Physical Abuse: may involve hitting, shaking, throwing, poisoning, burning or scalding, drowning, suffocating, female genital mutilation or otherwise causing physical harm to a child. Physical harm may also be caused when a parent or carer fabricates the symptoms of, or deliberately induces, illness in a child.

The following provides a guide to some of the common injuries found in the physical abuse of a child. Whilst some injuries may appear insignificant in themselves, repeated minor injuries, especially in very young children, may be symptomatic of physical abuse.

It can sometimes be difficult to recognise whether an injury has been caused accidentally or non-accidentally, but it is vital that all concerned with children are alert to the possibility that an injury may not be accidental, and seek appropriate expert advice.

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Examples which may indicate physical abuse include (this is not designedto be used as a checklist):

• Patterns of bruising, including inconsistencies of stories as to how bruising or injuries occurred;

• finger, hand or nail marks, black eyes;

• bite marks;

• round burn marks, burns and scalds;

 • lacerations, wealds;

•  fractures;

•  bald patches;

•  symptoms of drug or alcohol intoxication or poisoning;

•  unaccountable covering of limbs, even in hot weather;

•  fear of going home or parents being contacted;

•  fear of medical help;

•  fear of changing for PE;

•  inexplicable fear of adults or over compliance;

•  violence or aggression towards others including bullying;

•  isolates him/herself from peers.

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Emotional Abuse: is the persistent emotional maltreatment of a child such as to cause severe and persistent adverse effects on the child’s emotional development.

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This may include:

• conveying to children that they are worthless or unloved, inadequate, or valued only insofar as they meet the needs of another person;

•  feature age or developmentally inappropriate expectations being imposed on children;

•  interactions that are beyond the child’s developmental capability, as well as overprotection and limitation of exploration and learning, or preventing the child participating in normal social interaction;

•  seeing or hearing the ill treatment of another – this is particularly relevant in respect of domestic violence;

•  serious bullying, causing children frequently to feel frightened or in danger;

 •  the exploitation or corruption of children.

 Some level of emotional abuse is involved in all types of maltreatment of a child, though it may occur alone. Emotional abuse may be difficult to recognise, as the symptoms are usually behavioural rather than physical. The indicators of emotional abuse are often also associated with other forms of abuse.

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Examples of behaviour which may indicate emotional abuse include: (this is not designed to be used as a checklist)

•  over-reaction to mistakes, continual self-deprecation;

•  delayed physical / mental / emotional development;

•  sudden speech disorders, elective mute / deaf;

•  inappropriate emotional responses, fantasies;

•  neurotic behaviour, rocking, banging head, regression, tics and twitches;

• self-harming, drug or solvent abuse;

•  fear of parents being contacted;

• running away, compulsive stealing;

•  appetite disorders – anorexia nervosa, bulimia;

•  soiling, smearing faeces, enuresis;

•  a child scapegoated within the family;

• frozen watchfulness, particularly in pre-school children;

•  low self-esteem and lack of confidence;

•  withdrawn or seen as a ‘loner’ – difficulty relating to others.

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Sexual Abuse: involves forcing or enticing a child or young person to take part in sexual activities, including prostitution, whether or not the child is aware of what is happening.

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This may include:

•  activities of a sexual nature which may involve physical contact, including penetrative (e.g. rape, buggery or oral sex) or non-penetrative acts.

•  activities of a sexual nature which may include non-contact activities, such as involving children in looking at, or in the production of, sexual on-line images, watching sexual activities, or encouraging children to behave in sexually inappropriate ways.

 Children of both genders and of all ages may be sexually abused and are frequently scared to say anything due to guilt and/or fear. It is particularly difficult for a child to talk about and full account should be taken of the cultural sensitivities of any individual child / family.

Recognition can be difficult, unless the child discloses and is believed. There may be no physical signs and indications are likely to be emotional or behavioural.

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Examples of behaviour which may indicate sexual abuse (this is not designed to be used as a checklist):

•  sexually explicit play or behaviour or age-inappropriate knowledge;

•  anal or vaginal discharge, soreness or scratching;

•  the presence of sexually transmissible infections;

•  truancy, lateness, reluctance to go home;

 • inability to concentrate, tiredness;

•  refusal to communicate, selective mutism;

•  thrush or other throat infections;

•  persistent complaints of stomach disorders or pain;

•  eating disorders such has anorexia nervosa and bulimia;

•  attention seeking behaviour, self-mutilation, substance abuse;

•  aggressive behaviour including sexual harassment or molestation;

•  unusually compliant;

•  regressive behaviour;

•  enuresis, soiling;

•  frequent or open masturbation, touching others inappropriately;

•  depression, withdrawal, isolation from peer group;

•  reluctance to undress for PE or swimming;

•  bruises, scratches etc in genital area;

•  does not trust familiar or particular adults.

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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.

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Neglect may occur:

•  during pregnancy as a result of maternal substance abuse;

•  if a parent or carer fails to provide adequate food, clothing and shelter (including exclusion from home or abandonment);

•  if a parent or carer fails to protect a child from physical and emotional harm or danger;

•  if a parent or carer fails to ensure adequate supervision (including the use of inadequate care-givers);

• if a parent of carer fails to ensure access to appropriate medical care or treatment;

•  as a result of unresponsiveness to a child’s basic emotional needs.

 Neglect can be difficult to identify as it often relates to long standing shortcomings on the part of parents or carers rather than a single abusive incident. It is not uncommon for the level of care provided to change from inadequate to adequate and back again.

 Neglect is not always intentional; sometimes a parent’s own condition or circumstances, such as physical and learning disabilities, can lead to the neglect of their child.

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Examples which may indicate neglect include: (this is not designed to be used as a checklist)

•  hunger;

•  tiredness and listlessness;

•  child dirty and unkempt;

 •  poorly or inappropriately clad for the weather;

•  poor school attendance and often late for school;

 •  poor concentration;

•  poor home conditions;

•  affection or attention seeking behaviour;

•  untreated illnesses / injuries;

•  pallid complexion;

 • stealing or scavenging compulsively;

•  failure to achieve development milestones,e.g. growth, weight;

•  failure to develop intellectually or socially;

•  neurotic behaviour.

Generate Love’s staff are advised to familiarise themselves with the definitions above and will ensure that staff members, whether paid or unpaid, undertake training to gain a basic awareness of the signs and symptoms of child abuse.

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