Categories of Child Abuse and their Effects
Categories of Child Abuse and their Effects
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Child abuse is categorised as physical, neglect, emotional and sexual.
Some level of emotional abuse is involved in all types of maltreatment, although it may also occur alone.
Please remember that categories of abuse all overlap and should not be seen in isolation.
There are many other forms of harm inflicted on children and young people such as:
Modern slavery
Trafficking
Honour-based violence
Forced marriage
Child sexual exploitation
Extra-familial risk
Peer impact
Exploitation and involvement in serious youth violence
Some others are shown below.
Physical Abuse
Physical abuse is deliberately hurting a child and causing injuries such as bruises, broken bones, burns or cuts.
It isn’t accidental - children who are physically abused suffer violence such as being hit, kicked, poisoned, burned, slapped or having objects thrown at them. Shaking or hitting babies can cause abusive head trauma. Sometimes parents or carers will make up, or cause, the symptoms of illness in their child, perhaps giving them medicine they don’t need and making the child unwell – this is known as fabricated or induced illness (FII).
There’s no excuse for physically abusing a child. It causes serious, and often, long-lasting harm - and in severe cases, death.
How common is physical abuse?
The NSPCC has reported that 1 in 14 children have been physically abused.
How does physical abuse impact on a child?
The child will feel immediate pain and suffering
There may be medical problems caused by the physical injury
The emotional pain will last long after the bruises and wounds have healed
The longer physical abuse of a child occurs, the more serious the impact. Chronic physical abuse, or a single episode of severe physical abuse can result in long-term physical disabilities, including brain damage, hearing loss or eye damage
The child can die in the instance of severe physical abuse
What are the signs of physical abuse?
Some of the common signs can be:
Bruising - especially in areas that are not usually injured
Cuts and scratches - especially in areas that are not usually injured
Bite marks
Burns and scalds
Broken bones - without a good explanation
Shaken babies (abusive head trauma) - causes bleeding into the brain so the baby may be unconscious or fitting
Signs of physical abuse can also be more subtle: a child may be fearful, shy away from touch, be reluctant to change for PE or appear to be afraid to go home
What always needs to be taken into account?
The origin of bruising in babies and children can sometimes be difficult to identify. The child's age and stage of development can be a helpful guide; for example, a non-mobile infant should not have bruises anywhere unless there is a clear differential diagnosis such as recent injury or an underlying medical condition, seek advice from an expert; whilst a school-aged child may have bruising on their limbs caused during normal play. If you’re not sure seek advice from someone who can support you
The child's explanation (where this is possible) and the parent or carer's explanation for the injury. In abuse, the parent's explanation may not fit with the injury seen, seem very vague, or change every time they are asked about the injury. The child may have been 'trained' to echo the parent's explanation
Neglect
Neglect is the persistent failure to meet a child's basic physical and/or psychological needs, likely to result in the serious impairment of the child’s health or development. This may or may not be deliberate.
When might neglect occur?
Neglect may occur during pregnancy as a result of maternal alcohol/substance 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)
Protect a child from physical and emotional harm or danger
Ensure adequate supervision (including the use of inadequate caregivers)
Ensure access to appropriate medical care or treatment
It may also include neglect of, or unresponsiveness to, a child's basic emotional needs [1]
How common is neglect?
When asked, roughly 15% of young people had been neglected at some point in their childhoods.
How does neglect impact on a child or young person?
Examples include:
Infant or child is always feeling hungry, perhaps not growing properly
Being rejected at school by other children because of their dirty clothes and smell
Living in a filthy house without a clean bed to sleep in, no proper bedtime and therefore always feeling tired
Not getting medical care when they need it due to parental capacity. Therefore, the child/infant may present late to health services with an illness, which can have a significant impact on their health and development; and may have potentially fatal consequences
What are the signs of neglect?
Physical signs:
Ill-fitting, dirty clothes and shoes
Not dressed warmly enough in cold weather
Appearing very dirty, with matted and unwashed hair or smelling bad
Untreated or delayed treatment for illnesses and physical injuries
Behavioural signs:
Unsupervised young children playing outside
Left alone at home
Frequently late for school
Troublesome, disruptive behaviour, or withdrawn and passive
Running away from home - in the case of adolescents
Emotional Abuse
Emotional abuse is the persistent emotional maltreatment of a child that causes severe and persistent adverse effects on the child’s emotional development.
What does this involve?
This can include:
Conveying to children that they are worthless, unloved, inadequate or valued only when they meet the needs of another person
Not giving the child opportunities to express their views, silencing them or ‘making fun’ of what they say or how they communicate
Experiencing domestic abuse in the home
Age or developmentally inappropriate expectations being imposed on children such as:
Interactions that are beyond the child’s developmental capability
Limitation of exploration and learning
Overprotection and preventing the child from participating in social interaction
Serious bullying (including cyber bullying) which causes children to feel frequently frightened or in danger
Exploitation or corruption of children
Emotional impact (short- or long-term) of witnessing domestic abuse
All types of maltreatment involve some level of emotional abuse, but emotional abuse may also occur in isolation.
How common is emotional abuse?
Parents from all types of backgrounds may emotionally abuse their children. About 7% of children in the UK experience frequent and severe emotional maltreatment during childhood
How does emotional abuse impact on a child?
The child or young person may feel:
That he or she is not worthy of being loved by anyone
A poor sense of wellbeing, self-image and self-esteem
A poor sense of security, and difficulty in trusting others
It is hard to feel happy
Responsible for the abusive parent's displeasure or unhappiness
What are the signs of emotional abuse?
It's not always easy to identify when a child is being emotionally abused. Some of the ways children react to emotional abuse are:
Having low self-confidence and a poor self-image
Being withdrawn, unable to trust others and having difficulty when forming relationships
Being delayed emotionally, socially or academically
Becoming anxious, depressed, demanding, aggressive, destructive or even cruel
Displaying increased risk-taking behaviour
What actions of a parent/carer are emotionally abusive?
Parents or carers may:
Say things to the child over and over again until the child believes he or she is 'no good', 'worthless', 'bad' or 'a mistake'
Speak to the child in a terrifying way such as shouting, swearing, threatening or bullying
Humiliate the child by making sarcastic comments, negative comparisons to others, or shame a child in private or public
Terrorise the child, e.g. threatening to use a knife or other means in order to hurt, torture or kill a pet, a loved one or the child themselves
Force a child to watch violent acts, threaten him or her with abandonment or place the child in dangerous situations
Reject the child, withhold affection or refuse to acknowledge the child's presence and accomplishments. The abusing adult communicates dislike for the child who also may become the 'scapegoat' for family problems
Isolate the child by restricting contact with others and preventing him or her from forming friendships. Normal family interactions are restricted; a child may be required to stay in his or her room or in the closet, basement or attic for extended periods of time
Corrupt the child by encouraging anti-social or delinquent behaviour. Corruption exists when children are given alcohol or other drugs, encouraged to commit crimes or are exposed to cruelty toward animals or other human beings
Adolescents may be emotionally abused by peers at school or intimate partners
Create an environment of fear and intimidation in the home through domestic abuse
Sexual Abuse
What are the signs that a child has been/is being sexually abused?
What is sexual abuse?
Sexual abuse involves forcing or enticing a child or young person to take part in sexual activities. It does not necessarily involve a high level of violence, and the child may or may not be aware of what is happening.
The activities may involve physical contact, including assault by penetration (for example, rape or oral sex) or non-penetrative assault (for example, masturbation, kissing, rubbing and touching outside of clothing).
Sexual abuse may also include non-contact activities, such as involving children in looking at, or in the production of, sexual images, watching sexual activities, encouraging children to behave in sexually inappropriate ways, or grooming a child in preparation for abuse (including via the Internet).
Sexual abuse is not solely perpetrated by adult males; women can also commit acts of sexual abuse, as can other children [1].
Child sexual exploitation (CSE) is a type of sexual abuse where the child or young person receives something (e.g. money, food, shelter, drugs) in return for sexual activities. There is a power imbalance between the perpetrator and victim.
How common is sexual abuse of children and young people?
Many children do not tell anyone about sexual abuse, so it is difficult to know the true number of children and young people affected. Between 5% and 10% of girls; and between 1% to 5% of boys are exposed to penetrative sexual abuse during childhood, although figures that include any form of sexual abuse are much higher, up to 25%.
The majority of perpetrators are males, either adults or other young people, who were known to the child or young person. Teenage girls aged between 15 and 17 years reported the highest rates of sexual abuse in the past year [3].
What is the impact of sexual abuse on a child or young person?
The most common reaction that a child feels is terrible shame. They may have tried to tell someone but not have been believed. They may have even been blamed for what has happened. Many sexually abused children wait until they are much older to tell anyone what has happened to them, or they sometimes never tell.
Many young people who are sexually abused by their partner are afraid to tell friends and family.
What are the signs of sexual abuse?
Most children (boys and girls) who present with an allegation or a history of sexual abuse do not have any physical signs when examined by a specialist doctor. This is because the abuse may have taken place sometime before the examination and injuries to the genital area heal very quickly or because the abuse was non-penetrative (for example, kissing or touching).
The child’s behaviour may suggest sexual abuse if he or she:
Becomes anxious about going to a particular place or seeing a particular person
Suddenly starts having behaviour problems such as being aggressive
Suddenly starts having extreme mood swings such as brooding, crying or fearfulness
Has a sudden deterioration in school results
Displays unexpectedly explicit sexual knowledge for their age, including inappropriate sexualised behaviour
Starts wetting the bed again, having previously been dry by night
Adolescent victims of sexual abuse in the home or with an intimate partner or gang, are more likely to:
Do poorly at school
Abuse alcohol or drugs
Self-harm
Have unprotected sex with numerous partners
Continue the patterns of violence into future relationships
What are the characteristics of a child sex abuser?
Usually the abuser is a family member or someone known to the child, such as a family friend. For teenagers it is commonly a boyfriend or girlfriend. Child sex abusers can come from any professional, racial or religious background, people in a position of trust, and can be male or female.
Abusers may act alone or as part of an organised group. After the abuse, they will put the child under great pressure not to tell anyone about it. They will go to great lengths to get close to children and win their trust, such as choosing employment that brings them into contact with children, or by pretending to be children in internet chat rooms intended for children and young people. Child sex abusers are sometimes referred to as 'paedophiles' or 'sex offenders', especially when they are not family members or intimate partners in teenage relationships.
Nobody is above suspicion and if any concerns are identified or raised with you, you must take action and not assume that somebody couldn't be a perpetrator simply because of their role, status or demeanour. Every organisation will have a policy for 'managing allegations against professionals' that you need to be aware of.
Further Information on Safeguarding Concerns
Please click the pictures
Cyber
In the past years, the increased use of social networking sites by children has, along with its many benefits, brought with it increased vulnerability to grooming and to the misuse of provocative or sexual images (self-generated or otherwise) [4].
Professionals should be aware that both bullying and CSE can be aided by texting, 'sexting', social networking sites and other 'apps'.
Local safeguarding services can provide details of current apps or sites of concern.
Female genital mutilation (FGM)
Female genital mutilation (FGM) is the partial or total removal of external female genitalia for non-medical reasons. It's also known as female circumcision or cutting.
Religious, social or cultural reasons are sometimes given for FGM. However, FGM is child abuse. It's dangerous and a criminal offence.
There are no medical reasons to carry out FGM. It doesn't enhance fertility and it doesn't make childbirth safer. It is used to control female sexuality and can cause severe and long-lasting damage to physical and emotional health.
We all have a statutory duty to report any concerns about actual or suspected FGM in a girl under 18 years old.
Domestic violence and abuse
The UK Government’s definition of domestic violence and abuse is:
''Any incident or pattern of incidents of controlling, coercive, threatening behaviour, violence or abuse between those aged 16 or over who are, or have been, intimate partners or family members regardless of gender or sexuality. The abuse can encompass, but is not limited to psychological, physical, sexual, financial, emotional.
Children and young people can suffer as a consequence of domestic abuse occurring within their household. They may experience direct physical, sexual or emotional abuse, and there is also the abusive impact of witnessing or being aware of abuse to a parent or other family member (usually their mother).
Recent UK research found that 12% of under 11-year-olds, 17.5% of 11–17s and 23.7% of 18–24 year olds had been exposed to domestic abuse between adults in their homes during childhood [5].
It is increasingly recognised that physical, sexual, or psychological/emotional abuse can occur within teenage relationships. It can occur both in person and electronically, and may occur between a current or former partner or may be gang-related. This tends to be called 'intimate partner violence' in the UK and 'teen dating abuse' in the USA. This form of abuse is common; in a recent study, about 25% of adolescent girls and 18% of boys in the UK had experienced some form of physical abuse from their partner [5].
Bullying
Bullying may be defined as deliberately hurtful behaviour, usually repeated over a period of time, where it is difficult for those bullied to defend themselves.
Bullying can take many forms, but the three main types are physical (for example, hitting, kicking, theft), verbal (for example, racist or homophobic remarks, threats, name calling) and emotional (for example, isolating an individual from the activities and social acceptance of their peer group).
There is increased recognition of 'peer-on-peer' abuse - which can occur in varied settings such as school, youth groups, gangs or friendship groups. This may include a combination of emotional, physical and sexual intimidation.
The damage inflicted by bullying can frequently be underestimated. It can cause considerable distress to children to the extent that it affects their health and development or, at the extreme, cause them significant harm (including self-harm). All settings in which children are provided with services or are living away from home should have in place rigorously enforced anti-bullying strategies.
Radicalisation
PREVENT is a scheme that is part of the Government's counter-terrorism strategy called CONTEST. It aims to reduce the risk to the United Kingdom and its interests overseas from international terrorism, so that people can go about their lives freely and with confidence.
These forms of terrorism include:
Far right extremists
Al-Qa’ida influenced groups
Environmental extremists
Animal rights extremists
Young people from their teenage years onwards can be particularly vulnerable to getting involved with radical groups through direct contact with members, or increasingly, through the internet. This can put a young person at risk of being drawn into criminal activity and has the potential to cause significant harm.
Serious and violent crime
Children and young people may be drawn into gangs or criminal exploitation through a number of routes:
Peer pressure, they need to feel important or part of something
They want to feel protected
Money and promised rewards
Status and the feeling of power
Excluded from school and feel they have no place to be
Poverty
Children and young people may be coerced or threatened into committing crime or supporting criminal activities. The exploiters will physically, and/ or sexually abuse the child or young person to ensure the exploiters can maintain control over the child or young person. The gangs may be:
Peer groups
Street gangs or larger organised criminal groups
Scenarios
There are two scenarios, have a go, see if you can identify the type of abuse.
Effects of Child Abuse
Abuse and neglect can have major effects on all aspects of a child's health, development and wellbeing. The impact of any abuse will vary from child to child depending on the:
Nature of the abuse
Duration of the abuse
Age of the child
Individual child’s reaction to the abuse
Home/family environment
Impact and speed of any intervention
Consequences of the intervention
Professional response and support
Wider lived environment of young people
Influence of peer's
Abuse and neglect during childhood increases the later risk (in adolescence and adulthood) of:
Drug and alcohol misuse
Poor physical/mental health
Early and multiple sexual relationships and teen pregnancy
Risk of perpetrating or being a victim of domestic violence
Difficulty with job performance
Relationship problems
Likelihood of going to prison
Risk of criminal and sexual exploitation, involvement in serious youth violence
Risk of serious injury and death
Adverse Childhood Experiences (ACEs)
The term 'adverse childhood experience (ACEs)' refers to a range of negative situations a child may face or witness while growing up. These experiences include emotional, physical, or sexual abuse; emotional or physical neglect; parental separation or divorce; or living in a household in which domestic violence occurs. Adverse Childhood Experiences can have a significant impact on the health and development of children and young people; the effect can last into adulthood.
On the positive side, many children, and young people, despite having suffered from abuse, overcome this adversity and go on to enjoy successful and contented lives.
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