Multi-Disciplinary Working & Safeguarding Flashcards
How common is emotional behavioural disorder (EBD)?
1 in 5 children in UK presenting with externalising or internalising behaviour
What is a healthy attachment cycle?
- Baby has a need and cries
- Needs met by PC
- Trust develops
- Secure attachment promoted
What is a disturbed attachment cycle?
- Baby has a need and cries
- Needs not met by PC
- Rage develops instead of trust
- Insecure or disorganised attachment is promoted
What domains do securely attached infants show optimal functioning in?
Emotional Social Behavioural adjustment School achievement Peer-related social status
80% of children who have a Child Protection Plan (CPP) in the UK have:
Disorganised attachment
Why is observing the relationship between the dyad important?
To identify attuned interactions and be able to identify the less than sensitively responsive interactions so early intervention can ensue
What 3 dimensions of interactional behaviour must be kept in mind when observing parent-infant interactions?
- Engagement: over-intrusiveness to unengagement
- Predictability: consistency and contingencies varying from predictable to unpredictable
- Genuineness: true and genuine to false and deceptive affect
What specific behaviours should be looked out for in the dyad?
- Mutual gaze i.e. looking at eachother
- Mutual and reciprocal vocalisations
- That in the interaction all engagement is balanced/equal
- How baby is positioned and if caregiver respects infants body
- Warmth/affection shared and if its noticeable
- Agenda of dyad and if its shared and not shewed towards care-giver
- Turn-taking and if its paced and reciprocal
- Mothers expression of empathetic understanding and mind-mindedness
- That babies self-soothing strategies are minimal
What is the most important time for building a childs optimal security and healthy brain development?
Conception-2 years (1001 critical days) because:
- Brain growth
- Synaptogenesis (experience-dependent)
- Attachment as bio-behavioural mechanism activated by anxiety so aim to reduce stress and restore security to enable secure attachment
What affect does maternal antenatal stress have on the baby?
Emotional state of mother can change filtering capacity of placenta so more cortisol can pass through to foetus which can be toxic for foetal brain and can adversely affect a no. of areas including the HPA axis responsible for setting the stress thermostat resulting in these children experiencing higher levels of stress throughout childhood into adulthood
What are the obstetric consequences of antenatal anxiety?
LBW/small for gestational age
Pre-term labour
Impaired blood flow or raised resistance index to foetus through maternal uterine arteries associated with IUGR and pre-eclampsia
Prenatal stress causes an increased risk of neurodevelopmental outcomes in 3-16 years. What are these?
Child emotional problems esp. anxiety and depressions
ADHD symptoms
Conduct disorder
How can parents move from unresolved to resolved?
They need the opportunity to address the issues from their childhood and help to learn how to understand the mental state of oneself and others to break the intergenerational transfer (ghosts in the nursery) of trauma and promote secure attachment
What is the probability of a abused parent NOT harming their child?
2/3rds
What does infant mental health problems affect?
Capacity of child from birth to form close relationships, manage and express emotions and explore the environment within the context of a parent/care-giver with the infant
What does it state in Good Medical Practice with regards to relationships with patients children and young people?
- Be aware of needs and welfare of children/young people when seeing parents/carers esp. if they represent a danger
- Safeguard and protect health and wellbeing of children/young people
- Offer assistance to children/young people if there is a reason to think their rights have been abused or denied
What does it state in the General Medical Council (GMC) state?
Effective communication between doctors, children/young people and parents is essential to provision of good care and allows you to find out what they want and need to know, issues important to them and opinions/fears about health/treatment
If you suspect a child may be the victim of abuse what is the next steps?
This over-rides duty of confidentiality to child/parent as we are obliged to act in best interest of child (if in doubt discuss with senior)
What is child abuse and neglect?
Forms of maltreatment which entails inflicting harm or failing to prevent harm for a child occurring in a family, institutional or community setting by those known to them or more rarely, strangers
What are the different types of abuse?
Physical (non-accidental injury (NAI)) Female genital mutilation (FGM) Munchausen syndrome by proxy (MSBP) Sexual Emotional Neglect
Often interact with eachother not existing in isolation
What does the Children Act include?
- Lord Laming report focusing on universal and targeted services
- Every Child Matters which is a green paper to protect and maximise the potential of children
- 5 outcomes for children
- Revised Children Act
What are the 5 policies of Every Child Matters?
Be healthy Stay safe Enjoy and achieve Make a positive contribution Achieve economic wellbeing
Whos responsibility in England is child protection?
Department for Education who issue guidance to local authorities with the most recent being “Working together to safeguard children” where Local Safeguarding Children’s Boards (LSCBs) use this guidance to produce their own procedures that should be followed by practitioners and professionals
What is the Local Safeguarding Children Board (LSCB)?
Statutory multi-agency body that replaced the Area Child Protection Committees to coordinate and lead child protection activities in an area and audit/review safeguarding and welfare promoting
