The types and possible signs and indicators of child abuse. Physical Abuse. This may involve the hitting, shaking, throwing, drowning, suffocating fit the injuries shown or otherwise causing harm to a child. Physical harm may also be when a parent or alternatively a carer fabricates the symptoms of an illness deliberately in a child. Physical abuse can be defined as a deliberate physical assault resulting in any of the above taking place. Physical indicators to be aware of professionally include any injuries that there is no explanation for or when the explanation given does not fit the injuries shown.
Another indicator can be when the explanation/story keeps changing and is not consistent. Injuries have different stages of healing and a watchful eye needs to bear this in mind. Questions will need to be asked at any stage of a child presenting an injury, in particular following an absence from school with or without an explanation from the parent or carer.
Injuries may have a pattern or may look as if they have been caused by an object, for instance a hand print, a mark caused by a stick, buckle or even a stove element.
Bruising may or may not be in usual places, such as the ears, body (trunk), neck or buttocks. Children present in different ways signs of physical abuse and can be protective of their abuser. This can be because they do not know any different and although they do not want to be hurt anymore, they are afraid of the unknown and what may happen.
The behaviour indicators to look out for without a disclosure can be a child afraid or unwilling to go home, running away from school or home. The child may show unusual signs of aggression, rages or tantrums.
Patterns may include poor school performance and attendance, poor self-esteem which can reflect in the child believing that they are bad and feel that punishment is deserved, regardless of the situation and what they may have done or not done. Any child that flinches when touched in a normal way or sudden movements made towards them and may be withdrawn raises concern. The most severe symptoms is when a child has suicidal thoughts or self-destructive behaviour patterns, this can include self-mutilation, suicide attempts and extreme risk-taking. Emotional Abuse.
Emotional abuse is the continual emotional mistreatment of a child by causing severe negative effects on a child’s emotional development. This is often a parent or carer conveying to a child that they are worthless or unloved, that they are inadequate and not valued unless they are meeting the needs of another person. Some level of emotional abuse is involved in all categories of child abuse. For some children it may involve seeing or hearing the abuse of others. It may involve serious bullying, causing the child to be frequently frightened or feel in danger for themselves.
Emotional abuse can be the most difficult form of abuse to detect, however the indicators to look for are both physical and behavioural. Including bed wetting or persistent diarrhoea, children can complain of frequent psychosomatic symptoms like headaches, nausea and abdominal pains. A child’s behaviour will show in ways of emotional or mental development, they will isolate themselves from friends or even have no friends what so ever. They will complain of social isolation and have inappropriate behaviour for their age.
These children will have a real fear of failure and have overly high standards and expectations, they may be reluctant to play or participate and have a fear of the consequences of their actions which will often lead to them lying. They may be withdrawn, aggressive and have mood swings; other signs could be that a child is too compliant and well mannered. A child may exhibit signs of being excessively clean, neat and tidy, alongside extreme attention seeking behaviour and poor peer- group relationships.
In extreme cases this may lead to severe depression and suicidal tendencies, another significant factor within a school setting is that work may be subject to violence. These children often show signs of severe anxiety or worries, but little anxiety towards strangers. Sexual Abuse. Sexual abuse is when a child is used or is likely to be used for the sexual gratification of another person. This can include the forcing or enticing of a child or young person to participate in sexual activities, including prostitution, touching or inviting to touch for sexual purposes, penetration and sexual intercourse ( vaginal, oral or anal methods).
Menacing or threatening sexual acts, obscene gestures, communication or stalking. This also includes involving children looking at or in the production of pornographic material or by encouraging children to behave in sexually inappropriate ways and aspects of organised or ritual abuse. The indicators to look for in child suffering sexual abuse can be both physical and behavioural. Physical indicators will include unexplained and persistent pain, bleeding or unusual discharge in the genital or anal areas, pregnancy and sexually transmitted diseases.
The behaviour indicators to be aware of include age inappropriate sexual play, knowledge, language and sexual drawings. Engaging other children in sexual play, inserting objects into the vaginal and rectum area, touching others or themselves inappropriately. Direct sexual behaviour towards adults and the receiving of unexplained gifts, for instance new clothes and money. The child may exhibit changes in school performance and attendance; they will become secretive with regards to new friends, family members or family friends, phone calls, activities or internet use.
A child that was toilet trained can become regressive and revert back to having accidents and bed wetting. The behaviour patterns in the extreme may include the misuse of drugs and alcohol, stealing, unsettled and flinching from being touched. A child may or may not show signs of one or several of these signs. Neglect. Neglect is probably the most common of the categories of abuse. Neglect is the persistent failure to meet the child’s physical and/or psychological needs, which is likely to result in the serious impairment of the child’s health and development.
Neglect takes on many different forms, it may occur during pregnancy as a result of maternal substance and alcohol abuse. Once a child is born neglect may involve a parent or carer failing to provide adequate food, clothing and shelter, including exclusion from home or abandonment. This includes the failure to protect a child from physical, emotional harm or danger, the failure to ensure adequate supervision including the use of inadequate and inappropriate carers. This also includes the failure to make sure access to appropriate and necessary medical care and treatment is provided.
It could be argued that neglect of or unresponsiveness of a child’s basic emotional needs could be included. Neglect involves an act of omission by the parent or carer, which results in or is likely to result in harm to the child. In this category there are two main types of signs “disclosures and indicators”. Sometimes children will tell a trusted adult that they are being abused and neglected. Children often begin with one example and wait for the outcome. In other cases children will not disclose directly, but indirectly.
This will be through behaviour patterns, emotional, art, writing, appearances, concerns or talks about fear, inquiries or relationships. Physical signs of neglect may include injuries where medical care has been unusually delayed or avoided all together, injuries that have occurred from lack of supervision. Medical or dental needs that are constantly not attended to, “failure to thrive” in a child where no medical reason has been found is more professionally known as non organic. A child’s clothing may be or could be viewed as inadequate for the weather conditions, dirty, un-ironed or ill-fitting.
They may be constantly hungry, looking for extra portions at school mealtimes, begging or stealing food from other children. They may show signs of poor hygiene standards, smelling and/or be dirty. Their behaviour patterns may include foraging or hoarding food, it may be that their development will suffer setbacks. School attendance could suffer, they may show a lack of concentration and constantly be tired and lack energy. Being sad, flat or tired in expression is a common indicator.
These children will often be reluctant to go home and are high risk of their parents being involved in the misuse of drugs and/or drugs or suffering from mental illness, which increases their vulnerability of using drugs or alcohol to overcome their own problems. Failure to thrive. Whilst failure to thrive is a component of neglect, it is also a category of its own, this is a child who has stopped growing and/or has experienced a significant weight loss or ability to gain weight due to a non-medical condition. Medical assessments are imperative to all of the abuse categories. However failure to thrive takes precedence.
A diagnosis as to whether the child’s condition is organic due to a medical condition or non-organic due to emotional, physical, neglect or sexual abuse is crucial. The behavioural indicators to look out for are that a child appears lethargic and undemanding; this child will rarely cry and be uninterested in its environment or surroundings. In a school environment this child will display very little energy or movement, very little interest in peer group play or activities. Bullying and Harassment. In each category of child abuse it could seem that bullying and harassment have a role to play.
However in a school environment this is usually child on child abuse, bullying and harassment can consist of verbal abuse, physical assault and emotional harm. Indicators to look out for are a child that is withdrawn and isolated, this child will avoid any group activity and peer closeness. The child may be tearful, waiting to avoid break-times and clinging to teachers and support staff. A bullied child will fabricate illness to avoid going to school, this child could be vulnerable of becoming a bully to avoid bullying of himself/herself. A bullied child is vulnerable to self-harming and suicide attempts to escape further torture or torment.