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Block 5 > Multi-Disciplinary Working & Safeguarding > Flashcards

Multi-Disciplinary Working & Safeguarding Flashcards

1
Q

How common is emotional behavioural disorder (EBD)?

A

1 in 5 children in UK presenting with externalising or internalising behaviour

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2
Q

What is a healthy attachment cycle?

A
  1. Baby has a need and cries
  2. Needs met by PC
  3. Trust develops
  4. Secure attachment promoted
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3
Q

What is a disturbed attachment cycle?

A
  1. Baby has a need and cries
  2. Needs not met by PC
  3. Rage develops instead of trust
  4. Insecure or disorganised attachment is promoted
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4
Q

What domains do securely attached infants show optimal functioning in?

A 
Emotional
Social
Behavioural adjustment
School achievement
Peer-related social status
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5
Q

80% of children who have a Child Protection Plan (CPP) in the UK have:

A

Disorganised attachment

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6
Q

Why is observing the relationship between the dyad important?

A

To identify attuned interactions and be able to identify the less than sensitively responsive interactions so early intervention can ensue

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7
Q

What 3 dimensions of interactional behaviour must be kept in mind when observing parent-infant interactions?

A
  1. Engagement: over-intrusiveness to unengagement
  2. Predictability: consistency and contingencies varying from predictable to unpredictable
  3. Genuineness: true and genuine to false and deceptive affect
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8
Q

What specific behaviours should be looked out for in the dyad?

A
  • Mutual gaze i.e. looking at eachother
  • Mutual and reciprocal vocalisations
  • That in the interaction all engagement is balanced/equal
  • How baby is positioned and if caregiver respects infants body
  • Warmth/affection shared and if its noticeable
  • Agenda of dyad and if its shared and not shewed towards care-giver
  • Turn-taking and if its paced and reciprocal
  • Mothers expression of empathetic understanding and mind-mindedness
  • That babies self-soothing strategies are minimal
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9
Q

What is the most important time for building a childs optimal security and healthy brain development?

A

Conception-2 years (1001 critical days) because:

  • Brain growth
  • Synaptogenesis (experience-dependent)
  • Attachment as bio-behavioural mechanism activated by anxiety so aim to reduce stress and restore security to enable secure attachment
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10
Q

What affect does maternal antenatal stress have on the baby?

A

Emotional state of mother can change filtering capacity of placenta so more cortisol can pass through to foetus which can be toxic for foetal brain and can adversely affect a no. of areas including the HPA axis responsible for setting the stress thermostat resulting in these children experiencing higher levels of stress throughout childhood into adulthood

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11
Q

What are the obstetric consequences of antenatal anxiety?

A

LBW/small for gestational age
Pre-term labour
Impaired blood flow or raised resistance index to foetus through maternal uterine arteries associated with IUGR and pre-eclampsia

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12
Q

Prenatal stress causes an increased risk of neurodevelopmental outcomes in 3-16 years. What are these?

A

Child emotional problems esp. anxiety and depressions
ADHD symptoms
Conduct disorder

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13
Q

How can parents move from unresolved to resolved?

A

They need the opportunity to address the issues from their childhood and help to learn how to understand the mental state of oneself and others to break the intergenerational transfer (ghosts in the nursery) of trauma and promote secure attachment

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14
Q

What is the probability of a abused parent NOT harming their child?

A

2/3rds

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15
Q

What does infant mental health problems affect?

A

Capacity of child from birth to form close relationships, manage and express emotions and explore the environment within the context of a parent/care-giver with the infant

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16
Q

What does it state in Good Medical Practice with regards to relationships with patients children and young people?

A
  1. Be aware of needs and welfare of children/young people when seeing parents/carers esp. if they represent a danger
  2. Safeguard and protect health and wellbeing of children/young people
  3. Offer assistance to children/young people if there is a reason to think their rights have been abused or denied
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17
Q

What does it state in the General Medical Council (GMC) state?

A

Effective communication between doctors, children/young people and parents is essential to provision of good care and allows you to find out what they want and need to know, issues important to them and opinions/fears about health/treatment

18
Q

If you suspect a child may be the victim of abuse what is the next steps?

A

This over-rides duty of confidentiality to child/parent as we are obliged to act in best interest of child (if in doubt discuss with senior)

19
Q

What is child abuse and neglect?

A

Forms of maltreatment which entails inflicting harm or failing to prevent harm for a child occurring in a family, institutional or community setting by those known to them or more rarely, strangers

20
Q

What are the different types of abuse?

A 
Physical (non-accidental injury (NAI))
Female genital mutilation (FGM)
Munchausen syndrome by proxy (MSBP)
Sexual
Emotional
Neglect

Often interact with eachother not existing in isolation

21
Q

What does the Children Act include?

A
  1. Lord Laming report focusing on universal and targeted services
  2. Every Child Matters which is a green paper to protect and maximise the potential of children
  3. 5 outcomes for children
  4. Revised Children Act
22
Q

What are the 5 policies of Every Child Matters?

A 
Be healthy
Stay safe
Enjoy and achieve
Make a positive contribution
Achieve economic wellbeing
23
Q

Whos responsibility in England is child protection?

A

Department for Education who issue guidance to local authorities with the most recent being “Working together to safeguard children” where Local Safeguarding Children’s Boards (LSCBs) use this guidance to produce their own procedures that should be followed by practitioners and professionals

24
Q

What is the Local Safeguarding Children Board (LSCB)?

A

Statutory multi-agency body that replaced the Area Child Protection Committees to coordinate and lead child protection activities in an area and audit/review safeguarding and welfare promoting

25
Q

What are the National Society for the Prevention of Cruelty to Children (NSPCC) recommendations?

A
  • Improve information sharing for early intervention and effective protection
  • Develop a common assessment framework
  • Introduce a lead professional
  • Develop on spot service delivery
  • Accountability and integration locally, regionally and nationally
  • LSCBs
26
Q

What are named professionals with regards to children’s protection matters?

A

Each trust has a NAMED doctor, nurse and midwife to take the lead with responsibilities including education, support and supervision and to be the appropriate person to contact with any child protection matter to refer to Children’s Social Care (if no one is available, you must take care of it)

27
Q

What is the CAF triangle?

A
  1. Child developmental needs: health, education, emotional/behavioural development, identity, family/social relationships, social presentation and selfcare skills
  2. Parenting capacity: basic care, ensuring safety, emotional warmth, stimulation, guidance/boundaries and stability
  3. Family and environmental factors: community resources, family’s social integration, income, employment, housing, wider family and family history/functioning
28
Q

What is the first stage of the child protection process in all four nations?

A

A children protection referral as soon as some aspect of the childs life is giving cause for concern

29
Q

What is a referral?

A

A request for services to be provided by childrens services where the child is previously not known to them, or where the case was previously open but is now closed

30
Q

What does the Child Protection Conference do?

A

Designed to look at all relevant information and circumstances to determine how best to safeguard the child and promote their welfare - may be held following an investigation under section 47 of the Childrens Act (child protection investigation)

31
Q

What is a Child Protection Plan?

A
  1. Child Protection Conference agrees an outlined plan
  2. Ensure child is safe and prevent child from suffering further harm is the plan and this can be done by:
    - Promoting childs health and development
    - Supporting family to safeguard child and promote welfare
  3. Plan is implemented by the Core Group and reviewed regularly at Review Child Protection Conference
32
Q

Where is guidance of Child Protection Conferences contained?

A

Working Together to Safeguard Children

33
Q

What is the Working Together to Safeguard Children guidance?

A

Guidance designed to ensure that there is coordinated and child-centred approach to safeguarding - published by Department of Education

34
Q

What is the commonest reason for children subject to a Child Protection Plan (CPP) or Child Protection Register (CPR) in England and Wales?

A

Neglect e.g. shaken baby syndrome (Northern Ireland is physical abuse)

35
Q

What is the 2nd commonest reason for children subject to a Child Protection Plan (CPP) or Child Protection Register (CPR)?

A

Emotional abuse (upwards trend being seen)

36
Q

What is the NSPCC All Babies Count Campaign?

A

Wants people to recognise the vulnerability of infants to abuse and how babies are 8x more likely to be killed than older children with 45% of serious case reviews in England relating to babies under 1 years old

37
Q

Why is neglect hard to define?

A
  • Most definitions are based on personal perceptions of what constitutes “good enough” care and what a childs needs are
  • Its effects are cumulative
  • Often co-exists with other forms of child maltreatment with boundaries between abuse and neglect becoming blurred
38
Q

Why is the lack of a neglect defition a problem?

A

There has been serious implications as a result of lack of clarity making it difficult for professionals to make clear and consistent decisions identifying the point at which to make a referral regarding children at risk of neglect

39
Q

How should information be shared?

A

On a NEED TO KNOW basis

40
Q

What type of abuse is always present?

A

Emotional

Block 5 (29 decks)

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