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Types of abuse

1. Introduction

This document is a best practice reference document for use by those in the Church who have a role with children, young people and adults.

It contains information about the types of abuse which can occur and how to recognise them, including physical signs and symptoms as well as behavioural changes that you might observe. Bear in mind that children, young people and adults may be subject to one type of abuse or a combination of types of abuse. It is informed by the definitions available in Working Together 2018 and the Care Act 2014.

The lists of signs and symptoms below are not exhaustive – there may be other signs or symptoms which are not listed below which could be indicators of abuse. Similarly, some of these signs and symptoms will not always be indicators of abuse. The following lists under each category of abuse contain examples of possible indicators. The presence of one or more of these signs or symptoms does not necessarily confirm abuse.

Please note that many types of abuse are also criminal offences and should be treated as such.

2. Children

2.1. Physical abuse

Physical abuse may or may not cause injury and includes physical ill treatment, causing unjustifiable physical discomfort, for example injury, pain or impairment.

Abusive Actions Signs and Symptoms

Hitting

Cuts, lacerations, puncture wounds, open wounds, bruising, welts, black eyes, burns, bite marks, broken bones and skull fractures

Slapping

Untreated injuries in various stages of healing or not properly treated

Kicking Poor skin condition or poor skin hygiene
Shaking Dehydration and/or malnourishment without an illness-related cause
Inappropriate restraint Loss of weight
Withholding or misuse of medication Soiled clothing or bedding
Squeezing Broken eyeglasses or frames
Biting Physical signs of being subjected to punishment or signs of being restrained
Suffocating Inappropriate use of medication, overdosing or under dosing
Poisoning Cowering and flinching
Drowning Emotional distress, low self-esteem, untypical self-harm
Killing Telling you they have been hit, slapped or mistreated
Physical abuse may also be caused when a parent or carer fabricates symptoms of, or deliberately induces, illness in a child. This is called Fabricated or Induced Illness. Aggressive behaviour or severe temper outbursts
Involuntary isolation or confinement Reluctance to get changed, for example in hot weather
Inappropriate application of techniques or treatments Depression
  Withdrawn behaviour
 

Remember: most children will collect cuts and bruises as part of the rough-and-tumble of daily life.
However, important indicators of physical abuse are bruises or injuries that are either unexplained or inconsistent with the explanation given, or visible on the ‘soft’ parts of the body where accidental injuries are unlikely, e.g. cheeks, abdomen, back and buttocks.

A delay in seeking medical treatment when it is obviously necessary is also a cause for concern.

Children may also display:

  • Fear of parents being approached for an explanation
  • Running away from home

2.2. Sexual abuse

A sexual act carried out without the informed consent (see below) of the other individual is abuse. Such behaviour includes contact and non-contact abuse.

Contact abuse may include rape, indecent assault, being forced to touch another person, sexual intercourse or being pressurised into consenting to sexual acts.

It is also important to remember that it is not just adult men who sexually abuse children – there are increasing numbers of allegations of sexual abuse of children against women and sexual abuse can also be perpetrated by other children or young people.

Abusive Actions Signs and Symptoms
Rape Bruises around the breasts or genital areas

Sexual assault

Unexplained STI or genital infections
Kissing Unexplained vaginal or anal bleeding
Fondling/caressing Vaginal discharge or infection
Involving children in looking at, or in the production of, sexual images, watching sexual activities Torn, stained or bloody underclothing
Downloading child abuse images The child telling you they have been sexually assaulted or raped
Encouraging children to behave in sexually inappropriate ways Pain or itching in the genital area
Sending sexualised texts and emails and transmitting sexually explicit images through social media Sexually transmitted disease
Grooming Stomach pains or discomfort when walking or sitting down
  Pregnancy
 

Changes in behaviour which can also indicate sexual abuse include:

 

  • Sudden or unexplained changes in behaviour e.g. becoming aggressive or withdrawn
  • Fear of being left with a specific person or group of people
  • Having nightmares
  • Running away from home
  • Sexual knowledge which is beyond their age, or developmental level
  • Sexual drawings or language
  • Bedwetting
  • Eating problems such as overeating or anorexia
  • Self-harm, suicidal thoughts, suicide attempts;
  • Substance abuse
  • Suddenly having unexplained sources of money
  • Not allowed to have friends (particularly in adolescence)
  • Acting in a sexually explicit way, specifically children towards adults

Age of consent

The age of consent (the legal age to have sex) in England is 16 years old. This applies to both heterosexual and homosexual sex.

The laws are there to protect children from abuse or exploitation, rather than to prosecute under-16s who participate in mutually consenting sexual activity. Underage sexual activity may be a possible indicator of child sexual exploitation.

Statutory agencies have agreed that if 13-16-year-old sexual activity is discovered then an assessment of risk should be carried out.

Risks to be considered include:

- Whether the child is competent to understand, and consent to, the sexual activity they are involved in
- Whether the sexual activity is with someone of a similar age, ability and aptitude
- Whether there is a power imbalance
- Whether there any coercion or bribery, overt aggression, misuse of alcohol or other substances acting as a disinhibitor
- Whether the sexual partner is known by one of the statutory agencies

To help protect younger children the law says anyone under the age of 13 can never legally give consent. This means that anyone who engages in any sexual activity with a child who is 12 or younger is breaking the law. Sexual activity with a child who is under 13 should always result in a child protection referral. The law gives extra protection to young people who are over the age of consent but under 18. It is illegal:

- To take, show or distribute indecent photographs of a child (this is often called sexting).
- To pay for or arrange sexual services of a child.
- For a person in a position of trust (for example teachers or care workers) to engage in sexual activity with anyone under the age of 18 who is in the care of their organization. The Sexual Offences Act 2003 applies in England and Wales. It gives more information about specific offences and the related penalties.

Age of criminal responsibility for children

The age of criminal responsibility in England is 10 years old.

This means a child is considered capable of committing a crime and old enough to stand trial for a criminal offence. Their case will be dealt with by a youth court and if they are convicted, their sentence will take their age into account.

 

2.2.1. Grooming

Grooming is a form of sexual abuse. It is when someone builds an emotional connection with a child to gain their trust for the purposes of sexual abuse, sexual exploitation or trafficking. Grooming may also include threats or bribes, which persuade the person that it would be impossible to ask for help. It may appear as an unhealthily close friendship which stretches or breaks approved boundaries. Children and young people can be groomed online or face-to-face, by a stranger or by someone they know - for example a family member, friend or professional.

Methods of making contact online via social networking and chat-based applications (often used on mobile phones) are often used for this, although grooming can take place face-to-face. When grooming takes place online it is easy for potential abusers to disguise their identity, including their gender, location and age.

Signs of grooming

The signs of grooming aren't always obvious, and groomers will often go to great lengths not to be identified. If a child is being groomed they may:

  • Be very secretive, including about what they are doing online
  • Have older boyfriends or girlfriends
  • Go to unusual places to meet friends
  • Have new things such as clothes or mobile phones that they can't or won't explain
  • Have access to drugs and alcohol In older children

In older children, signs of grooming can easily be mistaken for 'normal' teenage behaviour, but you may notice unexplained changes in behaviour or personality, or inappropriate sexual behaviour for their age.

How grooming happens

Grooming happens both online and in person. Groomers will hide their true intentions and may spend a long time gaining a child's trust. Groomers may try to gain the trust of a whole family to allow them to be left alone with a child and if they work with children they may use similar tactics with their colleagues.

Groomers do this by:

  • Pretending to be someone they are not, for example saying they are the same age online
  • Offering advice or understanding
  • Buying gifts
  • Giving the child attention
  • Using their professional position or reputation
  • Taking them on trips, outings or holidays

2.2.2. Child Sexual Exploitation

Child sexual exploitation is a form of child sexual abuse. Sexual abuse may involve physical contact, including assault by penetration (for example, rape or oral sex) or non-penetrative acts such as masturbation, kissing, rubbing and touching outside clothing. It may include non-contact activities, such as involving children in the production of sexual images, forcing children to look at sexual images or watch sexual activities, encouraging children to behave in sexually inappropriate ways or grooming a child in preparation for abuse (including via the internet).

The definition of child sexual exploitation is as follows:

Child sexual exploitation is a form of child sexual abuse. It occurs where an individual or group takes advantage of an imbalance of power to coerce, manipulate or deceive a child or young person under the age of 18 into sexual activity (a) in exchange for something the victim needs or wants, and/or (b) for the financial advantage or increased status of the perpetrator or facilitator. The victim may have been sexually exploited even if the sexual activity appears consensual. Child sexual exploitation does not always involve physical contact; it can also occur through the use of technology.

Like all forms of child sexual abuse, child sexual exploitation:

    Can affect any child or young person (male or female) under the age of 18 years, including 16 and 17-year olds who can legally consent to have sex Can still be abuse even if the sexual activity appears consensual Can include both contact (penetrative and non-penetrative acts) and non-contact sexual activity Can take place in person or via technology, or a combination of both Can involve force and/or enticement-based methods of compliance and may, or may not, be accompanied by violence or threats of violence May occur without the child or young person’s immediate knowledge (through others copying videos or images they have created and posting on social media, for example) Can be perpetrated by individuals or groups, males or females, and children or adults. The abuse can be a one-off occurrence or a series of incidents over time and range from opportunistic to complex organised abuse Is typified by some form of power imbalance in favour of those perpetrating the abuse. Whilst age may be the most obvious, this power imbalance can also be due to a range of other factors including gender, sexual identity, cognitive ability, physical strength, status, and access to economic or other resources
    Possible indicators of CSE

    The following list of indicators is not exhaustive or definitive, but it does highlight signs which can assist in identifying possible CSE:

      Keeping secrets Inappropriate sexual or sexualised behaviour Sexually risky behaviour Repeat sexually transmitted infections Repeat pregnancy, abortions, miscarriage Receiving unexplained gifts or gifts from unknown sources Having multiple mobile phones and worrying about losing contact via mobile. Having unaffordable new things (clothes, mobile) or expensive habits (alcohol, drugs) Changes in the way the person dresses Going to hotels or other unusual locations to meet friends Contact with known perpetrators Involved in abusive relationships, intimidated and fearful of certain people or situations Unexplained changes in behaviour or personality – e.g. mood swings, volatile behaviour, emotional distress Self-harming, suicidal thoughts, suicide attempts, overdosing, eating disorders Drug or alcohol misuse Getting involved in crime Injuries from physical assault, physical restraint, sexual assault The adult may create special relationships with a particular person or have difficulties in keeping to boundaries. They may try to have secrets from others in the group.

      2.3. Neglect

       

      2.4. Emotional abuse

      2.5. Domestic abuse

      2.6. Bullying and cyber-bullying

       

      3. Adults

      3.1. Physical abuse

      3.2. Sexual abuse

      3.3. Psychological abuse

      3.4. Financial/material abuse

      3.5. Modern slavery

      3.6. Discriminatory abuse

      3.7. Domestic abuse

      3.8. Organisational or Institutional Abuse

      3.9. Neglect and acts of omission

      3.10. Self-neglect

      4. Additional vulnerabilities

      4.1. Additional Signs and Symptoms of Abuse

      5. Additional Specialist Guidance

      5.1. Complex abuse

      5.2. Honour based violence or abuse 6

      5.3. Forced marriage

      5.4. Female genital mutilation

      5.5. Spiritual abuse 9