Professionals

Sudden Infant Death Syndrome (SIDS) is the sudden and unexplained death of a baby where no cause is found. While SIDS is rare, it can still happen and there are steps parents and carers can take to help reduce the chance of this tragedy occurring.

As professionals, it’s important you know and can talk to families about Safe Sleeping particularly when parents have additional vulnerabilities that may place babies and young children at risk.

The mechanisms that cause unexplained deaths in infancy is not yet fully understood, therefore it is not possible for any manufacturer to say that a particular product will prevent SIDS. It is possible, however, to significantly lower the chances of it happening by following this safer sleep guidance. This advice is based on strong scientific evidence where, unlike many products, safety has been proven. You should give the advice to parents for all sleep periods where possible, not just at night.

For more information, go to the Lullaby Trust site.

Fathers matter a great deal to children; they play a significant role within the family, whether or not they are resident, and increasingly want to be fully involved in their children’s upbringing.

Despite this, many children and family services are still predominantly mother-focused and often struggle to engage with fathers as a result. Services need to look at how they can change this or they will fail to meet the needs of children and families.

The ‘Dad Test Guide’ aims to help health, family and children’s services, schools and third sector agencies identify how they can engage more effectively with fathers. It explains why supporting father involvement is crucial to the well-being and educational development of children.

It contains a simple ‘Dad Test’ to help managers and practitioners start to assess how father-inclusive their service is, with ideas for small changes they can make to meet the needs of both parents more effectively.

Professionals know that mothers are important. What is less well understood is that when dads are positively involved, children do better in all sorts of ways.

Fatherhood Institute has produced a series of ‘Why dads matter’ five-minute digests which can be downloaded and shared:

• Five-minute guide 01 – Dads during pregnancy and birth
• Five-minute guide 02 – Dads in the early years
• Five-minute guide 03 – Dads in the school years
• Five-minute guide 04 – Dads and older children
• Five-minute guide 05 – Different types of dads

Bringing Fathers In is a series of evidence-based information sheets

The sheets and the supporting research summaries, are intended for an international audience of health, education and social care professionals, policy makers, programme managers and designers, researchers and evaluators. Topics include:

• ‘why’ to engage dads
• 'how’ to engage dads effectively

The National review Panel have published their third Annual Review The Myth of Invisible Men” Safeguarding children under 1 from non-accidental injury caused by male carers – it can be found here:

The Myth of Invisible Men

The Children Act 1989 states that a child is disabled if s/he is ‘blind, deaf or dumb or suffers from mental disorder of any kind or is substantially and permanently handicapped by illness, injury or congenital deformity or other such disability as may be prescribed.’

Disabled children are recognised as one of the most vulnerable groups in terms of safeguarding their wellbeing because they trust and rely on their care-givers to be sensitive to their personal care needs, their health, their emotional well-being and their safety. Disabled children may be especially vulnerable due to a number of reasons; for example, they may:

• have fewer outside contacts than other children
• receive intimate care, possibly from a number of carers, which may both increase the risk of abusive
• behaviour and make it more difficult to set and maintain physical boundaries
• have an impaired capacity to resist or avoid abuse
• have communication difficulties which may make it difficult to tell others what is happening
• be inhibited about complaining through fear of losing services
• be especially vulnerable to bullying and intimidation
• be more vulnerable to abuse by peers

It is important to remember that evidence of good quality care does not always mean that there are no safeguarding issues.

Additional Information:

Safeguarding disabled children in England | NSPCC Learning

Domestic Abuse includes any incident or pattern of incidents of controlling, coercive or threatening behaviour, violence or abuse between those aged 16 or over who are or have been intimate partners or family members regardless of gender or sexuality. This can encompass but is not limited to the following types of abuse:

• Psychological;
• Physical;
• Sexual;
• Financial;
• Emotional;

Controlling behaviour is: a range of acts designed to make a person subordinate and/or dependent by isolating them from sources of support, exploiting their resources and capacities for personal gain, depriving them of the means needed for independence, resistance and escape and regulating their everyday behaviour.

Coercive behaviour is: an act or a pattern of acts of assault, threats, humiliation and intimidation or other abuse that is used to harm, punish, or frighten their victim.

This definition, which is not a legal definition, includes so called ‘Honour’ based violence, female genital mutilation (FGM) and forced marriage, and is clear that victims are not confined to one gender or ethnic group.

Domestic Abuse Act:

The Domestic Abuse Act was published in April 2021. The aim of the Act is to ensure that domestic abuse is properly understood and that it is considered unacceptable behaviour that will be challenged in the cCourts and in the minds of the public.

The new Act supports the view that domestic abuse can take many forms. The legal definition now incorporates a range of abuses beyond physical violence, including emotional, coercive or controlling behaviour and economic abuse. The abuse can be behaviour consisting of a single incident or a course of conduct.

The new Actlegislation will also provide further protection to the millions of people who experience domestic abuse, as well as strengthen measures to tackle perpetrators.

The full Act can be accessed by clicking here.

The Domestic Violence Disclosure Scheme:

The Domestic Violence Disclosure Scheme(DVDS) was introduced on the 8th of March 2014.The DVDS gives members of the public a formal mechanism to make enquires about an individual who they are in a relationship with, or who is in a relationship with someone they know, where there is a concern that the individual may be violent towards their partner. This scheme adds a further dimension to the information sharing about children where there are concerns that domestic violence and abuse is impacting on the care and welfare of the children in the family.

Members of the public can make an application for a disclosure, known as the ‘right to ask’. Anybody can make an enquiry, but information will only be given to someone at risk or a person in a position to safeguard the victim. The scheme is for anyone in an intimate relationship regardless of gender.

Partner agencies can also request disclosure is made of an offender’s past history where it is believed someone is at risk of harm. This is known as ‘right to know’. If a potentially violent individual is identified as having convictions for violent offences, or information is held about their behaviour which reasonably leads the police and other agencies to believe they pose a risk of harm to their partner, a disclosure will be made.

Domestic Abuse and Children:

Children living with domestic violence and abuse is now recognised as a matter for concern in its own right by both government and key children’s services agencies. The link between child physical abuse and domestic violence is high, with estimates ranging between 30% to 66%.

In 2002, nearly three quarters of children subject of a Child Protection Plan lived in households where domestic violence and abuse occurs.

Children living in a family environment where there is dDomestic violence and aAbuse are at risk whether or not they have directly witnessed the abuse. Some children living with domestic violence and abuse are at risk of significant harm.

A key concern in safeguarding children and young people is the potential for long term emotional damage caused by the presence of domestic violence and aAbuse during early formative years. Children can witness and be affected by domestic violence and aAbuse from all corners of the household, and over 90% are aware of it happening.

Additional Information:

Learning from Case Reviews- The NSPCC has published a briefing based on case reviews published since 2019 where children experienced domestic abuse. Domestic abuse: learning from case reviews | NSPCC Learning

The Staffordshire and Stoke Domestic Abuse strategy 2021-2024 can be found here. The strategy aims to: “Prevent domestic abuse from happening and to respond appropriately and effectively to those vulnerable to, or affected by, domestic abuse to enable them to move forward, living safe, fulfilling and independent lives.”

Parental substance misuse refers to the abuse of drugs and/or alcohol by parents and carers of children and young people. Whilst there may be different treatment methodologies for adults with these problems, they are considered together because the consequences for the child are quite similar. Substance misuse refers to both illicit drugs, alcohol, prescription drugs and solvents, the consumption of which is either dependent use, or use associated with having harmful effect on the individual or the community.

Risks:

Drug or alcohol misuse of a parent can have a negative impact on children in a number of ways, including:

• Substance misuse in pregnancy may impair the development of an unborn child;
• The risk of physical injury to a child sleeping next to an adult, occurring as a result of the adult lying over or against the child (over lay) is increased if the adult is sedated due to the effects of alcohol and/or prescribed or illicit drugs;
• The risk from drugs and drug equipment being left lying around – there have been a number of cases recently in Wirral where children have ingested methadone that was left unattended
• A parent’s practical caring skills may be diminished by substance misuse;
• Substance misuse, or withdrawal from substance misuse, may give rise to mental states or behaviour that put children at risk of injury, psychological/emotional distress or neglect;
• Children’s physical, emotional, social, intellectual and developmental needs can be adversely affected by their parent’s misuse of substances
• Substance misusing parents may find it difficult to prioritise the needs of the children over their own i.e.: health appointments, schooling;
• Children may be introduced to drug and alcohol misuse at an early age by the behaviour of the parents and the availability of the substances within the home.
• Money available to the household to meet basic needs may be reduced;
• Members of the family, including children, may be drawn into criminal activity;
• Children may be at risk of Physical Harm, or death if drugs and drugs paraphernalia are not stored safely and children have access to them;
• Children may be endangered if they are carried as passengers in vehicles driven by a substance misusing parent;
• Children being forced to take on a caring role and feeling they have the responsibility to solve their parent’s, alcohol and drug problems.
• There are potential risks to the child from parental acquaintances or family members if they are also involved in drug/alcohol misuse.

Protective Factors:

Risks associated with parental drug use can be mitigated by other protective factors. These include:

• Sufficient income and good physical standards in the home.
• A consistent and caring adult, who will provide for the child’s needs and give emotional support.
• Regular monitoring and help from health and social work professionals, including respite care and accommodation.
• An alternative, safe residence for mothers and children subjected to violence and the threat of violence.
• Regular attendance at nursery or school.
• Sympathetic and vigilant teachers.
• Belonging to organised out-of-school activities, including homework clubs.

Some children grow up with parent(s) and or carers who have diagnosable mental health problems. Some of these mental health problems may be mild and or short-lived, whilst others may be severe and enduring which include: depression, anxiety disorders, schizophrenia, personality disorders and bi-polar disorder. Some parents/ carers may also have long-term alcohol and or substance dependency and or a combined mental health problem and alcohol and substance dependency. Mental ill health in a parent or carer does not necessarily have an adverse impact on a child's development. Just as there is a range in severity of illness, so there is a range of potential impact on families.

It is important to recognise other issues that can exacerbate the risk presented by mental health issues. For example, the presence of drug or alcohol dependency and domestic abuse in addition to mental health problems with little or no family or community support would indicate an increased likelihood of risk of harm to the child, and to the parents' mental health and wellbeing. Relying on a diagnosis is not sufficient to assess levels of risk. This requires an assessment of every individual's level of impairment and the impact on the family and parenting capacity.

It is essential that the diagnosis of a parent/carer's mental health is not seen as defining the level of risk. Similarly, the absence of a diagnosis does not equate to there being little or no risk. An assessment should consider the impact on the child.

Where a parent has enduring and / or severe mental ill-health, children in the household are more likely to suffer significant harm. This could be through physical, sexual or emotional abuse, and / or neglect.

A child likely to suffer significant harm or whose well-being is affected, could be a child:

• Who features within parental delusions;
• Who is involved in parental obsessional compulsive behaviours;
• Who becomes a target for parental aggression or rejection;
• Who has to take on caring responsibilities
• Who may witness disturbing behaviour arising from the mental illness (e.g. self-harm, suicide, uninhibited behaviour, violence, homicide);
• Who is neglected physically and / or emotionally by an unwell parent;
• Who does not live with the unwell parent, but has contact (e.g. formal unsupervised contact sessions or the parent sees the child in visits to the home or on overnight stays)

The following factors may impact upon parenting capacity and increase concerns that a child may be suffering, or likely to suffer, significant harm:

• History of mental health problems with an impact on parental functioning;
• Unmanaged mental health problems with an impact on parental functioning;
• Maladaptive coping strategies;
• Misuse of drugs, alcohol, or medication;
• Severe eating disorders;
• Self-harming and suicidal behaviour;
• Lack of insight into illness and impact on child, or insight not applied;
• Non-compliance with treatment;
• Poor engagement with services;
• Previous or current compulsory admissions to mental health hospital;
• Disorder deemed long term 'untreatable', or untreatable within time scales compatible with child's best interests;
• Mental health problems combined with domestic abuse and / or relationship difficulties;
• Mental health problems combined with isolation and / or poor support networks;
• Mental health problems combined with criminal offending (forensic);
• Non-identification of the illness by professionals (e.g., untreated post-natal depression can lead to significant attachment problems);

The NSPCC lists the potential impact on children when living with parents with mental health problems. These include:

• increased risk of developing behaviour problems such as physical aggression by the time they reach school age
• risk of developing mental health difficulties
• taking on a caring role, providing emotional and social support, basic household chores and more intimate tasks such as nursing or bathing their parents
• demands of caring may lead to fewer opportunities to have fun and build friendships, disruption of education, educational underachievement and reduced life chances
• constant worry about their parents' or carers' health and wellbeing and denial of their own needs and feelings
• distress if faced with frightening situations such as a parent's suicide attempt, overdose or volatile behaviour
• a lower standard of living or financial hardship if their parent's illness makes it difficult for them to work
• embarrassment or shame over their parents' or carers' condition, limiting their friendships and social interaction due to the social stigma attached to mental illness
• bullying and social isolation
• separation from parents or carers by Children's Services or the parent's hospitalisation
• in the most serious cases, children may suffer abuse or neglect from a parent or carer with a mental health problem.

Additional information:

• NSPCC,Parental mental health: How to help children living with parents with mental health problems
• Children and families at risk
• Think child, think parent, think family: a guide to parental mental health and child welfare
• Stress and resilience factors in parents with mental health problems and their children