Question

Suppose you have a child client who displays several distinct behavioral and emotional concerns indicative of physical abuse. What are the six categories of behavioral and emotional indicators of physical abuse? Give an example of each category. Assuming that your client displays many of these indicators, yet no physical symptoms of abuse, how would you assess whether he or she is being physically abused?

Answer 1

There are different types of child abuse that is inflicted on a child. These cause emotional, behavioral and physical damage to the child. 6 types of abuse are:

1. Emotional abuse
2. Neglect
3. Physical abuse
4. Presence or use of dangerous or illegal substance
5. Sexual abuse
6. Domestic and family violence

In case of Physical Abuse, there will always be physical indicators like injury, pain, bruises, fractures, laceration, burns, welts, etc. These are usually covered up by either the parent or the child himself either by using clothing or using excuses. If there are many bruises combined with emotional and behavioral indicators of abuse then it is considered as Physical Abuse. Behavioral and emotional indicators include:

1. Fear of forming bond, close contact or any kind of physical contact. Is especially wary or fearful of adults, his/her own parent or older people and is watchful or alert ad flinches or jumps at sudden movements. Example, when a doctor tries to put a reassuring hand onto the child's arm the child gets scared and backs a bit.
2. Shows either extreme aggression or withdrawal symptoms (either one) which looks out of the place. Is either hurtful, destructive, hyperactive and aggressive or is compliant, shy, passive and uncommunicative. Example, when someone asks a child what his/her name is child looks scared, looks like it is going to cry and does not answer and moves away.
3. Shows certain regressive behaviors like soiling of clothes or bed wetting which might be inappropriate for his/her age. Example, child who was strictly toilet trained and was completely doing well till age of 5, has suddenly started wetting his bed almost every night now according to his mother.
4. Has tendencies to run away, bunking classes, being inattentive in class or is always absent from the class. Example, When the child's teacher is contacted and asked about her, teacher tells that the child is always absent from the class and she keeps missing out on classroom activities.
5. Shows tendencies to lie, or act like a cornered animal, or is acting out, trouble regulating emotions, etc. Example, when you ask if the child has friends she lies about having many. And then when you ask her what she has done with them and ask for their names she becomes fidgety and angry.
6. Older children (mostly adolescents) show criminal activity, are rebellious, or delinquent, and/or may show symptoms of drug or substance abuse, etc. Example, child shows symptoms of delinquency like bullying weaker kids, bunking school, defacing of walls, etc.

Most of the physical abuse usually have physical signs, otherwise it is usually taken as neglect or emotional abuse. But still certain physical symptoms do not show up like if a parent slaps, or pinches, or twists a child's hand occasionally (not as corporal punishment, but with the intent to hurt). Since the parent does not do it with full force enough to leave a mark, physical signs may not appear. In such cases a closer look at the situation will help assess whether s/he is being physically abused. For example,

• wearing inappropriate or oversized clothes (sometimes not according to the climate)
• parents come up with excuses or evade topic when it comes to abuse
• parents call child as being useless, evil, etc. (anything in a negative way)
• child shows low self-esteem, and is scared and jumpy at slight movements
• child does not like going home and is scared of parents or shrinks away from parents
• parents are rigid and harsh about discipline and are seen as unforgiving or abusive when angry or the child is unable to meet their expectations.

Looking at these signs are enough to tell that a child is being abused at home even if there is a lack of physical evidence.