Definition CSE
- A form of CSA (child sexual assault).- An individual or group take advantage of an imbalance in power to coerce manipulate or deceive a child or young person <18y into sexual activity in exchange for something the victim wants / needs.
- and/or for the financial advantage or increased status of perpetrator or facilitator.
- victim may have been sexually exploited even if appears consensual
- can occur through use of technology
One of the key factors - some sort of exchange: sexual activity in return for something (including intangible rewards such as affection or status)
Definition of child sexual abuse
Involving, forcing or enticing a child or young person to take part in sexual activities, not necessarily involving a high level of violence, whether or not the child is aware what is happening
Age of consent to sex
16 years old
Is sexual activity <16y unlawful?
Yes, though court unlikely to prosecute consensual sex in 2 young people / peer to peer
What ages does CSE include
<18y
Although age to consent to sex is 16y, <18y are legally a child and CSE can include young people up to the age of 18y.
Ways in which CSE can occur
- Peer on peer CSE/Gang activity and county lines
- Groups of adults abusing young people
- Online abuse
- Inappropriate, sexually exploitive relationships
- Trafficking
- Abuse through commercial CSE
Indicators for CSE
- Frequently missing from home
- unexplained items
- self harming
- gang association
- trafficked person
- reduced contact with family and friends
- sexual activity with someone older
Spotting the signs - physical
- Late presentation of untreated injuries or illnesses
- self harm
- unexplained injuries
- rapid change in appearance
- revolving door with A&E or police
- repeated STIs and frequent testing
- PID
- repeat pregnancy
- alcohol / drug use
- physical injuries
Spotting the signs - psychological
- Psychological health problems
- suicidal ideation
- multiple personality disorders
- dissociation
- depression
- sleep disorders
- eating disorders
- PTSD
- alcohol or drug use
- self harming
- low self esteem
Spotting the signs - behavioural
- running away / missing
- inappropriate sexual behaviour
- repeated absence from school
- unemployment
- criminal behaviour
- lethargy
- bullying
- suicide attempts
- self blame
- disruptive behaviour
- homeless
- chaotic life
- isolated from family and friends
- secretive
- attached to phon
Explaining confidentiality to a young person
It is important to explain the limits of confidentiality to a young person at the beginning of any interaction.
Explain you won’t talk to anyone without their permission unless they or someone else in danger.
7 Caldicott principles
- don’t use confidential data unless absolutely necessary
- justify the purpose - must be appropriate
- use the minimum necessary personal confidential data
- access to personal confidential data should be on a strictly need-to-know basis
- make sure everyone with access to personal confidential data is aware of responsibilities
- comply with the law
- duty to share info is as important as duty to protect confidentiality
According to GMC guidance - when is disclosure without consent justified?
- patient does not have sufficient understanding to appreciate what advice or treatment being sought may involve
- patient cannot be persuaded to involve an appropriate person in the consultation
- in the doctors belief, be essential to the best medical interests of the patient
Doctor can breach confidentiality when all these conditions are met
Who to refer to if you suspect child maltreatment?
One of:
- Local child social services
- Police
- NSPCC
These have statutory child protection powers to act immediately to secure safety of the child.
Consider safety of other children eg siblings
Type of child maltreatment
- Neglect
- Emotional abuse
- Sexual abuse
- Physical abuse
- Fabricated or induced illness
What is a child protection plan?
For children perceived to be at risk of ongoing harm
- assess the likelihood of child suffering harm and look at ways to protect child
- decide on long and short term goals to reduce risk of harm and protect the child
- clarify responsibility of each involved person and actions to be taken
- outline how the process will be monitored and evaluated
What is a child protection register?
Contains confidential details of
Children at continuing risk of abuse or neglect and / or for whom there is a child protection plan
What is a local safeguarding children board?
A local authority body responsible for coordination and monitoring of effective multi-agency working as required by section 13 of the Children Act 2004
