Prevalence Facts and Figures (NSPCC)
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1 in 14 children have been physically abused (Source: Radford, L. et al (2011) Child abuse and neglect in the UK today) |
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Disabled children are over 3 times more likely to be abused than non-disabled children (Source: Jones, L. et al (2012) Prevalence and risk of violence against children with disabilities: a systematic review and meta-analysis of observational studies.) |
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Over 6,000 children were identified as needing protection from physical abuse last year (Source: Child protection register and plan statistics for all UK nations for 2016.) |
Consequences of Child Physical Abuse
Risk assessment requires the assessor to identify, specifically, the likelihood of potential harm occurring but also the nature and degree of the harm should it occur. Therefore it is insufficient for an assessment to identify "Physical Abuse" as the risk question, the assessor needs to articulate what form of physical abuse: what does it look like and what are the likely consequences for the child in question should the abusive acts occur.
Physically abused children experience injuries and pain of varying severity and intensity. Consequent problems include
Greater neonatal problems and failure to thrive,
More early developmental delays,
Neurological soft signs: Soft signs refer to subtle abnormalities in sensory-perceptual, motor, or other central nervous system functions. They are findings that are pathological at any age, but more subtle manifestations of hard signs (or behaviors that are abnormal because they persist beyond a normal age). Neurological Soft Signs include clumsiness, motor incoordination, motor overflow, difficulty with motor sequencing or rapid successive movements, right-left confusion.
Serious physical injuries, skin markings and scars.
*The neurobiological cosequences of physical abuse are now quite well documented indincating compromised brain and central nervous system development.
Exposure to severe physical abuse cancause cognitive or intellectiual deficits. Research on these outcomes is soemwhat varied but there is sufficient research to indicate these abuse related deficits may manifest as:
Reduced task initiation and motivation
Limited intellectual functioning
Language deficits in both receptive and expressive areas
Problems with academic performance may include:
low attainment in both maths and reading tests
School discipline problems resulting in exclusions
Disruption to school attendance
Certain perceptins or attributions related to the experience of physical violence have been reported by child victims of physical abuse. Physically abused children are
More willing to use physical punishment
More likely to assimilate aggressive stimuli
More often attribute hostile intent to their peers' behaviour
More recently research has identified that abuse-specific attributions were predicitve of the level of psychopathology experienced by child victims of physical abuse, beyond the variance of the severity of the parent -child violence that was experienced:
Self orientated attributions (i.e. self blame) were associted with internalised symptoms;
Other oriented attributions (i.e. perceiving the world as a dangerous place) were associated with externalising symptoms.
In general physically abused children have been found to experience in various social - cognitive skills:
Greater problems with perspective taking
Generating fewer alternative solutions to hypothesised social problems and repeating or prolonging negative solutions after a problem has passed.
Difficulties in understanding appropriate responses to interpersonal situations.
Some children that have been physically abused have been characterised by heightened attributions of hostile intent and limited self esteem.
One of the most extensively documented clinical consequences in child physical abuse victims is heightened aggression and related externalising behaviours, including:
Poor anger modulation
Increased rule violations
Oppositionalism
Delinquency
Property offences and criminal arrests
Drinking, drug use and cigarette smoking
Anti-social behaviour
As with reports describing the primary role of changes in affective regulation following trauma, studies have found the presence of negative affect in younger and older abused children.
Higher levels of internalising symptoms have been found among abuseed preschoolers and adolescents. Limited affective expressiveness may be attributed to underlying deficits in cognitive-perceptual (information processing) skills.
There is some evidence for an association between child physical abuse and suicidality e.g. increased suicidal ideation and behaviour.
One of the primary consequences associated with a history of child physical abuse is Post Traumatic Stress Disorder.
Child physical abuse is also associated with several other diagnoses:
MAjor depression
Conduct disorder
Oppositional Defiant Disorder
Agoraphobia
Overanxious disorder and Generalised Anxiety Disorder (GAD)
Higher rates of depression and conduct disorder have been found inb physically abused adolescents and a history of maltreatment is also associated with borderline personality disorder (BPD), attention deficit hyperactivity disorder, and oppositional disorder.
Physical abuse has been found to contribute to the prediction of current diagnoses of several disorders:
Unipolar depression;
Disruptive disorders;
Cigarette smoking ;
As well as other lifetimne disorders and problems such as druga abuse and conduct disorder
Attachment:Disturbance in the formation of stable attachments are important due to their associations with with childhood adjustment, individuation, sense of personal competence, and the ability to regulate affect (mood).
Maltreated children have been found to experience insecure attachments (demonstarted by avoidance and resitance) and separation problems . There is also some longitudinal evidence suggesting childhood maltreatment is associated with insecure / disorientated attachment.
Peer Relationships:
Abused children have been found to exhibit less friendly or positive peer interactions.
Engage in less parrallel or group play.
Initiate and receive fewer positive peer interactions.
Older child victims have been described as showing limited social competence.
Difficulty making friends.
Socially withdrawn
In studies have been found to be rated as more often disliked and unpoular than controls.
In adolescents a history of physical abuse has been associated with greater social competence deficits and hightened coercion in dating relationships.
Child Physical Abuse
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.
(Definition provided by Working Together)
Conceptualisation and Models of Child Physical Abuse
Most contemporary models of child physical abuse emphasise the interplay between individual(e.g.psychological states), family-interactional (e.g. use of hostile and aggressive behaviours), and social- system variables (e.g. availability of resources and the presence of stress). There is a large body of literature that suggests that physically abusive behaviour represents an exaggerated aggressive or hostile response that occurs within a continuum of parenting practices and the abusive behaviour must be interpreted in its family-social context. (Kolko, David; "Child Physical Abuse in "Tha APSAC Handbook on Child Maltreatment 2nd Ed ; SAGE 2002)
Summary
The aetiology of child physical abuse, like other forms of abuse and neglect is complex.The broad characteristics of abusive families demonstrate the need to evaluate risk of harm in terms of parenting, parent-child relationships and the historic experiences of parents and children as individuals and as a family along with environmental conditions that contribute to or mitigate physically abusive parenting.