Risk Assessment and Decision Making Child protection, safeguarding

Whether a nurse, doctor, allied health professional, manager or clerical worker, the contribution of health service workers to the protection of children is crucial. The well-being of children and in some cases child’s life depends not only on professional vigilance and a willingness to consider the possibility of abuse but also on action taken in response to it. It depends on talking to the child, listening to what they say; sometimes believing things people think do not, could not or should not happen to children.
Ensuring the safety and promoting the welfare of children who are at risk of harm is not an easy undertaking. It is sometimes difficult to assess the significance of the information about a child, to gauge its seriousness and decide what to do next. It is easy to lose a sense of perspective and the focus on the child in an attempt to also take into account the needs of the parent, family and professional network. It is not necessary to be an expert in pediatrics or child abuse to have concerns about a child but following child projection guidance once abuse is suspected is a requirements for everyone, managers and clinicians alike. The protection of children is a responsibility that crosses all services and hierarchies. It places equal value on each person’s contribution to the process of protecting children, and its guidance is designed to inform everyone working in health service as well as workers in other agencies. (Judy Barker and Deborah hodes 2007).

Child abuse and neglect occur across all socioeconomic, religions and ethnic groups. No one single source can be identified (Finkelhor & Korbin 1988.)
However, because many occurrences of child abuse and neglect go unreported or undetected, official figures do not necessarily state the true incidence. They tend to reflect on what State government agencies are doing. ( James, M.1994).
There is a lack of consistency in how ‘neglect’ is defined. Several definitions of neglect have been proposed. Most commonly they emphasise that a child’s basic developmental needs have not been met by acts of omission by those responsible for that child. In contrast, abuse is associated with acts of commission resulting in harm to the child. Usually neglect is categorised into physical, emotional, supervisory, medical and educational neglect with several sub-categories for each type. Greater specificity of definition is hampered by debates about what constitutes basic developmental needs and the level of care considered adequate to meet these needs. Definitions are further qualified by debates about actual harm, potential harm, impaired development, social conditions, cultural beliefs, levels of chronicity and severity and the intent of caregivers. Neglect is the most common form, and also the fastest growing category, of maltreatment in Canada, United States and the United Kingdom. In Australia overall rates of neglect appear lower. However, definitional differences make international and interstate comparisons in Australia, difficult. (Dr Johanna Watson 2005).
Recently there has been an increase in public awareness of the intricacy of all of the issues connected with child abuse and neglect, as well as a realisation of the complexity of the responses required. Much of this is due to increased television, radio and newspaper coverage of the topic as well as specific mass media campaigns.
The professional community, however, continues to recognise that child emotional abuse and child neglect can be just as damaging as child physical abuse and child sexual abuse. There is, therefore, a concern to understand both how best to respond to the issue and what can be done to prevent all types of child abuse and neglect from ever occurring in the first place. The long-term nature of the problem and the difficulties in finding solutions has led to the search for more refined responses which involve a range of activities and support programs (Calvert et al. 1992). This needs to involve an interdisciplinary perspective and extend across the community in order to protect abused children and bring about change in their families (Untalan and Mills 1992).
Decision-making takes place all the time; it toggles between small and large, slight and most important, compound and simple, tense and easy, multi-agency or single practitioner (Mantell, 2009) .

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