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Emotional Abuse

Emotional abuse is the cornerstone of all the abuses because emotional abuse is always present during physical child abuse, child neglect, and sexual child abuse, and it is the only abuse that can stand on its own. It does not have to accompany any of the other abuses. Emotional child abuse is defined as the constant attack of a child or youth by an adult that negatively affects the child or youth's self-worth. It is important to note here the word 'constant'. With emotional abuse, the child/youth receives only negative messages, nothing positive. There are six types of emotional abuse:

rejecting isolating ignoring corrupting exploiting terrorizing

Types of emotional abuse #1: Rejecting Putting down a child or youth's worth or putting down their needs.

constant criticism name-calling telling child he/she is ugly yelling or swearing at the child frequent belittling-use of labels such as "stupid", "idiot" constant demeaning jokes verbal humiliation constant teasing about child's body type and/or weight expressing regret the child wasn't born the opposite sex refusing hugs and loving gestures physical abandonment excluding child from family activities treating an adolescent like she/he is a child expelling child from family not allowing youth to make own reasonable choices

FACT: The most insidious of the types of emotional abuse comes under rejection. Victims report that the most damaging statements a caregiver can say to a child or youth are: "I wish you were never born" and "I wish you were dead". FACT: A U.S. study that randomly assigned rejection experiences to students found that rejection can dramatically reduce a person's IQ and their ability to reason while increasing their aggression (Baumeister, 20021).

Types of emotional abuse #2: Isolating Keeping a child away from family and friends.

leaving child in room unattended for long periods keeping child away from family not allowing child to have friends not permitting child interaction with other children keeping child away from other caregiver if separated rewarding child for withdrawing from social contact ensuring child looks and acts differently than peers isolating child in closet insisting on excessive studying and/or chores preventing youth participating in activities outside the home punishing youth for engaging in normal social experiences

FACT: Isolated emotional child abuse has had the lowest rate of substantiation of any of the types of emotional abuse (Kairys, 20022).

Types of emotional abuse #3: Ignoring Failing to give any response to or interact with a child or youth at all.

no response to infant's spontaneous social behaviours not accepting the child as an offspring denying required health care denying required dental care failure to engage child in day to day activities failure to protect child not paying attention to significant events in child's life lack of attention to schooling, etc. refusing to discuss youth's activities and interests planning activities/vacations without adolescent

Types of emotional abuse #4: Corrupting Encouraging a child or youth to do things that are illegal or harmful to themselves.

rewarding child for bullying and harassing behaviour teaching racism and ethnic biases encouraging violence in sporting activities inappropriate reinforcement of sexual activity rewarding child for lying and stealing rewarding child for substance abuse and sexual activity supplying child with drugs, alcohol and other illegal substances promoting illegal activities such as selling drugs teaching and promoting prostitution

Types of emotional abuse #5: Exploiting Giving a child or youth responsibilities that are far greater than a child/youth that age can handle. It is also using a child for profit.

infants expected not to cry anger when infant fails to meet a developmental stage child expected to be 'caregiver' to the parent young child expected to take care of younger siblings blaming child or youth for misbehaviour of siblings unreasonable responsibilities for jobs around the house expecting youth to support family financially encouraging participation in pornography sexually abusing child or youth requiring child or youth to participate in sexual exploitation

Types of emotional abuse #6: Terrorizing Causing a child or youth to be terrified by the constant use of threats and/or intimidating behaviour. This includes witnessing, which is when a child or youth observes violence, hears violence, or knows that violence is taking place in the home.

with infants and children, excessive teasing yelling and scaring unpredictable and extreme responses to child's behaviour extreme verbal threats raging, alternating with periods of artificial warmth

threatening abandonment beating family members in front of or in ear range of child threatening to destroy a favourite object threatening to harm a beloved pet forcing child to watch inhumane acts against animals inconsistent demands on the child displaying inconsistent emotions changing the 'rules of the game' threatening that the child is adopted and doesn't belong ridiculing youth in public threats to reveal intensely embarrassing traits to peers threatening to kick adolescent out of the house

FACT: Children and youth who witness family violence experience all six types of emotional abuse.

Emotional Abuse Signs:


withdrawn passive approval-seeking compliant frustrates easily infinite patience clinging to adults overly dependent stubborn tease excessively worry excessively somatic complaints

aggression temper tantrums fights with peers and siblings bullying tactics frustrates easily disobedience lying and cheating destructive behaviours impulsive behaviours argumentative loud tease excessively worry excessively withdrawn

Emotional child abuse is by definition "constant negative messages", but even a single message of rejection can have long-lasting negative effects on the child or youth. The effects of severe emotional abuse, however, may be more physiological than previously thought: FACT: Studies on abandoned and severely maltreated Romanian children revealed striking lesions in certain areas of the brain. The repeated traumatization led to an increased release of stress hormones, which attacked the sensitive tissue of the brain and destroyed newlyformed neurons. The areas of their brains responsible for the "management" of their emotions were 20% to 30% smaller than in other children of the same age. It would be logical to conclude that this damage can result in any child (not only Romanian) who suffers such abandonment and maltreatment (Dr. Alice Miller, Childhood Trauma, presented as a lecture to the YWHA, New York City, 19981).

Physical Effects

speech problems lags in physical development failure to thrive (especially in infants) facial tics eating disorders

inability to trust others depression inappropriate behaviour for age withdrawal profound sadness

habit disorders - sucking, biting, rocking aggression stealing lying self-harm prostitution engaging in risky behaviours attempts at or completed suicide

substance abuse (drugrehabhelp.org/ provides information and resources for drug and alcohol rehabilitation.) self-harm - burning, cutting attempts at or completed suicide

Behavioural Effects

low self-worth irritability overly reactive sleep disorders

Emotional Effects

inability to control emotions questioning of religious beliefs

Physical Abuse

The definition of physical child abuse is any physical force or action that results in or may result in a non-accidental injury of a child. Physical abuse may involve striking the child a single time or it may involve a pattern of occurrences. Physical abuse is usually connected to physical punishment or is confused with child discipline.

Signs of physical abuse #1: Bruising

Bruising is the most common of abuse injuries. There are four factors to take into account when determining whether or not the bruising is suspicious: location, size, colour and frequency. Location

Normal bruising can be found on the knees, shins, elbows, and the forehead. Toddlers are especially vulnerable to forehead bruising, as they frequently bump into furniture, counters, anything that is at their head level. But the size of the bruise(s), the colour, and the frequency in which bruising occurs can turn even normal bruising into suspicious bruising. Suspicious bruising can be found on the face, head, chest, back, arms, genitalia, thighs, back of the legs, and buttocks. Size The size of the bruise(s) can tell us what object or body part the child was struck and/or harmed with. See under Beatings and Choking for more details on size of bruising. Colour The colour of the bruise(s) can tell us how fresh the bruise is and the force with which the child was struck. With Caucasian people, a bruise takes on a red, purple, black or blue appearance when it first appears, depending on the force of the blow. As the bruise heals it will turn green, then become a jaundice yellow before fading away completely. Though it seems obvious, I'll say it anyway: these changes in colour will be difficult to see in darkskinned children. Just remember that bruising is only one sign; keep reading for other signs. Frequency The more frequent the bruising incidents occur, the more likelihood of physical child abuse. The child may have a legitimate reason for the bruising, but if there are too many incidences, then the red flags of suspicion should go up.

Signs of physical abuse #2: Beatings

The pattern of bruising and/or abrasions will resemble the shape of the object or body part used. The most common are belts, sticks, bats, bottles, and fists), but children are frequently attacked with firearms and knives. If a belt is used, there will be red welts that are the width of the belt. There may also be bruising, and/or bleeding. The length of the welt depends on how much of the belt came in contact with the skin. Typically, caregivers who use a belt will strike the buttocks, the back, and the backs of the legs. If a child is beaten with a fist, the shape of the bruise(s) can be that of a whole fist, or the bruising can show up as a cluster of lines (the imprint of the fingers of the fist). If the knuckles were used, bruising will be a line of roundish discolorations that are somewhere between the size of a dime and a quarter, depending on the size of the fist. Caregivers who use their fists generally give blows to the face, head, chest, stomach, and arms. Injuries are often to the face and head: black eyes, bloody and/or broken nose, fat and split lips, swelling of the eyes, cheeks or jaw, bruising and abrasions to the side of the head. Broken ribs and internal injuries can also result with severe blows to the chest and stomach.

Signs of physical abuse #3: Burning

Burning is the third most frequent cause of death in children from 1 - 14 years of age, and the fourth most frequent in children under one year of age (Feldman, 1987, p. 197 2). 70 90% of childhood burns occur in the home during the winter months, early morning and late afternoons being the most vulnerable times (Feldman, 1987, p. 198 3). There are several kinds of burns: chemical, cigarette, electrical, heat, and water burns. Each present their own unique signs of physical abuse. With chemical burns on the skin's surface, depending on the chemical used, there can be a rash, blistering, and/or open sores that are pussing and/or bleeding. When caustic substances such as lye or acid are thrown, they are typically aimed at the child's face. If a child is forced to ingest chemicals, there will likely be nausea, vomiting, cramping, chest and abdominal pain, distention, and possibly unconsciousness. Cigarette burns will be the size and shape of the cigarette tip. Typically, caregivers who burn children/youth with cigarettes do so on the backs of the arms, the buttocks, and the backs of the legs. Electrical burns appear as black marks at the site of the burn, and can extend beyond, depending on the electrical appliance used, and the volts of electricity the child is exposed to. Size and shape are also determined by these latter two factors. Heat burns such as that from a flame and/or flammable liquid can encompass any part of the body. If clothing is ignited, the whole body can be burned. Victims of this type of burning are often older children.

It is important to note here that not all water burns constitute signs of physical abuse. Accidental water burns generally appear as a splatter of splash burns. With non-accidental water burns, excessive splash marks will appear above the site of the primary impact, on body parts where accidental burning is unlikely. A child who is held under flowing hot water or immersed in scalding water will learn that the pain is lessened if they keep perfectly still. What results is what the medical profession calls the red sock or red glove. There will be a clear margin of bright red skin starting where the water line was and continue to all parts of the body that were immersed. Typically, the buttocks, legs, feet, and hands. Eventually, there will be peeling of skin layers.

Signs of physical abuse #4: Choking and Hanging

With these signs of physical abuse, a child who is choked will have bruising around the front and back of the neck that will resemble the fingers and thumb of the caregiver doing the choking. The bruising can also take the shape of a red band, depending on the pressure used, the length of time the pressure was exerted, and how much of the hand came in contact with the skin. If the caregiver is facing the child, the bruises at the front of the neck will be two thumb imprints, while the bruising at the back of the neck will be a tier of finger marks. This will be reversed (finger marks at the front, thumb marks at the back of the neck) if the caregiver is behind the child when doing the choking. Bruising and possibly 'rope burns' around the neck will be evident when a child is hanged. The bruising will take on the imprint of the rope or material used to hang the child. With these two signs of physical abuse, the child may be hoarse and/or have a cough, especially immediately and shortly after the choking or hanging incident. Damage to the larynx can occur in more severe cases. In extreme incidences', the neck may be broken.

Signs of physical abuse #5: Smothering and Drowning

During smothering, a child's breathing may be compromised, but other than this immediate effect, there may not be any noticeable physical abuse evidence. There can be bruising around the face, especially the nose and eyes, and upper chest area, depending on the item used to do the smothering, and the force exerted to asphyxiate the child. With drowning, there may be hand or finger bruising at the back or side of the neck, or at the shoulders where the child was held under water with force. The child's breathing may be jeopardized on a more long-term basis when these two signs of physical abuse are done regularly. If the child's breathing is raspy or the child has difficulty catching his/her breath, this may be a sign of smothering or drowning.

Signs of physical abuse #6: Poisoning

Poisoning may be difficult to detect because quantity is what determines the ill effects. Children can be poisoned with drugs, dish liquid, gas (i.e., combination of ammonia and bleach), and other noxious substances. A child who has been poisoned may suffer from nausea, vomiting, abdominal cramping, diarrhea, lethargy, sleepiness, light-headedness, dizziness, and, in more severe cases, unconsciousness. When noxious substances are forcefed to a child, depending on the substance, signs of physical abuse are: redness, chemical burns or bleeding in and around the mouth. If a child is forced to ingest dish liquid, the child will not be able to control his/her bowels, and a rash may be present around the mouth and lips.

Signs of physical abuse #7: Hair-pulling

Thinning hair and bald patches on the scalp may be present with severe hair-pulling. The child may experience headaches, and may also exhibit neck pain if the hair-pulling incidents are accompanied with jerking or snapping of the child's head.

Signs of physical abuse #8: Pushed from Heights

Bruising and broken bones are the most common abuse injuries when a child is pushed from heights. If a child is pushed down a flight of stairs, bruising may be present anywhere and everywhere on the child's body.

Signs of physical abuse #9: Shaken Baby Syndrome

Shaken Baby Syndrome (SBS) is the most common cause of infant mortality and accounts for the most long-term disability in infants and young children due to physical child abuse. It is frequently a single event and there may be no visible signs of injury. The most common trigger for SBS is inconsolable crying. Feeding problems and difficulties with toilet training are also common triggers. Though there is often no intent to harm the child, the resulting injuries of SBS may be severe. Depending on the force used and the length of time the child is violently shaken, the signs of physical abuse are:

retinal damage in one or both eyes that may result in blindness lethargy tremors vomiting irritibility siezures

coma death

Signs of physical abuse #10: Munchausen Syndrome by Proxy

Munchausen Syndrome by Proxy (MSBP), also known as ficticious disorder, is defined as "the deliberate production or feigning of physical or psychological signs or symptoms in another person who is under the individual's care, motivated by a psychological need to assume the sick role by proxy" (Barnett, Ola, et al., 1997, p. 44 9). Generally, the victim is under the age of five, and the perpetrator of the physical child abuse is most often the child's mother. Perpetrators may use the following to cause the victims' illness, resulting in a variety of signs of physical abuse:

administering laxatives, causing severe diarrhea and dehydration applying substances to the skin that cause burns or rashes altering lab test results withholding required medication or over/under medicating administering barbiturates, anti-depressants and/or poisonous substances contaminating the child's urine sample with blood, feces or other substances

Munchausen Syndrome by Proxy results in the child suffering from the caregiver's actions. The child is at risk for long-term psychological problems, physical illnesses, as well as death. Health care professionals unknowingly become accomplices when they provide unnecessary and potentially dangerous testing procedures and therapies. MSBP is very difficult to prove, in part, because this form of physical child abuse is so difficult to believe. Often, it is only suspected after a child is repeatedly admitted to hospital for treatment. The red flag for MSBP is when the child exhibits no symptoms or illness when the caregiver is away from the child for an extended period of time. Perpetrators of MSBP may be motivated by the support, sympathy and attention they receive from health care workers. Family and friends are often supportive of what seems to be a very loving, concerned and caring mother anxious to get help for a sick child. Some perpetrators have considerable experience and/or knowledge in health related areas and may enjoy working with health care staff (Barnett, Ola, et al., 1997, p. 44 10).

Abuse and Discipline: A Comparison Abuse Discipline

Demonstrates anger and hostility.

Demonstrates love and affection.

Make child listen.

Teach child right from wrong.

Teach child that decisions are at the whim of the caregiver.

Teach child to make healthy choices for him/herself and prepare child for eventual independence.

Caregiver has all the power; child is given no respect.

Based on a balance of power and mutual respect.

Involves humiliation.

Does not involve humiliation.

Requires submission.

Does not require submission.

Physical child abuse effects vary from child to child, depending on six factors: severity of the physical abuse frequency of the physical abuse age of the child when physical abuse began child's relationship to the abuser availability of support persons child's ability to cope

Severity of the physical abuse: How hard a child is struck is only one aspect of severity. The implement the child is struck with is also a factor. This does not mean that using an open hand or fist will result in fewer or lesser effects; the harm done to the child is measured both by physical injury and emotional injury. Frequency of the physical abuse: A single incident of physical abuse can result in severe trauma, but generally, the more often the physical abuse occurs the greater the impact on the child.

Age of the child when physical abuse began: The younger the child was at the onset of physical abuse, the greater the imprint, and thus, the greater the impact. This is particularly evident when the abuse continues throughout the child's life. Child's relationship to the abuser: When a child has a very close relationship with his/her abuser, the feelings of betrayal are that much greater; the very person who is supposed to protect is instead hurting that child. Availability of support persons: When a child has no one to turn to, increased feelings of abandonment occur, which in turn adds to the physical child abuse effects. Child's ability to cope: A child will find a way to cope with the abuse. The methods a child uses can add to the effects. Coping skills can be: Physical, such as raging or becoming the "comedian" or "class clown". While being "funny" is generally considered an attribute, there are children who use humour to cover up the fact that they are suffering. Emotional, such as the child refusing to try anything new for fear of failure, and therefore avoids receiving even more negative messages about themselves. Inward, where the child turns against him/herself, either physically (such as in selfharming in the form of cutting or burning) or emotionally (such as in self-blame). Outward, such as when the child acts out against someone else.

Children and youth suffer physical pain, trauma, and emotional scars when they are victims of child abuse. The physical child abuse effects also vary depending on the age of the child.

does not trust fearful of physical contact startles easily, cowers, cringes afraid when other children cry aggressiveness or withdrawn exaggerated politeness profound sadness difficulties in school difficulty concentrating lying stealing

low self-worth psychosomatic illnesses

does not trust developmental lags never cries or always cries extreme aggression or extreme passivity rage thrill-seeking behaviours manipulative

short attention span self-harm and/or harms others substance abuse failing in school, truancy runaway sets up negative reactions from others criminal behaviours inability to control emotions; physically lashes out attempted suicide

Child Neglect
Child neglect is defined as when a caregiver fails to provide those basic human needs that are necessary for a child/youth to grow into a healthy adult. Children need four specific behaviours from caring adults in order to develop into mature, healthy adults (Mosher, 19941):

Verbal communication skills A safe environment to explore both physically and socially Their needs met appropriately according to their developmental stage The verbal & non-verbal expression of positive feelings towards them.

Since neglect is chronic, neglected children and youth are constantly dealing with their needs not being met. Over time they begin to feel unworthy of attention and energy; acknowledging parental rejection and lack of care is more threatening to them than believing that they are the cause of their parents' unkind acts towards them (Gauthier, Stoaalk, Messe & Aronoff, 1996, p. 5492). Basic human needs are split into two categories: emotional needs and physical needs.

Emotional Needs:
Caring and Love Though it seems obvious, it's important enough to say anyway: A caregiver would show caring and love with hugs and kisses, compliments, spending time with the child. The child needs to feel important. A caregiver could very well love the child, but if the child doesn't feel loved, then neglect is probable.

Hugs and Kisses Hugs and kisses are included several times within these examples, because hugs and kisses encompass both the physical and emotional fundamentals of the basic human needs. Here it is listed as an emotional need; children feel loved when there is human contact. More about this under 'physical needs'.

Respect Most caregivers would agree that children should respect them and other adults. However, many caregivers fail to realize that respect is a two-way street, and that children learn to respect by being respected, not by being told to respect others. This is not to say that discipline can't enter the picture; firmness and decisiveness is an integral part of parenting. Respecting a child comes in the form of listening to a child, speaking to the child in a way that demonstrates respect for the emotional and physical well-being of the child. A child who is constantly put down, degraded, and/or otherwise left feeling as though they don't matter is a child suffering from neglect, a child not getting their basic human needs met.

Moral Guidance and Discipline Moral guidance is teaching a child right from wrong. Discipline is following through to ensure the child is learning the lesson. The abuse and discipline section of my Physical Child Abuse page offers details of what a caregiver is trying to achieve with discipline.

Time Together Time together means communicating and interacting with a child. With small children it can be getting down on the floor with the child and playing and talking with them. With youth, going out to watch the youth's soccer or football game(s), taking her/him to the mall for shopping, and having dinner with the family are three examples of communicating with adolescents.

Encouragement, Reassurance, Praise, Support and Attention A child needs to feel valued. Phrases such as "Well done!", "Good job!", etc. are clear examples of encouragement, praise, support, and attention. Reassurance is the act of making a child feel a sense of self-worth. This is particularly important when a child/youth makes mistakes. If the child is berated for these mistakes, his/her self-esteem is adversely affected. Low self-esteem is one of the signs of child neglect. Focusing on the positive instead of dwelling on the negative is a powerful way to ensure a healthy self-worth.

Listening Ears

Of the basic human needs, listening ears is as simple as it sounds: paying attention and hearing what a child has to say, without judgment.

Education An education falls under basic needs because a child must learn to read, write, add, subtract, multiply and divide in order to effectively contribute to society as an adult. An education is mandatory in North America. It is the responsibility of parents or caregivers to send their child to school--in Canada, kindergarten through grade 12--or to home school their child. It is the child/youth's responsibility to do homework.

Physical Needs:
Food Though there is room for what we call junk food in a child's diet, overall, food has to be nutritious and should follow basic nutritional guidelines: fruit, vegetables, proteins, grains and cereals. Adequate quantity of food is just as important as quality. Poor nutrition is one of the top signs of child neglect. With poverty, food is often the first of the basic human needs that is neglected. Does this mean there is neglect if proper nutrition is not provided when a family is stricken with poverty? If neglect by definition is a choice as identified earlier in this page, then the answer to this question must be a resounding 'no'. But the answer isn't as simple as that. And even if the answer is no, the child or children are not getting proper nutrition, regardless of the cause. For more discussion on the poverty issue, check out poverty and child neglect on this site.

Clothing Clothing must be clean and appropriate for the weather: warm coat and boots for winter, and adequate clothing to protect from other outdoor elements. This is one of the signs of child neglect that is most often noticed.

Shelter The criteria for appropriate shelter is that it be warm, dry, clean and safe. Housing can be an apartment, basement suite, house, or any lodgings that fit the above guidelines. Inappropriate housing is another of the most determinable signs of child neglect.

Safe Environment

A safe environment encompasses all aspects of safety in, around and outside of the home (like safe driving when in the car), and takes into account the age of the child or children. This not only means keeping the child safe from harsh outdoor elements, the removal of dangerous surroundings, and the incorporation of safety rules, it also includes ensuring that young children are not left unattended around hot stoves, ovens, furnaces, hot water, etc.

Supervision Supervision is generally not thought of when considering the basic human needs. It is often one of the signs of child neglect that is determined only after a child is injured in some way. For small children, supervision means not leaving them unattended. Supervision is required daily and during potentially dangerous activities such as swimming and driving. With adolescents, supervision means asking where the youth is going, who he/she is going with, what time he/she will be back, and imposing curfews. Again, I'm stating the obvious when I say a caregiver needs to know where their children or youth are at all times, otherwise child neglect is present.

Good Hygiene Good hygiene is as simple as making sure the child is bathed regularly and that their hair is clean. In terms of signs of child neglect, your sense of smell is the best indicator here.

Medical and Dental Care Medical care means getting a child to the doctor in a timely manner when the child is not feeling well, the child is in pain, has a fever, and/or the child is vomiting. Dental care requires that a caregiver provide a toothbrush, toothpaste and dental floss for the child to keep their teeth clean. If a child has a toothache, the caregiver must get him/her in to see a dentist. Rotting teeth, coupled with ongoing bad breath is one of the signs of child neglect. NOTE: Braces or other orthodontal work are not considered basic human needs.

Physical Touch: Hugs and Kisses Here we are with hugs and kisses listed again, this time as a physical need. The act of touching is a primary need for children, for human beings in general. This primary need was tragically demonstrated during war time when orphaned babies, too many for the scant reserve of nursing staff to hold, rock or even touch, except for occasional diaper changes, died as a result of lack of human contact.

Adequate Rest

Adequate rest is paramount for children and youth to function properly. This is not just curfews for youth, but with a small child it means she/he needs to be in bed early to ensure the child gets enough sleep. Also, a mattress, clean sheets and an appropriately warm blanket are necessary to provide a setting for the child to get adequate rest. If a child is constantly too tired to perform day to day activities, or if the child is frequently dozing off, these may be signs of child neglect.

Exercise and Fresh Air Exercise and fresh air are two of the basic human needs that Canadian schools have taken into account with our mandated physical education program. While there is no predetermined number of hours set as the minimum required, experts advise that children should receive at least 3 hours of exercise per week, and 1 hour of fresh air daily. FACT: [Research into common characteristics shared by neglectful parents show that] many neglecting mothers possessed a limited capacity to meet their child's needs because, as children, they experienced childhood neglect (Polansky et al., 1985 1).

Possible Signs of Child Neglect

Physical, Psychological and Behavioural Signs:

in infants, failure to thrive difficulty concentrating difficulty learning low self-esteem withdrawal depression frequent absences from school poor health body odour always dirty and severely unkempt rotting teeth and chronic bad breath sleepiness/always tired child unusually small for his/her age child is very thin and always hungry child is rifling through garbage for food child is stealing food and/or lunch money from others

PLEASE NOTE: Some of the above signs of child neglect are clearly due to some type of

neglect. Other signs must be taken in combinations, and may also be signs of other forms of abuse. The purpose of including this list here is to raise the red flags of child neglect. As with all other forms of abuse, if you suspect that abuse is taking place, report it to the appropriate authorities. The effects of child neglect are not limited to the children in the neglectful families. Research is now showing that effects last well into adulthood. And not just emotionally, but physically as well.

Some Child Neglect Facts

Many neglected children feel unworthy to interact with peers, may isolate themselves and may encounter peer rejection (Lowenthal, 1996, p. 221). Among the different groups of maltreated students, child neglect was associated with the poorest academic achievement (Lowenthal, 1996, p. 222). More children die from neglect than from abuse (Mosher, 19943). Child neglect was a significant factor in 74 of 100 deaths of children in Ontario from January, 1994 to December, 1995 (Gadd, 1997, A24). The significance of child neglect should come as no surprise, given that a lack of parental care and nurturance--hallmarks of child neglect--poses one of the greatest threats to children's healthy growth and well-being (Rutter & Stroufe, 20005; Sameroff, 20006). Poverty and child neglect are related, but poverty does not cause neglect. Although poverty does not cause neglect, poverty permeates neglecting families. What is the difference between poverty and neglect? Poverty is when the caregiver does not have the resources to provide the need. Neglect is when the caregiver has the resources, but chooses not to provide the need. Therefore, neglect is a choice.

Sexual Abuse
Sexual abuse of children and youth is shrouded in secrecy, guilt and fear. Offenders use intimidation and threats to keep the child from telling, but the number one reason children and youth don't tell is that they are afraid they won't be believed. Though there is widespread under-reporting of child molestation by both male and female victims, males are much less likely to disclose. The definition of sexual abuse with children is when an older child, a youth or an adult uses a child or youth for his or her own sexual gratification. This includes incest. Incest with

children is when the child is sexually violated by a parent, parent figure, older sibling, other relative, or other significant person in the child's family life.

Definition of Sexual Abuse: Non-Contact

forced to watch sexual acts forced to listen to sexual talk, including comments, tapes, and obscene phone calls sexually explicit material such as videos, DVDs, magazines, photographs, etc.; can be in-person, on the computer via e-mails, and otherwise through the Internet forced to look at sexual parts of the body--includes buttocks, anus, genital area (vulva, vagina, penis, scrotum), breasts, and mouth sexually intrusive questions or comments; can be verbal, on the computer, or in notes

Definition of Sexual Abuse: Contact

being touched and fondled in sexual areas, including kissing forcing a child or youth to touch another person's sexual areas forced oral sex--oral sex is when the mouth comes in contact with the penis, the vagina or the anus; many children believe that oral sex is "talking dirty" forced intercourse--can be vaginally, anally or orally; penetration must occur; penetration can be with body parts and/or objects (the most common body parts used are the fingers, tongue and penis)

Sexual Abuse Signs: Physical signs:

physical trauma such as redness, rashes, and/or bleeding to oral, genital and/or anal areas bruises on breasts, buttocks, lower abdomen, thighs, genital and/or rectal areas complaints of pain or itching in genital or anal areas difficulty walking or sitting unusual or offensive body odours

difficulty in bladder or bowel control constipation pain or discomfort on urination blood in urine abnormal dilation of vaginal or rectal openings foreign bodies in vaginal, rectal or urethral openings sexually transmitted diseases found vaginally, rectally or orally yeast or bacterial infections frequent sore throats; difficulty swallowing; choking ear infections/problems (see Ear infections as a sign of sexual abuse? at Ask Darlene on this site for the reason why this can be a sign) sudden weight gain or extreme weight loss severe psychosomatic complaints such as stomachaches and headaches

Behavioural signs:
sexualized behaviour that is inappropriate for the child's age promiscuous behaviour see also emotional abuse signs on this site for a comprehensive list. Sexual abuse effects on children and youth can be evident in emotional, physical and behavioural ways. These effects can be just as devastating whether there was only one occurrence or there were repeated occurrences. Sexual abuse cannot be compared, because each abuse experience is unique.

Vulnerability Factors:
Children are vulnerable to sexual abuse because of their age, size and innocence. When a child or youth is molested, she/he learns that adults cannot be trusted for care and protection: well-being is disregarded, and there is a lack of support and protection. These lead to grief, depression, extreme dependency, inability to judge trustworthiness in others, mistrust, anger and hostility. And as if all that isn't enough, children's bodies often respond to the sexual abuse, bringing on shame and guilt.

Points to consider: Children/youth are unable to protect themselves and stop the abuse. Children/youth are susceptible to force. Children/youth are susceptible to the use of trickery by offenders. Often times, children/youth have no control over their own bodies. All too often, children/youth are unable to make others believe them.

The above factors lead to: anxiety fear shame a sense of inadequacy the need to control situations and others a perception of self as victim identification with the aggressor

Factors That Influence Sexual Abuse Effects

Miraculously, not all children or youth molestation victims display signs that something is wrong. FACT: Between 21% and 36% of sexually abused children will display few or no symptoms (Oates, O'Toole, Lynch, Stern & Cooney, 19941). Why do some victims display a multitude of emotional and behavioural effects, while others display few or none? In spite of few or no outward symptoms, child and youth victims do suffer emotionally. These emotional effects come in varying degrees, depending on the following six factors: The nature of the relationship between the victim and the offender: the closer the emotional relationship, the greater the emotional trauma. The age of the child when the abuse began and the duration of the sexual relationship: an ongoing sexual relationship with repeated contacts is generally more traumatic and usually produces more sexual abuse effects than a single contact. The type of sexual activity the victim is exposed to: sexual acts involving strictly non-contact sexual abuse appears less traumatic than sexual acts that involve contact. It is important to note, however, that trauma and the sexual abuse effects are still very real when any type of sexual abuse occurs. For an excellent discussion written by Colette Dowling, M.S.W. about sexual abuse in school girls, check out www.womens-wellbeing-and-mental-health.com. Colette is an

internationally renown lecturer and author of eight books, including her best-seller The Cinderella Complex, which has been in print for 25 years. The degree of physical aggression directed at the victim: violence adds to the trauma of the abuse. Being physically abused, having a mother who is mentally ill, not having someone to confide in, and being socially isolated are significant predictors for childhood sexual abuse (Fleming, Mullen & Bammer, 1997 2). The response the victim receives when she/he discloses the abuse: healing is apparent when a disclosure is met with compassion and is followed with effective intervention; if the victim is met with skepticism and accusations, anger, or no response at all when she/he discloses, the sexual abuse effects are compounded. The availability of a supportive person in the victim's life: a caring, loving, nurturing, and listening person in the victim's life lessens the trauma; a lack of a supportive person intensifies the abuse and leaves the victim feeling even more lonely, helpless, and unworthy.

Emotional and Physical Sexual Abuse Effects:

Molested children suffer many losses, including: self-esteem and self-worth trust childhood, including the opportunity to play and learn the opportunity for normal growth and development intimacy control over his/her body normal loving and nurturing safety and security

Behavioural Sexual Abuse Effects:

nightmares, phobias, and regressive behaviours such as thumb-sucking and bedwetting

learning problems clinging and smothering insecurity, which put the child at risk for further abuse and exploitation psychosomatic complaints such as stomachaches and headaches precocious sexual activity--a young child knows more than they should about sexual activity; child may exhibit seductive behaviour FACT: 17% of abused children exhibit age inappropriate sexual behaviour (Trocme & Wolfe, 2001, p.283). FACT: Of the sexual abuse effects exhibited, sexualized behaviour is the most consistent indicator of sexual abuse (Cavanagh Johnson et. al., 1995, pp.50-514). with young children, a preoccupation with sexual organs of self, parents and others-often this shows itself in language and art aggression and bullying behaviours FACT: 14% of abused children exhibit behaviour problems (Trocme & Wolfe, 2001, p.28 5). sudden changes in eating and/or sleeping habits depression and anxiety FACT: 29% of abuse children exhibit depression or anxiety (Trocme & Wolfe, 2001, p.286). refusal to change clothes in front of others isolation obsessively good behaviour obsessed with cleanliness relationship problems FACT: 13% of abused children exhibit negative peer involvement (Trocme & Wolfe, 2001, p.287). anti-social behaviour unwillingness to participate in social activities

running away FACT: 85% of runaways in Toronto have been sexually abused(Conference on Child Victimization & Child Offending, 20008). truancy / long absence from school FACT: 10% of abused children have irregular school attendance (Trocme & Wolfe, 2001, p.289). long absence from participation in extracurricular activities dissociation--a child's existence is dependent on his/her ability to separate from the pain, which, in the most repulsive cases, may result in multiple personalities risky behaviours such as firestarting, stealing and other delinquencies animal cruelty alcohol and drug abuse FACT: According to the Conference on Child Victimization & Child Offending (2000 10), sexual abuse effects on children with a history of molestation reflect that they are seven times more likely to become drug/alcohol dependent FACT: In a sexual abuse effects study of 938 adolescents admitted to residential, therapeutic communities for the treatment of substance abuse and related disorders, 64% of the girls and 24% of the boys reported histories of sexual abuse (Hawke, Jainchill, & DeLeon, 2000, pp.35-4711). dysfunctional relationships avoiding confrontation self-harm, including cutting and burning paranoid behaviour FACT: Post Traumatic Stress Disorder (PTSD) is one of the sexual abuse effects that plague sexually abused children and adult survivors of child abuse. Symptoms experienced are similar to those experienced by Vietnam veterans and may include sleep disturbances, anxiety and depression, which negatively impact on their daily psychosocial functioning and for which many seek professional help (Wiehe, 1998, p.5012). preoccupation with sex promiscuous behaviour compulsive and aggressive sexual behaviours

self-destructive sexual behaviour and prostitution in adulthood, sexual dysfunction--avoidance of or phobic reactions to sexual intimacy becomes the abuser FACT: Studies done by Haywood, Kravitz, Wasyliw, Goldberg and Cavanaugh in 1996 reflect some disturbing sexual abuse effects. The study found that the odds of becoming a child molester were 5.43 times greater for adult male victims of childhood sexual abuse than for adult male non-victims (Lee, Jackson, Pattison, & Ward, 2002, p.8814). attempted and completed suicide FACT: Children with a history of sexual molestation are ten times more likely to attempt suicide (Conference on Child Victimization & Child Offending, 2000 15). Sexual abuse effects on the child or youth are connected to the child/youth's life before, during and after the sexual contact. We must understand that the effects apply every bit as much to the disclosure and intervention as it does to the abuse itself. Sexual abuse effects continue long after the abuse stops.

Why Children Don't Tell

Sexual abuse is shrouded in secrecy. Child and adolescent sexual abuse victims are encouraged to keep the abuse secret because: Children fear reprisals from the offender. Offenders tell the child that no one will believe them; and that even if someone does believe, the child will be blamed for the abuse. Offenders openly threaten the safety of the child and/or members of the child's family. Offenders tell the child the perpetrator will get into trouble if anyone discloses the sexual abuse. This is particularly fearsome for the child when the perpetrator is a family member, because the child fears abandonment. Offenders promise gifts and rewards and offer bribes for the child to keep the secret. With young children, this can be candy, toys, trips to McDonald's. With youth, it can be videos, DVDs, rides in a car, sports tickets, sports equipment, clothes, makeup, jewellery, money, anything that is valued by the youth.

How Victims Adapt:

The longer the secret continues, the more trapped in

the abuse the child or youth sexual abuse victims become. Survival means learning to adapt to the abuse in a variety of ways:

sexual abuse victims minimize the abuse by pretending that whatever is happening is not really bad--this can take the form of a tough sense of humour they rationalize the abuse by explaining it away--they blame the abuse on the offender's drinking, drug use, etc.; they develop a twisted sense of love, telling themselves the offender is showing them love

they deny that the abuse ever took place

FACT: When children's self reports of sexual abuse were compared to video tapes of the incident on film apprehended from the perpetrator, it was found that child sexual abuse victims have a tendency to deny or belittle the experience (Sjoberg & Lindbland, 2002, pp.312-3141).

sexual abuse victims forget that the abuse ever took place, which is one of the most common and effective ways children deal with abuse they label themselves--sexual abuse victims believe they deserve the abuse and that it's their fault. Nothing can be further from the truth! they become controlling--sexual abuse victims try to control themselves and others; they become super-alert and eager to please Though these coping skills are self-destruction, they are highly effective: they help numb the pain and get the child or youth through each day.

Why Males Don't Disclose

A cultural bias maintains that males cannot be victims. Males are expected to be confident, knowledgeable, and aggressive. To be a victim means one is an inadequate male. If the boy's body has responded sexually, he feels he is somehow responsible for the sexual abuse. Male victims of sexual abuse struggle with issues of homosexuality as most offenders are male. Their homophobia plus their confusion and fear encourage silence. Not to mention the social stigma attached to homosexuality. If a boy receives money for sex, he is less likely to be perceived as a victim.

If a boy has a homosexual orientation, he is often blamed for the "seduction" of the older male, instead of being acknowledged as a legitimate victim of sexual abuse. Molestation by an older female is often viewed positively as a kind of "initiation rite" into manhood. Cultural pressure encourages participation while denying feelings. Male victims of sexual abuse, more than female victims, may fear loss of freedom and independence if the sexual abuse should be made public. Fear of reprisals from the offender plays a role in under-reporting. When boys are victimized, they tend to be blamed more for their abuse and are viewed as less in need of care and support. Boys fear negative judgment by family and friends. Embarrassment and/or confusion prevent male victims of sexual abuse from disclosing.

In one study of 30 male victims of sexual abuse, the average age at the first time of abuse was 8 years, 4 months (Dorais, 2002, p. 1848).

Societal Biases of Female Victims of Sexual Abuse

If a female has a crush on the male who sexually assaults her, she may be blamed for seducing him, rather than the blame being placed where it belongs: on the offender. As with boys, if the girl's body has responded sexually, she feels she is somehow responsible for the sexual abuse. If the girl doesn't fight her abuser, she may be viewed as "liking it". FACT: Female victims of sexual abuse often don't give struggle. Girls are still taught to be "nice" and many won't fight off an offender because of this perception. If a girl believes her abuser will become more violent if she fights, then often times, she will submit. If she does submit, cultural biases tend to put the blame on her as a willing participant. If the girl is promiscuous, she is often blamed for her sexualized behaviour, rather than seen as a legitimate victim of sexual abuse. FACT: Promiscuity is one of many signs of sexual abuse, as well as one of many effects of sexual abuse.

If a girl dresses in a provocative way, she may be seen as "asking for it". If a girl receives money for sex, she is less likely to be perceived as a victim. If a girl is well endowed, if she is voluptuous, if her body looks more mature than her years, or if she acts more mature than her years, society may see her as "looking older than she is" or "acting older than she is" and excuse the offender's behaviour, rather than recognize the girl has been sexually abused. Regardless of how a child or adolescent responds to sexual advances, sexual abuse is NEVER the child's fault. Blame lies ENTIRELY with the offender. Words From Sexual Offenders I am probably well-known and liked by you and your child. I can be a man or woman, married or single. I can be a child, adolescent, or adult. I can be of any race, hold any religious belief, and have any sexual preference. I can be a parent, step-parent, relative, family friend, teacher, clergyman, baby-sitter, or anyone who comes in contact with children. I am likely to be a stable, employed, respected member of the community. My education and my intelligence don't prevent me from molesting your child. I can be anybody

Male Offenders There are 3 categories of sex offenders: fixated offenders regressed offenders child rapist The fixated offender has a primary sexual orientation towards children, especially male children; these sex offenders have commonly been called pedophiles. The typical

pedophile is attracted to children both physically and emotionally. These offenders get a sense of power, control and omnipotence in their relationships with children. The regressed offender is a non-pedophile molester. These male sex offenders are men who have achieved normal adult heterosexual functioning but who, in a time of crisis and stress, may seek out sexual activity with children and youth, in particular female children. They are not as compulsive or as demanding as pedophiles, but as incest offenders they may persist in having sexual activity with their children from an early age into adolescence (Wiehe, 1998, p. 652). The child rapist uses violence and assault to involve children. This group of sex offenders is categorized as the angry rapist, the power rapist or the sadistic rapist (The Family Violence Project, 1990, p. 1.333). It is important to note that not all child molesters are driven by a sexual attraction to children (Lanning, 1992, p. 34). It is also important to note that many sex offenders have characteristics of both the fixated and regressed offender. FACT: The majority of sex offenders have multiple paraphilias Female Offenders

Why Abusive Behaviour by Female Offenders Goes Unreported Children are reluctant to report the person they depend on. Inappropriate sexual behaviour is often masked in bathing, dressing or comforting the victim. When boys are the targets of female offenders, they are less likely to disclose. There is denial of the existence of sexuality in females. Females who sexually abuse undermines feelings about how women should relate to children. People find it difficult to understand how women could sexually abuse. Children and adolescents who disclose sexual abuse by female offenders are often told they are fantasizing.

When the victim is a male adolescent, often times the sexual abuse goes unreported because of the perception that sex with an older female is a "right of passage". But victimization by female sex offenders can have results as devastating as victimization by male sex offenders, including: self-blame low self-esteem problems in sexual functioning: avoidance of sex sexual compulsivity substance abuse

Profile of Female Sex Offenders:

low self-esteem history of severe emotional and verbal abuse absence of parent during childhood sexual (especially incest) victimization of the woman as a girl loss of spouse responsibility for supporting family feelings of isolation and alienation history of indiscriminate or compulsive sexual activity history of drug or alcohol abuse