Appendix 3.
Definition and
Recognition of Child Abuse
Introduction
Child abuse can
be categorised into four different types: neglect, emotional abuse,
physical abuse and sexual abuse. A child may be subjected to more than one
form of abuse at any given time. The National Guidelines have adopted the
following definitions of child abuse:
Neglect
Neglect is
normally defined in terms of an omission, where a child suffers significant
harm or impairment of development by being deprived of food, clothing,
warmth, hygiene, intellectual stimulation, supervision and safety,
attachment to and affection from adults, or medical care.
Harm can be
defined as the ill treatment or the impairment of the health or development
of a child. Whether it is significant is determined by his/her health and
development as compared to that which could reasonably be expected of a
similar child.
Neglect
generally becomes apparent in different ways over a period of time rather then
at one specific point. For instance a chid who suffers a series of minor
injuries is not having his/her needs met for supervision and safety. A
child whose on-going failure to gain weight or whose height is
significantly below average may be being deprived of adequate nutrition. A
child who consistently misses school may be being deprived of intellectual
stimulation. The threshold of significant harm is reached when the child’s
needs are neglected to the extent that his or her well being, and or development,
are severely affected.
Emotional Abuse
Emotional abuse
is normally to be found in the relationship between a caregiver and a child
rather then a specific event or pattern of events. It occurs when a child’s
needs for affection, approval, consistency and security are not met. It is
rarely manifested in terms of physical symptoms. Examples of emotional
abuse include
(i) Persistent
criticism, sarcasm, hostility or blaming.
(ii)
Conditional parenting in which the level of care shown to a child is made
contingent on his or her behaviour or actions.
(iii) Emotional
unavailability by the child’s parent/carer.
(iv)
Unresponsiveness, inconsistent or inappropriate expectations of a child.
(v) Premature
imposition of responsibility on a child.
(vi) Unrealistic
or inappropriate expectations of a child’s capacity to understand something
or to behave and control himself in a certain way.
(vii) Under or
over protection of a child.
(viii) Failure
to show interest in or provide age appropriate opportunities for a child’s
cognitive and emotional development.
(ix) Use of
unreasonable or overly harsh disciplinary measures.
(x) Exposure to
domestic violence.
Children show
signs of emotional abuse by their behaviour (for example, excessive
clinginess to, or avoidance of the parents/carer), their emotional state
(low self esteem, unhappiness), or their development (non-organic failure
to thrive). The threshold of significant harm is reached when abusive
interactions become typical of the relationship between the child and
parent/carer.
Physical Abuse
Physical abuse
is any form of non-accidental injury that causes significant harm to a
child, including:
(i) Shaking
(ii) Use of excessive force in
handling
(iii) Deliberate poisoning
(iv) Suffocation
(v)
Munchausen's syndrome by proxy (where parents fabricate stories of illness
about their child or cause physical signs of illness)
(vi) Allowing
or creating a substantial risk of significant harm to a child.
Sexual Abuse
Sexual abuse occurs
when a child is used by another person for his or her gratification or
sexual arousal, or for that of others. For example
(i) Exposure of
the sexual organs or any sexual act intentionally performed in the presence
of a child
(ii)
Intentional touching or molesting of the body of a child whether by a
person or object for the purpose of sexual arousal or gratification
(iii)
Masturbation in the presence of a child or involvement of the child in the
act of masturbation
(iv) Sexual
intercourse with the child, whether oral, vaginal or anal
(v) sexual
exploitation of a child
(vi) Consensual
sexual activity between an adult and a child under 17 years. In relation to
child sexual abuse, it should be noted that, for the purpose of criminal law,
the age of consent to sexual intercourse is 17 years. This means, for
example, that sexual intercourse between a 16-year-old girl and her
17-year-old boyfriend is illegal, although it might not be regarded as
constituting child sexual abuse.
Recognising
Child Abuse
The ability to
recognise child abuse depends as much on a person’s willingness to accept
the possibility of its existence as it does on knowledge and
information. It is important to
note that child abuse is not always readily visible, and may not be as
clearly observable as the “text book” scenarios outlined in these
guidelines suggest. The recognition
of abuse normally runs along three stages:
(i) Considering the possibility – if a
child appears to have suffered an inexplicable and suspicious looking
injury, seems distressed without obvious reason, displays unusual
behavioural problems or appears fearful in the company of parents/carers.
(ii) Observing signs of abuse – a cluster
or pattern of signs is the most reliable indicator of abuse. Children may make direct or indirect
disclosures, which should always be taken seriously. Less obvious disclosures may be gently
explored with a child, without direct questioning (which may be more
usefully carried out by the health board or An Garda Siochana). Play situations such as drawing or story
telling may reveal significant information. Indications of harm must always be considered in relation to
the child’s social and family context, and it is important to always be
open to alternative explanations.
(iii) Recording of information – it is
important to establish the grounds for concern by obtaining as much
detailed information as possible.
Observations should be recorded and should include dates, times,
names, locations, context and any other information which could be
considered relevant or which might facilitate further
assessment/investigation.
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