Safeguarding Children

Question 1

What is child protection?

Answer 1

Activity undertaken to protect specific children who are suffering, or are at risk of suffering from significant harm.

Question 2

Who are the “children in need”?

Answer 2

Those who require additional support or services to achieve their full potential.

Question 3

What are the 3 main measures taken to safe guard children?

Answer 3

• Protecting children from maltreatment
• Preventing impairment of children’s health or development
• Ensuring that children are growing up in a safe and caring environment.

Question 4

What is child abuse and neglect?

Answer 4

Anything which those entrusted with the care of children do, or fail to do, which damages their prospects of safe and healthy development into adulthood.

Question 5

What 3 elements all must be present in child abuse?

Answer 5

Significant harm to the child
Carer has some responsibility for that harm
Significant connection between carer’s responsibility for child and harm to child.

Question 6

What is the children’s and young people’s act 2014?

Answer 6

It has 4 major themes- children’s rights, getting it right for every child, early learning and childcare and “looked after” children.

Question 7

What are 4 contributing factors of child abuse?

Answer 7

Adult, child, community/environmental and family violence/dysfunctional family.

Question 8

What are the big 3 concerns for parenting capacity?

Answer 8

Domestic violence
Drug/alcohol misuse
Mental health problems.

Question 9

What are the 5 child abuse categories?

Answer 9

Physical
Emotional
Neglect
Sexual
Non-organic failure to survive.

Question 10

What children are classed as vulnerable?

Answer 10

Under 5’s
Irregular attenders
Medical problems and disabilities.

Question 11

How many visits should a child get from a health visitor/nurse during the first couple years of life?

Answer 11

11 home visits to all families (8 within the first year of life and 3 child health reviews between 4-5 years).

Question 12

What is neglect?

Answer 12

Neglect is a signifiant and under-recognised problem which affects the wellbeing of many children; agencies and their staff need additional professional support in the assessment and intervention with such children and young people. Acentre for children’s wellbeing should include a focus on research and on developing a range of interventions that will be effective.

Question 13

What are some effects of neglect on a child?

Answer 13

Failure to thrive
Inappropriate clothing
Ingrained dirt
Dental caries
Withdrawn or attention seeking behaviour.

Question 14

What are examples of short and long term damage to a child from neglect?

Answer 14

Short= physical, emotional, social and cognitive development.

Long= arrest, suicide attempts, major depression, diabetes and heart disease.

Question 15

What is the definition of dental neglect

Answer 15

The persistant failure to meet a child’s basic oral health needs, likely to result in the serious impairment of a child’s oral or general health or development.

Question 16

What can severe dental disease do to a child that is neglected?

Answer 16

Toothache
Disturbed sleep
Difficulty eating/change in food preferences
Absence from school.

Question 17

Dental disease may put a child at risk of…

Answer 17

Teasing due to poor dental appearance
Repeated antibiotics
Repeated general aesthetic extractions
Severe infection.

Question 18

What are indicators of dental neglect?

Answer 18

Obvious dental disease
Impact on the child
Practical care has been offered but the child has not returned for treatment
Repeated GA for dental extractions
Irregular attendance.

Question 19

What are the three stages of managing dental neglect?

Answer 19

Preventative dental team management
Preventative multi-agency management
Child protection referral.

Question 20

What happens during stage 1 of managing dental neglect?

Answer 20

Raise concerns with parents, offer support set targets, keep records and monitor progress.

Question 21

What happens during stage 2 of managing dental neglect?

Answer 21

Liase with other health professionals
A child may be the subject of a CAF (common assessment framework) at this level
Check if child is subject to a child protection plan
Agree joint plan of action, review at agreed intervals

Letter to HV of children under 5 who fail appointments and have failed to respond to letter from dental practice.

Question 22

What happens during stage 3 of managing dental neglect?

Answer 22

In complex situations
Follow local guidelines
Referral to social services (telephone then followed up in writing).

Question 23

From what date is it illegal to physically punish a child?

Answer 23

7th November 2020.

Question 24

What are types of injuries a child can get from physical abuse?

Answer 24

Head (95% of serious head injuries in first year of life)
Body (10% of 5 year olds attending A&E)
10-12% of childhood burns are non-accidental.

Question 25

Name some accidental and non-accidental injuries?

Answer 25

Accidental- injuries to forehead, elbow, palm of hand, shins and knees etc- usually bony prominences and match the history. Non-accidental- triangle of safety injuries, soft tissues of cheek, intra-oral, chest, abdomen, soles of feet, groin, inner aspect of arms and back/side of trunk- concerns raised by untreated injuries, injuries to soft tissue, any injury that doesn't fit the explanation or injuries to both sides of the body.

Question 26

What are extra oral signs of physical abuse?

Answer 26

``` Bruising of face/ears Abrasions and lacerations Eye injuries Hair pulling Fractures Neck- choke or cord marks Burns and bites. ```

Question 27

What are major clinical features of physical abuse?

Answer 27

Skin lesions- bruises/bites/lacerations Bone lesions- fractures Intracranial lesions- from shaking Visceral lesions- blunt trauma.

Question 28

What is tattoo bruising?

Answer 28

Bruising in the shape of the instrument that has caused it.

Question 29

What are intra oral signs of physical abuse?

Answer 29

``` Contusions Bruises Abrasions/lacerations Burns Tooth trauma Frenal injuries. ```

Question 30

How can you identify is an adult has bitten a child?

Answer 30

The inter canine width is greater in adults than in children.

Question 31

When would you be suspicious of a frenal injury?

Answer 31

When the child is immobile.

Question 32

What are medical equivalents of extra oral lesions?

Answer 32

Impetigo (similar to cigarette burns) Birthmarks (mistaken for bruises) Facial infection (mistaken for trauma) Coagulation problems (bruise easily).

Question 33

What things can make you suspicious of child abuse?

Answer 33

``` Delay in seeking help Story vague and lacking in detail Story changing every time Account not compatible with the injury Parents mood or behaviour abnormal Child's interaction with parent is abnormal History of previous injury History of violence within the family. ```

Question 34

What are some final checklist observations for physical abuse?

Answer 34

General demeanour of the child Nature of the relationship between guardian and child Child's reaction to other people The reaction of a child to dental observation Any comments by the child/guardian that give concern about the child's upbringing or lifestyle.

Question 35

How can a dentist help with child neglect/abuse?

Answer 35

Share concerns with named person Know where to go for help and advice (telephone initially then follow up in writing when referring) Know contact names and numbers ALL CONTACT DETAILS ARE ON THESE SLIDES!!!

Question 36

What happens after you refer a child?

Answer 36

If they are in immediate danger there might be: a child protection order, exclusion order, child assessment order or removal by police or authority of a JP If not in immediate danger- investigation takes place, initial assessment and discussion THEN a joint investigation in Scotland.