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Child Abuse and Neglect: Defined, Signs

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If you suspect a child is being harmed call the police and report the incident; don't wait.  Any concerned person can report suspicions of child abuse and neglect. . Some people (typically certain types of professionals) are required by law to make a report of child maltreatment under specific circumstances-these are called mandatory reporters.

Mandatory Reporters - professionals required to report suspected abuse
Individuals designated as mandatory reporters typically have frequent contact with children. Such individuals may include:

  • Social workers

  • Teachers and other school personnel

  • Physicians and other health-care workers

  • Mental health professionals

  • Childcare providers

  • Medical examiners or coroners

  • Law enforcement officers

  • Court Appointed Guardians

For more information about where and how to file a report, contact your local police department or child protective services agency. An additional resource for information and referral is the National Child Abuse Hotline (800.4.A.CHILD)
 

Recognizing Child Abuse

The following signs may signal the presence of child abuse or neglect.

The Child:

  • Shows sudden changes in behavior or school performance

  • Has not received help for physical or medical problems brought to the parents' attention

  • Has learning problems (or difficulty concentrating) that cannot be attributed to specific physical or psychological causes

  • Is always watchful, as though preparing for something bad to happen

  • Lacks adult supervision

  • Is overly compliant, passive, or withdrawn

  • Comes to school or other activities early, stays late, and does not want to go home

The Parent:

  • Shows little concern for the child

  • Denies the existence of-or blames the child for-the child's problems in school
    or at home

  • Asks teachers or other caregivers to use harsh physical discipline if the
    child misbehaves

  • Sees the child as entirely bad, worthless, or burdensome

  • Demands a level of physical or academic performance the child cannot achieve

  • Looks primarily to the child for care, attention, and satisfaction of emotional needs

The Parent and Child:

  • Rarely touch or look at each other

  • Consider their relationship entirely negative

  • State that they do not like each other
     

The four Types of child Abuse

1. Physical Abuse

2. Sexual Child Abuse (Rape, molestation, child pornography production and possession)

3. Emotional Abuse (Aka: Verbal, Mental, or Psychological abuse)

4. Neglect (Physical neglect, educational neglect, and emotional neglect)
 

Who does it happen to?
A child of any age, sex, race, religion, and socioeconomic background can fall victim to child abuse and neglect.
 

1. Physical Abuse

Inflicting physical injury on a child.

Characterized by injury, such as bruises, lesions and fractures that result from hitting (hand, stick, strap, or other object), punching, shaking, kicking, beating, choking, burning (with open flame or hot objects – boiling water, cigarettes), throwing, stabbing or otherwise harming a child.

The parent or caretaker need not have intended to hurt the child
for it to constitute physical abuse.

Other types of physical child abuse include:

> Shaken Baby Syndrome (SBS) is the collection of signs and symptoms resulting from the violent shaking of a baby that can cause tearing of the brain lining (dura), bleeds, permanent brain injury, or death).

> Munchausen by Proxy Syndrome - Inducing medical illness in a child or wrongly convincing others that a child is sick. This is a serious psychiatric disorder of parents or caregivers of children.

> Drug, cigarette or alcohol use during pregnancy. Alcohol use can lead to Fetal Alcohol Syndrome
 

Physical abuse indicators include when the child:

>  Has unexplained burns, bites, bruises, broken bones, black eyes, or welts in the
    shape of an object (wire hanger, stick, belt etc).

Has fading bruises or other marks noticeable after an absence from school.

>  Seems frightened of the parents and protests or cries when it is time to go home.

>  Flinches or cowers at the approach of a parent or adults.

>  Reports injury by a parent or another adult caregiver.

Consider the possibility of physical abuse when the parent or other adult caregiver:

>  Offers conflicting, unconvincing, or no explanation for the child's injury.

>  Describes the child as ‘evil,’ or other negative way.

>  Uses harsh physical discipline with the child.
 

2. Sexual Abuse

Any sexual behavior with - or sexual exploitation of - a child.

There are four types of sexual offenses against children: Rape, molestation, production, distribution or possession of child pornography. exploitation-trafficking

Any vaginal or anal intercourse with a child is rape. A child cannot legally give consent to sexual activity. Sexual abuse is never a child’s fault.

Child sexual abuse includes a wide range of behaviors, including:

>  Vaginal or anal penile penetration (Rape)

>  Oral sex by or to any adult

>  Genital contact without penetration

>  Fondling of a child's breasts or buttocks

>  Indecent exposure

>  Production or possession of child pornography by an adult

>  Sexual Exploitation: Use of a child in prostitution, pornography

Most (90%) sexual abuse is incest perpetrated by a family member (40%) or someone the child knows (50%), including those in biological families, adoptive families, and stepfamilies. Strangers account for 10% of sexual abuse. Incest most often occurs within a father-daughter relationship; however, mother-son, father-son, and sibling-sibling incest also occurs.

Sexual child abusers can be: fathers, mothers, siblings, relatives, friends, childcare professionals, babysitters, clergy, teachers, athletic coaches, foster-parents, neighbors, and strangers.

There are no medical signs in the vast majority of sexual abuse cases.
This is for a number of reasons including the abusers wish not to hurt the child so as to continue the abuse at another time, the elasticity and self-moistening of a vagina, quick healing in children of bruises and tears, elasticity of the anus. Sexually transmitted diseases, while not immediately visible, will show up in tests and on the child's genitals later. Oral abuse leaves no signs.

When the perpetrator doesn't care the signs are obvious: bruising, bleeding, tearing of tissue, perforation of bowel or vagina, infection.

Some signs of sexual child abuse:

>  Inappropriate interest in or knowledge of sexual acts.
>  Seductive behavior by a child.
>  Avoidance of things related to sexuality, or rejection of own genitals or body.
>  Over-compliance or excessive aggression.
>  Fear of a particular person or family member.

Sexual abuse may have occurred when the child:

>  Reports sexual abuse by a parent or another adult caregiver.
>  Has difficulty walking or sitting.
>  Changes in behavior, including discipline problems, fecal soiling, bed wetting,
    insomnia, nightmares, depression, changes in appetite.
>  Suddenly refuses to change for gym or to participate in physical activities.
>  Demonstrates bizarre, sophisticated, or unusual sexual knowledge or behavior.
>  Becomes pregnant or contracts a venereal disease, particularly if under age 14.
>  Runs away.
 

3. Neglect

Neglect is a pattern of failing to provide for a child's basic needs. It is abuse through omission; of not doing something resulting in significant harm or risk of significant harm.

There are three types of neglect: Physical neglect, educational neglect, and emotional neglect.

1. Physical Neglect: Failure to provide food, clothing appropriate for the weather, supervision, a safe and clean home, medical care.

2. Educational Neglect: Failure to enroll a school-age child in school or to provide necessary special education. Allowing excessive absences from school.

3. Emotional Neglect: Failure to provide emotional support, love, and affection to a child. Exposure of to spousal, pet, or drug and alcohol abuse.

These types of abuse are more typically found in combination than alone. A physically abused child, for example, is often emotionally abused, and a sexually abused child also may be neglected.

Consider the possibility of neglect when the child:

>  Is frequently absent from school. 
>  Is excessively hungry. Begs or steals food or money 
>  Lacks needed medical or dental care, immunizations, or glasses
>  Is consistently dirty 
>  Has severe body odor
>  Lacks sufficient weather appropriate clothing 
>  Abuses alcohol or other drugs
>  Apparent lack of supervision at home.

Failure to thrive is a condition in which children fail physically to develop to their normal full genetic potential. It is caused, most commonly, by medical conditions that can result in children not growing as expected. A lack of interaction between parent and child. It can be caused by intentional or unintentional behavior on the part of the parent.
 

4. Emotional Abuse
(Aka: verbal abuse, mental abuse, and psychological maltreatment)

Emotional child abuse is any attitude, behavior, or failure to act that interferes with a child's mental health or social development. A repeated pattern of caregiver behavior or extreme incident(s) that convey to children that they are worthless, flawed, unloved, unwanted, endangered, or only of value in meeting another's needs.

It can range from a simple verbal insult to an extreme form of punishment. Emotional abuse is almost always present when another form of abuse is found. Emotional abuse can have more long-lasting negative psychiatric effects than either physical abuse or sexual abuse.

Emotional abuse is illustrated by:

>  Belittling, rejecting, ridiculing, blaming, scape-goating, bullying
>  Terrorizing, threatening violence or fearful conditions
>  Isolating - confinement, restricting the child from social interactions, etc
>  Exploiting or corrupting
>  Denying the child an emotional response
>  Mental health, medical, and educational

Consider the possibility of emotional maltreatment when the child:

>  Shows extremes in behavior - overly compliant or demanding behavior,
    extreme passivity, or aggression.
>  Is either inappropriately adult (e.g. parenting other children) or inappropriately
    infantile (e.g. frequently rocking or head-banging).
>  Is delayed in physical or emotional development.
>  Has attempted suicide.
>  Reports a lack of attachment to the parent.

 

Sign and Symptoms - Expanded (Click)
 

More Information:

 

Sources:

National Clearinghouse on Child Abuse and Neglect Information

Administration for Children and Families

National Center on Child Abuse and Neglect

National Institutes of Health & the National Library of Medicine

U.S. Department of Health and Human Services

With thanks to: Child Welfare Information Gateway

"Child Abuse: An Overview" was written by C. J. Newton, MA, Learning Specialist and published in the Find Counseling.com (formerly TherapistFinder.net) Mental Health Journal in April, 2001.
http://www.findcounseling.com/journal/child-abuse/physical-child-abuse.html


 

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