S1 - Child Safeguarding Flashcards
Wh at is child abuse?
Maltreatment of a child (<18yrs)
• Infliction of harm OR
• Failing to act to prevent harm
• ‘Significant harm’
– Ill-treatment or impairment of health or
development
Legal justification for LA intervention in family life
Categories of Child Abuse
1- Neglect
• Physical
– Including FII/perplexing presentations
– Including FGM
2- Sexual
3- Emotional
What is neglect ?
The persistent failure to meet a child’s basic
physical and / or psychological needs, likely to
result in the serious impairment of the child’s
health or development.
- May occur during pregnancy as a result of
maternal substance abuse.
Examples of neglect ? (Once a child is born)
Failure of parent to -
Provide adequate food, clothing, shelter
Protect a child from physical and emotional harm or danger
Ensure adequate supervision
Ensure access to appropriate medical care or
treatment
neglect of, or unresponsiveness to,
a child or young person’s basic emotional need
Examples of neglect based on history ?
Neglect based on patients history
Recurrent non-attendance at appointments/non-adherence to medication
Missed routine screening/immunisations Faltering growth
Delay in development
Recurrent infestations/infections/injuries
Poor school attendance
History of injury where explanation suggests inappropriate supervision
Examples of neglect based on examination ?
Neglect based on patients examination
Poor nutritional status/poor growth
Dental decay
Signs of recurrent/chronic infection or infestation
Dirty/unkempt/smelly
Define Physical abuse ?
May involve hitting, shaking, throwing,
poisoning, burning or scalding, drowning,
suffocating or otherwise causing physical
harm to a child.
Physical harm may also be caused when a
parent or carer fabricates the symptoms of illness OR
deliberately induces, illness in a child
Examples of physical abuse based in child’s history ?
Lack of or inadequate explanation for injury
Delay in seeking medical attention / inappropriate response
Inconsistent accounts
Presence of multiple risk factors/Child or family known to SocialCare
Direct disclosure
What should you investigate if a child’s examination reveals unexplained bruises ?
If under age of 2 = concerning
Under 1 = very concerning
Check for medical reasons - FBC , look at clotting factors
Do heat CT - any brain bleeds
Retinopathy - eye bleeds from shaking child
Examples of physical abuse based on child’s examination ?
Unexplained bruising in vulnerable child
Unexplained fractures/burns/scalds/head injury
Patterns: Implement/sparing/bites
Injury not consistent with history developmental age
Examples of sexual abuse in children ?
Forcing or enticing a child or young person to take part in
sexual activities, not necessarily involving high levels of
violence, whether or not the child is aware of what is
happening.
• May involve physical contact (including assault by penetration
or non-penetrative acts)
• May be non-contact activities (involving children looking at or
producing sexual images, watching sexual activities,
encouraging children to behave in sexually inappropriate
ways, grooming.
• Can take place online, and technology used to facilitate offline
Child sexual exploitation - what is it ?
An individual or group takes advantage of power imbalance to coerce, manipulate or deceive a CYP (<18 yrs) into sexual
activity
a) In exchange for something the victim needs / wants, and / or
b) For financial advantage / increased status of the perpetrator.
Does child sexual exploitation always have to involve physical contact ?
No - can occur through technology
In child sexual exploitation , the child appears consensual - is it still child sexual exploitation then ?
Yes , Victim may have been exploited even if sexual activity
appears consensual.
Sexual abuse , examples of it seen in child’s history ?
Disclosure
Pregnancy/signs of sexual activity in child under 13yrs
STIs
Anogenital injury/unexplained bleeding Recurrent vaginal discharge
Soiling/wetting ( in child who has previously potty trained) differential diagnosis
Behavioural change
What should you do if you see Sexual abuse in child’s examination ?
STEPS you would take
Immediate health needs are paramount
Referral to Social Care
Forensic assessment undertaken at specialist
Sexual Assault Referral Centre by staff with appropriate skills & expertise
What is child emotional abuse ?
Persistent emotional maltreatment of a child causing severe and persistent adverse effects on the child’s emotional development.
Broad Examples of child emotional abuse ?
Rejecting
Isolating
Terrorising
Ignoring
Corrupting
Cyberbullying
Specific examples of emotional abuse ?
Conveying worthlessness/unloved/inadequate Deliberately silencing or making fun of child’s voice
Imposing age/developmentally inappropriate expectations on children
Ex - Overprotection & limiting of exploration or learning
Ex- Preventing participation in normal social interaction
– Serious bullying/exploitation/corruption
Child emotional abuse based on history (non specific ) in infants ?
Feeding difficulties
crying
poor sleep patterns
delayed development.
Child emotional abuse based on history (non specific ) in toddlers / pre school
Behavioural spectrum from overactive to apathetic, noisy to quiet, dev delay
Child emotional abuse based on history (non specific ) in school aged
Wetting & soiling, relationship difficulties, poor school performance, non-
attendance, antisocial behaviour
Child emotional abuse based on history (non specific ) in Adolescents ?
Depression, self-harm, substance misuse, eating disorders, oppositional,
aggressive, delinquent behaviours.
Child emotional abuse based on history (non specific ) across all ages
Growth (underweight)
emotional signs (non-specific)
behavioural (wide range),
development (failure to achieve milestones, academic failure)
