3.6 Types of Abuse and Neglect

1. Introduction

This chapter considers the different types of abuse and neglect as specified in Working Together to Safeguard Children (Department for Education). Practitioners should not limit their view of what constitutes abuse or neglect, as they can take many forms. The circumstances of the individual case should always be considered.

2. Forms of Abuse

2.1 Maltreatment

All forms of physical and/or emotional ill-treatment, sexual abuse, neglect, or negligent treatment or commercial or other exploitation, resulting in actual or potential harm to the child’s health, survival, development or dignity in the context of a relationship of responsibility, trust or power.

2.2 Abuse

A form of maltreatment of a child or young person. Somebody may abuse or neglect a child by inflicting harm, or by failing to act to prevent harm. Harm can include ill treatment that is not physical as well as the impact of witnessing ill treatment of others. This can be particularly relevant, for example, in relation to the impact on children of all forms of domestic abuse, including where they see, hear, or experience its effects. Children may be abused in a family or in an institutional or extra-familial contexts by those known to them or, more rarely, by others. Abuse can take place wholly online, or technology may be used to facilitate offline abuse. Children may be abused by an adult or adults, or another child or children.

2.3 Child criminal exploitation

Where an individual or group takes advantage of an imbalance of power to coerce, control, manipulate or deceive a child or young person under the age of 18 into any criminal activity:

a) in exchange for something the victim needs or wants; and / or

b) for the financial or other advantage of the perpetrator or facilitator; and/or

c) through violence or the threat of violence.

The victim may have been criminally exploited even if the activity appears consensual. Child criminal exploitation does not always involve physical contact; it can also occur through the use of technology.

For more information see, Multi Agency Child Exploitation Protocol

2.4 Child sexual exploitation

Child sexual exploitation is a form of child sexual abuse. It occurs where an individual or group takes advantage of an imbalance of power to coerce, manipulate or deceive a child or young person under the age of 18 into sexual activity:

a) in exchange for something the victim needs or wants; and/or

b) for the financial advantage or increased status of the perpetrator or facilitator.

The victim may have been sexually exploited even if the sexual activity appears consensual. Child sexual exploitation does not always involve physical contact; it can also occur through the use of technology.

For more information see Sexual Exploitation and Abuse (including Organised Abuse)

2.5 Emotional abuse

The persistent emotional maltreatment of a child so as to cause severe and persistent adverse effects on the child’s emotional development. It may involve conveying to a child that they are worthless or unloved, inadequate, or valued only insofar as they meet the needs of another person. It may include not giving the child opportunities to express their views, deliberately silencing them, or making fun of what they say or how they communicate. It may feature age or developmentally inappropriate expectations being imposed on children. These may include interactions that are beyond a child’s developmental capability, as well as overprotection and limitation of exploration and learning, or preventing the child participating in normal social interaction. It may involve seeing or hearing the ill-treatment of another. It may involve serious bullying (including cyber bullying), causing children frequently to feel frightened or in danger, or the exploitation or corruption of children. Some level of emotional abuse is involved in all types of maltreatment of a child, though it may occur alone.

2.6 Extra-familial harm

See also Supporting Children at Risk of, or Experiencing, Harm Outside the Home chapter

Children may be at risk of or experiencing physical, sexual, or emotional abuse and exploitation in extra-familial contexts. Extra-familial contexts include a range of environments outside the family home in which harm can occur. These can include peer groups, school, and community / public spaces, including known places in the community where there are concerns about risks to children (for example, parks, housing estates, shopping centres, takeaway restaurants, or transport hubs), as well as online, including social media or gaming platforms.

While there is no legal definition for the term extra-familial harm, it is widely used to describe different forms of harm that occur outside the home. Children can be vulnerable to multiple forms of extra-familial harm from both adults and/or other children. Examples of extra-familial harm may include (but are not limited to): criminal exploitation (such as county lines and financial exploitation), serious violence, modern slavery and trafficking, online harm, sexual exploitation, child-on-child (non-familial) sexual abuse and other forms of harmful sexual behaviour displayed by children towards their peers, abuse, and/or coercive control, children may experience in their own intimate relationships (sometimes called teenage relationship abuse), and the influences of extremism which could lead to radicalisation.

2.7 Financial exploitation

Financial exploitation can take many forms. It can include exploitation which takes place for the purpose of money laundering. This is when criminals target children and adults and take advantage of an imbalance of power to coerce, control, manipulate or deceive them into facilitating the movement of illicit funds. This can include physical cash and / or payments through financial products, such as bank and cryptocurrency accounts.

2.8 Neglect

The persistent failure to meet a child’s basic physical and / or psychological needs, likely to result in the serious impairment of the child’s health or development. Neglect may occur during pregnancy as a result of maternal substance abuse. Once a child is born, neglect may involve a parent or carer failing to:

• provide adequate food, clothing, and shelter (including exclusion from home or abandonment);
• protect a child from physical and emotional harm or danger;
• ensure adequate supervision (including the use of inadequate caregivers);
• ensure access to appropriate medical care or treatment;
• provide suitable education.

It may also include neglect of, or unresponsiveness to, a child’s basic emotional needs.

2.9 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.

2.9.1 Bruising

The Child Protection Evidence Systematic Review on Bruising (RCPCH) found that bruising was the most common injury in children who have been abused. However, it is also a common injury in children who have not been abused, and can be caused by accidental bumps or falls for example. The exception to this is infants or children who are not independently mobile, where accidental bruising is rare (0-1.3%). A child who is not independently mobile is one who cannot crawl, cruise, bottom shuffle or roll over.

The number of bruises a child sustains through everyday activity increases as they get older and their level of independent mobility increases.

A report from the Child Safeguarding Practice Review Panel recommends that bruising in children who are not independently mobile is reviewed by a health professional who has the appropriate expertise to assess the nature and presentation of the bruise, any associated injuries, and to consider the circumstances of the presentation including the developmental stage of the child, whether there is any evidence of a medical condition that could have caused or contributed to the bruising, or a plausible explanation for the bruising.

A multi-agency discussion to consider any other information on the child and family and any known risks, and to jointly decide whether any further assessment, investigation or action is needed to support the family or protect the child is also recommended. This multi-agency discussion should always include the health professional who reviewed the child.

See also: Bruises on Children: Core Info Leaflet (NSPCC Learning).

2.10 Sexual abuse

Involves forcing or enticing a child or young person to take part in sexual activities, not necessarily involving a high level of violence, whether or not the child is aware of what is happening. The activities may involve physical contact, including assault by penetration (for example, rape or oral sex) or non-penetrative acts, such as masturbation, kissing, rubbing, and touching outside of clothing. They may also include non-contact activities, such as involving children in looking at, or in the production of, sexual images, watching sexual activities, encouraging children to behave in sexually inappropriate ways, or grooming a child in preparation for abuse. Sexual abuse can take place online, and technology can be used to facilitate offline abuse. Sexual abuse is not solely perpetrated by adult males. Women can also commit acts of sexual abuse, as can other children.

2.11 Significant harm

The Children Act 1989 section 31defines harm as ill-treatment (including sexual abuse and forms of ill-treatment which are not physical) or the impairment of physical or mental health or physical, intellectual, emotional, social or behavioural development including, for example, impairment suffered from seeing or hearing the ill-treatment of another.  Where the question of whether harm suffered by a child is significant turns on the child’s health or development, their health or development shall be compared with that which could reasonably be expected of a similar child.