Child protection

Question 1

Define child abuse

Answer 1

Child abuse or maltreatment constitutes all forms of physical and/or emotional ill-treatment, sexual abuse, neglect or negligent treatment, or exploitation, resulting in actual or potential harm in the child’s health or development.

Question 2

List the 5 different categories of child abuse

Answer 2

Physical Injury Physical Neglect Non-Organic Failure to Thrive Emotional Abuse Sexual Abuse

Question 3

List the different ways physical injury may be caused to a child

Answer 3

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 (known as Fabricated, sometimes Factitious) or Induced Illness.

Question 4

What are the alerting signs of physical injury in a child ?

Answer 4

Unexplained injuries, particularly if recurrent The explanation does not fit the injury Refusal to discuss injuries Untreated injuries, or delay in seeking treatment Excessive physical punishment Frequent attendance at A&E Departments

Question 5

What does physical neglect of a child constituting abuse involve ?

Answer 5

When a child’s basic physical/psychological needs are not being met. This can lead to an unhealthy child who may not develop properly. Neglect may also involve a failure to: Provide adequate food, clothing, shelter Protect a child from physical and emotional harm or danger Ensure adequate supervision Ensure access to appropriate medical care / treatment Neglect also includes when an adult or carer persistently encourages or allows a child to follow a lifestyle inappropriate to the child’s development needs. It will also include neglect of or unresponsiveness to a child’s basic emotional needs.

Question 6

What are the altering signs of physical neglect in a child ?

Answer 6

Constant hunger (stealing food) Tiredness / poor concentration Poor hygiene / poor or inadequate clothing Untreated medical problems Frequent lateness / unexplained absences from nursery/school Low self-esteem Poor peer relationships

Question 7

What is non-organic failure to thrive constituting abuse of a child ?

Answer 7

This is when a child fails to meet expected weight and growth norms. No hereditary or medical condition has been diagnosed. In its extreme form, children can be at serious risk from the effects of malnutrition, lack of nurturing and stimulation ==> greater susceptibility to serious childhood illnesses, failure to reach developmental milestones and reduction in potential stature.

Question 8

What are the alerting signs of non-organic failure to thrive in a child ?

Answer 8

Significant lack of growth Weight loss Hair loss Poor skin or muscle tone Circulatory disorders

Question 9

what does emotional abuse of a child constitute of ?

Answer 9

This is failure to provide for the child’s basic emotional needs It may involve conveying to children that they are: Worthless or unloved Inadequate or under-valued It can also include persistent hostility / rejection, lack of or inconsistent emotional warmth and love, wilful destruction or impairment of a child’s confidence, and scapegoating eg continually blaming the child. Emotional abuse may feature: Inappropriate expectations of the child Overprotection / limitation of exploration and learning Preventing child taking part in normal social interaction Seeing / hearing ill-treatment of another e.g. exposure to domestic abuse Serious bullying Causing a child to often feel frightened or in danger Exploitation or corruption of children.

Question 10

What are the altering signs of emotional abuse of a child ?

Answer 10

Significant decline in concentration Extremes of aggression or passivity Inability to make or sustain relationships Lack of understanding of social boundaries Self-harm Low self-esteem Compulsive stealing Running away

Question 11

What does sexual abuse of a child constitute of ?

Answer 11

Involves 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. Activities may involve physical contact, including penetrative or non-penetrative acts. May include non-contact activities, for example: Involving children looking at, or in production of sexual on-line images Watching sexual activities Encouraging children to behave in sexually inappropriate ways

Question 12

What are the strong indicators that a child may be experiencing sexual abuse ?

Answer 12

Pre-school age: Sexually explicit play and behaviour 6 - 12 years: Heightened sexual behaviour and arousal Avoidance of men or women (depending on gender of abuser) Older children: Sexually precocious behaviour and prostitution Starting to sexually abuse other children

Question 13

Anyone who knows or suspects that a child has suffered, is suffering or is at risk of abuse must make a child protection referral without delay - T or F?

Answer 13

True

Question 14

What should be done if you suspect abuse of a child ?

Answer 14

Question 15

What information should you record when worried about abuse of a child ?

Answer 15

Child’s details if known (full name, age, date-of-birth, address)

The date and time

Why you are concerned?

Is the child in immediate danger?

Are there any other children at risk?

Who do you think poses a risk to the child?

Why you think this person poses a risk?

Details (if known) of adults who have care of child

Record the name of the person to whom you are sharing the information/making a referral to

Question 16

What should you do if a child tells you something of concern (abuse)?

Answer 16

• Don’t promise confidentiality
• Accept what the child is saying
• Try not to react emotionally or to appear shocked as this may stop the child saying anything else
• Reassure them they were right to talk to an adult
• Record EXACTLY what the child says
• You must share this information with the core agencies

Question 17

After the intitial referral has been made about child protection concerns what is done ?

Answer 17

After the initial information gathering from agencies, a decision will be made whether to move to an initial referral discussion.

Question 18

What is the initial referral discussion (IRD) ?

Answer 18

The Initial Referral Discussion (IRD) is the first stage in a process of joint information sharing, assessment and decision-making about risk to children. It agrees a co-ordinated response by the 3 Core Agencies:

1. HEALTH
2. POLICE
3. SOCIAL WORK

These are the main features of the IRD:

• Initiated immediately by the Core Agency receiving a child protection referral
• Takes place before any agency proceeds with an investigation (except where emergency measures are taken)
• Welfare of the child is paramount
• The discussion includes consideration of other children who may be at risk, not only child who is subject of referral
• The discussion includes any key/significant adults who are involved/associated with the child

Question 19

During the initial referral discussion (IRD) what actions and decisions can be made ?

Answer 19

No Further Action or alternative action if child protection procedures are not required

Agreement on how the inquiry should proceed:

• Joint Investigation (Police and Social Work)
• Referral to Children’s Reporter
• Other Legal Measures (for example application to the Sheriff for a Child Protection Order.
• Roles and responsibilities assigned to named individuals.
• Medical Examination (discussion must take place with the paediatrician on call)

Question 20

Following the child protection investigation what may be carried out ?

Answer 20

A Child Protection Case Conference which is a formal multi-agency meeting where all of the professionals involved with the child / family share their assessments, including chronologies and risk assessments, and identify necessary actions to protect a child.

There are 4 Types of Child Protection Case Conference:

1. Initial - the first case conference held
2. Review - must be held at least 3 months from the initial case conference and at 6 monthly intervals thereafter until the child’s name is removed from the Child Protection Register
3. Pre-birth - held when there is concern about risk of harm to a child once born
4. Transfer - held when a child on the Child Protection Register moves from one local authority area to another

Question 21

If there is reasonable concern that a child may be at risk of significant harm this will ALWAYS override a professional or agency requirement to keep information confidential. Staff caring for adults should always ask whether there are dependent children at home.

True or false ?

Answer 21

True