Investigating child-facing practitioners' understanding of adversity and its impact on children's development and service provision.

Adversity during childhood is a common risk factor for poorer outcomes across physical, mental, and social health. Despite growing evidence and policy around preventing adversity and its sequalae, the incidence of adversity in childhood remains high. Child-facing practitioners (CfPs) may be well-placed to identify adversity and address its impact on children. This study investigated the understanding of adversity and current practice of CfPs working in the Education system, Healthcare and Social Care in England. An anonymous online survey was completed by 113 CfPs between April and June 2022. Data were analysed using descriptive statistics. Participating CfPs' reported using a range of assessment tools and direct observation, but there was a lack of consistency in the extent to which different types of adversity were explored in assessments. CfPs working in the Education system and Healthcare reported only liaising with Social Care services when a current worker was known to be involved with the family, or to make a referral. Indeed, a quarter of respondents from the Education system and Healthcare only considered early life experiences when capacity allowed. Over half of the CfPs in this survey 'did not know' or 'did not agree' that public services offer interventions to support families experiencing domestic abuse, parental mental health difficulties and addiction, or the impact of these adversities on children's wellbeing. The study highlights that CfPs could benefit from further training about the prevalence and impact of adversity to inform service delivery. A review of CfPs' routine assessments is needed to ensure that children's exposure to adversity is routinely identified; this will facilitate families to access appropriate support to mitigate the impact of such experiences.