Categories of Abuse

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Physical Abuse

Physical abuse is that which causes or exacerbates physical harm. It would include such actions as:

• Physical assaults that do not involve the use of a weapon or other implement; kicking, punching, slapping, pushing, pinching, scratching, shaking, pulling hair, spitting etc.
• Use of an implement or weapon or throwing things; household items not normally considered to be weapons, DIY tools, knives or other kitchen implements etc.
• Burning or scalding
• Choking, strangling
• Poisoning including over medicating, inappropriate use of medicine, alcohol etc.
  (for example to “help the child to sleep”) and also including such things as salt
  poisoning
• Withholding or withdrawing medical treatments or attention
• Starvation, withholding drinks etc. so as to cause malnutrition or dehydration
• Force feeding, causing excessive obesity through overfeeding / inappropriate diet
• Inappropriate or rough handling, including when performing personal care or
  administering first aid (eg removing a plaster forcefully so as to cause tearing of the
  skin)
• The use of excessive force or inappropriate restraint
• Bullying that involves physical harm
• Physical abuse can happen antenatally through substance misuse etc.

Signs and indicators of potential physical abuse would include:

• Bruising
• Burns
• Cuts/ lacerations
• Fractures or breaks
• Black eye
• Untreated medical need (eg. skin conditions, nappy rash ect)
• Stench of urine/ faeces
• Drowsiness/ excessive sleep
• Loss of weight
• Hunger/ Thirst
• Wearing extra layers of clothes
• Aggressive/ violent behaviours
• Withdrawn, anxious, flinching in specific situations or with specific people

Examples of factors which could cause confusion would include:

• Mongolian Blue Spot
• Brittle bones
• Leukaemia
• Other medical conditions

NB. It is not illegal (in England) for a parent to smack a child so long as the smack does not leave a lasting mark (e.g. not lasting more than 5 minutes or so). If the smack causes bruising it is excessive and is abuse and smacking in inappropriate places (e.g. head) is abuse.

NB. The considered decision not to have a child vaccinated is not abuse but failing to attend appointments may indicate neglect.

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Sexual Abuse

Sexual abuse involves forcing, enticing or coercing a child into engaging in sexual
activity or exposing a child to sexual materials or activity, whether or not the child is aware of the significance of what is happening. This would include:

• Forcing, coercing or enticing a child into sexual activity including grooming a child in preparation for abuse
• Physical sexual contact; rape (vaginally, orally or anally), penetration with an object, inappropriate touching / rubbing, fondling (whether inside or outside of the clothing), kissing, masturbation etc
• Non-contact activities; the viewing or production of sexual images, watching sexual activities, encouraging children to behave in sexually inappropriate ways, grooming a child in preparation for abuse
• Sexualised language or conversation and lack of appropriate boundaries and privacy
• Sexual harassment
• Indecent exposure
• Voyeurism
• Exploitation, causing someone to enter into prostitution
• Satanic or ritual abuse
• Bestiality

Signs and indicators of potential sexual abuse would include:

• Genital or urinary irritation or bruising in the genital area
• Frequent infections, pain or itching in the genital area
• Bleeding from the anus or vagina
• Sexually transmitted infections
• Stains on underwear or nightwear
• Wetting / soiling
• Bruising in inner thighs or upper arms
• Difficulty in walking and or sitting
• Wearing extra clothing
• Depression
• Role play
• Sexualised language or behaviour that is inappropriate for age or developmental
  stage
• Nightmares/flashbacks
• Agitation, upset or withdrawal from any physical contact

Examples of factors which could cause confusion would include:

• Medical conditions or infections
• Excessive masturbation
• Age / developmentally appropriate inquisitiveness, exploration and play

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Emotional Abuse

The persistent emotional maltreatment of a child resulting in ongoing severe
adverse effects on emotional development, sense of security, identity and self-
confidence. This would include:

• Making a child feel afraid, intimidated anxious or ridiculed including domineering
  behaviour
• Threatening the child, someone else, threatening to harm pets etc.
• Verbal abuse; shouting, name calling, swearing, use of inappropriate nicknames or
  descriptions etc.
• Causing a sense of worthlessness or inadequacy, including constant comparison
  (e.g. why cant you be more like…)
• Making a child feel unloved or only conditionally loved (eg making a child feel that they are only valued or loved insofar as they meet the needs or expectations of
  someone else)
• Suppressing or denying the opportunity for the child to express their views,
  intentionally silencing them, ridiculing them for their views or beliefs or for the way they communicate
• Expectations that are age or developmentally inappropriate are imposed on the
  child (over expectation or overprotectiveness that denies or impedes the child’s
  development)

Signs and indicators of potential emotional abuse would include:

• Excessive fear or anxiety
• Flinching in the presence of a particular person or in a particular circumstances
• Unusual patterns of crying, weeping, sobbing ect
• Low self-esteem
• Insomnia, sleep deprivation or the need for excessive sleep
• Change in appetite
• Unusual or unexplained weight loss or gain
• Paranoia
• Mood swings, changes in mood or behaviour
• Withdrawal and inability or discomfort with social situations and interactions

Examples of factors which could cause confusion would include:

• Death or illness in the family
• Family relationship breakdown
• Family stress or specific family issues
• Medical or psychological conditions
• Death of a pet

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Neglect

Neglect is the persistent and ongoing failure to meet the basic physical and/or
psychological needs of the child to the extent that it is likely to result in the serious impairment of the child’s health or development. This would include:

• Failure to provide the basic necessities of life such as adequate food, clothing,
  shelter
• Failure to protect a child from physical or emotional danger
• Abandonment, being left “home alone”, inadequate supervision (including
  inappropriate or inadequate care givers)
• Failure to provide adequate medical care (attending appointments, administering
  medications and / or treatments)
• Unresponsiveness to a child’s basic emotional, psychological or developmental
  needs
• Can occur antenatally through such things as maternal substance misuse

Signs and indicators would include:

• Significant needs persistently unmet
• Poor physical care
• Lack of food / drink inappropriate or inadequate diet
• Failure to access medical care or to follow medical advice / instruction
• Inappropriate clothing
• Poor hygiene
• Lack or supervision
  Isolation, ignoring, exclusion
• Lack of heating / lighting
• Leaving a child to lie in faeces / urine
• Not aiding communication or providing adequate stimulation
• Failure to meet cultural, religious or social needs
• Neglecting pets

Examples of factors which could cause confusion would include:

• Medical conditions
• Poverty
• Family Stress
• Parental disabilities/ young carers