Risk of Harm Indicators

Basic physical or psychological needs

In children

! poor standards of hygiene ! scavenging or stealing food ! extreme longing for adult affection ! no genuine interaction ! anxiety about being abandoned ! self-comforting behaviour eg rocking, sucking ! failure to thrive ! delay in developmental milestones ! loss of “skin bloom” and poor hair texture

In parents and caregivers

! failure to provide food, shelter, clothing or hygienic living conditions ! leaving child without appropriate supervision ! inability to respond emotionally to child ! withholding physical contact or stimulation for long periods of time ! scapegoating one child ! failure to provide psychological nurturing ! absence of social support from relatives, other adults or support systems Necessary medical care

In children

! untreated injuries ! symptoms of illness or poor health which may be harmful ! if left untreated ! failure to thrive

In parents and caregivers

! comments or behaviour indicating that the parent is unwilling or unable to arrange necessary ! medical care for the child Physical abuse and ill-treatment

In children

! bruising of the face, head and neck ! lacerations or welts from physical discipline or excessive ! restraint ! explanations which do not fit the injury ! bruising showing the cause of the injury eg belt mark ! large bite marks ! multiple bruises or injuries ! ingestion of poisonous substances ! ruptured internal organs without trauma ! dislocations, sprains , twistings ! broken bones, especially in under threes ! burns and scalds ! head injuries including drowsiness and vomiting, fits or eye bleeding

In parents and caregivers

! admitting that they fear they may injure the child ! family history of violence to children ! suffering abuse as a child or young person ! often taking child to doctor with injuries ! delaying seeking help for the child ! giving inconsistent accounts of the injury ! giving unbelievable accounts of the injury Sexual abuse and ill-treatment

In children

! tears, bleeding or bruising to the genitalia ! sexually transmitted diseases trauma to breasts, buttocks, lower abdomen or thighs ! descriptions of sexual acts ! age inappropriate behaviours ! regression in developmental achievements ! contact with a known sexual perpetrator

Stress

! nightmares and bedwetting ! marked changes in behaviour or mood, tantrums, aggressiveness, withdrawal ! complaints of hedaches or stomach aches with no physical ! findings

In parents and caregivers

! intentional exposure of children to sex acts ! exposing a child to prostitution or pornography ! previous history of sexual abuse ! not allowing child appropriate independence ! coercing a child to engage in sexual actswith other ! children ! verbal threats of sexual abuse Domestic violence

Children are at risk of serious psychological harm when:

! there is repetition or increased frequency or severity of ! the violence in a household ! a child has been physically harmed ! a partner requires medical attention ! weapons have been used ! police have attended the house, there is an AVO issued or ! breached.

Other things to consider are:

! Is the carer able to protect the child? ! Are there other factors present such as drugs, mental health problems or disability which may make it harder to protect the child and increase his/her risk of harm? Serious psychological harm

In children

! lack of trust in people ! lack of interpersonal skills ! extreme attention seeking behaviour ! other behavioural disorders eg bullying, aggressiveness, ! disruptiveness

In parents and caregivers

! constant criticism, belittling, teasing of a child, ignoring or ! withholding praise or affection ! excessive or unreasonable demands ! severe verbal abuse, rejection and scapegoating ! belief that the particular child is “bad” or “evil” ! using inappropriate physical or social isolation as ! punishment ! behaviour in situations which can harm the child’s safety, ! welfare or well-being