Level 4 – Development of the Baby or Child

Health

Child/young person has severe/chronic health problems
Child/young person’s weight and height drop in centile
Other developmental milestones unlikely to be met; failure to thrive
Lack of food may be linked with neglect
Refusing medical care endangering life/development
Seriously obese
Dental decay and no access to treatment
Persistent and high-risk substance misuse
Dangerous sexual activity and/or early teenage pregnancy
Child sexual exploitation (CSE)
Suspected imminent risk of FGM (female genital mutilation)
Sexual abuse
Self-harming
Non-accidental injury
Acute mental health problems e.g. severe depression; threat of suicide; psychotic episode
Physical/learning disability requiring constant supervision
Disclosure of abuse from child/young person
Evidence of significant harm or neglect
Disclosure of abuse/physical injury caused by a professional

Unable to determine boundaries, roles and responsibilities appropriately
Cannot maintain peer relationships e.g. is aggressive, bully, bullied
Regularly involved in anti-social/criminal activities
Repeated missing persons episodes
Prosecution of offences resulting in court orders, custodial sentences, ASBOs
Non-compliant or poor response to support
Professional concerns – but difficulty accessing child/young person
Unaccompanied refuge/asylum seeker
Privately fostered
Abusing other children
Young Sex Offenders
Serious or persistent offending behaviour likely to lead to custody/remand in secure unit/prison
Subject to Family Support or Child Protection Plan

Child/young person experiences persistent discrimination; internalised and reflected in poor self-image
Failed Education Supervision Order – 3 prosecutions for non-attendance: family refusing to engage
Socially isolated and lacking appropriate role models
Alienates self from others
Bullying
Lack of confidence is incapacitating
Victim of crime; may fear persecution by others
Poor and inappropriate self-presentation
Child/young person likely to put self at risk
Child sexual exploitation (CSE)
Evident mental health needs

Repeated missing persons episodes
Relationships with family experienced as negative (‘low warmth, high criticism’)
Rejection by a parent/carer; family no longer want to care for – or have abandoned -child/young person
Periods accommodated by Council
Family breakdown related to child’s behavioural difficulties
Subject to physical, emotional or sexual abuse or neglect
Child Exploitation (CE)
Suspected imminent risk of FGM (female genital mutilation)
Child is main carer for family member

Severe disability – child/young person relies totally on other people to meet care needs
Child neglects to use self-care skills due to alternative priorities, e.g. substance misuse