Child Abuse

Child abuse can result from physical, emotional, or sexual harm. While child
abuse is often in the form of an action, there are also examples of inaction
that cause harm, such as neglect. Some households that suffer from
alcoholism/substance abuse and anger issues have higher occurrences of
child abuse as compared to households without. Outcomes of child abuse can
result in both short and long term injury, or even death. There are some
children who may be unaware that they are victims of child abuse.

Definition
Child abuse is widespread and can occur in any cultural, ethnic, or income
group. Child abuse can be physical, emotional, verbal, or sexual. It can also
result from neglect. Abuse can result in serious injury to the child and possibly
even death.

Physical abuse involves non-accidental harming of a child by, for example,

burning, beating, or breaking bones. Verbal abuse involves harming a child
by, for example, belittling them or threatening physical or sexual acts.
Emotional trauma can result from several forms of abuse.

Studies show that one in four girls and one in eight boys are sexually abused
before the age of 18, and that approximately one in 20 children are physically
abused each year. Child sexual abuse is the deliberate exposure of a minor
child to sexual activity that the child cannot comprehend or consent to. This
means a child is forced or talked into sex or sexual activities by another
person. This behavior includes acts such as inappropriate touching of a child's
breasts or genitalia, someone exposing their genitalia to a child, fondling, oral-
genital contact, genital and anal intercourse, as well as exhibitionism,
voyeurism, and exposure to pornography.

Child neglect occurs when someone does not provide the necessities of life to
a child, either intentionally or with reckless disregard for the child's well being.
This can include physical neglect, such as withholding food, clothing, shelter,
or other necessities. Emotional neglect includes withholding love or comfort or
affection. Medical neglect occurs when medical care is withheld.
Religious freedom has become a point of contention — some states allow for
medical neglect due to religious objections. There are also examples of some
extreme religious acts that are considered child abuse that are acceptable in
other countries.

Symptoms
It's not always easy to recognize when a child has been abused. Children who
are abused are often afraid to complain because they are fearful that they will
be blamed or that no one will believe them. Additionally, the person who
abused them may be someone they love very much and want to protect.
Parents are often unable to recognize symptoms of abuse because they may
not want to face this reality.

If you suspect a child has been sexually abused, the child should be
examined as soon as possible by a trained health care professional; it can't be
stressed enough that an abused child needs immediate access to special
support and treatment. A doctor's exam should not be delayed for any reason.
Many signs of injury related to sexual abuse are temporary. Ideally, the exam
should occur within 72 hours of the event or discovery. A complete physical
exam must always be performed so that the examiner can look for any signs
of physical or sexual abuse. These two forms of abuse may coexist. The
longer the abuse continues, the less likely the child will make a full recovery.

Watch out for unexplained changes in your child's body or behavior. Conduct
a formal examination only if you have reason to suspect your child has been
abused. Otherwise, the child may become fearful. Be alert to any of the
following changes:

Signs of Physical Abuse: Any injury (bruise, burn, fracture, abdominal or head
injury) that cannot be explained

Signs of Sexual Abuse: Fearful behavior (nightmares, depression, unusual

fears, attempts to run away); abdominal pain, bedwetting, urinary tract
infection, genital pain or bleeding, sexually transmitted disease; extreme
sexual behavior that seems inappropriate for the child's age

Signs of Emotional Abuse: Sudden change in self-confidence; headaches or

stomachaches with no medical cause; abnormal fears, increased nightmares
or attempts to run away
Signs of Emotional Neglect: Failure to gain weight (especially in infants),
desperately affectionate behavior, voracious appetite and stealing food

Causes
Risk Factors

A combination of individual, relational, community, and societal factors

contribute to the risk of child maltreatment and abuse. Although children are
not responsible for the harm inflicted upon them, certain individual
characteristics have been found to increase their risk of being maltreated.
Risk factors are contributing factors—not direct causes.

Examples of risk factors:

 Disabilities or mental retardation in children that may increase caregiver

burden
 Social isolation of families
 Parents' lack of understanding of children's needs and child
development
 Parents' history of domestic abuse
 Poverty and other socioeconomic disadvantages, such as
unemployment
 Family disorganization, dissolution, and violence, including intimate
partner violence
 Lack of family cohesion
 Substance abuse in the family
 Young, single nonbiological parents
 Poor parent-child relationships and negative interactions
 Parental thoughts and emotions supporting maltreatment behaviors
 Parental stress and distress, including depression or other mental
health conditions
 Community violence
Treatments
If you suspect a child has been abused, contact a pediatrician or a local child
protective agency for help. Physicians are legally obligated to report all
suspected cases of abuse or neglect to authorities. They can also recommend
a therapist and provide the necessary information for investigators. Doctors
may also testify in court to obtain legal protection for the child or to help
criminally prosecute an individual suspected of engaging in child sexual
abuse.

Whatever the nature of the abuse, steps should be taken immediately to

report the abuse and obtain help. Delaying a report decreases the child's
chances for full recovery.

If he or she has been abused, your child will benefit from the services of a
qualified mental health professional. You and other members of the family
may be advised to seek counseling so that you'll be able to provide the
support and comfort your child needs. If someone in your family is responsible
for the abuse, a mental health professional may be able to treat that person
successfully, as well.

If your child has been abused, you may be the only person who can help him
or her. Do not delay reporting your suspicions of abuse. Denying the problem
will only worsen the situation; allowing the abuse to continue decreases the
child's chance for full recovery. In any case of child abuse, the safety of the
abused youngster is of primary concern. He or she needs to be in a safe
environment free from the potential for continuing abuse.

In most cases, children who are abused or neglected suffer greater emotional
than physical damage. A child who has been abused or otherwise severely
mistreated may become depressed or develop suicidal, withdrawn, or violent
behavior. An older child may use drugs or alcohol, try to run away, or abuse
others. The younger the child is and the closer the child's relationship to the
abuser, the more serious the emotional damage will be. As adults, they may
develop marital and sexual difficulties, depression or suicidal behavior. With
early intervention and treatment, these outcomes may be avoided.
https://www.psychologytoday.com/us/conditions/child-abuse
 What is child abuse?
Child abuse and neglect is also known as child maltreatment. It is behaviour which is not
accidental and which is not considered ‘normal’ (outside of norms of conduct). It can be
caused by parents, caregivers, other adults or older adolescents. Child abuse causes
serious risk of physical or emotional harm.
Child abuse behaviours can be intentional or unintentional. They can include acts of
omission. This means not doing certain things which are necessary for the child. They also
include commission. This means deliberate acts (CFCA Resource Sheet, 2015). Children
rarely experience only one form of abuse at a time.
It is important to also note acceptable behaviour in one social group may not be acceptable
in another (Tucci, Saunders, & Goddard, 2002). It varies between cultures.
What are the types of child abuse?
 Emotional abuse: Caregivers and adults fail to nurture a child. The child does not receive the love and security they
need. A child's environment and relationships with caregivers are unstable. The caregiver/s may use threats or force.
They may also be unable to support a child’s healthy development.
 Neglect and negligent treatment: A child’s essential needs are not met. These include the need for love, nutrition,
clothing, warmth, shelter, security, protection, medical/dental care, education and supervision.
 Physical abuse: A child is subjected to injury to their body which is not an accident.
 Family violence: This refers to the use or threat of violence by one partner to control another partner, children or
family members.
 Sexual abuse: A child is involved in any sexual activity with an adult, or with another child. The person committing
the activity is in a relationship of responsibility, trust and power over the child. It includes, but is not limited to,
manipulating, forcing or threatening a child into sexual activity, prostitution and child pornography.
 Organised abuse: This is very complex. It can involve multiple children. It can also involve multiple forms of
abuse. It can occur in family groups or perpetrator networks. The terms: 'organised abuse', 'sadistic abuse' and 'ritual
abuse' have been used to describe organised abuse.
How common is child abuse?
Child abuse is common. It’s probably more common than we think. That’s because it often goes
unreported. It’s often secret. There’s a lot of stigma around it. It’s often treated with silence. We do know
how many cases of abuse are reported and substantiated (proven) each year. However, these aren’t the
real numbers of children abused every day. Many children are scared of telling anyone (disclosing). Many
don’t disclose. Often, when they do disclose they’re not believed.
There are now mandatory reporting laws all around Australia (Higgins, Bromfield, & Richardson,
2007). These laws make certain professionals legally obliged to report any child they suspect is being
harmed or is at risk of harm (AIFS, 2017). Read more
here https://aifs.gov.au/cfca/publications/mandatory-reporting-child-abuse-and-neglect.
There laws are different in different states and territories.
During 2016–17, 168,352 Australian children received child protection services. These include
investigations, care and protection orders and/or were in out-of-home care. One in thirty-two children
received child protection services. Seventy-four percent of these were repeat clients. Aboriginal and
Torres Strait Islander children were 7 times as likely as non-Indigenous children to receive child
protection services. Children from very remote areas are four times as likely as those from major cities to
have a substantiation (AIHW, 2018). Read more here.
Understanding Abuse
In seven studies, Andrews found that in 75% of children knew their offender. In 40% of cases the offender
was a family member (Andrews et al., 2002).

In a study of 384 survivors of abuse by family members (Palmer et al., 2001) 45% reported physical,
emotional and sexual abuse combined; physical and emotional (21%); sexual and emotional (17%);
sexual only (11%) and emotional only (6%). The perpetrator was reported as biological father (34%),
biological mother (19%), stepfather, adoptive father and foster father (8%); stepmother, adoptive mother
and foster mother (5%); both parents equally (7%); other relative (14%); and sibling (10%).
Briere & Scott (2006) identified six key areas in which child abuse affects psychological function as
an adult:
1. Negative beliefs about themselves: Children who are abused develop negative beliefs about themselves,
their place in the world and other people. Thesee beliefs can persist as an adult. They can affect their
relationships and how they feel about themselves. It can be hard for survivors to develop close
relationships. This is because they can be too defensive, aggressive, scared or shy to fully connect with
other people.

2. Emotional reactions are easily triggers: Adults who experienced child abuse can be overwhelmed with
reminders of their abuse. These reminders can occur from everyday situations, words, or experiences.
Intense feelings of guilt, shame, grief or anger can be triggered. These can last a long time. These
"emotional storms" can make the day-to-day life frightening and unpredictable.

3. Body memories of abuse: Child abuse often involves fear, betrayal and powerlessness. A child cannot
understand or explain these experiences. Such experiences become "implicit". This means that they are
largely unconscious and cannot be spoken in words. They can be "body memories". When the memory
returns, it does so with the physical sensations, movements and emotional force of the original
experience. These experiences are called "flashbacks". They can be terrifying.

4. Developing a narrative about one’s abuse: For many adults, abuse is a part of their life history. Making
sense of it is challenging. Why did it happen? What does it say about my family? What does the abuse
say about me? These are common questions for many.

5. Way abuse affects thinking and memory: Being abused is overwhelming for children. They do
not understand abuse and can’t protect themselves. They are trapped. Often they have little memory of
their abuse. Even though memories of what happened may be "split off" from awareness, the trauma still
deeply shapes a survivor's thinking patterns and ways of relating.

6. Difficulty regulating their emotions: Survivors are often easily overwhelmed by everyday situations and
relationships. They often develop "avoidant" coping styles. This helps them feel less pain from their past
abuse. It also helps them escape their present-day discomfort. Survivors often avoid social situations and
personal relationships. Many self-medicate through alcohol or drugs, or self-harm to numb down or
‘release’ their pain.

In one study child abuse was associated with between 26 and 32% of adolescent and adult psychiatric
disorders (Green et al., 2010). 76% of adults reporting child physical abuse and neglect experience at
least one psychiatric disorder in their lifetime and nearly 50% have been diagnosed with three or more
psychiatric disorders (Borger et al., 2005).

https://www.blueknot.org.au/Resources/Information/Understanding-terms-trauma-and-abuse/What-
is-child-abuse

Myths about child abuse

Myth: Child abuse is rare

Fact: All types of child abuse and neglect are common in Australia (CFCA Resource Sheet, 2013). Child
abuse and neglect are often not identified as they occur in privacy and secrecy. Children also find it hard
to disclose, and be believed. Often there is little evidence to substantiate the crime (CFCA, 2015).
Myth: It is only abuse if it is violent
Fact: Child abuse does not necessarily involve violence or anger. Abuse often involves adults wielding
their power over children, and using children as objects rather than respecting their rights.

Myth: People lie about child abuse for

attention and sympathy
Fact: Research, including police and court statistics, shows that it is very rare for a person of any age to
say they were abused if they weren’t. However, “false negative reports” of abuse are common e.g. many
adults state that they were not abused as children when they were.

Myth: Children usually tell someone about

their abuse
Fact: Most children do not tell anyone. They are often silenced through threats or fear of not being
believed. Some children don’t have the words to speak about what is happening to them.

Myth: Children ‘get over’ bad experiences

in childhood
Fact: Adults are often deeply affected by childhood trauma and abuse. You can’t just “get over” it.
Survivors need the right care and support to overcome the impacts of abuse, recover and live full and
healthy lives.
Myth: People who sexually abuse children
are mentally ill
Fact: Most people who sexually abuse children are not mentally ill. They are often married and/or have
sexual relationships with adults. In anonymous surveys, a significant minority of men in the community
indicate a sexual interest in children.

Myth: People who sexually abuse children

have been sexually abused themselves
Fact: The majority of children who are sexually abused are girls. Yet the majority of sexual abusers are
male. Some studies have found that sexually abusive men are more likely to report a history of sexual
abuse than other men. However, the majority of men who sexually abuse children do not report being
sexually abused in childhood.

Myth: People do not “forget” child abuse

Fact: For over one hundred years, traumatic amnesia has been documented amongst war veterans,
survivors of natural and man-made disasters, and adult survivors of child abuse. These memories can
later resurface through flashbacks, nightmares and intrusive thoughts. These memories have sometimes
been called “recovered memories”.

Myth: Children are very suggestible and

they can easy "make up" stories of abuse
Fact: Children are no more suggestible than adults, and can clearly distinguish between reality and
fantasy. Research has shown that children resist making false reports during leading and suggestive
interviewing techniques.
 https://www.blueknot.org.au/Resources/Information/Understanding-abuse-and-trauma/What-is-child-
abuse-/Myths-about-child-abuse

Child abuse prevention

Preventing child abuse in all its forms, including neglect and the impacts of family violence is a significant
challenge in all communities. Child abuse and trauma is a substantial public health issue. It requires a
public health approach to prevention.
This include
 Primary prevention - stopping abuse before it occurs
 Secondary Prevention – focussing on groups which are at particular risks
 Tertiary Prevention – responding to those who have already been abused to minimise the risk of further harm.
In Australia, there has been a concerted effect to prevent child abuse. However the prevalence of abuse
continues to rise. Primary prevention requires simultaneous effort on multiple levels to promote, and
sustain, lasting social and behavioural change. We need approaches that accept that child abuse is a
widespread and harmful social practice that is reinforced every day by long-standing and problematic
cultural beliefs and values.
Safe nurturing and protective relationships with primary care-givers and significant others are important in
helping children establish a secure base from which to learn and grow. Relationships with other family
members, teachers, peers in their home and neighbourhood all help to shape a child’s experiences.
The following lists state and territory departments to which you can report suspected child abuse and
neglect: https://aifs.gov.au/cfca/publications/reporting-abuse-and-neglect
Guidelines around mandatory reporting can be found
here: https://aifs.gov.au/cfca/publications/mandatory-reporting-child-abuse-and-neglect
Information on responding to children and young people’s disclosures is
here: https://aifs.gov.au/cfca/publications/responding-children-and-young-people-s-disclosures-abu
Additional resources are here: https://aifs.gov.au/cfca/topics/child-abuse-and-neglect/resources
https://www.blueknot.org.au/Resources/Information/Understanding-abuse-and-trauma/What-is-child-
abuse-/Child-abuse-prevention

Telling your story

• Telling your story is different if you experienced trauma in childhood than it is for someone who didn’t.
That’s because childhood trauma has biological impacts on your brain and body.

• Some survivors can become activated (either hypo- or hyper-aroused) when telling their story.
Sometimes survivors can become as activated as they were at the time of the original trauma.
• Telling your story can be either be helpful or unhelpful, at different times. While it can help you make
meaning of what happened it can be also be traumatising.
At times, there are big hurdles and sometimes you don’t feel like dredging up any more crap. You get
tired of the gut churning feelings, but the pain is just below the surface at all times anyway and facing it
has really helped it to lose its powerful hold over me. Sometimes it is hard to talk about things. I just allow
the emotions and pain to come up and I try to ride with it. Then when I feel comfortable enough I speak of
why I am feeling the way I am… (study participant in van Loon & Kralik, 2005c).
Some professionals feel that little is to be gained by going back over past experiences. Others believe
that telling your story relieves the burden of carrying your history around, as though it is the sum total of
who you are. Your child abuse and trauma is not your whole story. Talking helps to put those past
experiences outside of you, and disconnect the issues they raise from who you are, so you are able to
separate yourself from the experiences (van Loon & Kralik, 2005c). Some survivors decide that they do
not need to dig too deep because the process of exploring their past may become re-traumatising (van
Loon & Kralik, 2005b). Some survivors believe that it is important to acknowledge their abuse and speak
about its impacts, rather than the details of what happened (van Loon & Kralik, 2005b).
It is important only to share your story when and if you feel ready to do so, and only within a safe
environment, with a person you can trust. If you don’t want to talk about your abuse or trauma
experiences, you may not be ready to do, and it might be preferable not to.
Disclosing your experiences can help rob the trauma or abuse of its power. Even though you can’t
completely erase the effects, they can be reduced, and coped with in a healthier way.
https://www.blueknot.org.au/Survivors/Telling-your-story

What is child abuse?

Child abuse is not just physical violence directed at a child. It is
any form of maltreatment by an adult, which is violent or
threatening for the child. This includes neglect.
When child abuse occurs in the home and the abuser is, for example, the child’s
parent or care-giver, this is a form of domestic violence .
 But children are sometimes abused by other adults on whom they are dependent,
such as day nursery workers, teachers and sports coaches.
Sometimes abuse is intentional, but not always. If parents or caregivers are no longer
able to cope with caring for the child, this can result in dysfunctional behaviour and
abuse.

Scope of child abuse

In 2010 Leiden University and TNO (Netherlands Organisation for Applied Scientific
Research) carried out a study into the scope and nature of child abuse. Every year an
estimated 119,000 children experience some type of abuse.

Types of child abuse

There are five general types of child abuse:
 Physical abuse: all forms of physical violence;
 Emotional or psychological abuse: an adult regularly berates the child, acts in a
dismissive and hostile manner towards the child or intentionally scares the child.
 Physical neglect: the child does not receive the care and nurturing that it needs.
 Emotional or psychological neglect: continuous lack of positive attention for the
child. Ignoring the child’s need for love, warmth and security. This category also
covers cases in which children are witnesses to violence between their parents or
caregivers.
 Sexual abuse: sexual contact which an adult forces upon a child.
https://www.government.nl/topics/child-abuse/what-is-child-abuse