Introduction/Background

Early in the 1900's there was a reluctance to accept the existence of violence towards children; many bone deformities were diagnosed as being caused by vitamin deficiency. The development in radiology with the ability to date fractures showed the deformities to have been caused by inflicted injury. The turning point came in the 1960's with the publication by Kempe of his Battered Baby Syndrome paper. In Britain the inquiries into the deaths of Maria Colwell, Kimberly Carlile, Jasmine Beckford and Tyra Henry have all contributed to understanding that children continue to be vulnerable from abuse inflicted by parents/carers.

Further advances in medical diagnosis/opinion have also assisted in understanding the complexity of abuse to children and their causes. The work of Professor Meadows in Leeds, for example, has played a major role in understanding Munchausen's syndrome by proxy as does other research that has been carried out in the past 10 years. Research findings on the incidence and prevalence are reported together with what is known about how best to secure optimal outcomes for children in whom illness has been fabricated or induced.

Definition

The definition of physical abuse has evolved since the introduction of guidelines and procedures to protect children. "Working Together to Safeguard Children" published by the Department of Health in 1999 defines it thus:

"Physical abuse may involve hitting, shaking, throwing, poisoning, burning or scalding, drowning, suffocating, or otherwise causing physical harm to a child. Physical harm may also be caused when a parent or carer feigns the symptoms of, or deliberately causes ill health to a child whom they are looking after. This situation is commonly described using terms such as factitious illness by proxy or Munchausen syndrome by proxy".

A recently published Supplementary Guidance re-defines Munchausen syndrome by proxy as "fabrication or induction of illness in a child by a carer".

Signs of Physical Abuse

• Bruises, bites, burns, fractures etc which do not have an accidental explanation
• Cuts/scratches/substance abuse
• Any injuries not consistent with the explanation given for them
• Injuries which occur to the body in places which are not normally exposed to falls, rough games, etc
• Injuries which have not received medical attention
• Reluctance to change for, or participate in, games or swimming

Effects of Physical Abuse

• Physical abuse can lead directly to:
• Neurological damage
• Physical injuries
• Disability
• Death

Harm may be caused to children by:

• The abuse itself
• The abuse taking place in a wider family or institutional context of conflict and aggression

Physical abuse has been linked to:

• Aggressive behaviour in children
• Emotional and behavioural problems
• Educational difficulties

Incidence of Physical Abuse Today

Whilst it is difficult to state accurately the level of physical abuse today, there are indicators of trends as recorded by the number of children whose names are included on Local Authority Child Protection Registers. At the end of March 2000 there was a total of 30,300 children on Registers in England (Source: London: Government Statistical Office, 2000.) This figure = 27 per 10,000 child population. Of these, 5,900 were registered for physical injury alone.

The statistics collated over the past five years show a reduction in the number of children on Child Protection Registers under the category of Physical Abuse: 8,703 in 1996 to 5,900 in March
2000.

Child Deaths

The recent reports relating to the death of Anna Climbie have again highlighted sadly, that children do die as a result of child abuse. A review of Home Office figures shows that the rate of child homicide in England and Wales has not dropped over the last 25 years. In each generation of children more than a thousand will be killed before reaching adulthood. Most will die at the hands of violent or neglectful parents or carers.

Some closing thoughts

Anna's death has again highlighted evil and how children can be and are harmed by their carers. Jesus and the apostle Paul both gave advice on the need to love and care for children. We need to be praying for children's safety and that they will know more of God's love in their lives. We need to be exploring how we individually and together as a church can act as the "salt and light" that Jesus talks of to ensure that children's experiences are positive and not predominated by acts of physical violence.

Useful publications

"Working Together to Safeguard Children" published by the Department of Health in1999.

"Child Maltreatment in the United Kingdom: A study of the prevalence of child abuse and neglect" - NSPCC.

"Safeguarding Children in Whom Illness is Induced or Fabricated by Carers with Parenting Responsibilities" published by the Department of Health in 2001.
Source: Criminal Statistics (England and Wales). Home Office

 

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