22 February 2017 09:10

A new draft guideline will help more professionals who work with children recognise and respond to any form of abuse and neglect.

Professor Corinne May-Chahal, a leading researcher in child protection at Lancaster University, is chair of the committee developing the draft guideline, out for public consultation, which presents information on how professionals working with children outside health settings, such as social workers, teachers and police officers, can spot the signs of abuse or neglect.

The guideline, from the National Institute for Health and Care Excellence (NICE), also highlights how to handle newly recognised forms of abuse such as female genital mutilation (FGM), sexual exploitation, child trafficking and forced marriage.

The draft recommendations call on all professionals who work with children to:

  • Make sure children feel like they have been listened to, with discussions recorded in a way they understand and are comfortable with;
  • Speak to colleagues from other organisations so children, and their parents or carers, do not have to repeat their concerns;
  • Think critically and use their professional judgement and not just rely on formal protocols;
  • Follow up on any referrals they have made to make sure action has been taken.

Professor May-Chahal said: “Our awareness of the different forms of child abuse and neglect is developing all the time but it is difficult for professionals to keep track of the best ways to assess abuse and intervene effectively. This guideline is important as it will help professionals spot the warning signs and then focus on what early help and interventions can be provided.

“The guideline gives examples of soft signs, the behaviours or emotions a child is exhibiting, which could indicate something may be wrong. These may not always be proof of abuse or neglect taking place, but they underline when to check on a child’s wellbeing. It also provides further context on stronger signs that should trigger professionals to take a more in-depth look at the child’s circumstances and welfare.”

NICE has already produced guidance for health professionals on recognising common signs of maltreatment.

This new guideline will provide practical advice for anyone who works with children outside health settings, including social care professionals and staff working in education or custodial settings.

It differentiates which physical and emotional behaviours indicate possible abuse or neglect and which should raise serious concern.

Recommended indicators described as ‘consider’ as potential signs of abuse may have another explanation for the child’s state.

It says staff should look at these soft signs and make judgements based on what they know about how each child usually behaves and whether it differs from what would be expected for their age. For example staff should consider abuse if a child has frequent rages at minor provocation, excessive clinginess, low self-esteem and recurrent nightmares.

Indicators described as ‘suspect’ abuse, should signal a more serious level of concern. These, which should not be seen as absolute proof but mean further investigation is needed, include a child regularly arriving at school unclean or with injuries, overtly sexual behaviours in children who haven’t reached puberty and parents carrying out excessive physical punishment.

Professor Gillian Leng, the Deputy Chief Executive at NICE, said: “Anyone working with children has to play their part in responding to abuse or neglect. Our previous guidance for this area focused on health professionals. Now we want to help staff outside of hospitals recognise when a child may be at risk of harm.

“We want all professionals to be aware and recognise when they need to ask questions or follow up with colleagues about a child’s wellbeing. Not all cases will cause concern but if we do not ask, we may miss opportunities to protect children in their time of need.

“This guideline will sit alongside existing statutory guidance providing important context on what works to help vulnerable children in the aftermath of abuse or neglect. Our committee looked at the best available evidence and have made recommendations on suitable therapies and approaches for helping children as well as their parents or carers.”

The draft guideline says that when assessing children, staff should collect information on all significant adults in their life such as parents, carers or siblings. These people should be involved in any plans, unless they are under investigation for inflicting the harm.

It also describes using drawings to help very young children understand discussions or, in trafficking cases, using interpreters from outside the community that exploited them.

The recommendations also describe how social care services should help families showing possible signs of abuse of neglect. It says to consider home visits for at least six months. If parents or carers need educational programmes these should cover anger management and addressing negative beliefs about themselves or their child.

The guidance states that, as a minimum, children who have suffered abuse or neglect should be given a safe place to stay and referred to appropriate support services.

Professor Leng added: “We now want feedback from people working to keep children across the country protected from harm. We will consider all views as we prepare the final guideline to make sure we have the right approach for improving how we respond to child abuse or neglect.”

The public consultation on the draft guideline will run until Wednesday 19 April. The committee will meet again in May to consider comments that were submitted. The final guideline is expected to publish in September.