Child Abuse

DEFINITION OF A CHILD • •

A person who is 18 years old or younger. A person who is above 18 but can not take care of himself due to certain circumstance.

THE RIGHTS OF EVERY FILIPINO CHILD It is my right: 1. 2. 3. 4. 5. 6. 7.

To be born. To have a name and nationality. To be free. To have a family who will take care of me. To have a good education. To develop my potentials. To have enough food, shelter, a healthy and active body. To be given the opportunity for play and leisure. To be given protection against abuse, danger and violence brought by war and conflict. 8. To live in a peaceful community. 9. To be defended and assisted by the government. 10. To be able to express my own views. THE CHILD ABUSE "Child abuse" refers to the maltreatment, whether habitual or not, of the child which includes any of the following: (1) Psychological and physical abuse, neglect, cruelty, sexual abuse and emotional maltreatment; (2) Any act by deeds or words which debases, degrades or demeans the intrinsic worth and dignity of achild as a human being; (3) Unreasonable deprivation of his basic needs for survival, such as food and shelter; or (4) Failure to immediately give medical treatment to an injured child resulting in serious impairment of his growth and development or in his permanent incapacity or death. DEFINITION IN PHILIPPINE LAW The Special Protection of Children Against Child Abuse, Exploitation and Discrimination Act or Republic Act 7610 (Art.1 Sec. 3) defines child abuse as maltreatment, whether habitual or not. •

A person who is below 18 years old or those over but are unable to fully take care of themselves from abuse, neglect, cruelty, exploitation or discrimination because of physical or mental disability or condition.

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By a person who is responsible for the child's welfare. Under circumstances which gravely threaten or endanger the survival and normal development of children.

Child Abuse Forms Child Abuse through: Physical Abuse is characterized by physical injury (e.g. bruises and fractures) resulting from punching, beating, kicking, biting, or otherwise harming a child. The injury may have resulted from overdiscipline or physical punishment that is inappropriate to the child's age or condition. The injury may be the results from over discipline or physical punishment that is inappropriate to the child's age or condition. An injury resulting from physical punishment that requires medical treatment is considered outside the realm of normal disciplinary measures. Neglect Child neglect is characterized by failure to provide for the child's basic needs. Neglect can be physical, educational or emotional. Physical Neglect includes refusal of or delay in seeking health care, abandonment, inadequate supervision and expulsion from home or refusing to allow a runaway to return home. Educational Neglect failure to enroll a child of mandatory school age and inattention to a special educational need. Emotional Neglect includes such action as chronic or extreme spouse abuse in the child's presence, permission of drug abuse or alcohol use by the child and refusal or failure to provide needed psychological care. Sexual Abuse includes wide range of behavior; fondling of a child's genitals, intercourse, rape, sodomy, exhibitionism and commercial exploitation through prostitution or the production of pornographic materials. Sexual Exploitation Children whether male or female, who for money, profit or any other consideration or due to the coercion or influence of any adult, syndicate or group, indulge in sexual intercourse or lascivious conduct, are deemed to be children exploited in prostitution and other sexual abuse. Emotional abuse includes acts or omissions by the parents or other persons responsible for the child's care and caused or could cause serious behavioral, cognitive, emotional or mental disorder. It is the most difficult form of child maltreatment. Child trafficking The act of trading or dealing with children, including but not limited to, the buying and selling children for money, or for any other consideration, or barter. Child Labor The employment of children below 15 years of age who force, suffer to work for money or any other consideration. The condition of employment endangers the life, safety, health and normal development of the

child. Abandoned The failure to provide for the care and support of a child for at least six (6) continuous months for no valid reason shall be presumed as an intent to abandon the child unless said failure is due to reasons beyond the control of the parent or is due to financial reasons. The failure to report to a law enforcement agency or to the Department of Social Welfare and Development (DSWD) that the child is missing within seventy-two (72) hours after his disappearance is discovered. READ: R.A. 7610 There are other types of abuse such as street children, children in conflict with the law, children in indigenous communities, and children in situations of armed conflict. However, the definitions specified above are the common abuses that is being reported and handled by Bantay Bata 163. Networks and partner agencies are tap to respond to abuses outside its scope. CAUSES OF CHILD ABUSE 1. PARENT FACTORS 2. CHILD FACTORS 3. FAMILY FACTORS 4. ENVIRONMENTAL FACTORS 1. Parent Factors A parent's overall history as a child, plays a large part in how prepared he/she may be to be a parent. Individuals who have not had their own developmental needs met may find it very difficult to meet the needs of their children. Although many abusive parents experience behavioral and emotional difficulties, mental illness plays a very small overall role in child maltreatment. No consistent set of personality traits or cluster of personality traits has been identified as characterizing abusive parents. Characteristics identified as characterizing abusive parents. Characteristics identified in some maltreating parents are low self-esteem, low intelligence, ego deficiency, impulsiveness, hostility, isolation and loneliness, anxiety, depression and apathy, rigidity, fear of rejection, low frustration tolerance, narcissism, fearfulness, immaturity and dependency, neuroticism, drug or alcohol abuse and criminal behavior. Alcohol and substance abuse continues to be a common problem or parents who maltreat their children. A variety of problems resulting from a lack of skills and knowledge have also been suggested as characteristics of some maltreating parents. This includes: • • • •

Lack of parenting skills (including overuse of physical punishment) Problems with coping and self-control Marital difficulties General lack of interpersonal skills

Parents' lack of knowledge of child development may result in appropriate expectations. Inappropriate attitudes can contribute to maltreating behavior, for example, acceptance of violence as a way to solve problems or belief that children are property.

Specific situations, such as untimely childbearing, physical illness and poor ability to emphatize with their children, can substantially increase the likelihood of child maltreatment, particularly when social stress and social isolation characterize the family. In some situations, single parents may be at higher risk of maltreating their children due to higher stress and low income. 2. Child Factors The child's age and physical, mental emotional and social development can greatly increase or decrease the likelihood of maltreatment, depending on the interactions of these characteristics with parental factors enumerated above. The child's behavior, for example, aversive crying and unresponsiveness, can increase the likelihood of maltreatment, particularly if a parent has a poor ability to empathize with the child and difficulty in controlling his/her emotions. Some children may inadvertently contribute to their victimization by possessing characteristics that make it difficult for caregivers to relate with them. For example, infants who are constantly ill are less capable of eliciting nurturing responses from mothers who lack emotional support, are working through the grief process, or have few nurturing skills. In general, children who are perceived as "different," such as disabled children, are at greater risk for abuse and neglect. 3. Family Factors Specific life situations of some families can increase the likelihood of maltreatment, such as marital conflict, conflicting relationships with extended family, domestic violence, employment and financial stress and social isolation. Families involved in child maltreatment tend to exhibit a pattern of day-to-day interaction characterized by a low level of social exchange, low responsiveness to positive behavior, and high responsiveness to negative behavior. Research on attachment and bonding (the development of love between parent and child) has demonstrated the importance of early parent-child interactions within the first days of life, particularly with premature and ill newborns. Specifically related to child maltreatment, studies have found that less parent-infant contact during early hospitalization was more likely to lead abuse. 4. Environmental Factors Environmental factors are often found in combination with child, parent and family factors. The incidence of child maltreatment is higher in some cultures, societies and communities than others. And what one culture defines as child abuse and neglect may be socially acceptable interaction in other culture. Economic pressure, values concerning the role of the child in the family, attitudes about the use of physical punishment, and the degree of social support for parents seem to account for these differences. Stress caused by such factors, as poverty is associated with higher rates of reported child abuse, as evidenced at times of increased unemployment and recession.

EFFECTS OF CHILD ABUSE TYPES OF ABUSE 1. Physical abuse

2. Sexual abuse 3. Neglect 4. Emotional abuse 5.

Munchausen syndrome by proxy (MSBP)

Physical Abuse Physical signs

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Unusual bruises or welts on face, neck, chest, buttocks or genitals Injuries in various stages of healing Injuries in shape of object (e.g., belt, electric cord) Unexplained burns on palms, soles, back or buttocks Fractures that do not fit story of injury Unexplained delay between occurrence of injury and medical help sought

Behavioral signs • • • • • • • • • •

Displays extremes in behavior-aggressiveness or withdrawal and shyness Displays self-destructive behavior Engages in destructive or delinquent behavior Fears going home Fears parents Fears other adults Reports injury by parents Presents poor self-image Uses drug or alcohol Seems uncomfortable with physical contact

Sexual abuse Physical signs

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Sexually transmitted disease Pain or swelling in genital area Bruises, bleeding or discharge in vaginal or penile area Pregnancy Stained or bloody underclothing Chronic genital irritation

• Difficulty in walking or sitting • Frequent urinary tract or yeast infections Behavioral signs • • • • • • • • •

Refuses to partake in gym or other physical exercises Relates poorly with peers Acts overly seductive around others Displays sexual behavior inappropriate for age Becomes a run-away or delinquent Exhibits drastic change in school achievement Displays regressive or childlike behavior Uses foul language Experiences nightmares or bed wetting

Neglect Physical signs

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Abandoned Unattended medical needs Consistent lack of supervision Consistent hunger, inappropriate dress, poor hygiene Lice, distended stomach, emaciated look

Behavioral signs • • • • • •

Is constantly hungry and begs for or steals food Shows an extreme willingness to please Seeks attention from any adult Is frequently absent from school Arrives early and stays at school, play area or other people's homes States that parents are rarely around

Emotional abuse Physical signs • •

Delays in physical development Speech disorder

Behavioral signs • • •

Learning problems Passive, aggressive Feelings of low self-worth

Münchausen syndrome by proxy (MSBP) A rare form of child abuse in which a parent or other caretaker, typically a mother, induces real or apparent symptoms of disease in a child. As a result, physicians usually perform various diagnostic tests, prescribe medications and may even hospitalize a child or perform surgery to determine the cause of the child’s illness. The syndrome occurs due to psychological problems in the parent or caregiver, and the unusual behavior can escalate to the point of severe physical harm or even death of a child. Causes

This syndrome almost always involves a mother abusing her child by seeking unneeded medical attention for the child. It is rare and poorly understood. The cause is unknown. The mother may fake symptoms of illness in her child by adding blood to the child's urine or stool, withholding food, falsifying fevers, secretly giving the child drugs to make the child throw up or have diarrhea, or using other tricks, such as infecting intravenous (given through a vein) lines to make the child appear or become ill. These children are often hospitalized with groups of symptoms that don't quite fit any known disease. Frequently, the children are made to suffer through unnecessary tests, surgeries, or other uncomfortable procedures. The parent is usually very helpful in the hospital setting and is often appreciated by the nursing staff for the care she gives her child. She is often seen as devoted and self-sacrificing, which can make medical professionals unlikely to suspect the diagnosis of Munchausen syndrome. Her frequent visits unfortunately also make the child accessible to her so that she can induce further symptoms. Changes in the child's condition are almost never witnessed by hospital staff and almost always occur only in the mother's presence. Munchausen syndrome occurs because of psychological problems in the adult, and is generally an attention-seeking behavior. The syndrome can be life-threatening for the child involved. Symptoms

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The child's symptoms do not fit a classical picture of illness or do not fit together well. The child's symptoms improve at the hospital but reappear at home. The parent is overattentive or "too helpful." The parent is often involved in a health-care field, such as nursing.

Treatment Once the syndrome is recognized, the child needs to be protected and removed from direct care of the parent. The affected parent should not be accused directly, but offered help.

Because this is a form of child abuse, the syndrome must be reported to the authorities. Psychiatric counseling will be recommended for the parent involved, but since the disorder is rare, very little is known about effective treatment.

Reference:

Johnson CF. Abuse and neglect of children. In: Kliegman RM, Behrman RE, Jenson HB, Stanton BF, eds. Nelson Textbook of Pediatrics. 18th ed. Philadelphia, Pa: Saunders Elsevier; 2007:chap 36. www.bantaybata163.com/

Child Abuse

Ch ild A b us e

A deeper understanding

Jade de la Rosa Johann Tapang