Neglect toolkit - signs of neglect

• Being smelly or dirty
• Being hungry or not given money for food
• Having unwashed clothes
• Having the wrong clothing, such as no warm clothes in winter
• Having frequent and untreated nappy rash in infants

Further considerations for children with additional needs:

• They may not experience hunger in the same way or may show they are hungry through their behaviour
• They may use continence products beyond infancy - are they appropriately fitted and changed regularly?
• They may only wear specific clothes - are these clean, appropriate sizes etc.?

• Anaemia
• Body issues, such as poor muscle tone or prominent joints
• Medical or dental issues
• Missed medical appointments, such as for vaccinations
• Not given the correct medicines
• Poor language or social skills
• Regular illness or infections
• Repeated accidental injuries, often caused by lack of supervision
• Skin issues, such as sores, rashes, flea bites, scabies or ringworm
• Thin or swollen tummy
• Tiredness
• Untreated injuries
• Weight or growth issues

Further considerations for children with additional needs

• Is the high or low muscle tone a result of their medical condition, is it managed correctly, so the child remains safe, appropriate wheelchairs, use of splints?
• Are they seen by a dentist appropriate to their needs, do they have a toothbrush, are there sensory needs related to their teeth?
• Are parents able to meet all medical appointments. If not, what are the barriers to this?
• Children may have additional medical needs, be frequently unwell, do parents understand them and act appropriately?
• Are we giving parents allowances as they have a lot to manage?
• Are there frequent accidents or injuries? Be mindful of explanations
• Is their equipment appropriate for their age and mobility?
• Medication is often needed and used for children. Is it used appropriately, the correct doses given, for the right child?
• Child should be supported to communicate. Do parents communicate with them appropriately? Do they get opportunities to communicate?
• Are communication devices, such as hearing aids, well fitted, well maintained?
• Considerations around weight, including being underweight - is this a sensory issue, are they restrictive in the eating, what do parents do to support this?
• Obesity is a safeguarding issue. Is food used to manage behaviour, does it impact their daily life?

• Living in an unsuitable home environment, such as having no heating (being left alone for a long time)
• Taking on the role of carer for other family members

Further considerations for children with additional needs

• Is the home adapted to meet the child's needs e.g. wheelchair accessible, safe areas, toys appropriate to both their age and sensory needs, appropriate stimulation? Is an OT involved to support this?
• Are wheelchairs/safe spaces/screens used as advised?
• Do the children get time out of these or away, are they supervised when using them? Are they used to modify behaviour rather than support it?

• Becoming clingy
• Becoming aggressive
• Being withdrawn, depressed or anxious
• Changes in eating habits
• Displaying obsessive behaviour
• Finding it hard to concentrate or take part in activities
• Missing school
• Showing signs of self-harm
• Using drugs or alcohol

Further considerations for children with additional needs

• Children may not be able to regulate their emotions. Are they supported to do this? Are parents coping with this need?
• Children can be very active and their sensory needs may make them hypersensitive or hyposensitive. How do parents keep them safe?
• Sexualised behaviours can be self-soothing and may be a sign of being unsettled
• Low self-esteem and mood swings
• Crying, upset or unsettled when they wouldn't usually be
• Self-harm may be seen in a different way, through headbanging, hitting themselves, picking at injuries

Neglect changes childhood. Children who've been neglected might experience short-term and long-term effects. These can include: problems with brain development taking risks, like running away from home, using drugs and alcohol or breaking the law getting into dangerous relationships difficulty with relationships later in life, including with their own children a higher chance of having mental health problems, including depression.