COD 8: Recognizing and managing suspected child maltreatment and/or neglect

Key Features

• This EPA focuses on recognizing and managing patients who have experienced physical, emotional, and/or sexual maltreatment or neglect, or in whom it is suspected.
• It also includes recognizing when a patient is at risk, when there may be a detrimental imbalance between care needs and care provided, or when police and/or social services need to be engaged.
• This EPA does not include preparing legal reports or testifying in court about alleged child abuse and/or neglect.

Assessment Plan

Direct observation by supervisor

Use form 1. Form collects information on:

• Age: neonate; infant; preschool; school age; adolescent
• Type of maltreatment: physical; emotional; sexual; neglect; Munchausen by proxy

Collect at least 3 observations of achievement.

• At least 1 physical maltreatment (including suspected)
• At least 1 sexual maltreatment (including suspected)
• At least 1 neglect (including suspected)

CanMEDS milestones

1. ME 2.2 Recognize and respond to factors that raise the suspicion of child maltreatment and/or neglect
2. ME 2.2 Recognize sentinel clinical findings suggesting child maltreatment and/or neglect, including injuries, behavioural and emotional changes and other clinical signs
3. ME 1.6 Work within professional boundaries, delegating forensic interviewing to other professionals as indicated
4. ME 2.2 Assess a child for signs and symptoms of child maltreatment and/or neglect
5. ME 3.4 Collect specimens for assessment of sexually transmitted infections and/or child maltreatment
6. COM 5.1 Document evidence of child maltreatment, including the use of diagrams and photographs as appropriate
7. ME 2.2 Select and/or interpret appropriate investigations
8. ME 2.4 Develop and implement a management plan that considers all of the patient’s health problems and context
9. ME 4.1 Develop a plan for ongoing management and follow-up
10. ME 4.1 Determine the need to involve specialized care professionals, child protective services, or law enforcement
11. COM 1.1 Communicate using a patient-centred approach that facilitates trust and autonomy and that is characterized by empathy, respect, and compassion
12. HA 1.1 Facilitate timely access to services and resources in the health and/or social system(s)
13. P 3.1 Adhere to requirements for mandatory reporting
14. P 3.1 Apply relevant aspects of child welfare legislation
15. P 1.1 Exhibit appropriate professional behaviours