In all cases where any form of abuse or neglect of a child is suspected, the need for medical assessment must be discussed during the initial Inter-agency Referral Discussion (IRD).
The decision to undertake a medical examination, the nature and timing of that examination and any decision not to examine the child must be made by the Paediatrician on-call for Child Protection indiscussion with other core agencies and clearly documented.
Any examination undertaken must be carried out by a doctor or doctor(s) with appropriate skills and competencies for the individual case.
The examination must be comprehensive, gathering information about the child’s overall wellbeing, growth and development, not just documentation and interpretation of injuries.
Even where the likelihood of finding recent injuries is thought to be small, examination may reveal evidence of previous injury and/or neglect. This is important in establishing any degree of significant harm.
- The purpose of the examination can be summarised as:
- Securing any immediate medical treatment required;
- Gathering medical and forensic evidence;
- Gathering relevant medical, family and social background;
- Gathering information on the child’s growth, development and emotional state;
- Initiating ongoing health care, e.g. treatment of sexually transmitted infections/pregnancy, mental health care;
- Reassuring the child and family.
The consultation may also offer an opportunity to gain an impression of the child’s emotional wellbeing, the quality of interaction with the parent(s)/carer(s) and the parent’s own needs and level of understanding.
You can access further information on the medical assessment and care of children where child abuse and/or neglect is suspected at the link below.