Lecture 13 - Child Safeguarding Flashcards
What is child abuse?
The maltreatment of a child (<18yrs)
The infliction of haram or failing to act to prevent harm
What is considered significant harm?
The ill-treatment or impairment of healthy or development giving hte legal justification for legal intervention in family life
What are the categories of child’s abuse?
Physical abuse (FII)
Neglect
Sexual
Emotional
What is included within physical abuse?
FII (fabricated or induced illness)
FGM
What is definition of neglect?
The persistent failure to meet a child’s basic physical and or psychological needs likely to result in serious impariemrrent of the child’s health or development
Can neglect happen to an unborn child?
Yes
Substance abuse in pregnancy
What are some examples of neglect ?
Not providing adequate food, clothing,, shelter
Not protecting from physical and emotional harm
Not adequately supervising
Not providing medical care
Not responding to child’s emotional needs
What is medical neglect?
Was not brought to medical attention
If a child did not attend an appointment how should it be recorded?
Was not brought (NOT did not attend)
What is the history of neglect?
Recurrent non attendance to appointment or non adherence to medication
Missed routine screening or immunisation
Faltering growth
Delay in development
Recurrent infections/injuries
Poor school attendance
What are some examinations seen in neglect?
Poor nutritional status/poor growth
Dental decay
Signs of recurrent/chronic infection or infestation
Dirty/unkempt/smelly.
What is physcial abuse?
Hitting, shaking, throwing, poisoning, burning or scalding, drowning suffocating or otherwise causing physical harm
May deliberately induce illness in a child or symptoms may be fabricated
What is the history likely to be for physical abuse?
Lack of inadequate explanation for injury
Delay in seeking medical attention
Inconsistent accounts of events
Presence of multiple risk factors
Direct disclosure
What examination findings are seen in physical abuse?
Unexplained bruising in vulnerable children
Unexplained fractures and injuries
Patterns (bites, sparing)
Injury not consistent with history
What is sexual abuse?
Forcing or enticing a child or Young person to take part in sexual activities whether or not that the child is aware of what is happening
Can be physical contact or nnon contact like watching or producing sexual images
What is child sexual exploitation?
Individual or group takes advantages of power imbalance to coerce, manipulate or deceive a young person into sexual activity in exchange for something the victim needs or wants or for financial advantages
What is likely to be seen in child sexual abuse?
Disclosure
Pregancy/signns of sexual activity in children under 13yrs
STIs
Anogenital injury
Recurrent vaginal discharge
Soiling/wetting
Behavioural change
What is likely to be seen on examination for child sexual abuse?
Immediate health needs are paramount
Referral to social care
What is emotional abuse?
What are some examples?
Persistent emotional maltreatment oof a child causing severe and persistent adverse effects on the child’s emotional development
Present in all other types of abuse
Rejecting
Isolating
Terrorising
Ignoring
Corrupting
Cyber bullying
What is seen in the history of emotional abuse?
Infants (feeding difficulties, poor sleep patterns, delayed development)
Toddler/preschool (behavioural spectrum from overactive to apathetic, noisy tt quiet)
School aged (wetting and soiling, relationship difficulties, poor performance in school)
Adolescents (depression, self-harm, substance misuse)
What is seen in the examination of emotional abuse?
Growth
Emotional signs
Behavioural
Development
What are the risk factors for child abuse?
Triad of vulnerability:
-domestic abuse
-mental illness or parent or carer
-parental drug and alcohol misuse
Who does child abuse happen most commonly to?
Under 2s
Preverbal babies and children
Those with additional needs/disbaility
Vulnerable and marginalised young people
What are some adverse childhood experiences?
Physical abuse and neglect
Sexual abuse
Emotional abuse and neglect
Domestic violence
Metal ill health
Incarceration
Substance misuse
Parental separation
What is the step by step process if you are concerned about a child?
Refer to local authority (social care)
If reasonable cause to suspect that a child is suffering or is likely to suffer significant harm local authorities make enquiries
What act ensures the duty to make enquires into child concerns?
Section 47 of the children act 1989
What are. Some intervention and support for families who are struggling?
Universal services (primary care etc.)
Early help (may have child with additional needs)\
Child in Need (consent required)
Child Protection (consent not required) the state intervenes
Who is safeguardings repsonibility?
Everyone’s
What do you do if you are concerned about a child’s welfare?
Don’t ask leading questions
Document verbatim what was said
Don’t promise confidentiality
Talk immediatliye to one of the proffeisonals that work with h you so escalation can occur if necessary
Why do we review child deaths?
To establish where possible cause or causes of child deaths
To identify any potential contributory and modifiable factors
Provide ongoing support to the family
Improve nationally to reduce child deaths
Who is Involved in the child death review process?
Health and local authorities found
Team : designated Dr, nurses, manager, admins and all agencies involved in the child’s life
What are the top 3 categories of child death?
Perinatal/neonatal events
Chromosomal/genteic abnormalities
Sudden unexpected unexplained death
