1. Recognising abuse
The warning signs and symptoms of child abuse and neglect can vary from child to child. Disabled children may be especially vulnerable to abuse, because they may have an impaired capacity to resist or avoid abuse. They may have speech, language and communication needs which may make it difficult to tell others what is happening.
By understanding the warning signs, you can respond to problems as early as possible. It is important to recognise that a warning sign doesn’t automatically mean a child is being abused.
There are a number of warning indicators which might suggest that a child may be being abused or neglected.
What is physical abuse?
Physical abuse is deliberately physically hurting a child. It might take a variety of different forms, including hitting, pinching, shaking, throwing, poisoning, burning or scalding, drowning or suffocating a child.
Physical abuse can happen in any family, but children may be more at risk if their parents have problems with drugs, alcohol and mental health or if they live in a home where domestic abuse happens. Babies and disabled children also have a higher risk of suffering physical abuse.
Physical harm may also be caused when a parent or carer fabricates the symptoms of, or deliberately induces, illness in a child. Physical abuse can also occur outside of the family environment.
Signs of physical abuse
Some of the following signs may be indicators of physical abuse:
- Children with frequent injuries;
- Children with unexplained or unusual fractures or broken bones; and
- Children with unexplained:
- bruises or cuts;
- burns or scalds; or
- bite marks
What is emotional abuse?
Emotional abuse is the persistent emotional maltreatment of a child. It is also sometimes called psychological abuse and it can have severe and persistent adverse effects on a child’s emotional development.
Although the effects of emotional abuse might take a long time to be recognisable, practitioners will be in a position to observe it, for example, in the way that a parent interacts with their child. Emotional abuse may involve deliberately telling a child that they are worthless, or unloved and inadequate. It may include not giving a child opportunities
Signs of emotional abuse
Some of the following signs may be indicators of emotional abuse:
•Children who are excessively withdrawn, fearful, or anxious about doing something wrong;
•Parents or carers who withdraw their attention from their child, giving the child the ‘cold shoulder’;
•Parents or carers blaming their problems on their child; and
•Parents or carers who humiliate their child, for example, by name-calling or making negative comparisons.
Sexual abuse is any sexual activity with a child. Sexual abuse may involve physical contact, including assault by penetration (for example, rape or oral sex) or non-penetrative acts such as masturbation, kissing, rubbing and touching outside clothing. It may include non-contact activities, such as involving children in the production of sexual images, forcing children to look at sexual images or watch sexual activities, encouraging children to behave in sexually inappropriate ways or grooming a child in preparation for abuse (including via the internet).
You should be aware that many children and young people who are victims of sexual abuse do not recognise themselves as such. A child may not understand what is happening and may not even understand that it is wrong. Sexual abuse can have a long-term impact on mental health.
Sexual abuse is not solely perpetrated by adult males. Women can commit acts of sexual abuse, as can other children.
Signs of sexual abuse
Some of the following signs may be indicators of sexual abuse:
•Children who display knowledge or interest in sexual acts inappropriate to their age;
•Children who use sexual language or have sexual knowledge that you wouldn’t expect them to have;
•Children who ask others to behave sexually or play sexual games; and
•Children with physical sexual health problems, including soreness in the genital and anal areas, sexually transmitted infections or underage pregnancy.
Child Sexual Exploitation (CSE)
Child sexual exploitation is a form of sexual abuse where children are sexually exploited for money, power or status. It can involve violent, humiliating and degrading sexual assaults. In some cases, young people are persuaded or forced into exchanging sexual activity for money, drugs, gifts, affection or status. Consent cannot be given, even where a child may believe they are voluntarily engaging in sexual activity with the person who is exploiting them. Child sexual exploitation doesn’t always involve physical contact and can happen online. A significant number of children who are victims of sexual exploitation go missing from home, care and education at some point.
Home Office Definition February 2017:
Child sexual exploitation is a form of child sexual
abuse. It occurs where an individual or group takes advantage of an imbalance
of power to coerce, manipulate or deceive a child or young person under the age
of 18 into sexual activity (a) in exchange for something the victim needs or
wants, and/or (b) for the financial advantage or increased status of the
perpetrator or facilitator. The victim may have been sexually exploited even if
the sexual activity appears consensual. Child sexual exploitation does not
always involve physical contact; it can also occur through the use of
Child sexual exploitation: definition and guide for practitioners Dept of Education Guidance 2017
Signs of child sexual exploitation
Some of the following signs may be indicators of Child Sexual Exploitation:
•Children who appear with unexplained gifts or new possessions;
•Children who associate with other young people involved in exploitation;
•Children who have older boyfriends or girlfriends;
•Children who suffer from sexually transmitted infections or become pregnant;
•Children who suffer from changes in emotional well-being;
•Children who misuse drugs and alcohol;
•Children who go missing for periods of time or regularly come home late; and
•Children who regularly miss school or education or don’t take part in education.
Neglect is a pattern of failing to provide for a child’s basic needs, whether it be adequate food, clothing, hygiene, supervision or shelter. It is likely to result in the serious impairment of a child’s health or development.
Children who are neglected often also suffer from other types of abuse. It is important that practitioners remain alert and do not miss opportunities to take timely action.
However, while you may be concerned about a child, neglect is not always straightforward to identify.
Neglect may occur if a parent becomes physically or mentally unable to care for a child. A parent may also have an addiction to alcohol or drugs, which could impair their ability to keep a child safe or result in them prioritising buying drugs, or alcohol, over food, clothing or warmth for the child. Neglect may occur during pregnancy as a result of maternal drug or alcohol abuse.
Signs of neglect
Some of the following signs may be indicators of Neglect:
•Children who are living in a home that is indisputably dirty or unsafe;
•Children who are left hungry or dirty;
•Children who are left without adequate clothing, e.g. not having a winter coat;
•Children who are living in dangerous conditions, i.e. around drugs, alcohol or violence;
•Children who are often angry, aggressive or self-harm;
•Children who fail to receive basic health care; and
•Parents who fail to seek medical treatment when their children are ill or are injured.
Female Genital Mutilation (FGM)
Female genital mutilation, also sometimes referred to as female genital cutting or female circumcision, refers to procedures that intentionally alter or cause injury to the genital organs for non-medical reasons. There are no health benefits, it causes severe pain and significant long-term psychological and physical problems.
The practice is illegal in the UK and it is also illegal to arrange for a child to be taken abroad for FGM. Since 31 October 2015 all registered healthcare professionals and teachers in England and Wales have a mandatory duty to report FGM cases to the police.
Signs of FGM
Some of the following signs may be indicators that a girl or woman is at risk of FGM or experienced FGM
One or both parents come from an ethnic group that traditionally practices FGM
An older sister or female cousins have undergone FGM
Parents express views which show that they value the practice
A girl is withdrawn from all teaching classes on personal, Social or Health Education
A girl is withdrawn from school to allow for an extended holiday, or a girl talks about a long trip planned during the school summer holidays
A girl may talk about “something special happening”, or that here will be “a big party” or “she is going to be a woman soon”
A girl may have difficulty walking, sitting or standing
A girl may spend longer than normal in the bathroom or toilet
A girl may have unusual behaviour after an absence from school or college
A girl may be particularly reluctant to undergo normal medical examinations
A girl may ask for help, but may not be explicit about the problem due to embarrassment or fear.
Harmful Sexual Behaviour
Sexual behaviour between children is considered harmful if the child is being coerced or threatened or if one of the children is older – particularly if there is more than two years’ difference in age or if one of the children is pre-pubescent and the other isn’t. When establishing if a child’s sexual behaviour is harmful, it is important to not only take their age into account but also their physical, intellectual and emotional development.
Children and young people who display harmful sexual behaviour are likely to have considerable levels of unmet need themselves. Evidence suggests that children and young people who harm others may have suffered considerable disruption in their lives, been exposed to violence within the family, may have witnessed or been subject to Physical Abuse or Sexual Abuse, have problems in their educational development and may have committed other offences. Such children are likely to be children in need; some will have suffered Significant Harm and may be in need of protection themselves.
Signs of Harmful Sexual Behaviour
Some of the following signs may be indicators of Harmful sexual behaviour:
Children use sexually explicit words and phrases
Children use sexual violence or threats
Children inappropriately touch themselves or others
Children have penetrative sex with other children or adults.
Child trafficking is a crime involving the movement of children for the purpose of their exploitation, for example sexual exploitation or forced labour. Children can be trafficked within their own countries and across international borders.
Signs of child trafficking
Some of the following signs may be indicators of child trafficking:
Children are living away from their family, often in unregulated private foster care
Children have no access to their parents or guardians
Children are not sure what county, city or town they are in
Children are unable or reluctant to provide personal information or details about their living arrangements
Children have no documents or their documentation is falsified
Children have no freedom of movement
Children possess unaccounted for money or goods or required to earn a minimum amount of money every day, or pay off an extortionate debt
Children are seen in inappropriate places or venues for example brothels or factories
Children may not be registered with a school or with health professionals
Domestic abuse is any incident or pattern of incidents of controlling, coercive or threatening behaviour, violence or abuse between people in a relationship - intimate partners or family members regardless of gender or sexuality. This can encompass but is not limited to the following types of abuse: psychological, physical, sexual, financial and emotional.
Domestic abuse can seriously harm children and young people. Witnessing domestic abuse is child abuse, and teenagers can suffer domestic abuse in their relationships.
Signs of domestic abuse
It's often difficult to tell if domestic abuse is happening, because it usually takes place in the family home and abusers can act very differently when other people are around.
Some of the following signs may be indicators of witnessing domestic abuse:
- Children become aggressive and or display anti-social behaviour
- Children experience depression or anxiety
- Children do not do as well at school - due to difficulties at home or disruption of moving to and from refuges.
Online abuse is any type of abuse that happens on the web, whether through social networks, playing online games or using mobile phones. Children and young people may experience cyberbullying, grooming, sexual abuse, sexual exploitation or emotional abuse.
Children can be at risk of online abuse from people they know, as well as from strangers. Due to abusers being able to contact children at anytime and in their safe places like bedrooms, children can often feel like there is no escape from online abuse.
Signs of online abuse
Some of the following signs may be indicators of online abuse:
- Children spending much more or much less time online, texting, gaming or using social media
- Children are withdrawn, upset or angry after using the internet or texting
- Children are secretive about who they are in contact with and / or what they are doing online or on their mobile phone
- Children have lots of new phone numbers, texts or e-mail addresses on their mobile phone, laptop or tablet.
Radicalisation is a form of grooming that focuses on promoting extremist violent ideology and terrorism. Radicalisation is a safeguarding matter as it places children and young people at the risk of significant harm.
There is no such thing as a 'typical’ young person when it comes to radicalisation and those involved in extremism come from a range of backgrounds and experiences.
Signs of radicalisation
Some of the following signs may be indicators of radicalisation
Children making significant changes to their appearance or demonstrating behaviours which are out of character
Children accessing violent extremist websites and social networks.
Children using extremist narratives and a global ideology to explain personal disadvantage
Children justifying the use of violence to solve societal issues
Children articulating support for violent extremism
Children associating with others believed to be at risk of radicalisation.
Children having contact with extremist recruiters
Forced Marriage and Honour Based Violence
A forced marriage is where one or both people do not (or in cases of people with learning disabilities, cannot) consent to the marriage and pressure or abuse is used. The pressure put on people to marry against their will can be physical (including threats, actual physical violence and sexual violence) or emotional and psychological (for example, when someone is made to feel like they’re bringing shame on their family). Financial abuse (taking your wages or not giving you any money) can also be a factor.
Honour based violence (abuse) relates to any practice used to control behaviour within families to protect perceived cultural and religious beliefs or honour. The Children Act 1989 does not specifically mention honour based violence and there is no specific offence of ‘honour based crime’. This is because HBV is an umbrella term which encompasses various offences which there are already laws in place for example: sexual or physical assault or kidnapping or false imprisonment. However, such crimes almost always constitute a form of child abuse because the risk of significant harm that it causes the young victims.
Signs of forced marriage and honour based violence
Some of the following signs may be indicators of HBV and forced marriage:
Poor attendance and performance at school or work
Being withdrawn from school or banned from working
Depression, self-harm, attempted suicide, eating disorders and substance misuse
Other family members going missing, forced to marry early or running away from home
Domestic violence, unreasonable restrictions eg ‘house arrest’
A potential victim may only have one chance to ask for help. Do not underestimate the risk to life that can be posed to individuals experiencing honour based violence. If the young person is allowed to walk out of the door without the support that one chance might be lost.
Self Harm Including Suicide
NEW: Guidance for professionals working with children and young people who self-harm.
As of November 2017 B&NES has adopted the information and guidance found on HarmLESS https://www.oxfordhealth.nhs.uk/harmless as a guide to multi agency professionals working with young people who self-harm. This provides up to date information about:-
• What is meant by self-harm including thoughts and acts of self-harm, and risks and triggers for young people
• Guidance on how to react and talk to young people who are self-harming using the acronym SLEEP (Stop, Listen, Empathise, Explore, Plan)
• An online assessment tool to complete with a young person. This assessment automatically generates a safety plan
• Links to others useful resources and web sites
• Links to (B&NES) Child and Adolescent Mental Health Services (CAMHS)
Anyone currently using the document entitled Multi Agency Guidelines for Professionals Working with Children and Young People who Self-harm should note that as of November 2017 this is now out of date and should be removed from circulation.