvicted sex offenders, and introduced Riskof Sexual Harm Orders that police can use tomonitor individuals deemed to be a risk,regardless of whether they have a conviction.

At the same time police and probation servicesestablished protocols for assessing andmanaging the risk posed by such offenders.These developed into Multi-Agency PublicProtection Arrangements (MAPPA), statutorybodies at local authority level that areresponsible for the monitoring of violent andsex offenders in the community. Police,probation, prison and social services arerequired to work together to monitor andmanage the risk to the public.

There are three levels of risk, with thosedeemed highest risk (level 3) referred to Multi-Agency Public Protection Panels (MAPPP) forcloser monitoring. There were 28,994 sexoffenders (‘category one’ offenders) beingmonitored by MAPPA in the community. Thoseposing highest risk (‘level 3’ offenders)numbered 1,478 in 2005 (this figure includesviolent offenders as well as sexual offenders).

A new computer system, ViSOR, wasintroduced by all police forces in 2005(including Scotland) in an effort to trackoffenders across areas, and this has now beenextended to all probation and prison servicesto support information sharing.

197There are

over 45,000 cases on ViSOR. Nearly 11,000are not currently managed. Those that are mayonly be managed very lightly. One constable

62


Box 22: Sarah’s Law

The death of Sarah Payne at the hands of a known sex offender in 2000 raised concernsover the government’s (in)ability to monitor sex offenders. It led to calls for a US-style‘Megan’s Law’ to be introduced in the UK. In some US states, details (including photosand addresses) of individuals on the sex offender register are readily available. Here,the request is that members of the community should have the right to request informationfrom police and probation services on individuals in their community who may posea risk to children, so that they can act to safeguard their children.

Yet the authorities already have the power to release the names of known sex offenders,and do so. They may inform parents, schools, police, leisure centres and so on, on aneed-to-know basis.

There is a valid argument against the introduction of legislation making sex offenders’details openly available. It is thought to drive sex offenders underground, leaving themfreer to reoffend. In the US, only 80% of sex offenders comply with registrationrequirements, a figure that has fallen since the introduction of Megan’s Law. The ratein the UK is 97%.35

Of course, such arguments rely on the public having confidence in the ability of policeand probation services to adequately monitor registered sex offenders. The repeatedcalls for Sarah’s Law would suggest that there is little confidence in the system.Nonetheless, the answer arguably lies in improving the system rather than handingthe management of sex offenders over to the public.

As one police officer commented, ‘if we lived in a nation where we could trust peopleto use the information sensibly, I would support its introduction. But the truth is thatwe have a significant minority who would use that information to attack offenders,which would drive them underground. That would be the worst thing; at least if weknow where these people are and they trust us enough to talk to us, we have a chanceof stopping them reoffending.’ 46

ʻ

ʻ

was quoted in 2007 as saying, of a high-riskoffender in her care who has numerousconvictions for child sexual abuse:

‘Being considered high risk sounds serious,doesn’t it? In reality, it means I spend an hourin his flat every three to six months, chatting tohim about what he’s been up to. You can’t getmuch information out of these people on thesevisits. It’s only if they choose to talk to you oraccidentally let something slip.’46

According to minimum standards set by theHome Office, even those deemed at very highrisk of reoffending may only be visited onceevery three months. MAPPAs have finiteresources; even if they did have infinite fundsat their disposal, legislation does not allow foroffenders (who in the eyes of the law havepaid penance for their crimes) to be monitoredaround the clock.

If this is not disturbing enough, numbers ofoffenders that MAPPAs are expected tomonitor are rising year on year. The SexOffenders Act (1997) is not retrospective andtherefore it will take some time for the registerto mature and stabilise.

194It is expected that

numbers will continue to rise, peaking at100,000 in 2015.

198This poses serious

questions regarding resources given thatservices are already feeling the strain, with toomany offenders not accessing treatmentprogrammes.

Desperate need for changeIt is worth quoting at length from the findingsof a Joseph Rowntree Foundation report onsafeguards for vulnerable children in relation tosexual abusers:

‘Given the high incidence of abuse, if realprogress were made in identifying andsuccessfully convicting a significant proportionof those who sexually abuse children, thecriminal justice system and prisons would beswamped. Even if community sentences weregiven instead, there would not be theresources to provide the supervision needed.On the other hand, if the problem goesunchecked, there will be an inexorable rise inthe numbers of children subjected to sexualabuse with all the damaging effects that canhave–mental health problems, self-harm, lowself-esteem and, perhaps worse still, aproportion will go on to abuse others. A radicalrethink of policy is needed. The problem mustbe tackled nearer to the source. A focus onprevention is needed, including programmesto offer help to abusers and their families toaddress the behaviour at an early stage.’

8

There has been no radical rethink of policy todate. But a Home Office review of themanagement of child sex offenders is due inApril 2007, and the Cross Government ActionPlan on Sexual Violence and Abuse contains

welcome ideas. It presents a three-tierapproach to prevention, targeting:

• everyone, through education and publicawareness;

• those at risk of both offending andvictimisation, for example, throughtreatment for young abusers; and

• existing victims and perpetrators, by ensuringjustice and treatment, for example.

116

There are some very promisingdevelopments in this field, many of whichhave been developed in the charitable orcommunity sector.

Child protection training forcommunity groupsMeanwhile, charities are equipping communityorganisations with the skills needed to identifyand respond appropriately to concerns aboutattitudes or behaviours. This is important work;many abusers will not be known, and even ifthey are, there is a chance that they will not beidentified (nothing prevents offenders fromchanging their names, for example).

The NSPCC has played an important role inmaking various community settings a saferplace for children, mainly through its varioustraining programmes. Its Child Protection inSport Unit, for example, has been busyensuring child protection processes are inplace in sports organisations in England,Wales and Northern Ireland (see Box 23).

CHILDREN 1st has been responsible forsimilar actions in Scotland, where it works inconjunction with sportscotland (a national non-departmental public body) to ensure sportsorganisations have child protection proceduresand programmes in place. In 2004/2005several thousand individuals were trained inchild protection.

63


Box 23: NSPCC Child Protection in Sport Unit (CPSU)

The CPSU has raised the profile of child protection in sport. Early in its existence, jointresearch between the NSPCC and Sports England into the National Governing Bodiesof Sport found:

• 41% were not sure if they had a child protection policy.

• Fewer than one in ten completed police checks on coaches and staff and only 3%on volunteers and officials.

• Just under half had no system for reporting allegations.

• Yet 29% had dealt with child abuse allegations.24

The Unit has built on the NSPCC’s knowledge on safeguarding standards, assessingsports organisations on their standards on behalf of government. In addition, it coordinatesresearch and provides training, information, advice and consultancy.

The Unit has also been successful at lobbying government; in England, minimumsafeguarding standards are now recognised and are linked to funding. Today, all fundedgoverning bodies meet the preliminary standards and now have in place a child protectionpolicy, reporting arrangements and a designated lead person.24

Other charities are working within religiousgroups and other community settings. TheChurch’s Child Protection Advisory Serviceis working with churches around the UK to raiseawareness of the risk that some individuals inthe faith community may pose to children.

Monitoring offenders in thecommunityRegistered child sex offenders pose a small butserious risk to children. MAPPAs are limited inwhat they can do to monitor such offenders.Just as the child protection reform programmesin England and Scotland emphasisedeveryone’s responsibility to safeguard children,there are increasing noises from those withstatutory responsibility for offenders that call forthe same approach for offenders. A seniorprobation officer was recently quoted assaying, ‘the public need to realise that sexoffenders will always exist […] Society needs tobe more mature and take responsibility for thereality of the world we live in.’

46

There is a small but growing response to thischallenge, largely in the form of Circles ofSupport and Accountability, a community-

based programme that originated in Canada.On release, high-risk sex offenders arematched with volunteers who meet regularly(at least weekly) with the offender, or ‘coremember,’ in an effort to reduce the risk ofreoffending.

6

Volunteers are highly trained and receive ahigh level of support and monitoring. Theywork in tandem with MAPPAs, and are by nomeans a replacement for professionalsupervision of offenders. But they offersomething that statutory services do not andcannot: a listening ear.

The cornerstone of the programme is the useof volunteers who are representatives of thecommunity that many sex offenders areexcluded from as a result of their crimes.Exclusion and the ensuing isolation aredangerous for offenders. As noted earlier,visits from police or probation are few and farbetween. If there is no family member orfriend around, recidivist behaviour is likely togo unnoticed. Moreover, loneliness, low self-esteem and the inability to form appropriate,adult relationships are risk factors forsexual offending.

64


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NPC highlightsCircles ofSupport andAccountability todonors as anexcitingopportunity topreventreoffending.

‘There is something very powerful for an ex-offender to come into a room of people whoare there because they want to be, notbecause they are paid professionals.’

6

As the name suggests, Circles of Support andAccountability exist to support the offender inmanaging his or her own risk. Via moreinformal, longer-term contact, volunteers areable to develop a much greater insight intooffenders’ thoughts and behaviour thanstatutory services can. They are thereforehelping contribute to a ‘wealth of data relatedto recidivist behaviour that had previously beendifficult to collate’.

6

The Home Office funded pilots of the schemein 2002, working in partnership with a range ofstatutory and community organisations.Measuring success is not easy. Evidence fromCanada, where the programme has beenrunning for longer, suggests that theprogramme can reduce recidivism by 50%.Where abusers have reoffended, the offence isless severe than that for which they wereoriginally convicted.

199

As noted above, however, most sexual abusegoes unrecorded. Extremely few cases resultin conviction. Therefore measures ofreconviction are a poor indication ofeffectiveness. The Circles programme allowsfor much closer monitoring of thoughts andbehaviour. The three-year study of the ThamesValley pilot, led by the Quakers, found thatself-esteem, emotional isolation and feelings ofbeing governed by internal rather than externalfactors improved by the end of the circle. Of20 cases, eight offenders exhibited problembehaviours. Seven were identified via membersof the circle itself, and half were dealt withwithin the circle itself, in conjunction withMAPPA. No offender has been reconvicted ofany new sexual offence. This is true of all UK(and Canadian) Circles to date. Bearing inmind that these offenders are classed as highrisk, this is very positive.

The programme is developing organicallyrather than through a strategic, coordinatedplan. The Quakers have helped run around 25circles to date in the Thames Valley andHampshire. The Lucy Faithfull Foundationcurrently runs six circles, and is helping localauthorities set up new ventures around thecountry. Other projects are beginning in severalparts of the UK. The government’sFuturebuilders programme has allocated agrant and loan to the Quakers to set up anational umbrella organisation, Circles UK, toensure that projects run safely and maintainthe high quality of the pilots.

Not everyone supports such work:professionals as well as members of the publicfind it difficult to set aside the view of child sexoffenders as monsters, and finding volunteerspresents an ongoing challenge.

Funding has been pledged by the Home Officeuntil 2008, and programmes are increasinglylooking to local authorities (police, probation,social services and so on) for funding.

At the moment, circles are expanding only asa result of the commitment of a small band ofdedicated individuals, who are runningschemes on tight budgets. NPC highlightsCircles of Support and Accountability todonors as an exciting opportunity to preventreoffending. Donors could either fund existingcircles through the Quakers or The LucyFaithfull Foundation, or contribute to the setup of the proposed national organisation,Circles UK.

Treatment for young abusersBetween one quarter

200and one third of

abusive sexual acts are perpetrated bychildren and young people.

7Between one and

three quarters of sexual offenders beganoffending before the age of 18 and havemultiple victims.

81

These statistics are not reflected in convictionrates. Concerns were expressed at section13 of the Sexual Offences Act (2003), whichmaintains that children are equally liable forpunishment if they have committed asexual offence.

Concerns were expressed for a number ofreasons. First, children who abuse often havemultiple issues themselves. A combination ofsocial skills deficits, lack of sexual knowledge,high levels of anxiety and low self-esteem canresult in young men (for the majority are male)being drawn to inappropriate relationships orbehaviours with younger children.

201

65


There issomething verypowerful for anex-offender tocome into aroom of peoplewho are therebecause theywant to be, notbecause they arepaidprofessionals.

Codes of Support andAccountability

6

Box 24: Child sexual abuse within the family

The focus on ‘stranger danger’ can distract from the real danger, not just for the generalpublic but for children themselves. Children may not recognise that what might behappening to them at home is abuse.

The NSPCC prevalence study suggests that children are more at risk from those knownto them but not related. Other studies have come out with higher rates of intrafamilialabuse. One reason given for this is that it is difficult to assess what is or is not appropriatewhere there exists such a close relationship. Moreover, incest is particularly taboo, whichmay have affected levels of disclosure.

There is some evidence to suggest that intrafamilial abuse is more harmful in the longterm than other forms of sexual abuse. It is particularly complex; the relationship isabusive, but this does not preclude it also being a loving parent/child, brother/sister,grandfather/granddaughter relationship. Children are likely to have mixed feelings. Theywant the abuse to stop, but they do not want the family to be torn apart in the process.

Dealing with the aftermath is also particularly challenging. Support for non-abusingrelatives is needed; if they do recognise the abuse and the implications (which somedo not), they may have enormous issues of guilt to deal with alongside having to providesupport to the abused child.

The Lucy Faithfull Foundation is keen to start work with non-abusing parents, for whichit is seeking funds.

ʻʻ

The mediaportrayal of a“monster” imageof the “typical”sexual abuserdiscouragespeople fromseeking helpabout theirbehaviour orabout thoseclose to them.

The Lucy Faithfull Foundation4

Moreover, harmful sexual behaviour in youngpeople is linked to them having been abusedthemselves, both sexually and in other ways.

201

Between one quarter and one third of sexuallyabused children are thought to exhibitsexualised behaviour.

202Not all are emerging

sexual abusers; far from it. One six-year follow-up study of children with sexually harmfulbehaviour found that only 5% who had beenoffered treatment had reoffended, comparedwith 18% who had not received treatment.

201

Tackling the abusive behaviour alone is unlikelyto get to the root of the problem. Children maybe responding to their own experiences. Assuch, children need support and treatment firstand foremost, related to a broad range ofdevelopmental needs, rather than punishment.

As such, the Sex Offenders Act is beingapplied in a ‘targeted and sparing manner’when it comes to children. In the first eightmonths of the act (effective from 1 May 2004)there were 38 prosecutions and 21convictions. Just over one third (15) were foroffences against children under the age of 13and of those, 11 cases resulted inconviction.

185

Research undertaken by Eileen Vizard and hercolleagues, based at the NSPCC’s YoungAbusers Project in North London, hasidentified a priority group for treatment.Children with early onset sexually abusivebehaviour (before the age of 11) display morepredatory and forceful sexual behaviour thanthose with late onset sexual behaviour, and arenearly twice as likely to be convicted in laterlife. Predictive characteristics includedinadequate family sexual boundaries, lack ofparental supervision, early difficulttemperament and insecure attachment.

203

The report authors concluded the followingwas needed to reduce the risk of recidivism inadulthood:

• Primary prevention services in the form ofprofessional agencies working together andtraining parents and young people.

• Local, community teams to assess andtreat children and adolescents presentingwith sexually abusive behaviour.

• A network of regional specialist teams toprovide consultation, teaching, andmanagement in complex cases.

• A small number of specialist residentialtreatment facilities for juvenile sexualabusers.

203

There is also a need for work with parents ofchildren with sexually harmful behaviour.Parents experience a feeling of failure; shockand denial; guilt and shame; isolation andstigma; and powerlessness in the face ofprofessional responses.

201They need help with

this if they are to help their child.

At present, work at each of these levels ispatchy. It is thought that there are around 200services or projects offering some kind ofservice to children with sexually harmfulbehaviour, but much of this is non-specialist.

201

This does not necessarily matter, given the factthat these children often have a range ofissues they need support for which theseservices may be meeting.

But the issue of sexual abuse by children isstill very much taboo, and many professionalsfeel out of their depth when dealing with thisgroup. Progress is hampered by the fact that itis unclear which department should haveultimate responsbility for this group; is it amatter for the police, social workers, or healthprofessionals? A 2006 report from theDepartment of Health called for a lead agency,in addition to a network coordinating the fewservices there are and a common assessmenttool to ensure consistency.

50

A cross-government strategy on young peoplewho sexually abuse is currently underdevelopment, building on work done by theDepartment of Health and the Victims ofViolence and Abuse Prevention Programme(see Section 7).

The situation with regards to treatment forabusive behaviour is little better in Scotland.NPC has been able to identify only threeprojects working with young abusers inScotland, all run by Barnardo’s, and there is noofficial government policy as yet.

The Young Abusers Project in North Londonwas one of the first to work with young peoplewho sexually abuse. It is now managed by theNSPCC, and works with children from all overthe UK (including Scotland). The average ageat referral used to be 16 or 17; it is now 11.When NPC visited the project in 2006, 27children were being supported. All had been

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abused themselves, and at a young age. Onaverage, they had begun their own abusivebehaviour by the age of six. This means theirbehaviour had not been dealt with for severalyears; as a result, their arousal patterns werewell developed, they had been ostracised orneglected as a result, and work to changepatterns of behaviour and issues such as self-esteem was all the harder.

Capacity is limited. There are only eight staff,of whom three are part-time. Children maycome to the centre for assessment, but usuallythis has to involve carers and otherprofessionals, which means that the staff atthe centre end up travelling long distances.Not all parents give their consent to the work;indeed, some may be implicated in the abuse.Even if they do consent, the complexity of thework means it is expensive. Not all referringauthorities can afford the £9,000assessment fee.

204

The NSPCC runs eight other centres foryoung abusers, around the country. Only acouple of other charity providers are offeringtreatment services, in conjunction withprobation services. Barnardo’s runs a dozenprojects for children with harmful sexualbehaviours, two of which overlap with servicesfor abused children. It is also carving out aniche for itself in policy work, through specialistbriefings for professionals that push itsevidence-based calls for action from bothnational government and local authorities.These include further research on theeffectiveness of treatment and an audit of localauthority provision.

201

Respond is one of the only charities workingwith children and adults with learningdifficulties, who are thought to be over-represented among the abused and abusers.Again, data is poor, but information from onecounty council showed that disabled childrenmade up only 2% of the local child population,yet accounted for 10% of those on the childprotection register. The figure often quoted isthat disabled children are three times morelikely to be abused.

205

One study of special schools found high ratesof abusive behaviours, and points to thedifficulties that professionals have in identifyingand acting on abuse, not least the lack ofappropriate services (see Box 25).

37There are

examples of people with learning difficultieswho have been refused services becausethose services are not suited to their needs.

6

Respond is one of the few charities to workwith both the abuser and the abused,recognising that there is often overlap. It hasdeveloped expertise in working with peoplewith learning difficulties, which other servicesmay not take on. The charity deliverspsychodynamic counselling to around 30

clients each year, who come from around theUK, at its London base. The Department ofHealth provides some funding, but usually thecharity can only afford to take clients who payfor their place or those for whom the referringagency will pay, as rates are just under £7,000per year, of which £3,500 is charged to theclient. This rules out around 80% of those whocontact the service. The charity would like tosubsidise more places, but does not have theresources to do this.

For those who cannot access the service,there is a national helpline, which receivesaround 2,000 calls each year. The charity hasa wealth of information, in the form of casestudies, indicating positive change. Funding isneeded to conduct further research into theeffectiveness of the model.

Recognising and responding toabusive behaviourAs mentioned above, it is thought that sexuallyabused children are more likely to displaysexualised behaviour. Between one quarterand one third of sexually abused childrenexhibit such behaviour.

202It is not a definite

sign of abuse, however; research into patternsof sexual behaviour within English homesfound that, in families where no abuse wasreported, similar proportions of childrendisplayed sexual behaviour of some sort,

44so

drawing any hard and fast conclusions fromsuch indicators is not possible.

These figures highlight the fact that we live in asexualised society. What children see, hearand feel is likely to influence their ownbehaviour from a young age. Much of this willbe harmless, but individuals need support indistinguishing what may or may not count asabusive behaviour.

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Box 25: Sexually abusive behaviour in special schools

One study of special schools across four English councils found that 88% reportedincidents of sexually inappropriate behaviour. In over half of these cases, incidentsoccurred at least once per month. The majority were deemed ‘minor’ (inappropriatetouch, public masturbation, sexualised language, flashing), but four schools reportedattempted or actual anal or vaginal penetration.

Despite these serious incidents, only a minority of schools had a specific policy in placeregarding sexually inappropriate behaviour. Referring cases was problematic, treatmenteven more so. ‘Only a minority of these young people were able to gain access totherapeutic support services. Some services for juvenile abusers simply would not workwith young people with learning difficulties, others had long waiting lists or rejectedindividuals after initial assessments showed that they were "not engaging with thetherapeutic process".’

Labelling was a big issue for professionals, who were reluctant to label children aslearning disabled or sexual abusers for fear that this would put them at a socialdisadvantage and further encourage the negative traits associated with the behaviour.Although understandable, the outcome was a lack of professional awareness andappropriate intervention. In some cases sexually abusive behaviour was allowed thereforeto deteriorate to the point of sexual offending.37

Disabledchildren arethree timesmore likely [thanother children]to be abused.

Until a few years ago, there was nowhere forconcerned individuals, their families or friendsto turn for help and advice. In 2002, the LucyFaithfull Foundation started Stop it Now! UK& Ireland, based on a US model of the samename. Although managed in the UK by theLucy Faithfull Foundation, it is actually afederation comprising a number of charities,including NCH, Barnardo’s and the NSPCC.

The campaign has three prongs:

• a national helpline;

• regional and local projects; and

• dissemination of information.

The helpline offers advice and support to threemain groups:

• individuals concerned about their ownthoughts, feelings or behaviour;

• individuals who are concerned about thebehaviour of a family member, friend orclient (for professionals); and

• parents or carers who are concerned aboutthe behaviour of a child.

Since the helpline launch, numbers havesteadily grown. In 2005/2006,150 calls werereceived per month, 80% of which were fromthe target groups (more than originallypredicted). The helpline is staffed by trainedprofessionals, who offer guidance and support.As the helpline is housed within the LucyFaithfull Foundation, callers can be referred tospecialist assessment or treatment services.Where local support is not available, thehelpline offers individual counselling.

The aim of all of this work is the prevention ofchild sexual abuse. Prevention is difficult tomeasure; many callers remain anonymous.However, the helpline has been able to gathercase studies, which indicate that the provision ofoptions to people who had no previous accessto services may help prevent (re)offending. Onesuch example is given in Box 26.

There is someweight to theargument thatthose who viewchild abuseimages areabusers byproxy.

The helpline is supported by regional and localprojects, which disseminate information aboutthe helpline through posters, leaflets andpostcards. The programme is dependent oncollaboration and partnership between anumber of different professional agencies. Assuch, local programmes are usually hostedwithin (and funded by) another organisation,whether a larger children’s charity, such as theNSPCC or Barnardo’s, or local authorities,such as the Local Safeguarding Children’sBoard. To date, projects have been set up inSurrey, Derbyshire, the Thames Valley, theBlack Country and Northern Ireland. Theproject is making great strides in a number ofother areas, including the Republic of Ireland,Wales and Scotland.

Despite enjoying a strong reputation in thefield, the charity remains low on the radar ofmost donors and funders. This is partlybecause of the subject area, but also becausethe charity has to date lacked fundraising andmarketing staff. The project is seeking fundingfor a media, marketing and communicationsofficer, in addition to individual project work.This presents a sensible option for donors,who could thereby support the development ofa much-needed service.

Safeguarding children onlineGiven that online abuse has only recentlyemerged in the public consciousness, it isdifficult to talk about increases in numbersinvolved with any great certainty. It is likely thatthe development of the internet has led to anincrease in volume of child abuse images incirculation and an increase in sexual offendingagainst children. It could also be that it issimply ‘opening a window that was previouslyclosed and allows us to glimpse into a worldthat we never saw other than in the flimsiest ormost ethereal of outlines’.

206ChildLine

reported a 115% increase in calls related toconcerns about the internet between 2001and 2004, with the majority related to onlineabuse.

207Charities working with offenders,

such as the Lucy Faithfull Foundation, havealso noticed a big increase in referrals for menwho are regularly looking at child abuseimages.

What is uncontroversial is that the majority ofhouseholds with children have domesticinternet access, as do all UK schools, and thatthere are associated risks.

206Parents do not

tend to be as vigilant with regards to theirchildren’s safety online as they would be inother settings. Yet children are moreaccessible online, and increasingly so, astechnology has moved from fixed points (suchas within the home) to mobile access. Thismakes it easier to target and groom children.In addition, children are thought to be moremalleable online, making them even morevulnerable.

208

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Box 26: Case study of caller to Stop It Now! helpline

Arnold, aged 32, was referred to Stop It Now! by his GP. He was a gardener by profession.In the lead up to the summer holidays, he was increasingly concerned about his growingattraction to the teenage girls he saw sunbathing in the gardens where he worked.

He had approached both the police and probation services, who had both told him theycould do nothing as he had not committed any offence. His GP told him that it was‘pretty normal’ for men to fantasise about teenagers, but passed him the number ofthe helpline.

It is difficult to say what might have happened had he not been able to discuss hisconcerns with a trained professional. The person who took the call was able to listento his concerns and suggest ways he could manage his own behaviour. He was givenpractical fantasy management techniques and encouraged to change his work habitsso as to be around children less. In addition, he was given contact details for twocounsellors in his area who had specific expertise. His chosen counsellor was to bebriefed by the helpline worker, with the consent of Arnold. He was encouraged to getback in touch with the helpline to help him manage his thoughts and prevent him actingupon them.36

The following section looks at the two mainproblems: grooming and child abuse images.The former presents an undeniable and directrisk to children, even if numbers involved aresmall. The link between child abuse and viewingimages of child abuse is less clear. We knowlittle about the link between viewing images andcommitting abuse, tending as a society to lumpall individuals involved under the category of‘paedophile’, whatever their offence or age.

Of course, the manufacture of child abuseimages in many cases involves direct abuse ofchildren. Such cases are thought to make upless than 1% of reported sexual abuse.

209In

addition, demand leads to supply. Viewingimages of abuse directly fuels the abuse ofchildren. Many of the victims are likely to beoverseas, making the manufacture of imagesextremely difficult to tackle.

Grooming children onlineMuch of the work to prevent grooming is in thehands of government, which is now coveringthe issue relatively well. There is some scopefor private donors, however; the children’scharity NCH has taken a prominent role insafeguarding children online, funding one part-time worker to run the Children’s Charities’Coalition for Internet Safety (CHIS), whichhas nine charities as members. The alliancelobbies the government and industry, but onan ad hoc basis given its limited resources.

Since the Criminal Offences Act (2003), it is acrime to sexually groom children, ie, engage achild online or by any other means with theintention to abuse them. An investigation inAugust 2006 found that an estimated 50,000abusers were online at any one time; one thirdof children had been subjected to unwantedsexual comments and one in 12 children hadmet face-to-face with a stranger they hadmet online.

210

Since 2001, there have been in the region of60 prosecutions for rape or sexual assaultresulting from contact made online. This beliesthe number of children involved: a recentinvestigation uncovered a man who had had70 sexual conversations online with childrenand young people, met and abused 20, with aconviction related to just two of the incidents.

211

The Home Office has had a Taskforce on ChildProtection on the internet since 2001, out ofwhich several initiatives have emerged, notleast the Child Exploitation and OnlineProtection Centre (CEOP). This is housedwithin the newly formed Serious OrganisedCrime Agency (SOCA), and began operating inApril 2006. CEOP is a law enforcement agencythat draws on business, voluntary sector andgovernment knowledge. It acts as a point ofcontact and advice centre for all concernedwith the targeting or abuse of children as wellas undertaking proactive investigations, both inthe UK and internationally. Between 2003 and2006 the government spent £1m each year onraising awareness relating to online dangers.

212

Specific government initiatives include lessonsfor children in e-safety to warn of the dangersonline, as part of the national curriculum, as ofSeptember 2006.

That there is such commitment fromgovernment is attributed to public support forsuch measures.

211Yet there remains room for

improvement. A report in 2006 by thecoordinator of CHIS identified six gaps, andcalled for a new NGO network funded bygrant-making trusts or private sources, whichcould monitor developments independently ofthe internet and mobile phone industries.

213

One of the emerging concerns is the newtechnology that allows roaming internetaccess, such as 3G phones. The mobilephone industry maintains it is impossible to

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ChildLine reported a115% increase incalls related to theinternet between2001 and 2004, withthe majority related toonline abuse.

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monitor activity on such phones, and barparticular sites or users. There is currently noindependent body with the resources toinvestigate this claim.

Child abuse imagesChild pornography, or child abuse images asthey are more appropriately named, usuallyinvolves abuse. However, individuals havebeen convicted for manipulating and creatingindecent images. The viewing of such imagesis not passive.

The existence of a record of the abuse meansthat the victim is subject to re-abuse each timethe pictures are looked at. There is also theterrible legacy of not knowing who has accessto those images. Victims report extremefeelings of powerlessness, and are aware thatthe images can be used in the abuse of otherchildren, who may be shown the pictures.

209

There is therefore some weight to theargument that those who view child abuseimages are abusers by proxy. More so asaccessing images is arguably leading toincreased abuse, as demand feeds supply.

The internet has facilitated a proliferation ofimages. As an illustration, in GreaterManchester in 1995 the sum total of imagesthat were discovered by the police was 12. In2003, an arrest of one man in the UK led tothe discovery of 450,000 images in hispossession. In New York, one man wasestimated to have a million images.

206Images

are getting worse, too: nearly one third of allchild abuse images fall into the ‘mostdistressing grade’ today, compared with 7%in 2003.

214

Tackling online images of child abuse requiresan international response, given the nature ofthe medium, which has raised problems forpolice, not least because there are no lawsregarding child pornography in nearly 100countries.

215There are several international

bodies tasked with fighting the spread of suchmaterial. Identifying children involved in themaking of the images is extremely difficult;since 1995 fewer than 400 children involved inchild abuse images have been identifiedand found.

216

It is thought that the interest in images isfuelling the abuse of children, as the internethas opened up a market in which images canbe produced for financial gain.

8The

connection between an individual viewingimages and his or her own behaviour is lessclear, although manufacturing and possessingimages is a crime. Public opinion does nottend to distinguish between those who viewchild abuse images and those who sexuallyabuse children.

‘Child pornography is used for sexualstimulation, to legitimate and normaliseoffenders’ sexual activities with children, to

maintain a permanent record, to ensure aconstant source of material at the age ofsexual preference and as a tool for grooming,entrapment and blackmail.’

209

Further research into the link is desperatelyneeded.

8The supposition is that, even if

viewers are not abusing children, viewingimages may fuel fantasy and erode ‘inhibitors’;the barriers that prevent people from acting ontheir impulses (see Box 21). The little researchthere is suggests there is a link. One US studyputs the figure thought to be abusing childrenas high as one in three of those who possesschild abuse images.

206It is feared that the

internet is encouraging individuals who maynot previously have explored child abuseimages. Some argue that the internet servesas a community for some in which abuse isnormalised, further eroding inhibitors.

206

However, there is no available research intocausation. Interviews with paedophilesundergoing treatment in the UK havesuggested that ‘the internet was where theyfirst found child abuse images, sometimesinitially by accident, later deliberately. Otherssay they were always aware of their sexualinterest in children but were too scared to doanything about it until the internet providedthem with the means.’

206

Recent investigations such as Operation Ore(see Box 27) have further dispelled the myth ofthe ‘dirty old man.’ The suspects identified inthe operation are a cross-section of the adultmale population, including judges, priests,doctors, teachers and others who work withchildren. Of those identified, only 5% werealready known to police.

8

Operation Ore is the tip of the iceberg; onlythose with credit cards, internet access, andarguably those stupid enough to sign up, werecaught, and only via one particular site. BTannounced in 2006 that it had recorded35,000 hits from domestic users attempting toaccess images of child abuse online, threetimes the number only 18 months previously.

217

BT, which accounts for one third of the UKinternet market, has spent £1.5m developingblocks to known sites containing images ofchild abuse for internet service providers. Thenumber attempting (successfully) to accesschild abuse images could, therefore, be threetimes as high.

The Internet Watch Foundation (IWF) is a UKhotline, funded by the industry and publicbodies, that enables people to report abuse. Itreported in July 2006 that child abuse contentis primarily hosted in the USA (50%), althoughother nations such as Russia and Japan arecatching up. The fact that some websites werereported by the IWF to the host nations fiveyears ago yet are still in operation points to thedifficulties the UK has in getting other nationsto cooperate in its fight against online child

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Recentinvestigations suchas Operation Orehave furtherdispelled the mythof the ‘dirty oldman.’ The suspectsidentified are across-section of theadult malepopulation,including judges,priests, doctors,teachers and otherswho work withchildren.

abuse. Even those countries with acommitment to tackling the problem havewidely different approaches; for example, thestrategy in the UK (as implemented by IWF) isto shut down sites and remove images whendiscovered, to prevent proliferation of interestand images. ‘Choke off the supply and youeffectively suppress demand.’

206In the US,

effort is concentrated on catching those whoproduce the original images.

218

The result is that, whereas 50% of material ishosted in the US, only 0.2% of all material ishosted in the UK, down from 18% in 1997,which is a success.

219The number of sites has

increased significantly in the same period (itwas estimated in 2003 that there were at least200,000 sites hosting child abuse images,double the figure of 2001).

215

There is not much scope for charities intackling the creation of such images. There is,however, considerable room for charities inworking with individuals who are viewingabusive images, as well as their partners. TheLucy Faithfull Foundation has developed twoprogrammes, Inform and Inform+, for thosewho look at online child abuse images andtheir family and friends. The scheme is part-funded by those who take part in the course.

ConclusionsThis section has given an overview of what is acontroversial area of an already difficult field forcharities and donors. Despite often simplisticreporting to the contrary by some elements ofthe media, the main danger to children is notposed by known child sex offenders. Themajority of offenders are unknown toauthorities. Also in contrast to the stereotypesseen sometimes in the media, one third ofsexual offences is committed by those underthe age of 18.

For those offenders that are identified,conviction rates are extremely low, andsubsequent monitoring and treatment servicesare woefully lacking.

In order to effectively tackle sexual abuse,much needs to change. Charities areextremely well-placed to lead this change, andprivate donors are uniquely well-positioned tosupport them.

Donors can make a great impact bysupporting work with sexual abusers in thefollowing areas:

• Schemes that equip community groupswith child protection training.

• Monitoring and supporting offenders in thecommunity, to prevent reoffending.

• Treatment for abusers, particularly youngabusers. Early intervention is critical toprevent long-term offending patterns.

• Helping people recognise and respond toabusive behaviour, for example, throughhelplines.

All four areas promise significant results. ButNPC must remind donors of the potentialchallenges of funding work with sexualabusers. Public attitudes are set againstabusers, who are demonised and portrayed asmonsters. This means that such work will notbe popular, and may require additional effortsto combat public perceptions.

An additional area of work that donors couldfund is protecting children online fromgrooming, and tackling the production andsharing of child abuse images.

Prioritising fundingMost sexual abusers (and all potential abusers)are unknown to authorities and cannottherefore receive any treatment to preventthem offending through the child protectionsystem or state treatment programmes.

A priority for funding, therefore, is work thathelps to identify offenders and potentialoffenders. The Stop It Now! programme, ledby the Lucy Faithfull Foundation, can fulfilprecisely this role. By advising individualsabout the behaviour of people known to them(including family members and children), it canhelp to identify abusers and prevent abuse. Byadvising individuals about their own behaviour,it can provide a source of support andtreatment that can prevent offending. Theimportance of this work cannot beemphasised strongly enough.

The lack of resources available for treatmentservices, even to known offenders, and theintense pressure on police, probation andprison services means that we need to look tothe community for responses, whereappropriate. Community-based models suchas the Circles of Support and Accountabilityhave the potential to manage, monitor andsupport offenders so that they do not reoffendand deserve private funding.

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Box 27: Operation Ore

A US investigation into a subscription service based in Texas that gave access to onlinechild abuse images began in 1999. It uncovered a network of 250,000 subscribers acrossthree continents.

The Federal Bureau of Investigation (FBI) handed over 6,500 names of British residentsto UK police, leading to Operation Ore. The huge operation is still underway, and it isestimated that the figures to date are as follows: 4,283 homes searched; 3,744 arrests;1,848 charged; 1,451 convictions; 493 cautioned; 879 investigations underway, and109 children removed from suspected dangerous situations.30

Those with convictions or cautions will be placed on the sex offenders register. It isimpossible to arrest this many suspects in one go, so the investigation has takenconsiderable time. Police in some instances have relied on informing close relativesof the suspects in the hope that they will be vigilant. However, given the taboo thatsurrounds such crime, it is unlikely that those around the suspects are in a position todeal with or act appropriately on the information given.

6SchoolSchool can offer a safe haven for childrenand young people. For some, it provideswelcome respite from issues affecting themelsewhere. It is also a place where abusecan be identified and children supported,whether that abuse is happening in thehome or elsewhere. Children can be taughtabout danger, and attitudes andbehaviours can be tackled, potentiallypreventing abuse.

Abuse, however, happens in schools too.Half of all primary schoolchildren and onequarter of secondary schoolchildren reportbeing bullied in the last year. Charities havebeen instrumental in highlighting suchpeer-on-peer abuse, and continue to bevery active in tackling bullying.

Setting the context for donorsOne of the most important features of schoolsin the context of child abuse is the amount oftime that children spend there. Through regularand long-term contact with children, schoolscan gain the trust and knowledge that allowsthem to play a role both in identifying abuseand teaching children about abuse and harm.

Children also represent future generations. Ifattitudes to abuse, and abusive behaviours areto be changed, today’s children are likely to beat the centre of much of that change. Theirattitudes and behaviours may be lessdetermined than those of adults, and work tochange behaviours may be most fruitful at thisstage of life.

This section describes the work of charities inschools around child abuse. Given the primaryrole that schools play in the lives of children,we were surprised not to find more work.Several excellent approaches and projectswere identified during NPC’s research, buttheir number is astonishingly small comparedto the number of schools in the UK. There isstill huge scope for charities to developeffective approaches to abuse in a schoolcontext.

Options for donorsThere are three main areas of charities’ work inschools that donors might be interested insupporting:

• Tackling bullying through campaigns tochange attitudes and behaviours, andprogrammes to help children deal withbullying;

• Identifying abuse through charities workingin schools, using education, awareness-raising and general counselling; and

• School-based support for children whohave been abused, often based around amodel of counselling support.

All three approaches can play important rolesin tackling abuse. At the end of this section,we present an overview of the results of theseareas of work to help donors think aboutprioritising their giving in this area.

Tackling bullying For some, schools can provide a welcomeescape from abuse. For others, abusehappens at school, in the form of bullying.Charities have been instrumental in shifting theperception of bullying. It is no longer seen asan inevitable part of schooling, but as theharmful practice that it is. Bullying isconsistently raised by children and youngpeople as one of their major concerns.Although a relatively innocuous word, bullyingcan cover a range of offences including‘physical violence, racial and sexualharassment, sexual exploitation, using threatsto obtain money or property, andpsychological torture.’ 21

Bullying is the single biggest reason whychildren call ChildLine, accounting for aroundone in four of the helpline’s calls.

220Research

conducted on behalf of the DfES andChildLine in 2003 discovered that half of all

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Through regularand long-termcontact withchildren,schools cangain the trustand knowledgethat allowsthem to play arole, both inidentifyingabuse andteachingchildren aboutabuse andharm. P

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primary schoolchildren and one in foursecondary schoolchildren had been bullied inthe previous year.

220The NSPCC prevalence

study in 2000 found that one in ten youngadults report having been bullied ordiscriminated against systematicallythroughout their childhood, the results ofwhich were affecting them still.

55

Bullying is now taken seriously. Every school isrequired to have an anti-bullying policy. NPC’sreport on education, On Your Marks, identifiedthree main ways of tackling bullying:

• Educating children about the importance ofrespecting their peers and the damagebullying can cause;

• Helping schools and parents to understand,recognise and deal with the symptoms ofbullying; and

• Giving support to children who are beingbullied, by providing information, help andguidance inside and outside of school.

The report identifies that charities are therecognised experts when it comes to bullying,although the proliferation of websites offeringadvice makes it difficult to understand clearlyhow best to tackle the problem.

The Anti-Bullying Alliance (ABA) is astrategic alliance, funded by government,designed to coordinate responses tobullying.

221It has one coordinator per

government region, which is an enormousamount of ground to cover given the size ofthe problem. In practice, how well bullying isdealt with depends on the individual school.

The ABA’s Anti-Bullying Week in Novemberhas a very high profile. The effectiveness ofcampaigns in terms of reducing bullying ishard to ascertain, but it certainly helps keepthe problem in the public eye.

NPC’s report, On Your Marks, also highlightsthe fact that bullying ‘is not merely a schoolproblem.’

221Although we have categorised

bullying under schools, bullying occurs in othercontexts. A report on safeguarding childrenaway from the home concluded that bullying‘is extremely destructive and one of the mainproblems that worry children. It needs to betackled in all institutional contexts.’

21

The charity beatbullying (see Box 28) ishelping to spread this message. Its latestcampaign highlights that bullying happens notonly in schools but on the way to school, onthe way home from school, in shoppingcentres and so on. It is encouraging thereporting of abuse in addition to runningworkshops on tackling attitudes amongyoung people.

Helping identify abuse in schoolsJust as schools are on the frontline in tacklingschool-based abuse, professionals working inschools are in a strong position to identify andreport abuse among the over-fives. Across arange of issues, from abuse to running awayto sexual exploitation, experts seem to believethat greater links with schools would bebeneficial.

159

School staff, ‘by virtue of their daily contact,hold much of the responsibility for meetingchildren’s immediate needs.’

222Schools have

traditionally worked quite separately fromsocial services and other professionals taskedwith keeping children safe. This is improvingwith the Every Child Matters agenda, whichrequires professionals to work together andshare information. Moreover, all schools are tobecome ‘extended schools’ by 2010, offeringstudy support activities, childcare, parentingsupport and wider learning for the community.Bringing services together like this shouldfacilitate quick and easy access to specialistservices (such as children’s mental healthservices) for children who are at risk of abuseor who have been abused.

But schools and teachers often have limitedtime to devote to anything other thanacademic attainment. Building up relationshipswith children so that they trust the teacherenough to discuss or disclose abuse takestime; time that is often simply not available.

73

Not seen and not heard School

[Bullying] coversphysical violence,racial and sexualharassment,sexualexploitation,using threats toobtain money orproperty, andpsychologicaltorture.

Academic21

Box 28: beatbullying

beatbullying was established in 2001 following research that placed bullying amongthe most significant issues that children face at school everyday. beatbullying is nowone of the largest bullying charities in the UK, reaching out to both victims and perpetratorsof bullying through a variety of means. Through schools and youth centres, beatbullyingworks with children directly, raising awareness about the effects of bullying anddeveloping strategies to prevent it.

Research continues to play an important role in beatbullying’s work. It spends a significantamount of time and resources on monitoring the impact of its various projects, inconjunction with Southbank University. Its achievements include a reduction of 39%in the incidence of bullying and an increase of 60% in the actual reporting of bullying.beatbullying also claims that 61% of young people who participate in its courses areable to stop bullying within six weeks.

The charity is about to start a pilot to be evaluated over two years, specifically targetingsexual bullying and harassment among children and young people. The following casestudy shows the type of issues the charity seeks to address.

A 15-year-old boy and 14-year-old girl at the same school had a flirtatious relationship.As they became closer, they chatted online about starting a sexual relationship. Soonthe boy changed tack. He started to make threats of publishing the chat on a socialnetworking site, telling all her friends she was a ‘slag’ and a ‘tart’, and that she wasavailable for other boys to have sex with. This escalated to the point that the boy triedto blackmail her, saying if she did not send him pictures of her naked he would telleveryone. Confused, frightened, ashamed and with no one she felt she could talk to,she sent the photos. The next day they were posted on a social networking siteanonymously.

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Things are moving slowly. The 2006 annualsurvey of trends in education highlightedignorance regarding children’s servicespartnerships, cornerstones of the Every ChildMatters agenda, and a lack of enthusiasmamong education professionals. Only 2% ofprimary schools and 6% of secondary schoolsinclude social services as part of theirextended services.

223

Education programmesNPC has come across a number ofeducational programmes for use in schoolsthat attempt to raise awareness and, moreambitiously, change attitudes. Most aredesigned by charities or individualschools/local authorities. They are mostcommonly delivered in sex and relationshipeducation or Personal, Social and HealthEducation, both of which are non-statutoryparts of the national curriculum.

Programmes range from anti-bullying work toexploring violence against women.Womankind Worldwide, for example, deliverswork in schools focusing on domestic violenceand sexual bullying, in partnership with manyagencies. Its website contains lots ofresources for use in schools.

One of thereasons childrenmay not reportabuse when it ishappening isthat they are notaware that it iswrong.

Such programmes often report positive resultsbased on short-term research, but there is nolongitudinal research identifying whether suchprogrammes actually change behaviour orattitudes in the longer term (ie, into adulthood).Donors interested in this area should considerfunding long-term research.

In the meanwhile, there are some locally-driven, innovative responses to identifyingabuse in schools. Eighteen and Under’sViolence Is Preventable (VIP) project beganas an educational programme, using videos,games and discussion to broach what abuseis; what situations might be inappropriate; andhow children can act to protect themselves(see Box 29). Its work is so interesting that wewill spend some time here exploring it in detail.

The programme has been subject to academicevaluation. An as yet unpublished studylooked at both primary and secondary schoolage classes, including work with knownvictims of abuse. For the 6 to 13-year-olds andsurvivors, there was a significant differencerelating to knowledge and skills (for example,recognising a situation as worrying, saying no,getting away and telling someone) betweenthe groups who had gone through theprogramme and those who had not. This alsoapplied to the group of children who hadexperienced abuse previously.

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The gains were slightly less for secondaryschool pupils, suggesting that the programmeis more effective with younger children.Across the programes, there was no realdifference in results across gender, ethnicity orsocio-economic status. The results heldwhether the lessons were delivered by theteacher or project worker, which means theprogramme can be replicated.

224Indeed,

Eighteen and Under has created publicationpacks for all their programmes, for use byteachers or youth workers, available directlyfrom the charity.

Children found the lessons enjoyable and themessages easy to understand. They felt moreconfident in keeping themselves safe. Despitethe subject matter, when asked, none of thechildren reported feeling upset. Nor did theybecome overly anxious, fearful of strangers, oroverly assertive.

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Whether or not such schemes actually preventabuse is unknown.

148As with adults, there is a

difference between thinking something anddoing something. However, it seems likely thatat least some of the children will retain theinformation given to them, which could provebeneficial if they were ever at risk of abuse.Moreover, the scheme can be a way ofintervening early where children are already atrisk. One of the reasons children may notreport abuse when it is happening is that theyare not aware that it is wrong.

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Box 29: Eighteen and Under

The Dundee charity Eighteen and Under has been working with victims of abuse, bothchildren and adults, for many years. Although this work continues, the charity felt itwanted to prevent abuse, or at least identify it early, rather than simply picking up thepieces once abuse had happened.

The Violence is Preventable (VIP) programme began in 1998. It has been adapted fordifferent age groups, from pre-school (Wee VIPs) to secondary school (Teen VIPs). Theprogramme has even now been developed and adapted for use with older people, tohelp protect them from abuse.

NPC visited a Tweenies (primary school) session. Through the use of a video and interactivegames, children are encouraged to recognise situations that may be unsafe or thatmake them feel uncomfortable, whether involving relatives, friends or strangers. Theyare given simple messages (Say no! Go! Tell!) to help keep them safe. Attitudes thatlead to violence are also challenged, such as whether someone ever ‘deserves’ to behit. Children are encouraged to express themselves, and are taught that they have aright to be listened to. The programme was delivered directly to over 800 children in2005/2006, and a further 400 were reached through the Wee VIP and Teen VIPprogrammes.

Many more are reached indirectly. Over 500 parents, teachers and youth workers weretrained in the same period. In addition, resource packs are available from the charityfor all its programmes. These contain the same interactive tools and are designed tohelp adults, whether teachers or youth leaders, to talk to children about staying safe.All of the schools and nurseries in Dundee use the resources, to some extent, and therehave been requests for packs from as far away as Devon. NPC could envisage theseresources being used in all schools in the UK, were the funding available to marketand produce them. At present, the programme has only two paid staff members. Thecharity is now actively marketing the VIP programme but struggling to meet demand.Ultimately, the charity would like to see the programme available around the UK.

Putting a price on the service is not easy, given that the programme is delivered inpart indirectly through trained adults and resource packs, and the results of this indirectwork are not monitored. The cost per child taught directly by Eighteen and Under isestimated to be no more than £90.

‘I didn’t know what my god brother was goingto me was wrong. I thought it was all a gameso I wasn’t disturbed by it at the time.’

‘I cannot remember a day of my childhoodwhen I was not abused. It was not until Ireached secondary school that I realised thatthis sort of thing doesn’t happen toeverybody.’

15

This is where the Eighteen and Under schemereally stands out. It has a strong emphasis ondisclosure, expecting children to put into placethe ‘telling’ strategies it has taught them. Giventhat children tend not to disclose abuse, thestudy found it elicited a surprisingly highnumber of disclosures, during lessons andafterwards, particularly from younger children.

Of the 68 children who had lessons deliveredby an Eighteen and Under project worker,there were 16 accounts of physical abuse, 11of physical assault and three of sexual abuse.A further nine spoke of domestic violence andmany more of bullying, with a few disclosuresof grooming and other harmful practices.Rates were not so high among teacher-ledsessions, although out of 20 pupils there werestill four counts of abusive incidents. A further36 disclosures were made on the Eighteenand Under helpline around the same period,compared with none the previous year. Fewerdisclosures were made by secondary school

pupils. None of the children in the waiting listcontrol groups made any disclosures.

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So why such high levels of disclosure? Fromthe children’s perspective, some felt they couldtalk about their feelings more openly becausethey heard others doing so, which may explainthe high numbers of disclosures. They alsoexpressed greater assertion in ‘telling’ as aresult of their experience of adults listening,believing them and giving them choices.Indeed, teachers reported that childrenseemed more willing to ‘tell’ of incidents, bothin and out of school, following the session.

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The differences between the Eighteen andUnder-led and teacher-led sessions could befor a number of reasons. Eighteen and Underexpects disclosures to be made, given rates ofabuse among children. It also uses a broaderdefinition of abuse to include all harm (hencethe inclusion of theft, for example). The studyhighlighted that workers are very open with thechildren, spontaneous talk among children wasencouraged and children were given spaceand time to talk without being judged. Mostsimply perhaps, children were asked specificand explicit questions about harm, to whichthey responded.

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Much of this was in evidence when NPCvisited the programme in action in one Dundeeprimary school.

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Disclosures are passed on to the designatedchild protection officer in the school; whathappens next is not known. Eighteen andUnder continues its original counselling servicefor victims of abuse (children and adults); theevaluation discovered a spike in calls to thehelpline from children who had taken part inthe lessons. Around one quarter of the 72 callsrelated to bullying, with one further quarterdisclosing domestic violence, physical andsexual abuse.

224One of they key issues for the

charity is how to continue to provide thesupport services (helpline, one-to-one andgroup counselling), much of which dependson volunteers.

The service is genuinely child-friendly andfocused; that the service has a high level ofdisclosures is no coincidence. Eighteen andUnder is a compelling option, therefore, fordonors interested in working directly withchildren to help them protect themselves.

School-based supportOnce abuse has been disclosed or hasstopped, there is an ongoing role for schoolsto play in reducing the negative effects ofabuse. Enjoying school and doing well thereare key protective factors against the ongoingnegative effects of abuse. Ironically, some ofthose negative effects, such as low self-esteem and poor mental well-being, can affect

a child’s ability to do well at school. Abusedchildren are more likely to truant or beexcluded from school.

60Children who have

been abused, or who are experiencing abuse,may well need extra support in school.

Charities are increasingly showing the way. Forexample, The Place2Be works in over 100primary schools across England and Scotland,delivering counselling to over 25,000 childrenin 2005. Counsellors are based in the schoolsin the long term, enabling children andcounsellors to build trusting relationships.Children can go and talk to The Place2Beabout whatever is worrying them, whether afall out with a friend or abuse within the home(see Box 30). The non-stigmatising and openaccess approach means that around 70% ofchildren access the service in each school.

Around one in five of these children will bereferred on to more specialist, longer-termcounselling. The charity uses the GoodmanStrengths and Difficulties Questionnaire tomeasure the results of this work. A recentassessment found that 60% of children areclassed as ‘abnormal’ on scales measuringemotional well-being and social behaviour priorto accessing the service, compared with 10%in the general population. This reduced to41% following the service. The number ofchildren classified as ‘normal’ increased from22% to 40%.

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Eighteen andUnder is acompelling optionfor donorsinterested inworking directlywith children tohelp themprotectthemselves.

A number of schools and local authoritiesaround the country are keen to introduce theservice, as the improved well-being of pupilshas knock-on effects. Many reports by theschool inspection body Ofsted have noted thepositive ethos of schools that have ThePlace2Be. With children able to explore theiremotions in a safe and private setting,classrooms are more conducive to learning.This positive effect spreads into homes andother settings, especially in areas where thecomplimentary parent service and training forstaff are also available.

If donors are interested in this kind of support,previous NPC reports On Your Marks andSchool’s out? highlight further examples ofcharities that are delivering emotional andsocial support in schools.

ConclusionsThis section has given an overview of charities’work in schools to tackle child abuse. Thereare examples of excellent, effective practice,but there is also a postcode lottery forchildren, as the approaches highlighted areonly available in a very small proportion ofschools across the UK.

Schools are not fulfilling their potential tosafeguard children as well as they could.Change is afoot with the Every Child Mattersagenda, and schools are increasingly payingregard to pupils’ welfare as well as theiracademic attainment. But the role of charitiesis likely to remain critical in schools’ efforts toprotect children from abuse.

Charities have done much to ensure thatbullying is seen as the abusive practice that itis. The charity beatbullying has a good modelof direct service delivery combined withcampaigns that continue to tackle the public’sattitudes to the issue.

School is also an excellent place to identifyabuse. Charities like Eighteen and Under arehelping to encourage direct disclosures fromchildren, as well as aiming to empowerchildren to help them protect themselves frombeing abused in the first place. Assessing the

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effectiveness of any purely preventativescheme is difficult, but giving children anopportunity to explore such important issues ina non-frightening, educational and enjoyableway is an impressive achievement.

In addition, charities like The Place2Be havedeveloped excellent models that should act asa blueprint for how schools respond to theworries and problems of their pupils.

The scope for donors to support work in thisarea is huge. Examples of effective practicecould, over time, be funded to expand acrossthe country. NPC would be delighted todiscover, when updating this report in anumber of years, that approaches pioneeredby charities like Eighteen and Under,beatbullying and The Place2Be could be foundin the majority of schools.

Prioritising fundingTackling bullying, identifying or even preventingabuse, and school-based support all have greatpotential to create an impact, and all three haveshown measured results. This creates the bestpossible dilemma for donors—choosingbetween approaches that demonstrate equallyhigh levels of effectiveness.

Donors may wish to think about prioritisingsupport instead based on their preference forwork focusing on preventing and protectingchildren from abuse, or on treating its effects.

Box 30: Alfie’s experience

Seven-year-old Alfie suffered abuse at the hands of a family friend for three yearsbefore his mother found him stabbing himself with a fork. It was his way of dealingwith the fear and hurt he was experiencing. Alfie’s mother was very distressed andwent to see her GP and the headteacher at his school. Alfie was referred to a Place2Becounsellor.

Through play, Alfie was able to communicate to the counsellor what he had experiencedand how it made him feel. The Place2Be offered Alfie a place where he could feelsafe enough to express himself, and thereby feel less alone or to blame. After a yearof sessions with the counsellor Alfie improved dramatically. He was much happierand more confident in class, much more outgoing, and he now has many friends toplay with. His mother noticed the changes in her son. ‘Alfie is a different boy. He ishappier, chattier, has friends and plays out like a normal boy. He is more settled atschool and is coping better with school life.’

7Adult survivors The majority of abused children do notreceive the support and treatment theyneed to overcome the potential damagecaused by abuse. Most children do notreport their abuse at the time it ishappening. Most children fall through thenet of the child protection system. Thismeans that there are many more adultsurvivors of abuse than children beingabused at any one time. NPC estimatesthat there could be as many as five-and-a-half million survivors in the UK alone.

Not all survivors of abuse want support, oractively seek it. However, the number oforganisations that have sprung up to offera listening ear or more formal counsellingfor survivors suggests that many do wanthelp. These groups do little advertising oftheir work; demand could massivelyoutstrip their capacity if all survivors wereaware that support was available.

For those survivors who do want help, thereare barriers to accessing support. The highnumbers of adult survivors in mental healthservices and the prison system suggest thathelp is not there early enough for the vastmajority of those who need it.

Setting the context for donorsThis section outlines the support that charitiesprovide to adult survivors of childhood abuse. Itis largely delivered through small, local projects.

The survivors’ sector is beset by fundingproblems. It has a very low profile with privatedonors and the general public. Since NPC’sresearch into child abuse began, severalsurvivors’ organisations we identified havebeen forced to close due to lack of funding.This picture provides important context fordonors interested in supporting work withsurvivors, as they will face an ongoingchallenge to keep charities afloat, let alone tohelp them develop to meet the demand thatmight be out there.

The local nature of services also means thatprovision is patchy. Survivors in different areaswill find very different levels of supportavailable; some may be able to access aservice providing best practice support, whileothers may not be able to access anything atall. Donors are constrained by this localvariation, although we will also highlightnational charities that contribute to greateravailability of services regardless of location.

Options for donorsDonors wishing to support adult survivors ofabuse have three main options:

• Funding local survivors’ groups, which areoften small, reliant on volunteers andexisting on minimal or shrinking funding.This is a direct way of meeting the need.

• Supporting a helpline, which can helpprofessionals and members of the publicidentify local support.

• Supporting the sector as a whole, througha coordinating body, which can representthe needs of survivors to both policy-makers and the general public.

These three options generate results indifferent ways. National and sector-wide workcan reach more survivors, but is likely togenerate results in the longer term. Localsupport groups are more limited in reach, butcan help individuals more directly and moreimmediately.

At the end of this section, we outline ways inwhich donors can think about prioritising theirsupport across these different options.

Long-term effects of abuseSection 1 exposed the potential long-termeffects of childhood abuse. The strongestcorrelation seems to be with mental healthproblems, but there are also links with lateroffending and re-victimisation (whether throughdomestic or sexual violence). Research intosurvivors of sexual abuse in West Yorkshirefound the three most common problems weremental health problems, self-harm and suicidalfeelings. These problems were found in morethan four out of five survivors. They wereclosely followed by relationship problems,parenting difficulties and substance abuse.

2

These reports come only from those survivorswho disclose abuse or are identified as a resultof the other problems they have. It would bewrong to make the assumption that allsurvivors of abuse have such problems. Itwould also be wrong to conclude that theproblems they have are directly caused bytheir childhood abuse.

NPC estimates that there are around five-and-a-half million survivors of serious childhoodabuse (see Appendix 1 for calculations), manyof whom will never have disclosed abuse to aprofessional agency or received professional

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The effects ofabuse canemerge at anytime; whetherfive, 10 or 50years after theabuse occurred.

The highnumbers ofadult survivors inmental healthservices and theprison systemsuggest thathelp is not thereearly enough forthe vast majorityof those whoneed it.

help. Not all survivors want or need such help.Some are relatively unaffected by the abusethey suffered.

This is not to say that they will never needsupport. Sadly, the effects of abuse canemerge at any time; whether five, 10 or 50years after the abuse occurred. Many reportthat having their own children was a difficulttime, others that the trigger point was whentheir children reached the age they were whenthe abuse started. Bereavement, a high-profilecase in the news, or even a televisionprogramme might trigger renewed trauma.

16, 225

It is likely that many turn to friends and familyfor support, but this option is not alwaysavailable. Friends and family may be ill-equipped to deal with disclosure and may notknow what to do. Indeed, recent researchsuggests that disclosure can be moredamaging than non-disclosure if met with anegative response.

104The demand for survivor

stories, self-help literature and counsellingwould suggest that there are a number ofsurvivors who want help. At the extreme end,the high numbers of adult survivors in mentalhealth services and the prison system suggestthat help is not there early enough for the vastmajority of those who need it.

What services are available; whatare needed? In an ideal world, there would be no need forservices for survivors of abuse. Child abusewould be prevented. Failing that, picking upabuse earlier on and offering appropriate,effective treatment and support should reducethe number of survivors who continue to sufferongoing harmful effects of abuse.

But even if all of the problems presented so farin this report were solved (an unlikely outcomegiven the scale of the problems), survivors ofabuse would still exist, and need help dealingwith their abuse. Sexual abuse, for example,exploded in the public consciousness only ageneration ago. Prior to the 1980s, it was verymuch hidden behind closed doors. Incest hasbeen recognised and legislated against for acentury, and sexual abuse is certainly not anew phenomenon, but it was not a topic forpublic discussion. Nor was it the focus of childprotection agencies.

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The National Commission of Inquiry into thePrevention of Child Abuse received over 1,000letters from survivors of abuse in the mid-1990s. Only around half had had any formalhelp, and in nearly nine out of ten cases thiswas in adulthood as opposed to at the time ofabuse. Around two thirds of those whoaccessed survivors’ groups or other charitiessuch as the Samaritans (the only 24-hour

counselling helpline) found them to be mosthelpful. Professional services, for example,health, psychiatric and social services, wereleast likely to be viewed as the main or mostuseful source of help.

Many received informal help, from friends orfamily. Nearly one third, however, felt that noone or nothing was helping, with only one infive stating that they had come to terms withthe abuse.

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Some survivors may be identified when theybecome parents, or, more worryingly, oncetheir own parenting is called into question.Many of the services discussed in Sections 2and 3 will have come across parents whodisclose their own abuse. A great opportunityhas been missed when the fallout of abuse isnot picked up until the next generation suffers.

For want of other services, the burdencurrently falls on the Department of Health.Indeed, the treatment of survivors is primarilyseen as a mental health issue bygovernment.

226Research in Bradford among

local service providers, both government andcharitable, found that two thirds came acrosssurvivors of sexual abuse regularly. Half werereferred to local authority mental health orpsychotherapy teams.

2

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Not seen and not heard Adult survivors

A greatopportunity hasbeen missedwhen the falloutof abuse is notpicked up untilthe nextgenerationsuffers.

Box 31: Birmingham Rape and Sexual Violence Project (RSVP)

RSVP is a small, professional charity offering a helpline and counselling service for victimsof sexual abuse or violence. Three out of five clients were abused as children, the majorityat the hands of family members.16 Triggers for approaching the service, if not sexualviolence, were typically relationship breakdown or because clients now had childrenthemselves. The majority experience mental health problems, with self-harm and drugsand alcohol used as coping mechanisms.

One in five clients is male. In the charity’s experience, men take longer to come forwardfor help. As a result, they are more likely to be at crisis point by the time they arrive, livingchaotic lives and using greater quantities of drugs and alcohol to cope. They may alsoexperience confusion over their sexuality if they have been sexually abused by men. Theservice is promoting its service to the lesbian, gay and bisexual community in the area.

The helpline, which took nearly 700 calls in 2005/2006, offers a listening ear, educationand information. Where possible the service offers face-to-face counselling, using volunteercounsellors (students or qualified). Counsellors use a variety of therapy styles,depending on the individual client. Only around 5% of those interested are offered theservice, given resource constraints. This equates to around 15–20 at any one time, whoare initially offered ten sessions, which may then be extended.16

The service uses feedback forms to get a sense of the impact the counselling is having.Clients are asked to comment on the level of self-harm or self-medication, for example,as a proxy for emotional well-being. The charity receives unprompted feedback also,such as letters expressing their gratitude for the ‘life changing’ support received. Theservice costs only a few hundred pounds per client.

RSVP is currently operating at only 25% of the capacity (hours of support delivered) itoffered in 2004. Funding cuts had forced the service to be reduced, and the servicewas only saved by the new Home Office Victims Fund. Only one in four of those whoapply to the Victims Fund receive funding, and the future of this funding pot is uncertain.RSVP is relatively robust in comparison with other survivors’ organisations, several ofwhich have closed since NPC started researching this area.

I am notmentally ill; I ama victim ofsexual abuse.

Survivor 2

they feel their own behaviour may bequestioned; this is particularly pertinent forparents and male survivors of abuse.

It is unsurprising in such a climate thatsurvivors may be reluctant to seek help.Reports from charities (see, for example, Box31) suggest there is nonetheless high demand.Charities, many of which have been set up bysurvivors or their friends or family, seem to beone of the few options between informalsupport from friends and family and psychiatricsupport.

‘Some survivors are in crisis but not all of usare. There seems to be an attitude of eitheryou are fine (recovered) or in crisis and acomplete wreck. We need a less black andwhite approach.’ 2

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Yet mental health services are under extremepressure. Mental ill health accounts for 13% ofthe NHS budget, but 20% of its users. Fundsallocated for mental health services are beingswallowed up by deficits in primary care trustsand strategic health authorities.

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Furthermore, the mental health connection is abarrier to asking for help. Mental healthremains a source of stigma and discriminationin the UK. Members of the public andprofessionals view people with mental healthproblems as dangerous, unpredictable, anddifficult to communicate and empathise with.

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Another barrier preventing survivors comingforward is the perceived connection betweenbeing abused and abusing others (see Box 2).Survivors may be reluctant to come forward if

Where was thewelfare then?Where was thecounselling?[…] I feel I shallnever be awhole humanbeing. Mymother used tosay youshouldn’t live inthe past. I don’t,the past lives inme.

Survivor 9

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Government response isimprovingThe research mentioned above wasconducted in Bradford by the charitySurvivors West Yorkshire. Of the survivorspicked up by local agencies, while half werereferred to specialist mental health services,two thirds were referred to specialistcharitable services.

2

The government response has in the pastbeen disjointed, but things are improving.The Home Office has some responsibility forvictims of crime. The Victims Fund wasannounced in 2004, with £4m to give awayover two years. This is less then 40p persurvivor of child sexual abuse each year.

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A further £1.25m was made available for2006/2007 and again for 2007/2008.

The Home Office argues that amounts aresmall as it is up to local authorities what theyprovide locally, not central government.Therapeutic support for survivors is seen as amental health issue, first and foremost, so localhealth authorities are expected to commissionadequate services. The Department of Healthis developing guidelines for primary care trustson commissioning services from charitiesworking with survivors.

The Home Office also argues that blanketfunding should not be available until it isestablished what works.

226This makes sense,

yet little research is available as yet on this.

A new programme housed within theDepartment of Health, the Victims of Violenceand Abuse Prevention Programme (VVAPP), isattempting to raise the profile amongprofessionals of the effects of domesticviolence, childhood sexual abuse and assault.To date, the team has produced research intothe effects of abuse and a review of the needsand effectiveness of programmes for youngsexual abusers. Its mapping programme ofservices for survivors, victims and youngabusers is yet to be published. It is alsocanvassing opinion among professionals(including survivors’ organisations) as to theeffectiveness of different therapeutic servicesfor survivors of sexual abuse.

In England, a cross-government action plan onsexual violence and abuse was launched inApril 2007, a key objective of which is toincrease access to health and support servicesfor victims.

116The National Stakeholder

Advisory Group on Sexual Violence andAbuse, containing representatives fromcharities, fed into the plan.

Similar moves are under way in Scotland. Initialresearch in 2003 estimated that only 1% ofcases of childhood sexual abuse aredocumented in health records, and that if thehealth service had to respond fully to thehealth consequences of childhood sexualabuse it would cost an extra £30–60meach year.

In 2005 the Scottish Executive announced anAdult Survivors Reference Group, with publicservices and charities as members. The aim isto ensure that existing services respond betterto survivors, with the recognition that a certainamount of pump priming will be needed.Accordingly, a Survivors Fund of £2m wasannounced.

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These developments are very welcome. Thiskind of commitment from government signalsto the public and local authorities (which fundservices) the seriousness of the issue.

The only warning note is that the strategy isexclusively focused on sexual abuse, as aremany services for survivors. This isunderstandable, given that sexual abuse wasignored for so long. Moreover, most childrenreceive no therapy to try to reduce the harmcaused by abuse.

To be fair, many of the survivors’ charities workwith survivors of other forms of abuse. But theexclusive focus on sexual abuse sends out themessage that sexual abuse is somehow moreimportant or damaging than other forms ofabuse. Recent evidence has emergedsuggesting that less obvious forms of abuse,such as verbal abuse, have just as deleteriouseffects as other more well-researched forms,such as sexual or physical abuse, particularlywhen combined with other forms, such asdomestic violence.

229Keeping the spotlight

exclusively on sexual abuse may preventsurvivors of other forms of abuse fromcoming forward.

Small charities are filling the gapMany would argue that there is no ‘right’ wayto help survivors. Survivors are an extremelydiverse group, with wildly different experiences,personalities and needs, and therefore a certainbreadth of provision is needed. For some of thesurvivors who wrote in to the Commissionmentioned above, formal counselling or therapywas best; for others, support from friends andfamily. What is important is that help isavailable if needed, and that there is a certainelement of choice. One literature review of theevidence concluded:

‘Providing choice in these matters clearly hasan important empowering function whichshould be one of the key goals of therapeuticintervention.’

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If I had got somepropercounselling it’spossible myfather would nothave got theopportunity tosexually abusemy owndaughter. Noone ever told methat he wouldcarry on doingthesehorrendousthings. I thoughtit was just me atthat time.

Survivor 9

ʻ

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Some services for adult survivors are relativelynew, and many have been set up by peoplewho have little previous experience ofestablishing and running organisations.Coupled with the fact that the issue is low onthe public and policy agenda, many groupsface an uncertain future.

It is important to note that funding difficultiesdo not mean charities are not effective.Funding does not follow results in the world ofcharities. Many of these charities are deliveringmuch-needed services in a very professionalmanner, which the most recent governmentaction plan recognises.

Local groups meeting local needsThere are thought to be around 150organisations catering specifically for survivorsof childhood abuse. Typically, they develop inresponse to local need. Many have been setup by survivors themselves who found therewas no support for them when they needed it.They are typically small (less than £100,000income). Although signposting betweenorganisations is good, there is some evidenceof ‘reinventing of the wheel.’ The area as awhole has suffered from being low on thepublic and policy agenda. Chronic under-funding threatens the ability of most groups tomeet the needs of current clients, let alone themany more clamouring at the door.

Helpingsurvivors canprevent somany ending upin mental healthservices or theprison system. Itmay alsoprevent theabuse andneglect of futuregenerations.

Many are attached to women’s groups, whichoffer counselling for victims of domestic andsexual violence. This no doubt arose from thefact that women who have experiencedphysical or sexual abuse in childhood are morelikely to be the victim of domestic violence orrape as adults.

65Most centres find they have

women who come in to discuss current orrecent abuse or violence and end up disclosingchildhood abuse (see Box 31 for one exampleof a counselling service). For some, thisrepresents up to 80% of their users.

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There is great variation in who these charitieswork with. Some work only with sexual abusesurvivors, others only with adult survivors ofchildhood abuse (rather than adult victims ofsexual violence). A handful have sprung upthat only work with men, developed on thebasis of need and also the exclusion of menfrom many organisations’ services, whetherbecause of practical constraints or ideologicalbarriers. Some work with both children andadults, such as Eighteen and Under(see Box 29). Others offer support to parents,siblings and partners of survivors of abuse, tohelp overall recovery. There is a particulargap in provision for men and adults withlearning difficulties.

2

Survivors’ charities offer a range of services,beyond counselling. They offer training tofellow professionals on the needs of survivors.They guide and support survivors whendealing with police, courts, legal and medicalservices. Some run arts and crafts groups, orbefriending services.

Little research has been done on theeffectiveness of survivors’ services, althoughVVAPP is looking into what works in terms oftherapy. Many charities implement their ownmonitoring systems, using informal feedbackor questionnaires to measure the progress ofthose they work with. As noted in Box 31,such support can be seen by survivors aslife changing.

National solutionsThe Home Office conducted research into thefeasibility of a rape crisis line a few years ago.The idea was dropped because of a lack oflocal direct services to where victims could bereferred.

226Arguably, there is the same difficulty

for survivors. As long as local support remainspatchy, it is difficult for something like anational helpline to fulfil its true potential.

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Box 32: The Survivors Trust

The Survivors Trust began as an informal support network for five survivors of sexualabuse organisations in 1999. It now has 120 members. Its aims are two-fold:

• to promote the efficiency and effectiveness of charities that work with male andfemale survivors of rape and/or childhood sexual abuse; and

• to advance the education of the public regarding effective responses to rape.

So far, lacking capacity and resources, it has largely acted as a representative of itsmembers. In 2005/2006 it has:

• been an active member of numerous expert groups within the Home Office andDepartment of Health, including facilitating the research undertaken by VVAPP;

• developed a funding database to support member groups applying to the VictimsFund and reported on the funding crisis facing the sector;

• coordinated the sector’s response to various consultation documents fromgovernment; and

• supported networking among its members through its inaugural conference,regular bulletins and direct advice on issues from funding to best practice.

The charity has ambitious plans. It is keen to develop media contacts to increase theprofile of survivors, and to conduct research on the effectiveness of its members’ work,to give just two examples. It is hampered by having only two members of staff.

Nonetheless, a charitable helpline, TheNational Association for People Abused inChildhood (NAPAC), has attempted to act asa national gatekeeper, offering a listening earbut referring on where possible. It started in2002 and ran for two years using sixprofessionally trained helpline workers. Justunder half of the 20,000 calls were answered,with around half calling to talk about sexualabuse, the remainder calling to talk aboutchildhood neglect, emotional or physical abuse.

The model proved too expensive, and thehelpline closed for a year before reopening in2006 using volunteers and a reducedtimetable. It aims to keep call length down(averaging 15 minutes), as the focus is onoffering choices rather than advice. Aroundhalf of callers are referred on to other services.

Over the same period, the charity TheSurvivors Trust has emerged. It is an umbrellabody that aims to coordinate survivor charitiesin an effort to raise the profile and resourcesfor the sector as a whole (see Box 32). It alsoreflects the weakness of the sector. As amembers’ organisation, its executive councilhas suffered from members being preoccupiedwith crisis funding situations within their ownorganisations. This inevitably reduces its abilityto perform. Yet, as Box 32 shows, it hasmanaged to make gains in the field.

If services for survivors are to improve, such anational service seems vital in order to create aplatform for survivors. The profile of the issueneeds to be raised, among the public andgovernment initiatives (which VVAPP is trying todo), particularly focusing on the potential long-term effects, without stigmatising survivors.

Survivors’ organisations signpost well to oneanother, but the small amounts of fundingavailable inevitably create competition. TheSurvivors Trust was in the unenviable positionof having to vie for funding with theorganisations that it seeks to represent. Thenew government action plan recognises thisproblem and has set aside separate fundingfor The Survivors Trust to help it develop in theshort term.

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ConclusionsNot every survivor wants or needs help.However, a significant number of the five-and-a-half million adults who have experiencedchildhood abuse do need help. Survivors arefound in the mental health system, substanceabuse treatment centres and the prison system.They are also over-represented among parentsbeing investigated by child protection services.Donors who want to tackle both the causes ofabuse and its effects should strongly considersupporting services for survivors of abuse.

Prioritising fundingAs things stand, survivors’ charities are a highrisk option for donors. Sustainability isquestionable given the funding situation, andresults are far from clear. Nevertheless, thelevel of demand means that there is acompelling reason for donors to support localsurvivors’ groups. The little evidence there issuggests that the non-judgemental supportoffered by charities can be very beneficial forclients. Academic research suggests that awide range of therapeutic styles are proven toreduce depression, anxiety and raise self-esteem. Such services tend to be cost-effective.

7They are also likely to reduce the

burden on local government services. Themajority of the estimated $98bn annual cost ofchild abuse in the US came from the longer-term fallout of abuse.

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Local and national services are needed intandem. NAPAC takes calls from all over theUK, and can enable professionals andmembers of the public to identify options, butif there are no local services to refer to, itsimpact is limited. The Survivors Trust canhelp to raise awareness of the sector, itspotential and its need for funding, as well asimproving the effectiveness of work throughlocal support groups. Supporting theinfrastructure of the sector as a whole shouldhelp reduce risks.

NPC would urge donors considering fundingthis area to remember that it is not simplyreactive. Helping survivors can prevent somany ending up in mental health services orthe prison system. It may also prevent theabuse and neglect of future generations.

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8SocietyBroader changes in attitudes andbehaviours are required across the countryin order to tackle child abuse head on.Work that aims to create change acrosssociety as a whole may be the mostfamiliar area of this field to donors.The Full Stop campaign by the NationalSociety for the Prevention of Cruelty toChildren (NSPCC) is by far the most visibleelement of charities’ recent efforts to tacklechild abuse.

But public attitude campaigns alone cannotstop child abuse. There are a number ofways in which charities can help to changesociety’s attitudes and ensure that directapproaches to tackling abuse can workeffectively. These steps are all necessary ifwe are even to hope that child abuse canbe totally prevented.

Setting the context for donorsAs we have seen in Sections 2 to 7, there area number of barriers to reporting abuse.At the very least, this allows abuse to carry onfor longer. At worst, it undermines efforts toprevent abuse. If all abuse was reported anddealt with swiftly, it could even preventsome forms of abuse from occurring in thefirst place.

On a personal level, the failure of society torespond can cause further harm. This can bemore damaging than the abuse itself. Thetestimony of survivors who wrote in to TheNational Commission of Inquiry into thePrevention of Child Abuse highlights this:

‘I suffered years of physical and mental abuseat the hands of my mother […] What hasalways bothered me more than anything elsewas the fact that nobody helped me.’9

‘To this day I am haunted by the thought ofhow many little girls had their childhoodsruined by this evil man […] Nobody confrontedhim or reported him […] Most of mynightmares are caused by the fact that nothingwas done after my ordeal to prevent him fromdoing it again to others.’9

By helping to remove barriers to reporting, andimproving the system once abuse is reported(covered earlier in this report), donors can helpto reduce the ongoing impact of abuse.

But we have to ask why there are suchbarriers in the first place, and why they are notbeing brought down when nearly everyoneagrees that child abuse has no place in acivilised society.

This final section of this report will examinehow these barriers can be overcome.

Options for donorsDonors wishing to support work tacklingabuse at the society level have a number ofoptions:

• Listening to children. Confidential spaces inwhich children can tell adults about abusethat is happening to them are vital. So arechannels through which children can voicetheir concerns and views about how theyshould be protected, and how the systemaffects them.

• Monitoring and campaigning for children’srights. Charities play a key role aswatchdogs, keeping a check on children’srights in the UK, and informing children oftheir rights.

• Changing attitudes and behaviours. Donorscan support important long-termcampaigns to change the attitudes thatunderpin society’s treatment of children.

• Empowering communities to help protectchildren, both through the use of volunteersin communities, and through work aroundharmful cultural attitudes and behaviours.

The results of charities’ work at the level ofsociety and community are likely to take placeover longer timescales than work withindividuals. Donors may want to think aboutbalancing their desire to see results in theshort term with achieving long-term changethat can potentially affect all children in the UK.

At the end of this section, we will return toconsider the results of work in these differentareas. This will help donors to think about howto focus their giving most effectively.

Society’s attitude to childrenMany professionals would argue thatunderlying the considerable problemsdescribed in this report is society’s attitude tochildren. This report has so far focused onmore immediate factors that are linked to childabuse, and how donors can tackle these.Society’s attitude to, and treatment of, childrenis perhaps less tangibly linked to child abuse.Yet it is an important factor.

Using the example of disabled children, it ispossible to draw connections betweensociety’s attitudes and greater vulnerability toabuse. In Section 5, we touched on the factthat disabled children are three times more

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The lack of aneffective, rights-based childprotectionsystem is both asymptom andcause of our notat all child-friendly society.

Peter Newell, Director ofChildren are Unbeatable!

Alliance

ʻʻ

likely to be abused than other children. This isfor three main reasons:

• factors associated with their impairment;

• inadequate services; and

• society’s attitudes and assumptions aboutdisabled children.

8

The three factors intertwine. Most people donot know that disabled children are more likelyto be the victims of abuse. A small proportionof disabled children are ‘isolated from theirfamilies […] with little or no contact withpeople outside their schools, foster orresidential homes and a circle of busyprofessionals.’

21This leaves them far more

vulnerable to abuse, particularly if they have animpaired capacity to protect themselves, orhave communication difficulties and thereforecannot express what is happening to them.

231

But no less important in our understanding ofthe abuse of disabled children is the fact thatover half of families with a disabled child live inpoverty, as it costs three times as much toraise a disabled child as a non-disabledchild.

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This links to the second factor. An AuditCommission report in 2003 found disabledchildren experienced a ‘lottery of provision, ajigsaw puzzle of services, and too littleprovided too late.’

232This is no doubt

connected to the further fact that four out offive families with severely disabled childrenhave reached ‘breaking point’,

232increasing

the risk that a child will be abused.

Combine the facts that any child is unlikely toreport abuse and that disabled children mayhave added difficulties in protectingthemselves or communicating abuse, and thelikelihood that abuse is reported becomesslim. If abuse is reported, barriers tosafeguarding disabled children have beenidentified at each stage of the process. Fromreferral to prosecution, professional attitudesrange from disbelief that abuse has occurredto a belief that disabled children do not makecredible witnesses.

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The effects that prejudice and ignorance of thiskind have should not be underestimated.Disabled children are ‘commonly seen in termsof their impairment and the characteristics thatmake each child unique—age, gender,ethnicity, religion and culture—are subsumedin the one label.’

8Disabled children are not

afforded equal protection.

Disabled children have particular needs andface particular prejudices; donors interested insupporting disabled children should refer toNPC’s report, Ordinary Lives.

The issues facing disabled childrenreflect the problems facing all children:

• If we do not know the extent to whichchildren are abused, we will not look out forsigns.

• If we do not know what factors lead tochildren being more vulnerable, we will donothing to protect them.

• If we do not listen to or believe children,abuse will not be stopped.

• If we do not see children as equal membersof society, with their own rights, child abuseis unlikely to be stopped.

• If we do not afford children equalprotection, child abuse is unlikely to bestopped.

• A lack of knowledge and awarenesscombine to keep abuse secret.Disincentives for abusers melt away.

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Society’s barriersPicking apart the literature on the matter, itseems there are four key barriers to beovercome:

• Children’s voices are not heard in everydaylife. This reduces the likelihood of abusebeing identified and, arguably, prevented.

• Children are not afforded the same level ofprotection as adults.

• Society as yet does not recognise thateveryone has a part to play in protectingchildren.

• Linked to the above, the‘professionalisation’ of child protection hasto some extent taken the focus away fromwhat communities can do to tackle abuse.

Each barrier has many facets, and manydifferent potential solutions. So what candonors do about such large and unwieldyissues?

Below we describe several options in each ofthese categories, options which in many caseshave been identified already in this report. Weintroduce only a few additional charities thatare helping to tackle what can be calledcultural causes of child abuse.

This section concludes with a consideration ofvery specific harmful cultural attitudes andpractices, such as ritual abuse, which havereceived growing interest in recent years.There is a frustrating lack of options for donorsin this field, although NPC continues to searchfor effective charities and liaise with fundersthat are active and have expertise in this area.

Just under onein ten childrensaid grown upsnever listened.

The National Commissionof Inquiry into the

Prevention of Child Abuse9

Not seen and not heardAt various points in this report, the failure tolisten to or consult children has been noted.Their voices are not heard in the literature onthe matter, certainly not as much as one mightexpect. Nor is the system very child-friendly. Itis perhaps little surprise therefore that childrengenerally do not report abuse.

When they are asked, children complain of notbeing listened to. The National Commission ofInquiry into the Prevention of Child Abuseconsulted around 1,000 children and youngpeople. They were asked, among other things,what they most wanted to change aboutgrown ups. The unequivocal answer was moreand better communication—more listening;greater understanding and support; moreattention; and more talking to children. Mostdid not believe that adults listen to what theysay. Around a half responded that theysometimes did. Just under one in ten saidgrown ups never listened.9

It is unfair to expect children to report abusewithout giving them the tools to do so, orguaranteeing a climate in which their reportingwill be taken seriously and acted upon. Neitherof these things is afforded to most children.

In Section 6 we touched on the importance ofchildren in schools exploring the concept ofharm, being asked directly if they have beenharmed, as the charity Eighteen and Underdoes to such effect. The evaluation of itsservice concluded that a large part of thesuccess of the charity in eliciting disclosureswas due to the openness and accessibility ofthe staff.

224They are, quite simply, very good

at listening to children.

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Adults cannot expect children to tell them thethings they think really matter if they do notlisten to them. Children express themselves intheir own way. Vivid examples of this areprovided every day at the NSPCC’s ChildLine(see Box 8 for more information). One boycalled to say he wanted to learn French. Thecaller did not question this, nor theappropriateness of the call. She simply allowedhim to talk, following his line of conversation. Ittranspired, quite quickly, that the child wantedto learn French because if he become good atFrench he would look good in class. This mighthelp him find some friends. He was beingbullied, and it was making his life miserable.

ChildLine does not promote itself as a childprotection helpline, despite having its origins ina That’s Life special uncovering sexual abuse.It promotes itself as a help and advice line,and has been very successful at promotingitself to children. The result is that children, likethe boy above, call about whatever isbothering them. Allowing children time andspace, and a certain level of confidentiality,encourages 4,500 callers each day.

The importance of this issue should not beunderestimated. Barnardo’s research intosexually exploited children found that theyoung people they worked with wanted toenter adulthood, ‘on almost any terms.’ In thiscontext, entering adulthood means hangingaround with dangerous adults, having sex,taking drugs. The authors concluded that thiswas a reaction to ‘powerlessness, and theirfrustration at not being heard when they speakof their lives and difficulties.’

11

Donors could support charities directlyinvolved in talking to children, such as thosementioned above. They should also ask of anycharity they are considering funding howchildren are involved in the service; forexample, how is it getting around the barriersto children accessing the service directly?

Does Every Child Matter?The lack of a voice for children is reflected atgovernment level. Children are not afforded thesame level of protection as adults. There havebeen some positive developments in recentyears, but there is still a long way to go.

As mentioned in Section 2, the UK is asignatory to the UN Convention on the Rightsof the Child. The last Committee report (2002)on how well the UK was adhering to theConvention was extremely critical of the UK’schildren’s rights record, and in UNICEF’s 2007report on children’s well-being the UK camebottom of a league table of 18 rich countrieson the well-being of its children.

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The government’s Every Child Matters reformprogramme includes elements of listening tochildren. Children’s services commissioned bylocal authorities have to take into considerationthe views of users, ie, children and theirfamilies. The programme also created the roleof Children’s Commissioner to representchildren’s views. However, the role in Englanddoes not have as much focus on children’srights as some campaigners would like, unlikein Scotland and Wales. The Children’s RightsDirector has a duty to represent children incare, whose voices have been heard through anumber of published reports.

These tentative steps sit uneasily with otherareas of government policy. Children continueto be seen as possessions rather than aspeople ‘with rights and developingresponsibilities of their own.’

20Indeed, it has

been argued that policy change in England isdriven more by a desire to secure the future ofthis country (its future citizens) than a desire toprotect children because they are people intheir own right.

196

Whether or not this is the case, there remainanomalies that do not fit well with the EveryChild Matters agenda. For example, theexistence of a legal defence for battery of achild suggests that children are not equal in theeyes of the law in either England or Scotland.The Children Act (2004) clarified the previousdefence of ‘reasonable chastisement’ inresponse to mounting pressure. The law nowstates that ‘battery of a child cannot be justifiedon the ground that it constituted reasonablepunishment’, but this applies only if it results inactual or grievous bodily harm. In Scotland,Section 51 of the Criminal Justice (Scotland)Act 2003 enshrines the right of parents andcarers to commit ‘justifiable assault’.

Many child protection professionals think thatcorporal punishment is a barrier to improvingchild protection in the UK.

7Children’s charities

subscribe to the importance of children’s rightsand enacting them at every turn. But they arenot always as vociferous as they could be. Thenew Chief Executive of Barnardo’s related amessage given to him by a senior governmentofficial when interviewed shortly after cominginto post:

‘God help us if the Big Five [NSPCC, NCH,The Children’s Society, Barnardo’s and Savethe Children] ever got their act together andcame at us with a united front.’13

Supporting alliances is one way of ensuringthat campaigns are coordinated for maximumimpact. The Children’s Rights Alliance forEngland (CRAE) is the focal point of activityaround children’s rights in England. It hasaround 350 members, mostly children’scharities, but is run with only a handful of staff.CRAE acts as a watchdog on children’s rights.

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God help us ifthe Big Five[NSPCC, NCH,The Children'sSociety,Barnardo's andSave theChildren] evergot their acttogether andcame at us witha united front.

Senior government official, asrelated by Barnardo’s Chief

Executive, Martin Narey13

The NSPCC canrightly claim tohave kept theissue of childabuse in thepublic eye.

ʻ

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It publishes a report each year on the State ofChildren’s Rights in England. The most recentreport found that significant progress had beenmade in 2005/2006 on only 12 out of the 78recommendations made to the UK by the 2002UN Committee on the Rights of the Child.

57

CRAE also produces publications for childrenthat make their rights clear. Finally, it uses itsknowledge base to lobby government. Overthe years, its successes include drafting theamendment to the Children Act (1989)requiring that social workers give dueconsideration to the child’s wishes and feelingsin child protection investigations. This is agreat step forward.

Children’s rights are not top of the agenda.The next stage of the charity’s strategy is tohire a barrister who can take on the cases thatare referred to the charity weekly, whichdemonstrate miscarriages of justice. A fewlandmark rulings should help push thegovernment further to implementing thelegislation it has pledged to support.

Many of the larger charities mentioned so farin this report lobby and campaign on a varietyof issues. On many issues, they work together,as in the case of CRAE. Donors shouldconsider supporting such work, as this iswhere the biggest gains are to be made.Supporting initiatives that change the culturaland legislative context can have a positiveeffect on a far greater number of childrenthan direct services. The downside is that theresults of such work are longer term, lesscertain, less easy to measure and lesspossible to attribute to any particularorganisation.

Tackling attitudes, Full StopThe NSPCC is the biggest player in the field ofchild abuse. It has the laudable and ambitiousaim of ending child cruelty, ‘full stop’. All of thecharity’s activities aim to end child cruelty. Oneof these activities, specifically linked to culturalchange, is its public campaigns.

The NSPCC regularly monitors publicperceptions on child abuse, in an attempt totrack the effect of its campaigns. Ending childcruelty in recent years has consistently comeout above other issues such as care forcancer patients and supporting human rights.

As noted above, attributing changes to anyone charity is difficult, and in recent years therehave been several very high-profile deathsrelated to child abuse that have receivedwidespread media scrutiny, not least that ofVictoria Climbié, which prompted the EveryChild Matters agenda. However, the NSPCChas done a lot to keep this issue high on theagenda, and the tracking systems that it usesshow peaks when the NSPCC runs

The conclusionthat child abuseas a whole canbe prevented isharder to justify.The myriad riskfactors linked toabuse makestopping abusedifficult, letalone preventingit altogether.

campaigns. It would seem that the NSPCCcan rightly claim to have kept the issue in thepublic eye.

This is the first step in its prevention strategy.The next steps are unprompted awareness ofthe four types of child abuse among thegeneral public; agreement that ‘we really canput an end to cruelty to children’, and anincrease in the number of those who sign upto the statements ‘I am playing a role in endingcruelty to children’ and ‘I am willing to takeaction to protect children.’ The charity is alsomeasuring the percentage of adults who agreewith the statement, ‘I would know what to doif I was worried about the safety of a child.’

From 2005–2006 there were gains in some ofthese areas, such as the importance of endingchild cruelty, but losses in others, such as ‘wereally can put an end to child cruelty.’

233

The crucial next step is moving people fromattitudes to action. The NSPCC’s campaignsare trying to test whether there are increases inthe percentage of adults:

• responding to hypothetical scenarios ofabuse and saying that they would takeaction; and

• who, having been in a situation where theywere worried that a child was experiencingcruelty, have taken action to safeguardthat child.234

It is less clear what has changed on thesemeasures. Measurement here still relies onwhat people say rather than what they do. Theacid test is in referrals, which are very difficultto measure. Referrals made by individualsmight not always make it through to ‘official’referrals to social services or the police. Butthe overall total of referrals to social serviceshas not gone up in recent years.

The NSPCC’s renewed commitment toprevention, of which these cultural campaignsare just one aspect, came with the strategyreview the charity underwent in the late 1990s.This was partly as a response to the NSPCC-funded National Commission of Inquiry into thePrevention of Child Abuse, which published itsfindings in 1996. Its bold conclusion was that:

‘Child abuse and neglect can almost always beprevented—provided the will to do so is there.’

20

One might reasonably question the logic ofthis conclusion.

To explain, it seems that the Commission wassaying that the worst outcomes of each case ofabuse can be prevented, if the abuse is knownabout, if appropriate interventions are made bythe agencies that have contact with the child,and if information is shared between all suchagencies to ensure the right action is taken.

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But this claim relates only to cases of abusethat have already been identified—to abusethat has already occurred.

The Commission’s claim, therefore, does notmean that all cases of child abuse arepreventable. It simply means that the negativeeffects of abuse can be minimised providingappropriate action is taken by the agenciesinvolved. But if no child protectionorganisation is aware of a child being at riskof harm, no action can be taken until theabuse is identified.

What the claim above does not do is provideany link between changing attitudes to abuseand tackling causal mechanisms that leadto abuse.

Attitudes can and do change. For example,sexual abuse was not really in the public eyeor on the professional agenda until the 1980s.Corporal punishment was banned in schools,when the majority of the population supportedit. Until the 1990s, sexually exploited childrenwere seen as child prostitutes, and treated asprostitutes rather than children. More andmore questions are being asked about thelegitimacy of corporal punishment in the home.

But the conclusion that child abuse andneglect as a whole can be prevented seemsharder to justify. The myriad risk factors linkedto abuse make stopping abuse difficult, letalone preventing it altogether. Improvedattitudes to abuse can certainly facilitate theidentification and reporting of abuse that isalready occurring, but they seem to have verylittle bearing on whether a substance-abusingparent neglects their child behind closeddoors, or whether a sexual offender choosesto abuse a child when they have theopportunity to do so in secret.

The conclusion of the Commission seems tobe based on the analysis of individual cases of(extreme or fatal) abuse that have beensubject to inquiries. There have been anumber of inquiries over the years, many ofwhich have concluded that the final outcomewas preventable.

Preventing extreme harm or death throughtimely and appropriate intervention is differentfrom preventing abuse altogether. It is perhapsbetter defined as early intervention thanprevention. This is not to say that earlyintervention is not important—it clearly is.Although it may prevent further abuse, it doesnot equate to prevention.

Preventing all abuse may nonetheless be aworthwhile ideal to work towards; anaspiration to motivate and inspire staff,volunteers, donors and all who want to tackleabuse. This aspiration, however, needs to bebalanced against the knowledge that a wide

range of work on prevention, protection,treatment and research is required to tackleabuse effectively.

The ‘professionalisation’ of childprotectionIt is very difficult to come to any definiteconclusions as to what has changed over theyears in child protection. It would be veryshocking, and quite unlikely, if children werenot safer today than they were 50 years ago inthe UK. But it could be that, with tighter andtighter legislation, we have become overlyfocused on child protection as a profession.

There are questions as to whether structuralchange is simply ‘a shifting around of thedeckchairs on the Titanic’ when the real needmay lie in cultural change.

7, 71

It is clear that the state cannot prevent all childabuse. Section 2 showed that the childprotection system only monitors and supportsbetween one third and two thirds of cases ofserious abuse, and even in those casesmistakes are made. Despite all the recentchanges, it seems that this picture will persist.

It is unfair and unrealistic to expect socialservices and the police to prevent all childabuse, or even always be there to stop it.Doubly so, when we consider that few peopleare willing to undergo greater scrutiny in theirlives, particularly in their homes and families.

Although expertise and training are needed inmuch child protection work, there are manysolutions to be found in the community. Toname just a few of the charities mentioned inthis report so far:

• Community Service Volunteers’Volunteers in Child Protectionprogramme, which supports volunteersfrom the local community in helpingfamilies and children deal with theaftermath of abuse in addition to helpingprevent it reoccurring.

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• The NSPCC’s ChildLine uses volunteers tolisten to children’s worries and to try andhelp them make sense of what ishappening, as well as offering them optionsfor action.

• Circles of Support and Accountabilityoffers a low-cost, effective way of reducingthe likelihood of sex offenders reoffending,by offering them a group of local people tomeet with.

All of these initiatives require a high level ofprofessional support and training, but areharnessing the will that exists in the generalpopulation to help children, in a number ofdifferent ways. NPC strongly urges donors tosupport initiatives such as these, as they offerthe promise of re-engaging the community inprotecting children from harm, rather thanplacing the entire burden on child protectionprofessionals.

Cultural attitudes and behaviourscan be harmfulWe highlighted at the beginning of the reportthe difficulty of defining abuse. Abuse isculturally defined and determined. Establishingabsolute measures is difficult; there is aconsiderable grey area, and it is one that shiftswith time.

‘Culture is perhaps the most basic issue forchild abuse and child protection […] Itprovides the basis for both our definitions ofabuse and neglect and the responses we havedeveloped to protect children and to preventabusive acts from occurring and recurring.’235

Culture has a profound influence on abuse.This becomes obvious when we are facedwith other cultures, with different attitudesand behaviours.

We are all influenced by how we were broughtup. Religious and cultural attitudes andbehaviours influence our perspectives. Forexample, when the government debatedparents’ rights to hit their children, the decisionwas influenced by religious arguments.Professional organisations (charities, localauthorities and health authorities) wereunanimous in their condemnation of physicalpunishment of children. But 70% of publicrespondents did not wish to see any changesto the law, and over half expressed strongreligious sentiment supporting parents in theirchoice of punishment.

140Children and young

people were not consulted, and no changewas made to the law.

An awareness of different cultures is importantin child protection, yet ‘cultural and ethnicdifferences are often not recognised at servicedelivery or policy level.’

236

Government guidance states that ‘in order tomake sensitive and informed professionaljudgements about a child’s needs, andparents’ capacity to respond to their child’sneeds, it is important that professionals aresensitive to differing family patterns andlifestyles and to child rearing patterns that varyacross different racial, ethnic and culturalgroups. At the same time they must be clearthat child abuse can not be condoned forreligious or cultural reasons.’27

This requires highly skilled workers who arenot afraid to challenge parents and evencommunity groups. It is a difficult line to tread.It was noted in the inquiry into the death ofVictoria Climbié that the social worker had notquestioned the odd formality between Victoriaand the two adults who were supposedlycaring for her, because ‘respect andobedience are very important features on theAfro-Caribbean family script.’

237

It is not clear whether children from black andminority ethnic groups are under- or over-represented when it comes to childprotection. It is thought that black children, forexample, are over-represented on the childprotection register, but this could be linked toother factors, such as their increasedlikelihood to live in poverty and be in contactwith social services.

On the other hand, a failure to challenge orcriticise the practices of other cultures out offear of causing offence may mean that childrenare also under-represented. In the absence ofdecent data or research indicating prevalenceand referrals, it is impossible to say either way.Some charities, such as Roshni and theNSPCC, are beginning to add to our evidencebase through their research (see Section 2).

It is clear, however, that there are specificcultural forms of abuse that must be tackled,such as female genital mutilation. Options for

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Box 33: Ritual abuse

The torso of a child found in the River Thames in 2001 lies at the extreme end of thespectrum of abuse. The killer was never found, but it is thought that the child camefrom Nigeria and had only been in the country for a few days. The state of the bodysuggested ritual abuse.

Ritual abuse, possession, or witchcraft, is found from Africa to South Asia to Europe.Physical abuse may occur when the child is ‘exorcised’. The ‘possessed’ child is oftena scapegoat, selected either as a result of changes to family structure, or disability, orany other reason that somehow marks them out as ‘different’. The neglect or emotionalabuse inflicted as a result can be extremely damaging.

The DfES commissioned a report into incidents of witchcraft and possession. By talkingto professionals, the researcher identified 38 cases, thought to have occured between2000 and 2006. Three quarters of cases were in London. The numbers are small, butit is likely that they present a minority of actual cases, as with other forms of childabuse.

The report concluded that ‘police and social workers are not able to change the beliefsof carers.’ 34 Many of the children were taken into long-term foster care, which is notideal as it is unlikely that many were offered specialist support or treatment to makesense of, and overcome, the abuse they suffered. Short of removing children from families,however, it is not clear how to tackle the problem on a wider and longer-term basis.

Culture has aprofoundinfluence onabuse. Thisbecomesobvious when weare faced withother cultures,and differentattitudes andbehaviours.

These problems are not easily overcome.Conferences and workshops are planned inthe next stage of the Community PartnershipProject, in order to identify issues andconcerns among more local groups. It ishoped that the improved informationgathered can inform police and other localauthority practice.

NPC has come across few charities that areworking with community groups specificallytackling child protection. The issue is highlysensitive so many are working below the radar.This makes it difficult for donors to find andsupport such groups. NPC continues to lookfor charities that are working successfully onsuch issues, and to liaise with expert funderswho support work in this area. We urgedonors interested in doing something aboutthis area to get in touch with NPC, as routesto supporting such work do exist.

Services cannot afford to be culturally blind;this applies whether they provide directservices or are engaged in campaigning andlobbying. Donors should ask charities,whatever their activity in this field, what theirtarget population is and how they are ensuringthey are not further excluding certain groups.

ConclusionsChild abuse is, at least in part, culturallydetermined and defined. This is heartening, asculture is not fixed. It follows that child abuseis not inevitable.

Realising this is one thing. The NSPCC is theonly charity that has explicitly set out toeradicate child cruelty, which is an ambitiousand impressive goal. It is largely responsiblefor the fact that child abuse remainsconsistently high on the public andpolicy agenda.

Knowing how to prevent child abuse isanother matter altogether. This section hashighlighted four key barriers at a societal leveland ways in which donors can help overcomethem by supporting charities:

• Services such as the NSPCC’s ChildLineand Eighteen and Under are activelylistening to children in an effort to overcomethe fact that adults often do not listen tochildren.

• Campaigning and lobbying charities andalliances like CRAE are tackling legislationthat discriminates against children.

• The NSPCC is attempting to keep theissue high in the public’s mind, encouragingeveryone to believe they have a role to play,and to play that role.

91


Approaches thathave listening tochildren at theirheart are mostlikely to offereffective routestowardscomprehensivelytackling abuseand its effects.

How many of ourchildren gothrough socialservices andcome outproperly? Theyshould tell usthat.

Participant in CommunityPartnership Project research19

donors wishing to tackle this and other formsof violence against women are laid out in theNPC’s forthcoming report on the subject.Other previously unrecognised forms of abuseare also giving cause for concern (see Box 33).

Abuse like this cannot be picked up unlessthere are good relations between the generalpopulation and the local authorities that existto help those communities. Good relationscannot always be found in the generalpopulation; the problem is exacerbated amongcertain groups.

‘Closed’ communitiesThe Metropolitan Police is currently runningCommunity Partnership Projects in eightLondon boroughs, following 2006 researchinto a pilot in Hackney and Newham in anumber of different ‘closed’ communities.These were defined as not being integratedinto the indigenous culture, and having littlecontact with, or understanding by, health andsocial care agencies.

19The research found

previously unknown problems:

• the importance placed on honour and faithsometimes leads to unacceptablebehaviours, including child abuse;

• cultural clashes; and

• a mistrust of agencies.238

Physical abuse was common, but was oftenseen as good parenting, and therefore notabuse. For example, one participant said, ‘It isOK to hit a child with a stick. Our mothers didit and we turned out good.’

19

Talk of sexual abuse was met with flat denialby men. Women were more likely toacknowledge it, but made it clear that childrenshould not (and therefore would not) discloseas it would damage family honour; the childwould be blamed rather than the abuser; andthe child would risk rejection.

19

This, in combination with the lack of reportingfrom black and minority ethnic communities,such as from British Asians, shown in Section2, raises serious concerns about how wellchildren in some communities aresafeguarded. The barriers to identification andreporting are all the greater, and theappropriateness of child protection services ifchildren are identified is unclear. This was notlost on those who participated in theCommunity Partnership Project’s research:

‘They don’t understand anything about whowe are. Why would we tell them?’

‘They don’t look at the bigger picture of whatis going on so how can they understandanything?’

‘How many of our children go through socialservices and come out properly? They shouldtell us that.’19

ʻʻ

• A number of initiatives, such as CSV’sVolunteers in Child Protectionprogramme and Circles of Support andAccountability, are using members of thecommunity to add extra capacity to over-stretched government services. At thesame time they offer something that socialservices could not.

The clearest and most measurable results canbe realised by supporting charities that workdirectly with individuals. However, these resultsare limited in scope to the number ofindividuals directly supported.

In contrast, the work of campaigning andlobbying organisations such as CRAE are lesseasy to measure, but have the potential toaffect many more children and in more areasof their lives. Charities like this are often lessattractive to donors, as they seem to befurther from the child. In reality, they are not. Allthe charities mentioned here have children atthe heart of everything they do.

Returning to the issue of culture, this sectionhas explored some of the ways in whichdifferent cultures can create harmfulbehaviours and legitimise abuse. This is adifficult area for donors to support because ofthe low profile of charities working in the area.But donors with a commitment to doing socan achieve results precisely because it issuch a relatively under-funded area.

Prioritising fundingCampaigns to change attitudes andbehaviours are important for keeping the issuein the spotlight and ensuring continuingcommitment to tackling it, but they do notdirectly offer us hope of preventing abuse.Changes in attitudes do not straightforwardlytranslate into changes in behaviour.

Legislative change, such as that pushed for byCRAE, may be less attractive to donors giventhe seeming intangibility of results, but canpotentially have the broadest impact.Changing the way that we view and respondto children is crucial in the fight against childabuse.

Indeed, the most compelling results are offeredby work that directly listens to children, forexample, the NSPCC’s ChildLine andthere4me listening services. It can inform howwe design and structure the child protectionsystem. It can result in increased reporting ofabuse. But most fundamentally, it allows us toact on what children tell us—about what isimportant to them, how they feel and howchild abuse appears through the eyes of thoseit affects. This may allow us to understandbetter how abuse can be prevented.

Not only can donors directly support work thatlistens to children, they can take the principleand apply it to their thinking about what tofund across all the areas discussed in thisreport. Approaches that have listening tochildren at their heart are most likely to offereffective routes towards comprehensivelytackling abuse and its effects.

92


93

Conclusions and recommendations

The scale of child abuse is huge; both interms of numbers affected and the highcosts for individuals and society. Thecomplexity of the problem might leaddonors to believe that they can do little toimprove the lives of children sufferingabuse. But the very opposite is true. NPChas explored the details of abuse preciselyso that donors can prioritise which areas tosupport to create maximum impact.

To achieve success in preventing abuse,protecting children from harm andminimising the effects of abuse when itoccurs will require a concerted effort bycharities across all the areas covered inthis report.

Yet charities can only provide part of thesolution to tackling abuse. A cultural shift isneeded, not only in terms of how we treatchildren, but also in terms of how we listen(or fail to listen) to them. Such change ispossible, but will take time to achieve—perhaps a generation or more. Bysupporting charities in this field, donorscan play a significant role in helping toachieve this change—and in protectingfuture generations of children from harm.

Where will funding have thegreatest impact?The greatest impact would seem to be offeredby focusing on prevention. But we do notknow how effectively work to change attitudesleads to changes in behaviour, so we cannotbe sure that efforts here will prevent abusefrom happening. Nevertheless, the potentialimpact deserves further exploration. We needto know more about how and whetherprevention works. Donors funding preventionshould also look for and support efforts tounderstand its impact.

We know that a great deal of (perhaps most)abuse is never reported and many abusedchildren never receive support. So the greatestresults are offered by work increasingidentification and reporting. But the childprotection system struggles to offer enoughsupport to those abused children it alreadyknows about. Increased reporting thereforealso needs increases in resources forprotection, treatment and support if it is tohave any impact. Donors wanting to fund inthis area should focus on lobbying to increasegovernment funding, as private funding cannotprovide the additional capacity required.

We do not know enough about theeffectiveness of different approaches totreating abused children to know where thegreatest results are to be found. This meansthat donors can achieve a great deal byfunding research and evaluation alongside vitaltreatment and support. We also do not knowenough about current prevalence of abuse,and how this responds to action taken bygovernment and charities. Research focusedspecifically on child abuse is required to fill thisgap, and allow donors and funders to focuson funding what is really effective atpreventing, tackling and treating abuse.

We know that abuse takes different forms, indifferent settings, and that these requiredifferent approaches to achieve success. Inthe home, donors can support work thataddresses risk factors like substance abuse,domestic violence and poverty. These may notbe popular areas to fund, but they may offerthe greatest results. Further NPC reports willhighlight effective charities working in theseareas. Donors could fund general familysupport, which addresses a range of problemsquite flexibly, although it will never tackleunderlying causes. But NPC does not prioritisefamily support, as this is primarily driven bygovernment funding.

Away from the home, donors should supportwork focusing on particularly vulnerablegroups, like runaways and those at risk ofsexual exploitation.

Sexual abuse requires a different approachaltogether. Most abuse occurs at the hands ofthose unknown to authorities, so the greatestresults are offered by work to identify andinfluence those at risk of offending. For thosethat are already known, treatment, supportand community programmes offer hope ofpreventing reoffending. But this work requireschanges in public attitudes, to avoiddemonising and sending underground thosewho pose a risk.

We know that schools provide an excellentopportunity for charities to reach children.Work that raises awareness of abuse and itseffects can both help to empower children toact to protect themselves, and set positiveattitudes and behaviours for children as theygrow up.

We think that most abuse goes unreported atthe time, so although we do not know howmany adults are survivors of childhood abuse,we do know that the number is huge.

Not seen and not heard Conclusions and recommendations

Supporting them is relatively cheap, but stillthe field faces critical funding problems.Donors can help large numbers of survivors bysupporting this area of work.

We know that society’s attitudes to childrencan create barriers that prevent us fromtackling abuse effectively. Primarily, adultsoften fail to listen to children, and this preventsa great deal of abuse from ever beingreported. Donors can achieve the greatestresults by supporting work that actively listensto children, and by ensuring that all theirfunding is directed towards charities that liveand breathe this principle.

How can funding be prioritised?The question posed on the previous page wasanswered in the form of a list of approachesthat offer the donor excellent results in theirattempts to tackle child abuse. This may seemto dodge the real point of the question—donors might legitimately ask NPC for the oneor two best options for them to fund.

We can answer this question if we know whata donor’s objectives are, and how much he orshe has to invest in the field. But withoutrelating funding priorities to personal objectivesand scale of investment, our answer is thatfunding should form a balanced portfolioacross all the areas. Such a portfolio ensuresthat all critical areas of work are funded: fromprevention to treatment; from guaranteedresults to riskier approaches; from establishedcharities to fledgling initiatives.

NPC’s concept of a balanced portfolio doesnot require every donor to divide their fundingacross all the options highlighted. But byfulfilling a coordinating role across the giving ofa number of donors, NPC can ensure that acoherent body of work is funded, that offersthe hope of making significant and lastingchange to the prevalence and impact of childabuse.

Donors who are committed to a significantinvestment in the field have two options forbuilding their own portfolio in this field. Theycan use the tool presented in Appendix 4 toprioritise funding options, in conjunction withthe outline of a balanced portfolio given below.Alternatively, they can approach NPC to builda coherent portfolio based on their level offunding commitment (scale and timescale),personal interests, objectives and appetite forrisk.

On the subject of prioritising funding, it isworth comparing the high stated priority givento tackling child abuse by the public to thelevel of funding the area receives. Child abuseconsistently appears higher on a list ofpriorities than tackling cancer. Yet the childabuse sector receives £500 million in publicdonations, compared to the £1 billion given towork on cancer.

Finally, listening to and empowering children isat the centre of NPC’s recommendations todonors. This principle cuts across prevention,protection and treatment. Donors can look forcharities that embody this principle, to ensurethat the very children who suffer most at thehands of abusers are firmly at the centre of allthe work that donors choose to support.

94

Not seen and not heard Conclusions and recommendations

Figure 8: A balanced portfolio for tackling child abuse

Prevention

Empowering children• Confidential spaces

• Education/awareness

• Children’s rights

Exploring roots of violence• New approaches to violenceand empathy

Sexual abuse• Helplines and advice

Protection

Child protection

• Family resilience andwhole family work

• Volunteers to support families

Tackling risk factors• See other NPC reportson these subjects

Away from home• Sexual exploitation

• Runaways

Treatment

For children• Lobbying for increased government funding

For sexual abusers• Treatment programmes

• Support/monitoring groups

Survivors

Survivors’ groups• Local groups

Sector coordination• Umbrella body to supportand raise awareness of sector

95

Appendices:Appendix 1: Calculating how manyabused children are protected bythe child protection systemComparing prevalence rates from the NSPCCstudy with those involved in the child protectionprocess is problematic, for a number ofreasons.

Single measure of abuseFirst, establishing a single measure of abuse isdifficult. Abuse is best understood as acontinuum of abusive behaviours, varying intype, severity, frequency and duration.

55There

is significant overlap between types of abuse,raising issues of double counting. The singlefigure of 11% used in our calculation forexperience of abuse is taken from the highestrate of any one type of abuse, that for sexualabuse.

55This means the figure is conservative.

Children are recorded on the child protectionregister by primary type of abuse, to avoiddouble counting. Therefore, the high rates ofchildren registered for neglect may mask thefact that other types of abuse are involved.

105, 239

Continuing risk ofsignificant harmIn addition, it must be remembered whenlooking at these figures that a child is placedon the register if they are deemed to be atcontinuing risk of significant harm. Therefore,those who have been abused but are no longerat risk would not be registered. They may stillbe receiving services however (see below). Thismay account for some of the gap betweenprevalence and child protection registrations.

Children in needChildren who are no longer at continuing risk ofsignificant harm are still entitled to services, ifthey are deemed to be a ‘child in need.’Significantly more children are known to localauthorities as children in need than are placedon child protection registers. At least 61,000more children are known to social services forabuse and neglect, if we compare children inneed data with numbers on the child protectionregister. Data on children in need is taken in theform of a snapshot census week in February,and does not tell us how the children came tothe attention of the authorities, why, whatservices they are receiving, for how long, norwhat the results of those services are. As such,although it is likely that social services areproviding services to more abused childrenthan are listed on the child protection register,data on this group is poor. We cannot includenumbers on these groups in our calculationtherefore.

AssumptionsWhen calculating prevalence rates we havehad to make the following assumptions:

• Abuse rates have remained the same overthe last 24 years (the age of the oldestrespondents to the NSPCC survey).

• Rates of abuse in England are repeated allover the UK.

Number of children abused eachyearFrom the NSPCC 2000 prevalence study weconservatively estimate that 11% of thepopulation have been abused by the age of18. 11% is the highest reported proportion ofvictims for a single type of abuse, taken fromthe proportion of young adults who reportedchildhood contact sexual abuse. This impliesthat 11% ÷ 18 = 0.61% of the under-18population are being abused for the first timeeach year.

Using population estimates from the Office forNational Statistics,240 in 2006 there wereapproximately 13,100,000 under-18s. Hencewe estimate that 0.61% x 13,100,000 =80,000 children are abused for the first timeeach year. The number for bullying iscalculated separately, based on 10% of youngadults who reported having been bullied ordiscriminated against systematicallythroughout their childhood.

5510% ÷ 18 =

0.56%, or 73,000 each year.

Table 2 is based on English data only, usingthe child population of England figure of10,980,000. 240 0.61% x 10,980,000 =66,978, which is the minimum number weestimate are affected each year. To calculatethe numbers affected each year using thehigher proportion of 24%, 24% ÷ 18 = 1.3%.1.3% x 10,980,000 = 146,400 children.

Percentage of abused childrenwho are monitored andsupported by the systemNumber of children placed on the childprotection register in England in 2005 =31,400 (approx 0.29% of the population).

105

Only 85% of these are first-time registrationshence approximately 0.24% of the under-18population of England is placed on the childprotection register for the first time each year.This corresponds to a predicted prevalencerate in the adult population of 0.24% x 18 =4.4%. This is less than 45% of the prevalencerate predicted by NSPCC.

Number of children placed on the childprotection register in Scotland in 2005 = 2,265(approx 0.21% of the population).

239

Again, only 85% of these are first-timeregistrations, hence approximately 0.18% ofthe under-18 population of Scotland areplaced on the child protection register for thefirst time each year. This corresponds to apredicted prevalence rate in the adultpopulation of 0.18% x 18 = 3.2%. This is lessthan 30% of the prevalence rate predicted bythe NSPCC.

Number of survivorsIn 2006, there were 22,573,800 men agedover 18 and 23,622,500 women aged over 18in the UK.241 Based on rates of prevalence ofabuse of 7% for boys and 16% for girls,55 thenumber of survivors can be calculated as (0.07x 22,573,800) + (0.16 x 23,622,500) =5,400,000. This is a conservative estimatebased on the rate of sexual abuse only (seeSection 1: What is abuse and how manychildren are affected?).

96

Not seen and not heard Appendix 1

97

Appendix 2: The reform ofchildren’s services

Period of reformThe Every Child Matters: Change for Childrenagenda, enshrined in the Children Act (2004),set out a wide range of changes for children’sservices in England. The catalyst for the reformwas an inquiry into the death of VictoriaClimbié, who died in 2000. Victoria died as aresult of ‘gross failure of the system,’according to Lord Laming, who chaired theinquiry into her death.

237His concluding report,

published in 2003, made 108recommendations.

That same year, the government responded tothese recommendations in its Every ChildMatters agenda. The changes, most of whichare being introduced over five years, from2004 to 2009, emphasise prevention and earlyintervention when supporting children,whatever their needs. The key changes relateto the structure of the children’s servicessystem, with government agencies required toshare information and work together. Thedriving principle is better outcomes forchildren.

Local Safeguarding Children’sBoardsChanges include the introduction of LocalSafeguarding Children’s Boards (LSCBs) inApril 2006. LSCBs have been assigned agreater level of responsibility for protectingchildren in their local authorities. Withoutadditional resources, it is difficult to see howthey will fulfil the enormous task they havebeen assigned.

LSCBs were previously known as area childprotection committees (ACPCs). They cameinto force in England and Wales in April 2006.In addition to being granted statutory force,LSCBs have a greater focus on prevention andensuring different bodies work together.Members of the board must include police,health, education and social services, inaddition to representation from charities andother interested parties. LSCBs work withinthe Every Child Matters outcomes framework,with particular regard to the outcome‘staying safe’.

The three key tasks of an LSCB are:

• To ensure standard child protectionmechanisms in the local community,including proactive work to increaseunderstanding of safeguarding in the localcommunity and who to turn to for help.

• To undertake proactive work that aims totarget particular groups such as children ‘inneed’ but not at risk of significant harm orvulnerable children (those who are awayfrom home, disabled, and so on).

• To undertake responsive work to protectchildren who are suffering, or at risk ofsuffering harm, including, among others,those in families where there is domesticviolence, substance misuse and childrenabused through prostitution.

In addition to the huge amount of workrequired by the above, by April 2008 LSCBswill have to instigate a review process whenthere is a child death (whether individually orwith other LSCBs), which has long beencampaigned for as there are considerablediscrepancies on how data is collected andmonitored. Child Death Overview Panels willsupply regular data on every child death to theDfES, which will then produce comparabledata for the whole of England, in an effort topick up on local trends.

242

Member organisations are expected tocontribute staff and finances to LSCBs tocreate a pooled budget. Core contributionscome from local authorities, primary care trusts(health authorities) and the police. Before thechange occurred, the DfES conceded that, insetting up LSCBs, services would effectivelyhave to run a dual service, which wasexpected to cost around 20% more initially.Nonetheless, no extra funding was madeavailable. A survey in 2006 found that 72% ofcouncils reported that the new LSCB costmore to run than its predecessor the ACPC,with one quarter spending more than 50%more and one further quarter spending21–50% more.

243

Sure Start Other changes are afoot, such as the Labourgovernment’s flagship Sure Start programme.This has undergone a number of changessince its inception in 1997. Sure Start centreswere originally designed to provide joined-upservices to children under four and theirfamilies. Many of the centres either involve, orare run by, charities. The 2002 spendingreview announced that all Sure Start centreswould become children’s centres, which wouldincrease to 3,500 (encompassing manyexisting local centres and children’s services),planned to serve all communities by 2010.

244

The centres now cover all children up to theage of five, and their universal coverage willmean they are no longer focused on deprivedareas. Control of the centres is shifting fromthe community to local authorities, which hasbeen much criticised.

245


The aim was ‘to work with parents-to-be,parents and children to promote the physical,intellectual and social development of babiesand young children—particularly those whoare disadvantaged—so that they can flourishat home and when they get to school, andthereby break the cycle of disadvantage forthe current generation of young children.’

246

Given the multiple causes of child abuse, andthe links with poverty, the scheme shouldreduce abuse.

The government remains committed to thedevelopment of multi-purpose centres forfamilies with children under the age of five thatbring together childcare, early education,health, employment and family support. Thesecentres are now known as children’s centresand, as of September 2006, there were 1,000across the UK. The DfES will spend £2.2bn onrevenue and over £1bn on capital for children’scentres and Sure Start local programmesbetween 2004 and 2008.

247Many centres

work with charities, but it is not clear what theexact proportion is, or to what extent charitiesare involved (ie, whether they run the centre orsimply offer a service within it).

Sure Start has been accompanied by a £20mevaluation and a number of public serviceagreements (government targets). The overalleffect of the programme is in question, withfew gains reported when comparing Sure Startareas with non-Sure Start areas.

248

In fact, results have got worse for the mostdeprived people in Sure Start communities,possibly because services were universalised.

248

One public service agreement related to thenumber of re-registrations on the childprotection register. A 20% reduction targetbetween 2000 and 2004 was met. Theimpressiveness of this figure is slightlytempered by the very small numbers ofchildren involved,

249and the fact that, as seen

earlier, re-registrations may not be a veryeffective measure of change for children. Thismeasure has now been dropped, along withtargets for reducing the proportion of motherswho smoke during pregnancy.

ScotlandScotland underwent its own reform around thesame period, in a similarly reactive mannerfollowing an inquiry into the death of KennedyMcFarlane in 2000. Seventeenrecommendations were made in the ensuingaudit of child protection, It’s Everyone’s Job toMake Sure I’m Alright, and a three-year childprotection reform programme was set up.Changes include greater information sharingbetween agencies.

This is a time of great change therefore forchildren’s services across the UK, and it isperhaps too soon to tell what the impact onchildren and families is or will be.

98


99

‘Some authorities may split current cases […]into sub categories such as open, dormant,allocated, unallocated or on review. [...] Wewere conscious that many [local authorities]made use of the census in 2000 to springclean their caseloads by removing those thatare “no longer current”. This would haveinvolved coming to a firm decision that theauthority was not intending to take any furtherinitiative on a case and then consigning it tothe “closed” status.’250

The number of children in need is based on asnapshot census week, undertaken in order toestimate their cost to social services. The dataavailable does not therefore tell us:

• why a child is registered (what abuse hasoccurred, who is responsible and so forth);

• what services he or she is receiving;

• what the results of those services are; nor

• for how long they are registered.

According to the most recent data collection inFebruary 2005, over one third (86,900) ofthose in need (234,700 in total) are registeredfor abuse or neglect. A further 63,800 areregistered for ‘acute family stress,’ ‘familydysfunction’ and ‘absent parenting.’

80


Appendix 3: The childprotection processIn England and Wales, when a referral reachessocial services, the child protection team has24 hours to decide what to do. In just underhalf of cases, the case is dropped by theteam, although a case may be passed on atthis stage to other agencies. Just over one infive referrals to child protection teams will havebeen referred within the last 12 months to thesame local authority social services team.

105

Figure 5 shows the numbers filtered out ateach stage of the process, based on2005 data.

105

Initial and core assessmentsIf it is thought that a child is at risk, an initialassessment has to be undertaken withinseven days of the referral to the childprotection agency.

A named social worker will be responsible forgathering evidence for an assessment, throughtalking to the child, his or her family andprofessionals who know the family. The aim isto develop a picture of the child’sdevelopmental needs, parenting capacity andfamily and environmental factors, using theFramework for the Assessment of Children inNeed (2000), the key elements of which areshown in Figure 9.

77

An initial assessment has to be completedwithin seven days, and can result in:

• no further action;

• the provision of services; or

• a more detailed core assessment.105

A core assessment follows on from an initialassessment and can take a maximum of 35days. The central or most important aspects ofthe child’s needs are investigated, with a viewto identifying services to meet those needs.Around two thirds of both initial and coreassessments take place within the maximumtimescale allowed.

105

If a child is deemed to be in need of supportfrom social services, whether through an initialor core assessment, under Section 17 of theChildren Act (1989) he or she will be registeredas a ‘child in need.’ Local authorities then havea duty to provide services with a view to bothprotecting the child and promoting his or herwelfare. Cases are reviewed and closed whenappropriate.

106There is some disparity

between local authorities as to how this isdone. Guidance to the 2005 children in needcensus states:

Figure 9: Framework for theAssessment of Children in Need

Health

Education

Emotional and Behavioural Development

Identity

Family and SocialRelationships

SocialPresentation

Selfcare Skills

Comm

unity

Resources

Family and Social

Integration

Income

Employm

ent

Housing

Wider Fam

ily

Family History and

Functioning

Basic Care

Ensuring Safety

Emotional Warmth

Stimulation

Guidance andBoundaries

Stability

PA

RE

NT

IN

G

CA

PA

CI

TY

CH

I LD

’ S D

EV

EL

OP

ME

NT

AL

NE

ED

S

F A M I L Y & E N V I R O N M E N T A L F A C T O R S

CHILDSAFEGUARDING

AND PROMOTING WELFARE

Section 47 enquirySection 47 enquiries, named after the relevantsection in the Children Act (1989), are initiatedwhere a child is judged to be at continued riskof significant harm (see Box 10). Childprotection teams prior to 1999 WorkingTogether guidance instigated enquiries on thebasis of the suspicion that children were at riskof, or were, suffering significant harm. Since1999, guidance states that children who are atcontinued risk of suffering harm should beprotected. This change is thought to haveincreased thresholds, and numbers on theregister have been dropping over the lastten years.

27

An initial strategy discussion is held whereprofessionals discuss their concerns. ASection 47 enquiry ‘is not a separate ordifferent activity’

77to initial or core

assessments. Yet if an assessment is takingplace under a cloud of suspicion orallegations, not only is the process likely to beaccelerated given the heightened risk, therelationship between professional and family isaltered. ‘To designate a case as family supportmeans to locate power with the parents. Todesignate a case child protection shifts power(except for some negative power) from parentsto the state.’

71

Within 15 days of a strategy discussion a childprotection conference will be held. Theconference is held to decide whether or notthe child should be placed on the childprotection register. Child protection registersare confidential lists, kept by separate localauthorities, of children who are at continuedrisk of significant harm.

106In 2005, 30,700

children were placed on the register, 13% ofwhich were re-registrations.

105

The child attends the child protectionconference only if the professionals think itappropriate. The conference may go ahead ifparents do not attend; this is left to thediscretion of the Chair of the conference.There can be around a dozen professionals ata conference, in addition to the parents andchild (if appropriate).

28The parents have a right

to read the assessment report prior to theconference, and the outcome is not aforegone conclusion, but the conference mustremain a daunting prospect for many families.

When a child is placed on the child protectionregister, a child protection plan will be drawnup. This determines who will monitor the child,when, how and what services are to beoffered. A review conference is held after thechild has been on the register for threemonths, then every six months.

Children are spending less time on the childprotection register. Of those de-registered in2005, 6% had been on the register for morethan two years, compared with 17% ten yearspreviously.

105

Care proceedingsThe Children Act 1989 makes it clear thatchildren are best cared for by their parents,but that parents may sometimes need help inbringing up their children. These remain theguiding principles of the child protectionsystem. Where it is felt change is unlikely tooccur, despite intervention, social services canapply for an interim care order. Examplesinclude where the abusing parent completelyor significantly denies any responsibility for thechild’s developmental state or abuse, or wherethe child is rejected or blamed, or where thereare significant other problems such assubstance abuse or parental mental healthissues that the parents refuse to acknowledge.

In such cases, social services apply to theFamily Proceedings Court with details of whereand how the child will be looked after. Thecourt must be satisfied when awarding anycare order that the child has suffered or is atrisk of suffering significant harm, and that theharm is caused by the parents. The court mustalso be satisfied that making an order is betterthan making no order at all.

106

An interim care order lasts eight days.Meanwhile, social services continue to gatherevidence to make a case for a full care order ifnecessary. At the final hearing the courtdecides whether to apply a full care order. Achild comes under the parental responsibilityof the local authority when a care order isawarded. Responsibility may be shared withthe child’s parents, although this is up to thelocal authority.

In 2005, 4,000 interim care orders were madeand a further 180 full care orders weremade.

108Therefore, from initial reporting of

suspected abuse, less than 1% of cases resultin children being removed from the home. Only14% of those judged at continuing risk ofsignificant harm (ie, placed on the register) aretaken into care, most of whom will be returnedto their parents at some point.

This report does not concentrate on lookedafter children (see Section 4); a subsequentNPC report will cover this group.

100


Court ordersSocial services do not have to wait for theoutcome of an initial assessment to remove achild from danger. An application can be madefor an emergency protection order, whichallows for a child to be placed in local authoritycare for up to eight days, or an exclusionorder on the abusing parent to allow the childto remain with the non-abusing parent.

106

Police protectionIf a child is thought to be in immediate danger,the police can remove a child from the homeor prevent them being removed from a safespace such as a hospital, and keep them for72 hours, without obtaining a court order. Thisis laid down in Section 46 of the Children Act(1989). There is a ten-fold variation betweenpolice authorities on the use of this power.

251In

2005, 2,100 children were taken under policeprotection.

108When and why it is used varies;

it may be at the request of social services, orsimply in instances where the police ‘sort ofstumble upon something.’

251

Scottish systemThe key difference in the Scottish system isthe existence of Children’s Panels. These aremade up of lay members, and are involved in awide range of circumstances that involvechildren and where the state has some kind ofresponsibility, from child abuse to youngoffenders. Instead of cases being referred tothe court when a care order is deemednecessary, relevant evidence is passed on tothe Reporter of the Children’s Panel. TheReporter is an official employed by theScottish Children’s Reporter Administration.The Reporter will undertake his or her owninvestigation, to decide on one of threecourses of action:


• refer the child or young person to the localauthority so that advice, guidance andassistance can be given on an informal andvoluntary basis; or

• arrange a Children’s Hearing.252

A Children’s Hearing will take place where it isfelt that compulsory measures of supervisionare necessary. The Children’s Panel, made upof three lay members, can make one of fourrecommendations, which have to beimplemented by the local authority:


• voluntary supervision, usually by socialservices; or

• a compulsory order for supervision in localauthority care (the child would then becomea ‘looked after and accommodated child’).

The Children’s Hearing system is undergoing anumber of changes following a wide-rangingreview, Getting it Right for Every Child, in2004. The changes are aimed at improvingoutcomes for children involved, and are linkedto the wider changes occurring to children’sservices as a result of the Scottish audit andreform of child protection services.

101


Appendix 4: Prioritisation tool for donorsWhen reviewing the options presented here, donors may find the following tool useful.

Tool 1: Prioritising private funding (H high, M medium, L low = NPC judgement of level of results, risks and priority for funding in each area)

102

Area of work Potential results Confidence in results beingachieved (level of evidenceavailable)

Risks threatening success Priority forprivatefunding

PREVENTION H L/M H H

Attitude change L awareness M measured H does not cause behaviourchange

L

Behaviour change M slow or little change L lack model of change orevidence

H high cost and longtimescales

L/M

Education and awareness H awareness reporting

H measured H system cannot cope H

Exploring roots of violence H empathyviolence

L lack practical evidence M long timescales M

Sexual abuse helplinesand advice

H reporting self-reporting

M measured H unpopularity of workdifficulty of raising funding

H

Confidential spaces forchildren

H well-being reporting

L little change measured H system cannot cope ifreporting increases

H

Children’s rights H changing legislation M lack evidence ofadvocacy’s impact

H political inertia M

PROTECTION M M H M

Identifying and reporting(helplines for adults)

H awareness reporting

L little change measured H system cannot cope ifreporting increases

M

Family support (volunteersupport)

M resilience crisis management

M some evidence available L good way to involvecommunity and use volunteers

M

Family support(family group conferencing)

M resiliencecrisis management

H measured M insufficient resource M

Tackling riskfactors and root causes

Number of approaches in different fields too broad to categorise here

TREATMENT H M M M

Parenting and family work H behaviourwell-being

M unclear evidence M external risks; largely drivenand funded by government

M

Therapeutic services forchildren

H well-being resilience

M limited evidence M private funding cannot meetlevel of demand so lobbyingfor increased governmentfunding higher priority

M

Sexual abuse work H preventionre-offending

M growing evidence H unpopular causemedia attention

H

Number of people affected = millions

SURVIVORS H L H H

Counselling and support H well-being L largely anecdotalevidence

H under-funding of fieldincreases risk of groupscollapsing–requires sectorcoordination

H

RESEARCH H H M H

Independent research H understanding effectiveness

H policy changes resultingfrom research

M long timescales andlack of resources

H

103

AcknowledgementsNot seen and not heard Acknowledgements

Aberlour Child Care Trust (ROC Refugeand Dundee Drug Outreach Team)

Bryan Evans, Trisha Hall andRomy Langeland

Aditi Consultancy Services Perdeep Gill

Africans Unite Against Child Abuse (AFRUCA)

Modupe Debbie Ariyo

Barnardo’s (Birmingham Space andAmazon teams, Dundee Bridge andPolepark teams)

Martin Narey, Ginny Wilkinson,Ann Manzi, Debbie Southwood andRos Stuart

beatbullying Emma-Jane Cross

Birmingham Rape and Sexual ViolenceProject (RSVP)

Lisa Thompson

British Association for the Study andPrevention of Child Abuse and Neglect(BASPCAN)

Jonathan Picken

Child and Woman Abuse Studies Unit,London Metropolitan University

Liz Kelly

Child Protection Reform Programme,Scottish Executive

Helen Hammond, Jennifer Stark, IreneMcGuggan and Sheila Foggon

ChildLine Anne Houston, Christine Renouf andWes Cuell

CHILDREN 1st (Dundee Family SupportTeam, Ettrick Project)

Maggie Mellon, Anita Roweth and JanMcCrory

Children are Unbeatable! Alliance Peter Newell

Children’s Charities Coalition for InternetSafety (CHIS)

John Carr

The Children’s Society (Time4U project) Gwyther Rees and Kathy Evans

Children’s Rights Alliance for England Carolyne Willow

Department for Education and Skills Colin Green, Richard Bartholomew, JaneCunliffe and Peter Clark

Department of Health Helen Musgrove and Clive Garraway

Dundee Child Protection Team Beverley Hart

Dundee Children and Young PersonsProtection Committee

Donald Mackenzie

Eighteen and Under Laurie Matthew, Sandra Hutton andIan Barron

Family Service Unit Birmingham Stephanie Ward

Family Welfare Association Rose de Paeztron

Home Start Kay Bews and Vivien Waterfield

Kids Company Camila Batmanghelidjh, Daniel Baltzer andNatalia Perry

Lucy Faithfull Foundation Hilary Eldridge, Tink Palmer, DonaldFindlater and Mel Nock

Child Abuse Investigation Command,Metropolitan Police

Peter Spindler

We are very grateful to thefollowing individuals —and theirorganisations—for their input intothis report:

104

Not seen and not heard Acknowledgements

National Council of Voluntary ChildcareOrganisations (NCVCCO)

Maggie Jones and Rebecca Edwards

National Association for People Abused inChildhood (NAPAC)

Peter Saunders

National Organisation for the Treatment ofAbusers (NOTA)

Jon Brown

National Society for the Prevention of Crueltyto Children (Barnsley Schools Service, LeedsQPFS Centre, Preston Adult Abuser Project,North London Young Abuser Project,Manchester Centre)

Mary Marsh, Wes Cuell, Philip Noyes,Jonathan Grounds and Nick Booth

NCH (Broxtowe Family Centre) Caroline Abrahams, Sean Kelly andJane Tindsley

Nia Project Nicola Weller and Marai Larasi

Ormiston Trust Sherry Peck

Quakers (Religious Society of Friends) Helen Drewery and Karen Morton

Respond Richard Curen and Noelle Blackman

Roshni Hamira Sarwar and Asim Khan

Scottish Childcare and Protection Network Brigid Daniel

The Survivors Trust Gillian Finch, Fay Maxted andRichard Curen

Volunteers in Child Protection (VCP),Community Service Volunteers

Cathy Worden-Hodge, Barbara Williamsand Jean Pardey

Walsall Street Teams Sue Bretherick

Wave Trust George Hosking

Women’s Aid Federation England Alison Buchanan

John Carr NCH

Jane Cunliffe Department for Education and Skills

Richard Curen Respond

Hilary Eldridge Lucy Faithfull Foundation

Perdeep Gill Aditi Consultancy

Colin Green Coventry City Council

Louise Hannigan Lloyds TSB Foundation for Scotland

Beverley Hart Dundee Child Protection Team

Shaun Kelly NCH

Mary Marsh and Philip Noyes National Society for the Prevention ofCruelty to Children (NSPCC)

Fay Maxted The Survivors Trust

Bharat Mehta City Parochial Foundation

Maggie Mellon CHILDREN 1st

Peter Newell Children are Unbeatable! Alliance

Helen Musgrove Home Office

Jonathon Picken British Association for the Study andPrevention of Child Abuse and Neglect(BASPCAN)

Linda Regan London Metropolitan University

Ann Stuart Metropolitan Police

Eileen Vizard Young Abusers Project

Nicola Weller Nia Project

Ginny Wilkinson Barnardo’s

Carolyne Willow Children’s Rights Alliance for England(CRAE)

Additionally we are heavilyindebted to the followingindividuals who provided uswith valuable input after takingthe time and care to read theconsultation version of thisreport:

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79 Chief Inspector of Commission for Social Care Inspection,Her Majesty’s Chief Inspector of Schools, Her Majesty’s ChiefInspector of Court Administration, Her Majesty’s ChiefInspector of Probation, Her Majesty’s Chief Inspector ofConstabulary, Her Majesty’s Chief Inspector of Prisons, ChiefExecutive, H.C. and Her Majesty’s Chief Inspector of theCrown Prosecution Service (2005) Safeguarding Children:The second joint chief inspectors’ report on arrangements tosafeguard children. Commission for Social Care Inspection.

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149 Giles, C., UK child poverty sees shock increase, in FinancialTimes 27 March 2007.

150 Doonan, M. (2006) Making the case for change in our childwelfare system. (unpublished).

151 Hamilton, A. (2005) Releasing the Power of the Family:Children 1st and Family Group Conferences 1999-2005.Children 1st.

152 Department for Education and Skills (2007) Care Matters:Consultation Responses.

153 Chand, A. and Thoburn, J. (2005) Research Review: Childand family support services with minority ethnic families:what can we learn from research? Child and Family SocialWork, 10: p. 169–178.

154 ChildLine (2001) Information Sheet 11: Homelessness andRunaways. ChildLine Information Sheet 11.

155 Safe on the Streets Research Team (1999) Still Running:Children on the Streets in the UK. The Children’s Society.

156 Rees, G. and Lee, J. (2005) Still Running II: findings from thesecond national survey of young runaways. The Children’sSociety.

157 Morgan, R., Children’s Rights Director for England, (2006)Running Away: A Children’s Views Report. Commission forSocial Care Inspection.

158 Rees, G., Safe and Sound: Outcomes from the DfES andChildren’s Society’s Research, in Safe and Sound: Workingwith Young Runaways conference. London (18 May 2005).

159 Rees, G., Franks, M., Raws, P. and Medforth, R. (2005)Responding to Young Runaways: An evaluation of 19projects, 2003 to 2004. The Children’s Society and TheUniversity of York. Department for Education and Skills,RR634.

160 Department of Health (2002) Children missing from care andfrom home - good practice guidance. Local authority circular(2002) 17.

161 The Children’s Society website,http://www.childrenssociety.org.uk/what+we+do/campaigning/children+at+risk+on+the+streets/Safe+and+Sound+Test.htm [accessed on 2 January 2007]

162 Middleham, N., Police responses to runaways, in Safe andSound: Working with Young Runaways conference. London(18 May 2006).

163 Jackson, L., Missing-person database is a runawaysuccess, in The Guardian 30 November 2005.

164 HM Inspectorate of Constabulary (2005) Keeping Safe,Staying Safe: Thematic inspection of the investigation andprevention of child abuse.

165 Evans, B., Short-term solutions: Aberlour Refuge, in Safeand Sound: Working with Young Runaways conference.London (17 May 2005).

166 Personal communication with Bryan Evans, AssistantRegional Director, Aberlour (10 March 2006).

167 Burney, S. and Bodey, C., Durham Social Care and Health,Emergency and Family Support Services, in Safe andSound: Working with Young Runaways conference. London(18 May 2006).

168 Smeaton, E. (2005) Living on the Edge: the experiences ofdetached young runaways. The Children’s Society.

169 Gilchrist, H. and Rees, G. (2004) ASTRA Project: Evaluationof Out-of-Hours Service, April to December 2003. TheChildren’s Society.

170 Harper, Z., Scott, S. (2005) Meeting the needs of sexuallyexploited young people in London. Barnardo’s.

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171 Chase, E. and Statham, J. (2004) The Commercial SexualExploitation of Children and Young People: An Overview ofkey literature and data. Thomas Coram Research Unit.

172 Swann, S. and Balding, V. (2002) Safeguarding Childreninvolved in Prostitution Guidance Review. Department ofHealth.

173 Palmer, T. (2001) No son of mine! Children abused throughprostitution: summary. Barnardo’s.

174 Barnardo’s (2005) Appropriate support for sexually exploitedyoung people: A Barnardo’s briefing for professionals.

175 Department of Health, Home Office, Department forEducation and Employment and National Assembly forWales (2000) Safeguarding Children Involved in Prostitution:Supplementary Guidance to Working Together to SafeguardChildren. Department of Health.

176 Home Office (2006) A Coordinated Prostitution Strategy anda summary of responses to Paying the Price. Home Office.

177 Home Office (2006) Criminal Statistics 2005 England andWales. Statistical Bulletin 19/06.

178 Iwaniec, D. and Sneddon, H. (2001) Attachment style inadults who failed to thrive as children: Outcomes of a 20year follow-up study of factors influencing maintenance orchange in attachment style. British Journal of Social Work,31: p. 179-195.

179 Stringer, E. (2007) A long way to go: Child refugees andasylum seekers, a guide for donors and funders. NewPhilanthropy Capital.

180 BBC Newsnight website,http://news.bbc.co.uk/1/hi/programmes/newsnight/6207392.stm [accessed on 17 April 2007]

181 Howard League for Penal Reform website,http://www.howardleague.org/fileadmin/howard_league/user/pdf/lord_carlile_inquiry_press_release.pdf [accessed on 17April 2007]

182 Doward, J., Outcry over ‘routine’ use of restraints on childprisoners, in The Observer 18 February 2007.

183 World Health Organisation (1992) World HealthOrganisation’s International Classification of Mental andBehavioural Disorders.

184 Aitkenhead, R., The shadow that refuses to disappear, inGuardian 25 February 2006.

185 Home Office (2006) Sexual Offences Act 2003: A stocktakeof the effectiveness of the Act since its implementation.

186 Home Office (2006) The child sex offender review: Anupdate. Violent Crime Unit, Home Office.

187 HM Inspectorate of Probation and HM Inspectorate ofConstabulary (2005) Managing sex offenders in thecommunity: A Joint Inspection on Sex Offenders 2005.

188 HM Chief Inspector of Prisons (2005) Report on anunannounced short follow-up inspection of HMP Lewes, 1 -4 August 2005.

189 British Medical Journal press release website,http://bmj.bmjjournals.com/content/vol333/issue7557/press_release.shtml#2 [accessed on 1 July 2006]

190 Ford, H. and Beech, A. (2003) The Effectiveness of theWolvercote Clinic Residential Treatment Programme InProducing Short-term Treatment Changes and ReducingSexual Reconvictions. National Probation Service.

191 Beech, A., Fisher, D. and Beckett, R. (1998) STEP 3: Anevaluation of the prison sex offender treatment programme.Home Office.

192 Analysis: Child protection - Counting the cost ofsafeguarding, in Children Now 23 November 2005.

193 HM Inspectorate of Prison (2006) Joint Thematic InspectionReport: Putting Risk of Harm in Context, an inspectionpromoting public protection.

194 HC Deb (2005-06) 441(written answers col.569).

195 Batty, D., Q&A: The sex offenders register, in GuardianJanuary 18 2006.

196 Parton, N. (2006) Safeguarding childhood: Early interventionand surveillance in a late modern society. PalgraveMacmillan: Basingstoke.

197 National Probation Service (2006) Annual Report 2005-2006.

198 Batty, D., Paedophile monitoring system ‘needs moreresources’, in Society Guardian 18 January 2006.

199 Wilson, R.J., Huculak, B. and McWhinnie, A. (2002)Restorative Justice Innovations in Canada. BehavioralSciences and the Law, 20: p. 363–380.

200 Kelly, L., Regan, L. and Burton, S. (1991) An exploratorystudy of the prevalence of sexual abuse in a sample of 16-21year olds. Child Abuse Studies Unit, University of NorthLondon.

201 Barnardo’s (2005) Working together for children and youngpeople with harmful sexual behaviours: A Barnardo’s briefingfor professionals.

202 Brilleslijper-Katera, S., Friedrich, W. and Corwin, D. (2004)Sexual knowledge and emotional reaction as indicators ofsexual abuse in young children: theory and researchchallenges. Child Abuse and Neglect, 28: p. 1007-1017.

203 Hickey, N., Vizard, E., McCrory, E. and French, L. (2006)Links between juvenile sexually abusive behaviour andemerging severe personality disorder traits in childhood.Department of Health, Home Office, National OffenderManagement Service: Dangerous People with SeverePersonality Disorder programme.

204 Personal communication with Colin Hawkes and EileenVizard, Young Abusers Project (16 March 2006).

205 National Working Group on Child Protection and Disability(2001) “It doesn’t happen to disabled children” Childprotection and disabled children. NSPCC.

206 Carr, J. (2004) Child abuse, child pornography and theinternet. NCH.


110

207 ChildLine (2005) ChildLine Briefing Paper: Children talking toChildLine about the internet. ChildLine.

208 O’Connell, R. (2003) A typology of childsexploitation andonline grooming practices. Cyberspace Research Unit,University of Central Lancashire.

209 Renold, E., Creighton, S., Atkinson, C. and Carr, J. (2003)‘Images of Abuse’ A review of the evidence on childpornography: Summary of research and findings. NSPCC.

210 Goodchild, S. and Owen, J., Children and the net, inIndependent on Sunday, 6 August 2006.

211 Personal communication with John Carr, Children’s Charities’Coalition for Internet Safety (23 February 2006).

212 Government News Network website,http://www.gnn.gov.uk/imagelibrary/detail.asp?MediaDetailsID=143716&HUserID=878,793,893,851,777,871,881,845,765,674,677,767,684,762,718,674,708,683,706,718,674[accessed on 14 January 2006]

213 Carr, J. (2006) ‘Out of sight, out of mind’ Tackling child sexabuse images on the internet – a global challenge: Summary.NCH.

214 Johnson, B., Worst child abuse images quadruple online inthree years, says watchdog, in The Guardian 17 April 2007.

215 International Centre for Missing & Exploited Children website,http://www.missingkids.com/missingkids/servlet/NewsEventServlet?LanguageCountry=en_US&PageId=2336 [accessedon 14 September 2006]

216 John Carr, in Safeguarding Children and Young People fromSexual Exploitation. London (1 November 2005).

217 Blakely, R., BT concern as child porn traffic spirals, in Timesonline 7 February 2006.

218 Personal communication with John Carr, (23 February 2006).

219 Internet Watch Foundation website,http://www.iwf.org.uk/media/news.173.htm [accessed on 20July 2006]

220 Thomas Coram Research Unit (2003) Bullying: How to BeatIt.

221 Copps, J. (2006) On Your Marks: Young people in education.A guide for donors and funders. New Philanthropy Capital.

222 Aitken, R. (2001) Domestic violence and the impacts onchildren: Results of a survey into the knowledge andexperiences of educational personnel within two Europeancountries. Refuge.

223 Chamberlain, T., Lewis, K., Teeman, D., Kendall, L. (2006)How is the Every Child Matters agenda affecting schools?Annual survey of trends in education 2006. NationalFoundation for Educational Research.

224 Barron, I. (2006) School-Based Abuse PreventionProgramme Evaluation. Dundee City Council EducationalPsychology Service, University of Dundee and Eighteen andUnder.

225 Personal communication with Peter Saunders, ChiefExecutive, NAPAC (16 February 2006).

226 Personal communication with Helen Musgrove, SexualCrime Reduction Team, Violent Crime Unit, Home Office (16August 2006).

227 Personal communication with Cleve Garraway, Victims Fund,Home Office (16 August 2006).

228 Scottish Executive website,www.scotland.gov.uk/News/News-Extras/sexualabuse[accessed on 6 March 2006]

229 Arehart-Treichel, J. website,http://pn.psychiatryonline.org/cgi/content/full/41/13/28?etoc[accessed on 7 July 2006]

230 Personal communication with Fay Maxted, NationalCoordinator, The Survivors Trust (17 April 2007).

231 Department for Education and Skills (2006) SafeguardingDisabled Children: A Resource for Local SafeguardingChildren Boards.

232 Langerman, C. and Worrall, E. (2005) Ordinary Lives:Disabled children and their families, a guide for donors andfunders. New Philanthropy Capital.

233 National Society for the Prevention of Cruelty to Children(2006) Tracking Research Wave 4 - March 2006. CoreQuestions and Scenario Module: Presentation of KeyFindings (unpublished).

234 National Society for the Prevention of Cruelty to Children(2006) NSPCC activities to educate, influence and change –implementation plan (unpublished).

235 Gough, D. and Lynch, M.A. (2002) Culture and ChildProtection. Child Abuse Review, 11: p. 341-344.

236 Marjolin, N. (2005) The NSPCC Respect to Protect Project inBrent. NSPCC.

237 Lord Laming (2003) The Victoria Climbié Inquiry: Report ofan Inquiry by Lord Laming, CM 5730. The Stationery Office:London.

238 Detective Superintendent Chris Bourlet, How can socialworkers and the police work together more effectively to helpsafeguard children and young people in faith communities?in Working with faith communities to protect children andyoung people. London (28 February 2006).

239 Scottish Executive National Statistics (2006) Child protectionstatistics 2005/06.

240 Office of National Statistics (2006) Population Estimates.

241 Office of National Statistics website,http://www.statistics.gov.uk/CCI/nugget.asp?ID=6[accessed on 16 February 2007]

242 Goveas, A., Analysis: Safeguarding - Sector welcomes finalguidance, in Community Care 19 April 2006.

243 Spiralling safeguarding children board costs worry localauthorities, in Community Care 26 May 2006.

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244 Department for Education and Skills website,http://www.everychildmatters.gov.uk/earlyyears/surestart/centres/ [accessed on 9 November 2006]

245 Glass, N., Surely Some Mistake? in Guardian January 52005.

246 Glass, N. website,http://www.bristol.ac.uk/sps/cnrpapersword/children/glass.ppt [accessed on 8 November 2006]

247 National Audit Office (2006) Sure Start Children’s Centres.

248 National Evaluation of Sure Start Team (2005) Early Impactsof Sure Start Local Programmes on Children and Families:Report of the Cross-sectional Study of 9-and 36-Month OldChildren and their Families. Department for Education andSkills. NESS/2005/FR/013.

249 Department for Education and Skills (2004) Departmentalreport.

250 Department for Education and Skills website,http://www.dfes.gov.uk/datastats1/guidelines/children/returns.shtml [accessed on 20 December 2006]

251 Masson, J. (2002) Police protection – protecting whom?Journal of Social Welfare and Family Law, 24(2): p. 157-173.

252 Scottish Executive website,http://www.childrenshearingsscotland.gov.uk/background.asp [accessed on 18 December 2006]


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Not seenand not heardChild abuseA guide for donors and funders

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Other publicationsCommunity

• A long way to go: Young refugees and asylum seekers in the UK (2007)

• Home truths: Adult refugees and asylum seekers (2006)

• Inside and out: People in prison and life after release (2005)

• Grey matters: Growing older in deprived areas (2004)

• Side by side: Young people in divided communities (2004)

• Local action changing lives: Community organisations tackling poverty and social exclusion (2004)

• Charity begins at home: Domestic violence (2003)

Education

• Lean on me: Mentoring for young people at risk (2007)

• Read on: Literacy skills of young people (2007)

• On your marks: Young people in education (2006)

• What next?: Careers education and guidance for young people (2005)

• School’s out?: Truancy and exclusion (2005)

• Making sense of SEN: Special educational needs (2004)

Health and disability

• Don’t mind me: Adults with mental health problems (2006)

• Valuing short lives: Children with terminal conditions (2005)

• Ordinary lives: Disabled children and their families (2005)

• Out of the shadows: HIV/AIDS in Burundi, Democratic Republic of Congo and Rwanda (2005)

• The hidden assassin: Cancer in the UK (2004)

• Caring about dying: Palliative care and support for the terminally ill (2004)

• Rhetoric to action: HIV/AIDS in South Africa (2003)

Cross-cutting research

• Striking a chord: Using music to change lives (2006)

Improving the voluntary sector

• Funding success: NPC’s approach to analysing charities (2005)

• Surer Funding: Improving government funding of the voluntary sector (2004, published by acevo)

• Full cost recovery: a guide and toolkit on cost allocation (2004 published by NPC and acevo)

• Just the ticket: Understanding charity fundraising events (2003)

• Funding our future II: A manual to understand and allocate costs (2002, published by acevo)

Forthcoming research

• Autism (2007)

• Environment overview (2007)

• Out of school hours learning (2007)

• Violence against women (2007)

• Financial exclusion (2007)

• How to fund (2007)

• Advocacy and systemic change (2007-08)

• Homelessness and housing (2007-08)

• Mental health of children and young people (2008)

• Substance abuse (2008)

This report is available to download free of charge from our website www.philanthropycapital.orgTo purchase a hard copy, please call Central Books: 0845 458 9910.

This report was funded by Lloyds TSB Foundation for Scotland and an anonymous individual

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Not seen and not heard:Child Abuse

New Philanthropy Capital • July 2007


Documents

A guide for donors and funders and not - NPC · of the child protection system. Central government is responsible for the current system, which identifies, reports and deals with