The document presents an overview of child abuse and neglect, covering definitions, types, statistics, and factors contributing to it, with a focus on the situation in India. It highlights various forms of abuse including physical, sexual, emotional, and neglect, and discusses the roles of healthcare professionals in identifying and managing these cases. Additionally, it addresses the lack of comprehensive legal protection for children in India and presents recent cases that underline the urgent need for action against child abuse.

1. GOOD MORNING

2. CHILD ABUSE &
NEGLECT
Presented by-
Akanksha Mishra

3. CONTENTS
• Definitions
• Types of Child Abuse and Neglect
• Statistics
• Factors responsible in Child Abuse
• Examining Child Abuse/Neglect
• Indian Laws for Child Abuse
• Various GO’s and NGO’s
• Current Scenario in India

4. • Child Abuse: …. Non –accidental physical
injury, minimal or fatal, inflicted upon children
by persons caring for them.
Selwyn et al,1985
• Battered Baby: is a child who shows clinical
and radiographic evidence of lesions that are
frequently multiple and involve mainly the head,
soft tissue, long bones, thoracic cage and that
cannot be unequivocally explained.
Selwyn,1985

5. • Neglected Child: is one who shows evidence of
physical or mental ill-health primarily due to
failure on the part of the parent or caretakers to
provide adequately for the child’s needs.
• Persecuted Child: is one who shows evidence
of mental ill-health caused by a deliberate
infliction of physical or psychological injury that
is often continuous in nature.

6. TYPES OF CHILD ABUSE
NSPCC(2003)
• Physical Abuse 31.8%
• Educational Abuse 26.3%
• Emotional Abuse 23.3%
• Sexual Abuse 6.8%
• Failure to thrive 4.0%
• Intentional drugging or
poisoning not specified
• Munchausen syndrome
by proxy not specified

7. TYPES OF CHILD NEGLECT
NSPCC(2003)
• Emotional neglect 27.8%
• Health care neglect 8.7%
including dental neglect
• Physical neglect 7.8%
• Safety neglect
• Nutritional neglect

8. ACCORDING TO THE STUDY BY
NSPCC :(2003)
9500 physically abused/year
6330 sexually abused/year
4 die every week due to abuse
50% of these cases involve dental injury
LOCATION OF INJURIES:
79% - scalp
59% - neck
52% - forehead
49% - cheek
48% - lower jaw and right leg

9. STATISTICS
• At least 60% cases remain undetected
• The average age of detection of child abuse and
neglect is 7.4 yrs.
• Reported cases in females is 51% and in males
49%.
• Sexual abuse is more commonly seen in females
whereas physical abuse is more common in
males.
• No sex, gender or socioeconomic status is spared
by child abuse

11. Child Abuse and Neglect
--A Dentist’s Perspective--
• Physical indicators of abuse include:
1. Bruises
2. Bite marks
3. Burns
4. Fractures
5. Injuries to the head
6. Dental/medical neglect

12. It is defined as any act which results in non –
accidental trauma or physical injury .
Young children are the victims.
Eg. Battered child syndrome
PHYSICAL ABUSE

13. SEXUAL ABUSE
Contacts or interaction b/w a child
and adult, when the child is being
used for sexual stimulation of
perpetrator or another person
{National Centre on CAN}
Complications- psychological and
emotional trauma, pregnancy, STDs
and physical trauma.

14. Evidence for suspecting sexual abuse
• Reports by the patient of sexual activities with
the parent.
• Tearing, bruising, and specific inflammation of
the mouth or genitals.
• Pregnancy and the girl is evasive in naming her
partner.
Causes of under-reporting:
– Culture- stigma for victim
– Victims are often young children
– Health professionals unaware of signs and
symptoms
– Health professionals unwilling to report

15. Emotional Abuse
systemic tearing down of another human
being.
Most difficult to identify.
Types of Emotional abuse
• Rejecting
•Ignoring
•Isolating

16. Indicators of emotional abuse
• Poor self esteem,
• insecurity
• Destructive behavior
• Angry acts
• Alcohol or drug abuse
• Difficulty in forming relationships

17. Criteria for diagnosing emotional abuse
• Severe psychopathology and disturbed behavior
in the child, documented by a psychiatrist .
• The continued refusal by the parent of treatment
for the child and himself/herself.
• Severe verbal abuse…

18. MUNCHAUSEN SYNDROME BY PROXY
• Definition: intentional production of physical or
psychological symptoms in another person who is under
individual’s care for the purpose of assuming sick role.
• Involves children -<6yrs
• Children are too young to be aware of or able to tell others .
• Signs & symptoms:
– Bleeding from various sites
– Recurrent sepsis-injecting contaminated fluids
– Chronic diarrhea
– Fever
– Skin rashes

19. INTENTIONAL DRUGGING/POISONING
• Administration of non-prescription or
prescription drugs harmful for children
• Uncommon
• Drugs given:
– Sedatives
– Hallucinogenic drugs

20. SHAKEN BABY SYNDROME
• This syndrome was first reported by
Guthkelch in 1971.
• This syndrome occurs primarily in
children 18mnths or age or younger.
• Classic medical symptom
• Retinal hemorrhage
• subdural or subarchnoid hematomas
• Absence of other external sign of abuse
• Breathing difficulties
• Seizures
• unconsciousness

21. PHYSICAL NEGLECT
• This consists of failure to provide
the necessities of adequate food,
shelter, clothing and medical and
dental care.

22. Evidence of physical neglect
• Clothes dirty, skin dirty, bad smell, halitosis,
lice.
• Undernourished child
• Rampant caries, periodontitis, cysts
• Untreated problems and diseases
• Constant sleepiness or hunger
• Failure of follow-up appointments.

23. EMOTIONAL NEGLECT
• It refers to the failure of the parents
or other caretakers to provide an
emotionally stable environment in
which may the child may develop
sound character.
• Most difficult to identify.
CHARACTERISTICS OF PARENTS :
– Violent/non-violent threats
– Use of degrading language
– Taunting
– Withholding love and affection
– Non-communication
– High expectations-socially, mentally, physically

24. INDICATORS:
– Stop communicating
– Play on its own and not become
involved
– Bully other children.
– Low self-esteem and lack of
confidence
– Pinching and self biting
– Possible speech disorders
MANAGEMENT:
– Build positive attitude
– Never draw a reference to other
children

25. NUTRITIONAL
NEGLECT

26. So what is our role in
Child Abuse ???
Protect
Suspect
Collect

27. Protect...
 Patient/family and
team safety are
paramount.
 Protect the life of
the patient as well
as gather as much
evidence as
possible.

28. Suspect…..
 Does the history fit
what you are seeing-
either injury or
illness?
 Is this a repeat
patient or family
member of a repeat
patient?
 Is there a history of
family violence?

29. Collect...
 Collect as much
evidence as
possible,
including…
 physical and
trace evidence
 information

30. Indian Laws for Child Abuse
• India has no law on/for child abuse per se
• Physical abuse:
Violence in home: Indian Penal Code
(IPC)323/IPC324
• Sexual abuse:
Girls: statutory rape : IPC376
Boys: unnatural sex offence : IPC377
• No law to protect child from other types of
abuses like emotional and educational.

31. Child Protective Agencies in India
• Police is the concerned authority
• National Human Right Commission(NHRC) also
have similar role
• UNICEF, www.unicef.org
• The Childline Organization, New Delhi,
www.childlineindia.org
• Ummid Sanstha, New Delhi, www.ummid.org
• Institute for support, healing and
awareness(IFSHA), www.ifsha.com

32. • Asha Sewabhavi Sanstha, Mumbai,
www.asha.org
• National Human Rights Commission, GOI, New
Delhi, www.nhrc.nic.in
• Organization for Children at Risk in India,
Mumbai, www.cari.com
• Sparsh Seva Sanstha, Mumbai, www.sss.org
CHILD LABOR LAW, on 5th Feb.96 in India

33. Current Scenario in India
• The rape of a 6-year-old girl at a school in
Bangalore has refocused attention on
sexual abuse of children in India, Human Rights
Watch. India’s central and state governments
should take immediate steps to implement the
2012 Protection of Children from Sexual
Offences Act.
19th July 2014

34. • Rape Horror Continues In India: Two More Cases Of
Minor Sexual Abuse Reported; Police Make Second
Arrest In Delhi Child Rape Case
April 22nd 2013
•Published on Dec 4, 2012
An Indian software professional and his wife were today held guilty of "serious
child abuse" and sentenced to jail terms for 18 months and 15 months
respectively. Chandrasekhar Vallabhaneni and his wife Anupama, who were
arrested by the police, were convicted for gross or repeated maltreatment of their
child/children by threats, violence or other wrong. "Oslo District Court has found
an Indian couple guilty on several counts of child abuse. In the view of the Court,
the couple deliberately burned their sons leg with a hot spoon or similar object
with the result that the child had burn marks measuring approximately 3 x 5
centimetres," an official statement said.

35. Shocking Case of Child Physical Abuse
Gurgaon, NCR : Jan 2011
An eight-year-old boy being physically abused
by his employer in Gurgaon. Haryana

36. Indian youths are tomorrow’s powerful and bright
future, but we as youths are restricted in doing this
only………