1 - Child Safeguarding Flashcards
What is abuse and neglect?
Forms of maltreatment of a child, may be by inflicting harm or faling to act to prevent from harm. Can occur in lots of settings, e.g school, sports teams, homes
What is the assessment framework triangle?
A way of assessing whether a child is in need, putting them at the centre.
What are some risk factors which increase the likelihood of child abuse?
- Parent has already abused a child.
- Pregnancy was not wanted.
- Parent has a background of abuse when growing up
- Young, unsupported mother often with low education.
- Parent is isolated and has few support
- Poverty
- Poor housing
- Issues with drugs and alcohol
- Mental health issues
- Relationship problems
What are some situations where there would be an immediate referral to social care as there is worries about a child’s safety?
Under two there is not much movement so baby shouldn’t be bruising
What is the toxic trio?
Domestic abuse, mental illness and substance misuse have been identified as common features of families where harm to children and adults has occurred.
What are the different categories of abuse?
What is the definition of physical abuse?
Causing physical harm to a child, e.g shaking, throwing, poisoning, burning, drowning.
Can also be when a parent or carer fabricates symptoms in a child or induces illness in a child (Munchausen’s)
What is sexual abuse?
- Forcing or enticing a child to take part in sexual activities, e.g penetration, masturbation, kissing, rubbing, making thm atch sexual activities
- Can be contact or non-contact
What is child sexual exploitation?
- Type of sexual abuse
- When a child is exploited they’re given gifts, drugs, money, status and affection, in exchange for performing sexual activities
- Can be exploited even if appears consensual
- Common in looked after children
- Perpetrator takes advantage of an imbalance of power to get something they need/want e.g money from sex trade
What is neglect?
- Persistent failure to meet a child’s basic physical and/or psychological needs, likely to result in impairment of the child’s health or development.
- Can even occur in pregnancy as a result of maternal substance abuse
What are some examples of neglect?
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What are some examples of medical neglect?
- Parent or care ignoring child’s illness or health (including dental hygeine) and failing to seek medical attention or give medication
- Can also be mother’s who fail to see ante-natal care or undergo substance abuse during pregnancy
What is emotional abuse?
- A child doesn’t get the nurture and stimulation they need. This could be through ignoring, humiliating, intimidating or isolating them from social interactions.
- Can include seeing or hearing the ill treatment of another
- Causes severe and persistent adverse effects on child’s emotional development
What is an Adverse Childhood Experience?
- Stressful events occurring in childhood that can lead to poor long term outcomes for the child, e.g cancer, heart disease and diabetes.
- Usually 4 or more events including things like domestic violence and having a parent in prison
What outcomes are you likely to get if you have 4 or more ACEs?
What is confirmation bias?
Tendency to search for and focus on information that confirms or conforms to our own preconceptions, easy to do in safeguarding
How do you handle a disclosure with a child opening up about abuse or neglect?
- Listen and don’t ask questions or interrupt if they are freely recalling events
- Remain calm and don’t give the impression what the child is telling you is shocking or upsetting
- Don’t promise not to tell anyone else or that everything will be ok
- Tell them it is not their fault, they have done the right thing by telling you and tell them the plan of action
- Make a report as soon as possible recording the time, setting, people present and quote child. Record all events up to the time of decision to start a Child protection investigation
What are the seven steps to take if you are concerned about the welfare of a patient, e.g a 1 year old with bruises on their legs?
What is safeguarding?
Process of protecting children from abuse or neglect, preventing impairment of their health and development to ensure they have optimum life chances and enter adulthood successfully.
What are some signs of a child being abused or neglected?
- unexplained changes in behaviour or personality
- becoming withdrawn
- seeming anxious
- becoming uncharacteristically aggressive
- lacks social skills and has few friends, if any
- poor bond or relationship with a parent
- knowledge of adult issues inappropriate for their age
- running away or going missing
- always choosing to wear clothes which cover their body
- poor hygeine
- unexplained repeated injuries
- lots of did not attend appointments
- eneuresis
What are some extreme cases that can happen if we don’t safeguard as schools, hospitals, police etc?
ALWAYS SEEK ADVICE IF YOU THINK A PATIENT MAY NEED PROTECTING
Why do we review child deaths?
What is the child death review process?
- If anyone dies from 22 week gestation to the day before 18th birthday
- Need to decided whether expected or unexpected death (wouldn’t know 24 hours before this would happen)
- Notify schools and other parties, e.g hearing test cancelled
What is the joint agency response to a child’s death?
- Done when death could be due to external causes, e.g RTA, under custody, unattended stillbirth
- Done before the child dies when on life support and the decision may be to withdraw care so can gather evidence quickly
When are the Joint Agency called to review a child death?
What are some of the most common causes of deaths in children?
- Association between deprivation and mortality
What is disguised compliance and what are some barriers to effective child safeguarding?
- Parents and carers appearing to co-operate with professionals in order to allay concerns and stop professional engagement
- Parent distract professionals away from harm, e.g not taken out rubbish as no car
- Bad for child welfare
What are the different levels of abuse?
As a doctor
- You are at risk if you do not share
- You are at minimal risk if you do share
When should doctors and schools be most concerned about FGM?
- Children who are at risk must be investigated
- Adults who are victims must be declared
- Summer holiday is high risk time as it gives the longest period for the child to heal un-noticed
What is the legislation regarding consensual sex?
- Children under the age of 13 can never consent
- Sexual activity under the age of 16 is illegal
- Children from 13-16 are unlikely to be prosecuted for sex if consensual
What is Gillick competence and Fraser guidelines?
Case where doctor gave contraception to an under 16 without parental consent.
Lord Fraser said the doctor could continue to give the contraception if…
