This participatory research sought the views of children and young people on their feelings of safety in church youth groups. Thirty-two young people, aged 9-19 years, participated in five focus groups. The research approach was designed in consultation with a young persons' steering group, who also helped in the coding and analysis of the data. A blended approach to qualitative analysis was taken, drawing on principles of phenomenology and grounded theory. Three core themes were identified from the data: Young people want to feel welcome and able to join in, they want to be respected and included and they want a safe and secure environment. These themes were explored in relation to the physical and social environment, leadership and the relevance of God, spirituality and religion for these young people. The findings point to the need for churches and other faith-based organisations to have robust and effective policies, structures and procedures for keeping children safe. These need to be embedded within and flow out of atmospheres that enable children to feel safe, respected, welcomed and included. For these to be meaningful, those running such services need to listen to children and young people, to hear their priorities and concerns, and take those into account in the way they design their programmes and activities.

Introduction The degree of disability in children with Cerebral Palsy (CP) can be evaluated with the Gross Motor Function Classification System (GMFCS), a valid tool which was designed for such purposes. However, there appears to be paucity of data on the awareness and use of the GMFCS particularly in the Sub-Saharan continent where the condition is still prevalent. Thus, this study aims to describe awareness, use, merits and demerits of the GMFCS system as perceived by health professionals who take care of children with CP.Methods: This was a cross sectional study of health professionals from three Nigerian teaching hospitals. Information obtained via structured questionnaire were demographic data, years of qualification, years of experience of working with children with CP, awareness, use, merits and demerits of the GMFCS. Factors associated with use of the GMFCS were also evaluated with the Chi-square analysis.Results: 78 health professionals participated in the study and majority (58.9%) were doctors. 55 (70.5%) of the study participants were aware of the GMFCS but only 33(42.3%) were using it. The nurses were neither aware of the system nor using it. A higher proportion of therapists (65.4%) were familiar with the system compared to the doctors (54.3%) . The location of practice was significantly associated with the use of the GMFCS (p=0.013). More doctors noted the merits and demerits of the system compared to the therapists.Conclusion: Though health professionals were aware of the GMFCS only a small proportion was using this vital tool in the clinical setting. Thus, there is the need to create more awareness on GMFCS and its clinical utility, and the training of nurses should be of paramount importance in the developing country.Key words: Awareness, cerebral palsy, gross motor function classification system, developing country

Background: The current social construction of young mothers is generally negative, pointing to a lack of engagement with universal services and poor outcomes for their infants and children. However, qualitative studies offer an alternative, more positive construct of young motherhood. Understanding the context of young motherhood can improve the relevance and efficacy of health promotion directed to this group of high-risk mothers. Aim: To explore the lived experience of young women transitioning to motherhood to better understand their experiences and perspective; and what influences their engagement with health promotion aimed to support safer parenting practices and whether their behaviour changes over time with exposure to parenting health promotion. Method: Longitudinal Interpretative Phenomenological Analysis (IPA) was used with five first-time mothers identified with characteristics known to influence poorer outcomes for infants and children such as low educational achievement and economic disadvantage. Participants aged 16 to 19 years were recruited antenatally. Serial in-depth interviews were conducted at three time points during the ante- and post-natal periods. Interviews were transcribed and data were analysed inductively following the prescribed method of double hermeneutic analysis for IPA. Finding: Three themes were identified from the full study: Transition, Information, and Fractured application; the focus of this paper is Transition. Transition revealed that becoming mothers impacted key adolescent developmental tasks; their identity and relationships were significantly affected, both positively and negatively and adolescent brain development influenced behaviour and decision making capability. Adolescence influenced how these young mothers engaged with and interpreted parenting health promotion messages. Conclusions: Young mothers in this study operate within the context of adolescence. Adolescence impacts participants' decision making activity and early parenting behaviours which informs the debate on why young mothers may fail to reduce risks for their infants. This insight can contribute to the development of more effective health promotion/educational strategies, and support professionals to better engage with this high-risk group to improve early parenting behaviour and subsequently improve outcomes for their infants and children.

Over the past 25 years, Jordan has made great strides in improving child health and nutrition. Child mortality has fallen substantially: under five mortality falling from 37 to 18 per 1,000 live births between 1990 and 2015 (1). Nevertheless, it is estimated that 4,000 children die in Jordan each year before the age of five, and a further 1,000 between the ages of five and 14.(1).

The British Society of Paediatric Dentistry's (BSPD) first policy document on dental neglect was published online in 2009. It proposed a new original definition of dental neglect, discussed the identification of dental neglect and recommended adopting a tiered response, with three stages of intervention according to level of concern. Furthermore, it detailed how the dental team should both contribute to the child protection process and implement wider measures to safeguard and promote children's welfare. Since 2009, these concepts have been widely adopted in the UK and beyond. Furthermore, there have been significant advances in both research and practice. Policy documents produced by the BSPD represent a majority view, based on the consideration of currently available evidence, and are tailored to a UK working environment. Although this updated document's recommendations remain broadly unchanged, this version reflects the professions' progress in understanding dental neglect and minor updates to terminology and, following a consultation process, has been amended to address the needs of two main audiences-dental professionals and nondental health and social care professionals-in order to enhance interdisciplinary working.

Aim To identify the common factors in serious case reviews (SCRs) where a child has died of a medical cause. Design Qualitative thematic analysis. Background SCRs take place when neglect or abuse results in children dying or being seriously harmed. Known key factors within SCRs include parental substance misuse, mental health problems and domestic abuse. To date, there has been no investigation of children who die of a medical cause where there are concerns about child maltreatment. Data sources A list of SCRs relating to deaths through medical causes was provided from previous coded studies and accessed from the National Society for the Prevention of Cruelty to Children National Case Review Repository. Twenty-three SCRs with a medical cause of death from 1 April 2009 to 31 March 2017 were sourced. Results 20 children died of an acute condition and 12 of a chronic condition; 20 of the deaths were unexpected and maltreatment contributed to the deaths of 18 children. Most children were aged either <1 year or >16 years at the time of death. Many parents were caring for a child with additional vulnerabilities including behavioural issues (6/23), learning difficulties (6/23), mental health issues (5/23) or a chronic medical condition (12/23). Common parental experiences included domestic violence/abuse (13/23), drug/alcohol misuse (10/23), mental ill health or struggling to cope (7/23), criminal history (11/23) and caring for another vulnerable individual (8/23). Most children lived in a chaotic household characterised by missed medical appointments (18/23), poor school attendance (11/23), poor physical home environment (7/23) and disguised compliance (12/23). All 23 SCRs reported elements of abusive or neglectful parenting. In most, there was an evidence of cumulative harm, where multiple factors contributed to their premature death. At the time of death, 11 children were receiving social care support. Conclusion Although the underlying medical cause of the child’s death was often incurable, the maltreatment that often exacerbated the medical issue could have been prevented.

To identify how British Child Death Overview Panels (CDOPs) and paediatric pathologists classify cause of death for sleep-related Sudden Unexpected Death in Infancy (SUDI). To determine compliance with national requirements for SUDI investigation. Electronic survey of CDOPs and pathologists using three vignettes of SUDI cases illustrating: accidental asphyxia, typical Sudden Infant Death Syndrome (SIDS) and SIDS with co-sleeping. Thirty-eight (41%) of 92 CDOPs returned questionnaires, and 32 were complete. Thirteen (14%) of 90 pathologists returned complete questionnaires. Thirty-one (97%) CDOPs and 7 (53%) pathologists agreed with the cause of death in the accidental asphyxia case; 24 (75%) CDOPs and 9 (69%) pathologists in the typical SIDS case; and 11 (34%) CDOPs and 1 (8%) pathologist in the co-sleeping SIDS case. Pathologists used the terms SUDI or unascertained as the cause of death for the accidental asphyxia case (46%) and the co-sleeping SIDS case (77%). These terms were used by CDOPs for the typical SIDS case (25%) and the co-sleeping SIDS case (41%). Seventeen (46%) CDOPs reported compliance with guidelines for investigation in more than 75% of cases. There is wide variation in classification of deaths, with only limited agreement between CDOPs and pathologists. The terms SIDS and accidental asphyxia are underused, even in typical cases.

The original research presented in this issue of Child Abuse Review explores some of the pitfalls, paradoxes and perplexity of working in child protection. We draw on work from Australia, France, the UK and USA covering issues ranging from abusive head trauma (AHT) in infants through to the criminal exploitation of young people. Working in child protection is never going to be easy, but these papers highlight some of the very real and complex challenges facing practitioners. They also suggest ways of navigating some of these difficulties. The papers in this issue deserve careful, reflective reading, so I would encourage you to grab a good cup of coffee (or whatever your favourite tipple might be), sit back and dip in … AHT is consistently reported as one of the commonest causes of serious and fatal child maltreatment, with a reported annual incidence between 14.2 and 33.8 per 100 000 live births in different international studies (Otterman and Palusci, 2020). The diagnosis and management of suspected AHT is, however, fraught with difficulties for clinicians, child welfare and criminal justice practitioners, and the courts, not least because the event leading to the injury is typically not independently witnessed. ‘The diagnosis and management of suspected AHT is… fraught with difficulties for clinicians, child welfare and criminal justice practitioners’ The first paper in this issue, from Anne Laurent-Vannier and colleagues (2021), reports on a case series of 100 infants diagnosed with AHT through shaking in the French courts. This complements another paper from these authors published in last year's special issue on AHT (Laurent-Vannier et al., 2020). The authors applied a rigorous approach to diagnosis using the evidence-based national HAS-SOFMER guidelines (Haute Autorité de Santé and Société Française de Médecine physique et de Réadaptation, 2017). The authors argue that by thoroughly analysing all the clinical and forensic data on these cases, they were able to determine when the symptoms that led to the diagnosis had occurred in 93 of the 100 cases. ‘whining, seeming to be in pain, amorphous, lethargic, unresponsive or much less responsive to interactions, no longer smiling, refusing his/her bottle or eating little, and often showing repeated and unusual projectile vomiting and sometimes with seizure.’ (Laurent-Vannier et al., 2021, p. 288) In an accompanying invited commentary, George Edwards (2021) reflects on some important questions raised in the interpretation of these results. First, Edwards (2021) points out that ‘the determination of the mechanism of an inflicted head injury is often difficult’ (p. 300) as the clinical findings of shaking, impact or a combination of the two may overlap. As Laurent-Vannier (2021) points out in her response, however, their diagnosis was based on the rigorous clinical criteria of the HAS-SOFMER guidelines with shaking being considered ‘the main and constant mechanism’ for all cases (p. 303). Indeed, both authors are clear that shaking, with or without impact, is the main admitted mechanism of AHT (Edwards et al., 2020). ‘Both authors are clear that shaking, with or without impact, is the main admitted mechanism of AHT’ The second challenging issue raised by these findings is the extent to which you can use clinical dating to identify possible perpetrators. The weight of evidence to date suggests that the onset of symptoms occurs either immediately or shortly after the abusive event, and this accords with Laurent-Vannier et al.'s (2021) conclusions. Nevertheless, Edwards (2021) urges some caution in this and points out potential ‘pitfalls in determining when the onset actually occurred’ (p. 301). I would encourage you to carefully read all three articles – Laurent-Vannier et al.'s (2021) original research, Edward's (2021) invited commentary and Laurent-Vannier's (2021) response. As with so many areas of child protection practice, this is an issue in which we can – and must – act with authority, drawing on the best possible evidence and being rigorous in our application of that evidence, and at the same time, exercising humility and respect in considering alternative interpretations and gaps in our understanding, while never losing sight of the primacy of the child's welfare (Sidebotham, 2013). One further finding of Laurent-Vannier et al.'s (2021) research is worth reflecting on. In contrast to many other studies, a majority of the presumed perpetrators were female: in 49 cases, the onset of symptoms occurred while the child was in the care of a nanny; in 31 cases, the child was with the father; and in ten cases, the child was with the mother. This finding may reflect cultural differences with a high prevalence of early childcare following childbirth among French mothers. The finding that mothers make up a minority of suspected perpetrators of AHT appears consistent across other published research. In spite of this, the majority of preventive programmes, while typically aimed at parents, are often delivered in maternity settings and hence primarily reach mothers (Lopes and Williams, 2018). If we are going to make any meaningful inroads into preventing AHT, it is crucial that we find effective, evidence-based programmes that specifically engage with fathers and – where contextually relevant – other caregivers such as nannies. Our next three papers look at two community-based programmes for supporting children and families, on opposite sides of the world, and a broader exploration of the role of nurses in supporting children and families and reporting abuse. ‘Two community-based programmes for supporting children and families, on opposite sides of the world’ First, Jonathan Scourfield and colleagues (2021) assess the impact on child welfare interventions of Flying Start – an enhanced early years programme targeted at areas of socio-economic deprivation. The programme aims to reduce inequalities in child development and parenting skills, and has been operating in Wales since 2006–7. The authors postulated that as well as the programme's primary aim of reducing socio-economic inequalities, it might have benefits in preventing harm to children and therefore result in fewer child protection interventions. Conversely, the provision of enhanced child and family services in areas receiving the Flying Start programme could result in higher levels of intervention as more vulnerable children are identified and referred to social services. The research team analysed administrative data: to identify numbers of children in public care and on child protection registers; and to compare these data between areas where Flying Start was operating and those where it was not, after controlling for overall levels of socio-economic deprivation. In keeping with other research, these authors found a strong socio-economic gradient in child welfare interventions, with a 16-fold increase in child protection registrations and a tenfold increase in children looked after in the 20 per cent most deprived neighbourhoods compared to intervention data in the 20 per cent least deprived neighbourhoods. Paradoxically, and in keeping with their second hypothesis, the team found a marked increase (43%) in the level of child welfare interventions in those areas receiving Flying Start compared to those that did not, after controlling for deprivation. These increases in intervention rates were even more marked in those Flying Start areas in less deprived neighbourhoods. The authors suggest a number of plausible explanations for this finding. In particular, they suggest that increased professional contact in Flying Start areas could be resulting in increased protective intervention. ‘It is possible, therefore, that although Flying Start might bring important societal benefits, both in the shorter term in terms of health and child development, and potentially the longer term in terms of health and social mobility … it may not be best suited to helping the families who are at risk of child protection interventions.’ (Scourfield et al., 2021, p. 315) From Wales to New South Wales, Australia, where Fay Hadley and colleagues (2021) report on a study exploring perceptions of child abuse and child protection among staff working in the out-of-school-hours care sector. These services, which provide play and recreation programmes for children before and after school and during school holidays, are required to ensure children's safety according to national standards, and their staff are mandated to report ‘any reasonable suspicions’ that a child might be experiencing significant harm (Hadley et al., 2021, p. 320). The authors combined data from an online survey, focus groups and one-to-one interviews with out-of-school-hours educators and managers. Both practitioners and managers identified a primary responsibility to keep children safe. This was perceived not just as a requirement of the job, but also as a clear legal and moral obligation, and a duty of care. Staff conveyed that they understood the process of reporting child abuse and felt confident in doing so. However, many of the participants commented on the hierarchical process of reporting, whereby they had to notify a supervisor, who then passed on the information to the relevant authorities, a process which staff found frustrating and disempowering. A second key theme to come through their findings was the importance of relationships and communication channels – both within the organisation, with staff emphasising the supportive nature of mentoring and supervision, and in how staff approached families when there were concerns. ‘Many of the participants commented on the hierarchical process of reporting… which staff found frustrating and disempowering’ In comparison to the role of education services in safeguarding children, there has been little empirical research on the role of out-of-school-hours services. This research provides a helpful perspective on how staff in this sector perceive their role in keeping children safe and responding to concerns. The authors highlight a need to review policies and practices to ensure that this sector can deliver effective models and resources to keep children safe. Another area of paradox in working with children and families lies in the nature of reporting suspected abuse or neglect. This reporting may be the only way of ensuring the safety of a vulnerable child, yet, at the same time, may be perceived as undermining the relationship between the professional making the report and the family who they are working with, thus hindering the opportunities for continued support and partnership. The next paper, from Lauren Elizabeth Lines and colleagues (2021) from Flinders University in South Australia, explores this paradox from the perspective of nurses working with children and families. As with many other countries, nurses in Australia are mandated to report suspicions of abuse to child protective services (CPS). The nurses in this study were aware of, and took seriously, their responsibilities as mandated reporters. Nevertheless, there was a strong sense that nurses felt disempowered by the process, perceiving that ‘they were not always taken seriously and had little control over outcomes following a report to CPS’ (Lines et al., 2021, p. 341). This perception, which the authors argue mirrors nurses' experiences with doctors and other professionals and may be rooted in the ways in which nursing practice has been constructed and maintained, could have significant implications. Nurses may be less motivated to address child abuse if they feel that their actions in reporting will not effect change. Alongside this negative perception of the impact of reporting, nurses also perceive a tension in how such reporting will impact on their ongoing relationship with the family. Reporting child abuse will typically be perceived as punitive by families, and this was particularly the case in First Nations communities where there was often an understandable culture of mistrust in government services. ‘Nurses also perceive a tension in how such reporting will impact on their ongoing relationship with the family’ While recognising these paradoxes, the nurses in this study identified strategies that they used to overcome them. These included ways of reframing their reports to clearly present facts or evidence, planning their reports in advance and seeing their role as educating CPS in relation to children's health needs. It also included the ways in which they communicated their concerns to families, often reframing reporting as a positive step towards getting support and helping parents cope. In their discussion, the authors point to the Family Partnership Model (Davis and Day, 2010), which is widely used in the UK and in child health (as distinct from paediatric) nursing in Australia. They suggest that this model ‘draws upon the qualities and skills of individual professionals to build relationships with families and support them to enact positive change’ (Lines et al., 2021, p. 343). Perhaps this and other models of working in partnership with families could provide a helpful way forward in working with the paradoxes of child protection practice. ‘Being drawn into exploitative situations, where children can be both victims and perpetrators of serious harm, can have severe consequences for them and for their families, friends and communities.’ (Child Safeguarding Practice Review Panel, 2020, p. 4) This complexity, and the perplexity that it presents to practitioners, is explored in our next paper from Kristen Olver and Ella Cockbain (2021). The authors, from the Department of Security and Crime Science at University College London, set out to ascertain the perspectives of criminal justice professionals in the West Midlands of the UK on responding to criminal exploitation linked to county lines drug supply. The term ‘county lines’ is widely used in the UK (though not elsewhere) to refer to ‘the process of gangs and organised criminal networks using mobile phone lines to coordinate the supply of drugs from major urban centres to other communities within the UK’ (Olver and Cockbain, 2021, p. 348). The researchers drew on semi-structured interviews with 11 participants from law enforcement, government and non-governmental organisations. Their findings were structured around five key themes which are worthy of careful reflection. First, the participants felt that the term ‘county lines’ is unhelpful, that it ‘obscures the actual crime/exploitation involved and impedes understanding among practitioners unfamiliar with the phenomenon and the general public’ (Olver and Cockbain, 2021, p. 351). Part of this confusion is because the term is used to refer to both the means of operation (through using mobile phone lines or routes for moving drugs) and the exploitation involved. A more helpful approach is to refer to ‘county lines criminal exploitation’ (Olver and Cockbain, 2021, p. 355) or, as suggested above, ‘criminal exploitation linked to county lines drug supply’. In a broader vein, the term ‘child criminal exploitation’ encompasses, but is not limited to, the criminal exploitation of children through county lines drug supply. The second theme identified by Olver and Cockbain (2021) is that current UK legislation, particularly the Modern Slavery Act 2015, is appropriate and that further legislation is not required. Instead, participants emphasised that adequate implementation of the existing legislation is what is needed. However, all participants recognised that information sharing, both within and between agencies, is an ongoing challenge – the third key theme. This is in spite of systems – such as the Police National Computer and Regional Organised Crime Units – put in place to facilitate the flow of information. None of this will be new to practitioners in the field, however, the participants did offer some suggestions of ways in which such information sharing could be improved. The fourth and fifth key themes focus on the victim–offender dichotomy and addressing victims' vulnerability. The reality is that young people involved in county lines activity are victims of exploitation, regardless of any offender status that they may obtain through this activity. This dual identity creates challenges for professionals in how to work with these young people. In addition, participants recognised that many of those who are now exploiting young people in this way were themselves victims of abuse or exploitation in their childhood. Alongside this, many of the young people involved in these county lines do not see themselves as exploited, rather they have a sense of agency and their involvement can be seen ‘as rational behaviour [offering] social and financial benefits’ (Olver and Cockbain, 2021, p. 353). With this shift in emphasis to seeing young people as victims, participants stressed the importance of prevention and early intervention, ‘including improving multiagency work, educating young people, engaging with communities … and training professionals’ (Olver and Cockbain, 2021, p. 354). ‘The reality is that young people involved in county lines activity are victims of exploitation, regardless of any offender status’ Working with young people who are the victims of criminal exploitation is challenging for professionals. This paper acknowledges this perplexity, while at the same time providing an empathetic understanding of the young people and insights into how professionals can work with them. Our Continuing Professional Development section in this issue includes a paper by Samantha Holcombe (2021) providing a social work perspective on medical neglect. Holcombe (2021) uses a tight definition of ‘failure by parents or caregivers to follow specific medical advice, which would have a severe adverse effect on the child’ (p. 363). She draws on evidence from the UK and USA to present an overview of the nature of medical neglect, some of the factors that may contribute to it and some pointers in how to manage it. In this, she presents a brief case study for reflection. Holcombe points out that medical neglect is a complex and challenging area for social workers, not least because of the specialist medical concepts, the often chronic nature of the children's needs, and the potential areas of disagreement between parents and professionals. ‘Medical neglect is a complex and challenging area for social workers’ We end this issue of Child Abuse Review with a training update and two book reviews. First, Ruth Gardner (2021) reviews the Social Care Institute of Excellence (SCIE) e-learning course on understanding child neglect. The course is described as ‘a valuable and easy-to-use introductory course’ (Gardner, 2021, p. 369), which draws on both reflective learning and the SCIE systems approach to analysing practice, and could lend itself to multiagency learning. The two book reviews include a review by Ben Donagh (2021) of Helen Bonnick's book on Child to Parent Violence and Abuse, and one by Edward Ong (2021) of Stuart Alladyce and Peter Yates' Working with Children and Young People Who Have Displayed Harmful Sexual Behaviour. Both books are felt to provide a good overview of their topic, both address some of the challenges and complexities inherent in working with these children and families, and the latter in particular identifies the perplexity of working with children who may be both victims and perpetrators of abuse – reflecting the difficulties highlighted above in relation to criminal exploitation linked to county lines drug supply. In all of these areas, as with so many issues in child protection, partnership working is crucial: between different professional groups, and between professionals and parents. This perhaps brings us back to the concept of authoritative practice – for professionals to act with confidence and competence, keeping the child's needs central while being empathetic to the views and perspectives of the family, and having the humility to work in partnership with others, recognising both our strengths and limitations in the face of the many pitfalls, paradoxes and perplexities of child protection practice. ‘In all of these areas, as with so many issues in child protection, partnership working is crucial’

The five original articles in this issue of Child Abuse Review present an eclectic mix of original research, examining issues around the disclosure of sexual abuse, the willingness of adults to intervene in situations of possible abuse or neglect, and different aspects of adverse outcomes for abused and neglected children, both fatal and long-term. In addition, we publish a letter to the editors, a training update and a book review, all of which provide useful pointers for keeping up to date. ‘Given the dynamics of power and control that often exist when such abuse occurs … disclosure of childhood sexual abuse can be a difficult and, in some cases, insurmountable task.’ ‘Sexual abuse… attacks the very core of an individual's identity and leaves scars that can persist throughout a person's life’ ‘… and then you finally get the courage up … to tell somebody about it, somebody who you think is going to do something for you … and you become a victim again … you become a victim … of … the system.’ (Mooney, 2021, p. 203) ‘Clear policy and guidance for social workers, a legal mandate and framework, and trauma-informed systems, such as those articulated in the EU Victim's Directive, for example, may enhance this area of practice.’ (Mooney, 2021, p. 207) ‘It is particularly important that the way we respond to those disclosing abuse does not compound the trauma they have already experienced’ In our next paper, Cristóbal Guerra and colleagues from Chile also pick up on the issue of disclosure, this time focusing on gender differences in patterns of disclosure by adolescents (Guerra et al., 2021). They, too, found significant barriers to disclosure, both internal and external, and identified particular challenges for adolescent boys. The researchers used a mixed-methods approach to explore issues around disclosure among 210 adolescents who had been sexually abused. They found that guilt and shame, along with fear – of being judged, of reprisals and of negative consequences for the family – were all important barriers to disclosure. Alongside this, they recognised a developmental trajectory in which there was a growing awareness by these young people that what they had experienced was actually abuse. ‘… some minimum support and security conditions are necessary for CSA disclosure by adolescents of both genders. The perception of family support, the certainty of being believed and education about the different forms of sexual abuse are thus highly relevant.’ (Guerra et al., 2021, p. 221) ‘Those adolescents who felt emotionally close to their family, felt they would be believed and had a supportive family member were more likely to disclose’ ‘All children, regardless of age, are entitled to have adults who respond to them in noticing when they are distressed, asking them about their wellbeing, taking them seriously, and taking action to protect them from further harm.’ ‘There are simple steps of listening and believing which can go a long way to supporting children and young people in disclosing the abuse’ In our next paper, Bibhuti Sar and Linda Bledsoe (2021) from the University of Louisville, Kentucky, explore another area where there are significant potential barriers to action: that of adults intervening when they observe possible abuse or neglect. In a cross-sectional survey of 306 adults attending a child abuse prevention training programme, they explored whether a history of childhood maltreatment and perceived knowledge of child abuse indicators affected the willingness of those adults to intervene in cases of possible abuse or neglect. They found that having a history of childhood abuse increased an individual's willingness to intervene, and this was partially mediated through perceived knowledge of the symptoms of abuse and neglect. ‘… individuals are likely to intervene if they possess the requisite skills and resources to act, and less likely to intervene if there is uncertainty and/or ambiguity about what they are witnessing or doubts about their abilities.’ (Sar and Bledsoe, 2021, p. 234) ‘The willingness of adults to intervene… can be enhanced by a greater awareness of the indicators of maltreatment’ In the introduction to their paper, Sar and Bledsoe summarise some of the literature on barriers to reporting, including a lack of knowledge of potential indicators of abuse and neglect. The barriers are substantial. Brennan and McElvaney's (2020) model of ‘need to tell’ and ‘opportunities to tell’ potentially provides a useful framework for how to improve rates of reporting and intervention by adults. If we can raise awareness of the impact of abuse on children, and the risks to the family, community and other children, while minimising the negative consequences of reporting, and alongside this, provide safe and effective opportunities for adults to report or intervene, then surely we can engage better with communities in protecting children from harm. Our next paper, by Juan Manuel Moreno-Manso and colleagues (2021) from the University of Extremadura in Spain, looks at the impact of physical and emotional abuse and neglect on children and young people; specifically on their executive functioning. As the authors point out, all forms of abuse and neglect can have profound and lasting impacts on brain development. This can be seen particularly in lasting difficulties in executive functioning – an individual's ability to perceive and process information, and to respond appropriately to different situations, both planning and executing suitable responses. ‘All forms of abuse and neglect can have profound and lasting impacts on brain development’ Moreno-Manso and colleagues suggest some helpful ways in which those working with young victims of abuse or neglect can draw on these findings – specifically in designing programmes that can help these children cope with the difficulties they find in their executive functions and to help build confidence and competency in these areas. Our final paper in this issue focuses on an even more disturbing and devastating form of maltreatment – child homicide. In a population-based study from Ontario, Canada, Anna Johnson and Myrna Dawson (2021) examine 533 cases of child homicide notified to the coroner's office between 1985 and 2012. They were able to collect data from coroners' records, police, prosecutor, court and media files to examine the effect of the victim–perpetrator relationship on the characteristics of child homicide. The authors compared extra-familial with intra-familial cases; those perpetrated by biological parents with those by step/foster-parents; and those perpetrated by mothers with those by fathers. They found that extra-familial cases were more likely to have male perpetrators, the victims were older, and the offence was more likely to take place in a public place and with the use of a weapon. They were also more likely to involve sexual violence. Compared to step- or foster-parents, biological parent perpetrators were more likely to be female, and to die by suicide following the homicide. Compared to maternal perpetrators, paternal perpetrators were more likely to kill older children, to die by suicide and to kill more than one family member. These findings emphasise the importance of a developmental perspective for understanding and preventing child homicide. The risks to young children are predominantly within the home where their biological parents, particularly mothers, are the main carers. There are risks, however, from biological fathers, step-parents and foster-parents as well as other carers; as has previously been shown, these risks extend across childhood, and may persist following separation, particularly in the context of domestic violence (Brown et al., 2014; Jaffe et al., 2014; Sachmann and Harris Johnson, 2014). In contrast, older children will increasingly face risks outside the family home as their social circle and activities expand. As has previously been emphasised, fatal child maltreatment is not a homogeneous phenomenon; we need to take a more nuanced approach, informed by developmental, psychological and ecological perspectives, if we are to better understand how and why children are killed, and ultimately to prevent such disasters (Brown and Tyson, 2014; Sidebotham, 2013). ‘These findings emphasise the importance of a developmental perspective for understanding and preventing child homicide’ Last year we published a paper by John Ratcliffe et al. (2020) reviewing the experiences of Local Safeguarding Children Boards in safeguarding children when fabricated or induced illness (FII) is suspected or proven. The authors identified a lot of uncertainty and anxiety on the part of professionals in managing these situations, and a number of challenges faced by Safeguarding Children Boards. In a letter to the editors, Dr Danya Glaser (2021) points out that, since this survey was carried out in 2017, further training has been delivered across the country, and earlier this year, the Royal College of Paediatrics and Child Health (RCPCH) launched new guidance on what they term ‘perplexing presentations’ and FII (RCPCH, 2021). ‘Earlier this year, the RCPCH launched new guidance on what they term “perplexing presentations” and FII’ The new guidance is a welcome update on the previous Royal College guidance and acknowledges the level of uncertainty and anxiety identified by Ratcliffe and colleagues in their survey. The introduction of the concept of perplexing presentations goes some way towards addressing this uncertainty and providing a framework for working with families without losing sight of the needs of the child. Over the course of my career as a paediatrician, I have been faced with a number of cases of suspected FII and have found these some of the most challenging situations to deal with. In a few cases, I have come across children who have been seriously harmed as a result. However, such serious outcomes are, in my experience, extremely rare. Far more commonly, I have had to struggle with situations where a child presents with medically unexplained symptoms and where the views of the parents and those of professionals do not necessarily align. It is in such situations, where there may nevertheless be significant concerns about potential harm to the child's physical or emotional wellbeing, that the RCPCH guidance provides a welcome perspective. Recognising that actual fabrication or induction of illness is extremely rare, but that the perceptions of parents who are anxious about their child can nevertheless inadvertently contribute to harm, allows practitioners to engage with parents, acknowledging their concerns and the practitioner's own uncertainties, while setting a clear framework for working with the child and family to minimise any risks and to promote a meaningful health and education rehabilitation plan. As Danya Glaser points out in her letter, the guidance ‘is written for paediatricians but is also applicable to the other professional groups involved including social workers, education staff and police’ (p. 268). I would encourage practitioners in all agencies to read the guidance and consider how they can incorporate it within their own local procedures. We conclude this issue with a training update and a book review. Carol Jolliffe (2021), a psychotherapist from London, reviews the APSAC/Foundling on-line course for child welfare and child maltreatment professionals. This is, in fact, a library of eight online courses covering a range of topics to provide greater knowledge about and understanding of child maltreatment and how to respond to it. The course is particularly geared towards practitioners in the USA and can provide a helpful grounding in the field from which to develop more evidence-informed practice. Sarah Tyndall (2021), a nurse consultant, reviews Declan Cooglan's book, Child to Parent Violence and Abuse: Family Interventions with Non-Violent Resistance. The aim of this book is to ‘provide a model of thinking and practice … for resolving the “wicked problem” of child to parent violence and abuse’ (p. 271). Tyndall concludes that this book offers ‘a realistic and thought-provoking account of current and emerging thinking’ and ‘a practical approach to working alongside families’ (p. 271). Perhaps there could be insights in both of these for how we understand and address the issues involved in family violence, abuse and neglect.

This article examines, by using principles of critical discourse analysis, the safeguarding policy of the Church of England as presented in the policy document Promoting a Safer Church. Overall, the document provides a succinct and comprehensive outline of the Church of England’s safeguarding policy, setting out a broad and whole-church approach to safeguarding that encompasses activities from prevention through to response and taking seriously the concerns of those who have been abused within the institution of the Church. However, the analysis also reveals some weaknesses of definition and accountability and an ongoing need, as highlighted by the recent Independent Inquiry into Child Sexual Abuse report, for a change in culture and behaviour within the Church.

This issue opens with a farewell from us as we step down from our roles as Co-Editors of Child Abuse Review. We have both thoroughly enjoyed being co-editors of the journal – Jane since 2007 and Peter since 2011. This has been a significant time for the journal, during which we have seen Child Abuse Review receive and increase its impact factor, transition to ScholarOne Manuscripts, undergo a brand and style change, move to more open-access publishing and online access, and steadily increase downloads and citations of papers. It has been exciting to be part of a great team that has steered the journal through all this, with an expanding team of national and international associate editors, the introduction of the continuing professional development section and the recent appointment of a social media editor. In all of this, we have been immensely grateful to our Editorial Manager Diane Heath (and Julia Walsh before her) for their incredible support and hard work, and to the whole team at Wiley and the Association of Child Protection Professionals. The door now opens to a new team and we are delighted to welcome and hand over to the new Co-Editors: Professor Kish Bhatti-Sinclair, Head of Social Work and Social Care at the University of Chichester, and Dr Lisa Bunting, Senior Lecturer in Social Work at Queen's University Belfast. We wish them well in the next chapter of Child Abuse Review and we look forward to seeing how the journal develops in their capable hands. ‘This issue opens with a farewell from us as we step down from our roles as Co-Editors of Child Abuse Review’ As we look ahead, we are aware of some particularly exciting opportunities for the new editorial team, for the journal and for the Association as they strive to support practitioners and researchers in the ever-changing but somehow familiar landscape of child protection. Our final issue for 2021 will be a special issue on the use of assessment tools in child protection, while our special issue for 2022 will focus on child protection during the perinatal period – both really important and practical issues. For the present, there are ongoing challenges for professionals as they seek to support children and families within the context of the ongoing COVID-19 pandemic and the gradual easing of restrictions globally. At the same time, familiar issues such as abusive head trauma (AHT) and sexual abuse and exploitation continue to present dilemmas for practitioners in all agencies. The need to be both child- and family-focused in our interventions presents both opportunities and challenges. These are all issues that are addressed in the reviews and research papers in this current issue of the journal. Our first paper in this issue is a structured review of the literature on the prevention of AHT by Debangshu Roygardner and colleagues (2021). AHT remains one of the most challenging issues in child protection. It continues to be one of the most common forms of child maltreatment fatality. AHT causes ongoing disability for many children, stress for families and dilemmas for practitioners around diagnosis and appropriate management (Otterman and Palusci, 2020). Over the past two decades, much has been achieved in understanding the complexities of presentation and management, and in developing programmes for prevention. Unfortunately, Roygardner et al. (2021) point out, that in spite of developments in prevention science, ‘only a small amount of child abuse prevention research to date has been performed with more sophisticated designs, and even less addresses AHT specifically’ (p. 386). ‘AHT remains one of the most challenging issues in child protection’ ‘(i) strategies which teach parents how to respond to newborn crying and the dangers of shaking babies; (ii) community and public health factors; and (iii) professional education and practice.’ (p. 385) The commonest prevention strategies to have been evaluated are parent education programmes, accounting for 30 of the 53 papers included in the review. The most commonly studied was the Period of Purple Crying (PPC) programme (Barr et al., 2009a, 2009b; Groisberg et al., 2020). The results for the PPC programme and other parent education programmes were mixed, with some evidence of effectiveness, particularly in improving parental understanding and behaviours, but only limited evidence – which was not replicated in all studies – that such programmes actually reduce the incidence of AHT. As with much of the evidence with which we are working in child protection, it is important to recognise that limited evidence of effectiveness of a programme is not the same as evidence that the programme is not effective. Definitive evidence of effectiveness through well-designed randomised controlled trials is difficult to achieve in low-incidence conditions such as AHT. In the UK at present, there is a lot of interest in the ICON (Infant crying is normal; Comforting methods can help; It's OK to walk away; Never, ever shake a baby) programme (https://iconcope.org/). While we are not aware of any published research to date on its effectiveness, this programme, along with the PPC and other parent education programmes, may carry benefits beyond the primary outcome of preventing AHT. The content and methods of different programmes, and how, when and where they are delivered may all have an impact on how they are received by parents, while a range of other contextual factors may also influence the extent to which parents and other carers are able to receive and act on the advice given. There is an ongoing need for robust quantitative and qualitative studies of the effectiveness of these programmes. ‘Limited evidence of effectiveness of a programme is not the same as evidence that the programme is not effective’ In a similar vein, community-wide awareness and education programmes had mixed evidence of effectiveness, and none of the studies in this category measured the impact on AHT incidence. One interesting finding though was reported in two studies which examined the effect of providing families with financial benefits (Klevens et al., 2016, 2017). These studies showed a reduction – at a state level – in AHT incidence following the introduction of paid family leave and earned income tax credit, respectively. Addressing the immediate socio-economic and community stressors facing families may have more of an impact in reducing the incidence of child abuse than programmes of parental or community education. The final group of studies in the Roygardner et al. (2021) review comprised programmes that were targeted at professionals. These studies demonstrated some improvements in professionals' awareness and management of AHT. Whether this leads in turn to reductions in AHT is unclear. The authors conclude that further research is needed in all three areas of AHT prevention, with a need for more sophisticated study designs. That, however, should not stop us using our current knowledge to continue to develop and offer prevention strategies to families, communities and professionals. Our second review paper in this issue is a systematic narrative review of family-focused practice (FFP) with families who have parents with mental health problems by Susan Lagdon and colleagues (2021) from Northern Ireland. FFP is an approach to support and intervention that centres on the whole family and is an effective approach for those with mental health difficulties. The review set out to ‘develop a working definition of family-focused practice (FFP)’ (Lagdon et al., 2021, p. 400) as previous studies had identified the lack of an agreed definition of the term. The work also sought to ‘identify the types of outcomes that are measured with a focus on service user experiences; and explore how well interventions in the included studies fit with previously established components of FFP’ (Lagdon et al., 2021, p. 400). Following a comprehensive search of 16 databases and grey literature to identify FFP research studies published between 1998 and 2016, 40 studies were included in the review and appraised using criteria adapted from the Critical Appraisal Skills Programme (2019). ‘FFP … is an effective approach for those with mental health difficulties’ The studies incorporated a range of different designs, with 30 study interventions focused on parents and children, four interventions delivered to parents only and six interventions delivered to children whose parents suffered with substance misuse, or children or young people whose parent/s had a mental illness. The core components of FFP were analysed and presented by the authors using a structure developed by Marston et al. (2016) including: ‘psychoeducation; direct treatment and support for mental health and/or problematic substance use; a focus on parenting behaviour; child risk and resilience; family communication; and family support and functioning’ (Lagdon et al., 2021, p. 401). The review also identified an additional component in some of the interventions which was about efforts to enhance access to and engagement with services and support networks in the community. In terms of research outcome measures, the research studies focused on symptoms and deficits, with the most common measures being around family functioning, parental mental health or parental substance misuse. The review team concluded that ‘there should be a greater focus on identifying what outcomes are important to families, and on measuring outcomes in a more consistent way that would facilitate comparison across studies and interventions, and open the possibility for more explicit and supported discussions with parents, and children, about their needs and professional responsibilities’ (Lagdon et al., 2021, p. 414). Interestingly, none of the studies incorporated an economic evaluation and many lacked explicit links to a relevant/appropriate theory base. Our first two research papers in this issue both address child sexual abuse and exploitation. First, Kira Nyhus-Runtz and colleagues (2021) report on an online survey of healthcare providers in the Canadian province of Saskatchewan. This survey was prompted by a recognition that, while many victims of sexual exploitation access healthcare, there are many barriers to identifying them as victims or responding appropriately. From an analysis of 125 completed surveys from physicians, nurses and psychologists, the authors found that while knowledge of the potential risk factors and presenting complaints was generally strong, healthcare providers ‘lacked confidence in identifying and managing sexually exploited children’ (Nyhus-Runtz et al., 2021, p. 427). Probing a bit deeper, it would appear that knowledge of more general risk factors, signs and symptoms was good, while knowledge of those more specific to sexual exploitation – including signs of potential grooming – was less good. Furthermore, in spite of a recognition of their legally mandated responsibility to report suspected cases, many healthcare professionals were not able to identify the correct reporting authority. The authors conclude that there is a need for specific professional education on child sexual exploitation in their province. ‘While many victims of sexual exploitation access healthcare, there are many barriers to identifying them as victims or responding appropriately’ Our next paper from Tara O'Neill and colleagues (2021) explores the potential mediating role of dissociation in the relationship between sexual trauma and psychotic symptoms. In total, 269 female survivors of sexual trauma from the UK, USA and Australia completed an online survey exploring their age at experiencing sexual trauma (237 in childhood and 32 in adult life) and their experiences of dissociative symptoms and psychotic-like episodes. Both groups experienced a high proportion of psychotic and dissociative symptoms, with those experiencing sexual trauma in childhood scoring higher than those in adulthood for both groups of symptoms. Mediation analysis showed that dissociative symptoms, particularly depersonalisation (e.g. looking in a mirror and not recognising yourself), play ‘a significant mediating role in the reporting of psychotic symptomatology among survivors of sexual trauma’ (O'Neill et al., 2021, p. 439). The authors point out that a better understanding of the relationship between sexual trauma, dissociative symptoms and psychotic symptoms can help in responding to the victims of sexual trauma. However, this can be challenging, not least because some of the dissociative symptoms may be adaptive responses to the trauma experienced. Translating this knowledge into helpful clinical practice remains a significant challenge. Our next three research papers focus on child protection practices. The first by Victoria Sharley (2021) from the University of Bristol reports on a case file analysis study of school staff's involvement in child protection cases when there are concerns about neglect. School staff are recognised as having a very important role to play in intervening early in cases of neglect and schools play a key role in the safeguarding system. However, this study sought to explore ‘the role of school staff as a combined professional group’ (Sharley, 2021, p. 445) in order to provide new evidence about this ‘group's involvement in the statutory provision of support to children living with neglect’ (p. 446). The study involved an analysis of 119 children's social work files from three local authorities in Wales, where the following sampling criteria were met: ‘(i) the school had referred the child to protection services; (ii) the child was of school age; and (iii) the child was on the child protection register under the category of neglect at the initial child protection conference (ICPC)’ (Sharley, 2021, p. 446). ‘School staff are recognised as having a very important role to play in intervening early in cases of neglect’ The study found that 50 schools (42%) in the sample provided a range of support services to children about whom they were concerned that they were living with neglect. Although ‘variation emerged in the types of neglect identified by members of school staff in different local authorities’ (Sharley, 2021, p. 452), physical neglect and other forms of abuse (e.g. physical, sexual or emotional abuse) were the two most common categories reported in the sample. If a child protection conference (CPC) had been convened, a member of staff from the school attended in 89 per cent of cases, and school staff had provided a report to the ICPC in virtually all cases (97%). While attendance dropped by ten per cent at the child protection review conference three months later, in over three-quarters of cases, schools took responsibility for some of the actions on the child's child protection plan developed during the ICPC. It was also apparent from the study findings that social workers regularly draw on information gathered from school staff ‘to inform statutory assessments’ (Sharley, 2021, p. 455). In an interesting discussion, the study also acknowledges some of the challenges encountered during the research in terms of data collection using case file analysis, for example, ‘large amounts of missing data on children's files and the restrictions this created for statistical measurement’ and the omission of school records in this study, alongside the ‘complexity of social work processes’ and differences in understanding of neglect in regional contexts (Sharley, 2021, p. 444). Our next paper in this issue by Helen Richardson Foster and colleagues (2021) from the University of Central Lancashire and University of Sheffield sought to examine how child-focused are CPCs. The rationale for this study was that despite recent research on children's participation in these statutory multiagency meetings, there is little evidence about how practitioners consider individual children's needs in such meetings. This interesting qualitative study drew on audio recordings and documentary evidence from 14 CPCs (3 initial and 11 review conferences), alongside interviews with 26 conference staff (including conference chairs, their managers and meeting minute takers) and six focus groups with 35 professionals from different agencies. Data analysis for the study drew on a four-part conceptualisation of child-focused practice developed specifically for the study, which included: the extent to which ‘assessment was informed by the child's daily lived experience’; the child's experience of abuse/neglect and aspects of parenting; whether the conference enabled children's participation and their voices to be heard and views taken seriously; and ‘whether outcome measures used for interventions and actions were rooted in the individual child's experience and based on detailed understanding of the child's circumstances established by the preceding three elements’ (Richardson Foster et al., 2021, p. 462). ‘Children's health, education and relationships were always discussed, and information was often presented in a factual way without consideration of how any difficulties or deficiencies were impacting on the child's welfare. Thus, a comparatively large amount of meeting time was taken up in discussing these general issues.’ (Richardson Foster et al., 2021, p. 464) ‘Pre-[child protection] conference reports often contained a lack of information and detail about the individual child's lived experience’ While most CPCs did not address in detail the child's daily lived experience, this was particularly the case with babies or in situations prior to the conference where there had been little engagement by parents with professionals. As found in other studies, children's and young people's participation in CPCs [in this study] was low with ‘child-focused decision-making and planning … rarely achieved’ (Richardson Foster et al., 2021, p. 458), and so practitioners and families may be ‘unclear about what is required to change’ (p. 469) as previous research has described (Appleton et al., 2015; NSPCC and SCIE, 2016). The research findings emphasised the important role of conference chairs in summarising discussions and keeping the focus on the concerns and welfare of the individual child. Our next paper, a short report by Sedigheh Khanjari and colleagues (2021), reports on the impact of an educational programme on child abuse recognition and reporting for a sample of Iranian nurses. Participants were working in paediatric and emergency care wards in public and private hospitals throughout Tehran, and the intervention was an in-service education programme on child abuse. Data were collected pre-intervention and six weeks following training using the Child Abuse Report Intention Scale (Feng and Levine, 2005). This quasi-experimental study found low levels of knowledge in both groups (intervention and control) pre-intervention and an increase in knowledge levels for the control group post programme. The study team concludes that the educational intervention is potentially effective in improving nurses' knowledge about child abuse, their attitudes towards child-rearing and discipline, their perceived behavioural control and their intention to report child abuse. ‘Educational intervention is potentially effective in improving nurses' knowledge about child abuse… and their intention to report’ Our final paper in this issue continues our personal practice series reflecting on the impact of the COVID-19 pandemic on children and families (Appleton and Sidebotham, 2020; Donagh, 2020; Jacob, 2020; Øverlien, 2020; Roberts, 2020). In a short case study from Germany, Tobias Heimann and colleagues (2021) report on three consultations from the Medical Child Protection Hotline, ‘a nationwide hotline for medical professionals in cases of suspected or substantiated child abuse and neglect’ (p. 486). In the three months from 15 March to 20 May 2020, the hotline received 116 consultations, of which 16 were specifically related to the effects of the pandemic or lockdown. The three cases presented here include a seven-year-old boy who disclosed physical punishment during home schooling and whose parents were reporting increased stresses because of the pandemic; a 16-year-old girl with allegations of escalating emotional and physical abuse during the lockdown; and a mother of a young infant with breathing difficulties who was refusing to seek medical advice because of fears of COVID-19. The authors highlight these cases as illustrating the influence of the pandemic and lockdown measures on families – including those in whom there had not previously been concerns. They point out that stresses on families may lead to an exacerbation of violence in the home and emphasise the need for easily accessible support during any lockdown. In December last year, the Child Safeguarding Practice Review Panel in England published its report on supporting vulnerable children and families during COVID-19 (Child Safeguarding Practice Review Panel, 2020). This report identified that ‘COVID-19 presents a situational risk for vulnerable children and families, with the potential to exacerbate pre-existing safeguarding risks, and bring about new ones’ (Child Safeguarding Practice Review Panel, 2020, p. 1). In particular, the report identified that parental and family stressors, such as changing family dynamics, disrupted routines, overcrowding and a lack of contact with extended family members, could lead to increases in domestic violence and mental health concerns. For some families, these stresses could lead to physical or emotional harm to children. There were additional impacts on the mental health and wellbeing of young people from the effects of school closures and the lack of their usual support structures. In addition to this, practitioners and service managers faced pressures as they adapted to COVID-safe working arrangements. As governments across the world gradually release some of the more stringent measures to control the COVID-19 pandemic and children return to school and other activities, we must keep alert to the potential ongoing impact of the pandemic and its social and economic effects on children and families, and we must reflect on how governments and child welfare services have responded to the pandemic so that we can learn lessons for the future. ‘We must keep alert to the potential ongoing impact of the pandemic and its social and economic effects on children and families’ We end this issue with a training update and a book review. First, Hannah Gaffney (2021) reviews the Anti-Bullying Alliance's free online training on Developing Effective Anti-Bullying Practice. This learning programme is geared towards reducing bullying, particularly of children and young people with additional needs. Gaffney found particular strengths of the training in its distinction between relational conflict and bullying behaviour, and its acknowledgement of the ever-changing landscape of bullying. The content was clear and evidence-based, and provides ‘an excellent resource for anyone working with children with disabilities’ (Gaffney, 2021, p. 494). This issue concludes with a review by David Clarke, a lecturer in social work at Glasgow Caledonian University, of Deborah Fry and colleagues' 2017 book Child Protection and Disability: Practical Challenges for Research. Clarke's (2021) review is very positive about the book which draws upon global research to highlight the prevalence of violence experienced by children with disabilities. Clarke emphasises that the book is geared towards researchers undertaking research studies with children with disabilities, rather than practical support for professionals. He highlights that the book helpfully addresses some of the challenges faced when undertaking research with this group of children, and notes that the book offers useful practical guidance on ethical issues, sampling and informed consent, with one chapter drawing on real-life examples to explore methodological challenges. With that breadth of content in the issue, we hope that you will find something to engage with or to inspire, challenge or support you in your practice. As the outgoing editors, we are extremely grateful to you, our readers, for all your support and engagement with the journal, and to all our authors, peer reviewers and the editorial team. We continue to be impressed by the amazing work going on every day to support vulnerable children and families, here in the UK and around the world, and it has been a privilege to see so much of that reflected in the pages of Child Abuse Review. We leave you in committed and capable hands! Jane and Peter ‘As the outgoing editors, we are extremely grateful to you, our readers… and to all our authors, peer reviewers and the editorial team’

Child sexual abuse (CSA) – as pointed out by Paediatric Research Across the Midlands (PRAM) (2021) in the first paper for this themed issue on sexual abuse and exploitation – is common, under-reported and often co-exists with other forms of maltreatment. These features form a backdrop to several of the original papers included in the issue. ‘Child sexual abuse … is common, under-reported and often co-exists with other forms of maltreatment’ The PRAM collaboration undertook an audit of child protection medical assessments in the West Midlands to establish whether CSA was being considered when children underwent medical assessments for other forms of maltreatment (PRAM, 2021). Their starting point was the understanding that some children who experience physical or emotional abuse or neglect will also be victims of CSA, but that much of this will go unrecognised, both because the children themselves find it difficult to report and professionals may not recognise, or look for indicators of, CSA. The authors analysed data from nine healthcare trusts over a four-week period ‘to establish which factors made it more likely that features specifically useful in the detection of CSA’ were looked for (PRAM, 2021, p. 12). Their audit included 91 medical assessments, mostly for physical abuse, in children aged from two weeks to 15 years. They found that persistent or recurrent anal or genital symptoms, bowel or urinary disorders and changes in behaviour were specifically asked about in less than half of the medical assessments, thus potentially missing important indicators of possible sexual abuse. They found that consultants were more likely than trainees to ask about abnormal sexualised behaviours, and that those doctors working in the community (who, they assert, will have had more specific training in CSA) were more likely to enquire about genito-urinary and bowel symptoms. The findings from this audit reinforce the challenge expressed by Finkel (2019, p. 99) that ‘the medical community at large could play a more proactive role in providing primary prevention and in the recognition and assessment of CSA’. When assessing children for other suspected forms of abuse or neglect, clinicians should be alert to the possibility of concomitant CSA, and they should specifically enquire about bowel and genito-urinary symptoms and changes in behaviour or mood that may raise concerns. ‘When assessing children for other suspected forms of abuse or neglect, clinicians should be alert to the possibility of concomitant CSA’ One aspect of this proactive approach that applies to all professionals – including those in health, education, social work and policing – is an awareness of harmful sexual behaviours. Not all sexual behaviour in children is harmful. Sexual development is an important part of normal child development, and this will involve different forms of exploration and interaction that are socially acceptable and developmentally appropriate. Professor Simon Hackett, a leading authority in this field, has proposed a continuum model of sexual behaviours in children from normal through to inappropriate, problematic, abusive and violent (Hackett, 2010). A similar differentiation is encompassed in the Brook Traffic Light Tool, which distinguishes between normal (green), concerning (amber) and harmful (red) sexual behaviours in children (Brook, 2013). ‘The Brook Traffic Light Tool… distinguishes between normal (green), concerning (amber) and harmful (red) sexual behaviours in children’ In our second paper of this issue, Sophie King-Hill (2021) presents a careful evaluation of the Brook Traffic Light Tool which was introduced, along with training, in a local authority in the south of England. King-Hill (2021) found that the multiagency training resulted in improvements in practitioners' knowledge and behaviours, in particular she found that ‘understanding of healthy sexual development had been raised through the training which provided clarity, a change in views, shared terminology and confidence among CYP professionals’ (p. 22). These elements of professional knowledge and confidence, clarity and shared terminology all contribute to appropriate responses to children's sexual behaviours. King-Hill (2021) echoes previous calls for a national strategy on sexual behaviours in children and young people, and proposes that a merging of the Brook Traffic Light Tool and the NSPCC Harmful Sexual Behaviour Framework (Hackett et al., 2019) could be a helpful way forward in developing such a strategy. Our third paper by Guy Shilo and colleagues (2021) addresses the complexities of commercial sexual exploitation of young people in Israel. Recognising that sexual exploitation is not a simple or homogeneous phenomenon, the authors explore aspects of the psychosocial background and past experiences of sexually exploited young people. Their study drew on data from case managers, intake meetings and case files of 57 cisgender females, 40 cisgender males, 23 transgender females and two transgender males. They found that, in addition to the abuse inherent in their sexual exploitation, the majority of these young people had also experienced other forms of abuse, predominantly within the family, but also from the perpetrators of the sexual exploitation. This included 68 per cent experiencing specific sexual abuse, 71 per cent experiencing physical abuse and 81 per cent experiencing emotional abuse. Adverse emotional, educational, health and criminal outcomes were common, with a high prevalence of mental health problems, drug misuse and criminality. Fifty-five per cent of the young people had attempted suicide, often multiple times. While 70 per cent had attended high school, only 20 per cent had graduated and matriculated. ‘Sexual exploitation is not a simple or homogeneous phenomenon’ Although Shilo et al. (2021) found some gender differences in the young people's psychosocial background factors, they did not find any solid gendered profiles. They conclude that these youth ‘cannot be characterised solely or predominantly by their gender identity’ (Shilo et al., 2021, p. 43), but that their findings ‘support the recommendation to use an intersectional lens… rather than a gendered one…, taking into consideration gender identity, race and sexual orientation as vulnerability variables to understand the paths of youth to commercial sexual exploitation and the ways to help them’ (Shilo et al., 2021, p. 43). In an inspiring study published in the Child Abuse Review 2019 special issue on sexual abuse and exploitation, Hallett et al. (2019) compared children and young people with experiences of child sexual exploitation and those presenting with harmful sexual behaviours. They found quite strong gendered differences in how these two groups were perceived and how professionals worked with them, but very similar experiences in terms of their exposure to prior abuse and domestic violence. These findings would seem to concur with those of Shilo et al. (2021) who recognise the unique vulnerability and risk factors for individual young people, regardless of their gender identity. They call for interventions with sexually exploited young people to ‘be tailored to reflect various needs specific to gender identity, sexual orientation, race and religion, as well as to the lived individual experiences of the youth’ – arguing for gender-inclusive rather than gender-specific programmes (Shilo et al., 2021, p. 43). Likewise, in their conclusion, Hallett et al. (2019, p. 452) suggest that ‘practitioners should be encouraged to be reflexive about their understandings of gender and sexuality among children, while practice should be directed to encompass and allow for a more complex understanding of vulnerability’. The educational disadvantage experienced by the young people in Shilo et al.'s (2021) study is not, of course, limited to victims of sexual exploitation, but is a common consequence of all forms of maltreatment and other adverse childhood experiences. This forms the topic of a longitudinal study by Lars Brännström and Sten-Åke Stenberg (2021) from Stockholm University. These authors draw on the sociological theories of Raymond Boudon (1974) to explore the pathways from socio-economic disadvantage to educational outcomes in children placed in out-of-home care. They propose two mechanisms through which early social disadvantage may result in poorer educational outcomes: a ‘primary’ ability-driven mechanism, through which genetic and socio-cultural factors affect an individual's level of school performance, and a ‘secondary’ choice-driven mechanism through which an individual's background affects the educational choices that he or she may make, regardless of any underlying educational ability. ‘Educational disadvantage… is a common consequence of all forms of maltreatment and other adverse childhood experiences’ Through an elaborate analysis of prospective longitudinal data from a cohort of more than 14 000 Swedes born in 1953, Brännström and Stenberg (2021) demonstrate that it is the secondary, choice-driven mechanism which is ‘the key driver in creating differentials in midlife educational attainment among individuals of different social origins’ (p. 48). They found that 61 per cent of individuals in the out-of-home care group ‘had not exceeded compulsory education or two-year vocational school compared to 39 per cent in the majority population’ (Brännström and Stenberg, 2021, p. 55), and that ‘out-of-home care individuals had substantially lower grades in the final year of compulsory school’ (Brännström and Stenberg, 2021, p. 55). They point out that there are disincentives to those from disadvantaged backgrounds choosing higher education, even when their academic abilities would not prevent such choices. This research has important implications for those working with looked after children and those who have experienced abuse or neglect. While interventions aimed at improving school performance are important, it is equally important to address the underlying socio-cultural disincentives to making positive educational choices. This requires a combination of advocacy to address the deep socio-economic inequalities in our society and a focus on building resilience and agency in individuals from such disadvantaged groups. ‘It is equally important to address the underlying socio-cultural disincentives to making positive educational choices’ Building resilience and agency is the basis of Keeping Our Girls Safe (KOGS) – a primary preventive service for young people at risk of child sexual exploitation. In a short report, Peter Unwin and Alexandra Jones (2021) of the University of Worcester report on an evaluation of the KOGS programme. In their introduction, they point out that the approach used by KOGS ‘counters deficit models and goes beyond risk assessment concerns, seeking to promote agency and protective factors within the young people attending by building their confidence, personal skill base and awareness of the environment’ (Unwin and Jones, 2021, p. 63). They reported an overall positive response by young people to the programme, with reported growth in confidence, self-esteem and knowledge of social behaviour. The young people particularly appreciated the trustworthiness of the staff, volunteers and peer mentors, and the authenticity of those who had ‘lived experience of unhealthy relationships, exploitation and abuse’ (Unwin and Jones, 2021, p. 66). The use of peer mentors and an accredited arts programme could provide a model for other preventive programmes that could help build self-esteem and positive life choices in young people who are at risk, thus – potentially – avoiding some of the educational disadvantage highlighted by Brännström and Stenberg (2021). In our final original paper, Nick Hindley and Lisa Lord (2021) from Oxford Health NHS Foundation Trust report on the development of guidance for responding to disclosure of non-recent CSA. With greater awareness among professionals of the nature and impact of early trauma and abuse, and an increased empowerment of survivors to speak out, they recognise the need for clear guidelines for professionals in how to respond to such disclosures. The approach this team took to developing their guidelines was inclusive and collaborative, multiagency, transparent and backed up by accessible information and advisory support. Drawing on those principles, they undertook a 12-stage process of guideline development including: identification of key stakeholders; a literature review; an extensive consultation process including service user participation; development of the guidance, supporting materials and training; review by a clinical ethics committee; and ongoing review of the programme. The process reported by Hindley and Lord (2021) presents an exemplary approach to the development of practice guidance which could be adapted for any complex area of professional practice. In relation to the uncertainties expressed by clinicians about how to respond to disclosures of non-recent sexual abuse, and in spite of initial anxiety and concern, the authors report ‘increased confidence in dealing with the complexities of this area of work was reported by both practitioners in the safeguarding team and the clinicians they were seeking to support’ (Hindley and Lord, 2021, p. 80). ‘Presents an exemplary approach to the development of practice guidance which could be adapted for any complex area of professional practice’ We end this issue with a training update and a book review. Michelle Jayman (2021) reviews an e-learning module from the Child Outcomes Research Consortium and Anna Freud Learning Network on Measuring Mental Wellbeing to Improve the Lives of Children and Young People. The e-learning module could be particularly useful for educational staff who now have a statutory responsibility to support pupils' mental wellbeing, yet often feel ill-equipped to manage this role. Michael Fanner (2021) reviews a wide-ranging international book on Errors and Mistakes in Child Protection by Kay Biesel and colleagues. Fanner (2021) concludes that ‘this innovative book facilitates a refreshing approach to the advancement of a global commitment to keep children safer from harm, through collective understanding, learning and, indeed, action’ (p. 86) and highly recommends it for all those ‘interested in child protection system design and strategy’ (p. 86).

Problem: While perinatal mental health issues are considered to have an impact on a mother?s parenting capacity, there is limited research exploring mothers? perceptions of their relationship with their child following traumatic birth experiences and how these might affect their parenting capacity. Background: Birth trauma is a well-recognised phenomenon which may result in ongoing physical and perinatal mental health difficulties for women. This may impact on their attachment to their children, their parenting capabilities, and their self-identity as mothers. Aims: To explore maternal self-perceptions of bonding with their infants and parenting experiences following birth trauma. Methods: In-depth interviews with ten mothers were undertaken using an Interpretative Phenomenological Analysis methodology. Findings: Women who experienced birth trauma often described disconnection to their infants and lacking confidence in their parental decision making. Many perceived themselves as being ?not good enough? mothers. For some women the trauma resulted in memory gaps of the immediate post-partum period which they found distressing, or physical recovery was so overwhelming that it impacted their capabilities to parent the way they had imagined they would. Some women developed health anxiety which resulted in an isolating experience of early parenthood. Conclusions: Women who have suffered birth trauma may be at risk of increased fear and anxiety around their child?s health and their parenting abilities. Some women may experience this as feeling a lower emotional attachment to their infant. Women who experience birth trauma should be offered support during early parenting. Mother-Infant relationships often improve after the first year. ? 2020 Australian College of Midwives. Published by Elsevier Ltd. All rights reserved.

One of the gifts of the strange circumstances of 2020 has been an increased awareness of just how much we are a global society. Whether it is the COVID-19 pandemic, the increasing impacts of the climate crisis, or the realities of racial inequalities and prejudices in our society and culture, we recognise that we are all affected. There must be few, if any, countries where the impact of coronavirus has not been felt – impacting on people's lives and livelihoods. And yet, while it is clear that all are potentially vulnerable, there are huge inequalities in the extent to which individuals are affected. It is also clear that both cultural and political factors have influenced how different countries have responded to the pandemic, and consequently have affected both morbidity and mortality rates between countries. As with the COVID-19 pandemic, child maltreatment is an issue which affects every country and society in our world. And – as with infectious diseases – while all are potentially vulnerable, there are inequalities within our societies, and both cultural and political factors influence the way in which we respond and the extent to which children are harmed or protected from harm. In this global-themed issue of Child Abuse Review, we explore child maltreatment across six low- and middle-income countries, addressing different aspects of abuse and violence against children, the societal and cultural factors influencing it, and how different areas are working to recognise and respond to – and ultimately to prevent – such harm. Our first two papers start the issue off on a positive note, demonstrating how engaging with local communities and understanding local cultures can lead to effective interventions to protect children and support families. In the first paper, from Ghana, Alhassan Abdullah and colleagues (2020) interviewed kinship carers to explore how the culturally informed traditional practice of kinship care might be an effective intervention strategy for parental neglect. In Ghana, kinship care has long been established as an informal, community-based practice which is able to respond to family difficulties. While formal options for protecting children in the country are limited with staffing, resource and financial challenges, kinship care may provide an alternative approach which is more readily accessible and potentially could carry better outcomes for children and families. ‘Engaging with local communities and understanding local cultures can lead to effective interventions to protect children and support families’ ‘Just look at how the houses are arranged, just next to my house is my mother's house, behind my mother's house is that of my sister and the husband's house. So now tell me who will be the first person to identify when children in these homes are treated badly?’ (Abdullah et al., 2020, p. 408) ‘These results add weight to the appropriateness of kinship care as a viable and positive alternative to more formal child protection interventions’ Our next paper, from Jennifer Driscoll (2020), looks at another alternative to more formal child protection processes, this time examining the role of para social workers (PSWs) in rural communities in Uganda. Driscoll used a community resilience model to analyse interviews with local government officers, civil society organisation staff and PSWs in two rural areas of Uganda. As with Ghana, formal child protection services are limited by resource and financial constraints. At the same time, traditional community responses to child maltreatment have ‘also come under pressure from entrenched poverty, a rising youth population and the AIDS epidemic’ (Driscoll, 2020, p. 417). Within that context, PSWs have arisen as a community-driven approach to address child protection concerns at a local level. There is, however, a limited evidence base of their effectiveness in protecting children. As with the Ghanaian study, this research presents a very positive view of the role of PSWs. The PSWs interviewed obviously took pride in their role. They were all drawn from within their local community leadership and saw their role as leading by example and being a trusted source of advice. Their role included ‘identifying children who have been maltreated or who are living in high-risk circumstances; referring cases to appropriate services and undertaking follow-up and providing family mediation’ (Driscoll, 2020, p. 423). They were able to deal with a wide range of lower-level instances of child abuse or neglect, while more serious cases were referred on to governmental or non-governmental social workers or community development officers. One of the key elements of the success of the PSW role seemed to rest in good communication, with the PSWs acting as a bridge between the local community and governmental institutions. This helped to strengthen the coordination of child protection work. To a large extent, there was good community ownership of the approach. However, this was not universal, and issues such as corruption or a lack of cooperation, or even active undermining of their role by local government officials presented barriers to such community ownership. The concept of community resilience came to the fore in the role of the PSW in organising community-level action to protect children. The research suggested that PSWs were proactive in engaging communities in owning their wider responsibility for bringing up children, and – as with the research from Ghana – kinship care within the wider family was a crucial part of this. There was a recognition that kinship care was, in fact, a better alternative to court removal of a child. In the words of one project coordinator: ‘We encourage the community. Because within the community that's where the child has been born and he knows the people, the culture, the behaviours’ (Driscoll, 2020, p. 427). Both of these papers demonstrate creative and culturally sensitive approaches to rethinking child protection within the constraints of limited resources and particular social contexts. While these specific approaches might not be easily translated to our Western contexts, they challenge us to think creatively about how we could adapt our systems to cope with the constraints that we face. In particular, they emphasise the importance of engaging with and listening to families and local communities – who might well have solutions that we as professionals and policymakers are unable to see. The concept of community resilience used by Driscoll has been defined as ‘the existence, development, and engagement of community resources by community members to thrive in an environment characterized by change, uncertainty, unpredictability, and surprise’ (Magis, 2010, p. 402). As we move through 2020 and into the decade ahead, perhaps this is a concept that we need to discover more in our own cultural contexts. ‘These papers demonstrate creative and culturally sensitive approaches to rethinking child protection within the constraints of limited resources and particular social contexts’ Community resilience is a concept that may also be relevant to addressing the culture of violence portrayed in the paper by Angela Trujillo and colleagues (2020) from Columbia. These authors used the Spanish version of the Parent–Child Conflict Tactics Scale (Straus et al., 1998) to assess parental reports of the use of corporal punishment in the four major cities of the country. They found that 77 per cent of parents admitted to using corporal punishment. The authors postulate that this high prevalence might be linked to an ongoing culture of violence in the country, particularly direct or indirect exposure to the armed conflict that the country has endured for over 50 years. However, as the authors point out, the peace agreement signed in 2016 offers some hope. In light of this, they suggest that ‘it is important to focus on everyday practices that are fostering other types of violence, particularly those among children, as the basis for achieving long-lasting peace in society’ (Trujillo et al., 2020, p. 434). Columbia is, however, far from being the only country where children experience high levels of corporal punishment. Our next paper by M. Atiqul Haque and colleagues (2020) looks at how child maltreatment is portrayed in Bangladeshi newspapers. The authors cite studies suggesting that as many as 91 per cent of children in Bangladesh experience corporal punishment at school and 97 per cent at home. However, a lack of robust epidemiological data and ongoing monitoring of child maltreatment is a barrier to fully understanding the nature and prevalence of violence against children in the country. The authors analysed newspaper reports on cases of child maltreatment published in the top four Bengali language and the top two English language newspapers between October and December 2014. They found 790 cases of child maltreatment reported in 1052 articles. The most commonly reported cases involved physical abuse, followed by sexual abuse and neglect, and nearly a third of the reported cases involved fatal child abuse. Their analysis seems to confirm that the media tends to report on sensational cases and with little social commentary and coverage of the societal consequences of child maltreatment or how such harm could be prevented; a finding that mirrors that of recent similar studies in both Israel and China (Katz et al., 2019; Qiao et al., 2018). The authors point out that the media can provide a relevant source of information on child maltreatment in a situation where official data are lacking, and that the media can be an agent for change. As Katz et al. (2019) comment, ‘The media plays a significant role in our lives and constitutes a very powerful socialising agent with the potential to influence public opinion and policymakers regarding social issues, such as child maltreatment’ (p. 127). However, where stories are sensationalised and children's rights, including their right to privacy, are not respected, such media reporting can compound the low status of children in a society and may cause yet further harm to those affected by maltreatment. ‘The media can provide a relevant source of information on child maltreatment in a situation where official data are lacking’ Our next two papers both apply a culturally aware approach to translating and adapting particular assessment/screening tools for use in a Middle Eastern context. First, Yoke Rabaia and colleagues (2020) explore the use of discipline and understanding of child abuse in the West Bank. This was a qualitative study undertaken as part of an adaptation of the International Child Abuse Screening Tools (ICAST). The researchers interviewed mothers, young men and young women to gauge their perceptions of the translated ICAST questionnaires. The interviews confirmed that questions on child discipline were clear, relevant and acceptable, and that physical punishment is common and considered acceptable within Palestinian society, though extreme forms of physical punishment are considered abusive and their effectiveness is questioned. The participants – both young people and mothers – emphasised the impact of the psychological abuse that often accompanies both physical punishment and other forms of discipline, and stressed that humiliating a child could be more damaging than physical punishment itself. The most striking finding of Rabaia et al.'s (2020) study was the unacceptability of questions relating to sexual abuse. All three groups of interviewees considered it inappropriate to ask questions about sexual abuse within Palestinian society. These findings reflected a general discomfort about discussing sexual abuse among both interviewees and interviewers. Interviewees in particular pointed out that sexual abuse is rarely disclosed in Palestinian society, and the very fact that a person has been sexually abused would be a source of shame. Participants felt that asking about such abuse could be psychologically harmful, through opening up old wounds, and suggested that ‘if “people” (i.e. parents, brothers, husbands) found out that young female family members had answered such questions (regardless of how they answered), they might be punished’ (Rabaia et al., 2020, p. 469). Furthermore, by including such questions in a questionnaire, the fieldworkers administering the survey could be at risk of harm from the community. The strength of feeling from the respondents on this issue was so strong that the researchers opted to remove all questions about sexual abuse from the final agreed versions of the ICAST questionnaires. ‘The most striking finding… was the unacceptability of questions relating to sexual abuse’ These findings emphasise the importance of careful engagement with local communities when adapting any child protection initiatives – whether they be screening or assessment tools, prevention programmes or statutory interventions – for use in a different country or cultural context. The authors have clearly taken a robust and ethical approach to adapting the ICAST questionnaires that is to be commended. The need for such an approach was emphasised in a previous paper by Strydom and Schiller (2019) from South Africa. Their use of intervention research highlights an approach that can be culturally sensitive and empowering to both practitioners and local communities. Nevertheless, it is concerning that sexual abuse is such a taboo subject and that cultural sensitivity meant that the researchers felt they could not ask about it, even in an anonymised research context. This raises important questions about how one can appropriately engage with communities to start to shift the culture of silence, denial and shame, and create a culture where such taboos are spoken about, young people are able to disclose when they have been abused and, ultimately, such abuse is prevented. ‘These findings emphasise the importance of careful engagement with local communities when adapting any child protection initiatives’ In our final research paper, Jumana Al Abduwani and colleagues (2020) also take a culturally sensitive approach to adapting an assessment tool – an Arabic language version of the Child Abuse Potential Inventory (CAPI). The CAPI is a well-validated screening tool that assesses the potential for physical abuse by parents. It has been adapted for use in many languages and cultures, and this is the first adaptation for an Arabic context. The authors found that the Arabic version of the CAPI was a valid and reliable tool with high internal consistency and test–retest reliability. Mothers who completed the tool felt that it was acceptable, realistic and culturally appropriate. Interestingly, mothers in the study indicated a desire for more parenting programmes to improve their parenting, provide health benefits and help prevent abuse. The actual CAPI results in this population showed a much higher mean score and 95 per cent cut-off score than the original US population. The scores were more in keeping with those in studies in other Mediterranean countries such as Turkey and Greece. Al Abduwani et al. (2020) comment that ‘It is not safe to assume that higher scores computed by the CAPI indicate that Omani mothers are more abusive in nature or necessarily carry a higher potential for perpetrating child physical abuse’ (p. 487). Rather, they state that ‘It seems likely that the discrepancy may be, at least partly, due to differences in parenting styles, practices and expectations’ (p. 487). In particular, they point out that the use of mild-to-moderate corporal punishment is not considered abusive – a conclusion that perhaps accords with the findings of other papers in this themed issue. The paper provides some useful insights into this Middle Eastern culture, and in particular into a culture in transition, with mothers apparently wanting to move to less harsh parenting approaches but being aware of how deep rooted some of these approaches are. As with all the research papers in this themed issue, the research by Al Abduwani et al. (2020) emphasises the crucial importance of engaging with local communities, learning to listen, and adapting our approaches to safeguarding children to take account of and draw on the strengths of the cultures and contexts within which children are living. We end this issue with the second of our reflective practice pieces on the impact of COVID-19 on child protection services. In this paper, Hannah Jacob (2020) reflects on her experience as a paediatrician and some of the safeguarding challenges that she and her colleagues have faced. These have included: delays in presentation of children with illness and injury; the stresses on parents stuck at home with young infants, without the usual sources of support and advice; the stresses on young people isolated from their peer communities; and huge changes to normal working practices. Jacob reflects on how she has had to learn to deliver clinical care in a virtual environment and find new ways of supporting and interacting with colleagues. However, she has found new opportunities alongside these challenges, including greater opportunities for online learning and peer review, and greater engagement in multi-professional safeguarding meetings. As we look ahead to reshaping our services in the light of the pandemic, there are undoubtedly fresh possibilities. There are opportunities to think creatively about how we work with children and families to ensure that children are safe and well. Perhaps there is much that we can learn from the children and families themselves – might there be untapped resources within their communities that could help reduce the pressure on our already stretched statutory services? Perhaps, too, there is much that we can learn from our colleagues in low- and middle-income countries who have often had to adapt in creative ways to work within their cultural contexts. ‘As we look ahead to reshaping our services in the light of the pandemic, there are undoubtedly fresh possibilities’

Aim: To identify how British Child Death Overview Panels (CDOPs) and paediatric pathologists classify cause of death for sleep-related Sudden Unexpected Death in Infancy (SUDI). To determine compliance with national requirements for SUDI investigation. Methods: Electronic survey of CDOPs and pathologists using three vignettes of SUDI cases illustrating: accidental asphyxia, typical Sudden Infant Death Syndrome (SIDS) and SIDS with co-sleeping. Results: Thirty-eight (41%) of 92 CDOPs returned questionnaires, and 32 were complete. Thirteen (14%) of 90 pathologists returned complete questionnaires. Thirty-one (97%) CDOPs and 7 (53%) pathologists agreed with the cause of death in the accidental asphyxia case; 24 (75%) CDOPs and 9 (69%) pathologists in the typical SIDS case; and 11 (34%) CDOPs and 1 (8%) pathologist in the co-sleeping SIDS case. Pathologists used the terms SUDI or unascertained as the cause of death for the accidental asphyxia case (46%) and the co-sleeping SIDS case (77%). These terms were used by CDOPs for the typical SIDS case (25%) and the co-sleeping SIDS case (41%). Seventeen (46%) CDOPs reported compliance with guidelines for investigation in more than 75% of cases. Conclusion: There is wide variation in classification of deaths, with only limited agreement between CDOPs and pathologists. The terms SIDS and accidental asphyxia are underused, even in typical cases.

The new decade brings with it the first anniversary of the Association of Child Protection Professionals (AoCPP; the charity was previously known as BASPCAN). The AoCPP charity and membership association aims to improve the lives and safety of children and young people by working with those in the field to provide research, representation, training and support. For example, in March 2019, over 100 practitioners, students and researchers came together in a conference in York to network and discuss some of the latest developments from authors of the third edition of The Essential Guide to Assessing Vulnerable Children, Young People and their Families (Howarth and Platt, 2019). Through such work with professionals, the organisation has been driving improvements in child protection and safeguarding to influence policy and practice for over 40 years. In November, our 40th anniversary conference celebrated some of these improvements, along with hearing from practitioners and academics of innovative developments across the UK. Our interprofessional and internationally recognised journal Child Abuse Review has played a central role in these initiatives through its coverage of all forms of child maltreatment research, practice and policy. Child Abuse Review continues to provide a forum for all professionals working in the child protection and safeguarding field to access the latest international research evidence, practice developments, training initiatives, new books and policy issues. This issue continues this forward drive in examining cutting-edge research on child sexual abuse (CSA) and filicide. ‘Child Abuse Review has played a central role in these initiatives through its coverage of all forms of child maltreatment research, practice and policy’ Two systematic reviews in this issue examine different aspects of CSA. The first, by Kirsten van Ham and colleagues (2020) from the University of Amsterdam in The Netherlands, examines instruments used to assess nonverbal emotional signs in children during an investigative interview for suspected sexual abuse. The review included nine studies (seven originated from the USA) that focus on assessment, observation or a clinical analysis of ‘nonverbal emotional signs and symptoms in children and adolescents aged three to 17 years during an interview or conversation for the investigation of CSA, conducted by a medical, forensic or psychological professional’ (van Ham et al., 2020, p. 15). van Ham et al. (2020) found that the nine studies all reported different study aims and described eight different instruments to assess nonverbal emotional signs. The instruments were all developed independently and included the coding of videotapes from the original forensic investigative interviews. They also found that study designs were not well reported, and that while all the studies discussed the instrument measurement properties, insufficient detail was given for analysis of validity and reliability. The challenges inherent in using assessment tools in child protection is one of the key themes of our 2021 special issue for which we are now inviting abstracts – further details are available on the journal and association websites and at the end of this issue. A key finding of van Ham et al.'s (2020) review was ‘the variability of the abuse verification status of the subjects in the included studies’ (p. 20), and an important recommendation is that in future research ‘the verdicts on whether or not CSA took place should be based on consensus by a multidisciplinary team of experts in the field of CSA, using a standard set of criteria’ (pp. 20-22). These authors call for the development of a single valid and reliable instrument to measure nonverbal emotional signs in children and young people for use during the clinical interview. They argue that this is essential to develop the evidence base in the field of suspected CSA. They state that because of the lack of current scientific evidence on this issue, medical and psychological professionals and those working in the courts ‘must be careful about drawing any conclusions that are (partly) based on children's and adolescents' nonverbal emotional signs’ (van Ham et al., 2020, p. 23). ‘[A] call for the development of a single valid and reliable instrument to measure nonverbal emotional signs in children and young people for use during the clinical interview’ ‘CSA experience is significantly related to an earlier onset of depression [among adult patients with depression] with a moderate effect size … which suggested that sexually abused patients were generally more likely to develop depression at an earlier age.’ (Li et al., 2020, p. 34) ‘Earlier CSA onset was found to be significantly related to the risk for depression with a small-to-moderate effect size in studies using female, adult or clinical/community samples and where CSA onset was measured as a continuous age variable. In contrast, this relationship was not found in studies with mixed-gender, younger age or student samples and where CSA onset was measured as a categorical developmental stage.’ (Li et al., 2020, p. 40) ‘Further research studies are required to investigate the relationship between CSA at different developmental time periods and depression’ Our third paper in this issue (Cook and Mott, 2020) explores the subject of child sexual exploitation (CSE), a topic that we have previously examined in Child Abuse Review (Appleton, 2014; Laws and Hall, 2019). Cases of CSE are frequently characterised by a power imbalance between the child/young person and the abuser. A power imbalance often reported is the age difference between the child/young person and the abuser. The paper by Louise Cook from Aneurin Bevan University Health Board, Newport, and Alison Mott from Public Health Wales, Cardiff reports on a study which sought to identify what age difference may be an indicator of CSE risk. The study sought to provide empirical data on the age difference observed between teenagers (aged 13–17 years) attending a sexual health clinic and their partners, compared with a second sample of 13–17-year-olds and their partners already known to children's social care services as a result of concerns around sexual exploitation. This is an important topic and Cook and Mott (2020) were driven by the fact that there is no clear guidance on what age difference should raise concerns for professionals. The study formed part of an evaluation by a sexual health services department. ‘There is no clear guidance on what age difference should raise concerns [about CSE] for professionals’ ‘In Wales, currently, when children are referred to children's services for CSE concerns the Sexual Exploitation Risk Assessment Framework (SERAF) is completed (Clutton and Coles, 2007). The SERAF identifies those at risk and provides an information and intervention pathway for preventing and responding to CSE.’ (Cook and Mott, 2020, p. 52) Our next two papers in this issue examine different aspects of filicide, offering unique insights into this type of fatal child maltreatment. The papers build on a previous editorial and themed issue (Brown and Tyson, 2014; Sidebotham, 2013) and continue Child Abuse Review's efforts to advance wider understanding of the nature and circumstances of child maltreatment fatalities. In particular, we have previously highlighted the need for ‘a wider [conceptual] framework of perpetrator characteristics, and an ecological understanding of the child's world’, including ‘factors in the wider family and environment; and the provision of public and other services to the child and family’ (Sidebotham, 2013, p. 306) The first paper by Sabine Amon from the University of Vienna, Austria, and colleagues (2020) makes an important contribution. Their study analyses the psychological, clinical and criminal characteristics of neonaticide focusing on court cases and their verdicts in Austria and Finland. The second by Salmi Razali from Monash University, Melbourne, Australia, and colleagues (2020) explores professionals' views about why women in Malaysia commit filicide. ‘Our next two papers in this issue examine different aspects of filicide, offering unique insights into this type of fatal child maltreatment’ Amon et al.'s (2020) paper describes a register-based study of all known neonaticide cases and their court files (28) in Austria and Finland between 1995 and 2005, with the intention of producing recommendations for judicial guidelines. Cases were gathered by screening death certificates from coroner departments and analysed alongside associated police files, court files, hospital reports recording the offender's treatment history and forensic psychiatric reports. The study focused on ‘the offence characteristics (place, method, motives), the offender's diagnosis and on the extent that these variables influence the judicial outcome’ (Amon et al., 2020, p. 64). They found that in all cases the offence took place at the same place as the delivery, and that there were a variety of methods of killing including drowning, suffocation, strangulation, neglect and ‘throwing against the wall’ (p. 65). The 28 cases were committed by 23 offenders, with one offender being responsible for four cases and two offenders for two cases each. Of the 18 offenders who underwent a forensic examination, half (9/18) had a mental disorder diagnosis and ten showed a deterioration in their mental health status following the neonaticide. ‘Five out of 21 convicted offenders were imprisoned with an average sentence of 1.65 years’ (Amon et al., 2020, p. 61). Of the 18 offenders examined for alleged responsibility of the crime, 14 were regarded as having full responsibility and one to have diminished responsibility, and three were not considered responsible. Main motives included ‘unwanted child’ (n = 11), ‘no motive’ (n = 9), ‘fear of abandonment/negative response from others’ (n = 7), ‘mental overload/powerlessness’ (n = 5) and ‘religious/cultural/shame’ (n = 3). Amon et al. (2020) highlight that ‘neonaticides are rare but multifaceted incidents’ (p. 69) with considerable variability in how such cases are examined legally and medically. They conclude the paper by making a series of recommendations that those countries without a neonaticide law might wish to consider, including that ‘investigation of suspected neonaticides be carried out by specialists with knowledge and experience of these crimes’ (Amon et al., 2020, p. 69) and that there should be standardised forensic psychiatric examinations conducted by two independent experts using structured methods. These findings concur with most of the published literature on neonaticide (Friedman and Resnick, 2009). The circumstances and characteristics of these cases differ from other cases of maternal filicide and typically involve young, single mothers with unwanted pregnancies or, in some cases, denial of pregnancy. In contrast to other maternal filicides, pre-existing mental health problems are less common. However, the motives behind these neonaticides reflect complex social, cultural and psychological factors. It is certainly not appropriate to label all young mothers with unwanted pregnancies as being at risk of neonaticide. As with other types of fatal maltreatment, a much more nuanced approach is required, both for prevention of neonaticide and the management and support of suspected cases. ‘The motives behind these neonaticides reflect complex social, cultural and psychological factors’ In the next paper, Razali et al. (2020) report on a qualitative study which they state is the first in Malaysia to investigate filicide from the perspectives of key professionals working in the field, including health, social work and education. Fifteen participants (14 of whom were women) were interviewed and data were analysed using Braun and Clarke's (2006) thematic approach. A key finding of the study was that professionals attributed responsibility for filicide cases predominantly to individual women and girls: ‘as a consequence of their failure to comply with social norms and religious teachings; the stigmatised social position of women who are pregnant and unmarried was identified as a contributing factor’ (Razali et al., 2020, p. 73). Surprisingly, no interviewees talked about the impact of gender-based violence against women and girls. When potential solutions to filicide in Malaysia were explored with participants, responses were largely directed at altering women's and girls' behaviour and improving morality. Razali et al.'s (2020) paper makes interesting and potentially disturbing reading. Research on maternal filicide frequently emphasises the complex circumstances and context behind such events – in particular, the contributions of adverse childhood experiences, domestic violence, mental health problems and social deprivation (Friedman and Resnick, 2009; Klier et al., 2019; Sidebotham and Retzer, 2019). Amon et al.'s (2020) paper once again highlights these complex social circumstances. In light of that, it is concerning that so much emphasis was placed by Malaysian professionals on the behaviour and morality of the women and girls. It would be all too easy for those of us looking at this through a Western lens to be judgemental without understanding the deep-seated religious and cultural factors contributing to their context, and without recognising the equally deep-seated issues of gender inequality and victim blaming within our own cultures. Razali et al. (2020) compare these findings in relation to their previous research with women convicted of filicide in Malaysia (Razali et al., 2019) and conclude that interventions that promote social change, improve support to women and their access to services, and change social attitudes might be more effective than strategies targeting women's behaviour. We can all learn from these lessons. ‘Interventions that promote social change, improve support to women and their access to services, and change social attitudes might be more effective’ This issue concludes with two book reviews. Tanya Davis (2020) reviews The Impossible Imperative: Navigating the Competing Principles of Child Protection by Jill Duerr Berrick. This book examines eight fundamental principles within child welfare, including that children should be safe, raised in families and have a say in decisions which affect them. Davis' review suggests that the book is accessible and could be useful to those wanting to expand their understanding of issues faced by child protection workers, although she would have liked to see further guidance around best practice in dealing with child welfare principles. Emily Colbrook (2020) reviews Betsy de Thierry's book The Simple Guide to Child Trauma: What It Is and How to Help. In a positive review, Colbrook (2020) states that this is a very useful introductory text for those working with children who have experienced trauma, combining research evidence with practical child-focused approaches ‘that can be used to help a child feel safe and begin to process their trauma’ (p. 86). As a children's nurse, she describes how this book has influenced her clinical practice and illustrates the impact of reading and the importance of continual reflection in driving improvements in safeguarding practice.

The world has been rocked by the coronavirus (COVID-19) pandemic, which has caused huge changes to all our lives. Entire populations have been socially isolated with daily life completely altered by the virus-control measures implemented by governments. For children and young people, the 'lockdown' has been particularly difficult; with many schools shut, children have been isolated from friends and peer networks, their routines disrupted, social lives and support opportunities considerably restricted and they have been required to stay at home with their families for an extended length of time. There have been a number of reports highlighting children and young people's vulnerabilities during the period of lockdown, including mental health difficulties (Young Minds, 2020), an increase in calls to Childline (Simpson, 2020), increased exposure to online abuse (Internet Watch Foundation, 2020) and risk of harm from violence in the home between adults (Bradbury-Jones and Isham, 2020; Chandan et al., 2020; Green et al., 2020; Peterman et al., 2020; UN Women, 2020). At the same time, issues such as redeployment and reduced face-to-face contacts with families have raised concerns among some professionals that children's needs would be missed. For front-line practitioners, the COVID-19 pandemic has required children's health, welfare, education and safeguarding services to be adapted and delivered very differently (Ferguson et al., 2020). As we are writing this editorial for Child Abuse Review, the UK has entered a period of recovery and restoration of services; essentially this involves getting public services up and running again for the population, and returning aspects of services as much as possible to business as usual. However, all four countries are tackling this differently and social distancing measures and the shielding of vulnerable groups continues. As the lockdown restrictions are eased, Child Abuse Review has put out a call for papers reflecting on professionals' understanding and learning in response to COVID-19, across public sector and third sector organisations. We very much hope that you will join and contribute to this important discussion. 'For children and young people, the 'lockdown' has been particularly difficult' The first two papers in this issue focus on how domestic violence perpetrators continue to use coercive control against their children post separation from their partners; this is particularly important given the lockdown and reports of increased incidence of domestic violence. The first paper by Emma Katz (2020) from Liverpool Hope University and colleagues from the University of Lapland, Finland, draws on a qualitative meta-synthesis of two data sets of interviews conducted with children and young people in the UK and Finland. The UK data set comprised interviews with 15 children and young people (five males and nine females, aged 10–20 years) with past experience of domestic violence, and the Finnish data set comprised 14 interviews (three males and 11 females, aged 4–21 years). The data sets were initially analysed separately using thematic analysis and then combined using Aguirre and Bolton's (2014) qualitative meta-synthesis approach. The paper provides important knowledge about how children and young people can experience coercive control from their fathers, post separation. This combined data set offers an insight into the tactics fathers and father figures use to exert coercive control from children's perspectives. Three important themes are discussed in the paper including: 'dangerous fathering,' where children are made to feel frightened and unsafe by threats, intimidation, violence and/or stalking; 'admiral' fathering, described in the children's narratives as 'their father/father figure playing the roles of a caring, indulgent, concerned and/or vulnerable-victim father' (Katz et al., 2020, p. 317); and omnipresent fathering in which children experienced a fearful mental and emotional state. 'Domestic violence perpetrators continue to use coercive control against their children post separation from their partners' This paper shows from children's own accounts how they may be harmed by non-physical abusive tactics and behaviours and reinforces the need, as Thompson-Walsh et al. (2018) have previously described, for thorough and ongoing assessment post separation of fathers who have a history of domestic violence when decisions are made about their involvement in contact and parenting. Katz et al. (2020, p. 322) conclude their paper by stressing the need for agencies to develop much more robust responses to fathers perpetrating coercive control and to identify and support children and young people 'as direct victims/survivors of coercive control' and prioritise 'their rights to be free of this abuse.' 'First, it is believed that contact is almost always in the child's best interest; second, that the abusive history ends with separation; and third, that children's participation in the decision-making process is harmful.' (Holt, 2020, p. 328) 'practice, policy and research challenge the assumption that contact is inevitably in the child's best interests as this may clash heavily with the culture of safety and protection at the heart of interventions designed to meet the needs of women and children experiencing domestic abuse.' The third paper in this issue is by Sharon Vincent and colleagues (2020) from Northumbria University and reports on interviews with experts involved in UK child abuse inquiries to seek their perceptions about the aims and outcomes of public inquiries. Public inquiries are major reviews organised by governments and conducted to investigate matters of serious public interest and concern, including child abuse and neglect. This study draws on a thematic analysis of the proceedings of a four-day expert summit held in Scotland in 2017 and interviews with 16 key informants who had significant involvement in current or previous child abuse inquiries or practice reviews. The findings of this study are quite significant and reveal that summit and interview participants felt that the three main functions of inquiries – 'learning lessons and prevention; finding out what happened/establishing the truth; and delivering justice' – were not always compatible and not always achieved (Vincent et al., 2020, p. 337). Participants talked about 'inquiry fatigue' with often predictable findings and, while noting that public inquiries can raise public awareness about child abuse, there is little evidence of their effectiveness. The paper by Vincent et al. (2020, p. 338) also points to disagreement among participants about whether public inquiries are 'an appropriate forum for hearing victims' voices.' The authors noted that: 'Public inquiries can raise public awareness about child abuse, [yet] there is little evidence of their effectiveness' 'Participants in both phases of this study felt that victims should be at the centre of any process to investigate child abuse and they should be able to talk about the effects that abuse had had on their lives not just about what happened to them at the time.' (Vincent et al., 2020, p. 343) 'Inquiries are only one source of evidence about what is happening in child protection practice and cases where things have gone wrong should be considered alongside evidence from the large number of cases where children are well protected.' (Vincent et al., 2020, p. 344) Our next paper by Yanyan Ni and colleagues (2020) from University College London and Zhejiang University in Hangzhou, China, reports on research which was conducted to examine the effects of different types of child maltreatment on adolescents' emotional and behavioural problems. Data were also collected from one parent of each participant and were reported in an earlier article (Ni et al., 2018); this paper provides the young people's perspectives. The study involved young people aged 10–16 years in two urban and rural schools from Zhejiang Province in China who were invited to complete a questionnaire survey distributed through the schools. The survey content was informed by a literature review, two existing validated measures of maltreatment, the Conflict Tactics Scale Parent–Child (CTSPC) and the International Society for the Prevention of Child Abuse and Neglect Child Abuse Screening Tool Children's Version (ICAST-C), with emotional and behavioural problems being assessed using the Strengths and Difficulties Questionnaire (SDQ). In total, 791 completed questionnaires were received. Prevalence of different forms of maltreatment during the past year identified high levels of child maltreatment in home settings, with 37.7 per cent of children experiencing physical maltreatment, 47.5 per cent experiencing emotional maltreatment, 49.4 per cent witnessing domestic violence and 20.9 per cent of young people reporting more than three types of maltreatment. Only 26 per cent of the participants reported no maltreatment. Data analysis using multinomial logistic regression found that emotional abuse in adolescents was consistently associated with both behavioural and emotional problems, after adjustments for exposure to other abuse and socio-economic factors. The study showed that severe physical maltreatment (which included being 'beaten up,' choked to prevent breathing, and threatened with a knife) 'showed the strongest association with behavioural problems,' while adolescents witnessing domestic abuse alone was not associated with behavioural/emotional problems (Ni et al., 2020, p. 347). The authors found that, 'The effect size of emotional maltreatment was greater for girls, while physical maltreatment had greater effects among boys' (Ni et al., 2020, p. 347). Study results also showed that an increase in the number of maltreatment types 'had a cumulative negative effect on child emotional and behavioural problems' (Ni et al., 2020, p. 347). The authors argue that with such high levels of child maltreatment in family homes causing considerable behavioural and emotional harm to young people, there is a need for widespread national education campaigns and programmes for parents and the introduction of a formal child protection system in the country. 'Emotional abuse in adolescents was consistently associated with both behavioural and emotional problems' The fifth paper in this issue is a study by Siobhan Murphy and colleagues (2020) from the University of Southern Denmark, Odense, and colleagues from London, Odense, Coleraine and Copenhagen who also studied the effects of different types of child maltreatment on psychiatric outcomes. The study is part of a larger project exploring risk factors and outcomes of different types of abuse and neglect. Participants (4718) were randomly selected by the Danish Centre for Social Research using the total birth cohort of children born in 1984 in Denmark. Structured interviews (administered in the home or via telephone) were conducted with 2980 participants and these data were supplemented with linked administrative data from the Danish health and social registers. In total, 411 participants (13.8%) reported child maltreatment, 'of which 9.7 per cent were classed as emotionally abused, 2.0 per cent sexually abused and 2.1 per cent experienced co-occurring forms of abuse' (Murphy et al., 2020, p. 370). The most common disorders were substance misuse (9.7%), mood disorder (4.1%), stress disorders (3.6%) and major depressive disorder (intermittent) (3.1%). The multivariate analysis showed that all maltreatment types 'were associated with psychiatric outcomes independent of other forms of adversity and parental history of psychiatric conditions' (Murphy et al., 2020, p. 365). The study also examined comorbidity among the maltreatment sub-groups which revealed that a 'substantial number of individuals with psychiatric conditions had more than one diagnosis' (Murphy et al., 2020, p. 373). The authors thus conclude from these high rates of comorbidity 'that maltreated children experience a complex symptom profile that requires more tailored treatment interventions that are developmentally appropriate' (Murphy et al., 2020, p. 374). They argue that an early intervention approach that adopts this approach 'may offset the risk trajectory for co-occurring psychiatric conditions' (Murphy et al., 2020, p. 375). Our next paper in this issue is a very interesting short report by Carolina Øverlien (2020) from the Norwegian Center for Violence and Traumatic Stress Studies, Oslo, and Stockholm University. This paper returns to the subject of domestic violence and reports on a survey conducted with the 46 domestic violence refuges across Norway to look at the impact of the COVID-19 pandemic on children living in refuges. In the paper, Øverlien outlines how refuges play a key role in Norwegian society. The anonymous survey was distributed at the beginning of April 2020 to obtain an overview of the impact of the COVID-19 crisis and the virus control measures implemented across the country on victims of domestic violence and abuse. The survey achieved a 100 per cent response rate and highlighted that children were the group that refuge staff (83%) were most concerned about. Refuge staff were both concerned about children living in households with domestic violence, and also children living in the refuges but not receiving the support that they needed due to the pandemic. For children living outside the refuge, staff were particularly concerned that violence 'would remain undisclosed, as contact between adults outside of the family and the abused child is dramatically reduced' (Øverlien, 2020, p. 383). This concern was exacerbated as schools and daycare centres were also closed and for many children living with abuse and domestic violence 'school represents normality and a zone free from the abusive parent' (Øverlien, 2020, p. 383). Also, 43 per cent of the respondents reported that their clients believed that having children in the home during the day increased the risks for violence and abuse. Øverlien (2020) concludes by stressing the need for vigilance among health, social care and education staff in identifying the negative consequences of the pandemic when children start returning to services. She also highlights the significant resource requirements of institutions including domestic violence refuges and services for children and young people, 'particularly those who provide safety and support to children living with domestic violence and abuse' who need to 'find new, creative ways to reach out to children and adolescents in vulnerable situations' (Øverlien, 2020, p. 385). Our final paper in this issue is a continuing professional development paper by Ben Donagh (2020) submitted to Child Abuse Review's call for papers reflecting on practice during the COVID-19 pandemic. Drawing on his experiences as an operational manager of two specialist children's services, his informative paper reflects on the practices of specialist services delivering support to children and young people in households experiencing domestic violence and abuse. Both the pieces by Øverlien (2020) and Donagh (2020) provide important insights into how specialist services have been working with children and young people living in situations of domestic violence. Donagh (2020) also emphasises the impact on professionals who have continued to work and provide remote support to safeguard children and young people during the COVID-19 pandemic. 'Important insights into how specialist services have been working with children and young people living in situations of domestic violence [during the COVID-19 pandemic]'