If a child has told someone that they have been sexually abused, a Strategy Discussion should be arranged with attendance from Devon and Cornwall Police and NHS Devon, in addition to Children’s Services, as a minimum so that decisions may be made about securing evidence; this may include a medical examination at the Devon and Cornwall Sexual Assault Referral Centre (SARC). Refer to Insert Plymouth practice standards for child and family assessments and S47 and Achieving best practice in criminal proceedings (ABE)
PDF – Achieving Best Practice in Criminal Proceedings (ABE)There should be consultation with the Safeguarding Paediatrician prior to the Strategy Discussion.
Child Protection medical examination when sexual abuse is suspected: The timing will depend on the nature of the alleged assault and the timing of the last incident, so it is key that any reports from a child that they have been sexually abused are dealt with immediately. A child protection medical examination is an opportunity for holistic assessment of all aspects of a child’s health and wellbeing encompassing both physical and mental health. The assessment has multiple purposes including reassurance to the child about their health, managing any medical issues that need addressing and, in some cases, gathering forensic evidence.
Evidence for the impact of medical examinations in CSA and good practice guidance for conducting them may be found in The Centre of Expertise Report on the Role and Scope of Medical Examinations. The review states “Medical examinations have a valuable place in the holistic assessment of abused children’s health and wellbeing”. It gives guidance to professionals about how these examinations should be conducted including the importance of the child having control about what is happening. It states “All and any part of the examination is optional for the child and young person. They can choose (including on the day) which parts of the examination they want and can change their mind at any time.” It also states “The time of medical examination might be an opportunity to influence discourse within the family and identify carers’ support needs. The access to and referral for therapeutic support facilitated at these health assessments should consider the wider family as a matter of routine”. This is particularly important as the long-term outcomes for abused children and young people are influenced by many factors but include the support, they receive from their non-abusing close family who may themselves be in need of support in coping with what has happened. Therefore, as part of your assessments and interventions consider the wider family networks in any plans for the child.
For sexual assault within the previous 7 days a strategy discussion must be held between social care, police and should include a Paediatrician from the Safeguarding Team at the Hospital and/or the Forensic Medical Examiner at Children’s Centre SARC. The timing of the medical assessment will be affected by the possibility of acquiring forensic evidence and whether the child / young person is likely to need urgent medical treatment. The medical services for this group of children and young people are based at SARC (Sexual Assault Referral Centre, Exeter).
Research and practice show that it can take years for a child to get to the point where they feel able to tell someone.
Half a million children are estimated to experience some form of sexual abuse each year, yet research indicates only around one in eight cases of child sexual abuse ever reach statutory services’ attention. Sadly, often the younger the child is when the abuse starts, the longer it can take for it to be uncovered. We cannot forget that there are many barriers to children telling adults about harm and they may not recognise what is happening to them is abuse.
It is vital that anyone who works with children knows how to recognise what is happening and understands how to help the child to have that conversation. This guide is for all people working with children, to give them guidance in talking about child sexual abuse, explaining what may be going on for children when they are being sexually abused; what prevents them from talking about their abuse; and what professionals can do to help children speak about what is happening. It brings together research, practice guidance, and expert input – including from survivors of abuse – to help give professionals the knowledge and confidence to act. (CSA Centre of Expertise)
Communicating with children | CSA Centre
Children who have experienced recent cases of sexual assault (10 days or less ago) in Devon, Cornwall and the Isles of Scilly are cared for at the SARC facility in Exeter. They will be given immediate medical care, a forensic medical assessment, emergency contraception if required, and support and advice about what to do next. The SARC can also arrange for an Independent Sexual Violence Adviser (ISVA) to support with any police investigation.
The SARC children’s services team gives the relevant contact details.
AIM3 Assessment Model – Leonard and Hackett (2019)
One example of specialist assessment used in Plymouth is AIM3. AIM3 is an Assessment of Adolescents and Harmful Sexual Behaviour (HSB). The AIM3 model of Assessment is designed to provided practitioners with a structured framework to assist in analysing the HSB in the overall context of the young person. It is designed to be used with those young people aged 12-18 years who have committed, or where there is an evidenced professional belief that they have committed, harmful sexual behaviour.
AIM3 is designed to be used not only at the initial stages following a referral, but at intervals thereafter, to assist with reviewing process being made as a result of Harmful sexual Behaviour Intervention These assessments may only be undertaken by suitably trained professionals. If you require an assessment but are not trained, you can request for one to be undertaken by contacting LINK TO BE ADDED.
It is important to note that what can be deemed as ‘harmful sexual behaviours’ can be responsive behaviours demonstrated by children and young people that have experienced trauma, and who could have been sexually abused.
Taking legal action to protect a child
If it becomes clear to the child’s Social Worker that the child cannot be kept safe from the risk of significant harm within their current family arrangements, or if this is the decision of a Child Protection Conference, the child’s Social Worker should follow their authority’s procedures for applying for a legal order.
There is information on the range of legal orders available at Safeguarding Hub.
Referral to the Plymouth Local Authority Designated Officer (LADO) if the adult accused of sexual abuse also works with children and young people.
A professional who has been made aware of concerns that a young person is being abused by an adult who also works with children and young people should refer to the Plymouth LADO via completion of this LADO Allegations Referral Form.
For all LADO enquiries, please email LADO@plymouth.gov.uk or call on 01752 306340
For further information on the Management of Allegations procedures, click the button below: