Identifying and Responding to Abuse or Neglect

Policy

We train staff to recognise the signs of abuse, neglect, and harm, or signs of a child being in an environment where there is family violence. All concerns should be reported to the lead clinician as soon as practicable to allow for timely reporting and response.

If the designated child protection lead is not available, or a concern relates to them, report to their designated deputy.

Oranaga Tamariki: Definitions of abuse, neglect, and harm and Child Matters: What is Child Abuse?

Responding to suspected abuse or neglect

Abuse and neglect are more likely to be identified through observations of behaviour or physical indicators than through a direct disclosure from a child. A child/young person may experience more than one form of abuse/neglect at a time.

Respond to suspected abuse or neglect quickly and sensitively.

1.	Document your observations	Make notes as soon as possible – include the date, time, and who was present. Write down what the child says – use their words/language. Record what you said, saw, and heard – make it clear when it is your inference. Keep the record factual and accurate. Do not: attempt to deal with the situation or make decisions on your own formally interview the child or young person ask leading questions or ask too many/repeated questions promise confidentiality inform the alleged perpetrator or parents/carers/whānau.
2.	Speak to the child protection lead as soon as possible	Do not make your own judgment or decisions. Work with the lead clinician to decide on next steps. If there is a conflict, or the child protection lead is away, you may need to work with another staff member. If you have concerns about a child's immediate safety – phone the police on 111.
3.	Notify the appropriate agency	Contact Oranga Tamariki \| Ministry for Children by phone or email: Phone 0508 326 459 Email contact@ot.govt.nz Even if there is no immediate danger, or if you are unsure what to do, you can contact Oranga Tamariki for general guidance. You are not making a decision about what has happened – you are simply sharing the facts and allowing others (e.g. police, Oranga Tamariki) to do their job. See also: Disclosing Patient Information
4.	Keep accurate written records	Record in detail: your concern and how/why it arose. notes from discussions/attempted discussions, meetings, and phone calls – include dates, times, and who was present. advice received (from agencies or elsewhere). actions taken by whom, when, and the rationale. Store all records securely.

Responding to disclosures of abuse or neglect

If a child makes a disclosure, we listen and respond appropriately.

Stay calm and give the child your full attention.
Listen to the child, reassure them they have done the right thing. Ask open ended questions (e.g. "What happened next?", "How come?").
Use questions to prompt. Do not interview the child.
Let the child finish explaining before you initiate any next steps.
Let them know what you will do next (i.e. that you need to tell someone else).

Speak to the child protection lead as soon as possible. Record word for word what the child said. Include:

date, time, and location
factual concerns or observations
action taken
any other relevant information.

Allegations against staff

All allegations against staff must be brought to the attention of the the lead clinician as soon as possible. If an allegation is connected to the child protection lead, speak to their designated deputy, who will consider the next steps.

Our response will be based on a review of all information, the seriousness of the allegation, and whether there is a need for immediate intervention. If we believe there is a risk to the safety of a child or young person, we may:

adjust a staff member's duties or place them under supervision, pending investigation
report allegations to Oranga Tamariki or the police
liaise with and notify professional bodies relevant to the person's role
seek employment and/or legal advice.

We take all allegations seriously, and prioritise the safety and wellbeing of the child or young person. However, we follow a process that is balanced, fair, and confidential, without bias to anyone involved.

We recognise that there could be occasions when staff need support following an incident, or if they have been involved in a difficult situation.

Record keeping

We keep all information in writing, and store it securely. This may include:

concerns and how/why they arose – include body maps if appropriate
notes from all discussions/attempted discussions, meetings, and phone calls – include dates, times, and who was present
reports made and advice received (from agencies or elsewhere)
actions taken by whom, when, and the rationale.

Related policies

Confidentiality

Disciplinary Process

Disclosing Patient Information

Privacy

Stress and Wellbeing

Resources

Body Map – Safeguarding Children

Handling Disclosures of Child Abuse – Child Matters

Practice Record of Concerns/Incidents – GPDocs template

Report of Concern – Safeguarding Children

Working Together to Support Tamariki, Rangatahi and their Family/Whānau – Oranga Tamariki Interagency Guide

Family violence, domestic violence, intimate partner violence IPV

Page Information

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Topic type Topic Types There are two topic types: Core content Text outside the yellow highlighting (as shown on the model site) is there for compliance, legislation, or best practice. The text is not normally changed. Core content is continually reviewed and kept up to date. Customised Core content on this page has been changed on request by the practice. Customised topics must be reviewed and updated by the practice because they are not automatically updated by GPDocs.	Core content
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Topic ID:	23420

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Contact

Phone: 0800 473 627
Email: support@gpdocs.co.nz

Indicators from children		Indicators from adults
Disclosing family violence Physical injuries Concentration difficulties Adjustment difficulties Being anxious or nervous Depression Fear of a parent, or partner of a parent Isolation from friends and family Unusual absences Fear of conflict Violent outbursts Aggressive language Bed wetting		Exhibiting controlling behaviour, making all of the decisions Threatening, criticising, blaming, or humiliating Mood swings Having a history of bad relationships Having a dominant belief system that supports being controlling

Indicators from children		Indicators from adults
Disclosing neglect Lack of sanitary protection for girls who are menstruating Frequent hunger Malnutrition Poor hygiene with few self-care skills Dental decay Medical conditions not being managed, not improving, or getting worse Seasonally inappropriate clothing Being left unsupervised for long periods Medical needs not attended to, being ill more than average Stealing food Staying at school outside of school hours Often being tired, falling asleep in class or at meal times Abusing alcohol or drugs Demanding affection or attention from adults, including strangers Displaying aggressive behaviour Not getting on well with peers Bed wetting		Prioritising adults' needs over needs and rights of children Failing to attend to a child’s basic needs Unresponsive parenting Failing to take the child for medical appointments Leaving the child unattended Repeated “accidents” (presumably injuries - clarify) Being emotionally unavailable Appearing to be indifferent to the child Seeming apathetic or depressed Believing children are unimportant and their needs are secondary to adults or community needs Ignoring or belittling children’s needs or rights

Indicators from children		Indicators from adults
Disclosing abuse Acting in a sexual way with toys or objects Nightmares Being withdrawn or clingy Personality changes, such as seeming insecure or anxious Complaining of headaches or stomach pains Fear of particular people or places without an apparent reason Problems with schoolwork Sexually transmitted infections Unusual or excessive itching or pain in genital or anal area Changes in eating habits Genital injuries (bruising, cuts, redness, swelling, bleeding) Blood in urine or faeces Pregnancy Being secretive Receiving gifts or favouritism from a particular person or people Displaying sexual behaviour or knowledge that is unusual for that child’s age Perpetrating sexual abuse Inappropriate masturbation Experiencing difficulty sleeping Persistent soiling or bed wetting or regression (starting to wet the bed again having stopped) Having difficulties relating to adults and peers Unexplained absences, unexplained gifts or money (often signs of sexual exploitation) Bed wetting		Refusing to allow a child sufficient privacy Insisting on physical affection Selecting/favouring one child Abnormal interest in the sexual development of a child or teenager Discussing/sharing sexual jokes or sexual knowledge/material with a child Insisting on time alone with a child, including babysitting and outings Spending most of their spare time with children Buying children expensive gifts or giving them money for no apparent reason Treating a particular child as a favourite Frequently walking in on a child using the bathroom, changing rooms, or toilet Grooming Forced hugging and kissing Encouraging a child to behave in sexually inappropriate ways Voyeurism (secretly watching or filming children) Exposing genitals Failing to protect a child from seeing and hearing sexual activities, media, or conversations

Indicators from children		Indicators from adults
Disclosing abuse Developmental delays (being behind peers of the same age) Displaying low self-esteem Tending to be withdrawn, passive, or tearful Displaying aggressive or demanding behaviour Being overly compliant – trying to keep everyone happy Being highly anxious Complaining of headaches or stomach pains (psychosomatic complaints) Displaying difficulties in relating to adults and peers Avoiding certain people, places, and situations Sleep disturbances Bed wetting Regression (acting like a much younger child) e.g. soiling, wetting pants When playing, behaviour may model or copy abusive behaviour/language Bed wetting		Rejecting a child (not giving them attention, love, and affection) Calling the child names and/or publicly humiliating them Frightening a child with threats Misusing authority, power, or position of trust Verbal abuse, yelling, swearing Being critical of a child’s efforts or ability Bullying and intimidation Forcing compliance Unpredictable responses (sometimes kind, sometimes volatile) Humiliation, making degrading comments/insults Having unrealistic expectations Severe or harsh interaction with a child Exposing a child to adult issues Shunning or rejecting a child Lack of emotional responsiveness and low empathy Having a harsh parenting style Threatening a child with physical harm Forcing a child to watch physical harm being caused to someone they love

Indicators from children		Indicators from adults
Disclosing abuse Bruises, burns, sprains, dislocations, bite marks, cuts, pressure marks (from fingers) Fractured bones (especially in an infant where a fracture is unlikely to occur accidentally) Poisoning Bed wetting Location and extent of injury does not fit the explanation Difficulty recalling how injuries happened/giving inconsistent explanations Showing wariness or distrust of adults or particular individuals Seasonally inappropriate clothing (to hide bruising or other injury) Demonstrating fear of parents and of going home, running away Becoming fearful when other people cry or shout Being: excessively friendly to strangers overly passive and compliant violent to animals or other children extremely aggressive or withdrawn		Overly rough play Pinching, pushing, dragging, slapping, throwing, or shoving a child Shaking an infant Hitting a child with hands or objects Story is vague, or changes when explaining causes of injury to a child Believing in physical punishment Perspective of “Didn’t do me any harm” Delay in seeking medical help for a child Making threats to harm Animal abuse Restraining a child as a punishment Force-feeding a child Choking, strangling, or suffocating a child, even if only attempted Lashing out or threatening a child in front of others General low empathy