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NICE Releases New Guidance on Child Abuse and Neglect

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The National Institute for Health and Care Excellence (NICE) has recently released guidance to be considered by all practitioners working with children and young people under the age of 18, including social workers, healthcare professionals and lead professionals in roles such as education.

The aim of the guidance is to assist practitioners working with children and young people to recognise the signs of abuse and neglect, carry out assessments, action interventions and provide assistance to the children, young people and their families and carers.

Behavioural and emotional indicators of abuse

At present, much reliance is placed on the child or young person reporting the abuse they have suffered from, in order for the relevant authorities and practitioners to act accordingly. Practitioners are asked to bear in mind that a child or young person, who has been the victim of abuse, may not feel able to speak about it. They may feel ashamed by what has happened, be afraid of confiding in someone for fear of the consequences of doing so, or they simply may not understand that what has happened to them amounts to abuse or neglect.

The focal point of the NICE guidance is to seek to assist in identifying signs that may be indicative of abuse. Practitioners are advised as to when they should consider abuse (recognise that abuse may be an explanation for an alerting feature) and when they should suspect abuse (hold a serious level of concern that abuse has occurred, but there no proof of it).

Abuse should be considered a possibility if a child or young person displays ‘a marked change in behaviour or emotional state’  or ‘repeated, extreme or sustained emotional responses’ that differ from what is to be expected from someone of their age and emotional state.

Some examples of the identified signs include:

  • Extreme distress;
  • Being fearful or withdrawn;
  • Recurrent nightmares;
  • Excessive clinginess;
  • Lack of ability to understand and recognise emotions
  • Disassociation;
  • Suicidal behaviours;
  • Eating disorders

Further, abuse or neglect should be suspected  if behavioural indicators are present such as:

  • Repeated sexualised behaviour or preoccupation;
  • Unusual sexualised behaviours;
  • Poor standards of hygiene affecting the child’s health;

Risk Factors

The guidance also as well as risk factors exhibited by the parents, carers or family members of the child, for the practitioners to take into consideration.

Abuse or neglect should be considered if the child’s parent, carer or family member has one or more of the below example risk factors;

  • They have substance misuse problems;
  • They are experiencing mental health problems;
  • There is a history of domestic abuse;
  • They are emotionally volatile;
  • They do not engage with service;
  • There has been one or more previous episode(s) of abuse.

A child centred approach

A key principle of the guidance is to take a child-centred approach. This includes involving, to the greatest extent possible, the child or young person in the decision making process and ensuring that practitioners are communicating with them effectively and appropriately giving consideration to factors such as their age and developmental stage.

Further, the guidance suggests that in all communications with a child or young person, practitioners should maintain an empathetic and sensitive approach, listen to the opinions and wishes of the child and provide explanations regarding the steps they will be taking. Practitioners should also provide advice in relation to confidentiality and ensure that the child is able to discuss their concerns in a private environment.

Involving parents and carers

The guidance aims to assist in building good working relationships with the parents and carers of children and young people.

Practitioners should have open and honest discussions with the parents and carers, whilst providing them with the opportunity to express their thoughts and opinions. They should ensure parents are aware of any issues or concerns leading to their involvement with the child, and avoid apportioning blame for any problems. Instead, the positives should be identified, and parents should be advised as to how they may make further progress.

Early Help

The guidance also refers to possible steps that can be taken if there are signs of abuse or neglect. This includes home visiting programmes and parenting programmes.


The draft guidance consultation is ongoing until 19 April 2017, with the final guidance expected to be published in September 2017.

Contact our child abuse claims experts today

At IBB, our personal injury team, led by child abuse claims expert Malcolm Underhill, has the expertise and knowledge to advise and represent you if you wish to make a compensation claim following current or historic child abuse. Whether you are the victim of abuse or you are the parent of a child who has been abused, we could help you obtain justice and compensation for the harm that you or your child has suffered. Please contact us today on 0333 123 9099, email us at or fill in our contact form.  Any discussions you have with us will be in the strictest of confidence and handled with the utmost sensitivity.

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