Community Flashcards
What are the risk factors for child maltreatment
Child:
Born after forced/commercial sex
Failure to meet parental expectations - gender, disability
Parent:
Mental health problems
Parental intolerance, over-anxiousness
Alcohol, drug abuse
Family: Step parents Domestic violence Multiple births Lack of social support Young parental age
Environmental:
Poverty
What are the main types of child maltreatment?
Physical abuse Emotional abuse Sexual abuse and sexual exploitation Neglect Fabricated or induced illness Intimate partner violence Female genital mutilation
Define abuse
Deliberate infliction of harm to child o
Or failure to prevent harm to child
Define physical abuse
Hitting, shaking, throwing, poisoning, burning, scalding, drowning, suffocating or otherwise causing physical harm to a child
Define emotional abuse
Persistent emotional maltreatment of a child resulting in severe and persistent adverse effects in child’s emotional development
E.g. conveying they are inadequate/unloved, overprotection, bullying, exploitation, witnessing maltreatment of another child
Define sexual abuse and sexual exploitation
Sexual abuse: Forcing a child to take part in sexual activities whether or not child is aware of what is happening
Involve physical contact or non contact
Sexual exploitation: Type of sexual abuse in which children are sexually exploited for money, power or status
E.g. online grooming
Define neglect
Persistent failure to meet child’s basic physical and/or psychological needs, likely to result in serious impairment of child’s development or health
E.g. food/clothing/shelter, protection from physical/emotional abuse, access to medical care, inadequate supervision
Define fabricated or induced illness
Group of behaviours by parents which cause harm to children, to fulfil the parents own needs
Fabrication: Parents invent symptoms+signs in the child, telling a false story to healthcare professionals, leading them to believe child is ill and requires investigation and treatment.
HCPs used as instruments to harm child through unnecessary interventions.
Induced illness: suffocation, admin of poisons, excessive/unnecessary admin of ordinary substances, excess/unnecessary medication
Define intimate partner violence
Observing violence between adults who are intimate partners or family members, irrespective of sex or sexuality
Define female genital mutilation
All procedures that involve partial or total removal of external female genitalia, or other injury, for non medical reasons
Somalia is high risk country
What are clinical features of physical abuse
Bruises: in shape of hand or object, on neck, around wrists or ankles, to buttocks in <2yo
Fractures: non mobile child, rib #, multiple #, multiple # of different ages
Burns: non mobile child, in shape of an implement, ‘glove and stocking’ burns
Bites: bruising in shape of a bite thought unlikely to be caused by young child
What are clinical features of neglect
Dirty Ravenously hungry Inadequate clothing in cold weather Misses medical appointments Lacks immunisations or needed medical/dental care
Parent: Appears Indifferent to child Appears Depressed Behaves irrationally Abuses drugs, alcohol
What are clinical features of emotional abuse
Parent perception:
‘Wrong’ gender
‘Difficult’ child
Born at fine time of parental separation/violence
Baby: delayed development, non-demanding, described as spoiled, attention-seeking
Infant: violent, apathetic, fearful
Children: wetting, soiling, relationship difficulties, nonattendance, antisocial behaviour
Adolescents: self harm, depression, aggressive, delinquent
What are clinical features of sexual abuse
Tell someone about abuse
Identified in pornographic material
Pregnant: pregnancy in <13yo means maltreatment because intercourse at that age is unlawful
STI
Physical:
PV bleeding, discharge, itching
Rectal bleeding
Behavioural:
Soiling, secondary enuresis
Self harm, aggression, poor school performance
Awareness or acting out of sexual behaviour beyond expected for age
Define safeguarding
Process of intervening when there are clear instances of child maltreatment, as well as recognising and alerting vulnerabilities to those involved in the child’s care
It is everyone’s responsibility
It is child-centred (for services to be effective at meeting child’s needs and views)
What is the procedure for raising concerns about child maltreatment
- Assessment of need:
Specialist - specialist high level unmet need
Early Help - broad spectrum of needs
Universal - needs that can be met wo additional services - Responding to need
Specialist: social care, CAMHS, disabled children service, youth offending teams
Early Help: services from multiple agencies provided through Team Around Family approach with lead practitioner
Universal: school, GP, youth services, public health workers
What are the duties of care for health professionals in safeguarding
Recognising children in need of protection, and parents in need of extra help
Contributing to enquiries about child or family
Assessing needs of children and capacity of parents to meet their needs
Planning and providing support for vulnerable children and families
Participating in child protection conferences
Providing therapeutic help to abused children and parents under stress
Contributing to case reviews
Investigations for infants <2
Bloods: FBC, clotting screen (+haematology input)
Fundoscopy
X Ray - skeletal survey
CT head
Developmental milestones - 6 weeks
Gross motor: head held in same plane in central suspension
Fine motor: maintains fixation, follows objects
Speech: startles at loud noise, throaty noises
Social: social smile
Developmental milestones - 6 months
Gross motor: rolls over, sits briefly
Fine motor: transfers, reaches out for objects, mouths objects
Speech: babble, turns to name being called
Social: okays with feet, holds onto bottle
Developmental milestones - 1 year old
Gross motor: crawling, pulls to stand, cruising
Fine motor: pincer grip, bangs 2 bricks together
Speech: two words, responds to simple instructions, shows recognition of objects
Social: waves, claps, empties cupboards
Developmental milestones - 2 year old
Gross motor: climbs and descends stairs one step at a time, runs, kicks ball
Fine motor: copies vertical line, builds 8 block tower
Speech: use plurals/nouns, selects toys, follows 2 step requests
Social: plays alone/alongside others, eats with spoon
Developmental milestones - 3 year old
Gross motor: tricycle, jumps, balances on one foot
Fine motor: copies circle, matches two colours
Speech: 3-4 word sentences, 3 colours, pronouns and plurals, prepositions
Social: out of nappies, separates from mother easily, eats with knife and fork
Developmental milestones - 4 year old
Gross motor: stands on one foot well
Fine motor: copies circle, square, 3 block bridge, draws man with 3 parts
Speech: counts to 10, identifies several colours, tells story, lots of questions
Social: shares toys, out of nappies at night, brushes teeth, toilets alone
