Recognising When a Child is at Risk
There are behavioural cues that alert the counsellor to the possibilities of a child being abused; different indicators are associated with the different abuses.
Remembering that the indicators mentioned here are not absolute and that one behaviour that the child displays may not mean they are abused or neglected. There are four recognised forms of child abuse:physical, sexual, and psychological and neglect.
Each has their own unique indicators for counsellor to be aware of, particularly when working with children. The term intra familial abuse is used when the perpetrator is a parent, carer or other member of the child or young person’s family. Extra familial abuse is perpetrated by a person outside of the family.
It is important for all counsellors to remember that one sign on its own may not be indicative of child abuse. The following list of indicators has been provided to assist clarification for a concerned person.
Physical abuse is persistent and/or severe mistreatment by beatings or shaking. Possible physical indicators are: broken bones, unexplained bruises, burns, or welts in various stages of healing. However, often the child or young person gives vague or bizarre explanations of how the injuries occurred.
There is a history of family violence, there is an unexplained or vague explanation of why a delay occurred between the injury occurring and when medical treatment was sought. Sometimes the parent/s will admit administering the injuries, and other times they may show little concern for the welfare or treatment of their child.
Sometimes the child will tell a teacher or counsellor of the mistreatment, other times they may not want to go home, or show fear when in the company of a parent. Children may attend school dressed inappropriately (such as in long sleeve shorts and jeans when the weather is particularly hot).
Psychological abuse is the repetitive ill treatment of a child or young person through threats, belittling or teasing comments, humiliating the child, bullying, prolonged ignoring and inappropriate encouragement. Children who have suffered psychological abuse will often feel worthless, unloved, unwanted; they could also have problems with cognition, memory, perception and irrational beliefs based on insecurities.
Possible indicators of psychological abuse include, elevated levels of anxiety and depression, compulsive lying and/or stealing, an inability to trust, indiscriminately seeking the attention or affection of others, rocking, sucking and self harming behaviours. Sexual abuse occurs when a child has been exposed or subjected to any sexual behaviour that is exploitive and/or inappropriate to his/her age and developmental level.
Children who have been subjected to sexual abuse can suffer from severe emotional trauma, physical injury, and sometimes infections. Possible indicators of sexual abuse include sexualised behaviours that are inappropriate for their age, knowledge of sexual behaviour inappropriate for their age, disclosure of abuse either directly or indirectly through drawings or playing, injury in and around the genital area, the presence of sexually transmitted infections.
More subtle indications could be the sudden uptake of unexplained fears, enuresis (bed wetting), encopresis (bed soiling), fear of being alone with one person, and the child may imply that they need to keep “secrets”.
Neglect is the deprivation of a child’s basic needs, such as adequate food, shelter, clothing and support. Neglect can be acute, chronic or episodic, and impact on the child’s social, educational and psychological development. Possible indicators of neglect are signs of malnutrition (such as hunger) and poor hygiene (such as mattered or dirty hair and/or severe body odour).
Sometimes the neglected child will have unattended physical or medical problems (including frequent illnesses and infections or sores). It must be stressed that the ongoing priority in all case work is the assurance and maintenance of child safety.
The counsellor needs to be in contact with all the service providers, professionals, carers and or appropriate legal organisation to ensure that the child is continuously protected. Not only is the cessation of the abuse essential for wellbeing and healing, but if the child is not protected from being re-victimised, the trusting relationship between the counsellor and the child can be irreparably damaged.
If the abuse continues, the child may lose hope, faith and trust in the ability of the counsellor and other relevant professionals to provide protection (Wickham & West, 2002)