Child Safeguarding

Question 1

What are the types of child abuse?

Answer 1

Physical
Sexual
Emotional
Neglect

Question 2

What are child related risk factors for abuse?

Answer 2

<4 years
Disability 
Low birth weight 
Chronic ill health
Prematurity

Question 3

What are adult related risk factors for abuse?

Answer 3

Mental illness
Post natal depression
Lack of support
Drugs/alcohol misuse
Financial difficulties

Question 4

What is physical abuse?

Answer 4

Causing physical harm to a child

Question 5

What features in a history would increase suspicion of child abuse?

Answer 5

Injury not compatible with mechanism 
Injury inconsistent with developmental age
Injury with little/no explanation 
Inconsistent history 
Delay in presentation 
Inappropriate parental reaction

Question 6

How should you investigate a presentation of bruising?

Answer 6

Coagulation screen

FBC

Question 7

How would you investigate a presentation of fractures?

Answer 7

Full skeletal survey
CT scan
Bone biochemistry

Question 8

How would you investigate a presentation of child abuse in a child less than 2?

Answer 8

Full skeletal survey
- repeat CXR + limbs after 2 weeks

CT head
Ophthalmological exam

Bloods

• FBC
• U&Es
• coagulation screen
• bone profile

Question 9

What is neglect?

Answer 9

Persistent failure to meet the child’s basic physical or psychological needs that is likely to result in the serious impairment of the child’s health/development

Question 10

What are the types of neglect?

Answer 10

Medical 
Nutritional 
Education 
Physical 
Failure to supervise

Question 11

What is medical neglect?

Answer 11

Unimmunised
Failure to attend appointments
Poor medication complicance
Failure to seek appropriate medical advice

Question 12

What is nutritional neglect?

Answer 12

Faltering growth due to poor diet

Obesity due to failure to control diet + lifestyle

Question 13

What is educational neglect?

Answer 13

Poor school attendance

Question 14

What is physical neglect?

Answer 14

Poor hygiene
Severe/persistent infestations
Inappropriate clothing

Question 15

What is emotional abuse?

Answer 15

Persistent, non-physical, harmful interactions with the child by the care-giver

Question 16

What are the symptoms of emotional abuse in an infant?

Answer 16

Developmental delay
Poor sleep 
Feeding difficulties
Persistent crying 
Irritable

Question 17

What are the symptoms of emotional abuse in a toddler?

Answer 17

Difficult/violent behaviour

Delayed social/language skills

Question 18

What are the symptoms of emotional abuse in a school age child?

Answer 18

Poor attendance
Truancy
Antisocial behaviour
Academic failure

Question 19

What are symptoms of emotional abuse in an adolescent?

Answer 19

Depression 
Selfharm 
Relationship difficulties
Substance abuse
Criminal activity 
Aggressive behaviour

Question 20

What is sexual abuse?

Answer 20

Physical contact, including penetrative and non-penetrative acts, exposure to sexually explicit material and child sexual exploitation

Question 21

How may sexual abuse present?

Answer 21

Allegatin 
Pregnancy 
STI
Ano-genital injury 
Unexplained vaginal bleeding
Unexplained rectal bleeding 
Enuresis
Behavioural difficulties