The most common form of physical abuse is the use of unnecessary, extreme or harmful force on a child by a parent or carer, intended to cause pain, injury and fear to the victim. This is different to the use of very mild, mindful, calm and appropriate forms of physical interaction or physical discipline by a loving and caring parent in a controlled and safe way.
Methods used include hitting (with/without weapon), punching, kicking, biting, shaking, burning, scalding or suffocation. The results of this type of physical abuse are usually quite obvious – from bruises, scratches and burns to broken bones, paralysis, loss of hearing or sight and brain damage. The vast majority of children who die as a result of abuse will have suffered some degree of physical violence against them.
Giving harmful substances such as alcohol, drugs or medicines to children is another form of physical abuse.
A more subtle and rarer form of physical abuse is the condition Munchhausen by proxy syndrome that involves the exaggeration or fabrication of illnesses or symptoms by an adult of a child in their care.
External Signs of Physical Abuse
Children often collect cuts and bruises in their daily life. These will tend to be on knees, elbows and shins – the ‘bony’ parts of the body – and are nothing to worry about. Some children are more accident prone than others, and it is normal for children to incur some minor injuries as they grow and learn to walk and climb and as they play.
Signs that may give cause for concern are:
· Injuries to parts of the body where accidents are unlikely, such as thighs, back and abdomen, especially on a baby that is not yet moving
· Excessive bruising, black eyes and broken bones
· Bruising with a distinctive shape or pattern eg hand prints, grab or finger marks or belt marks.
· Bite marks
· Scalds and burns
· Cigarette burns
· Any injuries to a small baby who cannot yet move independently
· Untreated or inadequately treated injuries
These injuries are particularly suspicious if the carer cannot offer a reasonable explanation for them, or if they are excessive, in many different/unusual places or keep happening.
Behavioral Signs of a Child Being Physically Abused
A child suffering from physical abuse may:
· Become sad, withdrawn or depressed
· Have trouble sleeping
· Behave aggressively or be disruptive
· A younger child may display signs of frustration such as ‘head banging’
· Show fear of certain adults
· Have a lack of confidence and low self-esteem
· Be unable to explain the injury or explain it unconvincingly
· Use drugs or alcohol
Behavioral Signs of the Adults Responsible for or Aware of the Abuse
The adults responsible or aware may:
· Delay or avoid seeking medical attention
· Have no satisfactory explanation for injuries or an explanation that doesn’t match the injury
· Not allow the child to speak for him/herself
· Try to avoid the child having contact with people, by keeping the child from family, friends and/or school.
· Cover the child in cream/chocolate/inappropriate clothing to hide injuries
· Keep the child in a pram or similar to avoid injuries being noticed