Safeguarding Training: Recognising The Signs Of Abuse

Paediatric Nurse, Angie, breaks down the different types of abuse, highlighting how to recognise the signs and how to escalate your concerns.

Disclaimer About This Training Video

This video contains graphic descriptions of abuse. It aims to supplement any existing qualification and experience you have in this subject and procedures, refresh your memory and prepare you for a regulated training course. (Of course, it is not a substitute for a course.) You can also find regulated training courses on Nurses.co.uk. Our courses will build your CPD, provide you with a certificate, and enhance your CV when job hunting.

Topics covered in this article

Why It’s Important To Recognise The Signs

Emotional Abuse

Physical Abuse

Sexual Abuse

Neglect

What To Do If You Recognise Signs Of Abuse

Why It’s Important To Recognise The Signs

Hi everyone. So my name is Angie and I'm the nurse behind nurse Angie Jay So, today's discussion on behalf of nurses.co.uk is on all things related to safeguarding. And I kind of wanted to focus on child abuse.

I think as professionals, it's important to have awareness and recognising the signs and what to look out for in regards to a child or young person who you may come across during your own practice in your areas of work, even out in the public, who you may feel maybe at risk. I don't feel like you necessarily had to be a paediatric trainers like myself to know, or be aware of child abuse because abuse to children and safeguarding as a whole is everyone's business.

You know, you could be an adult trained nurse and work with parents who have children or are a mental health nurse for example, who works with young teenagers, you can even be a care system who is you know, walking along the corridor and you seen something in relation to a child and parent kind of interaction and you're not quite happy with what you've seen. How would you deal with that kind of thing?

Emotional Abuse

Here in the UK, we have four categories of abuse that we deal with and they are emotional abuse, sexual abuse, physical abuse, and neglect. So, let's start with emotional abuse. Emotional abuse can be harder to detect, but it doesn't mean it's not possible. And this is basically any type of abuse that is continual emotional mistreatment of a child or young person. And sometimes it can be called psychological abuse and this can involve deliberately trying to scare or humiliate a child, you're ignoring them, threatening them and shouting at them in order to call them names or just making them feel startled and scared deliberately.

You're making that child a subject of jokes or using sarcasm to hurt the child. You're making the child perform degrading acts. You're not recognising the child's own sense of individuality or you're trying to control their lives. You know. Pushing a child too hard or not recognising their own limitations, exposing a child to upsetting events or situations like domestic abuse or drug taking is also a form of emotional abuse. Not allowing a child to have friends and develop friendships circles is also emotional abuse. What kind of signs would you be looking out for then? So a child might appear unconfident or they lack self-assurance and you know, resilience is really an issue for them. They struggle to control their emotions. They have difficulty making or maintaining relationships and friendship circles, and act in ways are sort of inappropriate for their age in babies and young toddlers for example, they may be overly affectionate to strangers or people that they don't actually really know that well.

So for example, if you've approached a child a young toddler before, certain age they would have a sense of stranger awareness and who is in their life and who isn't. But if you have a young person, a young person, a toddler who is reaching out their arms for cuddling, picking up, they are very overly affectionate. That's a sign of emotional abuse and maybe they're not getting that emotional warmth from their main caregivers. Children that have extreme outbursts and not able to regulate their emotions also another one. A child may seem isolated from their parents not having a very good relationship. You know?

Physical Abuse

So the next one we'll talk about is physical abuse. Now this is basically when somebody hurts or harms a child or young person on purpose, and that would include things like hitting, and that can be with your hands or with an object. Slapping, punching, kicking, shaking, throwing, poisoning, and burning or scorching a child or young person with things like cigarettes, candles, that kind of thing.

What would you be looking out for? You'll be looking out for bruising. And when I say bruising obviously children are gonna be falling over if there were of certain school age for example falling over on the playground, in the park, they bang their self on their bike handles, scooters, that's absolutely fine. It's in context. And you have to be looking at the consistency and if explanation matches the story basically. So for example if you've got bruising on a child on the back and it looks like fingertip bruising, then you kind of need to be thinking. And the same goes for that broken or fractured bones as well so for example if you've got a four month old or five month old baby, they're not as mobile are they? They're not gonna be kicking a football around to be fracturing or injuring their bones.

So if you have a baby or a young person under an age and they've come in with broken limbs, fractures, you kind of need to be thinking, how did that happen? Same again for burns and scolds you know, obvious cigarette circular burns you need to be asking. Bite marks as well is another one. So, in babies and toddlers we need to be looking at things like swelling and bruising, fractures as I've explained before, if that child is extremely sleepy or unconscious as well, vomiting, seizures, and these could be related to head injuries that might have this received as the terms of like trauma or being shaken.

Sexual Abuse

The next category of child abuse is sexual abuse. So this is when a child or young person is sexually abused. They're either forced or they're tricked into sexual activities. Now they might not necessarily understand what's happening to them because they've been groomed and coerced over time to maybe made to feel like it's normal. They'll often be told things like you know, it's normal it's between us. Don't tell anyone. And, you know that unfortunately gets imprinted in their head and you find that these children who have been sexually abused are afraid to speak out because of what they've been told.

They may often have been threatened as well. If you tell anyone I'm gonna hurt your mom or you know, that kind of thing. So we need to be very delicate and aware when it comes to sexual abuse and it can happen anywhere, you know, either in person or online. And this will involve sexual touching of any part of a child's body, whether they are clothed or not. Using body parts or objects to penetrate a child. Forcing a child to take part in any form of sexual activities and that includes oral sexual activities as well. Making a child undress or touch somebody else. Exposing or flashing a child. Showing a child pornography or sexual videos, sexual pictures is classed as childhood sexual abuse. Making a child also is also masturbate is also a form of child sexual abuse.

So the kind of signs we're looking out for will be bruising, bleeding, discharge, the child's complaining of pain or soreness in their genital or anal areas you need to be thinking about why that child is complaining of pain, any sexually transmitted infections, now no child should be getting any STI. So that's definitely a red flag to be looking at. And I also wanna add thrush into that as well. So obviously, you know, children may be susceptible to thrush because of maybe having taken antibiotics for example, even as adults we may get thrush every now and again, but when it's persistent and consistent along with for example, bleeding, discharge, pain in their genital anal area, then when you start putting two and two together.

Also signs of sexual abuse is pregnancy. If a child is pregnant, we definitely need to be looking at sexual abuse. Especially if that child is under the age of 12, because a child under the age of 12 in this country cannot be consenting to anything. Another big thing is sexualised behaviour and play in talk. So if a child for example, you've noticed around you who's playing with dolls or playing anything and the way they're playing with the dolls for example, is very sexual. The way they're talking, the words that they're saying, it's very sexualised we need to be thinking as well. The final category of child sexual abuse is of child abuse.

Neglect

The final category of child abuse is neglect and neglect is ongoing failure to meet a child's basic needs and actually unfortunately is the most common form of abuse, i see in the safeguard field. So this could be a failure to sort of meet a child's basic needs such as feeding, food, providing food, clothing, shelter. They're not being met properly or supervised or a child is not being kept safe and ensuring that your child is given an education. So if you quite happy for a child to just stay at home and not go to school, nursery, college, there's an issue there. You know, withhold nurture and stimulation is a form of emotional neglect and it could be things like you know, ignoring them, humiliating them, you know, not providing a stimulating and nurturing environment.

There's no toys in the home. You know, their walls are very bare. There's no colour stimulation, things that are gonna allow a child to be nurtured and develop. And then things like not taking a child purposely to hospital appointments, GP appointments, ignoring medical recommendations. Things like not going to the dentist or opticians you know, dental decay is a big thing and a big issue here in the UK amongst children particularly under the age of five where you know, children are having to go in for day-case surgery under general anaesthetic to have significant amount of teeth removed down to dental decay. So these are all things to be looking out for.

What To Do If You Recognise Signs Of Abuse

So what would you do if you suspect as a professional or a person out in public, you know, what would you do? So there would be an escalation policy, which I would hope you guys are aware of. So your trust, your ward, your department, your workplace should have an escalation policy in regards to how to escalate and report child abuse. And that might be things like filling out a mash form, contacting social care, and also if the child is in immediate danger, then you need to be calling the police straight away onto the scene.

So if you're not aware of the child, escalation policy for safeguarding and abuse, make yourself aware of where it is. If it's on your intranet, if it's in a folder in your offices somewhere, have a quick read for it and just make yourself used to what the policy and process is. So I hope you guys have found that quite useful and quite helpful. Thank you for listening and see you next time.