this presentation is about child abuse.

1. CHILD ABUSE AND BATTERD CHILD
BY
NISHAT ANSARI
M. SC (NSG)
CHILD HEALTH NURSING
JAMIA HAMDARD

2. “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."
WHO

3. DEMOGRAPHICS (SOURCE MINISTRY OF WOMEN AND CHILD DEVELOPMENT)
 Two out of every three children were physically abused
 53.22% children reported having faced one or more forms of sexual
abuse.
 Every second child reported facing emotional abuse.
 48.4% of girls wished they were boys.

5. A CHILD IS SAFE AND PROTECTED WHEN
• LOVED
• NURTURED
• SAFETY MEASURES
• NOT ABUSED
• CHILD HAVE FAITH IN SYSTEM

6. A CHILD IS UNSAFE WHEN
• NEGLECTED
• DISCRIMINATED
• ABUSED OR WITNESSED
• TORTURED/HARASSED
• SEXUALLY ABUSED
• EXPLOITED OR CHEATED

7. RISK FACTORS
 A HISTORY OF BEING ABUSED OR NEGLECTED AS A CHILD
 PHYSICAL OR MENTAL ILLNESS, SUCH AS DEPRESSION OR POST-TRAUMATIC STRESS DISORDER
(PTSD)
 FAMILY CRISIS OR STRESS, INCLUDING DOMESTIC VIOLENCE AND OTHER MARITAL CONFLICTS, OR
SINGLE PARENTING
 A CHILD IN THE FAMILY WHO IS DEVELOPMENTALLY, OR PHYSICALLY DISABLED
 FINANCIAL STRESS, UNEMPLOYMENT OR POVERTY
 SOCIAL OR EXTENDED FAMILY ISOLATION
 POOR UNDERSTANDING OF CHILD DEVELOPMENT AND PARENTING SKILLS
 ALCOHOL, DRUGS OR OTHER SUBSTANCE ABUSE

9. TYPES OF CHILD ABUSE
NEGLECT
PHYSICAL ABUSE
FAMILY VIOLENCE
EMOTIONAL ABUSE
SEXUAL ABUSE

10. EMOTIONAL ABUSE

11. EMOTIONAL ABUSE
Emotional abuse refers to the psychological and social aspects of child
abuse; it is the most common form of child abuse. Behaviours toward
the child that cause mental anguish are considered emotional abuse
(also called psychological abuse).

12. CAUSES OF EMOTIONAL
ABUSE
 Parents have negative attitudes towards children
 Perceive parents as unrewarding and difficult to enjoy,
 They associate their own negative feelings with the child's difficult
behaviour,
 Poor parenting methods.
 Parental mental health problems
 Domestic violence,
 Drug and alcohol misuse,
 Being abused or having been in care as children

13. SIGNS OF EMOTIONAL ABUSE
CHILDHOOD ADULTHOOD
 Feel unhappy, frightened and
distressed
 Behave aggressively and anti-socially,
or they may act too mature for their
age
 Experience difficulties with academic
achievement and school attendance
 Find it difficult to make friends
 experience incontinence and
mysterious pains
 Experience mental health problems and
difficulties in personal relationships
 Psychological and psychosocial
problems associated with multiple
forms of trauma in childhood

14. NEGLECT
 Parents or caregivers who are continually
unavailable for the child are considered
neglectful. Even if the parent is physically present
but unavailable or refuses to care for the child or
meet his/her needs, neglect occurs.

15. CAUSES
 SOCIOECONOMIC STATUS.
 NUMBER OF CHILDREN
 STRESS
 PSYCHOLOGICAL PROBLEM
 DRUG AND ALCOHOL MISUSE,
 BEING ABUSED
 STRICT BEHAVIOUR

16. SIGN AND SYMPTOMS OF NEGLECT
 developmentally delayed
 Be sick or tired most of the time
 Inadequately supervised or left alone for unacceptable
periods of time
 Malnourished: underweight
 Improper care or lack of hygiene
 Poor school attendance or school performance
 Poor social skills
 Demanding of affection or attention
 Has no understanding of basic hygiene

17. SEXUAL ABUSE

18. SEXUAL ABUSE OF CHILDREN
• Touching a child in a sexual manner, or having sexual relations with the
child is sexual abuse and includes any behaviour toward the child for
sexual stimulation. This type of abuse is characterized by fondling, forced
sexual acts, and indecent physical exposure. Often, the perpetrators are
the child’s relatives or people closest to the family – individuals who no
one imagined would commit such deeds.

19. SIGNS OF SEXUAL ABUSE
 Withdrawn, unhappy and suicidal behaviour
 Self-harm and suicidality
 Aggressive and violent behaviour
 Bedwetting, sleep problems, nightmares
 Eating problems e.g. Anorexia nervosa and bulimia nervosa
 Mood swings
 Detachment
 Pains for no medical reason
 Sexual behaviour, language, or knowledge too advanced for their age
CHILDHOOD-

20. IN ADULTHOOD
• Poorer mental health than other adults.
• A history of eating disorders, depression, substance abuse, and suicide
attempts.
• Sexual abuse is also associated with financial problems in adulthood,
• Decreased likelihood to graduate from high school or undertake further
education

21. PHYSICAL INDICATORS IN A CHILD WITH SEXUAL ABUSE-
 Torn, stained or bloody underclothing
 Bruises, lacerations, redness, swelling or bleeding in genital,
vaginal or anal area
 Blood in urine or faeces
 Unusual or excessive itching or pain in the genital or anal area
 Difficulty in sitting and/or walking
 Age-inappropriate sexual play with toys, self, others
 Sophisticated or unusual sexual knowledge
 Nightmares, sleeping problems

22. Continue….
 Becoming withdrawn or very clingy
 Becoming unusually secretive
 Sudden unexplained personality changes.
 Regressing to younger behaviours, e.g. Bedwetting
 Fear of certain places or persons e.g. Bedroom or bathroom, friend-uncle
 Eating disorders
 Outburst of anger
 Self-harm (cutting, burning or other harmful activities)

23. INDICATORS IN ADULT BEHAVIOUR:
 Insist on physical affection .
 Overly interested in the sexual development of a child or teenager.
 Insist on time alone with a child with no interruptions.
 Spend most of their spare time with children and have little interest in
spending time with people their own age.
 Regularly offer to baby-sit children for free or take children on overnight
outings alone.
 Buy children expensive gifts or give them money for no apparent reason.
 Treat a particular child as a favourite.
 Pick on a particular child.

24. FAMILY VIOLENCE
 Family violence, or domestic violence,
usually refers to the physical assault of
children and women by male relatives,
usually a father and husband/partner. In
these situations, a man uses violence to
control his partner and children, often in
the belief that violence is a male
prerogative .

25. SIGNS IN CHILDHOOD OF FAMILY
VIOLENCE
 BEHAVIOURAL AND EMOTIONAL
DIFFICULTIES
 LEARNING DIFFICULTIES
 LONG-TERM DEVELOPMENTAL PROBLEMS
 AGGRESSIVE LANGUAGE AND BEHAVIOUR
 RESTLESSNESS, ANXIETY AND DEPRESSION

26. PHYSICAL ABUSE / BATTERD CHILD SYNDROME/ OR NON-
ACCIDENTAL TRAUMA

27. “Battered child syndrome (BCS) refers to non-accidental injuries sustained
by a child as a result of physical abuse, usually inflicted by an adult
caregiver”
In 1962, Dr. C. Henry Kempe and his colleagues were the first to recognize and identify
child abuse and neglect in the defining paper, the battered child syndrome. This paper was regarded
as the single most significant event in creating awareness and exposing the reality of child abuse.

28. CAUSES OF BATTERED CHILD
• Found at every level of society,
• Incidence may be higher in lower-income households,
• Adult caregivers may suffer greater stress and social difficulties
• Lack of control over stressful situations
• Lack of education, single parenthood, and alcoholism or other drug addictions.
• The child abuser most often injures a child in the heat of anger or during moments of stress.
• Belief that they can control their children any way they wish.

29. SIGN AND SYMPTOMS OF BATTERED CHILD
• Symptoms may include a delayed visit to the emergency room with an injured
child
• An implausible explanation of the cause of a child's injury
• Bruises that match the shape of a hand, fist or belt;
• Cigarette burns; scald marks; bite marks; black eyes; unconsciousness; lash
marks;
• Bruises or choke marks around the neck; circle marks around wrists or ankles
(indicating twisting);
• Separated sutures; unexplained unconsciousness; and a bulging fontanel in
small infants.

30. EMOTIONAL TRAUMA
 A poor self-image
 inability to love or trust others
 Aggressive, disruptive, or illegal behaviour
 Anger, rage, anxiety , or fear self-destructive or self-abusive behaviour
 Suicidal thoughts
 Passive or withdrawn behaviour
 Fear of entering into new relationships or activities
 School problems or failure
 Sadness or other symptoms of depression
 Flashbacks or nightmares
 Drug or alcohol abuse

31. WHEN TO CALL HELP-
Anyone should call a health care provider or
child protective services if they suspect or
know that a child is being abused. Reporting
child abuse to authorities is mandatory for
doctors, teachers, and childcare workers in
most states as a means to prevent continued
abuse.

33. INVESTIGATION
1. Physical examination- will detect injuries such as bruises, burns,
swelling, retinal haemorrhages (bleeding in the back of the eye), internal
damage such as bleeding or rupture of an organ, fractures of long bones
or spiral-type fractures that result from twisting, and fractured ribs or
skull.
2. X rays and another imaging techniques, such as MRI or scans, may
confirm or reveal other internal injuries, ultrasound.
3. The presence of injuries at different stages of healing (i.e., Having
occurred at different times) is nearly always indicative of child abuse.

34. MANAGEMENT
 Counselling and the implementation of an intervention plan for the child's
parents or guardians are necessary.
 The child abuser may be incarcerated, and/or the abused child removed
from the home to prevent further harm.
 Decisions regarding placement of the child with an outside caregiver or
returning the child to the home will be determined by an appropriate
government agency .
 Both physical and psychological therapy for the abused child.
 If the child has siblings, the authorities should determine where they
have also been abused.

35. PROGNOSIS
The prognosis for child abuse will depend on the severity of injury, actions taken
by the authorities to ensure the future safety of the injured child, and the
willingness of parents or guardians to seek counselling for themselves as well as
for the child.

36. PREVENTION OF CHILD ABUSE AND BATTERED CHILD
 Recognizing the potential for child abuse
 Educational programs to teach caregivers good parenting skills and to be aware
of abusive behaviours and prevention
 Support from the extended family, friends, clergy, or other supportive persons
 Parents who are in danger of abusing their children should seek professional
counselling.
 Counselled through a parenting or caretaking crisis and offered guidance about
how to better handle the situation.

37. CONTINUE…
 Create safe places for children in community, neighbourhood and society.
 Create structures and systems to ensure safety and to ensure that children are
supervised.
 Educate children about safety measures. Provide information about the emergency
contact numbers.
 Create awareness: about child protection systems and networks. Keep this
information handy.
 Build network and develop support systems for children.
 Build public opinion for child protection so that child protection will get priority in
planning and budgeting.

38. AS A PARENT HOW CAN YOU PREVENT IT
 OFFER YOUR CHILD LOVE AND ATTENTION.
 DON'T RESPOND IN ANGER.
 THINK SUPERVISION.
 KNOW YOUR CHILD'S CAREGIVERS.
 EMPHASIZE WHEN TO SAY NO.
 TEACH YOUR CHILD HOW TO STAY SAFE ONLINE.
 REACH OUT

39. NURSES ROLE IN CHILD ABUSE AND BATTERD CHILD PROTECTION
 PHYSICAL CARE -.
 EMOTIONAL SUPPORT –
 OPPORTUNITY TO TALK ABOUT-
SCHOOL NURSES-
SPEAK TO THE SOCIAL WORKER-

40. NATIONAL LEGISLATION
The legislative frame work for children’s right is being
strengthen by the formulation of new laws and amendments
in old laws these includes-
 FOOD SECURITY BILL (2011)
 RIGHT TO FREE AND COMPULSORY EDUCATION ACT (2009)
 CHILD MARRIAGE ACT (2006)
 THE COMMISSION FOR PROTECTION OF CHILD RIGHT ACT
(2005)
 AMENDMENTS TO JUVENILE JUSTICE ACT (2006)
 RIGHT TO INFORMATION ACT (2005)
 THE CHILD LABOUR ACT (1986)
• NEW LEGISLATIONS INCLUDE THE BILL FOR PREVENTION OF
OFFENCES AGAINST THE CHILD AND HIV/ AIDS BILL.

41. RELATED RESEARCHES
1.BATTERED CHILDREN GROWN UP: A FOLLOW-UP STUDY OF INDIVIDUALS SEVERELY MALTREATED AS CHILDREN (VOLUME 16,
ISSUE I,1992)(CHILD ABUSE AND NEGLECT)BY
J A MARTIN; E ELMER (U.S)
• ABSTRACT
In this longitudinal study, 22 children in the sample were judged abused. Of these, 13 were interviewed as adults. The interview
included the administration of several standardized scales: the profile of mood states, buss and durkee's aggression measure,
moos' family environment scale, and a social support measure. Some individuals exhibited limited autonomy and few adult coping
skills, but others were raising families, holding jobs, and maintaining functional social ties. There was little evidence of overt
aggression in the group, but resentment and suspiciousness scores were high. Many subjects maintained ties with their troubled
parents, and others sought out birth parents after losing contact with them in childhood. Several had developed long-term stable
marriages, and social supports were adequate for most subjects in the group. Overall, study findings indicate that early abusive
trauma and adult functioning have no simple relationship. 6 tables, 25 references, and summaries in french and spanish

42. CONTI…
2.THE IMPACT OF FAMILY VIOLENCE ON THE SOCIAL AND PSYCHOLOGICAL DEVELOPMENT OF THE CHILD
S. AL MAJALI, H. ALSREHAN, AL AIN UNIVERSITY, RUSIA,5 NOVEMBER 2019
• Abstract: -children may become victims of physical, sexual, emotional abuse. Our research aims to evaluate the effect of
family violence on the child's social and psychological adaptation. 456 UAE university students voluntarily participated in
the study. Child abuse and trauma scale (CATS) were used to determine the level of domestic violence.
• A methodology-questionnaire of rogers-diamond was used to determine the degree of social and psychological
adaptation. As a result of the study, it was determined that students with a high level of domestic violence have a low
level of social and psychological adaptation of less than 20%. A questionnaire-methodology of rogers-diamond was used
to determine the degree of socio- psychological adaptation. The questionnaire contains 101 statements; 37 of them
meet the criteria of personality adaptation, 37 - maladaptation, 26 - are neutral. Among the statements of the latter
category is the so-called "scale of lies". Six integral indicators allow analyzing the survey results: 1) adaptation; 2)
acceptance of others; 3) internality (level of subjective control); 4) self-perception; 5) emotional comfort; 6) the desire to
dominate. The response scale includes 6 points.
• Results-according to the results of testing on the scale of abuse and psychological trauma in childhood, all respondents
were divided into three groups: high, medium, and low levels of psychological traumas in childhood due to family
violence on the cats scale.
• Conclusion- based on the results of the study, it can be concluded that domestic violence harms the social and
psychological development of the child. The violence, experienced in childhood, has a direct impact. It can also lead to
long-term consequences, often affecting the whole life. It can contribute to the formation of specific family relationships,
unique life scenarios

43. SUMMARY
So today we have discussed about child
abuse, its types, causes, sign and
symptoms, its effects and how it can be
prevented, management and related
researches.

44. CONCLUSION
• Preventing child abuse and neglect should be a
part of national agenda. In INDIA abuse and
battered child syndrome as a major social and
public issue especially among socially
marginalized and economically backward group,
such as children in urban slum, street and working
children of workers. Government should ensure
that child who are working in poor condition or
living with in the family are not exploited. As
healthcare professional, a nurse seek assistance
from special juvenile police units, child welfare
committee, child line 1098, NGOs and
governmental administrators to reach out to
neglected, deprived, abused and battered child.

46. REFERENCES-
 Marlow R. Dorothy. Redding A. Barbara. Textbook of pediatric nursing.6 edition. Philadelphia: Elsevier; 2010.Pp. 47-51.
 Dutta parul. Paediatric nursing.2nd edition. New Delhi: Jaypee; 2009. Pp.33
 Https://www.Mayoclinic.Org/diseases-conditions/child-abuse/symptoms-causes/syc-20370864
 Https://vikaspedia.In/education/child-rights/child-abuse
 Https://www.Savethechildren.In/child-protection/understanding-child-abuse-and-importance-of-child-protection/
 Https://casaspeaks4kids.Com/identifying-different-types-child-abuse/
 Https://en.Wikipedia.Org/wiki/child_abuse
 Http://www.Healthofchildren.Com/B/battered-child-syndrome.Html
 Http://www.Medterms.Com/script/main/art.Asp?Articlekey=8439
 Https://www.Savethechildren.In/child-protection/recent-statistics-of-child-abuse
 Http://www.Kempe.Org/about/history/
 www.Preventchildabuse.Org
 Https://www.Sciencedirect.Com/science/article/abs/pii/014521349290009G?Via%3dihub
 https://www.ojp.gov/ncjrs/virtual-library/abstracts/battered-children-grown-follow-study-individuals-severely
 Https://www.Redalyc.Org/journal/279/27962050025/html/