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Signs and Symptoms

Childhood is a time of playfulness, tumbling, climbing and adventures. And as such, all children are liable to get scratches, bruises, bumps and cuts from time-to-time. Therefore it is sometimes difficult to tell the difference between injuries suffered as part of a quite normal childhood, and those caused by physical abuse.

One of the best ways to help children is learning to recognize the signs of abuse. While these signs often take the form of physical injuries, behavioural indicators are also important when diagnosing abuse. The parent or other adult care giver may also display significant indicators that point towards the presence of child abuse.

The diagnosis of child abuse will rely not only on indicators but also on a family history and a social, educational and health assessment of the child. The list given below is therefore not, in itself, a comprehensive tool for recognising child abuse.

If you are concerned about a child please call the Front Door For Families on 01273 290400.

It is important to recognise that the different types of abuse often occur simultaneously. For instance where a child is physically abused, they often suffer emotional abuse as well. If you perceive a combination or repetition of any of the signs of child abuse then please contact the Front Door for Families as follows:

Front Door For Families
C/O Whitehawk Community Hub and Library
179A Whitehawk Road
Brighton, BN2 5FL

Tel: (01273) 290400
E-mail: FrontDoorForFamilies@brighton-hove.gcsx.gov.uk

or use the Online Referral Form

The government have provided some up to date guidelines for practitioners if you suspect a child is being abused: What to do if you are worried a child is being abused

In July 2009. The National Institute for Health and Clinical Excellence (NICE) published a quick reference guide ‘When to suspect child maltreatment’ for all healthcare professionals working in the NHS who work with children and young people. It may also be of interest to people outside of the NHS who work with children and young people.

This guidance is available in PDF (Hard Copy) and can be viewed ‘online’.

 

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Signs of physical abuse

Physical abuse may result in the symptoms described below. Aside from direct physical contact, physical abuse can also be caused when a parent or caregiver feigns the symptoms of, or deliberately causes ill health to a child whom they are looking after. Signs of physical abuse include:

  • Bruises on legs before a child is mobile
  • Black eyes without bruising to the forehead
  • Fingertip bruising and bruises in various stages of healing
  • Cigarette type burns anywhere, patterned burns (irons), rope burns. Contact burns in abnormal sites.
  • Lacerations to the body or mouth
  • Multiple fractures. Evidence of old fractures. Any fractures to children under two years old
  • Bite marks
  • Scalds, particularly to feet and bottom
  • Fading injuries noticeable after an absence from school
  • Seems frightened of parents, does not want to return home at the end of the day
  • Shrinks markedly (backs away) at the approach of adults
  • Displays frozen watchfulness
  • Constantly asks in words/actions what will happen next

Signs of sexual abuse

Sexual abuse involves forcing or enticing a child or young person to take part in sexual activities, whether or not the child is aware of what is happening. The activities may involve physical contact, including penetrative or non-penetrative acts. They may also include non-contact activities, such as involving the children in looking at, or in the production of, pornographic material or watching sexual activities or encouraging children to behave in sexually inappropriate ways. Signs of sexual abuse displayed by children include:

  • Difficulty walking or sitting
  • Pain/itching/bleeding/bruising/discharge to the genital area/anus
  • Urinary infections/sexually transmitted diseases
  • Persistent sore throats
  • Eating disorders
  • Self mutilation
  • Refuses to change for gym or participate in physical activities
  • Exhibits an inappropriate sexual knowledge for their age
  • Exhibits sexualised behaviour in their play or with other children
  • Lack of peer relationships, sleep disturbances, acute anxiety/fear
  • School refusal, running away from home

Signs of emotional abuse

Emotional abuse is the persistent emotional ill-treatment of a child such as to cause severe and persistent adverse effects on the child’s development. It may involve conveying to children that they are worthless or unloved, inadequate or valued insofar as they meet the needs of another person. It may feature inappropriate expectations being imposed on children, relative to their actual development or age. Signs of emotional abuse displayed by children include:

  • Excessive behaviour, such as extreme aggression, passivity or become overly demanding
  • Children who self-harm, for instance by scratching or cutting themselves
  • Is either inappropriately adult or infantile
  • Children who persistently run away from home
  • Children who show high levels of anxiety, unhappiness or withdrawal

Signs of neglect

Neglect is the persistent failure to meet a child’s basic physical and/or psychological needs. This is likely to result in the serious impairment of the child’s health or development. Signs of neglect include:

  • Frequent absenteeism from school
  • Begs or steals money or food
  • Lacks needed medical or dental care, immunizations or glasses
  • Lacks appropriate clothing, e.g. for weather conditions, shoes are too small, ill-fitted clothes
  • Clothes are consistently dirty or ‘smelly’
  • Teeth are dirty, hair quality is poor and contains infestations
  • Hands are cold, red and swollen
  • Loss of weight or being constantly underweight
  • The parent or adult caregiver has failed to protect a child from physical harm or danger

Child Sexual Exploitation

Sexual exploitation of children and young people under 18 involves exploitative situations, contexts and relationships where young people (or a third person or persons) receive ‘something’ (e.g. food, accommodation, drugs, alcohol, cigarettes, affection, gifts, money) as a result of them performing, and/or another or others performing on them, sexual activities. Child sexual exploitation can occur through the use of technology without the child’s immediate recognition; for example being persuaded to post sexual images on the Internet/mobile phones without immediate payment or gain. In all cases, those exploiting the child/young person have power over them by virtue of their age, gender, intellect, physical strength and/or economic or other resources. Violence, coercion and intimidation are common, involvement in exploitative relationships being characterised in the main by the child or young person’s limited availability of choice resulting from their social/economic and/or emotional vulnerability

Both girls and boys are at risk of sexual exploitation, and it is seriously harmful to children both emotionally and physically. Children and young people often find it very hard to understand or accept that they are being abused through sexual exploitation, and this increases their risk of being exposed to violent assault and life threatening events by those who abuse them.

Signs to look out for include:

  • Going missing for periods of time or regularly returning home late
  • Frequently staying out late or overnight with no explanation as to where they have been.
  • Going places that you know they cannot afford.
  • Skipping school or being disruptive in class
  • Suddenly acquiring expensive gifts such as mobile phones, jewellery – even drugs – and not being able to explain how they came by them.
  • Having mood swings and changes in temperament
  • Noticeable changes in behaviour – becoming secretive, defensive or aggressive when asked about their personal life.
  • Wearing inappropriate clothing that is too adult or revealing for their age.
  • Displaying inappropriate sexualised behaviours, such as over familiarity with strangers, dressing in a sexualised manner or sending sexualised images by mobile phone (‘sexting’)
  • Getting into trouble with the police.
  • Bruises, marks on the body, sexually-transmitted diseases, pregnancy, drug and alcohol abuse or self-harm.
  • Repeated phone calls, letters, emails from adults outside family social circle.

The WISE Project is a service for 13-25 year olds who are experiencing sexual exploitation or are at risk of experiencing it. The project is also a point of call for advice and guidance for those working with young people who have suffered from sexual exploitation.

Bullying

Bullying is not always easy to recognise as it can take a number of forms. A child may encounter bullying attacks that are:

  • Physical: pushing, kicking, hitting, pinching and other forms of violence or threats
  • Verbal: name-calling, sarcasm, spreading rumours, persistent teasing
  • Emotional: excluding (sending to Coventry), tormenting, ridiculing, humiliating.

Persistent bullying can result in:

  • Depression
  • Low self-esteem
  • Shyness
  • Poor academic achievement
  • Isolation
  • Threatened or attempted suicide

Signs that a child may be being bullied can be:

  • Coming home with cuts and bruises
  • Torn clothes
  • Asking for stolen possessions to be replaced
  • Losing dinner money
  • Falling out with previously good friends
  • Being moody and bad tempered
  • Wanting to avoid leaving their home
  • Aggression with younger brothers and sisters
  • Doing less well at school
  • Sleep problems
  • Anxiety
  • Becoming quiet and withdrawn

The Parent or Other Adult Caregiver

  • Denies existence of or blames the child for the child’s problems at home or at school
  • Sees and describes the child as entirely worthless, burdensome or in another negative light
  • Unrealistic expectations of the child i.e. demands a level of academic or physical performance of which they are not able to attain
  • Offers conflicting or unconvincing explanation of any injuries to the child
  • Appears indifferent to or overtly rejects the child
  • Refuses offers of help for the child’s problems

It is important to recognise that the different types of abuse often occur simultaneously. For instance where a child is physically abused, they often suffer emotional abuse as well. If you perceive a combination or repetition of any of the signs of child abuse then please contact the Front Door for Families as follows:

Front Door for Families

C/O Whitehawk Community Hub and Library

179A Whitehawk Road

Brighton, BN2 5FL

Tel: (01273) 290400

E-mailFrontDoorForFamilies@brighton-hove.gcsx.gov.uk

or use the Online Referral Form

 

In July 2009. The National Institute for Health and Clinical Excellence (NICE) published a quick reference guide ‘When to suspect child maltreatment’ for all healthcare professionals working in the NHS who work with children and young people. It may also be of interest to people outside of the NHS who work with children and young people.

This guidance is available in PDF (Hard Copy) and can be viewed ‘online’.