What is Abuse?
As understandings of abuse have developed, so have ideas about what the concept means and how it can be identified. There are global definitions of abuse, national (state-developed) and also regional or local. Many of these relate back to each other and are always developing and changing to take into account forms of abuse that emerge as our understanding of the area develops. The World Health Organization ([WHO], 2006, p.9) defines child abuse and neglect as:
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.
The World Health Organisation definition and discussions of this area, recognise that the term ‘child’ or ‘young person’ will necessarily be designated in different ways in various countries and cultures. They also emphasise that abusers of children and young people (abuse perpetrators) can be adults, young people, older children or organised crime gangs. Definitions of child abuse and neglect can include adults, young people and older children as the perpetrators of the abuse. Typically, policies around ‘child abuse and neglect’ refer to behaviours and treatment that result in the actual and/or likelihood of harm to the child or young person. Moreover, abuse can be intentional or unintentional and can include acts of omission (i.e. neglect) and commission (i.e. abuse).
The number of types of identified forms of abuse can be seen to vary across organisations. Whilst the WHO casts a wide net in outlining abuse, other organisations, have tried to categorise forms of abuse, partly to help individuals and professionals to understand and recognise them.
Here we will outline eleven types of abuse following the categorisation of abuse used by the National Society for Prevention of Cruelty to Children (NSPCC), UK. However, remember that these lists of types (typologies) are always developing and it is always worth keeping an eye on online policy documents in your own country to see how these are changing with emerging issues.
The National Society for Prevention of Cruelty to Children (NSPCC), which is a UK based NGO, with a remit to protect children and young people, identifies eleven areas of abuse, neglect, sexual abuse, domestic abuse, online abuse, physical abuse, bullying and cyberbullying, emotional abuse, child sexual exploitation, female genital mutilation, human trafficking and harmful sexual behaviour. What has to be remembered in the discussion below that no matter what type of abuse one is discussing, it is not relevant why the abuse occurs only the impact on a child or young person; in other words it is not okay to explain away abuse through the reasons for its occurrence. In the paragraphs below, the types of abuse identified in the NSPCC typology are discussed individually and other areas of abuse that are emerging as areas of concern, are also covered.
Going through the areas of abuse identified by the NSPCC in turn, neglect is the failure of parents/carers or others to meet a child or young person’s basic needs. This might be in terms of sustenance (food, drink, shelter, clean clothes etc.) but could be in relation to emotional needs and sense of security. Neglect often happens because of omissions in care, failures to do something that will support and sustain a child or young person’s needs or to protect them from dangers and risks. Neglect is very common and might be because someone does not know how to parent/care, because the carer has a mental health problem but also can be intentional and part of other wider patterns of abuse. It is hard to define and demonstrate in some cases because it might be intermittent, usually, professionals try to establish a pattern of behaviour, in order to show that neglect has occurred. However, that is not always the case. Abuse might include food or sustenance not being provided but it may also be about abandonment (the child or youth being left), neglect of emotional needs, failure to support the child/youth to attend school (often shown in truancy reports), not maintaining a safe place to stay so that the child can thrive (eg. Child is always tired because parent/guardian holds parties, invites strangers around, uses drugs or drink etc.) Neglect is perhaps one of most typical forms of abuse but the most difficult to grapple with as a concept for all kinds of practitioners (For more information see, the Child Welfare Information Gateway, 2013).
Child/young person sexual abuse, is typically recognised to be the sexual abuse of a person under the legal age of consent. It can involve the involvement in a child in sexual activities themselves, but also making them watch adults involved in sexual activities or pornography is also abusive. In most countries, a person legally defined as a child within that country’s legal system, is seen as unable to give consent to sex and in this sense, sexual relations with them is illegal and often technically defined as rape. This is even the case where a child or young person has agreed to the sex, because they are seen as lacking legal capacity to give consent. Sexual abuse may also occur above the age defined as part of childhood, these cases are invariably non-consensual, involving force (rape and sexual assault).
Child sexual exploitation
Child sexual exploitation (CSE) is a type of sexual abuse. Children and young people are often lured into exploitative situations and relationships, in which they receive money, gifts (such as mobile phones, jewellery or alcohol) or affection/friendship/group membership, as a result of performing sexual activities or for ‘allowing’ others to perform sexual activities on them. These kinds of situations often involve manipulation, coercion or trickery because the perpetrator often convinces the young person that they are in a relationship and that to please them, the young person must undertake the sex acts. These relationships often involve ‘grooming’ of young people, which involves the incremental development of an abusive and exploitative relationship with a person, for the purposes of abusing them further. The child or young person often is unaware of the type of relationship that is developing as ‘groomers’ can be skilled at convincing them that they are their friends, even boyfriends or girlfriends. This means that the young person often readily accepts or engages in what is happening because they believe it to be normal or part of a ‘relationship’. Conversely, there may instead be physical threat or force used or psychological threat (such as threatening to tell someone the young person knows or abandoning them) if they do not do what the abuser says. Playing on young people’s needs to belong, perpetrators of CSE will often ask young people to parties, provide them with alcohol and drugs and tell them that engaging in sex is a way to belong and be accepted in a group or that this is a normal part of being a girlfriend or boyfriend. Whilst some young people might be particularly vulnerable to these approaches, for youth workers all young people should be considered to be at risk of being drawn into CSE.
CSE may also be facilitated or carried out online, convincing young people to engage in sexual discussions or post pictures/videos of themselves. CSE can also be associated with human trafficking, when young people may find themselves moved between countries, regions or local areas for the purposes of sexual exploitation or criminal activities, such as making child pornography. Additionally, there can be a gang-membership component to CSE, where forced sex acts are used as part of initiation or make money for a group of young people who regard themselves as part of a distinct subcultural gang. Therefore, there can be overlaps between this and other forms of abuse recognised in categorisations of abuse types.
In order to further understand CSE it is worth examining the case of the Rotherham Child Sexual Exploitation case from the UK, which has had ramifications all around the world. Indeed social work, youth and welfare practitioners from Rotherham, who have helped the town to heal after at least 1400 young people were abused across a number of decades, are often contacted from as far afield as Australia, Canada and other European countries to help with CSE cases as they are emerging globally (Gladman and Heal 2017, also find the Rotherham report available online, see the Jay Report, 2014, in references).
Research within the EU (the Eurobarometer of gender based violence, 2016) has shown not only that domestic violence and abuse is common but that it is also recognised as such by EU citizens, who often feel unable to speak out or act to help themselves or others. Domestic abuse can be said to be violence against any person, male, female or non-binary (someone who does not associate themselves with any particular gender identity), which takes place within the domestic relationships and usually (but not always) within the relatively private spaces of the domestic home. It can involve any number or combination of types of acts of abuse, including sexual abuse, physical violence or psychological abuse and coercion. Whilst children and young people may be subject to acts of domestic violence against them personally, they also can be harmed by witnessing abuse against a parent, carer, sibling or other person and even hearing abuse happening but not being in the same room can be highly damaging (Unicef 2001; Kelly et al 2002).
Children and young people who experience this type of abuse may struggle with relationships, trust and may struggle at school, have bruising or injuries that are unexplained, be anxious or fearful and will often not tell about what is happening for fear of the perpetrator/s being taken away; this is especially the case where the perpetrators are parents, carers, grandparents or others who represent some form of stability to the young person (despite the abuse). Victims/targets of domestic violence commonly hide what is happening to them and experience shame, self-blame and distortion of reality to try to make sense of the abusers behaviour. These processes contribute to the typical lengthy period between domestic violence starting and a person reporting, escaping or taking other action. Mirela Sula, Founder of the Migrant Woman Association in the UK, has noted that in the case of migrants they are at higher risk of domestic violence, this is particularly the case for women and female youth. For refugees and migrants, there is often a fear that reporting domestic violence will lead to interactions with the police in which they might be removed and ‘sent back’ to their countries. Children and youth who are with family members who are abusing them, may be afraid that reporting will lead to parents or carers being taken away and them losing their home and security.
Cyber Abuse/Online Abuse
Online abuse includes a broad spectrum of abusive acts, carried out through the Internet and in cyberspace. It can include a host of other types of abuse but the key space in which these incidents occur and tool involved, is the web. Therefore, online abuse might include verbal abuse and threats, sexual behaviour towards the individual online and so forth. It may take place through a mobile phone or other form of equipment and can happen in chat rooms, forums, Facebook, Instagram, even online games, in which there are interactions between individuals (Get Safe Online 2018). Online abusers can be any age and it has been found that many online abusers are children or youth themselves. It can be hard for victims of this type of abuse to disengage from it because use of the Internet is such a common experience today and many people rely upon it to some degree or other. Therefore, victims find it hard to step away from this source of abuse. For young people and children, there is often also a need to feel part of online groups and activities, as the Internet can be pivotal in their peer networks. Indeed some young people even become psychologically addicted to using the Internet, with the instant feedback, ‘likes’ and sense of being part of a group that it provides. Online abuse can have connections to ‘real world’ abuse, such that victims may also suffer abuse from the perpetrators off-line as well.
Cyber abuse intersects with the other forms of abuse outlined above, in that many forms of these can be carried out through the internet, often in an area of the net that has been labelled the ‘dark web’. Europe and global agencies are involved in addressing these issues. Cyber abuse can happen between a victim and one perpetrator, who may groom and convince a young person to behave sexually online (such as sending photographs, video or live-stream of themselves). Alternatively, there are organised global criminal gangs who work transnationally to abuse children using online technology, in a range of countries. For instance, the Global Alliance Against Child Abuse Online, which was set up in 2012 between the European Commission and the US, note that children in a range of countries are often forced to perform sex acts ‘live’ for ‘consumers’ of the abuse who may be in a completely different global region (Global Alliance against Child Abuse Online 2018). The technology aspect of globalisation enables abuse to be perpetrated in one place and ‘consumed’ in another area. It also means that abusers may use different levels of regulation, prosecution and, therefore from their perspective – risk, to ensure they can abuse with little possibility of negative impact on themselves. Moreover, the use of cyber abuse linked to child or youth pornography, means that images or videos of the abuse may be distributed widely, even decades after the initial abuse; making recovery for the victims even more problematic (Kelly and Regan, 2000).
This is probably the most likely form of abuse that springs to mind in thinking about child abuse. Physical aggression against children can include beating is not accidental harm to a child, it involved deliberate actions that cause pain, injury and distress. Physical abuse may include being hit, kicked, poisoned, burned, and slapped or having objects thrown at them. Much younger children and babies also are known to experience damage from physical abuse such as shaking or hitting them, which can cause non-accidental head injuries (NAHI). In some situations, carers or parents, will make a child a child’s illness or cause them to be sick or have symptoms, in order to gain attention. This is often referred to as fabricated or induced illness (FII), a commonly known form of which is termed Munchausen’s syndrome by proxy. It is not always carers or parents who are perpetrators, other children or young people, community members, teachers or other professionals may also physically abuse. Children who have been physically abused may go onto display physical abuse to others, although this statement is contested, as some other victims/targets of physical abuse will choose to reject physical violence because of their own experience.
Bullying and Cyber Bullying
This type of abuse links with cyber and online abuse. Bullying, primarily by children and young people against victims of similar age groups, is increasingly common. In many cases, the victims and perpetrators might know each other from school, a youth club, another type of group or club or from the local community or town. The Internet is used by the perpetrator as a tool to expand the abuse, which often begins in real time, into the virtual sphere; meaning that the victim often feels they cannot escape. As noted above, because peer group engagement and networks are so important to children and young people, it is easy for perpetrators to exploit the victims need to link up with others and bully online. Although it can be hard to understand why this abuse is so upsetting if one is not a strong user of social media or other Internet networking, this is a very serious form of abuse, which has been linked particularly to school age child and youth deaths. However, it should not be ruled out that this abuse can happen at any age.
Emotional Abuse/Psychological Abuse
It is a common social misconception that physical or sexual abuse are the most injurious forms with the longest effects on victims; however, studies have shown that long term emotional abuse of children and young people has devastating effects, that can last into adulthood and influence life chances and outcomes (Pietrangelo 2018). Emotional abuse can include a range of behaviours towards children, young people or vulnerable adults, including, shouting, humiliating the person, saying they are stupid, controlling them, telling them that you will harm something of importance or value to them (a pet, a toy), gaslightling them (trying to make the person believe they are insane). In many cases of emotional abuse, damage is done for the child or young person because the adult consistently fails to believe them (calls them a liar) and does not meet the child or young person’s needs for emotional stability, warmth and engagement. Sometimes emotional abuse accompanies other forms of abuse, such as domestic violence, but other times it is the only form of abuse. Even where the latter scenario is the case, emotional or psychological abuse is highly damaging to the young person or adult that experiences it. Long term impacts can include, trust issues, difficulties with self-image and self-esteem and relationships.
Female Genital Mutilation or Cutting
Female genital mutilation or cutting involves the intentional damage of female genitals, this might include total removal of the clitoris and other external features of the female genitals, partial removal, using a needle to damage the genitals. A recent form of genital mutilation that has been noticed by health workers is elongation. This involves the elongation of the genital folds through intentional stretching of these tissues. In all cases, whether elongation, cutting or any other purposeful damage to the genitals of a person defined as a child, this is illegal in Europe. Whilst few cases are prosecuted, there is an increased focus on doing so, bring the perpetrators to justice. There are penalties for parents/guardians who allow or organise FGM and/or medical staff who perform it. FGM is a growing global problem, with high prevalence in many developing areas of the world, but due to migration and displacement, it is increasingly common in many places. The World Health Organisation (WHO) estimates that more than 200 million girls and women alive today have undergone female genital mutilation. Furthermore, there are an estimated 3 million girls at risk of undergoing female genital mutilation every year (WHO 2018).
Human Trafficking/Trafficking in Human Beings (THB)
“Trafficking in human beings (THB) is a serious crime and an abuse of an individual’s fundamental rights and dignity. It involves the exploitation of vulnerable persons traded by criminals as commodities for the sole purpose of economic gain. This crime often has a transnational character; it comprises victims of all genders and age and, due to its nature, is often hard to discover and investigate.” Europol (2018)
The concepts of human trafficking or THB are to be separated from people smuggling. Smuggling involves the taking of people over borders and often there are forms of abuse within that process; however, invariably smugglers release the smuggled people once across the border and so forth. Human trafficking typically involves abuse of people, usually for financial gain in sectors such as the commercial sex industry, agriculture, manufacturing, fast food, indeed, anywhere where workers are needed and money can be saved by forcing people to work. The methods used to control trafficked people are many, for instance, many trafficked people will have their passports taken away, will be physically, psychologically and/or sexually abused (Lee-Treweek 2012). Many will have been tricked into being trafficked with lies about regular jobs that they will be doing overseas and promises of wages. Trafficked people do not have control over their own lives and whilst some may be able to move about relatively openly, they will be afraid to tell others what is happening and are controlled by their captors. One of the key myths of trafficking is that people who are trafficked are locked up physically. This is not necessary when you have frightened people enough into being afraid of the consequences of trying to run away, either for themselves (if caught) or for their families back home. Many traffickers will use knowledge of family members back home to threaten the individual that they will kill or harm their loved ones, should they leave. On other occasions, trafficked people will be made to be afraid of authority figures, such as the Police, in the countries to which they are taken. In particular, they are often told that they will be taken to prison and see as criminals if found by authorities. This leads trafficked people to fear exposure and seek to maintain the secrecy of their trafficked status. It is far more useful for traffickers to terrorise the trafficked person into monitoring and policing themselves, than to have to lock them up. Therefore, many of us will pass trafficked people in our communities every day, working in the car wash, in beauticians, take aways and so forth. Human trafficking is commonplace throughout Europe and children and youth are trafficked for all forms of labour, including to be raped and abused in the sex industry (Kelly 2005).
Emerging and Changing Ideas about Abuse
There are differences between societies as to how child and young person abuse is understood, defined and seen in terms of criminality. It is important to attend to how different countries might separate out different types of abuse in different ways from the categories presented above. Also new ideas about what constitutes abuse are always emerging and developing, as we understand more about childhood, youth and the dynamics of abuse.
County Lines and Criminal Exploitation of Children and Youth
The concept of ‘county lines’ comes from the USA but it has been shown to be a form of abuse that is visible in many countries of the world. County lines is a form of Criminal Exploitation of Children and Youth, where, typically, gangs or groups of slightly older people encourage criminal activity of a young person. This is a complex form of abuse as often the young person thinks that they are an important part of the gang, that the members are their friends and that taking part in criminal activity is a way of proving their worth to others. In the psycho-social development of a child or teenager, the need to belong is strong and having a sense of peer membership is crucial to healthy development. Unfortunately, this is also a way young people can be abused, primarily because of these needs. Older people, often only up to five years older (but clearly psychologically more developed and usually of adult status), ‘groom’ a young person; encouraging them to be involved in the group, promising group membership, possibly material reward (money, phones, alcohol or drugs) in exchange for them taking part in criminal activity (National Crime Agency 2016). In the case of county lines, this usually involves sending a young person to an unfamiliar area, town or city, to deliver or sell drugs, collect criminal proceed (money) or carry out violence acts/be involved in group violence and so forth. The young person gains an emotional or psychological reward in being part of a peer group and for many young people that is highly attractive, especially if they come from circumstances where they feel excluded, ignored or may have been abused in other ways.
Some children and young people are more vulnerable to county lines and more general criminal exploitation, in particular those who are ‘looked after’ (living in care environments away from family of origin), those who have experienced abuse, young people from chaotic upbringings (mental health problems, drugs, alcohol abuse, domestic violence in the home). Another group who are at risk are children and youth from Black and Minority Ethnic groups and/or refugee or migrant children, all of whom might feel excluded from friendships, participation or opportunities in societies. County lines and criminal exploitation are newly recognised forms of abuse (the last five year), but will increasingly become important to debates as the knowledge base about them grows.
SIGNPOSTING TO RESOURCES: Criminal exploitation and ‘county lines’ resources in diverse languages can be found at The Children’s Society charity website:
We can also add to this list, the emerging area of ‘spiritual abuse’, where systems of religion, belief or faith are used as means to abuse children or young people. This is often visible through basic ideas or concept of religion, faith or believe, being deployed by perpetrators as control mechanisms to keep a child or young person under the abuser’s power and/or to manipulate them. Spiritual abuse can be intertwined with other forms of abuse, including child sexual abuse, psychological abuse or physical abuse. For instance, spiritual abuse might involve using religious doctrine to control a young person, such as using fear of the power spiritual entities to make them do the will of the abuser, to abuse children through notions of spirit possession and exorcism or controlling a child or young person through threatening them, or their family with being cursed. Spiritual abuse also extends into the indoctrination of a child or young person into a cult, in which they give up personal control over their lives, finances and so forth to an organised religion or faith group, who are often separated from society and control many aspects of their members’ lives.
Spiritual abuse can be carried out by an individual or a group and may be organised around diverse notions of belief and or religion. In many richer Northern countries of the globe, spiritual abuse has been found to operate through large-scale institutional religions, such as the Catholic Church, Church of England, Orthodox Church and so forth. However, it can also operate through widespread folk religion, such as Voodoo and witchcraft belief systems or Shamanism. It would be fair to say that every religious or spiritual system has the potential or ability to harbour or encourage abuse of children or youth. This is especially the case where some members, of a faith or spiritual groups, have more power or authority over others and this is supported by a strong belief system.
It is important to be mindful that some types of abuse outlined above may be sectioned out in different ways in specific countries. For instance, In the USA, child abuse is defined at a state and federal level and they add some categories of abuse to those above, which in Europe we might see as more generically under the general title child abuse:
- Substance abuse. Where a child or young person is exposed to drugs themselves, where drugs are used around them, manufactured around them, or where the carer uses drugs and this impairs their ability, therefore, to provide acceptable care.
- Prenatal Child Abuse, abuse in which an unborn child is exposed to drugs in vitro (in the womb).
Ideas about what constitutes sexual abuse of children or young people have changed rapidly in the last fifty years, across cultures. Leading to a generalised acceptance that children and young people need protection from diverse forms of sexual abuse.
Quick Question: Is there such a thing as a ‘Child Prostitute’ or Underage Prostitute?
Answer: No, there is no such thing as a child or underage prostitute. A legally underage person is unable to give consult to sexual acts; therefore underage sex is technically sexual assault. Unfortunately, you may see underage people referred to as child prostitute, especially when media outlets discuss children and youth who are sexually abused in poorer countries of the world. Remember that these accounts are using an inappropriate and wholly wrong term for what is happening to these young people. Even where a child behaves in a sexually precocious way, or invites sex (which can happen where a child/young person has been abused and is traumatised), that does not make it legal for any adult to act upon this and abuse that child or young person.
Activity 2: How is abuse categorised? What is missing?
Devon County Council in the UK identify seven types of abuse, which are:
- Psychological abuse
- Physical abuse
- Sexual abuse
- Discriminatory abuse
- Financial abuse
- Institutional abuse
Please turn to this link, to see what they include in these seven types. What would you suggest is missing from their conceptualisation of abuse?
Devon County Council, who are a statutory body who oversee public (state) services in the county area of Devonshire in the UK, have covered a number of basic areas of abuse on this webpage. However, there are some missing issues here,
- First, they do not attend to a wide variety of types of abuse and seem to merge some areas in together, which may not be helpful. For instance, they do not define ‘Modern Slavery’ as a separate category.
- Some newer areas of abuse need coverage in their list, for instance cyber abuse is not defined as a separate area but it would seem to cry out for being so.
- Spiritual abuse is an area that is absent; however there has been growing recognition since first use of the term in the early 2000’s in the USA, that this is an important area.
There are other typologies that are more extensive in their coverage of a wider range of areas of abuse. Above we have used the NSPCC list of categories, again from the UK, however, there are many others available in every country.
Activity 3: How is abuse categorised in your country and local agencies?
Gather information on types of abuse from your country and from your local authorities. Examine these in relation to the NSPCC material offered above. Write a short analysis of the coverage of issues. If you can, share this with a colleague or friend who is interested in abuse and safeguarding issues. Are you able to add to the list of types of abuse or are some missing in the materials you have collected? Why not email the PAPYRUS team to let them know about your findings?