Child maltreatment: when to suspect maltreatment in under 18s

What the guidance says

The NICE guidance provides a summary of the alerting features that healthcare professionals might come across that suggest a child might be being maltreated. The purpose of the guideline is to raise awareness and help healthcare professionals who are not specialists in child protection to identify children who may be being maltreated. The guideline does not give healthcare professionals recommendations on how to diagnose, confirm or disprove child maltreatment. The introduction to the guideline reminds healthcare professionals of their duty to work closely with other colleagues and agencies if there is concern about the welfare of a child.

The alerting features described in the guideline include physical signs, such as injuries, and also emotional signs, such as changes in a child's behaviour and the way the child and their parents or carers behave with each other at their appointment.

Some alerting features are more likely to indicate child maltreatment than others. For this reason the guideline tells healthcare professionals to either 'consider' or 'suspect' child maltreatment as a possible explanation for what they have noticed.

To consider child maltreatment means that a healthcare professional thinks it might be one reason for the alerting feature, but they are not sure.

The guideline tells healthcare professionals to suspect child maltreatment if they see one of the alerting features that is more likely to mean that a child has been maltreated. These are not proof that a child has been maltreated and healthcare professionals will have local procedures that they should follow in these situations.