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ICA > Child safeguarding and child death reviews > Flashcards

Child safeguarding and child death reviews Flashcards

1
Q

What is child abuse?

A

Maltreatment of a child (<18yrs)
Infliction of harm or failing to act to prevent harm

Harm being defined as ill-treatment or impairment of health/development or legal justification for intervention into family life

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2
Q

What are the 13 categories of child abuse?

A

Bullying/cyberbullying
Child sexual exploitation
Child trafficking
Criminal exploitation and gangs
Domestic abuse
Emotional abuse
Female genital mutilation (comes under physical sometimes)
Grooming
Neglect
Non-recent abuse
Online abuse
Physical abuse
Sexual abuse

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3
Q

4 main categories of child abuse

A

Neglect
Physical - including fabricated or induced illness, FGM
Sexual
Emotional

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4
Q

What is neglect?

A

Persistent failure to meet a childs basic physical and/or psychological needs likely to result in serious impairment of the childs health/development

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5
Q

When can neglect start?

A

Can start in pregnancy as substance abuse

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6
Q

Examples of neglect

A

Failure to:
- provide adequate food, clothing, shelter (exclusion from home or abandonment)
- protect a child from physical and emotional harm/danger
- ensure adequate supervision (inadequate care givers?)
- access to medical care
- unresponsive to child’s basic emotional needs

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7
Q

What should you mark down on appointment if child does not attend?

A

WAS NOT BROUGHT - DNA suggests it is childs fault, repeated ‘was not brought’ can alert to signs of neglect

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8
Q

History signs of neglect

A

Recurrent non-attendance to appointments
Missed screening/immunisations
Faltering growth
Delay in development - esp speech and language
Recurrent infestations/infections/injuries
Poor attendance at school
History of injury suggesting inappropriate supervision

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9
Q

Examination findings suggesting neglect

A

Poor nutritional status/poor growth
Dental decay
Signs of recurrent/chronic infection or infestation
Dirty/unkempt/smelly

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10
Q

What can physical abuse involve?

A

Hitting
Shaking
Throwing
Poisoning
Burning/scalding
Drowning
Suffocating
Or fabricates symptoms/induces illness in child

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11
Q

History suggesting physical abuse

A
  • Lack of or inadequate explanation for injury
  • Delay in seeking medical attention/inappropriate response
  • Inconsistent accounts - on different occasions or between parent and child etc
  • Multiple risk factors present/family known to social care
  • Direct disclosure
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12
Q

Examination findings suggesting physical abuse

A

Unexplained bruising in vulnerable child
Unexplained fractures/burns/scalds/head injury
Patterns - of implement/bites
Injury not consistent with history/developmental age

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13
Q

What is sexual abuse?

A

Forcing or enticing a child/young person to take part in sexual activities, not necessarily involving high levels of violence, whether or not the child is aware of what is happening

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14
Q

What can sexual abuse involve?

A

Physical contact eg assualt by penetration or non-penetrative acts

Non-contact activities eg children looking at or producing sexual images, watching sexual activities, encouraging children to behave in a sexually inappropriate way

Can be online - and this can be used to facilitate abuse

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15
Q

Who can be a sexual abuser?

A

Anyone - even other children

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16
Q

What is child sexual exploitation?

A

An individual or group takes advantage of a power imbalance to coerce, manipulate or deceive a child/young person into sexual activity

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17
Q

What does child exploitation usually involve to try and coerce children?

A

Exchange of sexual activity for something the victim wants/needs

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18
Q

What can child exploitation involve regarding the perpetrator?

A

Can occur for financial advantage or increase of status of the perpetrator

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19
Q

Can child sexual exploitation sexual activity seem consensual?

A

Yes

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20
Q

Is child sexual exploitation always physical contact?

A

No - can also occur through technology

21
Q

History suggesting sexual abuse/child sexual exploitation

A

Disclosure
Pregnancy/signs of sexual activity in child under 13 (if under 13 this is classed as rape)
STIs
Anogenital injury/unexplained bleeding
Recurrent vaginal discharge
Soiling/wetting - previously dry and now not?
Behavioural change

22
Q

Examination for someone who is a suspected victim of sexual abuse/CSE

A

Immediate health needs must be treated first
Then referral to social care - will be forensically assessed at specialist Sexual Assault Referral Centre

23
Q

When does emotional abuse usually occur?

A

Alongside the other forms of abuse or alone

24
Q

Examples of emotional abuse

A

Rejecting
Isolating
Terrorising
Ignoring
Corrupting
Cyberbullying

25
Q

What is emotional abuse?

A

Persistent emotional maltreatment of a child causing severe and persistent adverse effects on the childs emotional development

26
Q

What can emotional abuse involve?

A

Conveying worthlessness/unloved/inadequate
Deliberately silencing or making fun of a childs voice
Imposing age/developmentally inappropriate expectations on children - overprotection/limiting social interaction or expecting too much

27
Q

History suggesting emotional abuse at each age range

A

Infants - feeding difficulties, crying, poor sleep patterns, delayed development, describing child in negative terms

Toddler/preschool - overactive to apathetic, noisy to quiet, developmental delay

School aged - wetting/soiling, relationship difficulties, poor school performance, non-attendance, antisocial behaviour

Adolescents - depression, self harm, substance misuse, eating disorders, aggressive

28
Q

Examination findings for emotional abuse

A

Growth - underweight
Emotional signs - non specific
Behavioural problems
Development - failure to achieve milestones, academic failure

29
Q

What are the risk factors for child abuse, including the triad of vulnerability?

A

Triad - domestic abuse, mental illness of parent/carer, parental drug/alcohol misuse

Under 2 years old
Pre-verbal babies and children
Additional needs/disability
Vulnerable/marginalised - eg in care, not in education

30
Q

What is the triad of vulnerability?

A

Domestic abuse
Mental illness of parent/carer
Parental drug/alcohol misuse

31
Q

Examples of adverse childhood experiences

A

Physical abuse + neglect
Sexual abuse
Emotional abuse and neglect
Domestic abuse
Mental ill-health
Incarceration
Substance misuse
Parental seperation

32
Q

What can ACE’s lead to long term?

A

Early death - increase risk of heart disease, cancer and diabetes in later life

33
Q

What can ACEs cause short term/into adolescents?

A

Disrupted neurodevelopment
Social, emotional and cognitive impairment
Adoptions of high risk behaviours and crime

34
Q

What should you do if you have concerns about a child?

A

Report to local authority - social care or MASH - multi-agency safeguarding group

35
Q

What do social care / MASH do once they have receieved your referral?

A

If they have reasonable cause to suspect a child is suffering or is likely to suffer significant harm they have a duty to make enquiries under Section 47(1) of the childrens act 1989

36
Q

Interventions and support for child victims and accessibility

A

Universal services - anyone can access

Early help - offered if parents are mentally ill, child with more needs

Child in Need - consent needed from family (section 17 childrens act 1989)

Child protection - consent not needed (section 47 children act 1989)

37
Q

Potential consequences of failing to detect and act on concerns

A

Children die

38
Q

Key learning from child safeguarding reviews for improvement

A

Interagency communication and information sharing

See bigger picture and have family focus - can normalise these situations when you work with them everyday

Listen to and see the child - rely too much on parental accounts

Follow up missed appts, and link incidents

Recognise abuse and know the process for escalation

39
Q

If a child discloses abuse or you are concerned about their welfare what should you do?

A

Don’t ask leading questions

Document what was said

Dont promise confidentiality

Talk immediately to one of the professionals you are working with

40
Q

Why do we review child deaths?

A

Establish cause of death (with coroner)

Identify contributory and modifiable factors

Provide support for family
Learn lessons to reduce risk of further deaths

41
Q

What is the process when a child dies?

A

There is immediate decision making and notifications

Investigation and gather information

Child death review meeting

Independent review at child death overview panel by child death review partners

Child death is added to national child mortality database to identify themes/see if can reduce risk

42
Q

Who is involved in child death review process?

A

Dr, nurses, manager, admin

Health and local authority funded

Immediate response is - health, social care, police

Review process involves everyone - hospital specialties, community specialists, GP, midwife, heath visitor, school nurse, hospice, nursery/school, social care, public health, police, educational psychology, ambulance, voluntary organisations

43
Q

Average cases of child death in leicester, leicestershire and rutland per year

A

70 - 2/3 expected, 1/3 unexpected

44
Q

Top 3 categories for child death

A

Perinatal/neonatal events
Chromosomal/genetic abnormalities
Sudden unexpected unexplained death

45
Q

Child death review example of steps:

A

Notification received from hospital
Joint agency response
Info gathered
Child death review meeting
Inquest - narrative verdict
Child death overview panel - finalise analysis, reduce risk of future deaths

46
Q

Hi, if you can please could you fill out this feedback form so I can improve this deck and know how helpful the cards are. You only need to fill it out once for all my cards. Thanks, Ella :)

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