‘Rages and clinginess can signify neglect’

TEACHERS and police officers should consider whether tantrums and excessive clinginess are possible signs of child abuse, a watchdog has said.

New guidance says professionals working outside the NHS should be alert to “soft signs” that a child is experiencing abuse or neglect.

These can include “frequent rages” with only a small amount of provocation, excessive clinginess, low selfesteem and recurrent nightmares.

Children may also be withdrawn, wet themselves regularly, persistently seek attention, or display over-friendliness to strangers.

The guidance, from the National Institute for Health and Care Excellence (Nice), says workers should consider abuse if a child displays behaviours that differ from what is normal for the child or for their age or developmental stage.

Dr Danya Glaser, a consultant child and adolescent psychiatrist and member of the Nice guideline development committee, said professionals should use their instinct and experience to make a judgement.

“It’s probably a mixture of instinct and experience,” she said. “It’s about (noticing) some change in behaviour if you know the child.

“It’s a change in behaviour or an intense behaviour that is worrying.”

Dr Glaser said there was “far more under-recognition” of child abuse than overreporting of cases that then turned out to be untrue.

“We are saying err on the side of curiosity – it might be nothing but it might be something,” she said.

Dr Glaser said teachers should raise their concerns with the school’s individual responsible for child protection. But the guidance says some “red flags” are of such concern that social services should be alerted straightaway. These red flags include a child regularly attending school unclean or with injuries, overtly sexual behaviours in children who are below the age of puberty, and parents excessively smacking their children.

Gillian Leng, Nice’s deputy chief executive, said: “We want all professionals to be aware and recognise when they need to ask questions or follow up with colleagues about a child’s wellbeing.

“Not all cases will cause concern but if we do not ask, we may miss opportunities to protect children.”