CHILD ABUSE


What is abuse?

The World Health Organisation (WHO) defines child abuse and child maltreatment as”all forms of physical and / or emotional ill-treatment, sexual abuse, neglect or negligent treatment or commercial or other exportation, resulting in actual or potential to child’s health, survival, development or dignity in the context of a relationship of responsibility, trust or power.

Whilst most children grow and develop in loving, nurturing environments, it is a sad fact that a significant minority suffer harm either intentionally or inadvertently through the actions or omissions of their parents, careers or others. The reasons for such abuse or neglect are often complex and it may present in a variety of ways.
Categories of abuse
• Physical abuse
• Emotional Abuse
• Sexual Abuse
• Neglect

Child abuse across the globe

The UN secretary general’s investigation on violence against a child has given the following review of the situation of abuse and violence against children across the globe.

    • WHO estimates that almost 53,000 child deaths in 2002 were due to child homicide.
    • In the worldwide school-based well-being study completed in a wide range of developing countries, in the vicinity of 20% and 65% of school going child revealed having been verbally or physically tormented in school. Similar rates of harassment have been found in industrialized nations.
    • The latest study on the issue female infanticide and son preference is a worldwide phenomenon with 1.5 million female fetuses aborted every year.
    • An estimated 150 million young ladies and 73 million young men under 18 have encountered constrained sex or different types of sexual violence including physical contact.
    • UNICEF estimates that in sub-Saharan Africa, Egypt, and Sudan, 3 million girls and women are subjected to FGM (female genital mutilation) consistently.
    • ILO gauges that 218 million children were engaged with child labor work in 2004 propose that 5.7 million were constrained or fortified work, 1.8 million in prostitution and pornography and 1.2 million were casualties of trafficking.
  • Only 2.4 % of the world’s children are lawfully shielded from corporal punishment in all cases.

Child abuse in India

Nineteen percent of the world’s children live in India. As indicated by the 2001 Census, somewhere in the range of 440 million individuals in the nation today are matured beneath eighteen years and constitutes 42 percent of India’s aggregate populace i.e., four out of each ten people. This is a colossal number of youngsters that the nation needs to deal with. While articulating its vision of advance, improvement and value, India has communicated its acknowledgment of the way that when its kids are taught, sound, glad and approach openings, they are the nation’s most noteworthy human asset. It is a hidden phenomenon especially when it happens in the home or by family members, focus with regards has generally been in the more public domain such as child labor, child marriage prostitution, etc. Intra-family abuse or the abuse that takes place in institutions such as schools, government home have received government attention.

Child protection – whose responsibility?

CHILD PROTECTION IS:

  • Everyone’s responsibility
  • A shared responsibility
  • The responsibility of every member of the dental team.

Children in society

In 2006 a new tool will be introduced to help identify a child’s needs at an early stage and tackle any problems before they become serious. The common assessment framework has been designed for use by staff in any agency (e.g. health or education). It is hoped that its use will improve multi-agency working.

Recognizing abuse and neglect

    • Examining Child Abuse/neglect dentist and his staff should be educated to get a visual impression of the child as he enters the reception room. The practitioner should note whether the child and parent or guardian has an appropriate interaction.   After evaluating the history in suspected cases of child abuse/neglect, the examination for such children should be incorporated with a routine dental checkup.
  • Signs of Physical AbuseThe term ”battered child syndrome’’ was authored to portray the clinical indications of genuine physical abuse in young children. Another frame is “The shaken infant”. Shaking is a common type of abuse seen in very young children (less than 1 year). Think about physical abuse when the child:
    1. Has unexplained burns, nibbles, wounds, broken bones, or bruised eyes.
    2. Has blurring wounds or different imprints discernible after an absence from school.
    3. Seems alarmed of the guardians and dissents or cries when the time has come to go home.
    4. Shrinks at the approach of grown-ups.
    5. Reports damage by a parent or another grown-up guardian.
    6. Consider the likelihood of physical abuse when the parent or other grown-up guardians: Offers clashing, unconvincing or no clarification for the child’s damage.
    7. Describes the child as “evil,” or in some other negative way. Uses harsh physical teaching with the child.
    1. CONDITIONS THAT MAY MIMIC PHYSICAL ABUSE 
    2. Factors which contribute to abuse:
        1. Stress
        2. Unemployment
        3. Poverty
        4. Overcrowded living conditions
        5. Lack of a support network
        6. Substance or liquor abuse may expand the danger of children being presented to deliberate or non-unplanned wounds and also unexpected wounds.

It has been accounted for that child presented to drugs in utero regularly have formative issues which make them hard to oversee, along these lines expanding their odds of being abused. Sick children who require consistent consideration and exceptional necessities who are all the more requesting are additionally at expanded hazard for affliction abuse.

    • Types of Child NeglectNeglect is an act of omission or the failure to provide food, shelter, clothing, health care, safety need, dental care, and supervision.  These may be broadly categorized into the following four types:
      Emotional neglect 27.8%
      Health care neglect including dental neglect 8.7%
      Physical neglect 7.8%
    • The impact of neglect

      Children who have been neglected may experience short-term and long-term effects that last throughout their life.

      Children who don’t get the love and care they need from their parents may find it difficult to maintain healthy relationships with other people later in life, including their own children.

      Children who have been neglected are more likely to experience mental health problems including depression and post-traumatic stress disorder.

      Young people may also take risks, such as running away from home, breaking the law, abusing drugs or alcohol, or getting involved in dangerous relationships – putting them at risk from sexual exploitation.

    • Effects on brain development

      The first years of a child’s life have a big impact on how their brain develops. That is why neglect can be so damaging – a child’s experiences can change their thought processes and neural pathways.

      If a baby is malnourished, neural cells can become weak or damaged and this can cause lowered brain function.

      If a child has a poor relationship, attachment or little interaction with a parent then it can change how their brain develops emotional and verbal pathways.

      Neglect can severely alter the way a child’s brain works. This can lead to an increased risk of depression in later life as well as dissociative disorders and memory impairments. Changes to the brain caused by neglect have also been linked to panic disorder, post-traumatic stress disorder (PTSD) and attention deficit and hyperactivity disorder (ADHD).

    • Signs of Sexual Abuse Consider the possibility of sexual abuse when the child:
      1. Has difficulty walking or sitting
      2. Suddenly refuses to change for gym or to participate in physical activities
      3. Reports nightmares or bed wetting
      4. Experiences a sudden change in appetite
      5. Demonstrates bizarre, sophisticated, or unusual sexual knowledge or behavior
      6. Becomes pregnant or contracts a venereal disease
      7. Runs away
      8. Reports sexual abuse by a parent or another adult caregiver
      9. Consider the possibility of sexual abuse when the parent or other adult caregivers
      10. Is unduly protective of the child or severely limits the child’s contact with other children, especially of the opposite sex
      11. Is secretive and isolated
      12. Is jealous or controlling with family members

    • Signs of Emotional Maltreatment Consider the possibility of emotional maltreatment when the child:
      1. Shows extremes in behavior, such as overly compliant or demanding behavior, extreme passivity, or aggression
      2. Is either inappropriately adult (parenting other children, for example) or inappropriately infantile (frequently rocking or head-banging, for example)
      3. Is delayed in physical or emotional development
      4. Has attempted suicide
      5. Reports a lack of attachment to the parent. Consider the possibility of emotional maltreatment when the parent or other adult caregivers
      6. Constantly blames, belittles, or berates the child
      7. Is unconcerned about the child and refuses to consider offers of help for the child’s problems
      8. Overtly rejects the child

  •  WHAT SHOULD BE DONE?

    Diagnosing suspected abuse or neglect is only the first step, dentists must be prepared to take immediate remedial action on behalf of the victim. All members of the dental profession must be informed of the health, social, and legal aspects of child abuse and neglect, and they must inform other professions that dental abuse and dental neglect are serious components of child maltreatment. Recognition of child mistreatment is filled with frustration for most health care professionals. The trouble with recognition is the awful realization that parents and caregivers do hurtful things to unprotected, susceptible children. Educating professionals to recognize child abuse and neglect is only half the battle. Encouraging them to make required reports is the other half.

However, policy alone is not enough. Safeguarding children is about changing the whole environment.
You can do this by:

  • Listening to children
  • providing information for children
  • providing a safe and child-friendly environment
  • having other relevant policies and procedures in place.

In Case Of Child Abuse

There is a helpline website for child abuse: www.childlineindia.org.in/
Mobile helpline: 1098(All India child helpline number)

Reference Links