S1 - Child Safeguarding Flashcards

1
Q

Wh at is child abuse?

A

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

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2
Q

Categories of Child Abuse

A

1- Neglect
• Physical
– Including FII/perplexing presentations
– Including FGM

2- Sexual

3- Emotional

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3
Q

What is neglect ?

A

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.
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4
Q

Examples of neglect ? (Once a child is born)

A

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

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5
Q

Examples of neglect based on history ?

A

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

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6
Q

Examples of neglect based on examination ?

A

Neglect based on patients examination

Poor nutritional status/poor growth
Dental decay
Signs of recurrent/chronic infection or infestation
Dirty/unkempt/smelly

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7
Q

Define Physical abuse ?

A

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

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8
Q

Examples of physical abuse based in child’s history ?

A

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

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9
Q

What should you investigate if a child’s examination reveals unexplained bruises ?

A

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

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10
Q

Examples of physical abuse based on child’s examination ?

A

Unexplained bruising in vulnerable child

Unexplained fractures/burns/scalds/head injury

Patterns: Implement/sparing/bites

Injury not consistent with history developmental age

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11
Q

Examples of sexual abuse in children ?

A

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

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12
Q

Child sexual exploitation - what is it ?

A

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.

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13
Q

Does child sexual exploitation always have to involve physical contact ?

A

No - can occur through technology

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14
Q

In child sexual exploitation , the child appears consensual - is it still child sexual exploitation then ?

A

Yes , Victim may have been exploited even if sexual activity
appears consensual.

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15
Q

Sexual abuse , examples of it seen in child’s history ?

A

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

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16
Q

What should you do if you see Sexual abuse in child’s examination ?
STEPS you would take

A

Immediate health needs are paramount

Referral to Social Care

Forensic assessment undertaken at specialist

Sexual Assault Referral Centre by staff with appropriate skills & expertise

17
Q

What is child emotional abuse ?

A

Persistent emotional maltreatment of a child causing severe and persistent adverse effects on the child’s emotional development.

18
Q

Broad Examples of child emotional abuse ?

A

Rejecting
Isolating
Terrorising
Ignoring
Corrupting
Cyberbullying

19
Q

Specific examples of emotional abuse ?

A

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

20
Q

Child emotional abuse based on history (non specific ) in infants ?

A

Feeding difficulties
crying
poor sleep patterns
delayed development.

21
Q

Child emotional abuse based on history (non specific ) in toddlers / pre school

A

Behavioural spectrum from overactive to apathetic, noisy to quiet, dev delay

22
Q

Child emotional abuse based on history (non specific ) in school aged

A

Wetting & soiling, relationship difficulties, poor school performance, non-
attendance, antisocial behaviour

23
Q

Child emotional abuse based on history (non specific ) in Adolescents ?

A

Depression, self-harm, substance misuse, eating disorders, oppositional,
aggressive, delinquent behaviours.

24
Q

Child emotional abuse based on history (non specific ) across all ages

A

Growth (underweight)
emotional signs (non-specific)
behavioural (wide range),
development (failure to achieve milestones, academic failure)

25
Q

What is the wider context of safeguarding?

A

Online abuse & grooming
Child Criminal exploitation/County lines
Trafficking
Radicalisation
Modern slavery Female genital mutilation/cutting
Forced marriage
Honour based violence
Discriminatory abuse

26
Q

Risk factors for child abuse - what is the triad of vulnerability ?

A

Domestic abuse
Mental illness of parent or carer
Parental drug and / alcohol misuse

27
Q

What are some risk factors for child abuse ?

A

Triad of vulnerability

Under 2 years
Pre-verbal babies & children
Those with additional needs/disability
Vulnerable/marginalised young people

28
Q

What are ACE’s (adverse childhood experiences)

A

Any child who’s Been exposed to :

Physical abuse & neglect
Sexual abuse
Emotional abuse & neglect
Domestic violence
Mental ill-health
Incarceration
Substance misuse
Parental separation

29
Q

What are some interventions and support mechanism for children undergoing abuse ?

A

Universal services

Early Help

Child in Need – consent required.
Section 17 Children Act 1989

Child Protection – consent not required.
Section 47 Children Act 1989

30
Q

If you have concerns about a child , what should your next steps be ?

A

1 - Refer to local authority (social care / MASH)

2 - Re asonable cause to suspect that a child who lives or is found in their area is suffering, or is likely to suffer, significant harm

3 - Duty to make enquiries under Section 47(1) of the Children Act 1989

31
Q

If you have concerns about a child’s safety what should you do ?
If a child discloses abuse or you are concerned
for their welfare:
(Not next steps, think how would you treat child)

A

Don’t ask leading questions.
Document verbatim what was said.
Don’t promise confidentiality.
Talk immediately to one of the professionals you are working with – they will escalate
appropriately.

32
Q

Advantages of reviewing child deaths ?

A

To establish, where possible, a cause or causes of child deaths (with the coroner)
To identify any potential contributory &
modifiable factors
To provide ongoing support to the family
To learn lessons in order to reduce the risk of
future child deaths

33
Q

Who is involved in Child Death Review process?

A

Health (ICB) & Local Authority funded

CDR Team: Designated Dr, Nurses, Manager, Admin

Immediate response:
– Health, Social Care, Police

Review process: all agencies involved in the care of the ex - public health
child in life or investigating the death