Signs of Abuse

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Signs and indicators of abuse and neglect:

Signs and indicators of abuse and neglect Safeguarding Group 1

How might you find out about abuse?:

How might you find out about abuse? A child tells you what has happened or you witness it directly Changes in the child’s behaviour You see injury or behaviour consistent with abuse and unlikely to have been caused in another way You are told of the abuse by the child’s friends or their parents Signs of abuse are seen in artwork, play or creative writing Anonymous sources tell you of the abuse Parent’s explanations do not fit the injuries, or explanations change

Injuries:

Injuries If you see an injury, or are uncomfortable with the explanations given (inadequate or changing) Or Bruising on a pre-mobile baby Or Object-shaped injuries You must raise this with your designated person. Please check out the explanation by asking ‘what happened’

Physical Abuse – signs and symptoms:

Physical Abuse – signs and symptoms The following may indicate physical abuse; Injuries that the child cannot explain, explains unconvincingly or that have not been treated Bite marks or cigarette burns, bruising resembling hand or finger prints Blunt instrument marks or iron burns Immersion burns or scald marks Bruising in immobile babies Bruising in babies; In experience, immobile babies do not bruise themselves, bruising of any kind in an immobile baby should be questioned Parental explanations – fell on a plastic toy or slept on his dummy (a recent explanation for an injury) are often accepted. Often the same story is given to explain a series of injuries

How would you know whether or not an injury is abusive ? :

How would you know whether or not an injury is abusive ? There is a delay in seeking medical help The story of the “accident” is vague, lacking in detail and may vary with each telling, and from person to person The account of the “accident” is not in keeping with the injury observed The parent’s behaviour/demeanour is abnormal or gives cause for concern The child’s appearance and interaction with his/her parents is abnormal The child may say something

Common sites for accidental injury:

Common sites for accidental injury Nose Chin Hips Shins Spine Elbows Forehead Knees

Common sites for non accidental injury:

Common sites for non accidental injury CHEEK/SIDE OF FACE: Bruising, finger marks EYES: Bruising black (particularly both eyes). CHEST: Bruising, grasp marks. UPPER AND INNER ARMS: Bruising, grasp marks KNEES: Grasp marks. GENITALS: Bruising BACK, BUTTOCKS AND THIGHS: Linear bruising outline of belt/buckles/scalds/burns SKULL: Fracture, bruising or bleeding under skull (from shaking). MOUTH: Torn frenulum SHOULDERS: Bruising, grasp marks. NECK: Bruising, grasp

Parental punishment:

Parental punishment Caring for children can be challenging. A vital part of parenting is setting and reinforcing reasonable boundaries for children. The best way to do this is to reinforce positive behaviour. If smacking is part of the family culture, growing up with violence can make children insecure and fearful from an early age. Physical punishment is particularly serious when: It causes injury or leaves a mark on the child An implement is used to administer the punishment The child is hit on the head Ritual humiliation is part of the punishment

Emotional abuse signs and indicators:

Emotional abuse signs and indicators Physical, mental and emotional developmental delay Fear or over- reaction to mistakes, low self esteem Sudden speech disorders, speech delay or mutism Fear of new situations Inappropriate emotional responses to stressful situations Excessive need for approval, attention or affection Self harming Wetting or soiling Running away, drug/solvent abuse Continually putting themselves down Frozen awareness Parents excessively negative towards child, highly critical/low warmth Failure to grow/thrive Seeing someone else being harmed (for example in domestic abuse)

Emotional abuse:

Emotional abuse Emotional abuse is a difficult form of child abuse to identify and stop. In some instances an emotionally abused child will show no sings of abuse, or this will only manifest itself in adolescence or adulthood as: Insecurity, poor self esteem, withdrawal, difficulty in forming relationships and suicide Destructive behaviour and angry acts such as fire setting or cruelty to animals Risk taking behaviours including self harm, suicide, alcohol & drug misuse

Domestic abuse:

Domestic abuse What is it? “Any incident of threatening behaviour, violence or abuse (psychological, physical, sexual, financial or emotional) between adults who are, or have been, intimate partners or family members, regardless of gender or sexuality” This includes issues of concern to black and minority ethnic (BME) communities such as so called “honour based violence”, female genital mutilation (FGM) and forced marriage. (Home office 2006) Risk Factors Previous domestic abuse 35% of households have a second incident within 5 weeks of the first incident Women separating from their partners are at much higher risk of domestic abuse Escalation of violence, use of weapons, threats to kill Increased duration of violence Victim frightened for own safety Incidents occurring during pregnancy Jealous/possessive behaviour

Domestic abuse:

Domestic abuse 22% of women and 14% of men report being the victim of domestic abuse 47% of female homicides were killed by present or previous partners compared to 8% of men 33.3% of all children on the child protection register/plan are affected by domestic abuse A woman is physically abused approx 35 times before she reports it to anyone It is estimated that 95% of all incidents are witnessed by children Children are more likely to be at risk of physical, sexual or emotional abuse from perpetrators of domestic violence. Perpetrators may abuse the child as part of their violence against partners Children can also get injured trying to protect the victim

Sexual abuse:

Sexual abuse Physical signs Some physical abuse signs may be present in sexual abuse, i.e. bites, slap/grasp/punch marks Other physical signs which may indicate sexual abuse Sexually transmitted infections Recurrent urinary tract infections Soreness or injury to genitals, anus, thighs, lower abdomen, buttocks Soreness in throat or mouth Vaginal bleeding/discharge Torn, stained or bloody underwear Pregnancy Emotional signs Sexual knowledge inappropriate for age Sexualised behaviour in young children Sexually provocative behaviour or promiscuity Sudden changes in behaviour, running away, self harming Nightmares, bed wetting, eating disorders, suicide attempts Reluctance to change clothes after sports Sexual bullying of other children Preoccupation with sexual matters

Neglect signs and indicators:

Neglect signs and indicators Unkempt Under/overweight Inappropriately dressed for conditions/age Untreated medical conditions Playing out late Hungry/stealing food Dirty/smelly? Consider circumstances Untreated head lice Dental decay

Further examples of abuse:

Further examples of abuse Sexually exploited children Child victims of trafficking Children affected by gang activity Fabricated or induced illness (FII) Investigating complex (organised or multiple) abuse Female genital mutilation Forced marriage and honour-based violence Allegation of abuse made against a person who works with children Abuse of disabled children Child abuse linked to belief in “spirit possession” (Working together 2010, LSCB procedures 2011)

Remember!:

Remember! Don’t jump to conclusions when presented with indicators from the previous lists The indicators are not definite proof of abuse on their own, and should always be followed up by further enquiries by the investigating agencies (Police & Children's Social Care)

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