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Module 7 > Paeds > Flashcards

Paeds Flashcards

1
Q

What is safeguarding?

A

The action that is taken to PROMOTE THE WELFARE of all children and young people (CYP) and PROTECT THEM FROM HARM/MALTREATMENT.

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2
Q

What are the 4 forms of maltreatment?

A
  • Physical.
  • Emotional.
  • Sexual.
  • Neglect.
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3
Q

What is child protection?

A
  • A PART of safeguarding.
  • and includes activities undertaken to PROTECT CYP WHO HAVE BEEN HARMED or are at SIGNIFICANT RISK OF BEING HARMED.
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4
Q

What do the GDC standards outline regarding child protection responsibility? (3)

A
  • The ENTIRE DENTAL TEAM have an ethical responsibility to FIND OUT ABOUT & FOLLOW LOCAL PROCEDURES involved in RAISING CONCERNS about possible abuse and neglect of children.
  • This is NOT just the dentist’s responsibility but shared by all team members.
  • NOT responsible for MAKING A DIAGNOSIS but to SHARE CONCERNS appropriately.
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5
Q

What is child abuse/ neglect? 4 examples

A

Anything which those entrusted with the care of children do or fail to do which DAMAGES THEIR PROSPECTS OF SAFE & HEALTHY DEVELOPMENT INTO ADULTHOOD.
- physical, emotional, sexual, neglect.

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6
Q

How common is child abuse?

A

1 child per 1000 under 4 suffer from severe physical abuse.

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7
Q

4 categories of contributing factors to the aetiology of child abuse?

A
  • Adult.
  • Child.
  • Community/ environmental.
  • Family violence and dysfunctional family.
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8
Q

12 adult contributing factors to aetiology of child abuse?

A
  • Drugs, alcohol.
  • Poverty.
  • Unemployment.
  • Marital stress.
  • Domestic violence
  • Mental illness.
  • Disability.
  • Step parents.
  • Isolation.
  • Abused as a child.
  • Unrealistic expectations.
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9
Q

7 child contributing factors to aetiology of child abuse?

A
  • Crying.
  • Soiling.
  • Disability.
  • Unwanted pregnancy.
  • Product of forced/coercive/commercial sex.
  • Wrong gender.
  • Failed expectations.
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10
Q

2 community/environmental contributing factors to aetiology of child abuse?

A
  • Dwelling place & housing conditions.
  • Neighborhood.
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11
Q

3 family contributing factors to aetiology of child abuse?

A
  • Violence towards pets.
  • Social isolation.
  • Poverty
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12
Q

3 major parenting factors that can increase risk of child abuse?

A
  • Parental substance misuse.
  • Parental mental ill-health.
  • Domestic abuse.
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13
Q

3 characteristics of accidental injuries?

A

Typically:
- Involve bony prominences.
- Match the history.
- Are in keeping with the development of the child.

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14
Q

7 characteristics that raise concern of non-accidental injury?

A
  • Injuries to both sides of the body.
  • Injuries to soft tissue.
  • Injuries with particular patterns.
  • Injuries that don’t match the explanation.
  • Delays in presentation.
  • Untreated injuries.
  • Injuries in triangle of safety.
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15
Q

What is the triangle of safety?

A

Ears, side of face and neck, top of shoulders.

Accidental injuries in this areas are unusual.

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16
Q

4 children considered “VULNERABLE CHILDREN”?

A
  • Under 5s.
  • Irregular attenders.
  • Medical problems and disabilities.
  • Looked after children.
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17
Q

Why are irregular attenders considered vulnerable? (3)

A
  • Repeatedly DNA.
  • Return in pain.
  • Exposed to risks of GA.
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18
Q

Why are children with medical problems/ disabilities considered vulnerable (2)?

A
  • More at risk of experiencing abuse of all kinds.
  • Serious impairement of health/ development more likely as a result of untreated dental disease.
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19
Q

What children are considered “looked after children” (2)?

A
  • Children who are subject to compulsory measures of care are deemed as looked after by their local authority.
  • Children accommodated by the local authority on a voluntary basis with consent from parents (includes children receiving respite care).
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20
Q

Where may looked after children be living (4)?

A
  • Foster homes.
  • Their own homes.
  • In the care of relatives.
  • Residential establishments.
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21
Q

Define dental neglect?

A

PERSISTENT failure to meet a CYP’s basic oral health needs likely to result in the SERIOUS IMPAIREMENT of their ORAL or GENERAL HEALTH or DEVELOPMENT.

22
Q

3 legislative frameworks on child protection?

A
  • National guidance for child protection Scotland (2021).
  • Scottish approach (GIRFEC policy and practice model).
  • Engagement with children in child protection - Children Scotland act 2020.
23
Q

What does the national guidance for child protection Scotland 2021 state?

A

The most effective protection of children involves early support

24
Q

What are the SHANARRI principles?

A
  • Safe.
  • Healthy.
  • Achieving.
  • Nurtured.
  • Active.
  • Respected.
  • Responsible.
  • Included.
25
What would be considered dental neglect?
- OBVIOUS DENTAL DISEASE with an IMPACT on CYP, particularly if CARE has been offered. - Number of carious teeth in itself is not an indicator.
26
5 reasons why the number of carious teeth does not indicate the severity of dental neglect?
- Multi-factorial aetiology of dental caries. - Variation in individual susceptibility. - Inequalities in dental health (regional, social class). - Inequalities in access to dental treatment. - Differences in treatment philosophies.
27
What are 3 ways to manage dental neglect?
1. **A preventive dental team response** (raise concerns with parents, offer support, set targets and monitor progress). 2. **A preventive multi agency response** (contacting other professions who you know are involved with the family ex. named person, social worker, GP, school nurse). 3. **Child protection referral**.
28
What is involved in a preventive dental team approach to dental neglect?
1. Raise concern to parents. 2. Offer support. 3. Set targets. 4. Monitor progress.
29
What is involved in a preventive multiagency approach to dental neglect?
- Contacting other professions who you know are involved with the family. - GP, social worker, school nurse, named person.
30
What does ACE stand? What is it?
- Adverse childhood events. - Stressful or traumatic experiences that occur during childhood.
31
What do ACEs increase the risk for (5)? How many ACEs are needed?
- Heart disease. - Type 2 diabetes. - Mental illness. - Commit violence. - Imprisonment. - Risk increases with 4 or more ACEs.
32
Examples of ACEs (9)?
- Verbal abuse. - Physical abuse. - Domestic abuse. - Parental separation. - Household mental illness. - Household alcohol abuse. - Sexual abuse. - Household drug abuse. - Incarceration of household member.
33
What must be done regarding ACEs?
Identify early and support mechanisms in place.
34
4 things that would raise concerns of neglect?
- **Dirty**. - **Child small/ failing to thrive** (no explanation in MH). - **Atypical behavior** (ex. anxious, watchful, agression). - **Presentation of parent/ child).
35
What is expected of the dental team regarding neglect (5)?
- Observe. - Report. - Communicate. - Refer for assessment. - NOT expected to diagnose.
36
What do you do if you have concerns about a child's welfare even after consulting with experienced colleagues?
Contact one of the **CORE AGENCIES** with a **NOTIFICATION OF CONCERN FORM**. (social work, police, health education).
37
What are the 3 different possible responses to a notification of concern from?
Decision of core agencies: 1. No action, concerns noted. 2. Single agency response. 3. Joint action.
38
What do you do if you have concerns about a child's welfare but you NO LONGER DO after consulting with experienced colleagues?
- No further child protection action. - **Other actions needed**: provide necessary dental car, keep full clinical records, arrange dental follow-up as indicated.
39
6 local contacts for when you have a child protection concern?
- Child protection policy. - Paediatric consultant on call. - Lead person for child protection. - Social work. - Police public protection unit (101). - Child protection advice line.
40
What happens when the core agencies decide the concern "not progressed as child protection concern"?
Other services may be needed/ provided
41
What happens when there is a single agency response?
- Further assessment. - Single agency support.
42
What happens when there is inter-agency reponse?
- Investigation. - Medical. - Immediate emergency action - CP case conference (child protection register, child protection plan).
43
3 key outcomes of the Children's Act 2020 document?
- Any child irrespective of their age can have their views heard in court. - Children can express their views through art or a letter whichever way they feel comfortable and able. - All decisions from a children’s hearing have to be explained in a manner they can understand.
44
What should you do if you have a welfare concern (2)?
1. Initial referral by telephone. 2. Follow up in writing in 48 hour - Notification of concern form (proforma).
45
What is the course of action taken after a welfare concern has been made?
1. Investigation. 2. Initial assessment. 3. Discussion to assess if CYP is at risk of significant harm.
46
What happens if there is immediate danger?
Child protection order is issued to remove CYP from their parents/ carers.
47
What is the difference between safeguarding and protection?
- **Safeguarding**: a PREVENTIVE approach to child protection by minimising or eliminating harm to a child. - **Protection**: a REACTIVE approach to address suspected/ known cases of abuse or neglect.
48
3 things neglect may involve?
Failure to: - Provide adequate food, clothing, shelter. - Protect a child from physical/ emotional harm. - Ensure adequate supervision.
49
What is often a key indicator of neglect? (2)
- DENTAL neglect often a key indicator of neglect. - 60% of child victims of physical abuse show signs in the H and N region.
50
What is Gillick competence?
In Scotland **under 16s** can consent to medical or dental treatment if a doctor believes they understand **THE PROCEDURE, ITS RISKS and ALTERNATIVES**.
51
What is done when an under 16 is deemed to not have gillick competence?
- **Children (Scotland) Act 1995** applies. - Whoever has **PARENTAL RESPONSIBILITY** can provide consent.

Module 7 (9 decks)

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