CHILD ABUSE: RECOGNITION,

PREVENTION, AND INTERVENTION

Sheza Naeem
Institute of Psychology
 TYPES OF CHILD ABUSE

• Physical Abuse: Inflicting injury (bruises, burns, shaking).

• Emotional Abuse: Belittling, threats, emotional harm.
• Sexual Abuse: Involving child in sexual activities.
• Neglect: Failure to provide basic needs.
 IDENTIFYING SIGNS AND SYMPTOMS

• Physical: Children who experience physical abuse often present with unexplained bruises,
fractures, burns, or frequent injuries. These injuries may appear in various stages of healing
and might not match the explanations provided. Caregivers may delay seeking medical help
or offer inconsistent stories.
• Behavioral: Abused children may show signs of withdrawal, fearfulness, irritability, or
depression. They might become unusually passive or aggressive, exhibit anxiety, or develop
regressive behaviors such as thumb-sucking or bedwetting beyond the expected
developmental age.
• Academic Signs: A sudden and unexplained decline in academic performance, loss of
interest in school activities, or frequent school absences can be warning signs of abuse.
Children might find it difficult to concentrate, exhibit school avoidance behaviors, or appear
overly tired during the school day.
• Social Signs: Abused children often struggle with forming trusting relationships with peers or
adults. They may appear isolated, have difficulty making friends, or display intense fear
around adults or authority figures. Sometimes, they may cling excessively to familiar adults,
reflecting attachment disturbances.
• Indicators of Sexual Abuse: Sexual abuse may manifest through nightmares, sleep
disturbances, sudden onset of bedwetting, or other regressive behaviors. Children might also
display knowledge of sexual behavior that is inappropriate for their developmental stage or
engage in sexually explicit play or language that is unusual for their age.
 PSYCHOSOCIAL ASSESSMENT OF VICTIMS

• Establish Rapport in a Safe Environment

It is critical to first establish a trusting and safe environment where the child feels
comfortable. Creating a non-threatening space helps the child feel secure enough to
share their experiences without fear of judgment or punishment.

• Use Child-Friendly Language and Avoid Leading Questions

When speaking to the child, use simple, age-appropriate language that they can easily
understand. Avoid asking leading questions that might suggest answers (e.g., instead of
“Did your father hit you?”, ask “Can you tell me what happened?”). This ensures the
child’s account is authentic and unbiased.

• Use Multimodal Assessments and Observation

A comprehensive assessment should involve gathering information from multiple
sources, such as interviews, behavioral observations, teacher reports, and
questionnaires. Observing the child's behavior during sessions can provide important
non-verbal clues about their emotional state.
• Respect the Child’s Pace and Observe Non-Verbal Cues
It is important to allow the child to share information at their own
pace, without rushing or pressuring them. Watch for non-verbal cues
like body language, eye contact, and physical signs of discomfort, as
these can provide additional insights into their emotional state even
when they are reluctant to verbalize.

• Important Tools
• Child Behavior Checklist (CBCL):
A questionnaire filled out by parents or teachers that assesses a
child's emotional and behavioral problems, helping professionals
identify areas of concern.
• Trauma Symptom Checklist for Children (TSCC):
A self-report tool that allows children to describe symptoms they
might be experiencing after trauma, such as anxiety, anger,
depression, or dissociation.
 MANDATORY REPORTING

In many countries (e.g., the U.S.), school psychologists, counselors, and teachers are
mandated reporters.
This means they are legally required to report any suspected (not just confirmed) child
abuse or neglect to child protection authorities, even if they are not 100% sure. Failure to
report can lead to legal penalties for the professional.

What About Pakistan?

• Pakistan does not have a standardized, nation-wide mandatory reporting law for
child abuse like the U.S. has.
• Reporting structures are weak or unclear — especially in public schools.
• Some private schools may have internal policies for reporting concerns to
management, but there is no formal, universal legal duty to report abuse at the
national education level.
• Child Protection Bureaus (CPBs) exist in provinces like Punjab, Sindh, and KPK,
but they are not always efficiently connected to schools.
So, what can a school psychologist/student be trained
to do in Pakistan?

1. Follow Internal School Protocols First

• Encourage schools to have a Child Protection Policy (even if not legally required).
• If abuse is suspected, the first step is often to inform the school principal or child protection
committee (if it exists).
• Advocate for creating internal reporting procedures if they don't exist.

2. Document Observations Carefully

• School psychologists should keep detailed, factual records of any signs or disclosures (dates,
what was observed or said, child's emotional state).
• Avoid making accusations — focus on observations, not interpretations.

3. Parental Involvement (Cautious)

• In non-severe cases (e.g., neglect due to poverty), the school may first try parent meetings to
offer support or guidance.
• However, if the parent is the suspected abuser (especially in sexual or physical abuse cases), do
NOT confront them directly — this could endanger the child.
4. Referral to Child Protection Authorities (Where Available)
• If serious abuse is suspected, school psychologists can contact local Child
Protection Units:
• Punjab Child Protection Bureau (Child Helpline 1121)
• Sindh Child Protection Authority
• KP Child Protection and Welfare Commission
However, referral is a recommendation, not a legally mandated action.

5. Confidentiality with Caution

• Tell students that if a child discloses abuse, they cannot promise full
confidentiality.
• They must gently inform the child: "I may need to talk to other people who
can help you stay safe."
 PREVENTION, INTERVENTION, AND HEALING

Primary Prevention: Stopping Abuse Before It Happens

• School-Based Abuse Prevention Programs:

Schools can implement programs that teach children how to recognize inappropriate behavior, assert
their boundaries, and seek help from trusted adults. These programs empower students with
knowledge about safety and personal rights.

• Understanding Behavior Through a Trauma Lens:

Instead of immediately labeling a child as “defiant” or “difficult,” school psychologists are trained to
consider whether behaviors like aggression, withdrawal, or anxiety might stem from trauma.

• Creating Safe Spaces in Schools:

School psychologists advocate for safe spaces like calm rooms or check-in systems where students can
seek help when they feel overwhelmed.

• Parent Education on Positive Discipline and Child Development:

Educating parents on healthy, non-violent discipline methods and typical stages of child development
can prevent abuse. Parenting workshops can help caregivers better manage stress, understand
children's needs, and build nurturing relationships.
Secondary Prevention: Early Intervention for At-Risk Families

• Early Identification and Support for At-Risk Families:

Teachers, counselors, and healthcare providers can identify
warning signs in children or families (such as frequent injuries,
neglect, or emotional withdrawal) and intervene early. Early
support can prevent the escalation of abuse.
• School Counseling Services:
Providing accessible counseling services within schools can
support children showing early signs of trauma, anxiety, or
behavioral issues. Counseling can act as a protective factor by
offering a safe space for emotional expression and coping skill
development.
Tertiary Prevention: Interventions After Abuse Has Occurred

• Therapeutic Interventions (e.g., Trauma-Focused Cognitive

Behavioral Therapy - TF-CBT):
TF-CBT is a specialized type of therapy that helps children process
traumatic experiences, reduce emotional distress, and build coping
strategies. It combines trauma-sensitive approaches with
cognitive-behavioral techniques.
• Family Therapy When Appropriate:
In cases where family reunification is safe and possible, family
therapy can help address dysfunctional dynamics, improve
communication, and support healing for both the child and the
caregivers.
Healing Strategies: Supporting Long-Term Recovery

• Safe, Stable, Nurturing Relationships:

The presence of at least one stable, caring adult can significantly
buffer a child from the long-term effects of trauma. Trusting
relationships foster emotional security and recovery.
• Consistent Therapy Over Time:
Healing from abuse is not quick. Long-term therapeutic support —
without frequent disruptions — is important to help children rebuild
trust, process trauma, and strengthen emotional resilience.
• Building Resilience Through Self-Esteem and Empowerment:
Helping children rebuild their self-esteem, develop positive coping
strategies, and recognize their strengths empowers them to move
forward with confidence and reduce the risk of future victimization.
 CASE STUDY EXAMPLE

• 9-year-old boy: Sleepy, bruises, fearful of touch.

• Signs of possible abuse: Physical and emotional.
• Approach: Build trust, open-ended questions.
• Next steps: Follow ethical guidelines and mandatory
reporting.
 IMPORTANT NOTE

• Mandatory reporting of suspected abuse is required.

• Confidentiality must be explained carefully to the child.