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UNDERSTAND CHILD ABUSE
"Child abuse is when a child is harmed by an adult or another child – it can be over a period of time, but can also be a one-off action. It can be physical, sexual or emotional, and it can happen in person or online. It can also be a lack of love, care and attention – this is neglect." NSPCC
Child abuse refers to all forms of physical and/or emotional ill-treatment, sexual abuse, neglect or negligent treatment or commercial exploitation of a child. The result is actual or potential harm to the child’s health, survival, development or dignity. It takes place in the context of a relationship of responsibility, trust or power. It occurs in many settings, and the perpetrators of child abuse may be:
• parents and other family members;
• caregivers;
• friends;
• acquaintances;
• strangers;
• others in authority – such as teachers, soldiers, police officers and clergy;
• employers;
• health care workers;
• other children.
Violence against children by adults within the family is one of the least visible forms of child maltreatment, as much of it takes place in the privacy of domestic life, but it is nonetheless widely prevalent in all societies.
Child maltreatment is linked to other forms of violence – including intimate partner violence, community violence involving young people, and suicide.
While it is not possible to make any absolute statement about the numbers of children harmed by parents and other family members, child abuse is recognized internationally as a serious public health, human rights, legal and social issue. The nature and the severity of both the violence itself and its consequences can vary extremely widely. In extreme cases, it can lead to death. In the majority of situations involving maltreatment, however, the physical injury itself has a less severe effect in terms of damage to the child’s well-being than the acute psychological and psychiatric consequences, and the long-term impact on the child’s neurological, cognitive and emotional development and overall health. Child abuse, thus, contributes directly and significantly to some of the leading causes of death and chronic diseases all over the world.
TYPES OF ABUSE
It can be physical, sexual, psychological, or the result of neglect and deprivation. In our blog, we interview specialists to discuss daily examples of forms of abuse, and how they impact a child's physical and mental health for life, including how child maltreatment affects brain development.
Child abuse often occurs alongside other types of violence. For instance, violence against children by adults within the family is frequently found in the same settings as intimate partner violence. Maltreated children are themselves at increased risk in later life of either perpetrating or becoming the victims of multiple types of violence – including suicide, sexual violence, youth violence, intimate partner violence and child maltreatment.
It's a cycle of harm that has to be broken, and we truly believe that education is key to eliminate violence against children and its high cost to society.
Physical abuse of a child is the intentional use of physical force against a child that results in – or has a high likelihood of resulting in – harm to the child’s health, survival, development or dignity. This includes:
• hitting
• beating
• kicking
• shaking
• biting
• strangling
• scalding
• burning
• poisoning
• suffocating.
Violence against children by adults within the family is one of the least visible forms of child maltreatment, but it is widely prevalent in all societies.
Sexual abuse
is the involvement of a child in sexual activity that he or she does not fully
comprehend, is unable to give informed consent to, or for which the child is not developmentally prepared, or else that violates the laws or social taboos. Children can be sexually abused by both adults and other children who are – by virtue of their age or stage of development – in a position of responsibility, trust or power over the victim.
Emotional and psychological abuse involves both isolated incidents, as well as a pattern of failure over time on the part of a parent or caregiver to provide an appropriate and supportive environment. Acts in this category may have a high probability of damaging the child’s physical or mental health, or their physical, mental, spiritual, moral or social development.
Abuse of this type includes:
• the restriction of movement
• patterns of belittling, blaming, threatening, frightening, discriminating against or ridiculing
• other non-physical forms of rejection or hostile treatment.
Neglect includes both isolated incidents, or a pattern of failure over time on the part of a parent or other family member to provide for the development and well-being of the child – where the parent is in a position to do so – in one or more of the following areas:
• health • education • emotional development • nutrition • shelter and safe living conditions. The parents of neglected children are not necessarily poor. They may equally be financially well-off.
BEING A SURVIVOR
The consequences of abuse
Studies have indicated that exposure to maltreatment and other forms of violence during childhood is associated with risk factors and risk-taking behaviours later in life. These include violent victimization and the perpetration of violence, depression, smoking, obesity, high-risk sexual behaviours, unintended pregnancy, and alcohol and drug use. Such risk factors and behaviours can lead to some of the principal causes of death, disease and disability – such as heart disease, sexually transmitted diseases, cancer and suicide. Child maltreatment therefore contributes to a broad range of adverse physical and mental health outcomes that are costly, both to the child and to society, over the course of a victim’s life.
The Adverse Childhood Experiences (ACE) study, in which some 17 300 middle-aged, middle-class and mostly employed residents of the state of California participated, suggests that childhood maltreatment and household dysfunction contribute to the development – decades later – of the chronic diseases that are the most common causes of death and disability in the United States. The study examined the long-term effects of maltreatment and household dysfunction during childhood, including: psychological, physical and sexual abuse; violence against the mother; and living with household members who were either substance abusers, mentally ill or suicidal, or else had been in prison.
A strong relationship was seen between the number of adverse experiences (including physical and sexual abuse in childhood) and self-reports of cigarette smoking, obesity, physical inactivity, alcoholism, drug abuse, depression, attempted suicide, sexual promiscuity and sexually transmitted diseases in later life.
Childhood maltreatment and household dysfunction contribute to the development – decades later – of the chronic diseases that are the most common causes of death and disability in the United States.
Furthermore, people who reported higher numbers of negative experiences in childhood were much more likely to exhibit multiple health-risk behaviours, which the study suggested were adopted as coping mechanisms. Similarly, the more adverse childhood experiences reported, the more likely the person was to have heart disease, cancer, stroke, diabetes, skeletal fractures, liver disease and poor health as an adult.
Maltreatment and other adverse childhood experiences may thus be among the basic factors that underlie health risks, illness and death, and could be identified by routine screening of all patients. Although the study and its findings relate to a specific population within the United States, it is reasonable to assume that similar trends might be found in countries with different levels of economic and social development.
From Preventing Child Maltreatment: a guide to taking action and generating evidence by WHO and ISPCAN 2006.
Edited by Kika Salvi.