Defining child abuse
Many see child abuse as a socially defined construct- not an absolute unchanging phenomenon.1
Those whose professions place them in daily contact with children swiftly become aware of considerable variation that exists in the way in which children are brought up.2As a direct consequence of these differing methods of child rearing, it is hard to define the point at which child care within a family becomes intolerable.3
The issue of cultural relativity means, there may be practices viewed as acceptable by one culture, but as abusive or neglectful by another. In addition, sensitivity to culture applies within societies and between them.4
The government in its 1995 review of Department of Health sponsored research programmes stated the best way of understanding mistreatment of children is by viewing parental handling of children as a continuum ranging from acceptable and desirable to seriously abusive. Professionals determine the threshold of abuse which can shift over time.7
The 2000 guidelines by the Department of Health give four categories of abuse- Physical, physical neglect, sexual abuse and emotional abuse. Many overlap and there are connections between different forms of abuse. However, there are other forms of abuse including, for example, bullying, foetal abuse and institutional, ritual and organised abuse.8
Until 1988 there were no national statistics kept in Britain with regard to the extent of child abuse. Since 1988 figures have been available from the Department of Health, which annually collate the numbers of children on Child Protection Registers.9
Much research has been carried out on why abuse happens, the consequences of child abuse, child protection, prevention and prediction, assessment, treatment and support.10
For example, abuse can occur in families from all social classes, although physical abuse and neglect (but not sexual abuse) are more common in manual class families. Abuse is most common when the parent themselves were abused as children, among parents who abuse alcohol or drugs, or who have mental health problems and when the child has a disability.
Abuse and neglect have profound effects on all aspects of a child’s physical and mental health, often leading to failure to thrive, to repeated injuries, to withdrawal, mental illness, emotional and behavioural problems and to abusive relationships with partners and children in later life.11 The most serious cases can be fatal.12 For example, the case of Victoria Climbie as contained in the records discussed below.
Relevant records held at RCPCH
- Transcripts of witness seminars on “The recognition of child abuse”(2003)
Transcripts of discussions held in a seminar at the 7th Spring annual meeting, in which the topic “the recognition of child abuse” was discussed. In particular it looks at how the definition of child abuse has changed over time.
- Joint statement on child abuse (1987; 1993)
Ref: RCPCH/007/123; RCPCH/011/003/089A joint statement on child abuse by the Association of Police Surgeons and the BPA. The statement defines child abuse and outlines how it is to be dealt with.
- Medical evidence in cases of child abuse (1989)
Ref: RCPCH/011/008/137This document deals with the different types of courts and legal proceedings in which doctors may be called upon to give expert medical evidence about child abuse and suggests how doctors can give evidence in the most effective manner
- Guidance on paediatric forensic examinations in relation to possible child sexual abuse (2002)
This guidance attempts to address the deficiencies in the statement "Joint Statement on Child Sexual Abuse" produced in 1998 and describes further elements of good practice regarding the paediatric forensic assessment of children who may have been sexually abused. This guidance was produced by the Royal College of Paediatrics and Child Health and the Association of Police Surgeons.
- ‘The physical signs of child sexual abuse: an evidence-based review and guidance for best practice’ (2008)
A document created to be used by health professionals in the field of child protection.
- ‘child abuse enquiries’ (1985)
Ref: RCPCH/007/286; RCPCH/003/049/001/020Response by the BPA to a consultative paper prepared by the Department of Health and Social Services, and correspondence relating to the comments.
- ‘Protect your child: a guide about child abuse for parents (1987)
Leaflet produced by the NSPCC for parents about looking out for and preventing child abuse.
- Comments and responses by the BPA to documents on child abuse (1985-1995)
Ref: RCPCH/003/049/001/027; RCPCH/003/049/001/020; RCPCH/007/078; RCPCH/007/120BPA comments on Department of Health and Social Security documents: ‘Child Abuse: Working Together for the Protection of Children’ and ‘Child Abuse: Working Together – a draft guide to arrangements for interagency co-operation for the protection of children’. (1986); BPA comments on Department of Health paper on child abuse inquiries (1985); BPA Response to the Department of Education’s Circular: “The role of the education service in child protection, and the department’s procedures for dealing with misconduct by teachers and other staff”, with comments highlighting concerns with how allegations of abuse against teachers are investigated (1995).
- Records of the Joint Standing Committee on Child Abuse (1980-1990)
Records of the committee, including minutes of meetings, associated papers, reports and guidelines, and correspondence.
- Records relating to child abuse policies and cases (1987-2010)
Records relating to child abuse cases and national and RCPCH policies and responses, including The Lancet Child Maltreatment series and press cuttings and articles regarding child abuse, child abuse training, and child protection.
- 1. Brian Corby, Child Abuse (Buckingham, Open University Press, 2000), p. 66
- 2. Maher, Child Abuse the educational perspective (Oxford: Basil Blackwell, 1987), p. 36
- 3. Ibid., p. 37
- 4. Corby, p. 67
- 5. Mitch Blair and others, Child public health (Oxford: University Press Oxford, 2010), p. 69
- 6. Corby, p. 67
- 7. Corby, p. 70
- 8. Corby, p. 71
- 9. Corby, p.89
- 10. Corby
- 11. Blair and others, p.68
- 12. Blair and others, p.69