41. Child Protection Flashcards
Roughly how many children are abused in England?
What are the different types of child abuse, and what is the most common in the UK?
What is physical abuse?
What are some risk factors for physical abuse?
11 million.
Physical, neglect, sexual (incl. FGM and exploitation), emotional, fabricated and induced illness. Most common in UK: neglect (41.9%), second is emotional (28.4%).
Deliberately hurting a child, causing injuries such as bruises, broken bones, burns or cuts, hitting, shaking, poisioning, drowning, burning/scalding, suffocating.
Unrelated adult male in house, single young mum, MH problems, domestic violence, drug/alcohol abuse, previous parental police records, disabled child.
What age of infant is at higher risk of abuse and why?
What suspicious things might you find in a history?
How might abuse be detected in older children?
<4y because they can’t run away and they are more challenging to look after.
Fails to explain injury, vague history/unwitnessed, history changes, not appropriate to child’s developmental level, inappropriate delay in seeking medical help, repeated A and E attendance.
Disclosure to teacher/trusted adult/doctor, when sibling is identified, injuries spotted at school, may disclose to protect younger sibling.
What physical findings are suspicious of non-accidental injury?
Define neglect. Give examples.
What are some possible signs?
Face, neck, eyes, mouth (ferenulum), scalp, lower jaw and mastoid, ear (look behind), trunk (chest and abdo), fractures (esp. spiral = twisting), buttocks/lower back. Well demarcated burns. Retinal and subdural hemorrhages (SBS). Quite unusul injury areas.
Persistent failure to meet a child’s basic physical and/or psychological needs, likely to result in the serious impairment of the child’s health or development. Examples: failing to provide adequate food, shelter, clothing, protection (from physical harm/danger), failing to ensure adequate supervision/left alone, or access to appropriate medical care. Unresponsiveness to a child’s basic emotional needs.
Failure to thrive, passive, fearful. nappy rash.
Define sexual abuse.
List some presentations which may indicate sexual abuse.
What is FGM?
Forcing or enticing a child or young person to take part in sexual activities, including prostitution whether or not the child is aware of what is happening.
Pregnancy, STIs, vaginal/rectal bleeding, recurrent vulvovaginitis, dysuria/pain on passing urine/UTI, bedwetting/soiling, behavioural problems/sexualised behaviour. Sex with someone <13y = RAPE. LACK of clinical signs does NOT exclude abuse.
Proceedures involving partial/total removal of the female external genitalia or other injury to the female genital organs whether for cultural or other non-therapeutic reasons. It is illegal to aid, abet, counsel or procure the carrying out of FGM - inform safeguarding team and referral to social care.
What is emotional abuse?
What might be some signs of emotional abuse?
Who can help with child abuse?
Persistent emotional ill-treatment of a child such as to cause severe and persistent adverse effects on a child’s emotional development. Conveying to a child they are worthless, unloved or inadequate. Age or developmentally inappropriate expectations imposed on child, preventing it participating in normal social interaction. See/hearing ill-treatment of another (sibling/mother). Causing childen frequently to feel frightened or in danger.
Poor growth, short stature, delayed development, deliberate self harm.
Paediatric SHOs and registrars, paediatric consultants, named doctor for child protection, designated doctor for child protection (more senior, over several hospitals), named nurses.
What needs to happen if you suspect child abuse?
What is the role of the doctor?
What happens to children following the investigation (4 possible outcomes)?
Safeguarding causes should always be discussed with senior support, safe environment, non-confrontational approach, full history, examination and investigation, written referrals to social services (inform parents you are doing this), multi-disciplinary approach. Document: date/time, consent to examine child, history from parent and child, weight, height, hygiene, interaction, top-to-toe exam, document bruises/injuries on map and number them. Medical photography (only police ones used in court).
Don’t discharge from hospital if you have suspicions.
Doctor: child protection report, assess other medical problems, assess growth and development, ensure siblings are asessed, attend strategy meeting (initial meeting), contribute to child protection conference (if needed). Paediatrics, social services and police involved.
Taken into care, may stay with parents on child protection plan (criteria for parents to adhere to), may be a child in need (child in sub-optimum environment, additional watching and support from social worker), case closed. Parental responsibility remains with parents until it is removed by court.
