Neglect, Abuse, and Non-Accidental Injury

Question 1

What is the definition of child abuse?

Answer 1

Deliberate infliction of harm to a child of failure to prevent harm.

Question 2

What is the definition of neglect?

Answer 2

A persistent failure to meet a child’s basic physical or psychological needs that is likely to result in serious impairment of the child’s health and development.

Question 3

What are the three main types of abuse in children?

Answer 3

Physical, emotional, and sexual.

Question 4

What are the risk factors for neglect, abuse, and non accidental injury?

Answer 4

Child - preterm, physical and learning disabilities
Parents - mental health problems, substance misuse, history of child abuse
Family - domestic violence, poor housing, social deprivation

Question 5

What are the physical presentations in neglect, abuse, and non-accidental injury?

Answer 5

1. Delay in seeking medical attention
2. Inconsistent history and injury observed
3. Bruise or fracture in immobile baby
4. Fractured ribs, retinal haemorrhages, torn lingual frenulum, spiral fracture of humerus, bruising behind ear.

Question 6

What are the sexual presentations in neglect, abuse, and non-accidental injury?

Answer 6

1. Observation precocious sexual knowledge by the child
2. Non-specific - self-harm, withdrawal, change of behaviour
3. Any STI in a prepubertal child, genital discharge, pain
4. Underage pregnancy

Question 7

How is neglect, abuse, and non accidental injury investigated?

Answer 7

1. Involve social services immediately, follow local child protection guidelines, contact Child safeguarding officer.
2. Who’s at home, visitors, feeding, sleeping, substance misuse, parental mood, previous social service contact?
3. Skeletal x-ray survey, CT/MRI if suspecting head injury, fundoscopy retinal haemorrhages, extensive or unusual bruising - clotting screen.