Categories and types of abuse
Abuse and neglect are forms of maltreatment of a child. Somebody may abuse or neglect a child by inflicting harm, or by failing to act to prevent harm. Children may be abused in a family or in an institution or community setting or by those known to them or, more rarely, by a stranger. They may be abused by an adult or adults or another child or children.
Physical abuse
A form of abuse that may involve hitting, shaking, throwing, poisoning, burning or scalding, drowning, suffocating, or otherwise causing physical harm to a child. Physical harm may also be caused when a parent or carer fabricates the symptoms of or deliberately induces illness in a child (Working Together 2018).
Emotional abuse
The persistent emotional maltreatment of a child such as to cause severe and persistent adverse effects on the child’s emotional development. It may involve conveying to a child that they are worthless or unloved, inadequate, or valued only insofar as they meet the needs of another person. It may include not giving the child opportunities to express their views deliberately silencing them or 'making fun' of what they say or how they communicate. It may feature age or developmentally inappropriate expectations being imposed on children. These may include interactions that are beyond a child’s development capability, as well as overprotection and limitation of exploration and learning, or preventing the child participating in normal social interaction. It may involve seeing or hearing the ill-treatment of another. It may involve serious bullying (including cyber bullying), causing children frequently to feel frightened or in danger, or the exploitation or corruption of children. Some level of emotional abuse is involved in all types of maltreatment of a child, though it may occur alone (WT 2018).
Sexual abuse
Sexual abuse involves forcing or enticing a child or young person to take part in sexual activities, not necessarily involving a high level of violence, whether or not the child is aware of what is happening. The activities may involve physical contact, including assault by penetration (for example, rape or oral sex) or non-penetrative acts such as masturbation, kissing, rubbing and touching outside of clothing. They may also include non-contact activities, such as involving children in looking at, or in the production of, sexual images, watching sexual activities, encouraging children to behave in sexually inappropriate ways, or grooming a child in preparation for abuse (including via the internet). Sexual abuse is not solely perpetrated by adult males. Women can also commit acts of sexual abuse, as can other children (WT 2018).
In addition, sexual abuse includes abuse of children through sexual exploitation. Penetrative sex where one of the partners is under the age of 16 is illegal, although prosecution of similar age, consenting partners is not usual. However, where a child is under the age of 13 it is classified as rape under s5 Sexual Offences Act 2003.
Neglect
Neglect is the persistent failure to meet a child’s basic physical and/or psychological needs, likely to result in the serious impairment of the child’s health or development. Neglect may occur during pregnancy as a result of maternal substance abuse. Once a child is born, neglect may involve a parent or carer failing to:
- Provide adequate food, clothing and shelter (including exclusion from home or abandonment)
- Protect a child from physical and emotional harm or danger
- Ensure adequate supervision (including the use of inadequate care-givers)
- Ensure access to appropriate medical care or treatment
It may also include neglect of, or unresponsiveness to, a child’s basic emotional needs (WT 2018).
Whilst childhood obesity is not necessarily a safeguarding issue, childhood obesity as a consequence of parental neglect may be a child protection concern. in many instances it is not appropriate to institute child protection proceedings in relation to parental neglect as being the cause of the obesity. However, practitioners working with obese children must be mindful of the possible role of abuse or neglect in contributing to the obesity. Darlington Safeguarding Partnership has developed a policy and practice guidance document to support practitioners who may have concerns that a child is obese and that neglect is considered to be a factor. The guidance can be viewed here: Darlington Safeguarding Partnership - Safeguarding Response to Childhood Obesity in the Context of Neglect [PDF document]
Additional definitions can be found on NSPCC website [External Link].
Neglect is the most common reason for Child Protection Plans in the United Kingdom. Analysis of Child safeguarding Practice Reviews has made the link between neglect and childhood fatalities. Neglect causes great distress to children and leads to poor outcomes in the short and long term. Consequences can include an array of health and mental health problems, difficulties in forming attachment and relationships, lower educational achievements, and increased risk of substance misuse, higher risk of experiencing abuse as well as difficulties in assuming parenting responsibilities later on in life. For further information and guidance see DSP Neglect Practice Guidance [pdf document] and the DSP Darlington Neglect Strategy 2017-2020 [pdf document].
Types of Abuse
Domestic Abuse incorporating Forced Marriage/Honour Based Violence and Female Genital Mutilation
Domestic abuse includes any incident or pattern of incidents of controlling, coercive or threatening behaviour, violence or abuse between those aged 16 or over who are or have been, intimate partners or family members regardless of gender or sexuality. It also includes so called 'honour’ based violence, female genital mutilation and forced marriage. Domestic abuse occurs across society irrespective of age, gender, race, sexuality, wealth and geography.
Domestic abuse can affect both men and women over the age of 16 regardless of gender or sexuality within the context of intimate or familial relationships. Children living in a household where domestic abuse occurs are affected both directly and indirectly and there is a strong correlation between domestic abuse and child abuse.
Definition of domestic abuse
The cross-government definition of domestic abuse is:
‘any incident or pattern of incidents of controlling, coercive, threatening behaviour, violence or abuse between those aged 16 or over who are or have been intimate partners or family members regardless of gender or sexuality. The abuse can encompass but is not limited to:
- Psychological
- Physical
- Sexual
- Financial
- Emotional
Controlling behaviour
Controlling behaviour is a range of acts designed to make a person subordinate and/or dependent by isolating them for sources of support, exploiting their resources and capacities for personal gain, depriving them of the means needed for independence, resistance and escape and regulating their everyday behaviour.
Coercive behaviour
Coercive behaviour is a continuing act or a pattern of acts of assault, threats, humiliation and intimidation or other abuse that is used to harm, frighten or punish the victim.’
This definition, which is not a legal definition includes so called ‘Honour Based Violence’, Female Genital Mutilation (FGM) and Forced Marriage. The definition makes it clear that victims are not confined to one gender of ethnic group; domestic abuse occurs within all age ranges, ethnic backgrounds irrespective of gender identity or sexuality and economic and educational levels.
There is a strong evidence based link between domestic abuse and child abuse. Children who witness domestic abuse suffer emotional abuse and exposure to domestic abuse is always abusive to children. Research suggests that 62% of children who are exposed to domestic abuse are also harmed as a result of physical and emotional abuse or neglect. There is also increasing recognition of the damaging psychological impact that witnessing domestic abuse has on children.
Section 120 of the Adoption and Children Act 2002 extended the definition of significant harm (outlined in the Children Act 1989) as ‘any impairment of the child’s health or development as a result of witnessing the ill treatment of another person, such as domestic violence’.
Domestic abuse can impact on the safety and welfare of children in a number of ways including:
- children being physically assaulted or injured during an episode of domestic abuse
- children suffering emotional and psychological harm by witnessing the physical and emotional abuse of a parent or another adult within the household
- the safety of an unborn child may be compromised when a pregnant woman is subject to abuse
- the experience of domestic abuse will have a negative impact of the ability of an adult victim to care for a child.
The impact of domestic abuse on a child is exacerbated when:
- the child is drawn into the abuse, for example by trying to protect the parent who is being physically harmed
- a child directly witnesses the abuse
- a child is pressurised into concealing the abuse
- domestic abuse is combined with substance abuse and parental mental health issues.
A child’s exposure to parental conflict can lead to serious anxiety and distress and may result in behavioural problems, impaired cognitive functioning and in some cases may lead to long term development problems.
Multi-agency working is central to safeguarding children affected by domestic abuse and intervention should be in accordance with these Multi-Agency Child Protection Procedures.
Practitioners should refer to the DSP multi-agency threshold tool [pdf document] to establish the level of support and intervention required and consideration should be given to Early Help Assessment [external Link].
For further guidance on Domestic Abuse including Forced Marriage/Honour Based Violence and Female Genital Mutilation see Domestic Abuse Procedure and Practice Guidance- Safeguarding Children and Adults with Care and Support Needs [PDF Document]
Child/Adolescent to parent violence and abuse (CAPVA)-There is currently no legal definition of child/adolescent parent violence and abuse (CAPVA). However, it is increasingly recognised as a form of domestic violence and abuse and depending upon the age of the child may fall under the government’s official definition of DVA. For further guidance see Domestic Abuse-Darlington Multi-Agency Child/Adolescent to Parent/Carer Violence and Abuse (CAPVA) Procedural Flow Chart-Child Adult and Family [PDF Document]
For tools to assist in the assessment of risk see MARAC referral form/DASH Risk assessment tool [word document] and Stalking and Harassment Risk Assessment Tool [word document].
Fabricated and Induced Illness (FII)
Fabricated or Induced Illness (FII) perpetrated by parents or carers can cause significant harm to children. FII involves a well-child being presented by a parent or carer as unwell or disabled, or an ill or disabled child being presented with a more serious problem than he or she has in reality, and is likely to be suffering harm as a consequence. There are particular challenges for professionals in terms of managing an FII case. For further information see DSP Fabricated and Induced Illness Practice Guidance [pdf document].
Child Sexual Exploitation (CSE)
Definition of Child Sexual Exploitation
Child sexual exploitation is a form of child sexual abuse. It occurs where an individual or group takes advantage of an imbalance of power to coerce, manipulate or deceive a child or young person under the age of 18 into sexual activity (a) in exchange for something the victim needs or wants, and/or (b) for the financial advantage or increased status of the perpetrator or facilitator. “The victim may have been sexually exploited even if the sexual activity appears consensual. Child Sexual Exploitation does not always involve physical contact; it can also occur through the use of technology”.
Evidence has shown that parents/carers/relatives and those professionals (such as teachers, family workers, health professionals, social workers, GPs, Police Officers and the voluntary sector) who have regular contact with children and young people are well placed to notice changes in behaviour and physical signs, which may indicate involvement in sexual exploitation.
The earlier that sexual exploitation, or likelihood of it, can be identified, the more opportunities there are to prevent or minimise the harm suffered by a child or young person.
In order to identify children at risk of sexual exploitation or experiencing sexual exploitation and follow a clear plan of effective inter-agency action, practitioners should consider ALL of the 14 risk indicators as outlined within the Child Sexual Exploitation Risk Assessment Information Form which will assist in determining the level of risk for the child or young person after considering the risk indicators. Practitioners must then refer concerns to the Children' s Initial Advice Team, telephone 01325 406252.
For further guidance on CSE, the 14 risk indicators and the process for making a referral see DSP Child Sexual Exploitation Procedure and Practice Guidance [pdf document] and the Child Exploitation Risk Assessment Information Form [pdf document].
Modern Slavery and Human Trafficking
The term ‘Modern Slavery’ encompasses a wide range of criminal offences involving exploitation; it is an illicit trade in which human beings are turned into commodities to be bought, sold and exploited for vast profits. The Modern Slavery Act 2015 places a duty on specified public authorities to report details of suspected cases of modern slavery to the National Crime Agency. This is achieved through the National Referral Mechanism (NRM).
Modern Slavery is a complex crime and may involve multiple forms of exploitation. Victims may not be aware that they are being trafficked or exploited and may have consented to elements of their exploitation or accepted their situation. For this reason victims of modern slavery are often ‘held in plain sight’.
In all instances where a child is suspected of being a victim of modern slavery/human trafficking must be referred to the Police and to Children’s Services.
In some circumstances a rapid response is required to ensure the safety of the child. In the first instance contact Durham Constabulary on 101 or if the child is at risk of immediate harm or in a situation where a child may be imminently moved to a different location contact Durham Constabulary on 999.
A referral must also be made to Children’s Services . Contact the Children's Initial Advice Team on telephone 01325 406252. Out of hours, the Emergency Duty Team (EDT) can be contacted on 01642 524552.
Assessments: Prompt decisions are needed when the concerns relate to a child who may be trafficked to avoid the risk of the child being moved again. Where a child has been trafficked the assessment should be carried out immediately as the opportunity to intervene is very narrow. Children may not self identify as a victim and may be loyal to their ‘carers’. They are likely to be distrustful of the authorities. Many trafficked children go missing from care, often within the first 48 hours. Provision may need to be made for the child to be in a safe place before an assessment takes place and for the possibility that they may not be able to disclose full information about their circumstances immediately. Specific action during the assessment of a child who is possibly trafficked should include:
- considering the need for an urgent Strategy Discussion/Meeting
- seeing and speaking with the child and family members as appropriate - the adult purporting to be the child's parent, sponsor or carer should not be present at interviews with the child, or at meetings to discuss future action. Interpreters must be from an approved list and must not be connected to the child
- liaison with the police
- checking all documentation held by child, the family, the referrer and other agencies. Copies of all relevant documentation should be taken and together with a photograph of the child be included in the social worker's file. It is necessary to liaise with the police in respect of documentation as original documents may need to be secured for evidential purposes.
- checking with the local authority for children missing from education
For further detailed guidance on Modern Slavery, the National Referral Mechanism (NRM) and how to make a referral to Children’s Social Care and to the NRM see DSP Multi-Agency Procedure and Practice Guidance- Modern Slavery and Human Trafficking [PDF document] and Modern Slavery Referral Pathway [PDF Document].
Abuse by children and young people: peer abuse
Children, particularly those living away from home, are also vulnerable to physical, sexual and emotional bullying and abuse by their peers. Such abuse should always be taken as seriously as abuse perpetrated by an adult. It should be subject to the same safeguarding children procedures as apply in respect of any child who is suffering, or at risk of suffering significant harm from an adverse source. A significant proportion of sexual offences are committed by teenagers, and, on occasion, such offences are committed by younger children. Staff and carers of children living away from home need clear guidance and training to identify the difference between consenting and abuse, appropriate or exploitative peer relationships. Staff should not dismiss some abusive sexual behaviour as ‘normal’ between young people and should not develop high thresholds before taking action.
Work with children and young people who abuse others, including those who sexually abuse/offend, should recognise that such children are likely to have considerable needs themselves, and also that they may pose a significant risk of harm to other children. Evidence suggests that children who abuse others may have suffered considerable disruption in their lives, been exposed to violence within the family, may have witnessed or been subject to physical or sexual abuse, have problems in their educational development, are likely to be children in need, and some will in addition be suffering or at risk of significant harm, and may themselves be in need of protection. Children and young people who abuse others would be held responsible for their abusive behaviour, whilst being identified and responded to in a way which meets their needs as well as protecting others.
Three key principles should guide work with children and young people who abuse others:
- there should be a co-ordinated approach on the part of youth justice, children’s social care, education (including educational psychology) and health (including child and adolescent mental health) agencies
- the needs of children and young people who abuse others should be considered separately from the needs of their victims and
- an assessment should be carried out in each case, appreciating that these children may have considerable unmet developmental needs, as well as specific needs arising from their behaviour.
The following factors should be taken into account when assessing risks to a child. This is not an exhaustive list.
- an unexplained delay in seeking treatment that is obviously needed
- an unawareness or denial of any injury, pain or loss of function
- incompatible explanations offered or several different explanations given for a child’s illness or injury
- a child reacting in a way that is inappropriate to his/her age or development
- reluctance to give information or failure to mention previous known injuries
- frequent attendances at Accident and Emergency Departments or use of different doctors and Accident and Emergency Departments
- frequent presentation of minor injuries (which if ignored could lead to a more serious injury)
- unrealistic expectations/constant complaints about the child
- alcohol misuse or other substance misuse
- a parent’s request to remove a child from home or indication of difficulties in coping with the child
- Domestic Abuse
- parental mental ill health
- the age of the child and the pressures of caring for a number of children in one household.