The law and child protection Flashcards
What is a child in England, Wales, and Northern Ireland?
0-18
What is a child in Scotland?
0-16
Who has parental responsibility over a child?
Automatically the birth mother has parental responsibility until birth certificate is written
Father doesn’t automatically have parental responsibility unless he is married to the birth mother
When is knowing who has parental responsibility particularly important?
With neonates and consenting for procedures if birth has not been registered
What kind of things are under the children act of 1989?
Parental responsibility Safeguarding - Child assessment 'section 47' - Investigation powers - Emergency protection orders - Police protection orders - Child in need 'section 17' - Child taken into care 'section 20'
What types of abuse can a child experience?
Physical
Sexual
Emotional
Neglect
How common is abuse in children?
Approx 300-400 Sheffield children on list of those subject to child protection plan
Approx 650 looked after children
100 non-accidental deaths per year
Under 1 year - age group most likely to be murdered
Around 10% adults report abuse during their childhood
Much abuse never disclosed or reported to professionals
What parental factors can predispose a child to abuse?
Lack of support Generation effect Deprivation Mental health problems Learning difficulty Alcohol and substance misuse Domestic violence
What child factors can predispose a child to abuse?
Difficult to care for - disability, preterm, lots of medical conditions
Disabled
What should you make note of in a history of a potential abuse victim?
Part of whole child assessment
Document who said what and when
Identify discrepancies
What should you do when examining a potential abuse victim?
Record any explanations offered for any injuries
Use body chart to document injuries
Photos
Examine whole child
How might an abuse victim present?
Disclosure from child to trusted carer/parent/at school
Referral from other services
Injury observed eg at school
Found incidentally when attending for another reason
Injury presented with/without explanation
When should you be concerned that a child is being abused?
History that doesn’t fit with the observed injuries
- Too many
- Wrong site
- Unusual shape or pattern
- Wrong type of incident
- Not consistent with child’s development
- Delay in presentation
No history - can’t explain where injury has come from
A history that changes
What might the signs of physical abuse be?
Superficial - bruises, scratches, marks from implements, slap marks
Burns and scalds
Fractures - multiple, long bones, ribs, metaphyseal
Internal organ damage - abdominal, intracranial
Torn frenulum
How does a shaken baby present after shaking and impact?
Hypoxia SDH Rib fractures Retinal haemorrhages Other fractures Torn frenulum
What investigations should you do for a shaken baby?
XR whole body
Brain scan
What possible differentials are there for signs of abuse?
Birthmarks Mongolian blue spot Paint Bleeding tendencies - lots of bruises Brittle bones Normal accidents
What is neglect?
A standard of care that doesn’t meet the child’s need
What is neglect for one child might not be neglect for another eg disability
What does a child need?
Food and drink Warmth Shelter Clothing Grooming Health and dental care Education Appropriate social opportunities Emotional support Protection from harm Discipline - boundaries and behaviour
How common is emotional abuse?
Common
Often unrecognised
Coexists with other abuse types
Damaging
What type of relationship is an emotionally abuse relationship?
High in criticism, low in warmth
Legally - children exposed to domestic abuse
How common is sexual abuse?
Boys and girls Any age Family vs stranger Wide spectrum of activities Linked to other abuse types
How might sexual abuse present?
Disclosure
Behaviour change - sexualised, indicative of distress
Physical symptoms - bleeding, discharge, soreness, wetting or soiling, STI, pregnancy
How should you investigate a child you think may have been abused?
Medical assessment Labs - FBC, clotting if bruising/bleeding Swabs for possible infection Bone profile, vit D, PTH if fractures Radiology - skeletal survey, CT, MRI Developmental assessment
What other agencies are involved if a child is being abused and what might they do?
Social services assessment
+/- police investigation
What happens in a case conference?
Multiagency
Parents invited
Decide placement on list of children subject to child protection plan
Review process
Who leads a child protection plan?
Key worker
