All children deserve the opportunity to meet their full potential. The following five outcomes from Every Child Matters, now integrated into the Children Act 2004, are key to the wellbeing of children:
In order to have the opportunity to reach their full potential and achieve these outcomes, children should:
If children are denied the opportunity and support they need to achieve these outcomes, they are at increased risk not only of an impoverished childhood but of disadvantage and social exclusion in adulthood. They are also at increased risk of abuse and neglect.
Our current knowledge about abuse and neglect – and knowledge about how best to respond - is derived from a number of sources: experience, lessons learnt from public enquiries and from research. The professional judgements we make should be informed by this and from a thorough assessment about a specific child’s health, development and his or her family circumstances.
The sustained abuse or neglect of children physically, emotionally, or sexually can have long-term effects on the child’s health, development and well-being. It can impact significantly on a child’s self esteem, self image and on their perception of self and of others. The effects can also extend into adult life and lead to difficulties in forming and sustaining positive and close relationships. In some situations it can affect parenting ability and lead to the perpetration of abuse on others.
The context in which the abuse takes place may also be significant. The interaction between a number of different factors can serve to minimise or increase the likelihood or level of significant harm. Relevant factors will include the individual child’s coping and adapting strategies, support from family or social network and the impact and quality of professional interventions.
The child’s family environment and subsequent life events will also influence the outcome for the child.
The concept of Significant Harm was introduced in the Children Act 1989 as the threshold for compulsory intervention in family life in the best interests of children.
Section 47 of the Act places a duty on local authorities to make enquiries, or cause enquiries to be made, where it has reasonable cause to suspect that a child is suffering, or is likely to suffer Significant Harm.
There are no absolute criteria on which to rely when judging what constitutes Significant Harm. Consideration of the severity of ill-treatment may include the degree and the extent of physical harm; the duration and frequency of abuse and neglect; the extent of premeditation; the degree of threat, coercion, sadism, and bizarre or unusual elements. Each of these elements has been associated with more severe effects on the child and/or relatively greater difficulty in helping the child overcome the adverse impact of the maltreatment.
Sometimes a single traumatic event may constitute significant harm, e.g. a violent assault, suffocation or poisoning. More often, significant harm is a compilation of significant events, both acute and long-standing, which interrupt, change or damage the child’s physical and psychological development. Some children live in family and social circumstances where their health and development are neglected. For them, it is the corrosiveness of long term emotional, physical or sexual abuse that causes impairment to the extent of constituting significant harm. In each case it is also important to assess the strengths and supports within the family.
Under Section 31(9) of the Children Act 1989, as amended by the Adoption and Children Act 2002:
‘Harm’ means ill-treatment or the impairment of health or development, including for example impairment suffered from seeing or hearing the ill-treatment of another;
‘Development’ means physical, intellectual, emotional, social or behavioural development;
‘Health’ means physical or mental health; and
‘Ill-treatment’ includes sexual abuse and forms of ill-treatment that are not physical.
Under Section 31(10) of the Act:
Where the question of whether harm suffered by a child is significant turns on the child’s health and development, his/her health and development shall be compared with that which could reasonably be expected of a similar child.
A court may only make a Care Order or Supervision Order if it is satisfied that:
The abuse or neglect of a child can be caused by inflicting harm or by failing to act to prevent harm. Children may be abused in a family, in a community or institutional setting, by those known to them or, much more rarely, by a stranger. Medical opinion is generally and is important part of the evidence upon which a conclusion will be reached as to whether the child has suffered abuse or neglect.
The following definitions are taken from Chapter 1 of Working Together to Safeguard Children, 2006.
| 4.1 |
Physical AbusePhysical abuse 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. Supplementary guidance on this form of abuse is set out in the Fabricated or Induced Illness Procedure. |
| 4.2 |
Emotional AbuseEmotional abuse is the persistent emotional maltreatment of a child such as to cause severe and persistent adverse effects on the child’s emotional development. It may involve conveying to children that they are worthless or unloved, inadequate, or valued only insofar as they meet the needs of another person. It may feature age or developmentally inappropriate expectations being imposed on children. These may include interactions that are beyond the child’s development capability, as well as over protection 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 causing children 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 children, though it may occur alone. |
| 4.3 |
Sexual AbuseSexual abuse involves forcing or enticing a child or young person to take part in sexual activities, including prostitution, whether or not the child is aware of what is happening. The activities may involve physical contact, including penetrative (i.e. rape, buggery or oral sex) or non-penetrative acts. They may include non-contact activities, such as involving children in looking at, or in the production of, sexual on-line images, watching sexual activities, or encouraging children to behave in sexually inappropriate ways. See also the supplementary guidance set out in the Protocol for Joint Working with Young People At Risk of Sexual Exploitation and Child Abuse and Information Communication Technology Procedures. |
| 4.4 |
NeglectNeglect 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 and 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:
It may also include neglect of, or unresponsiveness to, a child’s basic emotional needs. |
The following are often regarded as indicators of concern:
Children can have accidental bruising, but the following must be considered as non accidental unless there is evidence or an adequate explanation provided:
Bite marks can leave clear impressions of the teeth. Human bite marks are oval or crescent shaped. Those over 3cm in diameter are more likely to have been caused by an adult or older child.
A medical opinion should be sought where there is any doubt over the origin of the bite.
It can be difficult to distinguish between accidental and non-accidental burns and scalds, and will always require experienced medical opinion. Any burn with a clear outline may be suspicious e.g.:
Scalds to the buttocks of a small child, particularly in the absence of burns to the feet, are indicative of dipping into a hot liquid or bath.
Fractures may cause pain, swelling and discolouration over a bone or joint.
Non- mobile children rarely sustain fractures.
There are grounds for concern if:
A large number of scars or scars of different sizes or ages, or on different parts of the body, may suggest abuse.
Emotional abuse may be difficult to recognise, as the signs are usually behavioural rather than physical. The manifestations of emotional abuse might also indicate the presence of other kinds of abuse.
The indicators of emotional abuse are often also associated with other forms of abuse.
The following may be indicators of emotional abuse:
Children of both genders and of all ages may be sexually abused and are frequently scared to say anything due to guilt and/or fear. This is particularly difficult for a child to talk about and full account should be taken of the cultural sensitivities of any individual child / family.
Recognition can be difficult, unless the child discloses and is believed. There may be no physical signs and indications are likely to be emotional / behavioural.
Some behavioural indicators associated with this form of abuse are:
Some physical indicators associated with this form of abuse are:
See also Children who Sexually Abuse Other Children Procedure for further guidance of what constitutes sexual abuse.
Evidence of neglect is built up over a period of time and can cover different aspects of parenting. Indicators include:
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