5N1770: You are the supervisor (Joan Dwyer) in a full daycare setting. Over the past months, you have noticed that Tom Murphy, aged 4 has attended: Early Care and Education Practice Course Work, OC, Ireland

You are the supervisor (Joan Dwyer) in a full daycare setting. Over the past months, you have noticed that Tom Murphy, aged 4 has attended the preschool service with dirty clothes. He has complained frequently of feeling hungry and displayed aggressive behaviors toward other children; this was not typical until now.

When Mum left him off he always arrived at 9 am. Tom’s Dad now drops him to your service and he is often late, he can arrive anytime between 10 am -12 am and Dad is often late collecting him and you have had to ring him several times this month.

The staff has noticed twice, bruising on Tom’s upper arms, and when brought to the father’s attention, Dad said he ‘knocked himself against the wall’. Staff recorded this and have spoken to Dad about their growing concerns with little response.

In a recent outbreak of head lice Tom returned to preschool with the condition untreated twice, the father took advice from staff but did not follow it up. Tom has lost interest in activities and seems to be overtired and agitated a lot of the time.

Staff is getting very concerned about the inconsistent patterns in Tom’s behavior, hygiene, and health. His development is not proceeding as it should and he appears to be regressing back to earlier stages i.e. he has had a few toileting accidents and started sucking his thumb again when anxious. His language is increasingly getting less; whereas before he was very chatty and excitable.

Tom’s Dad has been made redundant this year and his mother Judy has been ill recently and spends long periods in the hospital for treatments. You have decided to make a referral to Tusla and inform the parents that this is being done today.