Working Together 2015 recognises four categories of abuse. There are many lists of the indicators of abuse; none of them are exhaustive, none of them are definitive. Although the list below describes four discreet categories, in reality there is often considerable overlap.
•Bruising – particularly to soft tissue. The bruise may correspond with a
•an allegation of physical abuse
•Bruises in unusual places, such as ear or neck are suspicious. Also look out for ‘finger tip’ bruises- 4 marks one side and 1 the other
•Marks such as those made with a hand ( a slap or grab) or implement ( a belt or stick)
•Burns – may be neglectful or deliberate action, such as cigarette burns
•Adult bite marks
•Injuries caused by parent failing to protect
•Parent threatening violence to a child
•Inappropriate physical chastisement
•Parents whose delusions include harming the child
•Baby being shaken
Emotional abuse can be very hard to assess because there may be no direct allegation made by the child and often it will be necessary to observe parental behaviours towards the child.
Parental behaviours may include:
•Marked age inappropriate expectations of the child
•Persistent rejection, negative attributes directed towards the child
•Child may be scapegoated
•High criticism and low warmth expressed to the child
•Extreme discipline may be used or threatened and used as a justification for harsh punishment
•Child is frightened by the parents – they might be exposed to domestic abuse
•Child is not allowed to socialise and have friends, play and have fun
•Positive emotions such as pride, joy, enthusiasm, love are rarely expressed by the parents which impacts on the child’s ability to feel these
Impact on child:
•Severe emotional problems
•Inability to make friends, play and have fun
•Excessive timidity or withdrawal
•Cognitive development – ability to concentrate, develop memory, etc.
•Non organic failure to thrive
•Disclosure – direct or indirect, accidental or purposeful
•Physical injuries or bruising to genitals, inner thighs etc.
•Persistent vaginal or urinary tract infection or discharge
•Sexually Transmitted Infections
•But there is often no physical indicator of sexual abuse.
Where this is the case and child sexual abuse is suspected, professionals need to focus more on behaviour of the child and understand more about the dynamics of the family and what the child’s life is like. Reaching a view about whether the child is being sexually abused or not is complex without a disclosure.
Child sexual abuse is differs from other kinds of abuse because it is much more likely to take place in a world of secrecy and the child is very likely to have been silenced by the perpetrator.
•Inappropriate sexual knowledge
•Sexual preoccupation and compulsive behaviour – eg. Masturbation
•Sexually explicit language and drawings
•Challenging behaviours – self mutilation, arson, running away, withdrawn, aggression and tantrums, eating problems, bed wetting or soiling
•Depression and being withdrawn
•Headaches, stomach aches
•Changes in school attendance and performance
Most behavioural problems which might indicate sexual abuse could also be explained by other difficulties in a child’s life
•Medical treatment not sought when child requires it
•Child poor school attendance
•Child left unsupervised or inappropriately looking after other children
•Child persistently hungry, persistently dirty, smelly or inadequately dressed
•Unremitting low level of care provided by parent, resulting in child not only
•suffering above but poor stimulation and cognitive support, leading to low expectation of themselves as parents and then in turn of their child Child may show indiscriminate affection or is withdrawn or frightened
It doesn’t matter where you go on the globe, if you ask the adults the question ‘ is it OK to abuse children? you will never get the answer ‘yes’. What you will find is that different societies have different ways of bringing up children. However culture is never an excuse for abuse.Remember we ALL grow up in culture- we are all products of culture.