Safeguarding Flashcards

1
Q

What are the main types of child maltreatment?

A
  • Physical abuse
  • Emotional abuse
  • Sexual abuse (inc. sexual exploitation)
  • Neglect
  • Fabricated/induced illness
  • Witnessing domestic violence
  • Female genital mutilation
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What is physical abuse?

A

Causing physical harm to a child

(e.g. hitting, shaking, throwing, poisoning, burning, drowning, suffocating)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What is emotional abuse?

A

Persistent emotional maltreatment of a child resulting in severe and persistent adverse effects on the child’s emotional development. Includes:

  • Conveying to child they are unloved/worthless/inadequate/conditionally-valued
  • Developmentally inappropriate expectations & interactions
  • Overprotection
  • Abnormal social interaction
  • Witness the ill treatment of others
  • Serious bullying
  • Corruption/exploitation of children
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What is sexual abuse?

A

Forcing/enticing a young person to take part in sexual activities (inc. prostitution), whether or not the child is aware of what is happening.

Includes:

  • Physical contact
  • Non-physical contact (e.g. encouraging sexually inappropriate behaviour)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What is neglect?

A

Persistent failure to meet a child’s basic physical/psychological needs, likely resulting in serious impairment of the child’s health/development.

Includes parent/carer failing to provide:

  • Adequate food & clothing
  • Shelter
  • Protection from physical and emotional harm/danger
  • Adequate supervision
  • Access to appropriate medical care / treatment
  • Emotional support/responsiveness
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What is fabricated/induced illness?

A

A group of harmful behaviours by parent/carer.

May consist of:

  • Verbal fabrication (telling false story of child illness to get healthcare)
  • Induction of illness (via suffocation, poisoning, overdosing on meds, etc.)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

When do you suspect fabricated/induced illness?

A

When a child has frequent unexplained illness & multiple hospital admissions with symptoms that only occur in caregiver’s presence and are not substantiated by clinical findings.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What is female genital mutilation?

A

All procedures that involve partial or total removal of the external female genitalia, or other injury to the female genital organs for non-medical reasons

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What are the different types of FGM?

A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What are the risk factors for child maltreatment?

A
  • Inability to meet parent’s expectations
  • Child born as a result of forced, coercive, or commercial sex
  • Parental mental health problems
  • Parental indifference/intolerance/anxiousness
  • Parental alcohol/drug abuse
  • Step-parents
  • Domestic violence
  • Multiple/closely spaced births
  • Social isolation/lack of social support
  • Young parental age
  • Poverty & poor housing
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

How may child abuse present?

A
  • Physical symptoms/signs
  • Psychological symptoms/signs
  • Concerning interaction observed between child & parent/carer
  • Child may tell someone about the abuse
  • Abuse may be observed
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What do you need to consider in the presentation of a physical injury?

A
  • Child’s age and developmental stage
  • History given by the child
  • Plausibility of the explanation of the injury
  • Any background of previous injury/concerns
  • Delay in reporting the injury
  • Inconsistent histories from caregivers
  • Innapropriate reaction from caregivers (e.g. vague, evasive, unconcerned, excessively distressed/aggressive)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

When is a fracture more likely to be inflicted?

A
  • When seen in a non-mobile child (without fragile bones)
  • Rib fracture
  • Multiple fractures (Increased likelihood if # are different ages)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

When is bruising most likely to be inflicted?

A
  • Shape of a hand
  • On the neck (strangulation)
  • On the wrists/ankles (ligature marks)
  • On the buttocks (esp if < 2 yo or no reasonable explanation)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

When are burns most likely inflicted?

A
  • Immobile child
  • In the shape of an implement (e.g. cigarette, iron)
  • ‘Glove or stocking’ burn consistent with forced immersion
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

When are bites most likely inflicted?

A

Bruising in the shape of a bite thought unlikely to be by young child.

17
Q

What features of the child’s appearance/behaviour should make you consider the possibility of neglect?

A
  • Consistenly missing important medical appointments
  • Lacks needed medical/dental care/immunisations
  • Seems ravenously hungry
  • Is dirty
  • Is wearing inadequate clothing in cold weather
  • Is abusing alcohol/drugs
  • Says there is no-one at home to provide care
18
Q

What features of the caregiver’s appearance/behaviour would make you consider neglect?

A
  • Appears indifferent to the child
  • Seems apathetic/depressed
  • Irrational / bizaare behaviour
  • Drug/alcohol abuse
19
Q

What parental perceptions of the child can indicate emotional abuse?

A

Caregiver percieves child as:

  • ‘Wrong’ gender
  • Unduly ‘difficult’
  • Born during parental separation/violence
20
Q

What behaviour may hint towards emotional abuse of a baby?

A

Observable behaviour of the child:

  • Apathetic
  • Delayed development
  • Non-demanding

Mother may describe child as:

  • Spoiled
  • Attention-seeking
  • In control
  • Not loving her
21
Q

What behaviour may hint towards emotional abuse of a toddler?

A
  • Violent
  • Apathetic
  • Fearful
22
Q

What behaviour may hint towards emotional abuse of a school child?

A
  • Wetting/soiling
  • Relationship difficulties
  • Nonattendance
  • Antisocial behaviour
23
Q

What behaviour may hint at emotional abuse of adolescents?

A
  • Self-harm
  • Depression
  • Oppositional/aggressive behaviour
  • Delinquent behaviour
24
Q

How may sexual abuse be recognised?

A

Child / young person may:

  • Tell someone about the abuse
  • Be identified in pornographic material
  • Be pregnant
  • Have an STI with no clear explanation
25
Q

What physical symptoms may coincide with sexual abuse?

A
  • Vaginal bleeding, itching, discharge
  • Rectal bleeding
26
Q

What behavioural symptoms may coincide with sexual abuse?

A
  • Any of the symptoms for emotional abuse
  • Unexpected awareness / acting out of sexualised behaviour beyond age
  • Soiling / secondary enuresis (bed-wetting)
  • Self-harm
  • Aggressive or sexualised behaviours
  • Regression
  • Poor school performance
27
Q

What investigation is indicated in all children with suspected physical abuse under 30 months of age?

A

Full radiographic skeletal survey with oblique views of the ribs

28
Q

What alternative causes shoulde be considered and excluded in a child presenting with bruising?

A
  • Coagulation disorders
  • Slate gray naevi (Mongolian blue spot)
29
Q

What alternative causes shoulde be considered and excluded in a child presenting with fractures?

A
  • Osteogenesis imperfecta (Brittle bone disease, usually type 1)
    • Ask about family history bc autosomal dominant disorder
    • Examine for blue sclerae
    • Wormian bones in skull on skeletal survey (extra bones in skull sutures)
30
Q

What alternative causes shoulde be considered and excluded in a child presenting with scalds / burns?

A
  • Bullous impetigo
  • Scalded skin syndrome
31
Q

What investigations are required in ALL children with suspected brain injury?

A
  • Immediate CT head scan followed by MRI head scan
  • Skeletal survey (to exclude fractures)
  • Expert opthalmological examination (to identify retinal haemorrhages)
  • Coagulation screen
32
Q

How do you go about assessing a child for potential abuse?

A
  • Talk to the child seperately from parents with a chaperone, taking a detailed history and full examination
  • Any injuries or medical findings hsould be carefully noted, measured, recorded and drawn on a body map and photographed (with consent)
  • Plot height, weight and head circumference on centile charts
  • Note interaction between child & parent
  • Make sure all notes are meticulous, dated/timed and signed on each page.
33
Q

If abuse is suspected/confirmed and a decision is made to immediately protect any children from further harm, how is this done?

A
  • Admit to hospital (allowing for investigations and MDT assessment)
    • May require legal enforcement if parents not compliant
  • Placement with foster care (if medical treatment not necessary)
  • Alert police / social services to any concerns surrounding other children at home.
34
Q

Who has a role in child protection?

A
  • Social workers
  • Health visitors
  • Police
  • GP / Paediatrician
  • Teachers
  • Lawyers
35
Q

What is decided in child protection conferences?

A
  • Whether child should be provided with child protection plan & under what category
  • Whether there should be an application to the Court to protect the child
  • What follow-up is needed