Child maltreatment is any action causing potentially significant harm to a child. Maltreatment can be initiated by an adult or a child. It can involve physical, sexual, verbal or emotional abuse; neglect or exploitation.
Studies consistently show that only a minority of children who are maltreated are identified. We also know that many children experience more than one type of maltreatment at the same time. Overall, girls and young women are more likely to be exposed to child abuse. However, during primary school years both boys and girls are as likely to be affected.
Types of abuse include:
- sexual – including child sexual exploitation
- psychological or emotional
- violence in the home
- verbal or emotional abuse
- racial harassment and discrimination
- female genital mutilation
You can find an overview of the types of abuse faced by children in this guide for practitioners: ‘What to do if you are worried that a child is being abused’ and on the NSPCC website.
How does maltreatment affect mental health and development?
The impact of maltreatment on mental health
Evidence suggests that maltreatment increases the risk of a child experiencing symptoms of trauma. Maltreatment is also a major adverse childhood event (ACE) with long-term damaging effects on children’s physical and mental health. Neglect can be as damaging as physical, sexual or emotional abuse. The more types of maltreatment a child experiences, the greater the chance they will struggle with a range of poorer life chances as adults.
The effect of maltreatment on development
From birth, children have a strong need to feel safe, to have basic needs met and to be stimulated to develop healthily. Strong, nurturing, and trustworthy attachments from caregivers teach children how to manage day-to-day adversity and buffer them against excessive stress. Good quality attachments with caregivers make children feel safe and secure, promoting healthy child development, good mental and physical health, and stimulating cognitive development.
When a parent/carer becomes a source of fear rather than safety, this can be toxic for a child’s development. When such experiences are extreme or long lasting, they heighten a child’s exposure to damaging levels of stress and over-stimulate their ‘fight or flight’ response. This can make children jumpy and they can find it difficult to calm their emotions or behaviour.
Schools often see the knock-on effects of abuse, as distress is frequently communicated through children’s behaviour and through their inability to focus in school.
Child abuse and safeguarding
MindEd is a free educational e-learning resource for professionals on children and young people’s mental health. Resources can be used for individual professional training and used to prompt wider staff discussion. These sessions focus on factors linked to maltreatment and its prevention.
Remain calm, focussed and stay with what the child is saying or doing. Only intervene if they are putting themselves or others at risk.
Avoid asking leading questions or probing.
Ask ‘how’ rather than ‘why’ questions. ‘How did you get that bruise?’ Be as accurate as possible in your recording and pay particular attention to key words that the child uses. Avoid interpretation and stick to facts and observations.
Do not promise confidentiality. Let the child know you will have to share what they have told you with the designated person for safeguarding in school. Do not accept any retraction or backtracking from the child. If it has been said it needs to be reported.
Case study: recognising sexual abuse
Two young men, describe similar patterns of sexual abuse as children which they did not disclose until early adult years – by which time they were diagnosed with very serious mental health difficulties.
Before their diagnoses, neither had contact with child mental health services. One boy talked about abuse to his family but was not believed – which he described as a highly damaging experience. Both felt there were clues from very early on in their school careers – mainly through their behaviour. Both said they wanted teachers to notice that they were struggling, to ask if they were OK, to help them be safe, to be concerned and supportive and to have listened. They also felt that they needed earlier, compassionate help (day-to-day support from teachers, access to counselling).
Schools and safeguarding duties
All school staff have a legal responsibility to safeguard and promote the welfare of children. This includes a responsibility to:
- Provide a safe environment in which children can learn.
- Identify children who may be in need of extra help or who are suffering, or are likely to suffer significant harm. All staff then have a responsibility to take appropriate action, working with services as needed.
- Attend safeguarding training.
- Follow their school’s safeguarding policy.
There’s more information about school safeguarding roles and responsibilities in our section on a mentally healthy school.
Spotting the signs
It can be difficult to identify when a child is being maltreated. Signs are not always obvious and a child may hide things or not understand that what is happening is abuse. Studies indicate that only a minority of children actually disclose abuse.
However, children will often communicate experiences in other ways, with their responses dependent on the type, severity and extent of their abuse, their previous experiences of abuse/trauma and the balance of strengths and risk factors in their lives.
Signs of abuse or maltreatment can include:
- Behaviour changes; becoming aggressive, challenging, excessive or early risk taking, or being withdrawn.
- Struggling in school – concentration difficulties or being tired/hungry.
- Developmental milestones achieved late – with no apparent medical/educational reason.
- A reluctance to go home or a strong desire to avoid specific family members/adults.
- Poor school attendance and punctuality – or children who are regularly picked up late.
- Children who don’t like being touched or flinch at sudden movements.
- Children concerned about younger siblings but without explaining why.
- Children with consistently poor hygiene and/or with clothes that are ill-fitting/dirty.
- Children who don’t want to change clothes in front of others or participate in physical activities.
- Children who talk about being left at home alone with inappropriate carers/strangers.
- Children who run away.
- Children who seem anxious and/or depressed.
- Children with poor attendance and regular lateness.
Of course, many other drivers may trigger some of these signs. It is important, therefore, for concerns to be discussed with your designated safeguarding lead (DSL) and for school staff to piece together as many parts of the jigsaw as possible.
Abuse and neglect can happen in any family and with any child. But studies do indicate that some parental and community-based factors increase the likelihood of child maltreatment. These factors include poverty, lack of community support, not picking up parenting skills that consistently nurture and set boundaries for children (known as positive parenting approaches), parental mental health problems, lower than average parental educational achievement, parental alcohol and drug misuse, and living in a high crime area.
Protective factors: what schools can do
When a child has been maltreated, their basic needs (safety, belonging, trust, survival, etc.) are often not met and they may find it difficult to learn. School staff can help children move forward in a number of ways, by:
- Making sure that children’s basic needs are met consistently and reassuringly at school, and that they feel safe and valued.
- Creating a nurturing classroom climate that fosters caring, appreciation of differences, consistent rules and boundaries, and recognition of small successes.
- Being approachable. Helping children trust and open up by noticing and connecting with them; by listening attentively, supportively and sensitively when a child discloses abuse.
- Believing children and not blaming them.
- Being alert, watchful and questioning – particularly to what children might be trying to communicate via their play or behaviour.
- Investing in patient relationships with children who have been abused and who may have attachment or trust issues.
- Helping children exposed to, or facing maltreatment, not only through broader whole-school programmes/curriculum activity designed to build social and emotional skills, but also providing small, targeted group work.
- Helping children access extra support. They may well need extra care through pastoral/counselling, or through referral to the school nurse, accessing helplines or discussion with your SENCO lead. Some children will need referral onto community-based support and may need trauma-based expertise (e.g. early help, voluntary sector counselling or specialist CAMHS support).
- If appropriate, motivating some parents/carers to link up with additional support themselves – in the best interests of their child’s education and mental health. You will also find some national helplines and searchable service directories in the resources listed to get parents the help they might need.
Concerned about a child?
If you are worried that a child is at risk involve your designated safeguarding lead as a matter of priority who will contact the parents/carers and other services as necessary. If the child is at immediate risk, ensure that they are taken to their GP or A&E as a matter of urgency, depending on the severity of the concern.Read more