Children Act 1974 and its Practical Implementation Legal Analysis
1.1. Background
Challenges to the health of our children have been changing in recent decades as we are able to tackle many diseases through immunization and child health programmes. However, new challenges are being uncovered. Child abuse and neglect is one of them. This has been poorly recognized as a public health problem in the world, particularly in South-East Asia.1
More than strangers, care providers themselves and ideal figures of children are involved in child abuse. Indeed, about 40 million children are estimated to be abused every year resulting in physical, psychological, emotional and social sufferings. Child abuse exists in all sections of society and in all countries. Only the extent of the problem, the nature of abuse and consequences, and child protection and recovery modalities differ in different socio-economic strata.1
When parents are unhappy in their parental role or when a factional relationship exits between them, some babies become neglected or abused. The second year of life is a more common time for abuse than the first because babies are more troublesome to their parents and this triggers the outlet of anger, resentment and other unpleasant emotions endangered in the relationship of the parents.
Child abuse is not limited to home situation. The children’s presence in the labour market carries many implications, of which the most important is their absence from schools. A large proportion of the working children hardly goes to schools or has ever been to school. They are employed in unskilled jobs, where they do not get even the opportunity to learn meaningful skills. Invariably, a child who begins work from an early age spends his entire life at the lowest level of the society, doing routine, menial, low-wage and unskilled tasks.11
It is important especially for health educators to the behavior disorders and emotional problems that affect children. The emotional maladjustments of children frequently are characterized by anxiety reactions. They may include habit disorders-such as nail-biting, thumb-sucking, bed-wetting and temper tantrums and conduct disorders-such as extreme aggressiveness, lying, stealing, destructiveness, fighting, fire setting, cruelty and running away from home. Among infants, deprivation of mothering or problems in the infant’s relationship with the mother may lead to withdrawn behavior, continuous crying, inability to eat, insomnia. In the last half of the 20th century, child abuse and neglect have been seen as a significant factor in childhood disorders.(Williams-1980)
Child abuse also called cruelty to children, the willful and unjustifiable infliction of pain and suffering on children. The term can denote the use of inordinate physical abuse; unjustifiable verbal abuse; the failure to furnish proper shelter, nourishment, medical treatment, or emotional support; incest; other cases of sexual molestation or rape; and the making of child pornography. Frequently described by the medical profession as the “battered child syndrome,” abusive treatment of children is almost universally prescribed by criminal statutes.
Cruelty to children can have many causes, but several major ones stand out. Abusive patterns of behaviour on the part of parents can be thought of as maladaptive responses to stressful situations and feelings of powerlessness. Recent psychiatric and pediatric research has found that a high proportion of parents guilty of abusive and inhuman treatment of their children was physically and mentally maltreated themselves as children. Typically over disciplined and deprived of parental love in their infancy, these parents repeat the pattern with their own children, often hi the belief that they are legitimately exercising their parental right to punish a child.
With proper social and psychotherapeutic intervention, most child abusers can be helped. Many emotionally troubled abusers are believed to be found out, and they readily respond to the therapeutic help they receive. Legal remedies for child abuse range from incarceration of the offender to the removal of the abused child from the custody of parents or others guilty of committing the crime.
This dissertation is intended to identify the knowledge and perception of Child Abuse in order to strengthen the capacity of publics in understanding the challenges and barriers, identifying child abuse, preventing children from future abuse, and managing physical, sexual, psychological and social consequences of these abuses.
1.2 Justification
Abused children today can be abusers to their children tomorrow. Abused children today are likely to have poor physical and mental health tomorrow. Child abuse is unacceptable in any civilized society.
Because of its extent and gravity of the consequences, public health systems must be mobilized to prevent child abuse.
Child abuse in society has been endemic for generations and is a hidden phenomenon with only a small percentage being apparent. The most obvious cases seen by society and authorities are the complaints and detections by concerned adults. However, some of these cases would be denied by adults, dismissing them as an imagination or fantasy. Child abuse often presents indirectly as violence, school refusal, depression, suicide, substance abuse, in conflict with the law, or with sexualized behavior, and therefore not recognized as abuse. Some children present with somatic complaints such as abdominal pain, while others may come with “dissociated” disorder. A large number of children would not complain because they have been threatened, blackmailed or tricked with “bribes” and the abuse described as “games”. The largest numbers of abuse that occur in society do not get recognized because it may be justified in society as a “norm” such as corporal punishment with or without injury, child labour, sexual molestation of children or child marriages. Society may not only justify but may even glorify child soldiers.
Recently social reformers and social psychologist raised their concern about child abuse which is detrimental for the normal development of a child. Child abuse can have serious future consequences for the victims involved. It delays physical growth, impaired language and cognitive abilities. Problems in learning and behavior are common following instances of child abuse and neglect. Because the child is living through active and critical phases of development, the approach to diagnosis and children’s mental and emotional disturbances is necessarily different from that employ with adults. Personality is being molded and changed as the child grows and so it is essential that public health personal should have extensive knowledge of the developmental stage of personality.
In societies, in Bangladesh, which revolves around strict religious values and strong conservatism, children, even small babies are being sexually abused in this country. What is more horrifying is that the abusers of this gruesome act are people whom the children are familiar with their family members, family friends, neighbors, domestic servants, teachers, even those who teach them religion. (Star Weekend Magazine, July 25, 1997)
This study is taken in consideration to the fact that child abuse is an universal practice and should not be continued. Let us make the precious lives of our children safer by preventing inhuman abuse and neglect. Let our children grow free from abuse, social awareness should be created to curve this situation.
1.3 Research Question and Objectives
A. RESEARCH QUESTION
What is the awareness of knowledge and perception of child abuse among the adolescent boys?
B. GENERAL OBJECTIVE
To assess the knowledge and perception of child abuse among the adolescent boys in some selected school in Dhaka city.
C. SPECIFIC OBJECTIVE
To assess the knowledge and perception regarding child abuse among the adolescent boys attending in secondary school in term of types causes, ratings of behaviors, abusive persons, bad effects and experience of victim at home and school environment.
Ø To identify the sources of information about child abuse.
Ø To find out the opinion about preventive measures of child abuse.
Ø To find out the relationship between perception of child abuse and socio-economic condition of the family.
1.4 Variables
Socio-Demographic Variables;
§ Age
§ Section
§ Religion
§ Parents Education
§ Parents Occupation
§ Monthly Family Income
§ Types of Family Members of the Family.
Key Variables:
§ Ever Heard of Child Abuse
§ Source of Information about Child Abuse
§ Types and Ratings of severity of Child Abuse
§ Causes of Child Abuse
§ Sex differential and prevalence of Child Abuse
§ Abusive Persons for Child Abuse
§ Bad Effects for Child abuse
§ Nature of Child Abuse and Victim of parental abuse and at school.
1.5 Operational definitions
Knowledge: By the definition of Hornby AS, knowledge is the understanding on a subject or topic, or familiarity gained by experience or a range of information. In this study knowledge refers to degree of knowing how far the class ix students know about Child Abuse, its type, causes, bad effects and abused by parents at home and abused by teacher’s at school. .
Perception: means the feelings, attitudes, and images people have of different places, peoples, and environments. In this study perception refers to feelings of severity of Child Abuse and its types among the respondents.
Child: In this study child means, O-18* years of age of a person,
Respondents: in this study who were interviewed were called the respondents. The students of class ix of 3 schools were the respondents,
Adolescent: school boys of class ix have been considered as adolescents for this study, “Adolescent” has been defined as a population segment aged 10-19 years with specific characteristics according to WHO.
Age: age of the respondents was recorded in completed years as stated by the respondents during interview.
Religion: means whether the respondents were Muslim, Hindu or Christians etc. as stated by the respondents.
Occupational status of respondent’s parents: any activities a person involved in maximum time in a day.
Service: who is employed and gets salary on regular basis.
Business: person earns money from personal monetary investment.
Housewife: women do household works in her own house and not
Engaged in other service.
Labour: who earn the wages by physical labour.
Unemployed: who is currently unemployed and who earn money
before but does not earn money at present.
Education status of respondent’s parents: education qualification recorded as stated by the respondents.
Illiterates: respondent’s parents having no schooling or formal education they could neither write nor read.
Primary level: respondent’s parents attended or passed any level from class I- class v.
Secondary level: respondent’s parents attended or pass any
& level from class VI- class VIII.
SSC: respondent’s parents obtained secondary school certificate examination.
HSC: respondent’s parents obtained higher secondary school
certificate examination.
Graduate: respondent’s parents who have passed the bachelor degree.
Masters: respondent’s parents who have passed the masters degree.
Family member: total number of members, means members of family who have eating from one source of cooking.
Monthly family income: sum of the money earn by the family members (from any source)
Nuclear family: family is consisting one single married family along with their children.
Joint family: family is consisting of a number of married couples and their children and spouses living together in a same household.
Domestic Abuse: Any act or omission by a family members regarding of the physical location where the act take place, which negatively effects the Well-being, physical, sexual, and psychological integrity freedom or right to full development of a child.
Grading of Knowledge: To assess the knowledge status, question No-22,23 & 24 were selected and asked with its sub-division , each question carrying 1 point. Respondents were awarded by points according to their correct answers in respective question. Poor knowledge-can correct answered 7 to 12 questions. Good knowledge-can correct answered more than 13 questions.
Scoring of Perception: To assess the perception status, question No. 17 were selected and asked with its sub-division, each question carrying 4,3,2, or 1 points according to the severity of Abuse patterns. Respondents were awarded by points according to their correct answers in respective question.
Poor perception-can correct answered below 27 questions.
Good perception- can correct answered more than 27 questions.
First History of child abuse:
Abuse of children was first described in the West about forty years ago. In developing countries, although the prevalence is likely to be high. Physical Abuse was first described in Sri-Lanka in the mid-1980s and has been increasingly reported over the succeeding years, while sexual abuse was highlighted in the early 1990s.1
About 40 million children under the age of 14 years are estimated to suffer from abuse and neglect around the world ( WHO- 99). Child abuse in developing countries, including South Asia, is yet to be recognized as a major social and health problem with an enormous burden on the economy and society. Therefore it is imperative not only to recognize child abuse from a clinical perspective but also for society, including professionals, to understand and accept it as a malady as well as to change their attitudes towards it.1
Definition of child abuse:
The international Society for the prevention of child abuse and neglect recently compared definitions of abuse from 58 countries and found some commonality in what was considered abusive. In 1999, the WHO Consultation on Child Abuse Prevention drafted the following definition:
“Child abuse or maltreatment constitutes all forms of physical and/or emotional ill-treatment, sexual abuse, neglect or negligent treatment or commercial or other exploitation, resulting in actual or potential harm to the child’s health, survival, development or dignity in the context of a relationship of responsibility, trust or power.”2
Bangladesh definition:
“In case of child abuse it may be defined as children are not used in the right way. Child abuse is widely prevalent in Bangladesh as well as all over the world. But these are usually overlooked by families, friends, relatives and health workers because of prejudice, anxiety and shame.”3
Types of child abuse:
The definition given above covers a broad spectrum of abuse. This focuses primarily on acts of commission and omission by parents or caregivers that result in harm to the child. In particular, it explores the prevalence, causes and consequence of four types of child maltreatment by caregivers, namely:
– Physical abuse
– Sexual abuse
– Emotional abuse
– Neglect.
1 .Physical child abuse: types and warning signs
Physical abuse of a child is that which results in actual or potential physical harm from an interaction or lack of interaction, which is reasonably within the control of a parent or person in a position of responsibility, power, or trust. There may be single or repeated incidents (WHO, 1999).4
Physical child abuse is an adult’s physical act of aggression directed at a child that causes injury, even if the adult didn’t intend to injure the child. Such acts of aggression include striking a child with the hand, fist, or foot or with an object; burning the child with a hot object; shaking, pushing, or throwing a
child; pinching or biting the child; pulling a child by the hair; cutting off a child’s air. Such acts of physical aggression account for between 15 and 20 percent of documented child abuse cases each year.
Many physically abusive parents and caregivers insist that their actions are simply forms of discipline, ways to make children learn to behave. But there’s a big difference between giving an unmanageable child a swat on the backside and twisting the child’s arm until it breaks. Physically abusive parents have issues of anger, excessive need for control, or immaturity that make them unable or unwilling to see their level of aggression as inappropriate.
Sometimes the very youngest children, even babies not yet born, suffer physical abuse. Because many chemicals pass easily from a pregnant woman’s system to that of a fetus, a mother’s use of drugs or alcohol during pregnancy can cause serious neurological and physiological damage to the unborn child, such as the effects of fetal alcohol syndrome; mothers can also pass on drugs or alcohol in breast milk. A woman who drinks or uses drugs when she knows she’s pregnant can be charged with child abuse in many jurisdictions if her
Baby is born with problems because of the substance use.
Another form of child abuse involving babies is shaken baby syndrome, in which a frustrated caregiver shakes a baby roughly to make the baby stop crying. The baby’s neck muscles can’t support the baby’s head yet, and the brain bounces around inside its skull, suffering damage that often leads to severe neurological problems and even death. While the person shaking the baby may not mean to hurt him, shaking a baby in a way that can cause injury is a form of child abuse.4
An odd form of physical child abuse is Munchausen’s syndrome by proxy, in which a parent causes a child to become ill and rushes the child to the hospital
or convinces doctors that the child : ^k. It’s a way for the parent to gain attention and sympathy, and its dangers to the child constitute child abuse.
2. Sexual abuse in children: types and warning signs
Child sexual abuse is the involvement of a child in sexual activity that he or she does not fully comprehend, is unable to give informed consent to, or for which the child is not developmentally prepared and cannot give consent, or that violate the laws or social taboos of society. Child sexual abuse is evidenced by an activity between a child and a adult or another child who by age or development is (WHO, 1999) in a relationship of responsibility, trust or power, the activity being intended to gratify or satisfy the needs of the other person. This may include but is not limited to:
Ø The inducement or coercion of a child to engage in any unlawful
sexual activity.
Ø The exploitative use of a child in prostitution or other unlawful
sexual practices.
Ø The exploitative use of children in pornographic performances
and materials. (WHO,1999)
Sexual abuse, which accounts for about 10 percent of child abuse, is any sexual act between an adult and a child. Such acts include:
- Behavior involving penetration – vaginal or anal intercourse and oral sex
- Fondling – Touching or kissing a child’s genitals, making a child fondle an adult’s genitals.
- Violations of privacy – Forcing a child to undress, spying on a child in the bathroom or bedroom.
- Exposing children to adult sexuality – Performing sexual acts in front of a child, exposing genitals, telling “dirty” stories, showing pornography to a child.
- Exploitation – Selling a child’s services as a prostitute or a performer in pornography.
The adult who sexually abuses a child or adolescent is usually someone the child knows and is supposed to trust: a relative, childcare provider, family friend, neighbor, teacher, coach, or clergy member. More than 80 percent of sex offenders are people the child or adolescent victims know. It’s important to understand that no matter what the adult says in defense of his or her actions, the child did not invite the sexual activity and the adult’s behavior is wrong. Sexual abuse is never the child’s fault.
Children are psychologically unable to handle sexual stimulation. Even toddlers, who haven’t formulated the idea that the sexual abuse is wrong, will develop problems resulting from the overstimulation. Older children who know and care for their abusers know that the sexual behavior is wrong, but they may feel trapped by feelings of loyalty and affection. Abusers warn their victims not to tell, threatening children with violence or ostracism, and the shame associated with the sexual activity makes the child especially reluctant to tell. When sexual abuse occurs within the family, children may worry that other family members won’t believe them and will be angry with them if they tell — as is often the case. The layer of shame that accompanies sexual abuse makes the behavior doubly traumatizing.
Some signs of sexual child abuse
Often children who have suffered sexual abuse show no physical signs, and the abuse goes undetected unless a physician spots evidence of forced sexual activity. However, there are behavioral clues to sexual abuse, including:
- Inappropriate interest in or knowledge of sexual acts
- Seductive behavior
- Reluctance or refusal to undress in front of others
- Extra aggression or, at the other end of the spectrum, extra compliance
- Fear of a particular person or family member
Children who use the Internet are also vulnerable to come-ons by adults online. Among the warning signs of online sexual child abuse are these:
- Your child spends large amounts of time online, especially at night.
- You find pornography on your child’s computer.
- Your child receives phone calls from people you don’t know, or makes calls, sometimes long distance, to numbers you don’t recognize.
- Your child receives mail, gifts, or packages from someone you don’t know.
- Your child turns the computer monitor off or quickly changes the screen on the monitor when you come into the room. .
- Your child becomes withdrawn from the family.
- Your child is using an online account belonging to someone else.
3. Emotional child abuse: types and warning signs
Emotional abuse includes the failure to provide a developmentally appropriate, supportive environment, including the availability of a primary attachment figure, so that the child can develop a stable and full range of emotional and social competencies commensurate with her or his personal potential, and in the context of the society in which the child dwells. There may also be acts towards the child that cause or have a high probability of causing harm to the child’s health or physical, mental, spiritual, moral or social development. These
acts must be reasonably within the control of the parent or person in a relationship of responsibility, trust or power. Acts including restriction of movement, patterns of belittling, denigrating, ‘scapegoating’, threatening, scaring, discriminating, ridiculing, or other non-physical forms of hostile or rejecting treatment (WHO,1999).4
Examples of emotional child abuse include:
Verbal abuse • Belittling or shaming the child: name-
calling, making negative comparisons to others, telling the child he or she is “no good,” “worthless,” “a mistake.”
• Habitual blaming: telling the child that everything is his or her fault.
Withholding affection • Ignoring or disregarding the child
• Lack of affection and warmth: Failure to hug, praise, express love for the child
Extreme punishment These are actions that are meant to isolate and terrorize a child, such as tying the child to a fixture or piece of furniture or locking a child in a closet or dark room.
Corruption This involves causing a child to witness or participate in inappropriate behavior, such as criminal activities, drug or alcohol abuse, or acts of violence.
Emotional abuse can come not only from adults but from other children: siblings, neighborhood or schoolyard bullies, and peers in schools that permit a culture of social ostracism (the “mean girl” syndrome. The signs of emotional child abuse include apathy, depression, and hostility. If it happens at school, the child may be reluctant to go to school and develop or fake a physical complaint
4. Child neglect: types and warning signs
Neglect is a pattern of failing to provide for a child’s basic needs, to the extent that the child’s physical and/or psychological well-being are damaged or endangered. In child neglect, the parents or caregivers are simply choosing not to do their job. There are three basic types of neglect.
| Physical Neglect |
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| Educational |
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| Neglect |
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| Emotional Neglect |
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Some signs of child neglect:
· Clothes that are dirty, ill-fitting, ragged, and/or not suitable for the weather
· Unwashed appearance; offensive body odor
· Indicators of hunger: asking for or stealing food, going through trash for food, eating too fast or too much when food is provided for a group
· Apparent lack of supervision: wandering alone, home alone, left in a car
· Colds, fevers, or rashes left untreated; infected cuts; chronic tiredness
· In schoolchildren, frequent absence or lateness; troublesome, disruptive behavior or its opposite, withdrawal.
· In babies, failure to thrive; failure to relate to other people or to
surroundings
A single occurrence of one of these indicators isn’t necessarily a sign of child neglect, but a pattern of behaviors may demonstrate a lack of care that constitutes abuse.
Factors increasing child abuse:
A number of studies, mostly from the developed world, have suggested that certain characteristics of children increase the risk for abuse.
Age:
Child abuse- whether physical, sexual or neglect depends in part on a child’s age. Fatal cases of physical abuse are found largely among young infants. In reviews of infant deaths in Fiji, Finland, Germany and Senegal the majority of victims were less than 2 years of age. Young children are also at risk for non-fatal physical abuse, though the peak ages for such abuse vary from country to country. For example, rates of
non-fatal physical abuse peak for children at 3-6 years of age in China, at 6-11 years of age in India and between 6 and 12 years of age in the United States. Sexual abuse rates, on the other hand, tend to rise after the puberty, with the highest rates occurring during adolescence. Sexual abuse can also be directed at young children.2
Sex:
In the most countries, girls are at highest risk than boys for infanticide, sexual abuse, educational and nutritional neglect, and forced prostitution. Finding from several international studies show rates of sexual abuse to be 1.5-3 times higher among girls than boys. Male children appear to be at greater risk of harsh physical punishment in many countries. .
Special characteristics of child:
Premature infants, twins and handicapped children have been to be at increased risk for physical abuse and neglect. It is believed that low birth weight, prematurity, illness or physical or mental handicaps in the infant or child interfere with attachment and bonding and may make the child more vulnerable to abuse.
Caregiver and family characteristics:
Sex: whether abusers are more likely to be male or female, depends in part, on the type of abuse. Research conducted in China, Chile, Finland, India, and the United States suggests that women report using more physical discipline than men. In Kenya, reports from children also show more abuse by mothers than fathers. However, men are the most common perpetrators of life-threatening head injuries, abusive fractures and other fatal injuries;
Sexual abusers of children, in the cases of both female and male victims, are predominantly men in the many countries. Studies have consistently shown that in the case of female victims of sexual abuse, over 90% of the perpetrators are men, and in the case of male victims, between 63% and 86%of the perpetrators are men.2
Family structure and resources: Physical abusive parents are more likely to be young, single, poor, unemployed and to have less education than their non-abusing counterparts. In both developing and industrialized countries, poor, young, single mothers are among those at greatest risk for using abuse towards their children. In the United States, for instance, single mothers are three times more likely to report using harsh physical discipline than mothers in two-parent families. Similar findings have been reported in Argentina. Studies from Bangladesh, Colombia, Italy, Kenya, Sweden, Thailand and the United Kingdom have also found that low education and a lack of income to meet the family’s needs increase the potential of physical abuse towards children. In a study of Palestinian families, lack of money for the child’s needs was one of the primary reasons given by parents for psychologically abusing their children.
Family size and household composition: the size of the family can also increase the risk for abuse. A study of parents in Chile, for example, found that families with four or more children were three times more likely to be abused towards theirs children than parents with fewer children. Data from a range of countries indicate that household overcrowding increases the risk of child abuse.
Personality and behavioral characteristics: A number of personality and behavioural characteristics have been linked, in many studies, to child abuse and neglect. Parents more likely to abuse their children physically tend to have low self-esteem, poor control of their impulses, mental health problems and to display anti-social behaviour.
Prior history of abuse: Studies have shown that parents maltreated as children are at higher risk of abusing their own children. The relationship hare is complex, though, and some investigations have suggested that the majority of abusing parents were not, in fact, themselves abused. While empirical data suggest that there is indeed a relationship, the importance of this risk factor may have been linked to child abuse-such as young parental age, stress, isolation, overcrowding in the home, substance abuse and poverty-may be more predictive.
Causes of child abuse
Why would someone abuse a defenseless child? What kind of person abdses a child? Not all child abuse is deliberate or intended. Several factors in a person’s life may combine to cause them to abuse a child:
- Stress, including the stress of caring for children, or the stress of caring for a child with a disability, special needs, or difficult behaviors
- Lack of nurturing qualities necessary for child care
- Immaturity: a disproportionate number of parents who abuse their children are teenagers.
- Difficulty controlling anger
- Personal history of being abused
- Isolation from the family or community
- Physical or mental health problems, such as depression and anxiety
- Alcohol or drug abuse
- Personal problems such as marital conflict, unemployment, or financial difficulties.
No one has been able to predict which of these factors will cause someone to abuse a child. A significant factor is that abuse tends to be
intergenerational –those who were abused as children are more likely to repeat the act when they become parents or caretakers.4
In addition, many forms of child abuse arise from ignorance. Sometimes a cultural tradition leads to abuse. Such beliefs include:
- Children are property.
- Parents (especially fathers) have the right to control their children in any way they wish.
- Children need to be toughened up to face the hardships of life.
- Girls need to be genitally mutilated to assure virginity and later marriage.
Effects of child abuse
Child abuse can produce dire consequences during the victim’s childhood and adulthood. Some effects of child abuse are obvious: a child is malnourished or has a cast on her arm; a nine-year-old develops a sexually transmitted disease. But some physiological effects of child abuse, such as cognitive difficulties or lingering health problems, may not show up for some time or be clearly attributable to abuse. Other effects of child abuse are invisible or go off like time bombs later in life.
Emotional Effects of Child Abuse
Just as all types of child abuse have an emotional component; all affect the emotions of the victims. These effects include
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Many adults who were abused as children find it difficult to trust other people, endure physical closeness, and establish intimate relationships.4
Behavioral Effects of Child Abuse
Child abuse can play itself out not only in how its victims feel but in what they do years later. Children who suffer abuse have much greater chances of being arrested later as juveniles and as adults. Significant percentages of inmates in U.S. prisons were abused as children. One of every three abused or neglected children will grow up to become an abusive parent.4
Other behavioral effects include
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Health consequences of child abuse
111 health cause by child abuse forms a significant portion of the global burden of disease. While some of the health consequences have been researched, others have only recently been given attention, including psychiatric disorders and suicidal behaviour. Importantly, there is now evidence that major adult forms of illness-
Physical
Abdominal/ thoracic injuries
Brain injuries
Bruises and welts
Burns and scalds
Central nervous system injuries
Disability
Fractures
Lacerations and abrasions
Ocular damage
Sexual and reproductive
Reproductive health problem
Sexual dysfunction
Sexually transmitted disease, including HIV/AIDS
Unwanted pregnancy
Psychological and behavioural
Alcohol and drug abuse
Cognitive impairment
Delinquent, violent and other risk-taking behaviours
Depression and anxiety
Eating and sleep disorders ‘ Feelings of shame and guilt Hyperactivity relationships Poor school performance Post-traumatic stress disorder Psychosomatic disorders Suicidal behaviour and self-harm
Other longer-term health consequences
Cancer
Chronic lung disease
Fibromyalgia
Irritable bowel syndrome
Ischaemic heart disease
Liver disease
Reproductive health problems such as infertility
2.1 International studies
The historical perspective allows us to stand back from the everyday experience of confronting the bettered or neglected child and to reflect on the wider issues of what has been presented to us as a single incident in time. Those who have sought to uncover evidence of child abuse in the past have had to collect their material widely, often reading between the lines and recognizing indirect messages of what was happening. There is much to support a view of history that it was found in early societies that where there was lower level of child care, the more likely children were killed, abandoned, beaten, terrorized and sexually abused. Thus wrote Lioyd De Mause in the preface of his history of childhood. William Langer, Professor of History at Harvard University,7 wrote:
The direction of human affairs has never been confided to children, and historians, who have concerned themselves primarily with political and military affairs and at most with the intrigues and rivalries of royal courts, have paid almost no attention to the ordeals of childhood. Even the students of education have, on the whole, devoted themselves to the organization and curriculum of schools and with theories of education with only occasional reference to what happened to the pupils at home and in the world at large.
Yet the history of childhood must be of major importance to any study of human society, for if, as it is said, the child is the father of the man, it should be possible, with an understanding of any individual’s or any group’s past, to form a more intelligent judgement of their performance as adults.
Unhappily, the results of these investigations are most depressing. They tell a long and mournful story of the abuse of children from the earliest times even to the present day. We need not assume that the generalizations here advanced apply to all people at all time. No-one can doubt that there have always been parents who have loved and cherished their children and that such mistakes as they may have made in the upbringing were due to ignorance rather than to ill will.
However it was Freud who more dearly changed our view of childhood. It is found at case conferences that participants are interested to know of the parents’ childhood to understand their present actions (De Mause 1980)
Samuel Radbil in a conference in 1895 showed that London children were battered: “by boots, crockery, pans, shovels, straps, ropes, thongs, pokers, fire and boiling water”. Neglected children were described as miserable, vermin infested, filthy, shivering, ragged, nigh naked, pale, puny, limp, feeble, faint, dizzy, famished and dying. One hundred years ago, begging was common but children begging in the streets of London has become a common occurrence in 1991.13
He also commented on the way how child’s fitness to live was tested. The Germans would plunge the child into ice cold water, the Greeks would leave the child on a mountain top, North American Indians threw children into a pool of water to see if they floated. Naming of the child is another important way of recognizing the child’s existence. The Christian child required to be christened and given a name before his soul could go to heaven. Without christening, he would have to be buried in unhallowed ground along with the dogs and cats. Children
Born out of wedlock have long been outlawed and especially liable to abuse and infanticide (Radbill 1987).
Anxiety about violence has spread to children of all social classes. A recent poll in the United States revealed that one half of the children questioned said that their most important worry was that someone they loved would become the victim of a violent crime. Another study reported that 25%of the children in Midwestern inner-city grade school described at least one violent event that involved either the child, a family member, or a friend. Many of these children described tow or more violent events, and they were nearly twice as likely as their classmate to report low self-esteem, excessive crying, and worried about dying or being injured.5
Physical abuse
Almost 1.5 million children are reported to have been physically and/or sexually abused. Parents who abuse their children not only injure their child physically and psychologically but also “teach” the child to use force to resolve conflicts. Often, these same parents permit their children to be abused to their siblings and others.
The number of reports to children’s protective services (CPS) and law enforcement agencies in the country in which the alleged abuse or neglected occurred have steadily increased since mandated reporting began in the 1960s. Reports of all types of abuse increased 50%,from 30 per 1,000 children to 45 per 1,000, between 1985 and 1992. Inl992, 2.9 million CPS reports were filed, and 1,261 children died of maltreatment. Of reported children, 85% were younger than Syr of age,
and 45% were younger than lyr of age. 60% of these reports were
“Substantiated” by CPS.5
A survey of families with children aged 3-1 Syr indicated that 140 of 1,000(14%) were kicked, bitten, punched, hit with an object, beaten up, or threatened with a knife or gun in lyr. Approximately 10% of injuries to children younger than 5yr of age who are seen in emergency departments are due to abuse; 15% of the children admitted for burns and 50% of children younger than l yr of age with fractures are abused. In 1991, the National Child Abuse and Neglect Data System indicated that 24% of 838,232 reports were for physical abuse; 7% of children were younger than l yr of age, 27% were younger than 4yr of age, and 28% were 4-8yr of age. The rate of reports decreases in older children. Of the 1,229 assessments done in a pediatric hospital during that same period, 223(28%) of 797 reports were for physical abuse and the death rate was 6%. Immediate family members were the perpetrators in 55% of abuse cases. The most common perpetrators were the father (21%), Mother (21%),boyfriend of the mother (9%),baby sitter (8%)and stepfather (5%). The average age of the abuser was 25 yr.
Parents who abuse their children have been reported from most ethnic, geographic, religious, educational, occupational, and socioeconomic groups. Groups living in poverty may have increased reports of child abuse because (l) of the increased number of crises in their lives (eg.-unemployment or overcrowding); (2)they have limited access to economic or social resources for support during times of stress; (3)of the increased violence in the communities where they live; (4)of an association of poverty with other risk factors, such as teen-age and
Single parenthood and substance abuse; and (5)there may be more scrutiny by community agencies and neighbors.
More than 90% abusing parents have neither psychotic nor criminal personalities. Rather they tend to be lonely, unhappy, angry, young, and single parents who do not plan their pregnancies, have little or no knowledge of child development, and have unrealistic expectations for child behavior. 10-40%of abusive parents have experienced physical abuse as children. (Source—Neelson Pediatric Text Book of chapter
37,38)
Sexual abuse
Child sexual abuse does exist as a significant problem. Sexual abuse occurs in children of all ages, including the very young, too boys as well as girls, in all classes of society and frequently within the privacy of the family.
Media reporting and increasing adult disclosure have provided the first glimpses of what Roland Summit has termed “society’s blind spot”. If one was allowed only a single epithet to describe child sexual abuse, it might be ‘Hidden’ (Summit-1988).
There is little doubt that sexual abuse of children has been recorded as long as human beings have kept records. Growing up in Greece or Rome often being used sexually by older men. In Rome, boy brothels were common and there was rent- a- boy service in Athens. The abuse involved not only boys over 11 or 12, but also much younger children.
Girls were also involved as well as women. Aristotle commented that homosexuality often becomes habitual in ‘those who are abused from
Childhood’. There are remarkable parallels between the patterns of abuse in ancient Greece and what is being witnessed in England in the present day.
In the 18th century, sexual abuse was widespread amongst servants and others acting in parent roles. Freud also become aware of child sexual abuse, not only from his work with his adult parents in psychotherapy, but also from visits to the mortuary in Paris where he observed signs of rape in children.
In a study from the USA, Stanton et al. investigated the prevalence of problem behaviors in two samples of African -American children aged 10-14 and 945, respectively. The children lived in deprived urban areas. About 40% reported more positive feelings about sex than about other behaviors, particularly with increasing age. Furthermore, correlation between sexual experiences and other problem behaviors were low, while there were stronger correlations between behaviors not associated with sex, such as smoking cigarettes and using marijuana, using cocaine and other illicit drugs, being truant from school and being suspended, delivering drugs and selling drugs.
In typically Western culture, however, early sexual intercourse is regarded as a genuine problem behavior and as a risk factor for other problems such as substance abuse and delinquency. The conceptualization of early sexual intercourse as a problem behavior may thus be well justified in one culture but perhaps not in another (Santon, et al l993).
Essential characteristics of child sexual abuse
- Children in general do not like it.
- Sexual gratification of the abuser is the usual aim of the abuse.
- There is a power/ age differential which effectively removes meaningful consent.
- The activity is usually secretive, collusive and perpetuated by the more powerful person.
The rate of sexual abuse estimated by the American Association for protecting children, went from 1.4 per 10,000 to 17 per 10,000 children between 1976 and 1984. In a children’s hospital, the number of total assessments of sexual abuse increased by a factor of 4 between 1981 and 1991, Of 838,232 cases of child abuse reported to the National Child Abuse and Neglect Data System in’1991, 15% were of sexual abuse. Survey of adult women indicate that from 12-38% were sexual abused by 18yrs of age. The results of one study indicated that the likelihood of extra familial and interfamilial sexual abuse being reported was only 8% and 2% respectively. The incidence of sexual .,abuse of males ranges from 3-9% of the population; males constitute up to 20% of reports. Because fixed pedophiles shows a predilection for boys, it is theorized that the number of males who are sexually abused is higher. Furthermore, boys may refrain from reporting what might be interpreted as a homosexual action. In addition, in a society that expects males to be able to protect themselves from assault, boys may feel guilty if they are victimized.5
Approximately one third of sexual abuse victims are younger than 6 yr of age, one third are 6-12 yr of age, and one third are 12-18 yr of age. Females are more often perpetrators in child-care setting, including
babysitting. The number of female perpetrators may be higher because younger children may confuse sexual abuse by a female with normal hygiene care and adolescent males may not be trained to recognized sexual activity with an older female as a form of abuse. Sexual abuse by stepfather is nearly 5 times higher than among natural fathers. (Source— Keelson Pediatric Text Book of chapter 37,38).
Emotional abuse
Though emotional abuse is accepted category in the registration of children who have been abused it is probably the most complex form of abuse in term of definition, recognition, management and registration.
As Garbarino, et al so aptly stated, ‘Rather than casting psychological maltreatment as an ancillary issue, subordinate to other forms of abuse and neglected, we should place it as the centerpiece of efforts to understand family function and to protect children.’8 ;
The working group of the recent document ‘Working Together’ and of the Children Act 1989 defines emotional abuse as ‘actual or likely severe adverse effects on the emotional and behavioral development of the child caused by persistent or severe emotional ill-treatment or rejection.
All abuse involves some emotional abuse’ (Working Together-1991).15
Lourie and Stefano defined emotional maltreatment as ‘an injury to the intellectual or psychological capacity of the child, as evidence by an observable and substantial impairment in his or her ability to function within his or her normal range of performance and behavior with due regard to his or her culture’ (Lourie and Stefano-1978).
2.2 Bangladesh studies
Bangladesh is the twenty-second country to have ratified the UN Convention on Child Right. Bangladesh recognized the magnitude and importance of survival, development, protection and participation of the children. Anyone below 18 years of age is considered a child by the Convention. The Convention also demands the cessation of all kinds of child labor. As a result of ratifying the Convention, the economical situation of Bangladesh has not changed overnight.
Children’s Rights Clusters
Rights contained in the Convention categorized under appropriate; clusters
Survival Right to life, health and medical care, adequate nutritious food
Development
Right to education, standard of living adequate for child’s development, leisure and cultural activities.
Protection
Right to protection from abuse and neglect, protection for refugee children, protection for children without families.
Participation
Right to have views taken into account, freedom of expression,*freedom of association.
Mobilization
Implementation of rights, awareness of Convention, reporting on implementation.
Specific trends of abuse:
Child abuse is not confined to any specific zone. Home, workplace, street, prisons – everywhere children become easy prey of abuse. However, children are more prone to political abuse in urban areas especially in metropolitan cities. It appears from the analysis of the reported cases that destitute or underprivileged children belonged to poor families or children who are abandoned or street children are the most affected group by all sorts of abuse.
According to A.H. Monjurul Kabir, age is a major issue in assessing vulnerabilities. It appears that no age is safe age. Children are always vulnerable. The age group of 10-14 years came across as the period during which the hightest number of abuses occurs. Both boys and girls become the frequent victims of domestic and institutional abuse. Girls are more vulnerable than boy’s. Girl children have to face abuse twice. First the child is sexually abused. Next she is abused by society through its customs, practices, censures and ostracization. Adolescent girls are most susceptible to and fall pre to declarations of love. Boys are more prone to political abuse.10
The abuse against children mostly occurs in the poor income group. These children are forced to leave home and go to places that might provide food, shelter and work. As these children enter the labour force, their soft and developing bodies, their innocent minds and their young age expose them to horrifying situations against which they can hardly protect themselves (A.H.Monjurul Kabir-1999).
Domestic abuse
The activities performed by the child domestics, as Rahman put it, are varied and not well-defined. Their relationships with the employers ranged from extreme servitude to becoming an integral member of the family. The child domestics’ perceptions were mainly characterized by confusion, fear and uncertainty. They perceived their employers as having total power and control over their lives. The girl domestics for the sake of survival and as a coping strategy usually trusted the employers as the persons who might well arrange their marriages in future.
He added that the job of a child domestic is a means of financial contribution to its parental family, but only at the cost of numerous abuses. They are often the recipients of all forms of verbal abuse and sometimes physical abuse at the slightest pretext. In most intra-family feuds, the child domestics are used as the centre of discord when they undergo both verbal and physical abuse from the family members. They are often under threat of dismissal.
A relatively wide range of activities stretching from early morning till late hour at night were identified by him to be a child domestic’s usual chores. These activities include sweeping, washing clothes, dusting, floor polishing, cooking, grinding spices and others. They are always on call from all the family members to do all types of errands like fetching a glass of water, polishing shoes, peeling vegetables, looking after children, earring hot water for bathing, etc. ass these are isolated activities, they are never seen as real work. In brief, they are expected to be on their toes and never to feel tired (Rahman-1992).
Abuse at workplace
In Bangladesh, the dramatic increase of adolescent gir