Decision-Making on Child Neglect:

Ghanaian Social Workers’ Views and

Experiences

Esmeranda Manful, Alhassan Abdullah

& Ebenezer Cudjoe

International Journal on Child

Maltreatment: Research, Policy and
Practice
A Publication of The Kempe Center and
The Haruv Institute

ISSN 2524-5236

Int. Journal on Child Malt.

DOI 10.1007/s42448-019-00041-6

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https://doi.org/10.1007/s42448-019-00041-6
ORIGINAL PAPER

Decision-Making on Child Neglect: Ghanaian Social

Workers’ Views and Experiences

Esmeranda Manful 1 & Alhassan Abdullah 2 & Ebenezer Cudjoe 3

Accepted: 28 November 2019/

# Springer Nature Switzerland AG 2019

Abstract
Social workers’ ability to make decisions concerning whether (or not) neglect has
occurred is an important element towards ensuring the safety and wellbeing of
neglected (or at-risk) children. Yet, there is little empirical evidence on the procedures
adopted by Ghanaian social workers in identifying neglect. Drawing on semi-structured
in-depth interviews with 15 social workers, using a phenomenological approach, this
study sought to explore how social workers make decisions whether neglect has
occurred. Social workers reported the use of interviewing skills, observing incongru-
ence between verbal and non-verbal cues, field observations/home visits and the child’s
physical appearance as ways of identifying that neglect has occurred. The study
findings are indicative that social workers can develop guidelines to inform how they
identify that neglect has occurred to provide timely and adequate intervention for
affected children. Also, the findings suggest that probing into areas of inconsistencies
in parents’ statements could help social workers determine whether a parent has been
neglectful. The study highlights the usefulness of families’ ecological factors in
supporting child protection workers’ decisions on reported neglect cases. Studies that
examine the nuances in these ecological factors and other disadvantages such as
poverty in line with conventional child protection practice could help extend knowl-
edge on this topic.

Keywords Child neglect . Decision-making . Parents . Social workers . Ghana

* Alhassan Abdullah
abdullahalhassan14@gmail.com; aalhassa@connect.hku.hk

Esmeranda Manful
emanful.cass@knust.edu.gh
Ebenezer Cudjoe
ecudjoe3-c@my.cityu.edu.hk

Extended author information available on the last page of the article

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Introduction

Neglect is usually less manifested; yet, its effects are often more devastating than other
forms of maltreatments (Maguire & Naughton, 2016; Mennen, Kim, Sang, & Trickett,
2010). This is because neglect is generally insidious, making it difficult to detect
(Dubowitz, 2013). The implication of this is that neglect may occur for a long period
of time which could have negative consequences on the wellbeing of the child. Thus,
social workers’ role in earlier identification of neglect is key. When neglect is not
reported and substantiated, the risk for negative outcomes may increase, and children’s
needs could be denied (Dickerson, Lindner, Scurich, & Quas, 2017). Because of their
regular interactions with at-risk children, social workers play a key role in decision-
making regarding child neglect.
Although neglect is the most common form of child maltreatment (Bundy-Fazioli &
Hamilton, 2013; Manly, Oshri, Lynch, Herzog, & Wortel, 2013), recognizing the signs
of neglect, identifying the needs of children and families and intervening can be
challenging and complex (Daniel, Taylor, & Scott, 2010). There continue to be some
inconsistencies and disagreements with regard to how child neglect is defined and
operationalized (Bundy-Fazioli & Hamilton, 2013; Hearn, 2011; Taylor, Daniel, &
Scott, 2012). Several factors account for the difficulty in arriving at a consensual
definition for child neglect and its subsequent intervention. First, the concept is affected
by cultural practices which make operationalization difficult (Chan, Lam, & Shae,
2011). Different cultures could have different views on what act of caregivers’ omissions
constitute neglect (Horwath, 2007; Laird, 2016; Manful & Abdullah, 2018). Further,
social workers and parents may have different opinions about what behaviour consti-
tutes neglect in a given situation (Bundy-Fazioli & Hamilton, 2013; Rose & Selwyn,
2000). Moreover, there is limited empirical evidence to support a universal accepted
definition for neglect (Coope & Theobald, 2006; Dubowitz et al., 2005). Thus, it is
important to conduct investigations into how social workers are able to make decisions
on reported cases of neglect to develop timely intervention. As social workers’ timely
identification of neglect can lead to early intervention, thereby preventing the risks of the
long-term consequences of neglect on children (Hornor, 2014).
Social workers in Ghana are mandated by the Children’s Act 1998, Act 560, to ensure
the overall wellbeing of children in contact with child welfare services. Social workers at
the Department of Social Welfare in Ghana work with children and their families to
address reported issues of neglect. Majority of the cases reported to the Department of
Social Welfare centres on families’ inability to meet the needs of children; these are
categorized as child maintenance by the Department of Social Welfare (Ministry of
Gender, Children and Social Protection, 2014). Child maintenance cases are indicative
of child neglect because it involves omissions in care. However, both policy documents
and legislation guiding practitioners in child welfare do not provide specific definitions
of child neglect making its identification difficult. Therefore, children in these situations
may continue to suffer as their needs are continually ignored.

Social Workers’ Decision-Making on Child Neglect

Considering the fact that the concept of child neglect tends to be influenced by culture
and varies from different societies (Hua et al., 2014), social workers can face difficulties
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identifying whether (or not) neglect has occurred. Several studies have been conducted
on how social workers are able to make decisions on reported cases of child neglect. A
study by Tufford, Bogo and Asakura (2015) revealed that some social workers depend
on parents or caregivers’ beliefs to make decisions on reported cases of neglect. The
social workers indicated their use of validation skills to confirm whether the client
agrees that she or he has been a “bad parent” (Tufford et al., 2015). Because parents and
social workers could have different opinions on what behaviour constitutes neglect
(Bundy-Fazioli & Hamilton, 2013), an initial acknowledgement from a parent that she
or he has been neglectful could be a good starting point for a positive intervention.
Further, to make decisions on reported cases of child neglect, Tufford et al. (2015)
recommend that social workers should focus on the potential risk of child maltreatment.
Social workers and other professionals working with children are guided by guide-
lines from child welfare policies and frameworks in making decisions on reported cases
of child neglect (Mathews & Kenny, 2008; Schols, de Ruiter, & Öry, 2013). As a move
towards the early detection of child abuse and neglect, most countries including the
USA, Canada, and Australia have established mandatory reporting laws to protect
children. For example, the Child Abuse Prevention and Treatment Act (CAPTA) of
the USA has stipulated reporting procedures in cases of child neglect to help inform
subsequent intervention (Mathews & Kenny, 2008). Such provisions exist in Ghana
with the introduction of the Children’s Act 1998, Act 560, which mandates any person
with information on suspected child abuse to report to the Department of Social
Welfare. However, unlike the CAPTA that makes mention of child neglect as a unique
phenomenon, Ghana’s Children’s Act (560) makes less mention of child neglect as a
distinct type of maltreatment, and this could have negative consequences for neglected
children as their cases may not be timely and adequately addressed by practitioners.
Further, some social workers do not apply the Children’s Act in their practice as there is
evidence of a gap between legal intent and practice (Manful & McCrystal, 2011). Thus,
it is important to seek the views of frontline social workers regarding effective ways to
enhance implementation of child welfare legislation in Ghana.
Neglect may go undetected for a long time if action is not taken (Maguire &
Naughton, 2016; Mennen et al., 2010), and this is more so in Ghana where child
welfare and protection systems are not effective enough to provide timely intervention
for neglected children or children at risk of being neglected. Most cases of neglect in
Ghana are overlooked by the society due to the lack of a strong child welfare system
and poor economic conditions (Laird, 2016). The situation is compounded in Ghana
due to the prevalence of poverty and socio-economic disadvantages. Thus, it is
important for social workers to know and build on relevant skills that can be used in
identifying when neglect has occurred to protect and promote the wellbeing of children.
To the best of the knowledge of the researchers, this is the first empirical study in
Ghana to explore how social workers make decisions with regard to issues of neglect.

The Current Study

Child neglect is a multi-dimensional concept influenced by sociocultural factors and its

occurrence subjectively determined by professionals, parents and other stakeholders
(Bundy-Fazioli & Hamilton, 2013; Hearn, 2011). Because of the difficulties in arriving
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at consensual definitions to inform global practice, there is the need to explore practices
in local contexts to find out how practitioners identify when neglect has occurred.
Findings from such local contexts could contribute to global discussions and facilitate
in the achievement of parameters for conceptualizing neglect. This is important con-
sidering that neglect has damaging consequence on both the long- and short-term
physical and mental developments of children (Maguire & Naughton, 2016). To
achieve this, a main research question “How do social workers in Ghana identify that
neglect has occurred” directed the study.

Study Setting

The study was conducted in Kumasi, the second largest city in Ghana (Ghana Statistical
Service, 2014). The 2010 population census identified the city as the most populated
city in Ghana with an estimated population of 2,035,065. The study was conducted at
the Department of Social Welfare, Kumasi. The Department of Social Welfare is the
main governmental institution mandated to handle issues related to the welfare of the
marginalized and disadvantaged groups. To effectively carry out its mandate, the
Department of Social Welfare has categorized its activities under three broad thematic
areas, namely, Child Rights Promotion and Protection (CRPP), Community Care and
Justice Administration. Issues of child neglect are found under the CRPP section of the
Departments’ core activities. Major cases handled by the Department of Social Welfare
include abandonment, child maintenance, child custody, paternity, access and family
welfare cases, which have bearing on child neglect (Department of Social Welfare,
2015; Ministry of Gender, Children and Social Protection, 2014). However, issues of
child custody and child maintenance are the major cases reported to child welfare
authorities in Ghana (Ministry of Gender, Children and Social Protection, 2014).
For the Ghanaian practitioners, child maintenance generally refers to instances where
parents, especially fathers, fail to provide money for food, shelter, clothing and non-
payment of children’s school fees (Manful & Abdullah, 2018), whereas child custody
cases are defined as a situation in which either of the parent is seeking legal custody of his/
her child(ren). In the conduct of their duties, social workers at the Department of Social
Welfare conduct counselling and case conferences with parents aimed to identify solu-
tions to a reported case of child neglect. On the average, 15 counselling sessions are
conducted within a week at the Department. In line with the Children’s Act 1998, Act 560,
cases related to child neglect are to be reported to the child welfare authorities by anyone
who suspects the occurrence of such incidence.

Method

Participants

The study involved 15 qualified social workers from the Department of Social Welfare,
Kumasi. In line with the study’s objective of identifying how workers determine that
neglect has occurred, the researchers identified these frontline practitioners to seek their
views and experiences on the topic under investigation. The study participants were
purposively selected following some eligibility criteria: specifically, social workers
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with more than 1-year practice experience were eligible. The minimum 1-year practice
experience required ensured that the social workers would have had contact with cases
related to child neglect to enable them share their experience on the topic. However,
social workers not practising as frontline workers were exempted from the study.
From the demographic data presented in Table 1, it can be observed that majority of the
social workers had more than 5 years practice experience. The lengthy practice experience
of the social workers coupled with their educational qualification lends some credence to
the study findings as it presents insight from qualified frontline social workers.
In recruiting participants, the researchers had an initial visit to the Department of Social
Welfare in January 2017 to seek ethical approval from the Head of Department. During the
visit, the researchers took the opportunity to familiarize themselves with the organization
and the potential research participants. One of the social workers at the organization who
had prior working experience with the second author served as a gatekeeper (Given,
2008). The gatekeeper led the researchers to the Head of Department as well as the
research participants after gaining insight into the research project. During the next visit,
the researchers provided a brief explanation of the research project to the social workers as
a prelude to gaining their consent to participation. Workers who showed interest in
participating were asked to contact the researchers through the telephone numbers pro-
vided. Out of the total of 18 social workers identified at the Department of Social Welfare,
15 contacted the researchers agreeing to participate in the study. Actual interviews with the
selected social workers began on February 2017 through to April same year.

Measures

Study Design and Procedure

The qualitative phenomenological approach guided the conduct of this study. The use
of qualitative research is useful in describing complex and delicate issues such as those
surrounding child neglect. This method was used to understand the topic from the

Table 1 Demographics of social workers

Item Classification Number

Sex Male 8
Female 7
Age 20–25 2
26–30 6
31–35 2
36–40 5
Education Master’s degree 2
Bachelor’s degree 5
Diploma 8
Work experience 1–5 7
6–10 5
11–15 1
16–20 2
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perspectives of the research participants (Patton, 2014). The phenomenological design

was used to make sense of how the research participants describe, experience, feel
about, talk about and judge a particular phenomenon (Padgett, 2008; Patton, 2014).
This design was appropriate because the researchers were interested in the subjective
views and experiences of the research participants. Using this method, the social
workers’ views and experiences were explored, and common themes in their responses
were identified (Padgett, 2008; Patton, 2014).
Interviews were scheduled after interested participants contacted the researchers to
express their interest to participate in the study. Using a semi-structured interview
guide, all research participants were involved in in-depth interviews which lasted
approximately 40 min for each interview. The use of semi-structured interviews
enabled researchers to probe and explore participants’ narratives through follow-up
questioning techniques (Marvasti, 2004). Major questions on the interview guide
included how social workers make decisions to identify that neglect has occurred.
All interviews were audio recorded following participants’ consent (Silverman, 2013).
Interviews with the selected social workers were conducted in the English language.

Ethical Considerations

Ethical approval for this research was obtained from the research unit of the Kwame
Nkrumah University of Science and Technology and the Department of Social Welfare,
the state institution mandated with the responsibilities to promote access to social services
for the disadvantaged, vulnerable and excluded groups such as children. Each research
participant provided formal consent by signing the researchers’ informed consent form.
The consent form contained information on the purpose of the study, participants’ rights
before and after participation. Potential benefits to general child protection practice in
Ghana were also outlined in the consent form. Measures to conceal participants’ actual
names and other identifiers were made known to participants.

Coding

Audio recordings of each interview were transcribed verbatim. The transcribed data were
checked by the researchers and compared with the audios for correctness and precision.
The final amended transcripts were coded in line with the thematic analysis procedure
suggested by Braun and Clarke (2006). Following this, researchers conducted closed
readings of the transcripts to have general understanding, create meanings and patterns in
the narratives. Common narratives and phrases were coded after researchers’ familiarity
and closed reading of the interview transcripts (Padgett, 2008). Open coding was done
where the researchers conducted a line by line reading of the data to organize quotes that
reflected the research questions (Charmaz, 2014). Codes such as “the child’s physical
state”, “confirm from their home environment” and “their home says a lot” were devel-
oped from the data. The codes were organized into potential themes and further refined to
ensure they provided answers to the research questions. Themes that were organized under
the research questions were refined to ensure internal uniformity, that is, to ensure that
responses coded into a theme represented a coherent pattern. At this point, themes that
reflected similar ideas in meaning were merged and reported as one theme. The interview
data were managed with the NVivo 11 qualitative software.
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Findings

The findings have been presented based on the study’s objective: to know how social
workers identify that neglect has occurred. Major themes that emerged after indepen-
dent data analysis by the researchers have been presented with supporting quotes from
the research participants. Due to the insidious nature of the effect of child neglect, social
workers often face the challenge of making decisions on a reported case of child neglect
during assessment. However, evidence from the in-depth interview with 15 social
workers revealed workers use of interview skills, observing incongruence between
clients’ verbal and non-verbal cues, home visits or field observation and child physical
appearance as means of making decisions on whether a reported case of child neglect
can be substantiated.

Use of Interviewing Skills

Extracts from the narratives of the social workers revealed that they utilized their
interview skills to make decisions on reported cases of child neglect. Social workers
who shared this opinion argued that they probed aspects of clients’ narratives, espe-
cially where there seem to be inconsistencies, to make decisions on whether claims
made by reporters can be substantiated. This was how a social worker narrated the use
of interviewing skills to decide whether or not neglect has occurred:

We question them further especially at a point when we realise no linkage or

breaks in what they are saying. Even though some of the parents at times admit
right from the beginning that truly they have not been taking care of their children
others fail to admit, which calls for the use of our technique of interviewing like
probing and asking further questions to ensure that we do not prejudge parents on
mere allegations. (Male, Social worker 2)

The technique of further probing on areas of inconsistences in clients’ narratives to

make decisions on claims of child neglect cases was reiterated by another worker:

For me, I only dwell on how they present their cases to further probe the missing
link in their narration to arrive at a conclusion on their claims made. Not only the
respondent who has been reported on suspected child neglect, but I also probe the
narratives of the complainant to better understand his/her case and to know
whether he/she is saying the truth or not (Male, Social worker 4)

As part of the interviewing techniques, workers indicated that they relied on past
experiences to strengthen their position on clients’ inconsistencies. This was how a
worker narrated this:

…You know we work with a lot of clients from different background. But one
thing that’s unique is that the behaviour of the parents appears to follow same
pattern. So some of them like this, when we realise points of inconsistencies, we
don’t just assume right from there, No. But our decisions are confirmed based on
past behaviours of some of the parents (Female, Social worker 1)
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Comments from the participant suggest that parents’ deceptive attitudes are
utilized by social workers to prove them guilty on reported cases of parental
neglect. The participant’s assertion was echoed by another worker who noted that
such inconsistencies are unravelled during case conferences with both parents:

No. most at times you won’t know these inconsistencies when you interview
the parties separately. But in case conferences where both parties are present,
there you will see the shivering and talking here and there, hahahaha. So that
is that, during case conferences we get to know all these (Male, Social
worker 4)

Further, it was observed that some of the parents assist in the identification of these
inconsistencies and claims made by their partners during case conferences:

Most at times it escapes us, but the other party will draw our attention to that. So
that we probe further. (Male, Social worker 8)

This implies that parents’ presence during case conferences help social workers to
make decisions in matters relating to child neglect. Therefore, social workers should
collaborate with parents during case sessions and encourage them to voice out their
thoughts.

Observing Incongruence Between Verbal and Non-verbal Cues

As part of the idea of workers using interviewing techniques to identify that neglect has
occurred, workers’ observance of incongruence between clients’ verbal and non-verbal
response was identified as an added technique. According to the social workers,
incongruence between clients’ verbal utterances and their non-verbal cues helps them
to confirm whether the said parent has neglected his/her children. Excerpts from the
narratives of the social workers suggest that, often times, parents’ verbal utterances
were not corroborated by their non-verbal cues which indicates that claims made
against them could be true:

…Even the way and manner in which they talk and their gestures tell us that they
are not taking care of their children. Someone will say this is subjective, yes we
agree. But if someone is saying the truth both the verbal and non-verbal indicators
must align. So when there is a difference as well, we should be able to know.
(Female, Social worker 9)

It appeared that social workers observed incongruences in clients’ non-verbal cues

and verbal communications to support their decisions. Workers agreed that incon-
sistencies between what one says and their non-verbal actions help to validate
their decisions:

sometimes when they stand here to talk you can clearly depict from what they are
saying and their non-verbal actions whether they are lying or not. (Female, Social
worker 13)
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Adding to the observation of discrepancies between clients’ verbal and non-verbal

cues, a social worker argued that even though there may be instances of wrong
interpretations to the observed cues from clients, he believed that their training in social
work has provided them with adequate knowledge to carry out correct assessment. This
was his narration:

Well, you cannot take this out, there may be instances that we may judge clients’
non-verbal cues wrongly, that is a possibility. But I believe that, our training in
Social Work and our practice experience has provided us with enough techniques
and skills to draw correct conclusions from clients’ narratives and their non-
verbal cues. (Male, Social worker 4)

This view was echoed by a social worker who commented on the use of team work to
overcome possible misjudgement of clients’ non-verbal cues and verbal
communication.

…That is one of the reasons why we work in teams, or work under supervisors.
Handling cases in teams helps us to observe different aspects of clients’ non-
verbal cues based on which we can coalesce views to arrive at an objective
interpretation to make decision. (Female, Social worker 14)

The implication of this is that the involvement of social workers in case conferences
can help to improve workers’ judgement of clients’ non-verbal cues.

Field Observations and Home Visit

Social workers identified the use of field observations or home visits as means to support
their decisions on whether or not neglect has occurred. According to the social workers,
home visits and field observations help to ascertain facts and provide first-hand informa-
tion, particularly about the influence of the home conditions and environment:

We sometimes go to the field to witness the home conditions and ascertain the
actual fact with respect to the home conditions and environment as alluded by
some of the parents. (Female, Social worker 13)

Additionally, some social workers argued that they conduct home visits to observe and
interact with witnesses:

One way that we use to determine that neglect has actually occurred as reported
by the parents or reporters is through home visit. Through the home visit, we have
the opportunity to interact with witnesses mentioned in parents or clients’
narration and to observe the home conditions and family situations and assess
their impact on the reported child neglect case. (Female, Social worker 15)

Social workers in this study opined that they resort to home visit especially when
parents who report cases to the Department of Social Welfare refer to the home
condition as a predisposing factor of neglect. This was how a social worker narrated:
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We make use of the home visit because most of the parents or clients as part of their
case presentation refer to these home conditions and third parties as evidence and
witnesses to support their claims. So, for us to make a better decision we have to
visit the homes to observe and interact with the witnesses and ascertain the actual
fact. (Male, Social worker 3)

The social workers indicated that home visits are not always conducted based on the
parents’ narratives, rather the nature of the case sometimes impels them to conduct
home visit without clients’ notice and consent:

…Yes, not all the times that the parents are aware of the home visit, we conduct home
visit based on the nature of the case not on the demands of the clients. So sometimes
we surprise them, they will be there then we appear in their homes to have a feel of
the home conditions to support our decision. (Female, Social worker 15)

A social worker commented on the reason why they conduct surprise home visit
without clients’ consent:

It is not with any bad intention, no, we do that especially when we suspect that
there is something hidden. (Male, Social worker 2)

Thus, it appears some social workers conduct home visits without clients’ consent in
order to unravel clients’ hidden information so as to support their decision-making.

Child Physical Appearance

Further, interviews with the participants revealed that social workers observe the physical
appearance of the child, reportedly being neglected, to support their decision. Social workers
who shared this view indicated that observing the demeanour and physical state of the
neglected child can be useful in making decisions on whether neglect has occurred or not:
“sometimes a mere look at the child in question, tells us whether it is true or not that he/she is
facing neglect from the parents” (Male, Social worker 2). A detailed explanation regarding
the observation of child physical appearance was given by a social worker who cited the
nature of children’s clothing, incongruence in children’s age and rate of development as
physical features that can depict whether a child is suffering from neglect or not:

Sometimes we invite the subject, which is the child or children involved and often
times the parents bring them as evidence to their claims. Doing that we observe
their physical appearance, their clothing, and how they are developing physically
with respect to their age. Based on which we can tell whether the child is
suffering from neglect or not. (Female, Social worker 9)

Another social worker added:

I can tell that a child has been neglected when I see that the child’s clothing is in
terrible shape and looks unkempt and sometimes walking barefooted. (Male,
Social worker 3)
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Some social workers shared their opinion on how the practice of using child or
children’s physical appearance to support decisions on whether or not neglect has
occurred is actualized in practice:

If you are saying that you feed the children well or you buy them adequate
clothing we will verify when we see the children ourselves. (Male, Social worker
6)

Lessons can be drawn from this to assist social workers to identify whether neglect has
occurred.

Discussion

Child welfare policies and legislation in Ghana are silent about how social workers can
identify when neglect has occurred. Given this context, the current study provides
understanding about some relevant strategies for social workers to adapt in working
with children at risk of being neglected with an aim to inform practice and policy
decisions. By knowing the signs indicating that a child has been neglected, social
workers will be able to develop an early response to meet the needs of children (Turney
& Tanner, 2001). The social workers in this study indicated the use of interviewing
skills as an important practice skill in identifying that neglect has occurred. The social
workers indicated that they used probes to explore inconsistencies in parents’ narratives
to reveal whether or not parents neglected their duties. This corroborates with Tufford
et al.'s (2015) study which found that social workers use validation skills to confirm
whether the parent has been neglectful. However, because social workers and parents
could have different opinions on what actions or inactions constitute neglect (Bundy-
Fazioli & Hamilton, 2013), it might be difficult for both social workers and parents to
come to a consensus in deciding when a behaviour is considered neglectful.
The study found that social workers should pay attention to any discrepancies
between what clients say and their non-verbal behaviour. This is because sometimes
what clients say and their corresponding non-verbal cue may not be in tandem
(Kadushin & Kadushin, 2013). It appears that the incongruence between verbal and
non-verbal cues could help social workers decide whether a parent is neglectful. This is
because some parents’ non-verbal actions could be implying that they are neglectful
even when they say they have been good parents. The study findings suggest that the
social workers acknowledged that there could be flaws in their judgement of such
discrepancies. Thus, they recommended that social workers should collaborate with
colleagues to overcome the possibilities of misconstruing such discrepancies. There
could also be the possibility of interdisciplinary collaboration by involving profes-
sionals who are specialized in observing discrepancies between verbal and non-verbal
behaviours. However, such collaboration may not be helpful if the professionals are not
known to the family. Therefore, it is important for social workers who are known to the
families to observe and learn about these discrepancies.
Further, the study findings suggest the social workers use field observations and
home visits to identify that neglect has occurred. Harder (2005) observes that home
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visits are key to reducing the risk of child neglect. The social workers used field
observations and home visits to observe the home environment within which the child
lives and to determine whether it exposes the child to neglect. Ghana’s Children’s Act
1998, Act 560, mandates social workers to conduct home visits to ascertain whether
parents are providing adequate care for their children. Home visits are important part of
the workers’ practice as it helps them to observe children and their families in their
natural settings (Ferguson, 2018) and to assess the impact of the environment on the
child’s wellbeing. The social workers in this study indicated that home visits are
utilized when conditions in the home are identified as predisposing the child to neglect.
Thus, they could be used by social workers to corroborate reports of child neglect
especially in cases where the home environment is considered a predisposing factor.
However, social workers should be cautious in making conclusions based on conditions
in the homes of potential neglectful parents, due to the impact of poverty and other
socio-economic disadvantages on parental neglect. Therefore, in assessing potential
neglect issues, social workers should be aware of potential predisposing factors and
consider them as targets of intervention.
The social workers indicated that they usually consider the child’s physical appear-
ance to determine whether neglect has occurred. Maguire and Naughton (2016) argue
that neglect could have devastating consequences on the mental and physical health of
children. Consequently, social workers could be able to observe the child’s physical
appearance and identify whether they have been neglected. The workers indicated that
they could observe from the child’s physical development as well as consider their
clothing to identify whether she or he has been neglected. This is possible because child
neglect could be in the form of nutritional neglect (Laird, 2016; Choi & Thomas, 2015)
which could cause developmental delays in children. Moreover, some parents’ inability
to provide proper clothing for their children could be an indication of neglectful
behaviour. In most cases, when neglect causes physical and mental problems for
children, it could mean that the neglect has occurred over a long period of time
(Dickerson et al., 2017; Rose & Selwyn, 2000). Therefore, using the child’s physical
appearance to identify that neglect has occurred might not be a good early response
strategy. Nonetheless, using the child’s physical appearance is an important element for
social workers to consider using to identify whether neglect has occurred.

Implications for Practice

The study findings suggest several practical implications for social workers in deciding
whether (or not) neglect has occurred. First, when interviewing parents who are
suspected of being neglectful, social workers should use probes to ask further questions
in areas where there appear to be some inconsistencies in the parents’ statements. Social
workers could ask parents to confirm earlier statements to ensure that there are no
inconsistencies in such statements. When working on issues of child neglect, social
workers should regularly use case conferences where all individuals related to the case
are present to ensure that statements made by others in the meeting can be corroborated
by other individuals present at the case conference. Further, social workers should pay
attention to incongruence between clients’ verbal and non-verbal cues. This is because,
sometimes, a client could be saying something, while their non-verbal actions would be
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International Journal on Child Maltreatment: Research, Policy and Practice

telling something else. Thus, it is important for social workers to know that such
discrepancies could indicate whether a parent has been neglectful. As the study has
found that social workers could wrongly interpret such discrepancies, it could be helpful
to work in teams to confirm whether such discrepancies are an indication of neglect.
The study also suggest that the home environment of a family could reflect the existence
of neglect. Thus, social workers could conduct home visits and assess the family’s
environment to make decisions whether neglect has occurred. Interacting with families
in their natural environment could also help social workers determine how the child feels at
home, as a means of determining whether the home is the best place for the child. The study
indicates that social workers may conduct home visits without providing prior information
to parents. This could help the social workers gather some important information without
parents altering the process. Essentially, social workers may be able to observe the family in
their natural setting as parents’ prior knowledge of the visit could lead to parents disguising
themselves as “good caregivers”. Finally, social workers should observe children’s physical
appearance when engaging with them as the child’s appearance could help them decide
whether neglect has occurred. When observing the child’s physical appearance, social
workers can look up for signs including lack of proper clothing and poor growth.

Limitations of Study

There may be limitations to applying this study outside the study context. The use of the
qualitative research based on the phenomenological design could mean that the study
findings are contextual. Nonetheless, findings could be relevant to other contexts that
share similarities with the study setting. Also, the study only reported findings from
frontline social workers. Social workers working as policymakers and administrators
could have different opinions about decision-making regarding child neglect. More so,
the study findings do not illuminate how social workers consider the differences in
parents’ socio-economic advantages or disadvantages such as poverty in child protection
investigations to determine neglect issues. Studies that address these limitations could help
strengthen the contextual nuances of child protection assessment and decision-making.

Conclusion

Social workers’ ability to identify that neglect has occurred is an important element
towards ensuring the wellbeing of neglected children or children at risk of being
neglected. The study findings revealed the use of interviewing skills, observing incon-
gruence between verbal and non-verbal cues, field observations/home visits and the
child’s physical appearance as ways through which social workers are able to identify
that neglect has occurred. These are important elements for social workers to consider
using in making decisions concerning whether (or not) neglect has occurred. This is
because, child neglect, if not timely identified and addressed, could lead to devastating
outcomes for children. Although most low-income countries may not have sufficient
resources within their child welfare workforce to address issues of neglect, neglect
should not be overlooked. There is a need to pay attention to the generation of
knowledge within these countries about how children’s wellbeing can be promoted
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International Journal on Child Maltreatment: Research, Policy and Practice

by identifying neglect before it escalates. Social workers should develop knowledge in

assessing neglectful situations in context where parental actions are largely influenced
by inescapable factors such as abject poverty and parents’ material deprivation.

Acknowledgments This research paper emerged from the undergraduate dissertation of the second author;
Alhassan Abdullah, supervised by the first author; Dr Esmeranda Manful. The researchers acknowledge
efforts from the research participants and all social workers in the Ashanti Region.

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Affiliations

Esmeranda Manful 1 & Alhassan Abdullah 2 & Ebenezer Cudjoe 3

1
Department of Sociology and Social Work, Kwame Nkrumah University of Science and Technology,
Kumasi, Ghana
2
Department of Social Work and Social Administration, University of Hong Kong, HKU Centennial
Campus, Pok Fu Lam, Hong Kong
3
Department of Social and Behavioural Sciences, City University of Hong Kong, Kowloon Tong, Hong
Kong