School refusal is often a symptom of an underlying anxiety disorder. The child may get anxious on separating from their primary caregiver and this manifests itself in different ways depending on the age of the child as much as anything. There are 2 peak age groups who develop school refusal, 5-7 year olds and 11-14 year olds. 25% of school children refuse to attend school at some point in their school career but it becomes a routine problem in about 2% and the longer it goes on, the harder it is to reverse. It is not the same as truancy. It is not a mental illness in itself but many children who feel unable to attend school over a long period do have an underlying mental health issue. Unfortunately funding for CAMHS is being eroded and it is difficult to find good, and timely, help for school refusers. The websites I have listed in December 2010 Paediatric Pearls for GPs may help give parents pointers for why it is happening and how to set about managing it.
Category Archives: Child Protection
Forthcoming child protection courses
All professionals who come into contact with children need Level 1 and 2 training. You can do both levels on-line; register at www.e-lfh.org.uk where the safeguarding courses are listed under “Projects”.
The Royal College of Paediatrics and Child Health holds a number of courses and advertises others, many of which are open to non-paediatricians. Have a look at http://www.rcpch.ac.uk/Policy/Child-Protection/Child-Protection-Training.
The Advanced Life Support Group also run child protection courses which have been developed with RCPCH. More information about this on- line course from http://www.alsg.org/en/?q=en/cpip.
There is a very good course for paediatricians run at the Hillingdon Hospital twice a year on child protection and court skills. They run in June and November each year. See http://www.acpcltd.co.uk/hillingdon_cp_course.html.
Do let me know of any other courses using the Comments feature below.
Safeguarding resources
Please find local safeguarding boards contact details below. Lots of information on what the LSCB is, training courses on offer, what to do if worried about a child, relevant local contact details etc.:
http://www.walthamforest.gov.uk/index/care/childrenandfamilies/childprotect/lscb.htm
Child Protection Handbook produced by Royal College of Paediatrics and Child Health (RCPCH) available to download in full from http://www.rcpch.ac.uk/Policy/Child-Protection/Child-Protection-Publications. Do peruse the continually updated list of downloadable documents at this link. For example the guidelines on when to suspect Fabricated and Induced Illness were updated in 2009 and quite substantially broadened.
NICE quick reference guideline on When to Suspect Child Maltreatment (July 2009) available at www.nice.org.uk/nicemedia/pdf/CG89QuickRefGuide.pdf
Working Together (2013) is a guide to inter-agency working to safeguard and promote the welfare of children https://www.gov.uk/government/publications/working-together-to-safeguard-children
In May 2010, after the election, the Department for Children, Schools and Families became the Department for Education. The safeguarding content is currently split between the 2 websites. Most of the Every Child Matters information is at www.dcsf.gov.uk/everychildmatters but some of the more up to date news on safeguarding issues is at http://www.education.gov.uk/childrenandyoungpeople/safeguardingandsocialworkreform.
A useful document on recognising physical abuse in children with fractures has just been published jointly by the NSPCC and Welsh Child Protection Systematic Review Group. Compulsory reading for GPs and ED physicians I should think. This Cardiff Core Info Group publish a number of excellent pamphlets on bites, head injury, burns, bruises and neglect.
Do use the comments box below to let me know about any other resources you would recommend.