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"It's everyone's job to make sure I'm alright"
Report of the Child Protection Audit and Review

Chapter 1: Child Protection

What is child abuse and neglect?
What is child protection?
What is the extent of child abuse and neglect?
The changing social context
Signposts to success

1.1 All children in Scotland are entitled to proper care and protection. Children may need protection when their basic needs such as food and warmth are neglected or they may need protection from harm from other people, the environment or even from themselves.

1.2 Children's lives are like a jigsaw, with different agencies and individuals having responsibility for different pieces. Parents and children themselves tend to hold the largest pieces of the picture. Health visitors and teachers will hold some pieces. For some children, social workers and the police also hold pieces. In this review we wanted to bring all the pieces of the jigsaw together to see the complete picture of children's lives and needs. A number of agencies have specific responsibilities towards children. These include education, health, police, the Scottish Children's Reporter Administration and social work. It is, however, the responsibility of all adults to protect children, hence our title 'It's everyone's job to make sure I'm alright' - the words of one of the young people who participated in the review.

What is child abuse and neglect?

1.3 There is no single agreed definition of what child abuse and neglect is and definitions have changed over time. Abuse can be physical, sexual or emotional. It may be acute or involve a long-term pattern of physical neglect. Often children are abused in more than one way.

1.4 As understanding of child abuse and neglect has increased, situations which are considered to be abusive or neglectful, have broadened to include:

• organised abuse, for example, children involved in prostitution and ritual abuse;
• munchausen's syndrome by proxy/fabrication or induction of illness in a child by a carer;
• foetal abuse, for example, through maternal abuse of alcohol or drugs;
• domestic abuse (primarily of mothers) which causes physical or emotional abuse of children;
• children affected by parental drug abuse;
• racial abuse;
• female genital mutilation (circumcision);
• forced marriage; and
• children who need protecting from harming themselves, through self inflicted injuries or reckless behaviour.

1.5 It has become clear over the last twenty years that the agencies and individuals with responsibility for children do not always protect them. We are now more aware of institutional abuse, for example, physical, emotional or sexual abuse in care homes or schools. More recently 'system abuse' has been identified where the child protection or criminal justice systems or practices, in themselves, are experienced by children as being abusive. For example, children may experience medical examinations as abusive or they may be distressed by having to attend court.

1.6 Children and young people may not always define child abuse and neglect in terms used by official agencies. They tend to view child abuse primarily in terms of physical abuse and sexual abuse and are less likely to talk about physical neglect or emotional abuse. Research has shown that some children and young people experiencing abuse may not define it as such because they have learned to regard it as normal or deserved. Peer abuse has been identified as a major worry for children and young people, but bullying is not normally defined as child abuse by professionals.

What is child protection?

1.7 For many people the term child protection relates to the activities of agencies such as the police and social work services in their protection of individual children. Our study of public views suggests that this is the most common understanding. For others, it encompasses a wider range of activities such as making roads safer for children to cross, or educating children about drugs and other harmful substances. In this review we have examined closely those agencies involved in protecting individual children, but we also take a broader approach to understanding how children might be protected and consider preventative measures.

What is the extent of child abuse and neglect? ¹

1.8 Whilst it is impossible to measure the real extent of child abuse and neglect the following figures provide an important background:

• 670 children under 15 died during 2001, the majority of these deaths were health related, but 19 related to road accidents, eight to fires, two to suicides and 32 to Sudden Infant Death Syndrome.
• There were 10 child homicide victims in 2000.
• The number of persons proceeded against where the main offence was child abuse was 436 in 2000 (231 for sexual offences; 205 for non-sexual offences).
• 6,600 children were referred to social work departments in relation to child protection issues in 2000-2001.
• There were 2,000 children on the child protection register as at 31 March 2001.
• In 2000-2001, 22,436 children and young people were referred to the Reporter on non-offence grounds.
• ChildLine Scotland received 4,330 calls about abuse from new callers in 2000-2001.

1.9 These figures do not, however, reflect the true level of child abuse and neglect for the following reasons:

• Much abuse and neglect does not come to the attention of official agencies because children do not tell anyone they are being abused. Research studies, which ask people whether they experienced abuse or neglect in their childhood, result in far higher numbers of people reporting that they have experienced abuse.
• Deaths from child abuse are very difficult to quantify and research suggests that some child abuse and neglect deaths may be miscoded as deaths due to natural causes or accidents.
• The victim's age is not recorded by the police for some sexual crimes such as rape and for most offences involving physical violence.
• ChildLine are able to answer less than half (48%) of the calls made to them.

1.10 Scottish child protection statistics do not include information about ethnic background, disability or other factors, which might help service planning.

1.11 National figures suggest that a parent is the abuser in over three-quarters of reported child abuse and neglect cases. In calls to ChildLine Scotland in 2000-2001, parents were generally cited as the abusers in cases of physical abuse and neglect, but in fewer than 40% of cases in relation to sexual and emotional abuse. In some cases, children and young people were being sexually and seriously physically abused by their peers.

The changing social context

1.12 Recent Scottish Executive reports, including For Scotland's Children and Getting Our Priorities Right have shown that, of the one million children in Scotland, many are living in poverty or are suffering as a result of family breakdown, parental drug and alcohol misuse and domestic abuse.

1.13 Deprivation undoubtedly increases the risk of family problems, and levels of child poverty in Scotland are high. Levels of deprivation are particularly high in Glasgow where 42% of children are entitled to free school meals and 42% of children under 16 live in families dependent on income support. Scotland's poorest children are four times more likely to be killed in a road accident than the wealthiest and nine times more likely to die in a fire in the home. Links between deprivation and child abuse and neglect are, however, contentious. For example, national Scottish statistics do not show clear linkages between levels of deprivation and the percentage of children on child protection registers or the percentage of child protection referrals. Other research has demonstrated, however, that there is a connection, particularly in relation to neglect. National statistics do suggest a link between levels of deprivation in an area and the percentage of children who are looked after.

1.14 Family structures have changed considerably over the past century. Now, in any one year approximately 8,000 children live in families where their parents are divorcing and many more are likely to experience the separation of their unmarried parents. One in five households are headed by a lone parent and more than 280,000 children live in lone parent households. It is likely that children's experiences of family life have been affected by these changes in family structures. We know, for example, that the divorce or separation of parents and disputes over contact can be very stressful for children and this is borne out by the case audit findings.

1.15 Over the past few decades there has been a decrease in the proportion of children and young people living in residential accommodation and an increase in the proportion of those living in foster care. Although research has shown that outcomes may be better in foster care, foster places are not always available.

1.16 The level of teenage pregnancies has been highlighted as a concern. Though falling, the rate of teenage conception in Scotland remains the highest in Europe and the rate in the most deprived area of Scotland is over six times higher than in the least deprived areas. Young parenthood presents its own difficulties and these are compounded by poverty.

Drug and alcohol misuse

1.17 Many children are affected by parental drug and alcohol misuse in Scotland:

• New research suggests there may be between 40,594 and 58,916 children with a drug-using parent in Scotland.
• Between 9,391 and 19,553 children appear to be living with a drug-using parent.
• The number of babies born to drug-misusing mothers has almost doubled, rising from 9.3 hospital discharges per 1,000 maternity cases in 1996-1997 to 17.7 in 1999-2000.

Domestic abuse

1.18 A significant number of children are witnessing or experiencing violence. It has been estimated that around 100,000 children in Scotland live with domestic abuse and that in 90% of incidents, children are in the same or next room. In addition to the emotional impact of living in an atmosphere of violence, there is also evidence to suggest that men who abuse their partners may also abuse their children, or force them to participate in the abuse of their mothers. Children often try to protect their mothers from physical assaults, and may be injured themselves as a result. Children living with domestic abuse may suffer from stress-related illnesses and conditions and experience feelings of guilt, shame, anger, fear and helplessness.

Signposts to success

1.19 Whilst, for some children, the outlook is bleak, there have been a number of improvements in Scotland that clearly show change is possible and children's lives can be improved:

• The death rate of children under 1 year of age has reduced from 8.6 in 1989 to 4.9 in 1999 per 1,000 population.
• The incidence of Sudden Infant Death Syndrome (SIDS) fell from 128 in 1990 to 33 in 2000 due mainly to a more stringent diagnosis of SIDS and the 'Back to sleep' campaign which advised parents to lay children on their backs.
• Fewer children are living in low income households (the proportion of children who were living in households below poverty thresholds ² fell from 34% in 1996-1997 to 25% in 1999-2000 in real terms).
• The number of women smoking at the start of pregnancy has reduced from 28% in 1993 to 25% in 2000.
• Children are now much less likely to be routinely hit by their parents as a form of discipline than they were a generation ago.
• The greater recognition of children's rights in Scottish society.

Appendix C outlines the legal framework in relation to child protection in Scotland. It also describes the way in which agencies respond to allegations of abuse and neglect.

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