Child abuse and neglect

School nurse: Abuse is often associated with neglect, and refers to any act or failure to act, on the part of a parent or caretaker, which results in serious physical or emotional harm, sexual abuse or exploitation, or which presents an imminent risk of serious harm to a child, or even death. Child abuse may occur for many reasons, and could be related to psychological, emotional and social problems.

Trainee: What is the most common form of abuse?

School nurse: The most common is emotional abuse, with its psychological and social aspects. It is usually associated with physical and sexual abuse. Emotional abuse happens when adults tend to fulfill their own needs and goals rather than their children’s or the ones they are in charge of.

Trainee: Then, children can be subject to emotional abuse by anyone!

School nurse: Yes. They may be emotionally abused by any adult in a position of power, for example, teachers. Or even by other children.

Trainee: What signs may indicate that a child is emotionally abused?

School nurse: He will seem unhappy, frightened and distressful, behave aggressively and anti-socially, or may act too mature for his age. He may find it difficult to make friends, will show signs of physical neglect and malnourishing, or experience incontinence and unexplained pains.

Trainee: You also talked about emotional abuse being related to neglect…

School nurse: Yes, neglect includes failure to provide food, shelter, clothing, medical care, love and support, appropriate moral guidance and ensuring the child attends school regularly.

Trainee: This seems rather difficult to identify. Unlike physical abuse. I guess that this involves hitting, slapping or striking a child with an object.

School nurse: Yes, but also kicking, pinching or biting. Children will show emotional, behavioral and learning difficulties, but also long-term developmental problems, aggressive language, restlessness, anxiety and depression. They are also highly vulnerable to emotional situations.

Trainee: What about sexual abuse?

School nurse: Sexual abuse may be caused by an adult that engages a child in a sexual act, or exposes him to inappropriate sexual behavior or material, but also by another child. It also involves subtle forms of manipulation, in which the child is made to believe that the activity is an expression of love, or that he brought the abuse upon himself.

Trainee: What are the signs that can indicate that? I assume that the child remains silent, feels guilty or shameful…

School nurse: Sexually abused children show a range of signs like unhappiness, suicidal behavior, self-harm, aggressiveness and violence, bedwetting, sleep problems, eating problems, mood swings, detachment, pains for no medical reason, and sexual behavior, language, or knowledge too advanced for their age.