Signs of abuse

Neglect

Neglect is the persistent failure to meet a child’s basic physical and/or psychological needs, likely to result in the serious impairment of the child’s health or development. Neglect may occur during pregnancy as a result of maternal substance abuse or failure to participate in ante-natal care.

Once a child is born, neglect may involve a parent or carer failing to:

• provide adequate food, shelter and clothing; (including exclusion from home or abandonment)
• protect a child from physical harm or danger;
• respond to a child’s basic emotional needs;
• ensure adequate supervision; (including inadequate substitute care-givers)
• ensure access to appropriate medical care or treatment.

Signs which may suggest neglect:

• squalid, unhygienic or dangerous home conditions;
• parents fail to attend to their children’s health or development needs;
• children appear persistently undersized or underweight;
• children continually appear tired or lacking in energy;
• children suffer frequent injuries due to lack of supervision;
• the child is not attached or is anxiously attached to the parent;
• the child is not regularly sent to school including preschool;
• developmental delay due to lack of stimulation;
• the child has cold skin mottled with pink or purple;
• the child has swollen limbs with pitted sores which are slow to heal;
• the child’s skin condition is poor, especially in the nappy area;
• the child has dry sparse hair;
• the child stays frozen in one position for an unnaturally long time.

Physical abuse

Physical abuse may involve hitting, shaking, throwing, poisoning, burning or scalding, drowning, suffocating, or otherwise causing physical harm to a child. Physical harm may also be caused when a parent or carer fabricates the symptoms of, or deliberately induces, illness in a child.

Signs that may suggest physical abuse:

• any bruising to an immobile child;
• multiple bruising to different parts of the body;
• bruising of different colours indicating repeated injuries;
• fingertip bruising to the face, chest, back, arms or legs;
• burns or scalds with clear outlines e.g. a gloves and socks effect or burns of uniform depth over a large area. Also, splash marks above the main scald area – associated with throwing;
• retinal or pin point haemorrhaging – associated with shaking;
• rib fractures in very young children;
• adult bite marks;
• an injury for which there is no adequate explanation.

Emotional abuse

Emotional abuse is the persistent emotional maltreatment of a child such as to cause severe and persistent adverse effects on the child’s emotional development. It may involve:

• conveying to a child that they are worthless or unloved, inadequate or valued only in so far as they meet the needs of another person;
• age or developmentally inappropriate expectations being imposed on children. These may include interactions that are beyond the child’s developmental capability, as well as overprotection and limitation of exploration and learning, or preventing the child participating in normal social interaction;
• not giving the child opportunities to express their views, deliberately silencing them or making fun of what they say or how they communicate;
• causing children frequently to feel frightened or in danger;
• seeing or hearing the ill treatment of another person;
• the exploitation or corruption of children;
• serious bullying, including cyber-bullying.

Some level of emotional abuse is involved in all types of ill treatment of a child, though it may occur alone.

Signs that may suggest emotional abuse:

• excessive bedwetting/soiling, eating, rocking, head banging, aggression;
• self harm;
• attempted suicide;
• high levels of anxiety, unhappiness or withdrawal;
• seek out or avoid affection;
• sleeplessness/night terrors;
• food refusal;
• attention seeking;

Sexual abuse

Sexual abuse involves forcing or enticing a child or young person to take part in sexual activities, not necessarily involving a high level of violence, whether or not the child is aware of what is happening. The activities may involve physical contact, including assault by penetration e.g. rape or oral sex or non-penetrative acts such as masturbation, kissing, rubbing and touching outside clothing.  They may include non contact activities, such as involving children in looking at, or in the production of sexual images or in watching sexual activities, or encouraging children to behave in sexually inappropriate ways or grooming a child in preparation for abuse, including via the internet. Sexual abuse may be committed by men, women and children.

Signs that may suggest sexual abuse:

• injuries, infections, or abnormal discharge, in the genital/anal/oral area;
• pregnancy, and identity of father is a secret or vague;
• shows worrying sexualised behaviour in their play or with other children or adults;
• seems to have inappropriate sexual knowledge for their age;
• a confusion of ordinary affectionate contact with abuse.

More detailed information on the signs of abuse can be found on the Cheshire East Council online procedures system.