Updated: 23 September 2013
Children and young people exposed to repeated events of harm or neglect experience a profound and indelible diminution of their sense of safety, stability and wellbeing. As well as responding to the unique features of each event it is important that we recognise and assess the impact of cumulative harm on the child or young person in our response.
This key information discusses cumulative harm including its impact on children and young people, its relationship with neglect and family violence, and practice implications for social workers.
The material has been drawn from the publication 'Cumulative Harm: A Conceptual Overview' by Robyn Miller (2008).
Cumulative harm refers to the effects of patterns of circumstances and events in a child or young person's life which diminishes their sense of safety, stability and wellbeing.
Cumulative harm is compounded experiences of multiple episodes of abuse or layers of neglect. Constant daily impact on the child or young person can be profound and exponential, covering multiple dimensions of their life.
Information on the processes that support or disrupt an infant's developing brain indicates that disruptions to normal development in early life will fundamentally alter certain areas of the brain in later development. The chain of development suggests that a child's early life experiences have more relative importance in the organisation of the mature brain than that of later life experiences. For example, experiences that can be tolerated by a 12 year old can be life altering for an infant.
The understanding of cumulative harm requires workers to thoroughly analyse the particular vulnerability of infants and young children exposed to repeat harmful events.
Chronic neglect and cumulative harm are independent terms, however the high reoccurrence of neglect as an abuse type and its often silent co-existence with other identified abuse types means that it is frequently a factor in causing cumulative harm. Patterns of low level care, particularly during early development, must be considered in terms of the cumulative harm they may be causing.
Neglect must be considered an identified abuse type on par with all other forms of maltreatment given the evidence that its consequences can be damaging.
Family violence is a common factor in the lives of children and young people who are affected by cumulative harm. The presence of violence is highly damaging to the developing child, and a growing body of evidence suggests infants are particularly vulnerable.
Alongside the act of physical violence, other forms of maltreatment contribute to cumulative harm including emotional violence (e.g. humiliation, coercion, degradation), indirect impacts on parenting capability (e.g. anxiety and depression undermining a parent's ability to care for a child), and physical incapacitation as a result of an assault.
Parents/caregivers must be assisted to understand the impacts of family violence on their children, on themselves as people and parents and on their relationships with others.