tag:theconversation.com,2011:/us/topics/nspcc-42582/articlesNSPCC – The Conversation2018-02-01T11:13:05Ztag:theconversation.com,2011:article/909722018-02-01T11:13:05Z2018-02-01T11:13:05ZThe virtual door to online child sexual grooming is wide open<figure><img src="https://images.theconversation.com/files/204422/original/file-20180201-123826-1cimz24.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption"></span> <span class="attribution"><span class="source">Shutterstock.</span></span></figcaption></figure><p><a href="http://www.nationalcrimeagency.gov.uk/publications/670-emerging-new-threat-in-online-dating-initial-trends-in-internet-dating-initiated-serious-sexual-assaults/file">The nature of sexual offending has changed</a> with most interactions occurring online and involving younger victims. This change is seeing people taking more risks by virtually <a href="https://theconversation.com/stranger-danger-in-the-online-and-real-world-79517">opening their door to “strangers”</a>.</p>
<p>A harsh reality of “contact” sexual offending is that many offenders will use various <a href="http://onlinelibrary.wiley.com/doi/10.1111/cfs.12080/pdf">grooming techniques</a> to enable them to commit sexual offences. Whether this is an online conversation manipulated into a face-to-face meeting, or a chat in a cafe or bar resulting in a victim being led to a less crowded area, the reoccurring themes are coercion, control and trust.</p>
<p>A <a href="https://www.gov.uk/government/news/new-crackdown-on-child-groomers-comes-into-force">new offence</a> of sexual communication with a child was introduced in April 2017. Before this, police could not intervene until groomers attempted to meet victims face-to-face. </p>
<p>The latest figures reveal that a staggering <a href="http://www.bbc.co.uk/news/uk-42855172">1,316 offences</a> were recorded in the first six months of this law being introduced in England and Wales. There are now calls for social media sites to do more “grooming prevention” and consider the use of “<a href="https://www.nspcc.org.uk/what-we-do/news-opinion/more-than-1300-cases-sexual-communication-with-child-recorded-after-change-in-law/">anti-grooming alerts</a>” for potential victims. But there are some key issues that should be considered before furthering this idea. </p>
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<img alt="" src="https://images.theconversation.com/files/204272/original/file-20180131-157462-l9r83u.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/204272/original/file-20180131-157462-l9r83u.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=380&fit=crop&dpr=1 600w, https://images.theconversation.com/files/204272/original/file-20180131-157462-l9r83u.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=380&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/204272/original/file-20180131-157462-l9r83u.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=380&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/204272/original/file-20180131-157462-l9r83u.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=477&fit=crop&dpr=1 754w, https://images.theconversation.com/files/204272/original/file-20180131-157462-l9r83u.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=477&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/204272/original/file-20180131-157462-l9r83u.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=477&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
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<span class="caption">The realities of sexual grooming online are only just being discovered.</span>
<span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/silhouette-girl-using-her-tablet-computer-265870769">Shutterstock/KylieWalls</a></span>
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<h2>What is the true scale of online grooming?</h2>
<p>Crime figures released for 2015/16 indicate there were <a href="https://www.ons.gov.uk/peoplepopulationandcommunity/crimeandjustice/compendium/focusonviolentcrimeandsexualoffences/yearendingmarch2016/overviewofviolentcrimeandsexualoffences#what-do-we-know-about-sexual-offences">37,778 child sexual offences</a> (including grooming) in England – that’s 36.3 sexual offences per 10,000 children under 16. Wales, Scotland and Northern Ireland recorded even higher rates.</p>
<p>Within these figures, the <a href="https://www.nspcc.org.uk/globalassets/documents/research-reports/how-safe-children-2017-report.pdf">NSPCC reported </a> that there were 11,230 child rape offences and 25,577 involving sexual assault/sexual activity against children. These figures are much higher than the reported grooming offences (<a href="http://www.bbc.co.uk/news/uk-42855172">1,316 over six months</a>). But why?</p>
<p>Crime data does not detail how many sexual offences also included grooming, or whether grooming offences are dropped when evidence of child sexual abuse is found. Undetected grooming offences can lead to horrific sexual abuse, such as in the much publicised <a href="https://www.theguardian.com/uk-news/2016/apr/08/rochdale-grooming-case-10-men-sentenced-to-up-to-25-years-in-jail">Rochdale grooming case</a> (where young girls were targeted by older men who plied them with alcohol) and in the <a href="http://www.tandfonline.com/doi/abs/10.1080/13552600.2014.927009">online</a> grooming world too. Child victims describe grooming as a <a href="http://onlinelibrary.wiley.com/doi/10.1111/cfs.12080/abstract">key feature</a> of their abuse. </p>
<p>Is it that the intelligence tools available are unable to identify interactions in time to stop contact sexual abuse occurring? There is no doubt that the <a href="http://www.college.police.uk/News/College-news/Documents/Demand%20Report%2023_1_15_noBleed.pdf">demand on police</a> is ever increasing, with this type of crime requiring specialist skills and expertise. </p>
<h2>Responsibility on social media companies</h2>
<p>Social media companies should do all they can to reduce illegal behaviour on their platforms. A key issue centres on the ability to accurately identify potential groomers. Various studies have reported good results in <a href="https://link.springer.com/chapter/10.1007/978-3-319-13734-6_30">identifying grooming behaviour</a>. But research has also noted that offenders are using <a href="http://www.tandfonline.com/doi/abs/10.1080/01639625.2014.944074">a wide variety of grooming processes</a> to snare their victims. </p>
<p>Evidence of differing functions within <a href="http://journals.sagepub.com/doi/abs/10.1177/1079063210384275">offender-victim interactions</a> have been
observed with some restricting their sexual behaviour to online (fantasy-driven) and others using the internet to facilitate the abuse of children (contact-driven). Research has also shown that a <a href="http://www.internetbehavior.com/pdf/contact_and_cp_mcmanus.pdf">key part of the “offending pathway”</a> from online to contact abuse is grooming. </p>
<p>Consequently, many researchers agree that although the motivations behind interactions are sexually deviant, they may <a href="http://www.tandfonline.com/doi/abs/10.1080/13552600601069414">seem innocent</a> in nature when observed, making it <a href="http://www.tandfonline.com/doi/full/10.1080/01639625.2016.1197656">difficult to identify</a> before actual abuse occurs. This becomes more problematic if <a href="https://www.nspcc.org.uk/preventing-abuse/child-abuse-and-neglect/child-sexual-abuse/sexual-abuse-facts-statistics">young people</a> are the groomers, <a href="http://www.tandfonline.com/doi/full/10.1080/13552600701788608">displaying complex grooming behaviours</a>. Using multiple social media platforms, as well as online and offline methods, further reduces the ability to identify offenders.</p>
<p>There is also the controversial belief that some offenders find engaging in sexual deviant fantasies online <a href="https://link.springer.com/article/10.1023/B%3AASEB.0000029071.89455.53?no-access=true">reduces urges</a> to commit contact offences. A real fear is that social media warnings could push these offenders to interact offline.</p>
<p>But if the intention is for social media companies to give potential child victims “<a href="http://www.bbc.co.uk/news/uk-42855172">grooming alerts</a>”, this puts the onus on victims to acknowledge that they may be subject to grooming. The power a groomer has over a victim may override any considerations to stop interactions. </p>
<p>Those committing these offences are often highly skilled at <a href="http://www.tandfonline.com/doi/abs/10.1080/13552600601069414">identifying vulnerable</a> victims, and manipulating them by giving <a href="https://www.nspcc.org.uk/preventing-abuse/child-abuse-and-neglect/grooming/">compliments</a> and attention. </p>
<p><div data-react-class="Tweet" data-react-props="{"tweetId":"958061448642543616"}"></div></p>
<p>Developing grooming alerts may also inadvertently lead to parents/caregivers taking their eyes off the ball when it comes to their childrens’ social media accounts. Assumptions might be made that the technology is able to detect suspicious behaviour better than they can. Not enough is known about childrens’ online interactions, with reports only just highlighting this issue within <a href="http://www.nationalcrimeagency.gov.uk/publications/670-emerging-new-threat-in-online-dating-initial-trends-in-internet-dating-initiated-serious-sexual-assaults/file">adult populations</a>. </p>
<p>The new child grooming law was introduced to reduce the risk of contact sexual offences. However, it seems the ability to identify grooming behaviours before sexual abuse still falls short. There are issues here for social media companies, the police, teachers and parents. But the message is clear. The virtual door to strangers is wide open. More needs to be done to identify and respond to online sexual grooming.</p><img src="https://counter.theconversation.com/content/90972/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Michelle McManus receives funding from Lancashire Constabulary and Lancashire Police Crime Commissioner as part of a part-time secondment placement within Lancashire Constabulary's Evidence Based Policing Research Hub.</span></em></p><p class="fine-print"><em><span>Louise Almond does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.</span></em></p>The nature of sexual offending has changed, but can we better identify sexual groomers before abuse occurs?Michelle McManus, Senior Lecturer in Policing, Forensic and Applied Sciences, University of Central LancashireLouise Almond, Senior lecturer in Investigative and Forensic Psychology, University of LiverpoolLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/895992018-01-04T10:08:46Z2018-01-04T10:08:46ZChild sexual abuse: hearing the cry for help is not always a simple task<figure><img src="https://images.theconversation.com/files/200672/original/file-20180103-26145-axu56g.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption"></span> <span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/domestic-family-violence-little-girl-asking-175158260?src=K5PtPAyBy3hqNUrRE1FyIw-1-6">Shutterstock/SinishaKarich</a></span></figcaption></figure><p>Child sexual abuse is on the rise in the UK with the <a href="https://www.theguardian.com/society/2017/dec/18/cases-of-child-sexual-abuse-up-31-says-nspcc">NSPCC announcing a 31% increase</a> in police referrals in 2017 compared to the previous year. Worryingly, this is just the tip of the iceberg as child sexual abuse is widely under-reported. My research has revealed that a major factor in this issue is the use of language and a safeguarding system which is sometimes deaf to a child’s cry for help.</p>
<p>There are many reasons why a child will not tell anyone that they are being abused, including fear, shame and confusion. It is therefore important that adults are aware of <a href="https://www.nspcc.org.uk/preventing-abuse/child-abuse-and-neglect/child-sexual-abuse/signs-symptoms-effects/">behaviours</a> that may be symptomatic of sexual abuse. </p>
<p>Greater awareness of potential indicators of sexual abuse is undoubtedly crucial for helping adults to recognise when there may be a problem. But as a linguist, I am particularly troubled by reports of children who attempted to disclose sexual abuse, but felt that they were <a href="https://www.nspcc.org.uk/services-and-resources/research-and-resources/2013/no-one-noticed-no-one-heard/">never heard</a>. That is, their attempts to seek help failed. </p>
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<img alt="" src="https://images.theconversation.com/files/200681/original/file-20180103-26151-1xi1d76.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/200681/original/file-20180103-26151-1xi1d76.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/200681/original/file-20180103-26151-1xi1d76.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/200681/original/file-20180103-26151-1xi1d76.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/200681/original/file-20180103-26151-1xi1d76.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/200681/original/file-20180103-26151-1xi1d76.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/200681/original/file-20180103-26151-1xi1d76.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
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<span class="caption">Children need to be listened to when they reach out for help.</span>
<span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/upset-problem-child-head-hands-sitting-268132268?src=K5PtPAyBy3hqNUrRE1FyIw-1-17">Shutterstock/BrianAJackson</a></span>
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<p>The disclosure stage (the point at which an allegation of sexual abuse is made) is crucial in determining what action is taken, if any at all. The recipient must firstly acknowledge that a child has reported sexual abuse and then be willing to act.</p>
<p>There are several reasons why children’s voices may be unheard. Sadly, cases where recipients have not acted appropriately, either through <a href="https://www.theguardian.com/lifeandstyle/2017/dec/12/are-we-ignoring-an-epidemic-of-sexual-violence-in-schools">minimisation</a> or <a href="http://www.telegraph.co.uk/news/2017/11/20/jehovahs-witnesses-claim-told-not-report-child-sex-abuse-organisation/">cover-up</a> are numerous. Second, since children often do not make a clear disclosure, the full extent of their abuse may not always be apparent. They may only partially report the abuse, they may minimise the extent of the abuse, and they may <a href="https://www.nspcc.org.uk/services-and-resources/research-and-resources/2013/no-one-noticed-no-one-heard/">lack the vocabulary</a> to convey the full extent of their abuse. </p>
<h2>Linguistic skill</h2>
<p>But another reason why disclosures go unheard may be linked to the linguistic skill of the adult the child confides to.</p>
<p>In data that I am currently analysing (online counselling sessions between victims of sexual abuse and <a href="https://www.childline.org.uk/">ChildLine</a> volunteers) some children talk explicitly about sexual abuse. Within the opening lines of one counselling session, an 11-year-old child stated bluntly that she had been raped. </p>
<p>By contrast, a 15-year-old revealed sexual abuse more cautiously over a conversation lasting one hour and ten minutes. First, she reported she had had sex. Later, she explained that she didn’t consent. She then provided details about the level of force. Finally, one hour into the conversation, she asked for clarification over whether she had been raped. </p>
<p>Importantly, it was the counsellor that facilitated the disclosure and helped the child to articulate it. In this example, the process of reporting was very much a two-person interaction. The pressure shifted from the child being solely responsible for making the disclosure to the counsellor supporting and eliciting it. </p>
<p>From this perspective, it is understandable why some children report how they’ve tried to tell someone what has happened to them – but have not been heard. It is possible that the adults they spoke to were either not skilled in drawing out the information or following safeguarding advice and training were reluctant to do so for fear of contaminating the child’s evidence. </p>
<h2>Support versus evidence</h2>
<p>The problem is that an allegation made in an anonymous counselling session is very different to a disclosure made to a teacher or social worker. In a ChildLine counselling session, the focus is on supporting the child. By contrast, teachers and social workers are duty bound to report disclosures and the statement that the child produces constitutes evidence, which may be used in subsequent criminal proceedings. </p>
<p><a href="https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/592101/Working_Together_to_Safeguard_Children_20170213.pdf">Guidance</a> for social workers and teachers highlights the need to collect accurate and complete information from the child, reporting only the words that the child has used and without using leading questions. </p>
<p>This creates an apparent paradox since my research suggests some children rely on an adult to help construct their disclosure precisely so they can produce complete information. While the evidential approach is designed to collect uncontaminated evidence, it potentially fails those children who need adults’ help to actually say the words.</p>
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<p>In my data, a 12-year-old girl explicitly asked the counsellor to ask her questions because she found it easier than providing an unprompted narrative. Teachers are explicitly told that how they speak to the child can <a href="https://www.education-ni.gov.uk/sites/default/files/publications/education/Safeguarding-and-Child-Protection-in-Schools-A-Guide-for-Schools.pdf">affect the evidence</a> and questioning should be kept to the minimum. The child is expected to articulate their abuse independently. </p>
<p>It seems, then, that there is a potential tension between the needs of the child in making a disclosure and the needs of trusted adults who are in a position to help the child. For many children in my data, their concern was not with prosecuting their abuser. Many explicitly said they did not want this. What they often wanted was emotional support, reassurance that they did nothing wrong, and clarification about what had happened to them so that they could begin to make sense of it. </p>
<p>For as long as safeguarding policies place emphasis on the quality of evidence collected, rather than focusing on helping children to understand and verbalise how they’ve been abused, children’s voices will continue to be unheard.</p><img src="https://counter.theconversation.com/content/89599/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Samuel Larner does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.</span></em></p>Child sexual abuse is rising but there is still ignorance around how to speak to and support children who are badly in need of help.Samuel Larner, Senior Lecturer in Forensic Linguistics, Manchester Metropolitan UniversityLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/832702017-08-31T08:59:39Z2017-08-31T08:59:39ZRevealed: health prospects of children in care look worse than for anyone else<figure><img src="https://images.theconversation.com/files/184063/original/file-20170830-24267-vp4du9.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Nearly one in 100 children are in care</span> <span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/child-boy-mother-playing-educational-toy-546389527?src=6c0vVK68MzANR9bjcDbsJQ-1-7">santypan</a></span></figcaption></figure><p>When the state gets involved in the welfare of children or young people under 18, we call them “looked after”. They might live with foster parents, in a children’s home, with friends or relatives, or even with their own family under a <a href="http://www.chscotland.gov.uk/the-childrens-hearings-system/information-for-young-people/?slideId=1687">compulsory home supervision</a> order. </p>
<p>Nearly 95,000 British youngsters <a href="https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/556331/SFR41_2016_Text.pdf">live in</a> such arrangements, which is not far off one in 100. We know that their life chances are not as good as they should be. In the <a href="https://www.nspcc.org.uk/preventing-abuse/child-protection-system/children-in-care/">words of</a> the National Society for the Prevention of Cruelty to Children: “As a result of their experiences both before and during care, looked after children are at greater risk than their peers”. </p>
<p>The <a href="https://www.theguardian.com/society/2009/apr/20/care-system-failures">media</a> and <a href="http://www.gov.scot/Resource/0048/00489792.pdf">authorities</a> have tended to focus on how the education system fails this group. Their health has only more recently been identified as a priority, <a href="http://www.gov.scot/Resource/0048/00489792.pdf">at least by</a> the Scottish government, though it has been considered impossible to build up a meaningful statistical picture because of the way the different relevant departments collate the data. </p>
<p>We have managed to do this, however. We have focused on dental data of looked after children in Scotland, but the results are likely to be the tip of a very worrying iceberg. They are likely to prompt much wider research into the general health of this group of children, both in Scotland but also across the UK and beyond. </p>
<h2>The findings</h2>
<p>Our <a href="http://adc.bmj.com/content/early/recent">new paper</a>, just published in the Archives of Disease in Childhood journal, has found that there are stark differences between the dental health of children in care and those who are not. We compared 622,280 children in the general population with 10,924 who are looked after, which is the majority of the <a href="http://www.gov.scot/Publications/2017/03/6791%205660">approximately 15,000</a> in Scotland. The dental treatment needs of children, particularly for urgent work or for extractions under general anaesthetic, are important because they <a href="https://bmcpublichealth.biomedcentral.com/articles/10.1186/1471-2458-13-370">could be considered</a> an early marker for poor physical health later in life.</p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/184065/original/file-20170830-29609-evkr0l.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="" src="https://images.theconversation.com/files/184065/original/file-20170830-29609-evkr0l.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/184065/original/file-20170830-29609-evkr0l.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/184065/original/file-20170830-29609-evkr0l.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/184065/original/file-20170830-29609-evkr0l.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/184065/original/file-20170830-29609-evkr0l.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/184065/original/file-20170830-29609-evkr0l.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/184065/original/file-20170830-29609-evkr0l.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
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<span class="caption">‘Say aaah.’</span>
<span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/baby-girl-examines-teeth-dental-mirror-404191657?src=aTvGzrcnBQJv4V-101eQyw-1-10">Evgeniy Kalinovskly</a></span>
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<p>We found that children in care have twice as many urgent dental health needs as the general child population. Children in care, including those in foster and residential care, have double the rates of urgent dental treatment, and are half as likely to attend dental services as children in general. Children in care are twice as likely to have a tooth extraction under general anaesthetic. </p>
<p>Our key findings also included:
</p><ul>
<li> 49% of children in care do not attend the dentist regularly, in comparison with 38% of all children; </li>
<li> 67% of five year olds in care have dental needs compared with 36% of all children; </li>
<li> 23% of five year olds in care have urgent dental needs including severe dental decay or dental abscesses, compared with 10% of all children; </li>
<li> 75% of 11 year olds in care have dental needs compared with 58% of all children; </li>
<li> 7% of 11 year olds in care have urgent dental needs compared with 2% of all children; </li>
<li> 9% of children in care have had a tooth extraction under general anaesthetic compared with 5% of all children.</li> </ul><p></p>
<p>These differences coudn’t be explained by the standard measurable socioeconomic factors – children in care have considerably worse dental issues than other children in a <a href="http://www.gov.scot/Topics/Statistics/SIMD">similar socioeconomic group</a>. And this is in a context where children in UK’s poorest areas are <a href="http://www.nuffieldfoundation.org/inequalities-child-welfare-intervention-rates">ten times more likely</a> to be looked after. </p>
<p>We also identified variations between different categories of looked after children. Children in foster care had the best dental health, while those with the worst are the ones who remain in the family home with children’s panel and social work support. </p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/184067/original/file-20170830-24247-12ax4at.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="" src="https://images.theconversation.com/files/184067/original/file-20170830-24247-12ax4at.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/184067/original/file-20170830-24247-12ax4at.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=450&fit=crop&dpr=1 600w, https://images.theconversation.com/files/184067/original/file-20170830-24247-12ax4at.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=450&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/184067/original/file-20170830-24247-12ax4at.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=450&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/184067/original/file-20170830-24247-12ax4at.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=566&fit=crop&dpr=1 754w, https://images.theconversation.com/files/184067/original/file-20170830-24247-12ax4at.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=566&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/184067/original/file-20170830-24247-12ax4at.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=566&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">Different chances.</span>
<span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/old-see-saw-children-play-sand-539510137?src=M1FJ1aL_jqk5bRj5ckArGA-1-7">JKSippappas</a></span>
</figcaption>
</figure>
<p>We don’t yet know whether the poor figures for looked after children are the result of the family background that led them into care in the first place or because the state is failing to look after them once they are in the system. Neither could we get any information on pre-school children because of the nature of the data. </p>
<h2>Next steps</h2>
<p>We are keen to do follow-up work to better understand the barriers and facilitators into dental services, since the findings also suggest that such services are either failing these children or they are just not using them. But to do this work, and for much other work into the health prospects of looked after children to become possible, it is going to need even further joined-up work between health and social care services to compare data. </p>
<p>Different areas of the UK are merging health and social care to various degrees. If social services and NHS services were to use a single identifier number for clients, it would make it easier to understand what is going on. </p>
<p>For the time being, these findings are a stark reminder to us all of the need to focus our efforts to ensure the most vulnerable children are properly cared for. It looks as though we have a problem: before we can solve it, we are going to need to be able to look at the full picture.</p><img src="https://counter.theconversation.com/content/83270/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Alex McMahon received funding from National Records Scotland in relation to the study referenced in the article. He is also a member of the Royal Statistical Society. </span></em></p><p class="fine-print"><em><span>David Conway is a member of the British Dental Association, Chair of the Socialist Health Association in Scotland, and Chair of the board of the Coach House Trust (charity). He has been awarded research grant funding from the Scottish Government Chief Scientist Office, National Records Scotland and NHS Education for Scotland. </span></em></p>Landmark dental findings are likely to be the tip of an iceberg.Alex McMahon, Reader, Dental School, University of GlasgowDavid Conway, Professor of Dental Public Health, University of GlasgowLicensed as Creative Commons – attribution, no derivatives.