5 - Safeguarding

Question 1

Define children in need.

Answer 1

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

Question 2

Define child protection.

Answer 2

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

Question 3

Define safeguarding children.

Answer 3

measures taken to minimise the risk of harm to children

• protecting children from maltreatment
• preventing impairment of children’s health or development
• ensuring children are growing up in a safe and caring environment

Question 4

Define child abuse and neglect.

Answer 4

Anything those entrusted to look after children do, or fail to do (neglect), which damages the prospects of the safe and healthy development of a child

Question 5

What elements must be present to constitute child abuse?

3

Answer 5

• significant harm to child
• carer has some responsibility for said harm
• significant connection between carer’s responsibility for child and the harm to the child

Question 6

What is GIRFEC?

Answer 6

• getting it right for every child
• named person for every child to be the point of contact regrading the child’s wellbeing
• shared approach to identifying concerns, recording and sharing information about the child

Question 7

What are the factor that allow a child to be “ready to succeed”?

Answer 7

• nurtured
• achieving
• healthy
• safe
• included
• responsible
• respected
• active

Question 8

What is the UNCRC?

Answer 8

• right to respect
• right to information about yourself
• right to be protected from harm
• right to have a say in your life
• right to a good start in life
• right to be and feel secure

Question 9

What are contributing factors to child abuse? (adult)

Answer 9

• drugs
• alcohol
• poverty
• unemployment
• marital stress
• mental illness
• disabled
• domestic violence
• step parents
• isolation
• abused a child (intergenerational cycle)
• unrealistic expectations
• violence towards pets

Question 10

What are contributing factors to child abuse? (child)

Answer 10

• crying
• soiling
• disability
• unwanted pregnancy
• failed expectations
• wrong gender
• product of forced or coerced sex

Question 11

What are contributing factors to child abuse? (community)

Answer 11

• dwelling place
• housing conditions
• neighbourhood

Question 12

What are the big 3 concerns in parenting capacity?

Answer 12

• domestic violence
• drug and alcohol misuse
• mental health problems

Question 13

What are the categories of child abuse?

Answer 13

• physical
• emotional
• neglect
• sexual
• non-organic failure to thrive

Question 14

Which children are most at risk of child abuse?

Answer 14

• under 5s
• irregular attenders
• medical problems and disabilities

Question 15

What is the effect of neglect of nutrition?

Answer 15

• failure to thrive
• short stature

Question 16

What is the effect of neglect of warmth, shelter and clothing?

Answer 16

• inappropriate clothing
• cold injury
• sunburn

Question 17

What is the effect of neglect of hygiene and health care?

Answer 17

• ingrained dirt (finger nails)
• head lice
• dental caries

Question 18

What is the effect of neglect of stimulation and education?

Answer 18

Developmental delay

Question 19

What is the effect of neglect of affection?

Answer 19

• withdrawn
• attention seeking behaviour

Question 20

What is the typical victim of neglect?

Answer 20

• child under 1yr deprived of food and drink
• older independently mobile child being inadequately supervised (preventable accidents)

Question 21

What are the short term effects of neglect?

Answer 21

• physical health
• emotional health
• social development
• cognitive development

Question 22

What are the long term effects of neglect?

Answer 22

• arrest
• suicide attempts
• major depression
• diabetes
• heart disease

Question 23

Define dental neglect.

Answer 23

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

Question 24

What effects can dental neglect have on a child?

Answer 24

• toothache, disturbed sleep
• difficultly eating or changed preferences
• absence from school
• teasing due to appearance
• severe infection, repeated antibiotics
• repeated XGA

Question 25

Describe wilful dental neglect.

Answer 25

After problems have been pointed out: - irregular attendance - repeated failed appointments - repeated late cancellations - failure to complete treatment - returning in pain at repeated intervals - repeated XGA

Question 26

What are the 3 stages of managing dental neglect?

Answer 26

- preventative dental team management - preventative multi-agency management - child protection referral

Question 27

Describe stage 1of managing dental neglect.

Answer 27

- preventative dental team management - raise concerns with parents - offer support - set targets - keep records and monitor progress

Question 28

Describe stage 2 of managing dental neglect.

Answer 28

- preventative multi-agency management - liaise with other professionals (health visitor, GP etc) to see if concerns are shared - common assessment framework (CAF) - check if child is subject to child protection plan - agree joint plan of action, reviewed at regular intervals - send letter to HV of children <5 to fail appointments

Question 29

Describe stage 3 of managing dental neglect.

Answer 29

- child protection referral - in complex or deteriorating situations - referral is to social services by phone then followed up in writing

Question 30

What are examples of physical abuse?

Answer 30

- over chastisement (cultural) - acute / compassionate (eg shaking) - chronic / pathological (way of life)

Question 31

Describe acute / compassionate abuse.

Answer 31

- typically spontaneous and uncalculated reaction - remorse usually felt, take appropriate action taken - child's needs are priority

Question 32

Describe chronic / pathological abuse.

Answer 32

- way of life - help is sought but not actively - no remorse - child's needs are not priority

Question 33

Where do accidental injuries typically occur?

Answer 33

- bony prominences - match the history and description - in keeping with the development of the child

Question 34

Where do non-accidental injuries typically occur?

Answer 34

- both sides of body - soft tissues - patterns - doesn't match description of injury - delay in presentation - untreated

Question 35

What are oro-facial signs of physical abuse?

Answer 35

- bruising to face (punch/slap/pinch) - bruising to ears (pinch/pull) - abrasions and lacerations - burns and bites - choking marks on neck (hand or cord) - eye injuries - hair pulling - fractures (nose>mandible>zygoma)

Question 36

What are intraoral signs of physical abuse?

Answer 36

- contusions - bruises - abrasions and lacerations - burns - tooth trauma - frenal injuries in nonmobile children

Question 37

What is expected of the dental team when referring a child to social services?

Answer 37

- observe - record - communicate - refer for assessment - NOT expected to diagnose abuse

Question 38

What happens after referral if the child is in immediate danger?

Answer 38

- child protection order - exclusion order - child assessment order - removal by police or authority of JP