Vulnerable infants

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.

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

This content is now on Kāinga Rua.

Practice triggers

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.

Connolly, M., Wells, P., & Field, J. (2007) Working with vulnerable infants, Social Work Now, 38 (December),  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.