Background Looked after children and young people present with similar physical and mental health problems like their peers, but often to a greater degree. They often enter care with a worse level of health than their peers in part due to the impact of physical and emotional abuse and neglect.

The term looked after child means children and young people who are cared for by Government/local authority. In 2016/17 there were approximately 96,000 looked after children in the UK but the total number of looked after children in the UK has increased every year since 2010.¹ In England the majority of children (62%) were looked after due to abuse or neglect, whilst family dysfunction (15%) and acute family stress (9%) combined accounted for less than a quarter (March 2013).²

Aims of our study was to review healthcare needs as identified during initial health assessments of looked after children due to neglectful parenting and physical/emotional abuse.

Objectives Aims of our study was to review healthcare needs as identified during initial health assessments of looked after children due to neglectful parenting and physical/emotional abuse.

Methods Initial health assessment records of looked after children were collected from System one software in community Paediatric looked after children’s clinics between 1st October 2018 to 31st March 2019. Unaccompanied asylum seeker children and children under 1 year were excluded.

Necessary permission was obtained from Lead Paediatrician for looked after children and ethical clearance was obtained from Trust ethical committee.

Microsoft Excel was used to collect and analyse data.

Results Total 40 children were included in the study and their initial health assessment report were analysed out of which 22 were male and 18 were females. There was history of parental neglect, and physical/emotional abuse in all of them.

40% (16/40) children had learning difficulty/developmental delay.

25%( 10/40) were referred for assessment of autism spectrum disorder/attention deficit hyperactivity disorder and 20% had confirmed diagnosis.

35% children had associated mental/emotional problems including anxiety, attachment difficulties and emotional dysregulation.

Sleep problems (27.5%), Continence issues (10%) and Tooth decay (40%) were among other prominent health issues identified.

Conclusions Incidence of neurodevelopmental disorders (autism spectrum disorder/attention deficit hyperactivity disorder), mental health problems, learning difficulty and developmental delay are higher in children and young people who are in care because of neglectful parenting, emotional and physical abuse.

The authors conclude that early intervention and support should be provided to these vulnerable children to prevent/reduce the incidence neurodevelopmental disorder, developmental delay and mental health problems.

References

1. Bentley, H. et al. (2018) How safe are our children? The most comprehensive overview of child protection in the UK. London: NSPCC.

2. Department for Education, 2014. Outcomes for children looked after by local authorities in England, as at 31 March 2013 [pdf]. Department for Education.