1. Domestic Abuse

2. How may children be affected?  It can pose a threat to an unborn child – domestic abuse often begins or intensifies during pregnancy  Children may get hurt in the crossfire  Children’s carer is injured  Domestic violence is emotionally damaging for children

3. Parental Mental Illness

4. Assessing Risk 1 Assessing Risk 1 When did you last see the children: Are levels of child care different during periods of illness? Child/adult relationships: What does the adult say about their relationship with the child? Social networks: Are there extended family support networks?

5. Assessing Risk 2 Assessing Risk 2 Provision of basic needs: Is there adequate food, clothing and warmth for the children? Safety within the home: Is all medication kept securely? Other: Does the family remain in one area, or move frequently? If the latter, why?

6.  6% total population of children under 18 Serious Case Reviews:  2003 – 2005:47% < 1year  2005 – 2007:46% < 1 year  2007 – 2009:45% < 1year Brandon et al (2010) Building on the Learning from Serious Case Reviews; DfE

7.  66 = Physical assault - many cases involved head injury thought to be linked to shaking.  19 = Sudden infant death/co-sleeping – parental alcohol or drug use a common feature, and cases also often in context of neglect.  5 = concealed pregnancies and unattended births.

8.  Dependant and pre-verbal  Highly susceptible to physical harm  Unable to recognise abuse  Impact of post-natal depression on physical and emotional care of infant  Meaning of child in relationship  Pre term even more vulnerable

9. Abuse of disabled children Abusers think it is safer to victimise a disabled child. Abusers are attracted to immature behaviour. Disabled children receive less information about abuse. May be less able to understand that behaviour is inappropriate. More dependent – need extra care.

10. Vulnerability of disabled children Vulnerability of disabled children May receive less affection from carers so are more accepting of sexual relationship as form of companionship (Kemp & Kemp). Less able to disclose: - due to disability - less social contacts - due to isolation - less likely to be believed - limited ability to communicate

13. 13 Categories of abuse Physical Emotional Sexual Neglect

14. 14 Physical Abuse “Physical abuse may involve hitting, shaking, throwing, poisoning, burning or scalding, drowning, suffocating, or otherwise causing physical harm to a child. Physical harm may also be caused when a parent or carer fabricates the symptoms of, or deliberately induces, illness in a child.” WTSC 2013

15. 15 Burn Accidental distribution

16. 16 Burn Non-accidental distribution

17. 17 Accidental fracture patterns in children