Suspicion of child abuse

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What is it about ?

The term child abuse applies to all minors, i.e. children and adolescents aged 0 to 18 inclusive.

We speak of child abuse for all interactions based on the threat or violence towards a minor and which can (seriously) harm their normal development. The (potential) damage can be physical, mental or emotional.

Child abuse can manifest itself in different ways.

Physical abuse

It is the intentional use of physical force towards a child, which can be detrimental to their health, survival, dignity or development. Some examples: slapping, hitting, biting, shaking, strangling, burning, poisoning or suffocating. Physical violence against children is aimed at punishing them.

Sexual abuse

It is the involvement of a child in sexual activities that the child cannot conceive or understand, and to which he cannot consent appropriately. It is often a question of an unbalanced balance of power. A child can therefore be abused by an adult, but also by another child who, by virtue of his age or stage of development, has a position of responsibility, power or trust towards his victim.

Emotional or psychic abuse.

It is about a series of isolated incidents or repetitive failures of the adult to offer the child an adapted environment, which guarantees his safety and which provides him the psychic support which he needs. The emotionally negligent person may demean, reprimand, threaten, scare, discriminate, mock, and exhibit other non-physical forms of hostility or rejection.

Negligence

It is the inability of the parent and / or caregiver for the child to create a safe environment in which all of the child’s needs are met. Neglect can affect health, training, emotional development, nutrition, shelter and safe living conditions. Parents of neglected children are not all ‘poor’ by definition.

How to recognize it?

Child abuse can be suspected in some situations, but it can be very difficult to detect the signals. The symptoms are sometimes very subtle, especially in cases of emotional abuse, where awareness of the problem comes late. We cite a few examples. As these are suspicions, the greatest caution and the greatest discretion are required in this matter.

  • Physical lesions without a valid explanation: lesions in the form of hands, bites, burns in odd places (eg cigarette burns) or fracture (s) in a child who is not yet walking.
  • An unusually long time between the appearance of a lesion and seeing a doctor, for example a cut presented after only several days.
  • A sudden change in behavior.
  • Dissociative behavior, that is, the child suddenly cuts himself off from the world around him and literally lives on autopilot, without being aware of reality.
  • A child who takes on responsibilities at home that prevent him from carrying out his own activities (he no longer goes to school for example).
  • Self-harm.
  • Taking medication, such as sleeping pills, without a medical prescription.
  • Frequent and unjustified absences from school, but known to parents.
  • Lack of adequate supervision by parents or guardian, revealed by an injury or wound.
  • Repeated runaways.
  • A prepubescent child who commits sexual abuse or has overactive sexuality.
  • A young child with a sexually transmitted infection.
  • Pregnancy in a young girl aged 13 to 17, possibly as a result of unwanted sexual activity by the young mother or abuse by a trusted person.
  • A young child with genital or anal lesions.
  • Toxic interactions between the child and the parents.
  • Situations in which it appears that the parent does not feel responsible for the child.
  • A child who always wears dirty clothes.
  • A long-lasting infection with scabies or lice.

What can you do ?

If you are thinking of a case of child abuse, you can always go to a general practitioner to share your concerns and questions without putting yourself in danger and without being judged. If necessary, the general practitioner will direct you to the appropriate institutions or people.

If you feel the need to speak to a complete stranger, with the greatest respect for your anonymity, you can for example contact SOS-Enfants (by email [email protected] or call 02/542 14 10). There are various initiatives to lift the taboo on the subject of child abuse.

What can your doctor do?

The doctor (general practitioner) is trained in the early detection of risky situations. Warning signals can come from strange lesions noticed during a consultation or observation of the child’s behavior. If the doctor considers it justified, he can make a report to the trust center for abused children (SOS-Enfants). The SOS children team will start a survey to assess the child’s environment. Parents and children should be able to talk about the topic. The absolute condition is that the discussion is supervised by experts and that the safety of the child is guaranteed.

Finally, you can take action and go to the Youth Court. There are specific reference centers for child abuse. PMS centers (psycho-medico-social centers) can also play a major role in the detection and monitoring of cases of child abuse. You can always push their door.

Your doctor can document and note the injuries in a chart. This type of finding can be important if the case ends up in court.

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Source

Belgian practice guide ‘Child abuse’ (2014) – SSMG – Scientific Society of General Medicine