Recommendations for research

The guideline committee has made the following recommendations for research.

1 Recognition of child sexual abuse

What approaches to practice enable children (both boys and girls) who have been sexually abused to begin to tell practitioners about their experiences earlier, and in a way that does not contaminate the reliability of subsequent court proceedings?

Why this is important

Research shows that many children and young people who are sexually abused do not tell anyone about their abuse. Among those who do, many delay telling someone for a long time, sometimes until adulthood. We found little research identifying the approaches or techniques that would make it more likely for a child being sexually abused to tell a practitioner about it. Although there is an evidence base on Achieving Best Evidence interviewing as part of a formal investigation, there is less evidence about approaches that can be used at an earlier stage. Studies are needed that would identify effective approaches to enable children to talk about sexual abuse, while ensuring that these early conversations do not contaminate evidence at a later stage in an investigation.

2 Recognition of risk and prevention of female genital mutilation

What interventions are effective and cost effective in:

  • improving practitioners' recognition of children who are at risk of female genital mutilation (FGM) in the UK or overseas?

  • improving recognition of co-occurring forms of abuse where relevant?

  • preventing FGM in this group?

Why this is important

There is a lack of evidence from the UK about how practitioners can be supported to recognise girls and young women who are at risk of FGM and effective interventions to prevent FGM. This is despite evidence that many practitioners are likely to encounter young women at risk of FGM. There is also a lack of evidence about the extent to which FGM is a risk factor or indicator of other forms of abuse, and therefore whether the identification of FGM should be accompanied by other types of assessment and support. The Home Office has developed an FGM recognition and prevention e-learning resource; however, the effectiveness of this resource does not appear to have been evaluated.

3 Recognition of risk and prevention of 'honour-based' violence and forced marriage

What interventions are effective and cost effective in:

  • improving practitioners' recognition of children who are at risk of or experiencing 'honour-based' violence and forced marriage?

  • preventing 'honour-based' violence and forced marriage?

Why this is important

There is a lack of evidence from the UK about how practitioners can be supported to recognise children and young people who are at risk of or experiencing 'honour-based' violence, and how to prevent it. There is also little evidence showing which interventions are most effective for recognising young people at risk of forced marriage and for preventing such marriages from taking place. The government's The right to choose: multi-agency statutory guidance for dealing with forced marriage (2014) explains the issues around forced marriage, provides a clear definition and distinction from arranged marriage, lists some of the potential warning signs or indicators, and recommends organisational approaches to dealing with forced marriage. However, the effectiveness of these approaches has not been evaluated.

4 Early help home visiting

What are the components of effective home visiting programmes for preventing child abuse and neglect in families of children and young people at risk of child abuse and neglect in the UK?

Why this is important

There are numerous studies, based mostly in the US, involving home visiting programmes for families at risk of child abuse and neglect. The findings of these studies are mixed, with some programmes proving effective but not others. The descriptions of the programmes and their theoretical basis are often poorly reported. It is therefore difficult to ascertain the key 'active ingredients' in a successful home visiting programme. A meta-analytic study seeking to obtain additional information from study authors on the features of home visiting programmes and their effectiveness, for example using statistical modelling, would help in understanding these programmes.

5 Effective prevention of child abuse and neglect in the UK

What interventions are effective and cost effective in the UK to prevent abuse and neglect of children and young people in families at risk of, or showing early signs of, abuse and neglect?

Why this is important

The evidence reviewed for this guideline on the effectiveness of interventions to prevent abuse and neglect of children and young people was predominantly from outside the UK, and focused on home visiting programmes and parenting programmes. High-quality studies (ideally randomised controlled trials) are needed that:

  • look specifically at the effectiveness of interventions to prevent child abuse and neglect in the UK

  • focus on interventions already being provided in the UK that may have no or low-quality evidence to support them at present.

6 Reducing social isolation and associated child abuse and neglect

What is the impact of social isolation on children, young people and families at risk of abuse and neglect in the UK? What interventions are effective and cost effective in a UK context in reducing social isolation and any associated child abuse and neglect?

Why this is important

Evidence presented in How safe are our children? suggests a link between social isolation and child abuse and neglect. However, there is a lack of evidence about what interventions are effective in reducing social isolation and any associated child abuse and neglect. The aim of research should be to inform practitioners and policy-makers of the impact of social isolation, and the methods that lead to successful engagement with socially isolated children, young people and families, and reduction of associated child abuse and neglect.

7 Effective interventions for young people who have been abused or neglected

What interventions are effective and cost effective in improving the wellbeing of young people aged 12 to 17 who have experienced abuse or neglect, including those who are now in temporary or permanent alternative care placements or living independently?

Why this is important

There is little evidence on effective interventions to improve the wellbeing of young people who have experienced abuse and neglect, except for those who have been sexually abused. Studies are needed that evaluate interventions for young people aged 12 and over who have been abused or neglected in the past, but are now in temporary or permanent alternative care placements. These include foster care, kinship care, residential care, special guardianship and adoption.

8 Effective interventions for children and young people who have experienced online-facilitated abuse, including online grooming

What interventions are effective and cost effective in improving the wellbeing of children and young people who have experienced online-facilitated abuse, including grooming online?

Why this is important

There is little evidence on what interventions are effective in helping children and young people recover from trauma following online abuse, including online grooming. In particular, whether existing interventions may be suitable, or whether different kinds of therapeutic support are needed to address the particular features of online abuse.

9 Effective interventions for addressing child abuse and neglect in the UK

What interventions, approaches and methodologies provided by social care and voluntary sector services are effective and cost effective in the UK to prevent the recurrence of child abuse and neglect, and to improve the wellbeing of children, young people and families?

Why this is important

The evidence reviewed for this guideline on the effectiveness of interventions to address abuse and neglect of children and young people was predominantly from outside the UK, and within the health sector (therapeutic interventions). We identified interventions, approaches and methodologies being used by social care and voluntary sector organisations in the UK but many of these could not be included because they have not been evaluated using high-quality research designs. High-quality studies are needed to show policy-makers and practitioners which ones are effective in the UK and in what circumstances.

10 Interventions with fathers and male carers

What interventions are effective and cost effective when working with fathers and male carers to improve their parenting in families where children are being, or have been, abused or neglected?

Why this is important

There is a lack of research evidence from the UK showing what interventions are effective to improve fathers' and male carers' parenting in families where children are being, or have been, abused or neglected. Most studies reviewed for this guideline, both from the UK and elsewhere, focused on female carers. Studies are needed to show what interventions and practices are effective in engaging fathers and male carers, and improving their parenting if needed.

11 Interventions with male foster carers and adoptive parents

What interventions are effective and cost effective when working with male foster carers and adoptive parents who are caring for children and young people who have been abused in the past?

Why this is important

There is a lack of research evidence from the UK on what interventions are effective in working with male foster carers and adoptive parents – much of the existing literature is in relation to female foster carers and adoptive parents.

12 Effectiveness of home visiting following child abuse or neglect

Are home visiting interventions effective and cost effective in improving parenting and preventing recurrence of child abuse and neglect in families in which abuse or neglect is occurring or has occurred?

Why this is important

There is a lack of evidence from the UK on the impact of home visiting on families in which abuse or neglect is occurring or has occurred (as opposed to its impact on prevention). For children who are subject to a child protection plan, home visiting is one of the tools that may be used for monitoring their welfare and their interaction with their parents or carers. It is also used for engaging with parents or carers to address abusive or neglectful behaviours or ensure children are protected. There is a need for studies which identify what practices are effective in ensuring the safety and wellbeing of children and young people.

13 Effective interventions for parents or carers with substance misuse problems

What interventions, including family behaviour therapy, are effective and cost effective in improving parenting and preventing recurrence of neglect by parents or carers with substance misuse problems and whose children are on a child protection plan under the category of neglect in the UK?

Why this is important

There is a lack of evidence from the UK about the impact of family behaviour therapy and other interventions on parents and carers with substance misuse problems who show neglectful parenting. Studies are needed to examine the effectiveness of family behaviour and other interventions, and the timescales for delivering such interventions. In some cases, it may take longer than the 26-week timescale of care proceedings to address parents' substance misuse problems. This research could inform court decisions about whether to extend the time limit if there was a realistic possibility of reunification at the end of the intervention.

14 Effectiveness of web-based parenting programmes

Are web-based parenting programmes effective and cost effective for improving parenting and preventing recurrence of child abuse and neglect in families where child abuse or neglect has occurred?

Why this is important

There is a lack of research data about the impact of web-based parenting programmes on families where child abuse or neglect has occurred. Our review for this guideline identified 1 small-scale US study of a web-based parenting programme for parents of children with abusive head injury. Research would inform practitioners whether this type of parenting programme could be effective for families where child abuse or neglect has occurred, and if so which families would be most likely to benefit.

15 Relative effectiveness of interventions to support foster carers

What is the relative effectiveness and cost effectiveness of the KEEP intervention for foster carers of abused or neglected children compared to other interventions?

Why this is important

There has been no independent UK study of the relative effectiveness of the KEEP intervention for foster carers and abused or neglected children when compared head to head with other interventions for foster carers. (There are effectiveness studies, but these are with a waitlist or service as usual comparator, rather than comparing different forms of support 'head to head'.) Data about outcomes in fostering services which use the KEEP model are kept by the National Implementation Service, which has responsibility for ensuring that model fidelity is maintained, but does not make comparisons with outcomes of other intervention models. A comparison study would help service providers identify the most appropriate model for supporting foster carers and abused or neglected children.

16 Peer support for children and young people who have been abused or neglected

What peer support programmes are effective and cost effective in improving the wellbeing of children and young people who have been abused or neglected?

Why this is important

There is a small amount of research into peer support interventions for children who have been abused or neglected. There is also anecdotal evidence that children who have experienced abuse or neglect would appreciate formally organised peer support in addition to the informal peer support that children often provide each other. A research study, where careful consideration was given to issues like helping peer supporters to manage confidential information about abuse or neglect, could test the success of a formally organised peer support programme.

  • National Institute for Health and Care Excellence (NICE)