The Centers for Disease Control and Prevention (CDC) define child abuse as:
"Child maltreatment as any act or series of acts of commission or omission by a parent or other caregiver that results in harm, potential for harm, or threat of harm to a child."
In this article, we will look at child abuse and its symptoms in all its forms - physical, sexual and emotional. We will also look at child neglect and bullying.
Here are some key points about child abuse. More detail and supporting information is in the main article.
- Child abuse can happen anywhere, not just at home
- Physical abuse can include hitting, shaking or throwing
- In some countries, using corporal punishment is regarded as child abuse
- Emotional abuse can involve making a child feel worthless
- Grooming refers to preparing a child for sexual abuse
- Child neglect can start in the womb
- Bullying can be physical, emotional or verbal
- There are a number of signs of child abuse but they are difficult to pick up, even for experts
- One possible sign of abuse is when the child seems withdrawn, passive and overly compliant.
Child abuse comes in many forms.
A UK guidance: "Working Together to Safeguard Children 2010 (1.33-1.36)" says that there are four types of child abuse:
- Emotional abuse
- Sexual abuse
- Physical abuse
Child abuse can happen anywhere, in the child's home, school, community or other organizations, environments or places.
What is physical abuse?
Physical abuse may include, as defined in the UK and most other European Union countries:
- When a parent or caregiver fabricates a symptom in a child
- When a parent or caregiver induces an illness in a child deliberately
- Any other type of physical harm to a child
Some countries specifically define the following, as forms of physical abuse among others (some overlap those listed above)
- Blinding a person or causing impairment of sight
- Cutting or otherwise exposing somebody to something sharpExcessive pinching on the body
- Exposure to a dangerous animal
- Exposure to a toxic substance
- Exposure to cold, heat or radiation
- Infecting with a disease
- Placing in stress positions (tied or otherwise forced)
- Sleep deprivation
- Throwing or shooting a projectile
- Tickling non-consensually
- Withholding food or medication.
In a growing number of countries, using corporal punishment as a form of imposing or teaching discipline, is seen as a form of physical child abuse.
What is emotional abuse?
The National Society for the Prevention of Cruelty to Children (NSPCC) defines emotional abuse as:
"The persistent emotional maltreatment of a child such as to cause severe and persistent adverse effects on the child's emotional development."
Emotional abuse involves saying things and behaving in a way that conveys to the child that he/she is inadequate, unloved, worthless, or only valued as far as the other person's needs are concerned. This can be done in several ways, such as not allowing children to express their views and opinions, ridiculing what they say, silencing them, or mocking the way they are or how they try to communicate.
Expectations are imposed on the child which are not appropriate to their age or stage of development. They may be forced to interact in a way they are not ready for yet, or incapable of performing in.
Emotional abuse may also include some forms of overprotection, resulting in the child not being able to learn, explore, or take part in normal social interaction.
Seeing or hearing another person being ill-treated is also a form of emotional abuse.
Serious bullying, including online bullying, which frightens the child and may place them in danger, or exploitation, are also classed as forms of emotional abuse, as is the corruption of children.
All types of maltreatment to a child include some level of emotional abuse - however, it can also occur on its own.
What is sexual abuse?
Sexual abuse is defined as any act that forces or entices a child or young person to participate in sexual activities, regardless of whether the child is aware of what is going on. The definition does not necessarily have to include violence.
Sexual abuse activities may include assault by penetration, such as rape or oral sex, and non-penetrative sexual activities, such as touching outside of clothing, rubbing, kissing and masturbating.
There are some non-contact activities which are also classed as sexual abuse. These include looking at others performing sexual acts, sexual pictures, encouraging the child to behave sexually inappropriately, or grooming. Grooming refers to preparing a child for abuse.
Acts of sexual abuse may be committed by adult males, adult females and other children.
What is child neglect?
The US Child Abuse Prevention and Treatment Act (CAPTA) defines child neglect as:
"Any recent act or failure to act on the part of a parent or caretaker, which results in death, serious physical or emotional harm, sexual abuse or exploitation, or an act or failure to act which presents an imminent risk of serious harm."
The National Society for the Prevention of Cruelty to Children (NSPCC), a large UK organization, defines child neglect as:
"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."
The NSPCC goes on to explain that neglect can occur while the baby is still inside their mother - during pregnancy, as may be the case with maternal substance abuse.
After the child is born, a parent or caregiver may be committing child neglect if they fail to:
- Feed the child properly
- Clothe the child properly
- Shelter the child adequately. This includes abandonment or excluding the child from home
- Protect the child from emotional danger or harm
- Protect the child from physical danger of harm
- Make sure the child has access to medical treatment or care.
If a parent or caregiver does not respond to, or neglects a child's basic emotional needs, they could be guilty of child neglect.
What is bullying?
As mentioned earlier, bullying is not listed among the four types of child abuse and neglect. However, it involves at least one of the abuse categories, and often two or more.
Bullying is deliberate, it is hurtful behavior which persists for long periods - the victims invariably find it hard to defend themselves.
There are several different types of bullying:
- Physical bullying - examples include theft, kicking and hitting
- Verbal bullying - such as making racist or homophobic comments, calling the person hurtful names, and making threats
- Emotional bullying - making sure the victim is not accepted by his/her peer group, isolating them or giving them the "silent treatment."
Psychologists, pediatricians and education experts say the damage caused by bullying is often underestimated. In extreme cases, the child may be so distressed that he/she resorts to self-harm.
Recognizing the signs
Even experts may find it hard to initially pick up on the signs of child abuse. For lay people it is often harder still. The first step towards helping neglected and/or abused children is to learn to recognize the signs.
If just one sign is identified, this does not mean abuse has been occurring - some children may appear to display more than one sign and have not been abused.
Any citizen, be they health professionals or lay people, have a duty to help a child and their family if they suspect a child is being harmed - i.e. they must report their suspicions. Certain health or social services professionals have no choice; if they suspect it, they must report it.
Signs of abuse in the child
Detecting abuse in children can be very difficult.
- Arrives to school early, stays late after school - basically, does not seem keen on going back home
- The child appears to be in a permanent state of fearful alert, as if expecting some impending unpleasant event to occur
- The child appears to be withdrawn, passive, and overly compliant
- The child does not appear to have adult supervision
- The child has problems focusing (learning), which do not seem to be due to any specific psychological or physical causes
- The child's overall behavior changes
- The child's physical or medical problems that were brought to the parents' attention were not addressed
- The child's school performance changes.
Signs of abuse in the parent or caregiver
- Denies the child has any problems
- If a problem with the child is acknowledged, they blame the child
- Seeks out the child for his/her emotional needs, care, attention and satisfaction
- Tells the teacher or caregiver to be stricter and more severe with the child if there are any problems
- They seem unconcerned about the child
- Views the child as simply a burden, a worthless being, and even bad.
The parent/caregiver-child relationship
- The parent and child rarely touch each other
- They rarely look at one another
- They say they don't like each other
- They see their relationship as completely negative.
Signs and symptoms of physical abuse
The following signs may point towards the possibility that the child is being abused (but not necessarily):
- The child has unexplained black eyes, broken bones, bruises, bites or burns
- After being absent from school, fading bruises or other marks are visible
- The child protests or cries when school is over and they have to go home
- The child appears to be frightened of their parents
- The child is generally afraid of adults and shrinks away from them
- The child says they were injured by a parent or caregiver.
The parent who physically abuses may:
- Offer no explanation for the child's marks, bruises or injuries
- Says the child is evil, or makes some other extremely negative remark
- When with the child, the parent is overly severe and harsh
- Was abused when he/she was a child.
Signs and symptoms of child neglect
One potential sign of neglect is if a child begs for food.
- Medical care the child needs is not being provided
- The child abuses drugs and/or alcohol
- The child appears to have received no dental care
- The child begs for food
- The child begs for money
- The child is consistently unsuitably dressed for the time of year
- The child misses school a lot
- The child needs glasses but never has them
- The child says nobody looks after them at home.
The adult who is possibly guilty of child neglect may:
- Appear not to care about the child's happiness or general wellbeing
- May be depressed or apathetic
- Have bizarre or irrational behavior
- Abuses drugs or alcohol.
Signs of sexual abuse
Some of these signs may point towards sexual abuse (not necessarily):
- Sexual abuse is reported by the child
- The child becomes pregnant, especially if she is under 14 years of age
- The child cannot sit down without difficulty
- The child cannot walk without difficulty
- The child displays sexual knowledge or behavior which is beyond their years, bizarre or unusual
- The child runs away
- The child says they has nightmares
- The child says they are wetting the bed
- The child unexpectedly refuses to change for physical education
- The child unexpectedly refuses to take part in physical activities
- The child's eating habits suddenly change
- The young child becomes infected with a venereal disease.
If the parent or adult caregiver displays the following behavior, sexual abuse might be considered:
- The adult suddenly becomes very protective of the child, does not allow them to have contact with other children, especially those of the opposite sex
- The adult is very secretive
- The adult appears to be deliberately isolated
- The adult displays jealousy or a controlling attitude towards members of the family
What are the signs of emotional abuse?
Some of these signs may point towards emotional abuse (not necessarily):
- The child's behavior displays extremes of either compliance, passivity, aggression, or they becomes over-demanding
- The child behaves in a way that mimics adults, such as parenting other kids, or becomes extremely infantile, such as head banging or rocking back-and-forth
- The child tries to end their life
- The child says they have no attachment to the parent.
The adult might be abusing the child if:
- The child is forever being belittled, blamed for things, or berated
- Seems little concerned about the child's problems, and turns down offers of help
- Completely rejects the child.
A new study recently published in the American Journal of Psychiatry has found an association between child abuse and the reduction of gray matter in the brain that is responsible for information processing.
Still considered a rite of passage by some, research is now attempting to understand why victims of childhood bullying are at risk of poorer outcomes in adulthood, not only for psychological health, but also physical health, cognitive functioning and quality of life.