Vulnerable infants

This page provides an overview of the Vulnerable Infants practice triggers. These practice triggers are used to support case work with children aged under five years.

Expand all

Overview

Toddlers and babies are represented in statistics as the most significant group at risk of serious injury or death from abuse and/or neglect. Their inability to protect themselves from harm and their susceptibility to serious injury and death heightens the need to ensure our response to notifications for this group is appropriate.

Developmentally a child’s experience in these early years is also known to have long term consequences and effective early intervention will support more positive experiences and long term outcomes.

The Office of the Chief Social Worker has introduced a set of practice triggers to raise the profile of this vulnerable group and to enhance our assessment and response. These triggers are to be used to guide decision making and to assist case planning. They are an enhancement to the practice frameworks and work in conjunction with the perspectives and principles.

Even though the use of the practice triggers is focused on supervisors and social workers, it is important that all staff working with these children consider the safety and wellbeing of this group given their vulnerability. It is also important that should any child present with bruising and/or injury we must turn our minds to and fully explore all explanations including opinions from professionals and must adhere to other relevant policy, for example the Child Protection Protocol.

Perspectives

Infants are one of the most vulnerable groups of children referred to statutory child welfare systems, a fact research continues to reinforce. These practice triggers, developed as an enhancement to the practice frameworks, ensure a focus on the vulnerable infant and encourage decision making and an assessment that is focused on infants’ safety and wellbeing. The triggers are designed to be used throughout the intake and investigation process.

Supporting practice focusing on vulnerable infant intake and investigation phases

  • Those who don’t cruise rarely bruise. (Sugar, 1999)
  • Bruises are extremely rare in infants who are younger than 6 months and are distinctly uncommon in perambulatory infants who are younger than 9 months. Infants aged between 6 and 9 months may develop bruises as they begin to cruise. When infants begin to cruise, the frequency of bruises increases and bruises located in certain sites may be an expected finding. Bruises on the anterior lower leg and knee, as well as the upper leg and forehead, are common in cruising and walking toddlers. Bruises on the cheek, back, chest and upper arm are much less commonly observed but may be seen in infants as they begin to walk independently. Bruises on the abdomen, buttocks, hands and feet are extremely rare in both infants and toddlers. Bruises that are not over bony prominences are uncommon (Sugar, 1999).
  • "At birth the baby’s brain is only 15% developed. Most of a baby’s brain development actually occurs after the birth - in the first three years of life. It is the child’s experiences during these years that enable the brain to grow. In particular, it is relationally-rich experiences which provide children with the ‘brain-food’ they need to grow into happy, secure and well functioning adults. Poor experiences during this time can have lasting negative effects on a child’s brain…and who they can become." Brainwave Trust 2006.

Brainwave Trust website

Practice Triggers

The aim of the vulnerable infant practice triggers is to raise the profile of this group of children and to enhance our assessment and response. These triggers are used by social workers and supervisors at the point of intake and in all Child and Family Assessments and Investigations that include a child aged under five years of age. The triggers are used to guide decision making and to assist case planning. They are an enhancement to the practice frameworks and work in conjunction with the frameworks' perspectives and principles.

The purpose of these framework enhancements on vulnerable infants is to increase staff awareness of the significance of bruising and injury to children and particularly infants. The triggers heighten a focus on the safety and wellbeing of this vulnerable group. These triggers should be used as part of your decision making and case planning in relation to this group of infants, alongside the practice framework.

The triggers can be used in a number of situations, specifically when changing response times at Intake, when in supervision, in informal/formal case consultations and when supervisors are approving assessment records. The use of the triggers is to be evidenced in case notes.

Intake

These triggers represent an enhancement to our practice framework that prompt reflection and action relating to vulnerable children under five during the intake phase of our work.

Vulnerable infant triggers

  • Are we focusing on the safety and welling of the infant within a sibling group notification?
  • Are we paying attention to any injuries and brusing, particularly to the face and head, when considering the safety of the infant?

Supporting intake decisions for vulnerable infants

Resource: Working with vulnerable infants- Connolly, Wells and Field (2007) Work (PDF 7 MB)

Cumulative Harm

Keeping our Focus on mokopuna

Safe Sleep

Assessment and decision making — Policy

Assessment

These triggers represent an enhancement to our practice framework that prompt reflection and action relating to vulnerable children under five during the assessment phases of our work.

Vulnerable infant triggers

  • Given their vulnerability, is our assessment addressing safety and considering the wellbeing of the infant?
  • Are all the concerns in the notification, particularly any injuries or brusing and their explanation, being fully assessed?
  • Is the enquiry engaging the father and his family/whānau and considering their relationship to the infant?
  • Are we ensuring the safety and wellbeing of the infant, when developing the next steps with the family/whānau?

Supporting assessment for vulnerable infants

Working with vulnerable infants- Connolly, Wells and Field (2007) (PDF 7 MB)

Focusing on attachment and stability

Tuituia Assessment Framework (PDF 338 KB)

Tuituia Assessment Guidelines

Resource: Young & Holcombe (2007) Voices of Young Fathers: Partners for Fragile

Resources

Vulnerable infants — Practice triggers

Age and stage of development

Keeping our focus on mokopuna

Cumulative harm

Links

Adverse Childhood Events

Brainwave Trust - provides useful information about child development and attach

Centre for Attachment

Zero to Three

Key Reading

Alliston, L. (2007) Principles and practices in early intervention: A literature review for the Ministry of Education

Atwool, N. (2007). The role of secure attachment as a protective factor for vulnerable infants. Social Work Now, December 2007 (PDF 7 MB).

Connolly, M., Wells, P., & Field, J. (2007) Working with vulnerable infants, Social Work Now, 38 (December) (PDF 7 MB),  5-10

Gunnar, M. R., Fisher, P. A., and the Early Experience, Stress and Prevention Science Network (2006). Bringing basic research on early experience and stress neurobiology to bear on preventive interventions for neglected and maltreated children. Development and Psychopathology, 18, 651-677.

Karoly, L.A., Kilburn, R.M. and Cannon, J.S. (2006), Early Childhood Intervention: Proven Results, Future Promise, RAND Corp, Santa Monica.

Sykora, J. (2005) “Off to a better start: What we know about early intervention services.” Social Policy Journal of New Zealand, 26: 117–130.

Ward, H., Munro, E. & Dearden, C. (2006). Babies and Young Children in Care: Life Pathways, Decision-making and Practice. London: Jessica Kingsley Publishers.