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What is 'abuse'?

Abuse is a form of maltreatment of a child. Somebody may abuse or neglect a child by inflicting harm or by failing to act to prevent harm. Children may be abused in a family or in an institutional or community setting by those known to them or, more rarely, by others (e.g. via the internet). Abuse can take place wholly online, or technology may be used to facilitate offline abuse. They may be abused by an adult or adults or by another child or children.

Physical abuse

Physical abuse is a form of abuse which 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 fabricates the symptoms of, or deliberately induces, illness in a child.

Typical signs of Physical Abuse are:

  • Bruises and abrasions – especially about the face, head, genitals or other parts of the body where they would not be expected to occur given the age of the child.  Some types of bruising are particularly characteristic of non-accidental injury especially when the child’s explanation does not match the nature of injury or when it appears frequently.
  • Slap marks – these may be visible on cheeks or buttocks.
  • Twin bruises on either side of the mouth or cheeks – can be caused by pinching or grabbing, sometimes to make a child eat or to stop a child from speaking.
  • Grip marks on arms or trunk – gripping bruises on arm or trunk can be associated with shaking a child.  Shaking can cause one of the most serious injuries to a child; i.e. a brain haemorrhage, as the brain hits the inside of the skull. X-rays and other tests are required to fully diagnose the effects of shaking.  Grip marks can also be indicative of sexual abuse.
  • Black eyes – are most commonly caused by an object, such as a fist, coming into contact with the eye socket.  NB A heavy bang on the nose, however, can cause bruising to spread around the eye but a doctor will be able to tell if this has occurred.
  • Damage to the mouth – e.g. bruised/ cut lip or torn skin where the upper lips join the mouth.
  • Bite marks
  • Fractures
  • Poisoning or other misuse of drugs – e.g. overuse of sedatives
  • Burns and/or scalds – a round, red burn on tender, non-protruding parts, like a mouth; inside arms and on the genitals will almost certainly have been deliberately inflicted.  Any burns that appear to be cigarette burns should be cause for concern.  An experienced person will notice skin splashes caused when a child accidentally knocks over a hot cup of tea.  In contrast, a child who has been deliberately ‘dipped’ in a hot bath will not have splash marks.

Sexual abuse

Involves forcing or enticing a child or young person to take part in sexual activities, not necessarily involving a high level of violence, whether or not the child is aware of what is happening. The activities 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 of clothing. They may also include non-contact activities, such as involving children in looking at, or in the production of, sexual images, watching sexual activities, encouraging children to behave in sexually inappropriate ways, or grooming a child in preparation for abuse (including via the internet). Sexual abuse is not solely perpetrated by adult males. Women can also commit acts of sexual abuse, as can other children. The sexual abuse of children is a specific safeguarding issue in education through peer on peer abuse.

Typical signs of sexual abuse are:

  • detailed sexual knowledge inappropriate to the age of the child
  • behaviour that is excessively affectionate or sexual towards other children or adults
  • attempts to inform, by making a disclosure about the sexual abuse, often begin by the initial sharing of limited information with an adult.  It is also very characteristic of such children that they have an excessive pre-occupation with secrecy and try to bind the adults to secrecy or confidentiality.
  • fear of medical examinations
  • fear of being alone – this applies to friends/family/neighbours/baby-sitters etc
  • sudden loss of appetite, compulsive eating, anorexia nervosa or bulimia nervosa
  • excessive masturbation is especially worrying when it takes place in public
  • promiscuity
  • sexual approaches or assaults – on other children or adults.
  • urinary tract infections (UTI), sexually transmitted disease (STD) are cause for immediate concern in young children, or in adolescents if his/her partner cannot be identified.
  • bruising to the buttocks, lower abdomen, thighs and genital/rectal areas.  Bruises may be confined to grip marks where a child has been held so that sexual abuse can take place.
  • Discomfort or pain particularly in the genital or anal areas.
  • Drawing of pornographic or sexually explicit images.

Emotional abuse

Emotional abuse is the persistent emotional maltreatment of a child such as to cause severe and adverse effects on the child’s emotional development. It may involve conveying to a child that they are worthless or unloved, inadequate, or valued only insofar as they meet the needs of another person. It may include not giving the child opportunities to express their views, deliberately silencing them or ‘making fun’ of what they say or how they communicate. It may feature age or developmentally inappropriate expectations being imposed on children. These may include interactions that are beyond a child’s developmental capability as well as overprotection and limitation of exploration and learning, or preventing the child participating in normal social interaction. It may involve seeing or hearing the ill-treatment of another. It may involve serious bullying (including cyberbullying), causing children frequently to feel frightened or in danger, or the exploitation or corruption of children. Some level of emotional abuse is involved in all types of maltreatment of a child, although it may occur alone.

Typical signs of emotional abuse are:

There often aren’t any obvious physical symptoms of emotional abuse or neglect but you may spot signs in a child's actions or emotions. Changes in emotions are a normal part of growing up, so it can be really difficult to tell if a child is being emotionally abused.

Babies and pre-school children who are being emotionally abused or neglected may:

  • be overly-affectionate towards strangers or people they haven’t known for very long
  • lack confidence or become wary or anxious
  • not appear to have a close relationship with their parent, e.g. when being taken to or collected from nursery etc.
  • be aggressive or nasty towards other children and animals

Older children may:

  • use language, act in a way or know about things that you wouldn’t expect them to know for their age
  • struggle to control strong emotions or have extreme outbursts
  • seem isolated from their parents
  • lack social skills or have few, if any, friends

Neglect

Neglect is the persistent failure to meet a child’s basic physical and/or psychological needs, likely to result in the serious impairment of the child’s health or development. Neglect may occur during pregnancy as a result of maternal substance abuse. Once a child is born, neglect may involve a parent or carer failing to: provide adequate food, clothing and shelter (including exclusion from home or abandonment); protect a child from physical and emotional harm or danger; ensure adequate supervision (including the use of inadequate care-givers); or ensure access to appropriate medical care or treatment. It may also include neglect of, or unresponsiveness to, a child’s basic emotional needs.

However, typical signs of physical neglect are:

  • Underweight – a child may be frequently hungry or pre-occupied with food or in the habit of stealing food or with the intention of procuring food.  There is a particular cause for concern where a persistently, underweight child gains weight when away from home, for example, when in hospital or on an Academy trip.  Some children also lose weight or fail to gain weight during Academy holidays when Academy lunches are not available and this is a cause for concern.
  • Inadequately clothed – a distinction needs to be made between situations where children are inadequately clothed, dirty or smelly because they come from homes where neatness and cleanliness are unimportant and those where the lack of care is preventing the child from thriving.

Physical Neglect is a difficult category because it involves the making of a judgement about the seriousness of the degree of neglect.  Much parenting falls short of the ideal but it may be appropriate to involve Child Protection procedure in the case of neglect where the child’s development is being adversely affected.

Peer-on-peer abuse

It is important to note that the categories of abuse are not limited to a parent–child relationship. In some instances, children can abuse other children, more commonly known as ‘peer-on-peer abuse’.

Pimlico Academy offers training sessions to all staff on the different categories of abuse. In any case where abuse is suspected, the academy will work in conjunction with MASH and relevant external agencies to ensure the correct support is put in place for the child and family.