Signs, symptoms and risk factors: health visitors' perspectives of child neglect.

Following a brief review of child neglect in England, this small scale, descriptive study ranked in descending order of importance, based on their expertise in the field of child protection, the perceptions of experienced health visitors with respect to 45 signs, symptoms and risk factors of child neglect derived from the literature. The research employed a prospective, survey design using anonymised, self-completion, postal questionnaires and involved 124 health visitors working in East Anglia of whom 92 finally took part. The response rate was 74%. The study was conducted in 2002, over a period of one year, with respondents from care settings in Norfolk, Suffolk and Cambridgeshire, UK. On the basis of 4001 observations, findings demonstrated promising within-cohort professional agreement regarding ways in which significant features of child neglect were similarly regarded by health visitors and reflected broadly the established wisdom in the literature. The top ten ranked child neglect characteristics included violence to the child, the child being excluded by the family, the child being left unattended or left to care for other children, violence within the home, a domestic atmosphere of high criticism and low warmth, evidence of human and animal excrement, an unsafe environment, the availability of little or no food, a history of child abuse and poor parenting and unmet medical needs. By contrast, poverty, poor hygiene, housing and state of clothing, financial pressures and unemployment were scored as least important. While the importance of establishing a professional consensus on neglect is considered crucial to improving the evidence base of all protecting neglected children, further investigation is needed on the extent to which perception data might be used in education and practice and its impact on the identification and management of child neglect. Copyright © 2007 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]