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
Emotional development
- Puts self or others in danger e.g. missing from home
- Severe emotional/ behavioural challenges
- Unable to connect cause and effect of own actions
- Unable to display empathy
- Suffers from periods of severe depression
- Self-harming or suicide attempts
Behavioural developments
- 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
Identity and self-esteem
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Child/young person experiences persistent discrimination; internalised and reflected in poor self-image
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Failed Education Supervision Order – 3 prosecutions for non-attendance: family refusing to engage
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Socially isolated and lacking appropriate role models
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Alienates self from others
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Bullying
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Lack of confidence is incapacitating
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Victim of crime; may fear persecution by others
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Poor and inappropriate self-presentation
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Child/young person likely to put self at risk
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Child sexual exploitation (CSE)
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Evident mental health needs
Family and social relationships
- 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
Self care skills and independence
- 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
Learning
- Puts self or others at risk through behaviour
- No, or acrimonious, home-nursery or school link
- Young child with few, if any, achievements
- No school placement
- Child/young person is out of school
- Has no access to leisure activities
- Multiple fixed term exclusions or risk of permanent exclusion
- Consistently poor or no educational attainment progress