National Institute for Health and Clinical Excellence (NICE)
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Responding to child abuse and neglect - a view from NICE

Children who have experienced abuse or neglect could be offered therapy and their parents given the chance to take part in family support programmes.

A new guideline, from NICE, aimed at professionals who may come into contact with children, gives advice on what to do when faced with child neglect or abuse.

For social workers and other specialist professionals supporting children to recover after abuse or neglect, the guideline sets out the most effective approaches. It details a range of talking therapies and parenting programmes that should be used depending on the child’s age and the type of abuse suffered. Children and their families should be given a choice of proposed therapies if possible.

One of these could be attachment-based interventions which focus on improving the relationships between young people and carers or parents. This often means helping the carer to respond more sensitively to the child. Alternatively, child-parent psychotherapy could also be considered when a child has been exposed to domestic violence.

The guideline also includes some recommendations for senior managers and service providers. It says they should plan services that will allow children and their families to work with the same people over time.

Professionals such as teachers, police officers and others working with children outside hospitals, should act on their suspicions if they think a child is at risk or they suspect abuse or neglect has already taken place, the guidance says.

If the child is deemed to be at immediate risk of harm, then professionals should immediately contact police. But if not then the professionals should contact children's social care.

Early help can be provided by GPs, social workers or health visitors. It should include practical assistance, such as help to attend appointments and emotional support.

The guideline also calls on services to ensure they have processes in place to respond to newly recognised forms of abuse such as female genital mutilation (FGM), sexual exploitation, child trafficking and forced marriage.

The guideline is based on the best available evidence and draws on expert testimonies. It gives guiding principles for approaching and responding to each child, and their family or carers.

The committee talked to a group of children and young people who have personal experience of abuse or neglect.

NICE encourages staff to listen carefully to children and their families, and to act on their suspicions. They should tailor their language to the child's level of understanding and employ other methods that children may be more comfortable with. For example, it suggests using drawings with very young children or providing interpreters.

The guideline lists the signs professionals should be aware of, which may suggest abuse or neglect is happening.

These include recurring nightmares and children arriving at school injured and persistently unclean. It gives details of appropriate action to take to help those involved.

It says staff should make sure children know they have been listened to and that they understand and are comfortable with discussions. It encourages professionals to speak to colleagues in other organisations if they have concerns so that children, and their parents or carers, do not have to repeat difficult conversations.

The guidance calls on staff to use their judgement and to follow up to make sure action has been taken.

The guideline describes how to assess the level of risk and what help should be given early on. This includes seeing how a child behaves with and without their parents or carers around them.

It says staff should find out about all significant adults in a child’s life such as their parents, carers or siblings. These people should be involved in any plans, unless they are under investigation for inflicting the harm.

The guideline sits alongside existing legislation and statutory guidance on safeguarding children, produced by the Department for Education, and professional guidance, providing important context on what works to help vulnerable children and their families.

Read the NICE guideline on handling and responding to child abuse and neglect here

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