The document discusses the importance of child protection, outlining various categories of child maltreatment including physical, sexual, and emotional abuse, as well as neglect. It addresses the risks and signs to look for in potential abuse situations and emphasizes the responsibility of professionals to report concerns while detailing the obstacles and fears they may face. Lastly, it provides guidelines for how to appropriately handle suspicions of maltreatment and whom to contact for support.

1. Does Child Protection Matter?WWW.CALL111.COM

2. OverviewWhy is child protection important?

3. What are the Obstacles to overcome?

4. Categories of Child Maltreatment

5. The Risk Group

6. Parent-child interaction

7. What do I do when I have concerns?

8. Whom do I speak to locally?

9. What can happen to you if you refer?

10. What will happen to the child if you do not refer?

11. How to reduce Your Risk

12. Assessment QuestionnaireStatastics

13. Reporting Sources of Abuse

14. Child MaltreatmentPhysical and psychological symptoms & signsMay present with more than one type of abuse May be observed in child-carer interactionsConcerns may arise before child is born

15. Categories of Child MaltreatmentPhysical abuseSexual abuseNeglectEmotional abuseFabricated illness (“Munchausen's by Proxy”)Mixture of the above

16. Abuse CycleTension BuildingCommunication breakdown, victim becomes fearful & feels the need to placate the abuser IncidentVerbal, emotional, physical abuse, anger, blaming, arguing, threats and intimidationHoneymoon PeriodIncident is “Forgotten” and no abuse occur. The calm phase ReconciliationAbuser apologise, give excuses, blames the victim, denies abuse occurred, say it wasn’t as bad as the victim claims

17. Perpetrators by Relationship to Victims

18. Who Are At Risk?History of physical or sexual abuse (as a child)Teen parentsSingle parentsEmotional immaturityPoor coping skillsLow self-esteemSubstance abuseKnown past history of child abuseLack of social support (community)Extended familyDomestic violenceMOD PersonalsLack of parenting skillsLack of preparation for the stress of a new infantDepression or other mental illnessesMultiple young childrenUnwanted pregnancyDenial of pregnancyPrematurity of child

19. Effects – Short & Long term

20. Obstacles to identify maltreatmentConcern about missing a treatable disorderFear of losing positive relationship with familyWrongly blaming a carerDivided loyalties to adult and childBreaching confidentialityPersonal safetyComplaints

21. Features of Physical MaltreatmentUnexplained bruising or petechiaePattern of bruisingHuman bite markUnexplained lacerations, abrasions or scarsUnexplained burns or scaldsUnexplained Oral, facial & head injuriesCold injuries / hypothermiaOne or more unexplained fractures

22. Non-Accidental : Accidental Injury

23. Suspicious BruisingIn a non mobile childShape of a hand, grip, stick, ligature, specific implement, etcMultiple or in clustersOn non-bony parts of the bodyAround the neck, wrists & anklesFacial bruising or retinal haemorrhages

24. Pattern of BruisingMaguire S; Arch DisChild EducPract Ed 2010;95:170-177©2010 by BMJ Publishing Group Ltd and Royal College of Paediatrics and Child Health

25. Think& Ask Why?

26. Suspicious Burns or ScaldsAbsent or unsuitable explanationBurns in a child who is not mobileOn the back of hands, soles, buttocks or backCigarette burns (usually on exposed areas)Solid object burns (iron, electric fire)Immersion burns of buttocks & legs

27. Pattern of ScaldingMaguire S; Arch DisChild EducPract Ed 2010;95:170-177©2010 by BMJ Publishing Group Ltd and Royal College of Paediatrics and Child Health

28. Cigarette Burns

29. Suspicious FracturesAbsent or unsuitable explanationFractures in non-mobile childrenMultiple fractures at presentationSpiral or metaphyseal fracturesFractures of different ages (including occult)Skull fractures in infants (boggy scalp swelling)Facial fractures

30. Other suspicious physical injuriesHead injuriesIntracranial (particularly < 3 years)Chronic or multiple sub-dural haematomasEye injuries & retinal haemorrhagesOral injuries teeth, torn frenulumSigns of spinal injuryUnexplained Intra-abdominal injuries

31. Features of Sexual AbuseUnusual sexualised behaviour pre-pubertalPersistent / recurrent genital & anal symptomsAnogenital warts (no vertical transmission)Genital, anal or perineal injuries & FB’sPersistent abdominal painConstipation without medical causeSTD in a child younger than 13 yearsHep B, HIV (no vertical transmission)Pregnancy in a child under 13 years

32. Features of NeglectPersonal HygieneSevere & persistent infestationsNutritionFailure to ThriveAnaemiaFailure to seek medical adviceFailure to administer prescribed medicationsLack of supervisionChild being left in unsafe living environmentInjuries

33. Features of Emotional MaltreatmentFearful or withdrawnLow self-esteem and severe mood changesAggressive or oppositional behaviourOver-friendliness to strangers

34. Parent-Child Interactions - Potential causes for concernDomestic Violence (including substance abuse)Negativity or hostility towards the childRejection or scapegoat of the childEmotional unresponsiveness towards the childInappropriate threats or discipliningExposure to frightening or traumatic experiencesManipulating child to fulfil adult’s needsCarer consistently prevents access to the child