The document provides an extensive overview of child abuse, defining it as acts of physical, emotional, or sexual abuse towards minors, often perpetrated by caregivers. It discusses various factors contributing to child abuse, its long-term effects, and different forms including neglect, emotional abuse, and sexual abuse, supported by sobering statistics on prevalence. Additionally, it outlines governmental measures such as the Protection of Children from Sexual Offences (POCSO) Act aimed at preventing and addressing these abuses.

1. CHILD ABUSE
HARSHITA
M.Sc NURSING

2. CHILD ABUSE
The term child abuse has come to mean any
intentional act of physical, emotional, or sexual
abuse, including acts of negligence, committed by a
person responsible for the care of the child.

3. CHILD ABUSE
According to UNICEF violence against children
can be "physical and mental abuse and injury,
neglect or negligent treatment, exploitation and
sexual abuse. Violence may take place in homes,
schools, orphanages, residential care facilities, on
the streets, in the workplace, in prisons and in
places of detention." Such violence can affect the
normal development of a child impairing their
mental, physical and social being. In extreme cases
abuse of a child can result in death.

5. FACTORS AFFECTING CHILD
ABUSE
Parental factors:
• Parent has already abused a child
• Pregnancy was not wanted
• Young, unsupported mother often with low
education.
• Parents have unrealistic expectations of the child
and lack parenting knowledge

6. FACTORS AFFECTING CHILD
ABUSE
• Parent is isolated and has few supports
• Parent has a mental illness or is abusing drugs or
alcohol

7. FACTORS AFFECTING CHILD
ABUSE
Environmental factors:
• Overcrowding in the house
• Poverty or lack of opportunity to improve the
family’s resources
• Family violence is present
• A non biological adult living in the house
• Family is experiencing multiple stresses

8. FACTORS AFFECTING CHILD
ABUSE
Child factors:
• Baby is sickly, or unwanted
• Child has a physical or developmental disability
• Child is the product of an abusive relationship
• Lack of attachment between child and parent

9. EFFECTS THE FAMILY
Child abuse has long-term as well as immediate
effects. The abused child may be hyperactive; may
exhibit angry, antisocial behaviour; or may be
especially withdrawn. When child abuse is
suspected or confirmed, the child may be removed
from the home or separated from the family for
protection. Abusive parents often were abused
themselves as children; thus, the problem of child
abuse continues in a cyclical fashion from
generation to generation.

10. FORMS OF CHILD ABUSE
Child abuse has many forms:
• Physical,
• Emotional,
• Sexual,
• Neglect

11. FORMS OF CHILD ABUSE
Any of these that are potentially or actually harmful
to a child's health, survival, dignity and
development are abuse. This definition is derived
from the W.H.O.

12. PHYSICAL ABUSE
Physical abuse may occur when the caregiver is
unfamiliar with normal child behaviour.
Inexperienced caregivers may not know what is
normal behaviour for a child and become frustrated
when the child does not respond in the way they
expect.
Physical abuse is when a child has been physically
harmed due to some interaction or lack of
interaction by another person, which could have
been prevented by any person in a position of
responsibility, trust or power.

13. SHAKEN BABY SYNDROME
Shaken baby syndrome occurs when a small child is
shaken by the arms or shoulders in a repetitive,
violent manner. When the child is shaken, a
whiplash type injury occurs to the neck. In
addition, the child may have edema to the brain
stem and retinal or brain haemorrhage's. Loss of
vision, mental retardation, or even death may occur
in these children.

14. SHAKEN BABY SYNDROME
Clinical manifestations may include lethargy,
irritability, vomiting, and seizures, but often this
form of child abuse does not have easily noted
signs and can be missed on examination of the
child. Internal symptoms are detected by the use of
computed tomography (CT) and magnetic
resonance imaging (MRI).

16. MUNCHAUSEN SYNDROME BY
PROXY
In Munchausen syndrome by proxy, one person
either fabricates or induces illness in another to get
attention. When a caregiver has this syndrome, he
or she frequently brings the child to a health care
facility and reports symptoms of illness when the
child is actually well.
Child’s illness fabricated or induced by the parent
(usually the mother) Mother develops a dependent
relationship with her child’s doctor / medical staff.

17. MUNCHAUSEN SYNDROME BY
PROXY
This situation is frustrating for health care
personnel because it is difficult to catch the suspect
in the act of endangering the child.
Close observation of the caregiver’s interactions
with the child is necessary. For instance, if episodes
of apnea occur only in the presence of the
caregiver, be alert for this syndrome. The caregiver
who suffers from this syndrome must receive
psychiatric help.

18. EMOTIONAL ABUSE
Injury from emotional abuse can be just as serious
and lasting as that from physical abuse, but it is
much more difficult to identify. Injury from
emotional abuse can be just as serious and lasting
as that from physical abuse, but it is much more
difficult to identify.
Emotional abuse can be seen as a failure to provide
a supportive environment and primary attachment
figure for a child so that they may develop a full
and healthy range of emotional abilities.

19. EMOTIONAL ABUSE
Several types of emotional abuse can occur,
including:-
• Verbal abuse, such as humiliation, scapegoating,
unrealistic expectations with belittling, and erratic
discipline
• Emotional unavailability when caregivers are
absorbed in their own problems

20. EMOTIONAL ABUSE
• Insufficient or poor nurturing, or threatening to
leave the child or otherwise end the relationship
• Role reversal in which the child must take on the
role of parenting the parent and is blamed for the
parent’s problems

21. SEXUAL ABUSE
Sexual abuse is engaging a child in any sexual
activity that he/she does not understand or cannot
give informed consent for or is not physically,
mentally or emotionally prepared for. Abuse can be
conducted by an adult or another child who is
developmentally superior to the victim. This
includes using a child for pornography, sexual
materials, prostitution and unlawful sexual
practises.

22. SEXUAL ABUSE
Sexual abuse of children has existed in all ages and
cultures, but it seldom has been admitted when
perpetrated by parents or other relatives in the
home.
The Federal Child Abuse Prevention and
Treatment Act defines sexual abuse as “the
employment, use, persuasion, inducement,
enticement, or coercion of any child to engage in,
or assist any other person to engage in, any sexually
explicit conduct”.

23. SEXUAL ABUSE
The Indian government backed a survey of 125000
children in Thirteen states. Of the children
interviewed, more than half (53%) said that they
had been subjected to one or more forms of sexual
abuse. Over 20% of those interviewed said they
were subjected to severe forms of abuse. Of those
who said they were sexually abused, 57% were
boys. (2007)

24. NEGLECT
Neglect or negligent treatment is purposeful
omission of some or all developmental needs of the
child by a caregiver with the intention of harming
the child. This includes the failure of protecting the
child from a harmful situation or environment
when feasible.

25. NEGLECT
Child neglect is failure to provide adequate hygiene,
health care, nutrition, love, nurturing, and
supervision needed for growth and development.

26. NEGLECT
Neglect takes many forms and can be classified
broadly as physical or emotional maltreatment.
• Physical neglect involves the deprivation of
necessities ; such as food, clothing, shelter,
supervision, medical care, and education.
• Emotional neglect generally refers to the failure to
meet the child’s needs for attention, affection,
and emotional nurturance.

27. DIAGNOSIS
• Anxiety, Fear by child related to history of abuse
and fear of abuse from others.
• Ineffective Coping by the no abusive parent
related to fear of violence from abusive partner
or feelings of powerlessness.
• Impaired Parenting related to situational
stressors or poor coping skills.
• Disabled Family Coping related to unrealistic
expectations of the child by the parent.

30. IMPLEMENTATION
Relieving the Child’s Anxiety and Fear
• Observe the child for behaviour that indicates
anxiety or fear, such as withdrawal, ducking or
shying away from the nurse or caregivers, and
avoiding eye contact.
• Use a calm, reassuring, and kind manner, and
provide a safe atmosphere in which the child has
an opportunity to express feelings and fears.

31. IMPLEMENTATION
Supporting the No abusive Caregiver
In some cases, one caregiver in the family may be
an abuser while the other is not. The non abusive
caregiver is a victim, as is the child.
Give the non abusive caregiver an opportunity to
express fears and anxieties. He or she may feel
powerless in the situation. Support the passive
caregiver in deciding whether to continue the
relationship or leave it.

32. IMPLEMENTATION
• Try to preserve the caregiver’s self-esteem
because this is not an easy decision to make.
Remember that confidentiality is essential when
discussing such problems.

33. IMPLEMENTATION
Observing Interaction Between the Caregiver
and Child
While caring for the abused child when the
caregiver is present, take the opportunity to
observe how the caregiver relates to the child and
how the child reacts to the caregiver.
Give the caregiver the same courtesy extended to
all caregivers. Offer a compliment when the
caregiver does something well in caring for the
child.

34. IMPLEMENTATION
• Give the caregiver an opportunity to discuss in
private any concerns; during this time, you may
be able to gain his or her confidence.

35. IMPLEMENTATION
Promoting Parenting Skills and Coping
• Often abuse occurs when a caregiver is
unfamiliar with normal growth and development
and the behaviours common to a particular stage
of development.
• Help the caregiver develop realistic expectations
of the child. To help accomplish this goal, design
a teaching plan and include the caregiver in
caring for the child.

36. IMPLEMENTATION
• Teach the caregiver the child’s expected
responses and help him or her learn about
normal development.
• Praise the caregiver for displaying positive
behaviours. Point out specific behaviours of the
child and explain them to the caregiver.
• Explore the reasons for the caregiver’s absence
when he or she does not visit regularly.

37. EVALUATION
Goal: The child will exhibit decreased signs of
anxiety and fear.
Expected Outcomes: The child’s play, facial
expressions, and posture are relaxed; the child
displays no withdrawal or guarding during contacts
with the nursing staff.

38. EVALUATION
• Goal: The no abusive caregiver will begin to
cope with fears and feelings of powerlessness.
• Expected Outcome: The no abusive caregiver
expresses fears and concerns and makes plans to
resolve problems.

39. EVALUATION
• Goal: The caregiver will exhibit positive
interaction with the child.
• Expected Outcomes: The caregiver talks with
the child, is sensitive to his or her needs, and
refrains from making unreasonable demands on
the child.

40. EVALUATION
• Goal: The caregiver will be involved in the
child’s care and will verbalize examples of
normal growth and development and ways to
handle the child’s misbehaviour.
• Expected Outcomes: The caregiver states age
appropriate behaviour for the child, discusses
ways to handle the child’s irritating behaviour,
and is involved in counselling or other discharge
plans.

41. RECENT STATISTICS OF THE
CHILD ABUSE
In child labour cases, boys were abused as
frequently as girls according to the 2007 study
conducted along with the Ministry of Women and
Child Development.
488 cases saw the victim raped by grandfathers,
brothers, fathers and even sons. At 55% and 49%
respectively, Tamil Nadu and Gujarat reported the
highest number of child workplace sexual abuse
cases.

42. RECENT STATISTICS OF THE
CHILD ABUSE
The number of cases registered for child abuse
raised from 8,904 in the year 2014 to 14,913 in the
year 2015, under the POSCO(Protection of
Children Against Sexual Offences) Act. Sexual
offences and kidnapping account for 81% of the
crimes against minors.

43. RECENT STATISTICS OF THE
CHILD ABUSE
• POSCO: State wise cases –
• Uttar Pradesh led the highest number of child
abuse cases (3,078) followed by
• Madhya Pradesh (1,687 cases),
• Tamil Nadu (1,544 cases),
• Karnataka (1,480 cases) and
• Gujarat (1,416 cases).

44. Along with workplace cases, here are other findings
of rapists being known to children:
94.8% of rape cases saw children being raped by
someone they knew, not strangers.
These acquaintances include neighbours (3,149
cases) who were the biggest abusers (35.8%).
10% of cases saw children being raped by their own
direct family members and relatives.
RECENT STATISTICS OF THE
CHILD ABUSE

45. How the government is working
against child abuse?
POSCO (Protection of Children Against Sexual
Offences) Act
The Protection of Children from Sexual Offences
Act (POCSO Act) 2012 was formulated in order to
effectively address sexual abuse and sexual
exploitation of children. The Protection of
Children from Sexual Offences Act, 2012 received
the President’s assent on 19th June 2012 and was
notified in the Gazette of India on 20th June, 2012.

46. How the government is working
against child abuse?
The 2012 POCSO act enables fast tracking and
efficient prosecution in rape law (Section 376),
which previously allowed child molesters a legal
loophole.
POCSO lays down a seven years prison term that
can extend to life imprisonment. The act
necessitates cases to resolve in 60 days .

47. How the government is working
against child abuse?
• From harassment to gang-rape, all sexual crimes
against children fall under POCSO, which takes
the child’s verdict as the final word.
• POCSO makes it illegal to witness and not
report abuse, either by phone or in person, and
police officers must bring cases to the attention
of Child Welfare Committee with in 24 hrs.

48. How the government is working
against child abuse?
OPERATION SMILE
• Operation smile is a special initiative of the
Union home ministry (headed by Rajnath Singh),
and organizes regular rescues and rehabilitation
of children pushed into prostitution and bonded
child labor to ill-treatment by parents.

49. RAJNATH SINGH’S ‘OPERATION SMILE’ RESCUES, 19,000 MISSING
CHILDREN FROM SLAVERY; ABUSE (SEPTEMBER 19 2015)

50. POSTERS LAUNCHED BY
INDIAN GOVERNMENT

51. POSTERS LAUNCHED BY
INDIAN GOVERNMENT

52. BIBLIOGRAPHY
1. Lippincott Williams & Wilkins Broadrib’s Introductory Paediatric
Nursing 7th edition
2. Wong's Essentials of Pediatric Nursing
3. http://www.childlineindia.org.in/child-abuse-child-violence-india.html
4. http://www.hindustantimes.com/delhi-news/delhi-govt-launches-poster-
campaign-to-educate-kids-about-sexual-abuse/story-
IZwV4PtFtErh5HIdCzbiJK.html
5. https://www.savethechildren.in/resource-centre/articles/how-the-
government-is-working-against-child-abuse
6. https://www.savethechildren.in/resource-centre/articles/recent-statistics-
of-child-abuse