Session 1 Flashcards
What is Abuse and Neglect?
Abuse is defined as
•“Physical, sexual, financial, emotional or psychological violation or neglect of a person unable to protect themselves, or to prevent from happening, or to remove themselves from abuse, or potential abuse from others.”
Abuse and neglect are forms of maltreatment of a child. Somebody may abuse or neglect a child by inflicting harm, or by failing to act to prevent harm.
Children may be abused in a family or in an institutional or community setting; by those known to them or, more rarely, by others (e.g. via the internet). They may be abused by an adult or adults or another child or children.
Assessment Framework Triangle
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Who should have immediate referral into Social Care?
- Children at immediate risk of significant harm, including physical, sexual, emotional harm and neglect.
- Children with unexplained injuries, suspicious injuries where there is an inconsistent explanation of the injury.
- Children under two who have unexplained bruising.
- Child victims of trafficking.
- Children where there is evidence of repeated domestic violence witnessed or experienced by a child; adult mental health issues and substance use issues (toxic trio).
- Children who are experiencing, or at risk of, sexual abuse or exploitation
- Children under 1 year old where the parents/carers have significant substance use issues.
- Where there are serious concerns regarding the risk of significant harm to an unborn baby.
- Children who live or have contact with adults who are known to pose a risk to children.
- Children left ‘home alone’ and their age and vulnerability places them at risk.
- Children who allege abuse, including sexual abuse or evidence of grooming
- Adults who pose a risk
- Children who are primary age and reported to be
- self-harming
What are the different categories of abuse?
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, or deliberately induces illness in a child (Fabricated or Induced Illness).
Sexual Abuse
- Involves forcing or enticing a child or young person to take part in sexual activities, not necessarily involving a high level of violence, whether or not the child is aware of what is happening.
- The activities may involve physical contact, including assault by penetration or non-penetrative acts such as masturbation, kissing, rubbing and touching outside of clothing.
- They may also include non-contact activities, such as involving children in looking at, or in the production of, sexual images, watching sexual activities, encouraging children to behave in sexually inappropriate ways, or grooming a child in preparation for abuse (including via the internet).
- Sexual abuse is not solely perpetrated by adult males. Women can also commit acts of sexual abuse, as can other children.
Neglect
- Is 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.
- Neglect may occur during pregnancy as a result of maternal substance abuse.
- Once a child is born, neglect may involve a parent or carer failing to:
- Provide adequate food, clothing, shelter (including exclusion from home or abandonment)
- Protect a child from physical and emotional harm or danger
- Ensure adequate supervision (including the use of inadequate care-givers)
- Ensure access to appropriate medical care or treatment.
- It may also include neglect of, or unresponsiveness to, a child or young person’s basic emotional needs.
Medical neglect
•This involves carers minimising or ignoring children’s illness or health (including oral health) needs, and failing to seek medical attention or administrating medication and treatments. This is equally relevant to expectant mothers who fail to prepare appropriately for the child’s birth, fail to seek ante-natal care, and/or engage in behaviours that place the baby at risk through, for example, substance misuse
When a child doesn’t turn up for an appointment, do not put “did not attend”, instead put “was not brought” as we cannot expect children to make their own way to an appointment. Think why did they not attend and what will the consequences be.
Emotional Abuse
- Is the persistent emotional maltreatment of a child such as to cause severe and persistent adverse effects on the child’s emotional development.
- It may involve conveying to children that they are worthless or unloved, inadequate, or valued only in so far as they meet the needs of another person.
- It may include not giving the child opportunities to express their views, deliberately silencing them or ‘making fun’ of what they say or how they communicate.
- It may feature age or developmentally inappropriate expectations being imposed on children. These may include interactions that are beyond the child’s developmental capability, as well as overprotection and limitation of exploration and learning, or preventing the child participating in normal social interaction.
- It may involve seeing or hearing the ill-treatment of another.
- Some level of emotional abuse is involved in all types of maltreatment of a child, though it may occur alone.
Definition of Child Sexual Exploitation
- Child sexual exploitation is a form of child sexual abuse.
- It occurs where an individual or group takes advantage of an imbalance of power to coerce, manipulate or deceive a child or young person under the age of 18 into sexual activity (a) in exchange for something the victim needs or wants, and/or (b) for the financial advantage or increased status of the perpetrator or facilitator.
- The victim may have been sexually exploited even if the sexual activity appears consensual. Child sexual exploitation does not always involve physical contact; it can also occur through the use of technology.
What are Adverse Childhood Experiences, their possible implications and how can those children be protected?
Adverese Childhood Experiences or ACEs are traumatic childhood events which can include abuse and neglect but more such as bereavement, financial insecurity, a parent in jail and many more. If they have 4 or more, this massively increases their likelihood of having poor outcomes in life as an adult but not only in physical and mental health but also social health. Trauma informed care is to think about how we can recognise these groups but also implemtn protective factors such as a trusted adult (doesnt have to be family), a supportive group of peers including taking part in group activities, resiliance training. These factors make them more able to deal with ther ACES.
Handling a disclosure?
- Listen rather than ask questions;
- Do not stop a young person who is freely recalling significant events;
- Remain calm, and do not give the young person the impression that what they have said is shocking or upsetting;
- Don’t promise to not tell anyone else or that everything will be ok
- Make a report of the discussion as soon as possible, taking care to record the timing, the setting, the people present, as well as the content of what was said, quoting wherever possible the words used by the child;
- Record all subsequent events up to the time of the decision as to whether to start a formal Child Protection investigation.
- Reassure the child or young person that it was the right thing to do in telling
If you are concerned about the welfare of a patient, what course of action should you follow
- Where appropriate, seek an explanation for your concerns, usually from a parent, carer, or child.
- Record events accurately, date and sign, check background information, within your organisation.
- Inform and discuss with your line manager or supervisor.
- Agree on what action to take:
- Just keep a record
- Refer to other agency
- Fill in MARF form
- Refer to social care
- If areferal to social care ensure information is passed on immediately by phone.
- Within 24 hours, follow up with a written record of referral information.
- Provide further background information to social care when requested.
The wider context of safeguarding
- Domestic and sexual violence
- Trafficking
- Radicalisation
- Modern slavery
- Female genital mutilation/cutting
- Forced marriage
- Honour based violence
- Discriminatory abuse
Why review child deaths?
- To establish, where possible, a cause or causes of child deaths (with the coroner)
- To identify any potential contributory and modifiable factors
- To provide ongoing support to the family
- To learn lessons in order to reduce the risk of future child deaths
Child death review process?
Child is defined as from the momnt you are born up unitl the day of your 18th birthday.
Child review team notified
Everyone involved in the child e.g GP, school etc are notfied. Decision needs to be made as to whether the death was expected or not.If unexpected, police always notified, and they consider whether this was a safeguarding issue. Are the circumstances about the death potenitially criminal?
Investigations then follow. After information is gathered there is a child death review meeting (multi agency) to produce an analysis report. That then goes to an overview panel where they independently lookat the case and then find lessons from it.
What is the the joint agency response after a child death?
If death is unexpected a joint agency response follows. Examples of when this would happen are below:
- Death is or could be due to external causes e.g road traffic accident
- Sudden and no immediately apparent cause (inc SUDI/C)
- Occurs in custody/detained under MHA
- Initial circumstances raise suspicions death may not have been natural
- Unattended stillbirth
- Sudden collapse with very poor prognosis
Epidemiology of child death in the UK
Roughly 6000 child deaths per year, 2/3in the first yer of life. Above the age of one, most deaths are due to injury and most of those were preventable. Incidence is falling but lagging behind other countries.
How do social and economic inequalities affect rates of child death
Areas of higher deprivation see increased rates of children with ACEs and higher child mortality rates.
Key thmes from serious case reviews of children and absue
• The need to be aware of confirmatory bias and for practitioners to reflect on their own biases and ensure these do not cloud their work with children and families.
- The value of using chronologies, including medical and medication reviews, to support referrals to Children’s Social Care and provide clarity to all involved of the extent, pattern and severity of concern.
- Where information comes to the attention of practitioners which suggests that a primary age child has self-harmed serious consideration must be given to whether there are other underlying factors, including abuse
• Recognising males who may pose a risk • Balancing the needs of parents and children
