9 Child and adolescent psychiatry9.4 Child protection
9.4.1 Changing developmental needs and safeguarding
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Written by Resident Doctor Committee · Published
New in the 2027 syllabus
The College added this topic for exams from January 2027.
What safeguarding looks at
Safeguarding is not only about spotting an isolated injury or responding to an allegation. It asks a wider question: are this child's needs being met for their stage of development?
Go by developmental age, not just age in years. Disability and developmental delay can change the support a child needs. Chronological age alone does not tell you how independent a child is or how well they can communicate.
Needs across childhood
Stage | Needs to consider |
|---|---|
Infancy | Feeding, warmth, physical safety, responsive interaction and reliable care |
Early childhood | Supervision, predictable routines, language, play and help with managing emotions |
Middle childhood | Learning, friendships, boundaries, encouragement and safe chances to be independent |
Adolescence | Growing autonomy, privacy, trusted relationships, education and protection from exploitation |
What changes as children grow
Dependence usually falls with age. It can stay high when illness or disability limits a young person's self-care or their ability to recognise danger.
Peers and the online world matter more as the young person's social world widens. Assessment has to look beyond the home.
Autonomy should be supported alongside protection. Avoid giving a child responsibility too early, and avoid restricting them without need.
Participation means talking with the child in a way that fits their understanding, and giving weight to their own wishes and experiences.
Assessing unmet need
Look at three areas together: the child, the parents' capacity to care for them, and the family and wider circumstances. These circumstances include poverty and the support available.
A change in how a child is functioning may be a sign of distress or unmet need. Medical, developmental and contextual explanations also need to be considered.
Identify protective relationships and practical resources as well as concerns, so the plan builds on what is working.
Keep arrangements under review as the child develops and circumstances change. Care that was adequate at one age may not be enough later.
Safeguarding action responds to current or likely harm and need. Do not wait for a psychiatric diagnosis before acting.