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Abuse no more: Dealing Effectively with Child Abuse

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Section 3:   Part 1

Management Procedures:
Suspected child abuse

3.1   The management of suspected child abuse

3.1.1  Flow chart of the process where an educator suspects child abuse:

The flow chart below shows the course to be followed by the various role-players responsible for managing child abuse.

 

3.1.2  The identification of suspected child abuse

3.1.2.1  Information-gathering

There are various reasons why children do not discuss child abuse. It is therefore the duty of the educator to be mindful of the symptoms and characteristics of child abuse and to be able to identify them.

Note to the educator:
The following symptoms and characteristics of physical abuse, neglect, abuse, emotional abuse and rape trauma syndrome are provided to help you identify these different forms of child abuse.

Physical Abuse
Behaviour of an adult who abuses children Behaviour of an abused child Physical indications of child abuse
  • Complains that the child is difficult to control;
  • Little knowledge of child development. Makes unrealistic demands, e.g. expects good bowel control at too early an age;
  • May indicate that child is prone to injuries. Lies about how the child was injured;
  • Gives contradictory explanations about how the child was injured;
  • Inappropriate or excessive use of medical service;
  • Seems unconcerned about the welfare of the child.
  • Cannot explain injuries, or gives inconsistent explanations;
  • Absconds;
  • Cringes or withdraws when touched;
  • Babies stare with empty expression, rigid carriage, on guard;
  • Extremely aggressive or withdrawn;
  • Seeks attention from anyone who cares;
  • Extremely compliant, tries to please others;
  • Becomes scared when other children cry;
  • Scared to go home after school. Scared of adults;
  • Normal activities arouse anxiety;
  • Vandalises things.
  • Injuries – bruises, cuts, burns, fractures;
  • Various injuries, various degrees of healing;
  • Various injuries over a period of time;
  • Head injuries on babies and pre-school children, e.g. cuts, bruises, burn marks, abrasions which cannot be satisfactorily explained;
  • Injuries such as fractures, abrasions, burns and bruises which cannot be explained;
  • Inappropriate clothing to cover the body.

Neglect
Behaviour of an adult who abuses children Behaviour of an abused child Physical indications of child abuse
  • Behaviour indicates rejection of the child, e.g. child is left in cot or bedroom for long periods of time;
  • Ignores the child’s loving approaches, refuses to hold the child’s hand or hold her or him close;
  • Indicates the child is unwelcome;
  • Indicates the child is difficult to care for, e.g. the child is “demanding” and “difficult to feed”.
  • Listless and makes few or no demands, e.g. seldom cries;
  • Little or no interest in the environment;
  • Little or no movement, e.g. lies still in bed;
  • Does not react to strangers’ attempts to stimulate her or him;
  • Shows little fear of strangers, e.g. does not react to them;
  • Begs or steals food;
  • Continually tired, listless or falling asleep;
  • Says that nobody at home looks after her or him;
  • Irregular attendance at school;
  • Destructive and aggressive;
  • Inappropriate clothing, poor personal hygiene, continually hungry;
  • Physical and medical needs don’t receive attention.
  • The child does not grow, and/or loses a lot of weight (though this may also indicate under-development. A medical examination is necessary to determine the case.)
The following physical characteristics are often present in neglected children:
  • Child is pale and emaciated;
  • Very little body fat in relation to build, e.g. folds on buttocks; skin feels like parchment owing to dehydration;
  • Constant vomiting and/or diarrhoea;
  • Developmental milestones not reached within normal age-ranges, e.g. neck still limp at 6 months, cannot walk at 18 months.

Sexual Abuse
Behaviour of an adult who abuses children Behaviour of an abused child Physical indications of child abuse
  • Exceptionally protective towards child and jealous;
  • Discourages contact with peer-group when there is no supervision;
  • Acts seductively towards child;
  • Indicates that the spouses have marital problems;
  • Abuses alcohol and/or drugs.
  • Sexual play with self, others and toys;
  • Sexual vocabulary and/or behaviour not age-appropriate;
  • Drawings or descriptions with sex theme not age-appropriate;
  • Strange, sophisticated or unusual sexual knowledge, e.g. flirtation;
  • Promiscuity and/or prostitution;
  • Continual absconding;
  • Fear of seduction by members of the opposite sex;
  • Unwilling to participate in certain activities;
  • Sudden deterioration in school progress;
  • Poor relations with peers;
  • Withdrawal, fantasising, uncommonly childish behaviour;
  • Crying without provocation;
  • Depression, attempted suicide.;
  • Pain or unusual itching of genitals or in anal area;
  • Torn, stained or bloodstained underwear;
  • Pregnancy;
  • Injuries to genitals or anal area, e.g. bruises, swelling or infection;
  • Sexually transmitted diseases;
  • Difficulty in sitting or walking;
  • Regular urinary infection.
  • Throat irritations and/or soreness or mouth sores owing to forced oral sex.;

Emotional Abuse
Behaviour of an adult who abuses children Behaviour of an abused child Physical indications of child abuse
  • Blames the child for own problems and disappointments – child is seen as a scapegoat;
  • Continually expresses negative feelings about the child to other people and the child;
  • Conduct towards the child expresses continual rejection;
  • Withholds herself or himself from verbally or behaviourally expressing love to the child;
  • Continually trying to bribe, influence or terrify the child;
  • Continually trying to isolate the child, e.g. by prohibiting contact inside and outside the family.
  • Aggression, depression or extreme withdrawal;
  • Extreme compliance;
    • too well-mannered, too neat, too clean;
  • Extreme attention- seeking;
  • Extreme control when she or he plays – suppresses own feelings.
  • Enuresis (bedwetting) and/or encopresis (soiling) for which there is no physical cause;
  • Continual psychosomatic complaints, e.g. headache, nausea, stomach pain;
  • Child does not grow and develop according to expectations.

Rape Trauma Syndrome
 (Source: “Rape Trauma Syndrome” – Rape Crisis Cape Town Trust)
Behaviour of an adult who abuses children Behaviour of an abused child Physical indications of child abuse
  • Immediately after a rape, survivors often experience shock; they are likely to feel cold, faint, become mentally confused (disorientated), tremble, feel nauseous and sometimes vomit.
  • Pregnancy.
  • Sexually transmitted diseases like AIDS, syphilis and/or gonorrhoea; gynaecological problems like irregular, heavier and/or painful periods, vaginal discharges and bladder infections.
  • Bleeding and/or infections from tears or cuts in vagina or rectum, depending on what happened during the rape.
  • A soreness of the body. There may also be bruising, grazes, cuts, etc;
    • , depending on the kind of force used during the rape.
  • Nausea and/or vomiting.
  • Throat irritations and/or soreness owing to forced oral sex.
  • Tension headaches.
  • Pain in lower back and/or stomach.
  • Sleep disturbances like difficulty falling asleep, waking up during the night, being woken by nightmares about the rape, getting less sleep than usual, or on the other hand feeling exhausted and needing to sleep more than usual.
  • Eating disturbances such as not feeling like eating, eating less than usual and so losing weight, or on the other hand eating more than usual and so putting on weight.
  • Crying more than usual.
  • Difficulty in concentrating.
  • Being restless, agitated and unable to relax, or on the other hand just sitting around and moving very little.
  • Not wanting to go out and/or socialise, or on the other hand socialising more than usual.
  • Not wanting to be left alone.
  • Stuttering or stammering more than usual.
  • Trying to avoid anything that reminds the survivor of the rape, e.g. someone who was raped at a party may stop going to parties.
  • Many rape survivors don’t want to talk about what happened, because it makes them remember the rape.
  • More easily frightened or startled than usual;
    • Rape survivors often get very scared when someone walks up behind them without warning.
  • Being very alert and watchful.
  • Getting very upset by minor things that didn’t worry them before the rape.
  • Losing interest in things that used to be of interest to them before the rape.
  • Problems in relationships with people like family, friends, lovers and spouses. Rape survivors may become irritable and so may quarrel with others more easily; or they may withdraw from people with whom they had been close before the rape. They may also become very dependent on others, or on the other hand overly independent.
  • Sexual problems like a fear of sex, a loss of interest in sex or a loss of sexual pleasure.
  • Changes in work or school, e.g. playing truant, dropping out of school, changing jobs, or stopping work altogether.
  • Moving house.
  • Increased use of substances like alcohol, cigarettes and/or drugs. A person who didn’t use a substance before the rape may start to use it afterwards.
  • Increased washing and/or bathing, because of a feeling of being dirty from the rape.
  • Acting as if the rape never happened.
  • Intrusive thoughts and feelings about being dirty from (contaminated by) the rape. These feelings often make rape survivors wash or bath more frequently. These thoughts are known as obsessional thoughts.
  • Flashbacks – the sudden feeling that the rape is happening again, which makes the survivor very frightened and upset.
  • Nightmares about the rape.
  • Being very upset by anything that reminds the survivor of the rape.
  • Becoming extremely afraid of certain things that remind the survivor of the rape;. Such extreme fears are called phobias. Rape survivors often develop extreme fears of men, of strangers, of being alone, of leaving their homes, of going to school or to work, and of sex. These phobias are called traumaphobias, because they are caused by a trauma.
  • A loss of memory of part or all of the rape, which is called psychogenic amnesia.
  • Being unable to feel certain feelings like happiness, or feeling very “flat”. On the other hand, rape survivors can feel emotionally confused and have mood swings (quick changes of mood).
  • Feeling that they will not live for very long and/or feeling very negative about their future prospects.
  • Feeling depressed and/or sad, and sometimes having thoughts of suicide.
  • Feeling irritable and angry.
  • Feeling more fearful and anxious than usual. Rape survivors are often very afraid that their assailant(s) will return, that they are pregnant and/or that they have been infected with a disease from the rape.

Note to the educator:
Use the following procedure to identify possible incidents of child abuse:

  • Start gathering information as soon as you suspect child abuse. Continue to do so consistently, and document all information gathered. Treat all this information as confidential.
  • Discuss your suspicions and the information that you have gathered with the institution manager (unless she or he is possibly implicated).
  • Ensure confidentiality by opening a separate file for the particular learner. This file must be kept in the strongroom or safe (see note after Step 9, paragraph 3.2.1.2 in Section 3: Part 2).
  • The institution manager and the educator must consult the list of criteria (see the tables above) to verify the information before making any allegations of child abuse.
  • Remain objective at all times and do not allow personal matters, feelings or pre-conceptions to cloud your judgement.

Note to the educator:

  • Any information to do with child abuse is confidential and must be handled with great discretion.
  • The reporting and investigation of child abuse must be done in such a way that the safety of the learner is ensured.
  • Justice must not be jeopardised, but at the same time the support needed by the learner and her or his family must not be neglected.

3.1.3  Management procedures when child abuse is suspected by the educator:

Step 1   Report your suspicions to the institution manager.

Note to the educator:
Section 15 of the Child Care Amendment Act 96 of 1996 states that a physician, nurse, social worker, or educator must report child abuse or the suspicion of child abuse. Educators are legally protected if their actions are well-intentioned. Failure to report child abuse or the suspicion thereof will be prosecuted.

Step 2
The institution manager and the educator will discuss the observations or incident with the H: SLES at the EMDC (for the attention of the school social worker) who will help the institution to determine

  • whether there are reasonable grounds to suspect child abuse, and to advise on
  • which external role-players to involve in the process, such as the local welfare organisation(s) or the local social worker of the Department of Welfare, the SAPS, the Child Protection Unit, and (if an employee is involved) Labour Relations.

Step 3
If there are reasonable grounds for suspecting child abuse (as confirmed by, for example, an external role-player who is involved in the process), the institution manager will

  • discuss the matter with the parents or caregivers (unless the parent or caregiver is the suspected abuser) and
  • report the case or incident to the H: SLES at the EMDC, who will keep a confidential record of all such cases or incidents.

Note to the educator:
If it appears that the learner and/or her or his family require support (e.g. by the TST or by the Specialised Learner and Educator Support component at the EMDC), the institution manager must ensure that this support is provided and sustained.

If the institution manager is the suspect, the educator must report directly to the H: SLES at the EMDC.

Step 4
The institution manager will maintain contact with the internal and external role-players and will forward a report to the H: SLES on progress in the matter.

Note to the educator:
Internal support (if needed) could be provided by the TST, e.g. in helping academic progress, or by the Specialised Learner and Educator Support component at the EMDC, e.g. in providing psychological or emotional support.

Note to the educator:
The best interests of the learner are paramount in every incident that involves her or him. It is therefore important to manage any suspected abuse effectively in order to protect the learner and the educator from additional and unnecessary trauma. The trust that the learner will experience and develop in you, as well as in the process (including the support provided) at this stage, will largely determine whether she or he will be prepared to lodge a complaint or disclose information.

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