Child Protection 1 Flashcards
What is safeguarding
- Actions taken to minimise the risk and harm to children
- Protects children from maltreatment
- Prevents impairment of children’s health or development
- Ensures that children grows up in a safe and caring environment
What is child abuse
- Term used to describe a number of ways in which a child can be harmed
- Can happen to any child
- Occur as an isolated incident or as recurrent abuse
- Child is considered to be abused if he/she is treated in a way which is unacceptable for a certain culture at a given time
What are the consequence of child abuse
- Physical (including death)
- Psychological
- Intellectual
- Behavioural
Consequences can persist into adulthood
What are the GDC principles in regard to safeguarding
Principle 8: Riase concerns if patients are at risk
- 4 There needs to be an effective procedure in place for raising concerns that is available to all staff
- 5 take appropriate action if you have concerns about the possible abuse of children or vulnerable adults
What is the responsibility of the dental team in regards to safeguarding
- Be alert to the possibility of abuse
- Record incidents and concerns
- Familiarize yourself with local contacts and procedures
- Be prepared to discuss concerns with a senior colleague and refer if appropriate
- Follow guidelines for safe staff recruitment
- Keep up to date
Some of the things that MAY indicate abuse
- Difficult to engage
- Extensive decay
- Chronic infection
- Mother’s mental health
- Previous involvement of Child Social Services
- Development
- Hygiene
- Nutrition
- School attendance
Important to build up a picture over time
What are the categories of abuse
- Emotional
- Physical
- Sexual
- Neglect
What are the types of abuse and relative percentages
- Neglect- 42%
- Emotional abuse- 19%
- Physical- 16%
- Multiple- 14%
- Sexual- 9%
Common characteristics of abusers
- Younger parents
- Mental health problems
- Drug/alcohol abuse
- Victims of abuse themselves
- Personality traits (impulsiveness, low tolerance, aggressive tendencies)
- Unrealistic expectations from a child
Common characteristics of child
- Younger children
- Disabilities
- Unwanted pregnancy
- Premature/LBW babies
- Prolonged separation from the mother
- Characteristics that evoke negative response (persistant crying, behaviour difficulties)
What makes special need children more vulnerable
- General denial of possibility
- Increased stress on carers
- Reduced capacity to resist or avoid abuse
- Communication difficulties
- Increased number of carers, often providing intimate care
- More vulnerable to bullying/intimidation by carers or peers
Common environmental characteristics
- Poverty
- Social isolation
- Poor housing
- Domestic violence at home
- Poor access to facilities
What might suggest abuse
- A very serious single concern
- A series of apparently minor events
- A direct allegation or disclosure
- Signs and symptoms which are suggestive of abuse or neglect
- Observing the behaviour of a child and their interaction with carer
What is physical abuse and examples
- Deliberate physical injury to a child or the failure to prevent physical injury or suffering
- Hitting, shaking, squeezing, burning or biting
- Injuries resulting from restraining a child
- Harm to children as a result of giving alcohol, inappropriate drugs or poison
- Failure to prevent physical injury
- Fabricated or induced illness
Why is physical abuse dentally relevant
- 50-70% of child abuse cases involve injuries to H and N
- GDPs well placed to recognise possible abuse in children at routine check ups and emergency visits
What parts of history and examination would alarm you that physical abuse is occurring
History:
- Delay in presentation
- Inconsistent with injury
- Varies with each telling
- Variation in child’s vs carers account
Examination
- Site
- Type/pattern of injury
Typical Accidental Injuries examples
- Forehead
- Nose
- Chin
- Palm of hand
- Parietal bone/occiput or forehead
- Elbows
- Knees
- Shin
- Think bony prominence
- Match history?
Typical sites of non accidental injury
Triangle of safety
- Ears
- Side of face
- Neck
- Top of shoulders
- Side of trunk
- Black eyes especially if bilateral
- Soft tissues of cheek
- Intra-oral injuries
- Forearms when raised to protect self
- Chest and abdomen
- Soles of feet
Bilateral injuries
Soft tissue sites
Inconsistent with explanation
What is neglect and examples
-Persistent failure to meet a child’s physical, emotional and/or psychological needs, like to result in serious impairment of the child’s health/development
- Failure to provide adequate diet
- Failure to make proper arrangements for healthcare
- Inadequate clothing
- Lack of appropriate supervision
- Lack of stimulation
- Leaving children alone at an inappropriate age
Signs of neglect
- Recurrent infections
- Poor hygiene
- Abnormalities on hair/skin
- Developmental delay
- Non attendance at school
- Constant hunger/stealing
What is emotional abuse and examples
-Persistant emotional ill treatment of a child such as to cause severe and persistent adverse effects on the child’s emotional development
- Persistently withholding love and affection
- Constantly shouting at, threatening or demeaning a child
- Being overprotective: a child not able to mix with others
- Racial or other forms of harassment that undermine a child’s self esteem
- Telling them they wish they were dead
How might an emotionally abuser parent present
- Negative view of child
- Ignores child
- Constantly undermining and criticising
- Ridicule child
How might an emotionally abused child present
- Low self esteem
- Delayed development
- No sense of fun
- Self harm
- Constantly seeking approval
What is sexual abuse and examples
-Forcing or enticing a child to take part in sexual activities
- Making a child engage in sexual activities
- Make a child observe sexual activities
- Showing child porn
- Engaging a child in inappropriate discussions about sexual matters
