Child protection

Question 1

Child protection

Answer 1

activity undertaken to protect specific children
who are suffering, or are at risk of suffering,
significant harm

Question 2

Safeguarding children

Answer 2

Measures taken to minimise risks of harm to children
-protecting children from maltreatment
-preventing impairment of children’s health/ development
Ensuring that children are growing up in a safe and caring environment

Question 3

Children’s rights - the law - article 19

Answer 3

Children should be protected from all forms of physical or mental violence, injury or abuse, neglect or negligent treatment, maltreatment or exploitation

Question 4

Children’s rights - the law - article 24

Answer 4

Children have a right to the enjoyment of the highest attainable standard of health and to facilities for the treatment of illness and rehabilitation of health

Question 5

Children’s wants

Answer 5

Not to do dangerous work
To have water
To play
To be looked after
To not be hurt by other people
To have friends
To go to school
To follow any religion you choose

Question 6

Children’s needs - assessment framework

Answer 6

Child’s developmental needs
Parenting capacity
Family and environmental factors

Question 7

Government guidance: emphasis on

Answer 7

Preventing abuse and neglect
Improving multi-agency working
Encouraging early intervention

Question 8

GDC Standards

Answer 8

You must find out about local procedures for the
protection of children and
vulnerable adults. You must follow these procedures if
you suspect that a child […] might be at risk because of
abuse or neglect

Question 9

Good practice guidance (5 points)

Answer 9

1. Responsibility
2. Recognising
3. Responding
4. Reorganising
5. Resources

Question 10

Dentists are well placed to recognise signs

Answer 10

Skilled at examining head and neck and
recording findings
Head and neck is frequently site of injury in physical abuse
Untreated dental decay may be a sign of neglect
Children often attend the dentist regularly
Often treat more than one family member

Question 11

Prevalence by age

Answer 11

Total = 43,140
Unborn = 2%
<1 = 11.3%
1-4 = 30.3%
5-9 = 28.7%
10-15 = 25.2%
>15 = 2.6%

Question 12

Prevalence by type

Answer 12

Neglect - 41%
Emotional abuse - 31.7%
Physical abuse - 11.7%
Multiple - 10.8%
Sexual abuse - 4.8%

Question 13

Definition of physical abuse

Answer 13

May involve hitting,
shaking, throwing,
poisoning, burning or scalding, drowning,
suffocation or otherwise
causing physical harm to a child
Also includes fabricated and induced illness

Question 14

How to recognise physical abuse

Answer 14

Bruising, abrasions, lacerations, burns, bite marks, eye injuries, bone #s, intra-oral injuries
Site, size, patterns
Delay in presentation
Does not fir the explanation given

Question 15

Accidental vs abuse: accidental head injuries

Answer 15

Head injuries tend to involve parietal bone, occiput or forehead
Nose
Chin

Question 16

Accidental vs abuse: accidental rest of body injuries

Answer 16

Palm of hand
Elbows
Knees
Shins

Question 17

Accidental injuries: remember that they typically

Answer 17

Involve bony prominences
Match the history
Are in keeping with development of the child

Question 18

Accidental vs abuse: abusive head injuries

Answer 18

Ears - especially pinch marks involving both sides of ear
“Triangle of safety” (ears, side of face, and neck, top of shoulders)
Black eyes, especially if bilateral
Soft tissues of cheeks
Intra-oral injuries

Question 19

Accidental vs abuse: abusive rest of body injuries

Answer 19

Inner aspects of arms
Back and side of trunk, except directly over the bony spine
Forearms when raised to protect self
Chest and abdomen
Any groin/ genital injury
Inner aspects of thighs
Soles of feet

Question 20

Abusive injuries: remember concerns are raised of

Answer 20

Injuries to both sides of body
Injuries to soft tissue
Injuries with particular patterns 
Any injury that doesn't fit the explanation
Delays in presentation
Untreated injuries

Question 21

Bruises suggestive of abuse

Answer 21

In non-mobile infants
Over soft tissue areas
Carry an imprint of an implement
Large, multiple and in clusters

Question 22

Can you age bruises accurately?

Answer 22

No

Question 23

Burns

Answer 23

Accidental scalds – spill injuries - irregular edge
Intentional scalds – immersion - glove or
stocking pattern
Accidental burns – child reaching to grab - palm of hand, often single
Intentional contact burns frequently multiple

Question 24

Fractures

Answer 24

Multiple fractures are frequently seen in
abused children
May present at different stages of healing
E.g. skull fractures, rib fractures

Question 25

Differential diagnosis

Answer 25

``` Birth marks Infections e.g. scabies, impetigo Unintentional injury Bleeding disorders Osteogenesis imperfecta ```

Question 26

Differential diagnosis

Answer 26

``` Birth marks Infections e.g. scabies, impetigo Unintentional injury Bleeding disorders Osteogenesis imperfecta Leukaemia ```

Question 27

Oral injuries

Answer 27

Accidental oral injuries are common Lips are commonest site of oral injury in abuse Any oral injury in a non-mobile baby is a concern Torn labial frenum can occur as a result of a blow to the face – either abusive or accidental

Question 28

Sexual abuse definition

Answer 28

Forcing or enticing a child or young person to take part in sexual activities, including prostitution, whether or not the child is aware of what is happening

Question 29

How to recognise sexual abuse

Answer 29

``` Direct allegation (disclosure) Sexually transmitted infection Pregnancy Emotional and behavioural signs e.g. anxiety and depression, self-harm, drug, solvent or alcohol abuse ```

Question 30

Definition of neglect

Answer 30

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 Includes failing to ensure access to appropriate medical care or treatment

Question 31

How to recognise neglect

Answer 31

``` Failure to thrive Short stature Inappropriate clothing Frequent injuries Ingrained dirt Developmental delay Withdrawn or attention seeking behaviour ```

Question 32

Short term impact of neglect

Answer 32

``` Emotional health Social development Cognitive development Physical health ```

Question 33

Long term impacts of neglect

Answer 33

``` Arrest Suicide attempts Depression Diabetes Heart disease ```

Question 34

Neglect can kill - typical victim and scenario

Answer 34

Child under 1yr deprived of food and drink | Older child inadequately supervised

Question 35

Impact of dental disease

Answer 35

``` Toothache Crying and stopping playing Disturbed sleep Difficulty eating or change in food preferences Absence from school Repeated antibiotics Dental general anaesthesia Lower body-weight, growth and quality of life Poor dental appearance Severe infection ```

Question 36

Definition of dental neglect

Answer 36

The persistent failure to meet a child’s basic oral health needs, likely to result in the serious impairment of a child’s oral or general health or development

Question 37

Assessment of dental neglect - features of particular concern

Answer 37

Obvious dental disease Impact on child Acceptable care has been offered, yet child is not receiving treatment

Question 38

Vulnerable groups - parental risk factors

Answer 38

``` Young parents Single parents Mental health problems Parents with learning difficulties Alcohol and drug abuse ```

Question 39

Vulnerable groups - social risk factors

Answer 39

``` Poverty Social isolation Poor housing Family housing Family violence Asylum seekers and refugees Homeless families ```

Question 40

Vulnerable groups - child risk factors

Answer 40

Babies and toddlers - physical abuse/ neglect Older chilren - sexual abuse Children with disabilities Children with behavioural problems Children looked after in residential or foster care Children missing from education

Question 41

Toxic trio

Answer 41

Domestic violence Mental health problems Alcohol and substance abuse

Question 42

Barriers to referral

Answer 42

``` Lack of certainty about diagnosis Dear of consequences to child from intervention Fear of violence to child Fear of violence to professional Lack of knowledge of referral procedures Fear of litigation ```

Question 43

Agencies involved

Answer 43

``` Children’s Social Care/Children’s Services (social services) Criminal justice (police and probation) Health Education (early years, schools, further education) Voluntary sector organisations (e.g. NSPCC, faith communities) ```

Question 44

Recognising - summary

Answer 44

``` Direct allegations Physical signs Pointers in the history Parent-child interaction The wider picture ```

Question 45

CCDH was not brought protocol

Answer 45

Look at