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.
|
