Category — 2.4 Children with Environmental Risk Conditions: Physical Abuse

Physical abuse is defined as any non-accidental injury inflicted on a child. In other words, a child gets hurt, physically, and it is not due to an accident. Physical abuse is intentional. The person who is physically abusing the child intends to hurt the child physically.

Physical abuse has physical and behavioral symptoms.

The physical symptoms include:

• Bruises, contusions, abrasions (scrapes) and/or lacerations (cuts);
• Hot water burns (that is, putting a body part in hot or scalding water);
• Cigarette burns;
• Burns caused by shoving the child against a hot object (like a heater);
• Bike marks;
• Head injuries (such as concussions);
• Damage to internal organs;
• Broken bones and fractures (Fig. 1);

Figure 1. Broken bones and fractures

All children get hurt at one point or another in their lives. Sometimes it may be difficult to tell whether or not an injury is accidental. Some signs that the injury is not accidental include:

• The location of the injury: injuries from abuse are usually located on the back side of the body;
• The type of injury: for example, clear lines around a hot water burn are an indication that this is an intentional act. Most children and adults move when they come into contact with hot water, so the marks between the burned and non-burned areas tend to be blurry. When a child’s hand or foot is held in hot water the child is unable to move and the result is a clear line between the burned and non-burned areas;
• Having different injuries at different stages of healing: this could indicate abuse because  it means that the child has been seriously hurt more than once.

Physical abuse also has behavioral characteristics, which include:

• Being very scared when someone makes a sudden move;
• Being very passive and lethargic, and even displaying no feelings at all;
• Being very active and aggressive;
• Wearing many layers of clothing, in order to hide bruises (even on warm or hot days);
• Refusing to participate in sports;
• Being frequently absent from school;
• Being clingy and forming attachments to strangers;
• Not liking it when others touch him or her;
• Talking about ending his or her life and being extremely sad (Fig. 2);
• Not caring about school or grades;
• Engaging in self-mutilation (that is, physically hurting his or herself).

Figure 2. Being extremely sad

Physical abuse can affect many areas of development, especially:

• Cognitive and academic skills: some children who are physically abused do not perform well on standardized assessments, such as IQ tests (see full Glossary). Some do not do well because they do not care. Others do not do well because the fear in which they live prevents them from thinking clearly. Some children who are physically abused do not perform as well as their peers on some academic tasks. That could be because the constant fear in which they live prevents them from performing well on these tasks;
• Social/emotional skills: some children who are physically abused struggle with their social/emotional skills:
  • Emotional skills: some children who are physically abused have immature emotional skills. They may react in extreme ways to regular and simple situations. They may struggle when it comes to identifying emotions, both in themselves and others. Some  have negative self-esteem and poor self-confidence;
  • Social skills: some children who are physically abused have poor social skills. They may interrupt others or refuse to wait their turn. Others may be very eager to please and will do anything that is asked of them, making it easy for others to take advantage of them and even bully (see full Glossary) them;
• Language and communication skills: the language skills appear to be rather simplistic and very concrete. They sometimes struggle with complex or multi-step directions  and may not understand certain complex terms;
• Mental health: most children who are physically abused need the help of a psychotherapist. Some of them are severely depressed and may suffer from anxiety-based disorders, such as post traumatic stress disorder (see full Glossary). Others may be suicidal.

Children who are physically abused may not qualify for an Individual Education Plan (IEP) at school. They could, however, benefit from the following services:

• Psychotherapy: this is what most children who are physically abused need.  Most of them will need regular and sometimes intensive psychotherapy from a clinical psychologist. The psychologist will help them come to terms with what has happened to them, help them understand that what happened to them was not their fault, and help them learn to trust adults again. If the child is still in the custody of the biological parents, family therapy (see full Glossary) may be recommended as well;
• School counseling: some children who are physically abused could benefit from regular sessions with the school counselor in addition to the sessions they may be getting from a clinical psychologist. The school counselor can help these children manage their behaviors and feelings at school;
• Special education services: some children who are physically abused, especially those who may be performing less well than their peers cognitively or academically, could benefit from the help of the school’s special educator. The special educator will teach the child how to pay attention and get organized in order to learn what they need to learn.

Children who are physically abused need our help and compassion. They need to learn that not all adults are bad. They need to know  there are adults who care about them and whom they can trust. These needs are very important and need to be addressed in order for the healing process to start.

In the classroom, teachers need to be aware that children who are physically abused often behave differently than others. They may not like it when someone makes a sudden move and may be scared when there is a change in the class routine. These children may be unwilling to trust their teachers, at least at first, because they may be afraid of all adults. It is important to note that teachers can do a lot to help these children with the healing process. There is a reason why many children choose to tell their teacher that they are being abused. Teachers are usually seen as a source of trust and safety. This  is why many children go to them with their personal problems. Therefore, it is highly recommended that a teacher do everything in his or her power to reach the child who is physically abused. Collaboration with the school counselor (and psychotherapist, if possible) is highly recommended. The teacher may be the only constant in the child’s life, and his or her role cannot be under-stated.

It is important to note that there is huge controversy in Canadian society as to what constitutes physical abuse. For example, 50% of Canadians consider spanking child abuse, and 50% consider this discipline necessary to raising well-behaved children (Dana Brynelsen, personal communication, 2012).

To learn more about physical abuse, please visit the physical abuse section of the birth to six course.

see References
Crosson-Tower, C. (2009). Understanding Child Abuse and Neglect (8^th Ed.). Boston, MA: Prentice Hall.
Jenny, C. (2010). Child Abuse and Neglect. New York, NY: Harper Collins.
McCoy, M. L. & Keen, S. M. (2009). Child Abuse Neglect. New York, NY: Psychology Press.
http://www.nlm.nih.gov/medlineplus/childabuse.html