Abstract
Childhood abuse and neglect are tragic and distressing realities that persist in societies worldwide and can have profound and long-lasting effects on children and adolescents. It encompasses a wide range of harmful behaviours, including physical, emotional, and sexual abuse and neglectful acts of omission, such as failing to provide adequate care, supervision, or emotional support. This chapter focuses on recognising the different forms of abuse and neglect and the risk and protective factors that can be present across multiple levels of a child's ecology and interact to influence outcomes. Survivors of abuse and childhood neglect often face emotional, psychological, and physical consequences that can persist into adulthood. Addressing this global problem requires a coordinated understanding regarding the warning signs, the protective and risk factors and the impact and consequences. Evidence-based psychosocial interventions can assist children and their families to regain their functioning and facilitate the development of healthy, productive lives.
“Childhood should be carefree, playing in the sun;
not a living nightmare in the darkness of the soul.” – Dave Pelzer
TopIntroduction
Sneha, a 12-year-old girl, shared with her counsellor in school that her uncle had sexually abused her for several years. On sharing this with her mother, she refused to believe the incident, and it was then raised to the Juvenile Police Unit and Child Welfare Services. It was seen that her uncle was punished, and appropriate action was taken against him.
Sachin, a 6-year-old kid, had scratches and bruises on his forehead, which his teacher had noted in class. He claimed that his drunk father hit his head on a glass table because he had not cleaned his room. Sachin’s mother was called, and his dad was arrested. As needed, Sachin and his father were referred for evaluation and therapy.
Two infants, Saira and Rehna, aged seven months and one and a half years, respectively, were rescued by the police. They were rescued from a human organ trafficking racket, and after being medically and psychologically examined, they were handed over to the child protection agency.
Childhood Abuse and Neglect is a global social and public health problem with many severe short-term and long-term consequences. It is estimated that up to one billion children,between 2 to 17 years worldwide have experienced physical, sexual, or emotional neglect or violence in the past year (World Health Organisation, 2022). Childhood abuse and neglect is a universally condemned offence against children, as every day, thousands of children are exposed to sexual violence. Recognising the different forms of childhood abuse and neglect is essential for early identification and building awareness.
Children who have experienced severe abuse are frequently placed in foster care, where they may run a high risk of experiencing further long-term detrimental effects on their mental health (Zeanah & Humphreys, 2018). Almost all areas of development, including cognitive, linguistic, socio-emotional, and neurobiological development, are compromised by abuse and neglect.One of the most apparent sequelae of childhood abuse and neglect is mental health issues in children. We know that abuse significantly raises the risk of developing psychopathology. However, several internal (such as genetics and temperament) and external (such as consistent and caring carers) factors may act as protective factors and foster resilience in children who have faced severe adversity (Noll, 2021). Most cases of abuse and neglect involve young children, who need a rigorous evaluation of their caregiving contexts, which frequently involve several carers, to ensure that assessments and treatments are thorough (Flaherty et al., 2013).
Thus, various environmental factors that may support or exacerbate symptoms and impaired functioning must be addressed in the multimodal treatment of psychopathology linked to abuse and neglect in children. Mental health interventions are essential for practitioners to understand how to respond to and offer evidence-based interventions that can be effective for children and adolescents. Comprehensive and multimodal treatments are required, usually lasting for a while. The various challenging stressors that are present in the aftermath of abuse and neglect require additional clinical efforts to help the child navigate after the incidents. Psychological treatments for childhood abuse and neglect are effective and can assist children and their families to regain their functioning and facilitate the development of healthy, productive lives.
TopDefining Childhood Abuse And Neglect
The World Health Organization (WHO, 2022) has defined ‘Child Abuse’ as a “violation of the fundamental humanrights of a child, constituting all forms of physical, emotional ill-treatment, sexual harm, neglect or negligent treatment, commercial or other exploitation, resulting in actual harm or potential harm to a child’s health, survival, development or dignity in the context of a relationship of responsibility, trust or power”. ‘Child Neglect’ occurs when “a parent/guardian fails to provide for their child’s development, even when they are in a position to do so (where resources are available to the family or caregiver, distinguished from poverty).” (World Health Organisation, 2022). Most often, neglect can happen in one or more domains, such as health, nutrition, education, clothing, medical care, protection and supervision, emotional development or shelter. It can cause harm to the child’s health or physical, mental, spiritual, moral or social development.
Key Terms in this Chapter
Emotional Abuse: It refers to acts or behaviours undermining a child’s emotional well-being, self-worth, or psychological development. This abuse can include constant criticism, humiliation, rejection, verbal threats, or exposure to family conflict.
Trauma-Informed Care: It refers to an approach in healthcare and social service settings that recognises and responds to the impact of trauma on an individual’s health and well-being. It involves understanding the prevalence and effects of trauma, including physical, psychological and emotional effects. It comprises integrating this knowledge into all aspects of service delivery to create an environment that promotes healing, safety, and empowerment.
Sexual Abuse: It involves any sexual activity or exposure imposed on a child without their consent or understanding. This can include inappropriate touching, fondling, penetration, exhibitionism, or involving a child in pornography or sexual acts.
Physical Neglect: It involves the failure of caregivers to provide for a child’s basic physical needs, which can result in harm or endangerment. It includes the absence or inadequate provision of necessities such as food, clothing, shelter, hygiene, and medical care.
Emotional Neglect: It refers to the failure of caregivers to provide adequate emotional support, love, and nurturance to a child. It involves the chronic absence of emotional responsiveness and attention, resulting in a child feeling ignored, unimportant, or unloved.
Childhood Abuse and Neglect: Childhood abuse and neglect refer to harmful experiences that children may endure during their formative years, typically from birth to age 18. These experiences involve acts of commission or omission by parents, caregivers, or other individuals in a position of authority.
Exploitation: It refers to any form of mistreatment, abuse, or harm inflicted upon children for personal, social, or economic gain. It involves violating their rights and can take various forms, including but not limited to child labour, trafficking, child marriages, and soldiering.
Physical Abuse: It involves the intentional use of force that causes physical harm or injury to a child. It may include hitting, kicking, burning, shaking, or physically assaulting a child.
Childhood Traumatic Stress: It refers to the psychological and emotional response children may experience following exposure to single or multiple traumatic experiences. Traumatic events are typically characterised by their overwhelming nature, which exceeds the child’s ability to cope effectively.
Complex Trauma: It refers to prolonged or repeated exposure to traumatic events or experiences within the context of interpersonal relationships, typically during childhood or early developmental stages. Unlike a single traumatic incident, such as a car accident or natural disaster, complex trauma involves ongoing, chronic, or multiple traumas that often involve abuse, neglect, or violence within the family or caregiver system.