Mental health:

Children in foster care or newly adopted to Canada may have special needs for health supervision. Health Care for Children in Foster Care (AAP) International Adoption (Kids New to Canada)

Social determinants of health (SDH): Inquire about impact of poverty (e.g. housing or food insecurity) and offer resources to families with unmet social needs. Canada Benefits Finder Poverty Tool by Region (CEP) Supporting children during COVID (CPS) CLEAR tool kit Social determinants of health (CFPC) Infrastructure to address SDH (PCH) Housing need in Canada (CPS)

Prevention of child maltreatment:

• Unexplained injuries (e.g. fractures, burns), sentinel injuries, or injuries that do not fit the rationale provided or developmental stage raise concern for child maltreatment.
• Consider more support/resources for:
1. Parents with low socio-economic or educational status, younger maternal age, single parent family, history of abuse, mental health and/or substance use, unplanned pregnancy;
2. Families with intimate partner violence, high conflict relationships, isolation or lacking social connectedness, caregivers who use corporal punishment;
3. Children with behavioural or mental health conditions, or with special needs.
• Discuss with parents of preschoolers teaching names of genitalia, appropriate and inappropriate touch, teaching age-appropriate principles of consent and permission, and normal sexual behaviour for age.
• Exposure to personal violence and other forms of violence has significant impact on physical and emotional well-being of children.
• Assess home visit need: There is good evidence for home visiting by nurses during the perinatal period through infancy for first-time mothers of low socioeconomic status, single parents or teenaged parents to prevent physical abuse and/or neglect. Child maltreatment prevention (USPSTF)

Bruising in suspected maltreatment cases (CPS) Medical Neglect (CPS) INSPIRE: 7 strategies for ending violence against children (WHO) Traumatic Head Injury due to Child Maltreatment (CPS/PHAC) Risk and Protective Factors for Child Maltreatment (CDC) Children with suspected exposure to intimate partner violence (CPS)