Prevention of child abuse and neglect

Prof. (Dr.) Dharmakanta Kumbhakar

(drkdharmakanta1@gmail.com) 

Child abuse and neglect consist of any act of commission or omission
by a parent or other carer that results in harm, potential for harm, or threat of harm to a child, which impairs a child’s physical or emotional health and development. The WHO defines child abuse as a form of physical and/or emotional ill-treatment, sexual abuse, neglect or negligent treatment, or commercial or other exploitation, resulting in actual or potential harm to the child’s health, survival, development or dignity in the context of a relationship of responsibility, trust or power. It can occur in a child’s home or in the organizations, schools or communities the child interacts with. It creates lack of trust and relationship difficulties.

The earlier child abuse is caught, the better the chance of recovery and appropriate treatment for the child and the abuser. The following signs may signal the presence of child abuse: A) The child shows sudden changes in behaviour or school performance/has not received help for physical and medical problems brought to the parent’s notice/has a learning problem not due to a physical or psychological problem/is always watchful even in danger/lacks adult supervision/overt complaint, passive/comes to school early, goes late, and doesn’t like to go back home. B). The parent shows little concern for the child/denies the child’s existence or blames the child for a problem/sees the child as entirely bad, worthless and burdensome/asks the schoolteacher to punish the child for a problem/looks to the child for their own care, attention, and satisfaction/demands more performance from the child than they can achieve (C). The parent and child rarely touch or look at each other/consider their relationship entirely negative/state they don’t like each other. Major types of child abuse are: Physical child abuse is acts of commission that cause actual physical harm or have the potential for harm. This includes things like hitting, kicking, slapping, burning, pinching, hair pulling, biting, choking, shoving, whipping, and padding. Death in abused children is most often the consequence of a head injury or injury to the internal organs. Abuse is suggested by patterns of injury to the skin and skeletal manifestations, including multiple fractures at different stages of healing. There is evidence that about one third of severely shaken infants die and that the majority of the survivors suffer long-term consequences such as mental retardation, cerebral palsy or blindness. Signs of physical child abuse are: The child has unexplained and frequent burns, bites, welts, cuts , bruises, broken bones or black eyes/has fading bruises or other marks after an absence from school/always watchful even in danger/injuries have a pattern of hand or belt/wears inappropriate clothes to cover the injury/seems frightened of the parent and doesn’t want to go home/shrinks at the approach adult/reports the injury to a parent or other carer/if the parent cannot explain the child’s injury/describe the child as evil/has a history of child abuse/becomes over-disciplined and punishes the child.

Child sexual abuse (CSA) or child molestation is a form of child abuse in which an adult or older adolescent uses a child for sexual stimulation and gratification. This includes fondling, penetration, intercourse, exploitation, pornography, exhibitionism, child prostitution, child grooming, group sex, oral sex, or forced observation of sexual acts. It involves mental, physical and emotional abuse of a child through overt and covert sexual acts, gestures and deposition.

We should suspect CSA when we observe-Child is getting trouble in walking and sitting; change in the social behaviour of the child-a happy child becomes introverted, silent, refuses to participate in group activities/become insecure and cling to a trusted adult/become excessively submissive, fearful or excessively violent, easily enraged/child tries to avoid coming in contact with a particular person; change in the personal grooming of the child-neglects personal appearance /deliberately tries to look unhygienic, shabby or unattractive/begin to wear multiple layers of clothing, inappropriate for weather/change in eating habits, the child starts losing weight or may it excessively, thus put on weight; changes in academic performance/poor concentration/ distracted/ sleepy /lack of interest; replaying the abuse with another child generally younger or same age , become pregnant or contract venereal disease.

Emotional child abuse is any attitude or behaviour which interferes with a child’s mental health or social development. This includes constant belittling, shaming, and humiliating a child; calling names and making negative comparisons to others; telling them that they are bad, no good, and worthless or a mistake; frequent yelling, threatening or bullying; ignoring or rejecting a child as punishment; giving silent treatment; limited physical contact with the child and exposing the child to violence or the abuse of others. It also includes the failure to provide the affection and support necessary for the development of a child’s emotional, social, physical and intellectual wellbeing. It can severely damage a child’s mental and social development, leaving a lifelong psychological scar. Signs of emotional child abuse report of lack of attachment to parent/self-blame, attempted suicide, reacting by distancing from the abuser, using abusive words and fighting back by insulting the abuser, delayed physical or emotional development, acting as either inappropriately adult or child, showing extreme behavior/excessively withdrawn, fearful or anxious about doing something wrong.

Child neglect is the failure of a parent or other person with responsibility for the child to provide the basic needs for the development of the child, where they are in a position to do so. This includes lack of supervision, inappropriate housing or shelter, inadequate provision of food and water, inappropriate clothing for season or weather, abandonment, denial of medical care and inadequate hygiene. Signs of child neglect are are->frequently absent from school/frequently late or missing from school/beg or steal food or money/lack needed medical, dental, immunisation or glasses/consistently dirty and unbathed and have severe body odour/lack sufficient clothing for weather as ill-fitting clothing/abuse alcohol or other drugs/state that there is no one at home to provide care/when parents are indifferent to the child, apathetic and depressed, abusing alcohol or drugs and behaving irrationally.

The causes of child abuse and neglect are lack of parenting skills, parents setting expectations for their child that are clearly beyond the child’s capability, frustration caused by child non-compliance/unemployment and financial crises for parents/stress and lack of support for parents/superstitions like treating the child as a bitch/non-biological parents/large families/domestic violence are contributory factors for child abuse; children resulting from unintended pregnancies/children with disabilities are vulnerable to abuse and neglect; untreated mental illness in parents/parents that abuse substances like alcohol and cocaine are likely to mistreat their child.

 Trauma-focused cognitive behavioural therapy, abuse-focused cognitive behavioural therapy, rational emotive behaviour therapy, child-parent psychotherapy, group therapy, play therapy, art therapy, etc. are a few modalities for the treatment of abused children and abusers.

To prevent the child abuse and neglect  one should correct the  parenting skill (Parent should think that they have crossed the line and something might be wrong when they cannot stop anger on the child, begin to hit and shake or throw them, feel emotionally disconnected from their child by leaving alone, meeting the daily needs of their children seems impossible and other responsible people has expressed concern on their act on the child/Parent should learn what age appropriate is and what is not for the child, develop new parenting skills to control emotions, taking care of own to control anger and take professional help)/child school programme - good touch –bad touch/ empowering the child about safety /pregnancy planning/creating awareness/celebrating National Child Abuse Prevention Month  every April/participating in Blue Ribbon Campaign/reporting to child helpline and implementing law.