What is harm and significant harm in a child protection context?
Protecting children involves preventing harm and/or the risk of harm from abuse or neglect. Child protection investigation is triggered when the impact of harm is deemed to be significant.
‘Harm’ in this context refers to the ill treatment or the impairment of the health or development of the child, including, for example, impairment suffered as a result of seeing or hearing the ill treatment of another. ‘Development’ can mean physical, intellectual, emotional, social or behavioural development. ‘Health’ can mean physical or mental health. Forming a view on the significance of harm involves information gathering, putting a concern in context, and analysis of the facts and circumstances.
For some actions and legal measures the test is ‘significant harm’ or risk of significant harm. There is no legal definition of significant harm or the distinction between harm and significant harm. The extent to which harm is significant will relate to the severity or anticipated severity of impact upon a child’s health and development.
It is a matter for professional judgement as to whether the degree of harm to which the child is believed to have been subjected, is suspected of having been subjected, or is likely to be subjected is ‘significant’. Judgement is based on as much information as can be lawfully and proportionately obtained about the child, his or her family and relevant context, including observation. Assessment frameworks and tools, some of which may be specialised, can assist professional judgement. The way in which information about children’s developmental needs, parenting capacity, and family and community context is recorded will help professionals analyse the child’s needs, and the capacity of the parents or carers. Purposeful and accurate chronologies assist in analysis and decision-making.
Professional judgement entails forming a view on the impact of an accumulation of acts, events and gaps or omissions, and sometimes on the impact of a single event. Judgement means making a decision about a child’s needs, the capacity of parents or carers to meet those needs, and the likelihood of harm, significant or otherwise, arising.
The National Risk Assessment Toolkit is a resource which integrates the GIRFEC National Practice Model in a generic approach to assessment of risk, strength and resilience in the child’s world.
When there are concerns that a child may have experienced or may experience significant harm, and these concerns relate to the possibility of abuse or neglect, then police or social work must be notified. Along with other relevant services they will form a view as to whether the harm is or is likely to be significant (Information sharing: inter-agency principles). Professionals must also consider what harm might come to a child from failing to share relevant information, within the terms of their respective duties. Police and health also have single-agency duties in relation to protection from harm.
In assessing whether harm is or may become ‘significant’, it will be relevant to consider:
- the child’s experience, needs and feelings as far as they are known
- the nature, degree and extent of physical or emotional harm apparent
- the duration and frequency of abuse and neglect
- overall parenting capacity
- the apparent or anticipated impact given the child’s age and stage of development.
- extent of any premeditation
- the presence or degree of threat, coercion, sadism and any other factors that may accentuate risk to do with child, family or wider context
Sometimes, a single traumatic event may constitute significant harm – for example a violent assault, suffocation or poisoning. More often, significant harm results from an accumulation of significant events, both acute and long-standing, that interrupt, change or damage the child’s physical and psychological development.
The reactions, perceptions, wishes and feelings of the child must also be considered, with account taken of their age, language development and level of understanding. This will depend on effective communication, including with those children and young people who find communication difficult because of their age, impairment or particular psychological or social situation. It is important to observe what children do as well as what they say, and to bear in mind that children may experience a strong desire to be loyal to their parents or carers (who may also hold some power over the child). Steps should be taken to ensure that any accounts of adverse experiences given by children are as accurate and complete as possible, and that they are recorded fully.
Where there is evidence of harm relating to parental behaviour, assessing risk of future significant harm is enhanced by assessment of parental capacity to change. This consists in analysis of what helps and hinders the parents to change their behaviour. It also involves assessment of progress within supported opportunities for parents to resolve key difficulties, within an agreed timescale that relates to the child’s needs.
Significant harm is not the threshold for referral to the Principal Reporter. The test for referral to the Principal Reporter, in the case of those with a statutory duty (such as, local authority and police) to refer is, namely, that i) the child is in need of protection, guidance, treatment or control, and ii) it might be necessary for a Compulsory Supervision Order to be made. The grounds upon which a child can be referred to a children’s hearing are set out in s67 of the Children’s Hearings (Scotland) Act 2011. They define a broad range of harms or potential harms that might individually or in combination have significant effect, including, for example, exposure to a person who may cause harm, or lack of parental care which may cause unnecessary suffering or serious impairment to health and development.
A Compulsory Supervision Order may include a secure accommodation authorisation. Although risk of significant harm is not the test for such an order, the threshold for such an order is similarly high. The test is that the child has previously absconded and is likely to abscond again and, if the child were to abscond, it is likely that the child’s physical, mental or moral welfare would be at risk, or that the child is likely to engage in self-harming conduct or likely to cause injury to another person.
Significant harm is the test for the making of a child protection order in terms of the Children’s Hearings (Scotland) Act (2011).
Likely significant harm is the test set out in the Children’s Hearings (Scotland) Act 2011 for decisions which can be made in some circumstances, by children’s hearings, Sheriffs and Reporters, not to provide information to a person who would otherwise be entitled to that information.
Harm is included in relation to conditions for medical examination orders in terms of risk of self-harm (s87 of the 2011 Act).
The 2011 Act recognises that ‘serious harm’ (whether physical or not) may occur as a result of a child’s actions towards others. The need to safeguard and promote the welfare of the child throughout childhood is the paramount consideration for a children’s hearing, pre-hearing panel or Sheriff, unless the hearing, pre-hearing panel or Sheriff considers that a decision is necessary for the purpose of protecting members of the public from serious harm (whether physical or not). In such situations, the child’s welfare is ‘a primary’ but not ‘the paramount’ consideration.
Reflection and supervision play a role in supporting careful, balanced and legitimate steps. This is essential given the contested, complex and partial information that may be available, and as a result of the pressure of time when a situation is urgent. Variability in judgement can unfold from differences in presentation and source of concerns. Judgement may also be affected by differences in agency policy, leadership style, professional skills, experience, values, intuition and assumptions. There may be differences in personal or collective emotional response affecting judgement. The availability of experienced peer support is a quietly influential factor, the presence or absence of which can affect the perceptions and professional resilience of everyone involved in child protection. For these reasons, the likelihood and significance of harm will be aided by standard operating procedures, guidance and frameworks. Safe judgement also requires the development and preservation of reflective practice, supervision and teamwork under stressful conditions.
In summary, child protection involves activity to assess and prevent harm from abuse, neglect, maltreatment and exploitation. Inter-agency judgement about whether harm is significant will evolve from assessment activity in which the child is central. Significant harm remains the test for some legal steps and actions. However, the threshold is not precisely defined in law or in guidance. Professionals need to be open minded and clear about the evidence and analysis that informs professional judgement regarding potential harm to a child at a certain stage in time, recognising that risk factors interact and assessments must be reviewed to reflect change.