Discuss child abuse.

In this paper I will discuss child abuse, the definitions of abuse also the signs and symptoms to look out for. I will examine the affects of abuse and what can be done to help children that suffer from abuse. There is no absolute definition of child abuse; however official definitions of child abuse usually describe abusive incidents, taking into account whether there is definite knowledge of an intention to harm or knowingly not to prevent harm by any person having care or custody of the child. Harm includes physical injury, physical neglect and failure to thrive, e.g. exposure to dangerous circumstances or starvation; emotional abuse where the health and development of the child is threatened; and also sexual abuse where children under 17 years have been involved in sexual activities they do not truly comprehend or to which they do not give informed consent.

Neglect is the persistent lack of appropriate care of children, including love, stimulation, safety, nourishment, warmth, education and medical attention. It can have a serious effect on a child's physical, mental and emotional development. For babies and very young children, it can be life-threatening.

Observable Indicators

dirty skin
offensive body odour
unwashed, uncombed hair
tattered, under or oversized and unclean clothing
dressed in clothing that is inappropriate to weather or situation
frequently left unsupervised or alone for periods of time

Indicators of Poor Health

drowsiness, easily fatigued
puffiness under the eyes
frequent untreated upper respiratory infections
itching, scratching, long existing skin eruptions
frequent diarrhoea
bruises, lacerations or cuts that are infected
untreated illnesses
physical complaints not responded to by parent

Indicators of Malnutrition

begging for or stealing food
frequently hungry
rummaging through rubbish bins for food
gorging self, eating in large gulps
hoarding food
obesity
overeating junk foods

Indicators in Infants and Toddlers

listlessness
poor responsiveness
does not often smile, cry, laugh, play, relate to others
lacks interest, curiosity
rocks, bangs head, sucks hair, thumb, finger,
tears at body
is overly self-stimulating, self-comforting
does not turn to parent for help or comfort
hospitalization for failure to thrive - regresses upon return to home
unduly over or under active for no apparent purpose

Indicators in Children

cries easily when hurt even slightly
comes to school without breakfast
has no lunch or lunch money
needs dental care, glasses
falls asleep in class
often seems in a fog or dream world
comes to school early, does not want to go home
sees self as failure
troublesome at school
does no homework, refuses to try
destroys completed written work
destroys books, assignments and learning aids or toys
is withdrawn, overactive, underactive and/or lethargic (depressed)
is cruel to classmates
lies, steals from classmates, school
breaks objects or damages school property
frequently absent or late for school

A study completed by Cawson for the NSPCC found evidence to suggest that 18% of children experienced some absence of care during childhood and 20% experienced less than adequate supervision. 6% of children experienced serious absence of care at home during childhood. 5% of children experienced serious absence of supervision during childhood.
(Cawson et al., 2000,)

Emotional abuse is any kind of abuse that is emotional rather than physical in nature. It can include anything from verbal abuse and constant criticism to more subtle tactics, such as intimidation, manipulation, and refusal to ever be pleased. Emotional abuse is like ‘brain washing’ in that it systematically wears away at the child’s self-confidence, sense of self-worth, trust in their own perceptions, and self-concept. Whether it is done by constant berating and belittling, by intimidation, or under the pretext of "guidance," "teaching", or "advice," the results are similar. Eventually, the recipient of the abuse loses all sense of self and remnants of personal value. Emotional abuse cuts to the very centre of a person, creating scars that may be far deeper and more lasting than physical ones.

Types of Emotional Abuse

Emotional abuse can take many forms. Three general patterns of abusive behaviour include aggressing, denying, and minimizing.

Aggressing

Aggressive forms of abuse include name-calling, accusing, blaming, threatening, and ordering. Aggressing behaviours are generally direct and obvious. The one-up position the abuser assumes by attempting to judge or invalidate the recipient undermines the equality and autonomy that are essential to healthy adult relationships. This parent-child pattern of communication (which is common to all forms of verbal abuse) is most obvious when the abuser takes an aggressive stance.
Aggressive abuse can also take a more indirect form and may even be disguised and "helping." Criticizing, advising, offering solutions, analyzing, proving, and questioning another person may be a sincere attempt to help. In some instances however, these behaviours may be an attempt to belittle, control, or demean rather than help. The underlying judgmental "I know best" tone the abuser takes in these situations is inappropriate and creates unequal footing in peer relationships.

Denying

One form of Invalidating seeks to distort or undermine the recipient's perceptions of their world. Invalidating occurs when the abuser refuses or fails to acknowledge reality. For example, if the recipient confronts the abuser about an incident of name calling, the abuser may insist, "I never said that," "I don't know what you're talking about," etc.
Withholding is another form of denying: Withholding includes refusing to listen, refusing to communicate, and emotionally withdrawing as punishment. This is sometimes called the silent treatment.
Countering occurs when the abuser views the recipient as an extension of them ...

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Denying

One form of Invalidating seeks to distort or undermine the recipient's perceptions of their world. Invalidating occurs when the abuser refuses or fails to acknowledge reality. For example, if the recipient confronts the abuser about an incident of name calling, the abuser may insist, "I never said that," "I don't know what you're talking about," etc.
Withholding is another form of denying: Withholding includes refusing to listen, refusing to communicate, and emotionally withdrawing as punishment. This is sometimes called the silent treatment.
Countering occurs when the abuser views the recipient as an extension of them and denies any viewpoints or feelings which differ from their own.

Minimizing

Minimizing is a less extreme form of denial. When minimizing, the abuser may not deny that a particular event occurred, but they question the recipient's emotional experience or reaction to an event. Statements such as "You're too sensitive," "You're exaggerating," or "You're blowing this out of proportion" all suggest that the recipient's emotions and perceptions are faulty and not be trusted.
Some notable form of trivializing occurs when the abuser suggests that what you have done or communicated is insignificant or unimportant, is a more subtle form of minimizing.

Physical abuse includes hitting, shaking, kicking, punching, scalding, suffocating and other ways of inflicting pain or injury to a child. It also includes giving a child harmful substances, such as drugs, alcohol or poison. If a parent or carer reports non-existent symptoms of illness in a child, or deliberately causes illness in a child, this is also a form of physical abuse.

Physical abuse has damaging and long lasting effects. It can even be fatal, each week at least one child in the UK dies at the hands of their parents or carers. Physical abuse can have long-term effects on a child's health and development. It can cause physical injury, brain damage or disability and may lead to children developing emotional, behavioural or educational problems. For some children, these difficulties can continue in adulthood. For example, people who were physically abused as children may have problems with personal relationships and they may be more likely to treat their own children abusively. The child's age, the frequency of the abuse and how long it has been taking place all influence how much they will be affected by it. But sometimes a severe isolated incident can affect a child as badly as on-going abuse.

The signs of physical abuse

Bruises, black eyes and broken bones are obvious signs of physical abuse, but they are not the only ones. Other signs include:

Injuries that the child cannot explain or explains unconvincingly
Untreated or inadequately treated injuries
Injuries to parts of the body where accidents are unlikely, such as thighs, back, abdomen
Bruising which looks like hand or finger marks
Cigarette burns, human bites
Scalds and burns

Sometimes if a child is being physically abused they may show changes in behaviour, such as;

Becoming sad, withdrawn or depressed
Having trouble sleeping
Behaving aggressively or being disruptive
Showing fear of certain adults
Showing lack of confidence and low self-esteem
Using drugs or alcohol

Sexual Abuse is when a child or young person is pressurised, forced or tricked into taking part in any kind of sexual activity with an adult or young person. This can include kissing, touching the young person's genitals or breasts, intercourse or oral sex. Encouraging a child to look at pornographic magazines, videos or sexual acts is also sexual abuse.

Physical signs of abuse

pain, itching, bruising or bleeding in the genital or anal areas
genital discharge or urinary tract infections
stomach pains or discomfort walking or sitting
sexually transmitted infections

Behavioural signs of abuse

These might include a marked change in the child's general behaviour. For example, they may become unusually quiet and withdrawn, or unusually aggressive. Or they may start suffering from what may seem to be physical ailments, but which can't be explained medically. (Child line 2006)

The child may refuse to attend school or start to have difficulty concentrating so that their schoolwork is affected.
They may show unexpected fear or distrust of a particular adult or refuse to continue with their usual social activities.
They may start using sexually explicit behaviour or language, particularly if the behaviour or language is not appropriate for their age.
The child may describe receiving special attention from a particular adult, or refer to a new, "secret" friendship with an adult or young person.

Understanding the causes of child abuse, there have been numerous attempts to explain child abuse, using different and often conflicting methodological approaches. However, none of the theories so far explains the full range of child abuse. At best, they offer only partial accounts. (Colton 2001)

Kempe the American paediatrician, was credited with rediscovering child abuse, he focused on the importance of the attachment between mother and child in explaining physical abuse. Kempe’s approach was based on the work done by Bowlby and his attachment theory. Kempe suggested that mothers who abuse their children had often received little or no attachment with their own parents. Part of Bowldys theory suggested that they had little or no parenting skill of the own and subsequently abused their children because of this. Furthermore he also suggested that if a supportive mothering relationship was implemented that this would go far in helping the next generation of children within that family unit. (Bowlby 1988)

Bandura social learning theory views, child abuse as a consequence of poor learning experiences, and also inadequate controlling techniques. Parents themselves who were abused as children may not have learned how to control their children effectively using socially approved methods, as an alternative they adopted an abusive approach. Equally parents who where overindulged during childhood were unable to establish appropriate limits and quite often turn to violence when their children go too far.

Bandura helped to develop behaviour modification techniques within the area of child abuse. His attention concentrated on supplanting inappropriate and ineffective approaches to parenting with those that are both effective and socially acceptable. He also suggested that abusive behaviours are learned and therefore can be unlearned. (Bandura 1965) one theory that contradicts Bandura was the work by Lombroso (Lombroso 1876) Lombroses view is that cretin people are born, as criminally minded through the inherent of a physiological or genetic predisposition towards crime and subsequently abuse (Thui, Nellis, 2003)

There are numerous theory’s why people abuse children, however when abuse happens normally a range of interventions take place by different agencies including the police and also social services. There is an ongoing debate when it is appropriate for agencies to become involved one notable debate is an ongoing issue about parent’s rights to slap a child. Whether slapping a child is ever justifiable, despite this debate, there is no arguing that the immediate effects of physical abuse reflect the nature and severity of the injuries inflicted. These can range from minor cuts and bruises to fractured bones. In the most severe of cases internal injuries such as damage to liver, kidneys and spleen have been reported, these maybe as result of being kicked or punched, they can prove fatal if not treated. One to two children die every week in the UK from physical abuse (Office of National Statistics, Mortality Statistics 2006) Besharov identified a number of factors which might lead to the suspicion that an injury was caused by abuse.

These include:

The child’s level of development
The shape of the injury
The location of the injury
The type of the injury
The number of old and new injuries (Besharov 1990)

Some research indicates that children who suffer abuse, show delays in their physical growth and mental development. (NSPCC 2000)

Finkelhor revealed that the most frequent age at which both boys and girls begin to experience from sexual abuse is between the ages of 8 and 12 years old, in addition he suggested that it should not be overlooked that children of a much younger age also are subjected to child sexual abuse. Moreover he explored the question why some children are subjected to abuse while others are not. (Colton M, Sanders R, Williams M, 2001) Finkelhor reports that there could be up to eight independent predictors of sexual victimisation amongst girls and young women these are:

Having a step father
Living in a single parent unit
Having a poor relationship with the mother
Lack of an education
Certain parental characteristics
A punitive attitude with respect to sexual matters on the part of the mother
Households with low income
Having only two friends or less during childhood

It is obvious that the risks listed are to generalise to be used in identifying specific cases of abuse. However they could be used as indicators by relevant services, for the prevention of child sexual abuse.

Child sexual abuse victims may temporarily block memories of what has happened but the effects will surface as they grow. Not talking about what happened will not make it go away but encourages it to fester. Adults often do not talk about child sexual abuse because of their own discomfort with the topic. If adults are not willing to talk about the abuse, the child will probably feel there is something to be ashamed of, that it is dirty and just too awful to talk about. This attitude will only serve to increase the child's feelings of guilt, shame and feelings of being abnormal and will compound their problems. Children often feel powerless to stop the abuse. You cannot be responsible for consenting to an act you did not understand or which you were forced into.

Research has indicated that sexual abuse is likely to be more detrimental in cases where the abuse has be sustained for long periods of time, the abuser is a father figure also if the abuse was accompanied by violence or the threat of it, more significantly if the response to the child by the family is negative upon disclosure. Research in the UK also shows most abusers are known to the victims. On TV and in the media abusers are usually portrayed as strangers in the park wearing dirty raincoats or men who are members of a paedophile ring. But that is not the case. I can personally testify that in over ten years of running a recovery group for women who have been sexually abused and speaking to several hundred victims I have never ever met any woman who was pulled off the street and abused by a total stranger. Research also shows that most abusers are not only known to the victim but related to them. They are not strangers at all.(Cawson et al.2000,)

1% of children aged less than 16 experienced sexual abuse by a parent or carer, and a further 3% by another relative during childhood. 11% of children aged under 16 experienced sexual abuse during childhood by people known but unrelated to them.5% of children aged under 16 experienced sexual abuse during childhood by an adult stranger or someone they had just met. In total, 16% of children aged under 16 experienced sexual abuse during childhood. 11% of this was contact abuse and 6% was non-contact. Overall, 11% of boys aged less than 16 and 21% of girls aged under 16 experienced sexual abuse during childhood. (Cawson et al.2000,)

An NSPCC report reported 86% of abusers were a relative or someone known to the child, only 14% were abused by strangers. "Childline" statistics are even more revealing 95% of children who call Childline because they are being physically or sexually abused know the abuser. Abusers also appear no different to any other man or woman and come from every social strata builders, doctors, teachers or religious leaders. There was also no extraordinary racial or ethnic preponderance among the abusers beyond that of the general population.

In recent year’s child abuse on many levels has come to the attention of the media, not least the case of Victoria Climbie. Victoria was from the Ivory Coast she was brought to the UK via France in October 1998 by her aunt on the pretence that she would receive a much better standard of living, and also be well educated. By February 2000 she had died of the most tragic and brutal of deaths at the hands of her aunt and her boyfriend. Victoria was seen on no less than 10 different occasions by social workers, she was admitted to 3 different hospitals in the short 18 mouths that Victoria survived. This child suffered the most brutal forms of abuse on a daily basis, she was beaten, bit, scalded. Victoria spent much of her last days alive living and sleeping in bath in an unheated bathroom, bound hand and foot inside a bin bag, lying in her own urine and faeces. Just days before she tragically died she had difficulty walking unaided. She was forced to eat like a dog, given scraps of food left over from previous dinners on a plastic bag while still tied up.

When Victoria was admitted to hospital for the final time in February 2000, she was desperately ill. She was bruised, deformed and malnourished. Her temperature was so low it could not be recorded by a standard thermometer. The consultant responsible for her care said “I have never seen a case like this before, it is by far the worst case of child abuse and neglect that I have ever had the misfortune to witness” (the Victoria Climbie inquiry 2003) (Kouao) the aunt and (Manning) the boyfriend where both convicted of murder and will serve life imprisonment.

The report produced by Lord Laming made 108, recommendations to change the children’s act 1989, 46 of those recommendations where to be implemented within 3 months, a further 36 where to be implemented within 6 months, with the final 24 being implemented within 2years. These recommendations changed the way in which child services run within the UK today.

In January 2008 another high profile child abuse case hit the headlines, which could be seen to evidence what has already been referred to in this paper as blocked memories this relates to allegations of systematic sexual and physical abuse with in a care home in Haut de la Garenne Jersey. The investigation appears to link too historical abuse by former members of staff who have subsequently been arrested on suspicion of paedophile crimes. (The Times 2008) The States of Jersey Police first started a covert inquiry into the history of the home, speaking to victims of alleged abuse. The NSPCC said it has received 63 calls from adults reporting allegations of childhood physical, sexual and emotional abuse in Jersey dating back as far as the 1970s, so far referred 27 cases on to the police. The Haut de la Garenne closed as a children's home in 1986. Remains believed to be a scull belonging to a child was found in a seller, which started a full scale fingertip search of the whole building, after reports that abuse was suffered by children at the hands of cares in sellers underneath the building. Since the investigation first started in November 2006 more that 140 people have come forward alleging abuse.

In conclusion, children block memories of abuse do so because they believe at the time of events that it’s perfectly normal for that to happen within their families. Furthermore, it’s only when a person realises (normally from talking to others) what has happened that they then have problems associated with abuse. A basic requirement that children have is to be kept safe, this is universal and cuts across cultural boundaries. Every child living in this country is entitled to be given protection from abusers, regardless of his or her background. With the help of the children’s act 1989, and the recommendations made by Lord Laming, child services within the UK have been given the power to act when they feel a child is being abuse. As a society our first priority must be our children. In undertaking the research for this report I was shocked by the extent of child abuse and that it has no boundaries, colour creed wealth or religion. Historical abuse is all too common within our society, even though many would like to believe that abuse only happens to other people’s children.

Bibliography

Besharov 1990, Recognizing child abuse: A guide for the concerned. free press New York

Bowlby J, 1988 A Secure Base, Clinical application of the attachment theory: Routledge London.

Cawson et al, 2000, Child Maltreatment in the UK: A Study of the Prevalence of Child Abuse and Neglect, NSPCC

Colton M, Sanders R, Williams M, 2001. An introduction to working with children: Palgrave Hampshire

NSPCC 1986, Child Sexual Abuse Trends in England and Wales. World works London.

Lord Laming.2003. The Victoria Climbie inquiry. Crown London

Office of National Statistics, Mortality Statistics 2006

Thui, Nellis, 2003, Moving probation forward. Pearson Longman London

NSPCC, 2000, A cry for children stop the violence: World works London.

Whitney, Stephen D., Emiko A. Tajima, Todd I. Herrenkohl, and Bu Huang. Defining child abuse: exploring variations in ratings of discipline severity among child welfare practitioners. Child & Adolescent Social Work Journal (June 2006):

http://www.rcpsych.ac.uk/mentalhealthinformation/mentalhealthandgrowingup/19childabuseandneglect.aspx

The Times Newspaper 2008