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​Vulnerable groups

Certain individuals or groups of children may be more vulnerable to abuse or neglect because of risk factors in their family or environment, or because of the way they are perceived by their carers.

Recognising these vulnerable groups may enable the dental practitioner to take steps to promote and safeguard the well-being of such children and to respond appropriately to concerns.

It is important, however, not to stigmatize families because of the presence of particular risk factors; whilst the risks of maltreatment may be higher, the majority of children within these vulnerable groups are loved and cared for and do not experience abuse.

Parental factors

Young or single parents, parents with learning difficulties, those who themselves have experienced adverse childhoods and those with any mental health problems, including problems of drug or alcohol abuse, and those who live with intimate partner violence and abuse are all more at risk of abusing or neglecting their children.23, 61 They may often need extra support in meeting their children’s needs and may be more vulnerable to the stresses inherent in parenting.

Social factors

Families living in adverse social environments, for example due to poverty, social isolation or poor housing may also find it both materially and socially harder to care for their children. Where such issues are affecting a child’s care, it may be possible to intervene to support the family at an early stage before the child suffers harm.

Child factors

Age plays an important role in the patterns of child abuse. Younger children are much more vulnerable to physical abuse and neglect, with at least 10% of all abuse involving children under the age of 1. In contrast, sexual abuse more often (though not exclusively) involves older children, particularly girls.

Children with disabilities are much more at risk of experiencing abuse of all kinds.24 A wide variety of factors may contribute to that risk including sometimes greater dependence on carers, increased stresses on the carers and difficulties for the young person to communicate concerns. It is also well documented that people with disabilities face barriers when accessing health services. Particular attention should therefore be given to supporting the needs, including the dental needs, of children with disabilities and being alert to signs, symptoms and behavioural indicators that may indicate abuse or neglect.