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Tagged In:  Nursing

New draft guidance aims to help school nurses and other professionals spot the 'soft signs' of abuse and neglect in children and young people.




"School nurses have a vital role to play in schools protecting children as well as promoting their wellbeing, " said Children's Commissioner for England Anne Longfield in September last year. "They are one of the professionals at the front-line identifying abuse or neglect."

In February this year, the National Institute for Health and Care Excellence (NICE) issued new draft guidance on identifying indicators of abuse or neglect in children and young people. Currently out for consultation, the guidance is aimed at a range of professionals working outside healthcare settings, including nurses, social workers, police officers and nursery staff. Covering, physical, emotional and sexual abuse, it aims to support them by providing evidence-based recommendations for recognition, assessment and early intervention.

As well as obvious alarm signals which may cause professionals to suspect abuse or neglect, such as a child attending school unclean or with injuries, the guidance encourages them to 'consider' abuse or neglect if a child displays any of a range of so-called 'soft signs'. These include behavioural and emotional indicators, such as being fearful, withdrawn or aggressive, indiscriminate contact or affection seeking, and excessive clinginess.

The guidance also sets out best practice for interacting with children, tailoring communication to the child's age and developmental stage. It calls on professionals such as school nurses, teachers and social workers to make sure children feel confident that they are being listened to, as well as building good working relationships with parents and carers.

According to the NSPCC, there are over 57,000 children in the UK identified as needing protection from abuse. However, the charity also estimates that, for every one of these children, there are eight more suffering abuse which is going undetected. In 2014/15, police in England, Scotland, Wales and Northern Ireland recorded the highest number of sexual offences against children in the past decade. While worrying, this may be due to increased willingness to report abuse, rather than indicating that more is taking place. 



The School and Public Health Nurses Association is currently carrying out research to investigate the contribution of school nurses to the safeguarding of children and young people and their families. They're asking school nurses across the UK to help them by completing a survey.

In 2015, the Children's Society was commissioned by the Department of Health to produce an e-learning package for health professionals to recognise the signs of abuse in children and young people. At the heart of Seen and Heard is a 60-minute video-based module, focusing on the real experiences of young people, told in their own words.

The full NICE guidance on child abuse and neglect is scheduled to be published in September.

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