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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