Lecture 13 - Child Safeguarding

Question 1

What is child abuse?

Answer 1

The maltreatment of a child (<18yrs)
The infliction of haram or failing to act to prevent harm

Question 2

What is considered significant harm?

Answer 2

The ill-treatment or impairment of healthy or development giving hte legal justification for legal intervention in family life

Question 3

What are the categories of child’s abuse?

Answer 3

Physical abuse (FII)
Neglect
Sexual
Emotional

Question 4

What is included within physical abuse?

Answer 4

FII (fabricated or induced illness)
FGM

Question 5

What is definition of neglect?

Answer 5

The persistent failure to meet a child’s basic physical and or psychological needs likely to result in serious impariemrrent of the child’s health or development

Question 6

Can neglect happen to an unborn child?

Answer 6

Yes
Substance abuse in pregnancy

Question 7

What are some examples of neglect ?

Answer 7

Not providing adequate food, clothing,, shelter
Not protecting from physical and emotional harm
Not adequately supervising
Not providing medical care
Not responding to child’s emotional needs

Question 8

What is medical neglect?

Answer 8

Was not brought to medical attention

Question 9

If a child did not attend an appointment how should it be recorded?

Answer 9

Was not brought (NOT did not attend)

Question 10

What is the history of neglect?

Answer 10

Recurrent non attendance to appointment or non adherence to medication
Missed routine screening or immunisation
Faltering growth
Delay in development
Recurrent infections/injuries
Poor school attendance

Question 11

What are some examinations seen in neglect?

Answer 11

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

Question 12

What is physcial abuse?

Answer 12

Hitting, shaking, throwing, poisoning, burning or scalding, drowning suffocating or otherwise causing physical harm

May deliberately induce illness in a child or symptoms may be fabricated

Question 13

What is the history likely to be for physical abuse?

Answer 13

Lack of inadequate explanation for injury
Delay in seeking medical attention
Inconsistent accounts of events
Presence of multiple risk factors
Direct disclosure

Question 14

What examination findings are seen in physical abuse?

Answer 14

Unexplained bruising in vulnerable children
Unexplained fractures and injuries
Patterns (bites, sparing)
Injury not consistent with history

Question 15

What is sexual abuse?

Answer 15

Forcing or enticing a child or Young person to take part in sexual activities whether or not that the child is aware of what is happening

Can be physical contact or nnon contact like watching or producing sexual images

Question 16

What is child sexual exploitation?

Answer 16

Individual or group takes advantages of power imbalance to coerce, manipulate or deceive a young person into sexual activity in exchange for something the victim needs or wants or for financial advantages

Question 17

What is likely to be seen in child sexual abuse?

Answer 17

Disclosure
Pregancy/signns of sexual activity in children under 13yrs
STIs
Anogenital injury
Recurrent vaginal discharge
Soiling/wetting
Behavioural change

Question 18

What is likely to be seen on examination for child sexual abuse?

Answer 18

Immediate health needs are paramount
Referral to social care

Question 19

What is emotional abuse?

What are some examples?

Answer 19

Persistent emotional maltreatment oof a child causing severe and persistent adverse effects on the child’s emotional development

Present in all other types of abuse

Rejecting
Isolating
Terrorising
Ignoring
Corrupting
Cyber bullying

Question 20

What is seen in the history of emotional abuse?

Answer 20

Infants (feeding difficulties, poor sleep patterns, delayed development)

Toddler/preschool (behavioural spectrum from overactive to apathetic, noisy tt quiet)

School aged (wetting and soiling, relationship difficulties, poor performance in school)

Adolescents (depression, self-harm, substance misuse)

Question 21

What is seen in the examination of emotional abuse?

Answer 21

Growth
Emotional signs
Behavioural
Development

Question 22

What are the risk factors for child abuse?

Answer 22

Triad of vulnerability:
-domestic abuse
-mental illness or parent or carer
-parental drug and alcohol misuse

Question 23

Who does child abuse happen most commonly to?

Answer 23

Under 2s
Preverbal babies and children
Those with additional needs/disbaility
Vulnerable and marginalised young people

Question 24

What are some adverse childhood experiences?

Answer 24

Physical abuse and neglect
Sexual abuse
Emotional abuse and neglect
Domestic violence
Metal ill health
Incarceration
Substance misuse
Parental separation

Question 25

What is the step by step process if you are concerned about a child?

Answer 25

Refer to local authority (social care) If reasonable cause to suspect that a child is suffering or is likely to suffer significant harm local authorities make enquiries

Question 26

What act ensures the duty to make enquires into child concerns?

Answer 26

Section 47 of the children act 1989

Question 27

What are. Some intervention and support for families who are struggling?

Answer 27

Universal services (primary care etc.) Early help (may have child with additional needs)\ Child in Need (consent required) Child Protection (consent not required) the state intervenes

Question 28

Who is safeguardings repsonibility?

Answer 28

Everyone’s

Question 29

What do you do if you are concerned about a child’s welfare?

Answer 29

Don’t ask leading questions Document verbatim what was said Don’t promise confidentiality Talk immediatliye to one of the proffeisonals that work with h you so escalation can occur if necessary

Question 30

Why do we review child deaths?

Answer 30

To establish where possible cause or causes of child deaths To identify any potential contributory and modifiable factors Provide ongoing support to the family Improve nationally to reduce child deaths

Question 31

Who is Involved in the child death review process?

Answer 31

Health and local authorities found Team : designated Dr, nurses, manager, admins and all agencies involved in the child’s life

Question 32

What are the top 3 categories of child death?

Answer 32

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