Mental health articles

Risk can be defined as the probability of an event occurring, including the
consideration of the losses and gains associated with it. In this context (infant
development and child protection) it is not free of moral and emotional
overtones. There is a high degree of uncertainty in prediction of risk in childprotection
matters and inevitably this contributes to the anxiety felt by even
very experienced clinicians working in this area.
A number of different risks can be identified. These are:
• risk to the infant’s immediate physical or emotional safety.
• risk to the infant’s optimal development. This acknowledges the importance
of early experience in contributing to later outcome.
• indirect risk, such as repeated separation from a parent hospitalised with a
psychiatric or medical illness.
• cumulative risk. This occurs when an infant and family are exposed to
multiple risk factors. For example, a premature infant born to a young single
mother with a narcotic addiction with little family support is clearly at greater
risk than a premature infant with similar medical and biological risk factors,
born to a couple with adequate financial and practical support.
The greatest developmental risks are those that operate long term, for
example:
• chronic neglect
• chronic instability in the family’s personal and social circumstances
• exposure to:
– parental personality disorder or dysfunction
– ongoing hostility towards the child
– chronic marital disharmony or domestic violence.

Assessing risk of neglect, abuse or significant developmental disadvantage needs
to include:
• what each partner (caregivers and infant) brings to the relationship—their
strengths and vulnerabilities
• the parenting capacity of the caregivers
• the quality of the interaction between the caregiver and infant
• the social context—sources of support, stress and practical issues such as
housing
• the capacity for change in the infant, caretaker, relationship and environment.

Tags: infant