Child Sexual Abuse Hedgehogs Teachers Session 20 January 2010

1. Child Sexual Abuse Hedgehogs Teachers Session 20 January 2010 Leah Hilt Practice Manager For Referral and Assessment

2. Agenda • Legal Framework for Section 47 Child Protection Investigations • Recognition of abuse … what next ? • Making a referral to Children’s Social Care • The Child Protection Investigation • The CSA medical • Core assessment & Multi Agency input • Outcomes

3. Legal Framework Concept of Significant Harm • Children Act 1989 introduced the concept of significant harm as a threshold that justifies compulsory intervention in the best interests of children. • Giving Local Authorities a duty to make enquiries to decide whether they should take action. • No absolute criteria when judging what constitutes significant harm. • Single traumatic event or compilation of significant events

4. London Child Protection Procedures (3rd Edition) • Section 4.2.6 Sexual Abuse Sexual abuse involves forcing or enticing a child or young person to take part in sexual activities including prostitution whether or not the child is aware of what is happening. The activities may involve physical contact, including penetrative (e.g. rape, buggery or oral sex) or non-penetrative acts. They may include non-contact activities, such as involving children in looking at, or in the production of, pornographic material or watching sexual activities, or encouraging children to behave in sexually inappropriate ways.

5. Working Together to Safeguard Children ( DoE 2010) • Teachers & other members of school staff have key role to play in: • Creation and maintenance of a safe learning environment • Information sharing • Crucial role in helping identify welfare concerns; particularly early on • Contributing to Child Protection case conferences • For children who may have been abused or are at risk of being abused • Children are particularly vulnerable and their welfare is paramount • What to do If you’re worried a Child is being Abused

6. Recognition of sexual abuse • Direct allegation from child or adult Physical indicator’s: • Pregnancy • Unexplained or persistent pain, bleeding or unusual discharge in the vaginal or anal area • sexually transmitted infection • bowel disturbance/enuresis • foreign body in vagina/anus

7. Recognition of sexual abuse Behavioural Indicator’s • engage’s in inappropriate sexual play; or inappropriate sexual knowledge • Smear’s faeces • Has unexplained developmental setbacks eg; was toilet trained but reverts back • Forces or coerces another child to engage in sexual play • Is “secretive” about new friends or activities • Changes in school performance and attendance • non-specific expressions of distress • associated with other forms of abuse Many of the above will have other causes but CSA should be thought about

8. Immediate response • If an allegation has been made use non-directive questions: what, who, when , where? • Document responses verbatim • Consider immediate action : • child’s safety • Factors present that are indicators of the possibility of significant harm

9. Recognition of abuse ….. What next? • Careful assessment and discussion with agencies’ nominated Child Protection person. • Consultation with and/or referral to Children’s Social Care and/or the Police. • Inform parent of next steps unless that would put child at increased risk or jeopardise police investigation

10. Common Assessment FrameworkCAF • Family Details • Reason for Referral and Impact on child • Consent issues • What you think should happen • Remember this is your assessment; you know much about this child and family.

14. Child Protection Section 47 Investigation • Children Act 1989 Joint investigation with Police Child Abuse Investigation Team or SCD 2 – Sapphire Police Team • Strategy Discussion/Meeting • Need for CSA Medical ?forensic • Achieving Best Evidence Interview • Emergency Protection Order • Assessment Need • Multi-Agency – Paediatrician, School, GP, Police, Health Visitor etc

15. CSA medical • If CSA Medical: • forensic evidence possible, joint examination by paediatrician + Sexual Offences Examiner (Haven SARC) • Non-forensic examination at weekly CSA clinic Sunshine House • Accompanied by social worker or police • No physical findings does not mean no sexual abuse. • Support to child after medical

16. Achieving Best Evidence InterviewABE • Conducted by appropriately trained police officers and social workers (Child abuse investigation team) • Visually recorded interview • Purpose is gathering evidence for criminal proceedings and is the examination in chief of the child witness. • Takes place at the police station; interviews are planned and children are prepared in advance. • Accounts for child’s age and development • Goal is to obtain an accurate and truthful account • Child may still need to attend court • Recorded interview may be used in Children Services Proceedings

17. Examination Findings • Sexually transmitted infections • Pregnancy • Other injuries or behaviours may be associated but less specific • Diagnosis is not usually made on physical signs alone

18. Further reading • Recognising and responding to child maltreatment Gilbert R, Kemp A, Thoburn J, Sidebotham P, Radford L, Glaser D, Macmillan HL Lancet 2009 Jan 10;373(9658):167-80

19. The Core Assessment • Assessment Framework for Assessing Children and Families • Child Focussed • Multi Agency • Interconnected Domains/Impact on Child

21. Outcomes of Investigation and Assessment • Unfounded and No Further Action (NFA) – Agencies to monitor • Referral for ongoing support – CAMHS • Child Protection Case Conference – child subject to CP Plan • Section 20 – Child Looked After with parental consent • Section 31 – Child Looked After, Care Proceedings and shared parental responsibility with Local Authority.

22. Leah.Hilt @southwark.gov.uk 020 7525 1914 Referral and Assessment Duty 0207 525 1912 Duty Fax Number 0207 525 7992 Contact Details