As a Nursery provider it is our job to ensure every child feels safe and secure within our care to enable them to grow and develop. It is imperative that as a carer we are able to recognise any changes in the child’s behaviour, appearance and attitude towards others. Being able to recognise the signs and symptoms of various types of abuse is important so something can be done about it.
What is abuse?
A form 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 institutional or community setting by those known to them or, more rarely, by others (e.g. via the internet). They may be abused by an adult or adults or by another child or children.
You must report any suspicions of abuse to the Manager, you must document everything that is said to you by the child, exactly as they said it, then sign and date. This is because if any case went to court and it had been documented in your own words it would be invalid.
Below are the different types of abuse and the possible signs and symptoms:
Physical abuse is a form of abuse which 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.
It is important to remember children do get a number of bruises and bumps during normal play, this is why everything must be recorded. Physical abuse injuries tend to be accompanied by a story that does not match the injury.
What to look for
Injuries that can’t be explained or are explained unconvincingly.
Injuries that have not been treated or not treated adequately.
Injuries on part of the body where accidental injury is unlikely, such as cheeks, chest and thighs.
Bruising that reflects hand or finger marks.
Cigarette burns, adult human bite marks.
Broken bones (particularly in children under the age of two).
Scalds, for example rings on the arms, legs or where the child may have been made to sit or stand in very hot water.
Marks across the back caused by a foreign object such as a slipper, belt or pole.
How could their behaviour change?
The child is reluctant to have their parents contacted for any reason.
A child who shows fear when going home.
A child that flinches when approached or touched.
Reluctant to get undressed for any activity where a change of clothes is normal.
Covering legs and arms when hot.
Depression or mood swings that are out of character for the child.
Unnaturally compliant to parents or carers.
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 assult 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.
The majority of sexual abuse cases happen in private and the abuser will go to great lengths to prevent anyone discovering. Furthermore the child is often threatened to remain silent through a sense of guilt and shame.
Physical signs of sexual abuse
Pain, itching, bruising or bleeding in the genital or anal areas.
Sexually transmitted diseases.
Recurrent genital discharge or urine tract infections without apparent cause.
Stomach pains or discomfort when the child is walking or sitting.
Behavioural signs of sexual abuse
Sudden or unexpected changes in behaviour.
Running away from home.
Abuse of drugs or other substances.
Eating disorders e.g. anorexia, bulimia.
Sexualised behaviour and/or knowledge.
Possession of unexplained amounts of money.
The child not allowed to have friends.
Telling other adults or children about the abuse.
Alluding to secrets which they cannot reveal.
Reluctant to get undressed for example for sporting events, or where a change of clothes is normal.
As with the other forms of abuse emotional abuse can be difficult to identify with certainty. Some children are genuinely shy and find it hard to be out going and confident. Emotional abuse is the persistent emotional maltreatment of a child such as to cause severe and 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 developmentally inappropriate expectations being imposed on children. These may include interactions that are beyond a child’s developmental capability as well 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, although it may occur alone.
Physical signs of emotional abuse
A failure to thrive.
Sudden speech disorder.
Behavioural signs of emotional abuse
Compulsive nervous behaviour e.g. rocking.
Unwilling or unable to play.
Fear of making mistakes.
Self harm or mutilation.
Reluctant to have parents called.
Excessive lack of confidence.
Excessive need of attention, affection and/or approval.
Inability to cope with praise.
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 misuse. 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; or ensure access to appropriate medical care or treatment. It may also include neglect of, or unresponsiveness to, a child’s basic emotional needs.
Children that are neglected tend to develop more slowly than others and find it difficult to socialise with their peers.
Physical signs of neglect
Constantly hungry and stealing food from others.
Being in an unkept state e.g. often dirty and/or smelly.
Loss of weight or constantly underweight.
Inappropriately dressed for the weather conditions.
Untreated medical conditions.
Behavioural signs of neglect
Frequently missing school or being late.
Unable to keep hospital appointments.
Having few friends.
Being unsupervised frequently.
Often stealing or scavenging for food.
If a child confides in you . . .
Remain calm, accessible and receptive.
Listen carefully and without interrupting.
Remain aware of non-verbal messages e.g. body language.
Make it clear you are taking them seriously.
Acknowledge their courage and reassure them that they are right to tell.
Reassure them they are not to feel guilty and you are sorry that this has happened to them.
What to avoid . . .
Do not allow your shock or distaste show.
Do not ask for more information than is offered.
Do not make assumptions.
Do not make promises you cannot keep, for example that everything will be alright.
Do not agree to keep information a secret.
Never delay getting emergency help if required.
Child abuse can also have an impact on you as the child care worker, do not keep your emotions bottled up once the incident has been dealt with, speak to another member of staff or contact the NSPCC support line.
Bruising in children that are not independently mobile . . .
All bruising in children under six months or children that are not independently mobile must be reported to Children’s Services. If a child is seriously ill or injured, or in need of urgent treatment you should immediately refer them to hospital before referring them to Children’s Services. If a child gets bruised whilst at nursery you do not need to refer them to Children’s Services, but you should follow the policy for recording accidents/incidents. Bruising is the most common feature of physical abuse in children, the younger the child, the greater the risk that bruising is non- accidental. It is the responsibility of the examining pediatrician to decide whether bruising is consistent with an innocent cause or not, even if a plausible explanation is given by the carer.
Genital mutilation is where procedures take place to remove part or all of female genitalia as well as other injuries to female genital organs for non-medical reasons. This can cause long term health problems and severe pain. The majority of genital mutilation cases take place on girls between the ages of 5 and 8 and happens across Africa, the Middle East & Asia.
Physical signs of genital mutilation
Visual changes to genital organs
Pain and discomfort in genital area
Piercing to genital areas
Fractures/dislocation as a result of restraint
Vaginal and pelvic infections
Difficulties passing urine and urine infections
Scar formation in genital areas
Behavioural signs of genital mutilation
Lack of motivation
For all information regarding how to report an allegation please refer to the Safeguarding Policy.