WHAT IS ABUSE? A1

DEFINITION & RECOGNITION OF CHILD ABUSE “child” means a person under the age of 18 years who has not married NEGLECT EMOTIONAL ABUSE PHYSICAL ABUSE SEXUAL ABUSE CONSIDER POSSIBILITY OBSERVE SIGNS OF ABUSE RECORD INFORMATION A3

“Reasonable Grounds for Concern” specific indication from the child that (s)he was abused; an account by a person who saw the child being abused; evidence, such as an injury or behaviour which is consistent with abuse and unlikely to be caused another way; an injury or behaviour which is consistent both with abuse and with an innocent explanation but where there are corroborative indicators supporting the concern that it may be a case of abuse. An example of this would be a pattern of injuries, an implausible explanation, other indications of abuse e.g. dysfunctional behaviour; consistent indication, over a period of time, that a child is suffering from emotional or physical neglect Aspects of the child’s behaviour Consistent signs of neglect over a period of time Children First: 4.3.2. A4

Neglect “An omission, where the child suffers significant harm or impairment of development by being deprived of food clothing, warmth, hygiene, intellectual stimulation, supervision and safety, attachment to affection from adults, medical care”. Children First:3.2.1. A5

Emotional Abuse “When a child’s need for affection, approval, consistency and security are not met. Emotional abuse is normally to be found in the relationship between a care-giver and a child”. Children First:3.3.1. A6

Physical abuse Any form of non-accidental injury or injury which results from wilful or neglectful failure to protect a child. Children First 3.4.1 A7

Sexual Abuse “When a child is used by another person for his/her gratification or sexual arousal or for that of others”. Children First:3.5.1. A8

Threshold of Significant Harm “Harm can be defined as the ill treatment or the impairment of the health or development of the child. Whether it is significant is determined by his/her health and development as compared to that which could reasonably be expected of a child of a similar age”. Children First:3.2.3 A9

Neglect Physical Indicators Behavioural Indicators Exposed to danger; lack of age appropriate supervision Over protection- extreme control Low self esteem Child as parent(parentified) Caring for younger siblings Accident prone Poor hygiene - lack of self care Untreated illnesses A11 Physical Indicators Tiredness, listlessness Hunger Dental issues Dirty/smelly Bed wetting/soiled Failure to thrive Learning difficulties Lack of provision of health care Age inappropriate appearance - dress/style

Emotional Abuse Physical Indicators Behavioural Indicators Sudden speech disorders Eating disorders Self harm Wetting and soiling Signs of mutilation Attention seeking behaviour Frequent vomiting A12 Behavioural Indicators Mood change e.g.depression, failure to communicate Rocking, thumb sucking Fear of change Chronic runaway Poor peer relationships/isolation Truancy Delinquency

Physical Abuse Physical Indicators Behavioural Indicators Scratches Bite marks or welts Bruises in places difficult to mark e.g. behind ears, groin etc Burns, especially cigarette burns Under nourishment Untreated injuries Behavioural Indicators Self mutilation tendencies Poor concentration/learning Chronic runaway Aggressive or withdrawn Fear of returning home Undue fear of adults Bullying/being a victim A13

Sexual Abuse Physical Indicators Behavioural Indicators Soreness, bleeding, itching in the genital or anal area STIs Pregnancy Genital injury Eating disorders Stomach pains or headaches Pain on urination Bruises on inner thighs or buttocks Behavioural Indicators Inappropriate language, sexual knowledge for age group Chronic depression/low self-esteem Inappropriate sexual behaviour Substance/drug abuse Self harm A14

Why Children Don’t Tell ? Fear of abuser Fear of the consequence Fear of being disbelieved Guilt Taboo subject Abuse has been normalised Bribes Language A16

Why Children Do Tell ? Meet a person they can trust Begin to learn what is normal Become aware of their suffering Pain too great To prevent it happening to siblings and/or others A17

Dealing with Disclosure DON’T Panic Promise to keep secrets Ask leading questions Make the child repeat the story unnecessarily Delay Start to investigate Do's Stay calm Listen Believe Reassure Record in writing Discuss Report A18