RCGP Safeguarding toolkit

Any child can be at risk of abuse, however there are a number of factors that can increase a child’s vulnerability to abuse and neglect. NICE identifies these as:

Child factors:

• Age under four years old, or adolescence.
• Physical and/or mental impairment — may be due to factors such as impaired capacity to resist or avoid maltreatment, lack of effective communication, inability to understand what is happening or to seek help, and dependency on carers for personal assistance.
• Living in the care system.
• Being a twin or multiple.
• Being unwanted or failing to fulfil the expectations of parents/carers.
• Identifying as (or being identified as) lesbian, gay, bisexual, or transgender.

Parental/carer factors (which may be compounded by lack of support from family or friends):

• Substance misuse.
• A history of domestic abuse, including sexual violence or exploitation, and/or maltreatment as a child.
• Emotional volatility or having problems managing anger.
• A history of violent offending or other criminal activity.
• Mental or neurological disorders.
• Known maltreatment of animals.
• Poor education.
• Lack of parenting knowledge.
• Learning difficulties — child maltreatment may occur due to a lack of understanding of parental responsibilities and limited support.
• Low self-esteem.

Family and environmental factors:

• Poverty and financial pressures, poor housing — may be associated with a higher level of parental stress and an increased risk of child maltreatment.
• Maltreatment of other children within the family, or violence between family members.
• Family/relationship breakdown.

Community and societal factors:

• Gender and social inequality.
• Lack of adequate housing or services to support families.
• High levels of unemployment or poverty.
• Inadequate policies and programmes to prevent child maltreatment.
• Social and cultural norms that promote or glorify violence towards others or diminish the status of the child in parent/carer–child relationships.
• Social, economic, health, and education policies that lead to poor living standards or socioeconomic inequality or instability.

Risk factors for recurring or persistent child abuse and neglect include:

• refusal by the parent or carer to engage with services
• the parent or carer experiencing a mental health or substance misuse problem which has a significant impact on the tasks of parenting
• chronic parental stress
• the parent or carer experienced abuse or neglect as a child
• the child communicates in a different way – they may not know how to communicate that they are being abused
• may have never been given the words/tools to use to tell someone
• professionals/family/carers misunderstanding behaviour which may indicate abuse
• never been asked
• they are ignored
• they have multiple needs and need more care – more opportunities for abuse
• can be targeted for abuse as less likely to be able to tell
• may be unable to protect themselves due to their disabilities.