Recognizing when a child is at risk

Child abuse is a serious problem. Too many children are physically, sexually and emotionally abused, and other forms of harm include neglect and exploitation. When this happens, it is up to adults to speak up and report it.

Child abuse is defined as any act by a person that endangers a child or young person’s physical or emotional health or development. It may be a single incident or a number of separate incidents that happen over time.

Who is affected#

Child abuse is not limited to specific cultural or socio-economic groups, although it is more often associated with high mobility, a lack of parental education, loneliness, poverty, unemployment, inadequate housing or social isolation.

• For physical abuse, emotional abuse and neglect, boys are somewhat more at risk than girls.
• More girls than boys are sexually abused.
• The effects of family violence on a family are complex and often co-exist with other concerns such as drug and alcohol misuse, neglect, sexual abuse and mental health issues.

Children can be abused at any age. Some are more vulnerable, for example those under 2 years of age and children with disabilities. Sometimes abuse begins during adolescence, when parents start to struggle with a young person’s behaviour and desire for independence. Abuse may be directed at only one child in a family, and it usually takes place at home with someone the child knows rather than with a stranger. Both men and women commit physical abuse, emotional abuse and neglect.

Types of abuse and their signs#

Physical abuse#

Physical abuse occurs when a child suffers, or is likely to suffer, significant harm from an injury inflicted by a parent or caregiver. The injury may be deliberate, or the unintended result of physical punishment, aggressive treatment, or family violence between parents or carers. It may take the form of bruises, cuts, burns or fractures.

Possible physical indicators include bruises, burns, sprains, dislocations, bites and cuts; fractured bones, especially in an infant where a fracture is unlikely to happen accidentally; poisoning; and internal injuries.

Possible behavioural indicators include:

• being very passive, or showing wariness or distrust of adults
• wearing long-sleeved clothes on hot days to hide bruising or other injuries
• fear of parents or of going home
• becoming fearful when other children cry or shout
• being excessively friendly to strangers

Sexual abuse#

Sexual abuse occurs when a person uses power or authority over a child to involve the child in sexual activity. Physical force is sometimes involved. It covers a wide range of sexual activity, including fondling of the child’s genitals, masturbation, oral sex, vaginal or anal penetration by a penis, finger or other object, and exposing the child to pornography.

Sexual abuse often begins with grooming, in which the adult gives gifts or affection to gain the child’s friendship and build trust and dependence. It can be carried out by both men and women, toward both girls and boys.

Sexual abuse is not usually identified through physical signs. Often the first sign is when a child tells someone they trust that they have been abused. However, sexually transmitted infections, pregnancy, or bleeding or discharge from the genital or anal area may indicate sexual abuse. Possible physical indicators include:

• itching, soreness, discharge or unexplained bleeding from the genital or anal area
• torn, stained or bloodied underwear
• recurrent urinary tract infections
• unexplained pain in the genital area
• bruises, scratches or other injuries around the genital area that are not consistent with accidental injury

Possible behavioural indicators include:

• the child telling someone that abuse has occurred
• sexual behaviour or knowledge that is unusual for the child’s age
• acting-out behaviour such as aggression, lying, stealing, running away, drug or alcohol misuse, or self-harm
• problems with schoolwork or sleeping
• difficulty relating to adults and peers
• sudden changes in mood or behaviour, or regressed behaviour such as bed-wetting

Emotional abuse#

Emotional abuse occurs when a parent or caregiver repeatedly rejects a child, or uses threats to frighten the child. It may involve name-calling, put-downs or continual coldness, to the extent that it significantly damages the child’s physical, social, intellectual or emotional development. Exposure to family violence also affects a child’s safety, wellbeing and development, and is a significant risk factor for other harm.

There are few physical signs, although emotional abuse may cause delays in emotional, mental or even physical development. Possible behavioural indicators include:

• low self-esteem
• being withdrawn, passive or tearful
• aggressive or demanding behaviour
• being highly anxious
• delayed speech, or acting like a much younger child
• difficulty relating to adults and peers

Neglect#

Neglect is the failure to provide a child with the basic necessities of life — such as food, clothing, shelter, medical attention or supervision — to the extent that the child’s health or development is, or is likely to be, significantly harmed.

Possible physical indicators include frequent hunger, malnutrition, poor hygiene, inappropriate clothing such as summer clothes in winter, and being left unsupervised for long periods or even abandoned.

Possible behavioural indicators include:

• medical needs not being attended to
• stealing food
• staying at school outside school hours
• often being tired or falling asleep in class
• not getting on well with peers
• misusing alcohol or drugs, or aggressive behaviour

The effects of child abuse#

Children may experience a range of emotional, psychological and physical problems, and trauma, as a result of being abused or neglected. All forms of abuse are likely to lead to emotional problems for the child, in particular a lack of self-esteem and distrust of adults.

The longer the abuse continues, the more serious the effects. Abused and neglected children are more likely than other children to be self-destructive or aggressive, to misuse drugs or alcohol, or to become young offenders or homeless. In some cases abuse and neglect can cause permanent physical damage. The most serious effects are likely when no one acts to stop the abuse and protect the child.

Treatment and counselling services for children who have been abused help them work through the trauma and reduce the effects of the abuse.

Reporting child abuse#

We all share a responsibility for protecting the children in our community. Child protection services exist to:

• investigate situations where a child is believed to need protection and a parent is unable or unwilling to act protectively
• refer children and families to services that support children’s ongoing safety and wellbeing
• supervise children who are subject to legal orders.

If you have a significant concern for a child’s wellbeing but do not believe they are at immediate risk of significant harm, a referral to local family support services may be appropriate. These services are often free and can help families who are:

• under pressure due to a family member’s physical or mental illness, substance misuse, disability or bereavement
• experiencing significant social or economic disadvantage that may affect a child’s care or development
• experiencing significant parenting problems that may be affecting the child’s development
• experiencing family conflict, including family breakdown
• young, isolated or unsupported.

It may be difficult to decide whether a child needs protection, and many situations will not fit neatly into one category. The following questions may help you decide what to do:

• Has something specific happened to the child that has caused your concern?
• What is the likely impact on the child’s safety, health, wellbeing and development?
• Is this an ongoing issue, and have there been other concerns with this child or other children in the family?
• Are the parents willing and able to connect with support services for the child’s sake?
• With support, could the parents keep the child safe and promote their health, wellbeing and development?

In many places, certain professional groups — such as doctors, nurses and midwives, teachers and school principals, police, early childhood and youth workers, psychologists and counsellors, and people in religious ministry — are required by law to report when they form a reasonable belief that a child has been, or is likely to be, harmed by abuse and is not being protected. Where you are a mandated reporter, report as soon as practicable after forming your belief, and report again each time you become aware of further grounds for that belief.

Any person who believes on reasonable grounds that a child needs protection can make a report. The relevant authority will decide what follow-up is needed and how to classify the report — this may mean giving advice, starting an investigation, referring the family to community support, or taking no further action.

If you believe a child’s safety is in immediate danger, contact your local emergency services or police straight away. For other concerns, contact your local child protection or family support service for advice on how to make a report.

Key points#

• For physical abuse, emotional abuse and neglect, boys are somewhat more at risk than girls.
• Sexual abuse can be perpetrated by both men and women, toward both girls and boys.
• It may be difficult to determine whether the risk is such that a child needs protection, so seek advice if you are unsure.

Where to get help#