Orientation Topics

Definitions and Indicators

The attached table provides plain-language definitions as well as physical and behavioral indicators that will help you understand and respond to child abuse and neglect.

Types of Abuse Definition Physical
Indicators
Behavioral
Indicators
Physical Abuse Physical abuse is a deliberate
physical assault or action by a person that results in, or is likely to result in, physical harm to a child. It includes the use of unreasonable force to discipline a child or prevent a child from harming him/herself or others. The injuries sustained by the child may vary in severity and range from minor bruising, burns, welts or bite marks to major fractures of the bones or skull to, in the most extreme situations, death.
  • any injury to an infant who is not yet mobile, especially head/facial injuries
  • injuries to a toddler or older child for which there is no explanation
  • the explanation does not fit with the injuries, or the story keeps changing
  • injuries at different stages of healing
  • injuries that have a pattern or look like they may have been caused by an object (e.g., hand, stick, buckle, stove element)
  • bruising in unusual places such as ears, trunk, neck or buttocks
  • afraid or reluctant to go home, or runs away
  • shows unusual aggression, rages or tantrums
  • flinches when touched
  • has changes in school performance and attendance
  • withdraws from family, friends and activities previously enjoyed
  • poor self-esteem (e.g., describes self as bad, feels punishment is deserved, is very withdrawn)
  • suicidal thoughts or self-destructive behaviour (e.g., self-mutilation, suicide attempt, extreme risk-taking behaviour)
Emotional Abuse This is the most difficult type of abuse to define and recognize. It may range from ignoring to habitually humiliating the child to withholding life-sustaining nurturing. Generally, it involves acts or omissions by those in contact with a child that are likely to have serious, negative emotional impacts. Emotional abuse may occur separately from, or along with, other forms of abuse and neglect. It includes the emotional harm caused by witnessing domestic violence. Emotional abuse can include a pattern of:

  • scapegoating
  • rejection
  • verbal attacks on the child
  • threats
  • insults
  • humiliation

Emotional harm

When emotional abuse is chronic and persistent, it can result in emotional harm to the child. Under the Child, Family and Community Service Act, a child is defined as emotionally harmed if they demonstrate severe:

  • anxiety
  • depression
  • withdrawal
  • self-destructive or aggressive behaviour

 

  • bed wetting and/or frequent diarrhea
  • frequent psychosomatic complaints, headaches, nausea, abdominal pains

 

  • mental or emotional development lags
  • isolated and has no friends or complains of social isolation
  • behaviours inappropriate for age
  • fear of failure, has overly high standards, reluctant to play
  • fears consequences of actions, often leading to lying
  • extreme withdrawal or aggressiveness, mood swings
  • overly compliant, too well-mannered
  • excessive neatness and cleanliness
  • extreme attention seeking behaviours
  • poor peer relationships
  • severe depression, may be suicidal
  • runaway attempts
  • violence is a subject for art or writing
  • forbidden contact with other children
  • shows little anxiety towards strangers
  • unusual severe anxiety or worries
Sexual Abuse Sexual abuse is when a child is used (or likely to be used) for the sexual gratification of another person. It includes:

  • touching or invitation to touch for sexual purposes
  • intercourse (vaginal, oral or anal)
  • menacing or threatening sexual acts, obscene gestures, obscene communications or stalking
  • sexual references to the child’s body/behaviour by words/gestures
  • requests that the child expose their body for sexual purposes
  • deliberate exposure of the child to sexual activity or material
  • sexual aspects of organized or ritual abuse

 

  • unexplained or persistent pain, bleeding or unusual discharge in the genital or anal area
  • pregnancy
  • sexually transmitted diseases
  • engages in age-inappropriate sexual play or exhibits age-inappropriate sexual knowledge (e.g., through drawing or play)
  • forces or coerces another child to engage in sexual play
  • inserts objects into vagina or rectum
  • directs sexually intrusive behaviour to adults
  • has unexplained gifts, new clothes or money
  • has changes in school performance and attendance
  • is secretive about “new” friends, activities, phone calls or Internet use
  • has unexplained developmental setbacks (e.g., was toilet trained but reverts back)
  • is involved in sexually exploitative activities, such as performing sex acts for money
  • is involved in behaviours such as misuse of drugs or alcohol, stealing, fire setting, and flinches when touched
Sexual Exploitation Sexual exploitation is a form of sexual abuse that occurs when a child engages in a sexual activity, usually through manipulation or coercion, in exchange for money, drugs, food, shelter or other considerations. Sexual activity includes:

  • performing sexual acts
  • sexually explicit activity for entertainment
  • involvement with escort or massage parlour services
  • appearing in pornographic images

Children living on the street are particularly vulnerable to exploitation. Children in the sex trade are not prostitutes or criminals. They are victims of abuse.

Neglect Neglect is failure to provide for a child’s basic needs. It involves an act of omission by the parent or guardian, resulting in (or likely to result in) harm to the child. Neglect may include failure to provide food, shelter, basic health care, supervision or protection from risks, to the extent that the child’s physical health, development or safety is, or is likely to be, harmed.
  • injuries where medical care has been unusually delayed or avoided
  • injuries resulting from a lack of supervision
  • medical or dental needs that are consistently unattended to
  • failure to thrive” in a child where no medical reason has been found (see below for further information on failure to thrive)
  • clothing consistently inadequate for weather conditions
  • persistent hunger
  • poor or inadequate nutrition
  • poor personal hygiene
  • forages for, hoards or steals food
  • developmental delay or setbacks related to a lack of stimulation
  • poor school attendance
  • inappropriately takes on a caregiver role for a parent or siblings
  • tired or unable to concentrate at school
  • appears sad or has flat affect
  • reluctant to go home; speaks of being or appears to be left alone at home a lot, unsupervised
  • is involved in behaviours such as misuse of drugs or alcohol, stealing, fire setting
  • does not respond to affection or stimulation

Possible Indicators of Failure to Thrive

A child who has stopped growing and/or has experienced significant weight loss may be suffering from “failure to thrive” syndrome. Medical assessment is necessary to determine whether the syndrome is organic or non-organic in origin.

Physical Indicators

  • appears pale, emaciated, has “sunken cheeks”
  • body fat ratio is extremely low (e.g. wrinkled buttocks)
  • skin may feel like parchment paper as a result of dehydration, and
  • significant developmental milestones have not been attained within their  age range (e.g., cannot hold head up at six months of age, cannot walk at 18 months)

Behavioural Indicators

  • appears lethargic and undemanding (e.g., cries very little)
  • uninterested in environment or surroundings
  • displays little or no movement (e.g., lies in crib motionless)

You may want to print this table and keep it for future reference.

While all children are vulnerable, some are more vulnerable than others. Children with disabilities and very young children may not be able to protect themselves, and are particularly dependent on adults for their safety and well-being. As a service provider, you should be especially vigilant in cases of suspected abuse or neglect involving such children.