This excellent book reports on the authors' second major study into fatal child abuse in the UK. It is a follow-up to their report, Beyond Blame (Reference Reder, Duncan and GrayReder et al, 1993). The book describes the findings of their study of the 112 part 8 reviews (a part 8 review is the procedure carried out by local area child protection committees and local authorities after a child has been killed or seriously harmed by his or her caregivers) reported to the Home Office during the year ending March 1994.
Reder & Duncan describe many significant findings, outline implications for practice and make important recommendations. For example, they suggest that many assessments of risk are inadequate, owing to a failure to obtain comprehensive information on caregivers. They discuss ‘cumulative error’, where a number of factors or decisions (each of which may be relatively harmless) may interact and compound each other so that the risk of a disaster is greatly increased. The need for a coherent framework to guide assessments is discussed. Strong arguments are made for the adequate resourcing of services and proper training and supervision of professionals. A revised model for case reviews, which would both allow for disciplinary action where appropriate but also enhance opportunities to learn how to improve practice, is considered.
This book, attractively presented, with well-chosen case vignettes and excellent reference list, author and subject indexes, should be required reading for health, social services and other professionals involved in working with children, especially (but not only) in child protection work. Professionals (including psychiatrists) who work in adult services should also read it, as they may be in a position to make important contributions to the identification and prevention of child abuse. Those responsible for planning services and allocating resources also need to consider the messages of this study. It is to be hoped that the findings of Reder & Duncan, along with other recent work in this area (e.g. Reference DentDent, 1998), will help in developing services to protect children from harm.
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