Quality statement 1: Noticing changes

Quality statement

Children and young people who display marked changes in behaviour or emotional state are encouraged to talk about their wellbeing.

Rationale

Children and young people can find it difficult to tell someone or even understand that they are being abused or neglected. However, they may communicate an emotional reaction to their experiences indirectly through their behaviour. Practitioners who work with the same group of children or young people for an extended period are in a position to notice changes in the child or young person's behaviour, emotional state or attitude. These changes should be a prompt to explore concerns through a sensitive enquiry about their wellbeing, giving them space and opportunity to talk. Creating a supportive environment for the conversation, being sensitive and asking open questions may encourage children and young people to disclose abuse or neglect when they feel ready.

Quality measures

Structure

a) Evidence of local arrangements to ensure that people whose work brings them into contact with children or young people are trained to recognise alerting features for abuse and neglect.

Data source: Local data collection, for example, audit of organisational safeguarding policies and training records.

b) Evidence of local arrangements to ensure that people whose work brings them into contact with children or young people are trained to respond to child abuse and neglect in line with local safeguarding procedures.

Data source: Local data collection, for example, audit of organisational safeguarding policies and training records.

c) Evidence of local arrangements to ensure that there is a clear referral pathway to local authority children's social care, to be followed by anyone who has concerns about child abuse and neglect.

Data source: Local data collection, for example, audit of organisational safeguarding policies, local authority referral pathways.

Outcome

a) Number of children in need because of abuse or neglect.

Data source:  Characteristics of children in need: 2017 to 2018, Department for Education.

b) Number of children who were the subject of a child protection plan.

Data source:  Children in need census 2010 to 2011 (provisional), Department for Education.

What the quality statement means for different audiences

Organisations providing services and activities for children and young people (such as nurseries, schools, after-school clubs, community centres, sports clubs and health settings) have clear safeguarding policies, systems, protocols and staff training in place to ensure that staff have the awareness and skills to recognise alerting features for abuse and neglect and take appropriate action as soon as concerns arise.

Practitioners whose work brings them into contact with children and young people (such as those who work in early years, social care, health, education settings, police, the voluntary and community sector, youth justice services and adult services) understand their responsibilities in safeguarding children and young people and ensure that they take action as soon as they recognise risk factors or spot signs of abuse or neglect. They stay alert to changes in behaviour or emotional state in children and young people they work with and ask them about their wellbeing as soon as they have concerns.

Commissioners (such as national and regional schools commissioners, local authorities and clinical commissioning groups) commission services in which all practitioners can recognise and respond to child abuse and neglect and in which agencies work together and share information to ensure that effective actions are taken. They also ensure that clear referral pathways are in place and services work together to safeguard children and young people.

Children and young people who show a change in their behaviour are asked about how they are, their feelings, friends, family and home life. Children and young people are given space and opportunity to talk to someone they trust about their wellbeing.

Source guidance

Child abuse and neglect (2017) NICE guideline NG76, recommendations 1.3.5 and 1.3.12

Definitions of terms used in this quality statement

Marked changes in behaviour or emotional state

A change in a child's behaviour or emotional state which is not fully explained by a stressful situation that is not part of child abuse and neglect such as bereavement, parental separation or a medical cause. Examples of marked changes may include:

  • recurrent nightmares containing similar themes

  • extreme distress

  • markedly oppositional behaviour

  • withdrawal of communication

  • becoming withdrawn.

Practitioners should continue to consider the possibility of child abuse or neglect as a cause for behavioural and emotional changes, even if they are seemingly explained by another cause.

[NICE's guideline on child abuse and neglect, recommendation 1.3.12 and expert opinion]

Equality and diversity considerations

Children and young people who are displaying marked changes in behaviour or emotional state may have problems with communication, for example because they are very young (pre-verbal stage) or because of disability or speech or language problems.

Practitioners who work regularly with these children and young people and notice the change should actively look for alternative ways of finding out what may be causing the changes. For example, they can discuss their observations with family members or carers if that is appropriate or use play, art or other activities to explore their concerns and gather more information.