An Open Letter to Social Work Professionals

What If We Don’t Know Enough?

Dear Social Work Professionals,

I have been thinking a lot about what we are actually taught as social workers, and what we are then expected to understand about the children we work with. The more I have learned through my own practice and through looking beyond social work into health science, neuroscience, neurodevelopment and child development, the more uncomfortable I have become about the gap between the two. We are expected to understand complex children and make significant decisions about their lives, yet I am not sure we are always given enough of the scientific knowledge, training or understanding of individual children to do that as well as we could.

I say that as a social worker myself. I have been in practice for many years and have had to recognise that experience alone does not mean we know enough. I have had to go looking for knowledge that was not necessarily part of my original professional education. The more I have learned, the more I have realised how much there is to understand about the developing brain, the impact of adversity, trauma, neurodevelopment, prenatal experiences, sensory processing, memory and the way all of these things can interact across childhood. It has changed the way I think about children and families, and it has made me question how many times professionals may be trying to understand a child without having been given all the knowledge they need to do so.

This is not about blaming social workers. It is about asking whether we have got the balance right in professional training. We are trained to assess risk, safeguard, analyse information, understand relationships and make professional judgements, but how much of our training genuinely prepares us to understand the science of childhood development and the possible impact of harm on a developing child? How confident are we in recognising when behaviour may be connected to neurodevelopmental differences, disrupted development, sensory processing, memory, prenatal exposure or the cumulative effects of adversity? And how much time do we have to properly understand the individual child behind the assessment?

Because both things matter. We need the science, but we also need to know the child.

This is not a question I have arrived at in isolation. Through Child In Focus, an alliance of individuals, professionals and others calling for change in permanence, I wrote an Open Letter to the Government asking for a different approach to permanence and for greater recognition of what children and families need. We received a response from the Children’s Minister, which can be read here. For me, those conversations are part of the same bigger question: are we doing enough to equip the people responsible for understanding and supporting children with the knowledge they need?

A child’s history does not disappear when permanence is achieved. Permanence can provide safety, stability and belonging, but it does not automatically bring recovery, nor does it remove the impact of what happened before. Children who have experienced abuse, neglect, loss and rupture may also carry the effects of prenatal exposure, neurodevelopmental differences, sensory difficulties, chronic stress and other experiences that can influence how they develop and function. These things do not exist in isolation. They interact over time, and their impact can become more apparent as a child grows and the demands placed upon them change.

This is why I believe we need to think much more carefully about disrupted childhood development. We can become very focused on what a child is doing, without always having enough knowledge to understand what might sit underneath it. A child’s chronological age does not necessarily tell us how they are functioning. Difficulties with memory, regulation, communication, executive functioning, relationships or sensory processing may be understood as behaviour when they may instead be telling us something important about the child’s developmental experience.

And then there is the child themselves. No training course, framework or piece of research can tell us everything about an individual child. We have to know their story. What happened to them? When did it happen? What did they experience before they could communicate it? What has changed over time? What helps them? What overwhelms them? What does their behaviour look like when they are regulated compared with when they are not? What does their development tell us? What might we still not know?

That is why I created Journey of the Child. I did not create it because I believe I have all the answers, and I certainly did not create it as a way of telling other professionals that they do not know enough. I created it because I recognised a gap. I recognised that professionals need both a stronger understanding of the science behind childhood development and a way of bringing that knowledge back to the individual child in front of them. It came from recognising my own need to know more, and from asking what difference it could make if we all had better access to that knowledge.

For me, that is what professional development should be about. It should not simply be about completing training because we are required to. It should be about developing the knowledge that changes how we see children, how we interpret what they are communicating and how we make decisions about their lives. We should be able to say, I don’t know enough about this yet, and feel confident enough to go and find out. We should also be able to say, I don’t know enough about this child yet, and recognise that as a reason to become more curious rather than more certain.

This is also where Harm Seen comes from. It is about making sure we do not lose sight of the experiences that have shaped a child’s development. Hurt, Abuse, Rupture and Memory are not simply things that belong in a chronology. They are part of understanding the child we are working with now. The question is not whether these experiences provide an excuse for behaviour. They do not. The question is whether we have properly understood their possible impact before deciding what that behaviour means.

The PATCH System Review has identified concerns about behaviour taking priority over underlying need, services working in isolation, blame replacing curiosity and support arriving only when difficulties have escalated. These are not necessarily failures of individual professionals. They can be failures within the system itself, particularly when professional training, health knowledge and access to specialist understanding do not keep pace with what we now know about childhood development.

I think we need to be brave enough to challenge that. Not by dismissing professional judgement, risk or behaviour, but by asking whether we have understood enough before reaching our conclusions. Have we considered the child’s developmental history? Have we understood the cumulative impact of what they have experienced? Have we considered neurodevelopmental differences alongside trauma and adversity? Have we understood the science that might help explain what we are seeing? And have we spent enough time getting to know the individual child rather than allowing a diagnosis, behaviour or established narrative to become the explanation?

I do not believe every social worker can, or should, become a specialist in every aspect of health science, neurodevelopment or child development. But I do believe our professional education needs to give us a stronger foundation, and our systems need to make it easier to recognise when we need specialist knowledge. We cannot expect social workers to make sense of complex childhood development if we have not equipped them with the knowledge to do so.

This is not an attack on social work. It is a reflection on a profession I care deeply about. I believe in social work, but I also believe we have to be willing to question whether what we have always done is enough. Genuine reflection asks more than whether I followed the right process. It asks whether I understood the child, whether I understood what had happened to them, whether I understood the science that might help explain their development, what I assumed, what I might have missed and, knowing what I know now, whether I would make the same judgement again.

Children living in permanence deserve professionals who can bring together both sides of this: the science and the story, the knowledge and the child, what we know about childhood development and what we need to learn about this particular child. They deserve us to recognise that development can be disrupted, that harm can remain relevant long after the original experience has ended, and that permanence is not the end of a child’s story.

Perhaps the hardest question is not whether social workers care enough. I believe they do. It is whether we have been given enough of the right knowledge, training and health science to understand the children we are being asked to safeguard. And if we recognise that we have not, what are we prepared to change so that the next child is seen differently?

Fiona Wells
Founder, PATCH – Passionate Adopters Targeting Change with Hope