Safeguarding Flashcards
What is neglect?
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
Examples of neglect
Substance misuse in pregnancy
Failing to provide adequate food/shelter/clothing/protection from danger and abandonment
Failing to ensure adequate supervision
Failing to provide appropriate medical care
Failing to respond to child’s basic emotional needs
Possible indicators of neglect
Dirty bedroom, no sheets on bed, inappropriate sleeping place
Being tired all the time
Being unkempt, dirty or smelly
Frequently missing school or being late
Failing to keep medical appointments
A baby who never cries
Loss of weight or constantly being underweight
Dressed inappropriately for the weather conditions
Learning disabilities due to poor brain development
Psycho-social development, depression, psychiatric illnesses and personality disorders
Untreated medical conditions
Being left unsupervised regularly
Examples of physical abuse
Shaking Throwing Poisoning Burning/scalding Drowning Hitting Suffocating
When are non-accidental injuries suspected?
Injuries to both sides of the body Injuries to soft tissue Injuries with particular patterns An injury that doesn’t fit the explanation given Delays in presentation Untreated injuries Bruising on pre-mobile babies
Areas of non-accidental injury
Ears- pinch marks Triangle of safety: ears, side of face, neck, top of shoulders Soft tissues of cheeks Black eyes Intra-oral injuries Forearms when raised to protect self Chest and abdomen Any groin or genital injury Inner aspects of thighs Soles of feet
Physical indicators of physical abuse
Unexplained injuries
Untreated injuries
Injuries on parts of body where accidental injury is unlikely
Hand or finger-marked bruising; cigarette burn or bite marks
Scalds, esp. with upward splash marks, or rings where made to sit or stand in very hot water
Broken bones
Behavioural indicators of physical abuse
Reluctant for parents to be contacted Aggressive behaviour and temper Child who shoes fear of going home or runs away Child flinches when approached/ touched Reluctance to get undressed for sporting activities Covering arms/legs even when hot Depression Overly compliant to parents/carers
Sexual abuse is forcing or enticing a child to take part in
Physical contact including penetrative and non-penetrative acts
Sexual activities, including prostitution, whether the child is aware of what is happening or not
Non-contact activities including children looking at or being involved in the production of pornographic material, watching sexual activities, encouraged to behave in sexually inappropriate ways, and verbal sexual abuse
Physical indicators of sexual abuse
Pain, itching, bruising or bleeding in genital or anal areas
Any STI
Recurrent genital discharge or UTI without apparent cause
Stomach pains
Discomfort when child is walking or sitting down
Pregnancy
Bowel prblems, enuresis
Rectal/vaginal discharge or bleeding
Any child in close proximity with an adult identified as a risk to children
Behavioural indicators of sexual abuse
Sudden unexplained changes in behaviour
Apparent fear of someone
Being sexually coercive with other children
Nightmares or bed wetting
Self-harm, self-mutilation, suicide attempts, abuse of drugs/alcohol, eating problems
Sexualised behaviour or knowledge, drawings, language
Running away from home
Emotional abuse
Persistent emotional ill-treatment of a child causing severe and persistent adverse effects on child’s emotional development
Conveying that children are worthless/unloved
Imposing age-inappropriate expectations on children
Seeing/hearing the ill-treatment of another
Serious bullying
Exploiting and corrupting children
Physical indicators of emotional abuse
Failure to grow or to thrive, child thrives away from home
Sudden speech disorders
Delayed development, either physical or emotional
Behavioural indicators of emotional abuse
Compulsive nervous behaviours such as hair twisting or rocking
An unwillingness or inability to play
Excessive fear of making mistakes
Self-harm or mutilation
Excessive deference towards others, especially adults
Excessive lack of confidence, and need for approval, attentions and affection
Inability to cope with praise
What are some specific types of violence towards children?
Honour based violence Forced marriage Trafficking Prostitution Domestic servitude Spirit possession Female genital mutilation
Factors which raise concern
Parent (and/or child) misusing alcohol or drugs
Domestic abuse within the household
Parents with learning difficulties and/or mental health problems
Children with disabilities
Grooming and sexual exploitation (including online)
Teenage pregnancy and parenthood
Child trafficking
Highly mobile families and families without recourse to public funds
Bullying
Female genital mutilation
Self-harming behaviours
Response to concerns
Observe
Record
Share: speak to designated child protection officer, lead professional, key worker, allocated social worker
Protect: monitor, discuss with parents, share information
Refer
My Responsibility
Recognise
Report: document, use child/carer’s words, write in detail
Refer
Child risk factors for abuse
Being unwanted Prematurity Children under 4 Crying persistently Unable to meet parental expectations Chronic ill health Low birth weight Disability
Adult risk factors for abuse
Criminal activity Learning disability Alcohol misuse Own child abuse Drugs Lack of social support Post-natal depression Mental illness Financial difficulties
DD of bruising
Bleeding disorder Birth marks: Mongolian blue spot, capillary haemangioma, congenial melanocytic naevi Vasculitis disorders Infection: meningocccal septicaemia, HSP Drug related: NSAIDs Erythema nodosum Malignancy Striae Contact dermatitis
Need FBC and coagulation screen
DD of fractures
Birth injury (clavicular fracture) Infection (osteomyelitis) Malignancy Osteogenesis imperfecta Nutritional- vitD deficiency Copper deficiency
Full skeletal surgery
CT scan
Bone biochemistry
Presentation of physical abuse in <2
Investigations needed
Full skeletal survey
CT head
Expert opthalmological examination
Coagulation screen
Types of neglect
Medical: unimmunised, failure to attend appointments, poor compliance with medication, failure to seek appropriate and timely medical advice
Nutritional: faltering growth, obesity due to failure to control diet and lifestyle
Emotional
Educational: poor school attendance
Physical: inadequate hygiene, severe and persistent infestations/infections, inappropriate clothing for child’s size and weather
