How many breaks/fractures is "normal" for a 3 year old?

[MrsOverTheRoad]

I am a little concerned about someone I know in that their 3 year old has seemingly injured himself very often.

In the past 6 months he has fractured his arm, "broke his sternum" and had a fall in which he hurt his other arm quite badly but which the Mother didn't get checked out...she said she was worried about social services considering his other recent injuries.

The arm fracture occurred, she said when he was with his Grandparent...I spoke to the grandparent and they confirmed this. The sternum break when he ran into the corner of a table and the arm injury when he fell off a child's slide in their garden.

Is this a lot or pretty normal for an active boy?

The only reason I do have concerns is that when I have spent some time with him, he's shouted at me in a very adult way..."acted out" being agressive if you will.

Lots of "NO! YOU DON'T DO THAT!" etc in a loud shouty voice with finger wagging..again this could be normal but my DC never did it so I don't know.

But he otherwise seems happy and healthy...another person close to his Mother said that he worried that his Mum was agressive to him in the way she spoke to him.

Writing it all down it seems like an obvious "Tell someone" situation but it's hard to tell when you're closeish to the family.

I have a 9 year old DS. By the time he was 6 he'd fractured his ankle, broken two bones in his arm, broken the same two bones again a few weeks later, cut his head open needing glue, and cut the top off his finger needing plastic surgery. However in the past 3 years he's had no accidents at all.

Every incident was a complete accident and I'd have been absolutely devastated if anyone had reported us to SS.

However every time we were at A&E I was asked repeatedly exactly what had happened, so if I hadn't been telling the truth I think it would have been picked up very quickly. I've certainly never been told that it's highly unusual to have any broken bones at that age - there were often small children in the A&E plaster room on our far too many visits there.

I do agree though that it's a completely different matter - and one for concern - if a child's injuries aren't being seen and assessed by A&E or equivalent.

DS is 3 and has been to hospital almost a dozen times, but NEVER for a physical injury (apart from when he fiddled with his boy bits and tore his penile frenulum 🙄)
He's autistic and extremely active, always has bruises on him from his exploits but has only cut himself a few times and never seriously injured. He's very prone to illness such as tonsillitis and has severe asthma attacks.

In all honesty, I'd be a bit concerned. There is no level of normal, but 3 separate physical injuries would cause concern for me (I'm training to be a teacher, one of the things we've been told to look out for with Safeguarding)

But also, investigations are kept confidential so a neighbour or acquaintance wouldn't know aboif it, unless they were contacted by social services themselves with questions. Yes there would be visits if there was an ongoing investigation but unless you're spying on them or the mum told you, you wouldn't know.

DS1 was a complete blur of uncoordinated motion between the ages of 18 months and about 5 years (when he seemed to gain control of his extremities).

We had many a hospital visit and we DID get followed up by a social worker (when in UK).

It never occurred to me even once not to seek medical care for him. That is probably the biggest red flag.

He also never actually broke anything (well not until recently when he managed to break his toe getting out of the shower).

Some kids ARE accident prone. DS2 has had less supervision if anything and has never needed medical attention for an injury. He just pays attention more.

Make the call.

grannytomine medical failure to spot illness/injury is not uncommon. I know a few doctors and nurses who've gone the "walk it off" route for a few days before getting a child's injury seen to, a doctor who collapsed with peritonitis because he hadn't realised his stomach ache was appendicitis, and an obstetrician who took a good four months to realise she was pregnant.

I have a DC (2.5 yrs) who has broken a leg twice in 2 separate incidents, both unlucky/freak accidents. You need more than the fractures themselves to have reportable concerns.

I'm a nanny and have looked after many children.

Some children are just naturally clumsy. I looked after a set of twins who had 14 hospital visits between them in 5 years (only one in my watch and that was a freak accident). One of them is now a jockey and seems to be in hospital every other month!!

I've looked after 3 other sets of twins, all of whom had the odd bump and/or graze but no hospital visits for accidental injury.

My DD has two breaks before 14mo but after many many exams it turns out she has a rare bone disease. The doctors did raise the possibility of abuse with us...asked me if DH could have hit her, but I have known him since we were children ourselves and he's never hit anyone, and asked him if I might have dropped her but was too scared to tell anyone - admitting to dropping her would have been far easier than dealing with the rare bone disease gamut of diagnoses we went through. It was an awful time, and how do you prove you have not hit your child, but I can see why they asked.

It is possible this child is being abused or has a medical problem, either of which mean he need some help so I would report.

Akani
What's your source of information for saying investigations can go on behind parents backs. You mentioned something about your own experience but isn't it possible it just got referred to social care before they came and saw you? I'm not doubting your basing your opinion on something...but like the other posters I've never heard of it and I cannot imagine how that would be practically possible.

When something is referred to child protection, if the referral is accepted, the child and parents have to be seen within days, sooner if more urgent. Meeting the family would be the starting point of the assessment. In the vast majority of case, if the referrer is a professional, we will have expected that person to have informed the parent that they're making the referral. The screening process will also include a phone call to parents before deciding whether to accept the referral or not.

You're right that on some cases we wont speak to parents straight away due to the nature of the concerns. However, that would only last for up to 24 hours, usually parents would be told about the referral the same day as it comes in...just not before the child is spoken to obtain that case.

Investigations without parents being aware essentially cannot happen.

Except for a very limited time when a child may be spoken to.

Newdaylight, this is my exact understanding too.

My son broke his sternum playing rugby when he was about 13. The hospital did say that as he wasn't fully grown it was a greenstick fracture (so it bent but didn't snap) and that it is a much more serious injury in an adult as if it snaps it can obviously damage vital organs in the chest.

I hope the child doesn't have brittle bones. My DD did have a friend who seemed to break a bone every year, he was quite a crazy child. His parents were not negligent and he didn't have brittle bones. He's now a father himself and a Doctor!

I can't say what role I work in because there are many of us - it's related to CSE in a medical standpoint - however- you are both agreeing with the original point that I made which was there are times when parents are unaware of an investigation (it's not common, but it does happen).

Regardless, even if a parent was aware they may not necessarily have told the OP for many reasons.

the possibility exists that a child would be threatened or otherwise coerced into silence
there is a strong likelihood that important evidence would be destroyed
the child in question does not wish the parent to be involved at that stage, and is competent to make that decision.

(Reasons given by the Police as to guide decisions on when to and when not to disclose for a consenting child)

Yes but as the above OP says this would be for a very short duration, not weeks or months of an investigation going on behind a parents back with no discussion with the parents! To ensure a child is safe an assessment would take place quite quickly.

Investigations without parents being aware essentially cannot happen

This is quite frustrating to answer without disclosing personal information and my job but there absolutely have been investigations while parents have been unaware.

These blanket statements are disempowering and not correct.

I have known of some which have taken weeks/months. One was even closed without the parents even knowing that they had been investigated.

This was in Oxford.

" be for a very short duration, not weeks or months of an investigation going on behind a parents back with no discussion with the parents"

This absolutely does happen. Investigations often taken longer than safeguarding a child. A child can be deemed safe whilst investigations are ongoing - a child can even be allowed to return home when investigations are ongoing - look at Rotherham.

It is fairly common to have children return (sadly repeatedly) to A and E who are under current safeguarding investigations, yet have previously been allowed home.

Child with capacity do actually get a chance to have a say in what is and what isn't disclosed to parents. If a child is old enough and has the capacity to consent it's actually really unwise to not listen to their requests on this - particularly in the early disclosures.

Investigations without parents being aware essentially cannot happen

This is the type of inaccurate blanket statement that I was trying to weed out - it is incorrect, it is dangerous, particularly in reference to this thread. There are times that parents are unaware they are being investigated and there are times that parents are unaware their child is subject to an ongoing investigation. This happens, usually, as an additional safeguarding measure to protect the child.

I find that very hard to believe that a parent could be " investigated " without ever knowing.
In fact I'm pretty sure this would be a breach of confidentiality as you are allowed to request any information held about you from the police or social services therefore for them never to disclose it to you but then you find out I'm sure wouldn't be correct.
In an initial assesment written consent is requested to contact other departments and so on to allow access for information, if you're saying this can actually be completely over ridden anyway then what on earth is the point in these?

Embarrassedemma, I know you do and I can see that others do too.

I can't see how I could prove it on here though really. I have an LGO letter which I could look at redacting details on but I am not sure that it could be posted on here even with redactions.

These blanket statements about it 'never happening' though do worry me.

Mine had broken his arm twice by that age...
Saying that, cp is everyone's responsibility so you do need to act.

I agree that you need to act, sorry got distracted against the main issue.

I agree to act too.
Although a massive let down by the system if they've seen him in hospital and discharged with no follow up.
I'm not saying I disbelieve you, I'm just confused that you're saying they can speak to all different organisations without consent , amongst themselves, make a decision and if that decision is that it won't go any further the parent never knows about it!?

I was a kid in the 80's and I broke constantly due to a medical condition.

My parents probably had a social services visit every couple of months and a one point I was taken into care before a diagnosis of my medical condition was clear. I was given back when I fell and broke my hip while sat on a chair at the foster parents.

It was stressful for my parents but they've never held it against soaical services as they were just doing the best for me not my parents. It also sped up a diagnosis at the hospital when social services were like wtaf how did this kid break like that.

Fear of social services is absolutely no excuse for refusing a child treatment. Any parent that acts in that way is absolutely negligent. Be scared. Voice that fear. But don't not treat your child.

Call and report

I would definitely be concerned about a child not getting an injury checked out because of fear of social services. That in itself is neglect and should be reported.

Embarrassedemma, yes, it has definitely happened on more than one occasion in my area of the country that I worked in, one parent found out by accident when at the GP.
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