To guide child protection workers on the assessment and response to allegations of physical abuse.
Fabricated or Induced Illness (FII)
The procedure for assessing and responding to allegations of physical abuse should be read in conjunction with Chapter 2.2: Assessment and investigation processes.
Child protection workers must be cognisant of the following information relevant to assessing whether an injury or illness is non-accidental:
The purpose of the assessment is to identify whether the injury/illness is non-accidental by assessing whether the explanation for the injury is consistent and fits with the developmental abilities of the child.
Child protection workers must consider the following when assessing whether an injury is non-accidental:
Child protection workers must be cognisant that child physical abuse can be targeted to one child in the family, referred to as the ‘scapegoat’. Scapegoating of a child can occur in varying degrees of severity. Children that are not scapegoated often experience emotional abuse because they witness and participate in the abuse of their sibling(s). Children that are not scapegoated often initially attempt to reach out to the child victim, but quickly learn that empathic behaviour is not a safe response. These children may develop empathy deficits as a way of protecting themselves from the effects of witnessing the process or effects of the abuse.
Different roles parents can take in non-accidental injuries
Child protection workers must be cognisant of the different roles parents can take in non-accidental injuries including:
Family and domestic violence
Child protection workers should consider whether the perpetrator’s behaviour may be affecting the adult victim’s ability to respond protectively towards the child, particularly where the adult victim may have been a bystander (witnessed the abuse without intervening) and/or acted to conceal the event.
Alcohol and other drug misuse
Child protection workers should consider whether parental alcohol/drugs/substance use is resulting in:
Mental health issues
Child protection workers should consider whether parental mental health issues are resulting in:
Abusive head trauma (previously Shaken Baby Syndrome)
Child protection workers should consider the additional vulnerability of babies and young children to abusive head trauma. Abusive head trauma refers to an injury to the skull or the intracranial contents (e.g. brain) due to inflicted blunt impact (child being hit in the head or having their head hit against something) and/or shaking. This type of injury has some of the most severe consequences for a child’s future wellbeing and is the leading cause of death amongst children who have been abused.
Children aged less than six months are most vulnerable to abusive head trauma. The greatest risk period for babies is between six weeks and four months of age when their crying can be particularly problematic for parents.
Excessive physical punishment
It is lawful in Australia for parents, or those with parental responsibility, to use reasonable force to manage a child’s behaviour. We only have a role when a parent uses excessive physical force, which results in or is likely to result in significant harm to a child.
Child protection workers should consider the following factors to assess whether the use of physical punishment is reasonable:
Child protection workers must assess physical abuse through a variety tasks including:
Medical treatment, assessments and consultations
The child protection worker must refer the child for a medical assessment for the purposes of:
Child protection workers should consider all available medical evidence alongside evidence gathered through interviews, observation and other relevant information sources. In some cases, medical evidence may not be available or conclusive and child protection workers will need to use other sources of evidence.
Consultation with Perth Children's Hospital, Child Protection Unit or other medical practitioner
Child protection workers should consult with social workers and/or consultant paediatricians in the Perth Children's Hospital (PCH) Child Protection Unit in the following circumstances:
Child protection workers should make an appointment for the child at the PCH Child Protection Unit before taking the child there. This will allow relevant health professionals to prepare for the child’s assessment appropriately so the child is not further traumatised by being kept waiting. The child should be taken to an emergency department if their injuries are serious. Where necessary the child will be referred to the PCH Child Protection Unit by emergency department/hospital staff.
Interviewing the child, siblings and other related children
Child protection workers must interview the child, siblings and other related children to gather information on:
Interviewing parent(s) and other relevant individuals
Child protection workers must interview the parent/carers separately and consider the following:
Interviewing other relevant individuals
Child protection workers should consider interviewing any other individuals who may have relevant information, particularly those who have, or may have, witnessed the events that led to the child’s injuries.
Reviewing the child, siblings and other related children’s medical history and previous contacts with us
Child protection workers should review previous contacts with us and consider obtaining medical records to establish a chronology for the child, and assess whether this is a pattern of abuse, and/or whether it is escalating.
The child protection worker should consider:
The following tasks may be involved in seeking a medical history:
When developing a chronology of events, child protection workers should focus on identifying and analysing:
If there is a sibling group, consider the above list for each child including the developmental trajectory. This should also include any unrelated children living in the family.
Specific presentations of physical abuse
Child protection workers should refer to more detailed guidance for assessing the following concerns in related resources:
Child protection workers should refer to Casework Practice Manual Chapter 2.2: Signs of Safety - child protection practice framework for guidance on safety planning, including developing harm and/or danger statements and safety goals.
The following considerations also apply to safety planning in relation to physical abuse:
Unable to determine who is responsible for harm
There may be circumstances where the child protection worker is unable to determine who is responsible for harm. In these circumstances safety planning and ongoing assessment must occur to actively manage this uncertainty.
Considerations for safety planning
Child protection workers may consider the following when developing a safety plan for allegations of physical abuse cases:
Parental behaviours that indicate strengths and when tested demonstrate safety
Specific parental behaviours that indicate strengths and when tested demonstrate safety can include:
Where physical injury to a child in the CEO’s care constitutes or results from an offence (whether before or after the child comes into the CEO’s care), the child may be able to claim Criminal Injuries Compensation. For further information, refer to Chapter 3.3: Legal rights of children and caseworker responsibilities.