Protecting children from physical abuse

Last updated: 04 Sep 2018
Introduction

Physical abuse is defined as deliberately hurting a child and causing physical harm (Department of Health, 2017; Department for Education, 2018; Scottish Government, 2014; All Wales Child Protection Review Group, 2008). It includes injuries such as:

  • bruises
  • broken bones
  • burns
  • cuts.

It may involve:

  • hitting
  • kicking
  • shaking
  • throwing
  • poisoning
  • burning
  • scalding
  • drowning
  • any other method of causing non-accidental harm to a child.

Physical abuse may also happen when a parent or carer fabricates the symptoms of, or deliberately induces, illness in a child. This is known as Fabricated or Induced Illness (FII) (All-Wales Child Protection Review Group, 2008; HM Government, 2008; Department of Health Social Services and Public Safety, 2017; Scottish Government, 2014).

Impact

Impact of physical abuse 

Effects on infants

Shaking or hitting babies and very young children can cause:

  • fractures
  • broken bones
  • internal injuries.

Non-accidental head injuries (NAHI) can cause brain injury which can lead to:

  • learning problems
  • behaviour problems
  • seizures
  • hearing and speech impairment
  • visual impairment or blindness
  • changes in personality
  • severe brain damage
  • long-term disability
  • death.

Effects on older children

"My parents fight with each other, and they end up taking it out on me. Every day they argue and shout at me, when they get really angry they hit me and kick me too. They tell me that everything's my fault and they don't want me to be their child. I feel responsible for everything that's going wrong with my family. I'm so scared to be at home, I’m terrified that my parents will hit me again. Usually I leave the house and walk around until my parents find me. The only way I can calm down is to self-harm, I feel so upset and on edge all of the time, I just don't know what to do."

(Childline counselling session with girl aged 16)

Children who have been physically abused may experience effects including:

  • behavioural or conduct problems 
  • risk taking behaviour
  • mental health problems such as depressive disorders, anxiety disorders, and eating disorders
  • drug and alcohol problems
  • suicidal thoughts and feelings (Norman et al, 2012).

The psychological impact can last long after their injuries have healed.

Recognising

Recognising physical abuse

Bumps and bruises don’t necessarily mean a child is being physically abused – all children have accidents, trips and falls. These injuries tend to affect bony areas of the body such as elbows, knees and shins and aren’t usually a cause for concern. However, some injuries are more likely to indicate physical abuse.

Signs and indicators

Bruises:

  • commonly on the head but also on the ear, neck or soft areas (abdomen, back and buttocks).
  • defensive wounds commonly on the forearm, upper arm, back of the leg, hands or feet.
  • clusters of bruises on the upper arm, outside of the thigh or on the body.
  • bruises with dots of blood under the skin.
  • a bruised scalp and swollen eyes from hair being pulled violently.
  • bruises in the shape of a hand or object.

> See the Bruises on children: core info leaflet

Burns or scalds:

  • can be from hot liquids, hot objects, flames, chemicals or electricity.
  • these may be on the hands, back, shoulders or buttocks. Scalds in particular may be on lower limbs, both arms and/or both legs.
  • a clear edge to the burn or scald
  • sometimes in the shape of an implement – for example, a circular cigarette burn
  • multiple burns or scalds.

> See the Thermal injuries on children: core info leaflet

Bite marks:

  • usually oval or circular in shape
  • visible wounds, indentations or bruising from individual teeth.

> See the Oral injuries and bites on children: core info leaflet

Fractures or broken bones:

  • fractures to the ribs or the leg bones in babies
  • multiple fractures or breaks at different stages of healing.

> See the Fractures in children: core info leaflet

Signs of head injury in an infant:

  • visible signs such as swelling, bruising or fractures
  • unusual behaviour – being irritable, lethargic, unresponsive or not wanting to feed
  • seizures
  • vomiting
  • respiratory problems
  • being comatose.

Not all head injuries are caused by abuse. There are also other medical reasons a baby may have these symptoms.

> See the Head and spinal injuries in children: core info leaflet

Behavioural changes

  • fear of specific individuals
  • flinching when approached or touched
  • reluctance to get changed in front of others or wearing long sleeves or trousers in hot weather
  • depression or withdrawn behaviour. 

Risks and vulnerability factors

Physical abuse can happen in any family. But babies and children who have a disability are at a higher risk of suffering physical abuse (Jones et al, 2012).

> Find out more about safeguarding d/Deaf and disabled children

Some parents may also struggle to provide their children with safe and loving care if they are facing difficulties such as:

  • poverty
  • poor housing
  • substance misuse
  • relationship problems
  • domestic abuse
  • the effects of childhood abuse or neglect.

If parents are isolated and don’t get enough support, things can become even more challenging. The more of these problems a family is facing, the harder it can be to cope – and the greater the risk of harm to children.

Challenges parents or carers may face

Adults who physically abuse children may have:

  • emotional or behavioural problems – such as difficulty controlling their anger
  • health issues which make it difficult for them to cope
  • family or relationship problems
  • experienced abuse as a child (Miller-Perrin and Perrin, 2013).
Responding

Responding to physical abuse

Recording concerns

Physical abuse may form a long-term pattern of behaviour. Adults who are concerned a child is being physically abused should record individual incidents to build up an overview of the child’s lived experience. This should then be shared with other agencies as appropriate and used to decide what support a child and their family need.

If a child is frequently injured, and if the bruises or injuries are unexplained or the explanation doesn’t match the injury, this should be investigated. A delay in seeking medical help for a child when it is needed should also be reported.

Reporting

If you think a child is in immediate danger, contact the police on 999. If you're worried about a child but they are not in immediate danger, you should share your concerns.

  • Follow your organisational child protection procedures. Organisations that work with children and families must have safeguarding policies and procedures in place.
  • Contact the NSPCC Helpline on 0808 800 5000 or by emailing help@nspcc.org.uk. Our trained professionals will talk through your concerns with you and give you expert advice. 
  • Contact your local child protection services. Their contact details can be found on the website for the local authority the child lives in. 
  • Contact the police.

Services will risk assess the situation and take action to protect the child as appropriate either through statutory involvement or other support. This may include making a referral to the local authority.

> See our information about recognising and responding to abuse

Assessment

When you are assessing whether a child’s physical injuries were the result of abuse:

  • consider the injuries in the context of the child’s medical and social history
  • think about whether the explanation for the injury is consistent with the child’s stage of development and the environment where it was said to have occurred
  • check whether the severity of the injury fits with the description of the cause.

See our Core Info leaflets for more detailed information on assessing each type of physical abuse:

Prevention

Preventing physical abuse

Empowering children and parents

Children of all ages need support to identify abuse and to speak out if something is wrong. It’s also important that parents and carers know how to keep their children safe.

Parenting advice

Research shows there’s a risk of physical punishment escalating into more severe forms of abuse (Heilmann, Kelly, and Watt, 2015). So it’s important that parents are made aware of the harmful effects of physical punishment and given alternative strategies to use when reacting to challenging behaviour.

Share our parenting leaflets with parents are carers:

  • Positive parenting - techniques to encourage better behaviour
  • Handle with care - safe ways to hold and care for babies and ways to cope when the crying doesn’t stop

Supporting parents and carers

Adults who physically abuse children may never have been taught how best to respond to a child. They may have unrealistic expectations of the way children should behave or lack understanding of a child’s needs.

Early intervention services can help by teaching parents how to respond to a child who is displaying challenging behaviour, for example a crying baby.

NSPCC services

NSPCC provides services to support parents to provide safe and loving care for their families.

Baby Steps
A perinatal education program (for before birth and just after pregnancy) that supports parents in how to care for their new baby. We’re now supporting other organisations to deliver Baby Steps in local areas

> Find out more about the Baby Steps service on the NSPCC website

Parents Under Pressure™
Supports parents who are on a drug or alcohol treatment programme, including helping them learn strategies to keep calm and in control.

> Find out more about the Parents Under Pressure™ service on the NSPCC website

Coping with Crying
A programme to protect babies from non-accidental head injuries by showing new parents a film sharing the experiences and practical tips from new parents and advice from experts about crying.

> Find out more about the Coping with Crying programme on the NSPCC website

Speaking out

It’s vital to build safe and trusting relationships with children so they can speak out about any problems they are experiencing. This involves teaching children what abuse is and how they can get help.

Our Speak out Stay safe service for schools helps children understand abuse in all its forms and know how to protect themselves.

> Find out more about Speak Out Stay Safe

Legislation and guidance

Legislation and guidance about physical abuse

Key legislation

Across the UK, statutory guidance highlights the responsibility of those in the education, community and care sectors to safeguard children from all forms of abuse and neglect:

The law to protect children from physical assault dates back to 1861 (Offences Against the Person Act 1861).

Current child protection laws protect children from physical abuse. But children’s rights campaigners such as the NSPCC continue to call for changes in the law to protect children from physical punishment.

Equal protection from physical assault

The United Nations Convention on the Rights of the Child states that children should be protected from physical and mental violence, including physical punishment (United Nations, 1990 and 2006). But in the UK, children are the only group of people who are not fully protected from physical assault.

These defences can’t be used in cases where a child has suffered serious physical injury (actual bodily harm).

The Crown Prosecution Service (CPS) provides guidance on prosecuting child abuse in England and Wales (CPS, 2017). It sets out that the charge should be actual bodily harm (where the defence of reasonable punishment does not apply) "unless the injury is transient and trifling and amounted to no more than temporary reddening of the skin".

In cases of common assault, legal professionals are expected to judge for each individual case, whether the punishment was “reasonable and moderate”, taking into account factors such as the age of the child. This means they’re making subjective decisions on the severity of a child’s physical injuries and the pain they’ve experienced, and there could be variations in the extent to which children are protected from assault.

In Scotland and Wales, the governments are working to give children equal protection from assault.

The Scottish government has committed to giving children equal protection from assault: a Bill is working its way through the Scottish parliament (Proposed Children (Equal Protection from Assault) (Scotland) Bill).

Following a public consultation in early 2018, the Welsh Government has announced its intention to introduce legislation to remove the defence of reasonable punishment (Welsh Government, 2018).

Keep up to date with new legislation and guidance by signing up to CASPAR, our current awareness service for policy, practice and research.

References and resources

References and resources

Afifi, T.O. et al. (2017) Spanking and adult mental health impairment: the case for the designation of spanking as an adverse childhood experience. Child abuse and neglect, 71: 24-31.

All Wales Child Protection Review Group (2008) All Wales child protection procedures.[Accessed: 20/07/2018].

CPS (2017) Child abuse (non-sexual) – prosecution guidance. [Accessed 26/07/18].

Department for Education (DfE) (2018) Working together to safeguard children: a guide to inter-agency working to safeguard and promote the welfare of children (PDF). [London]: Department for Education (DfE).

Department of Health (2017) Co-operating to safeguard children and young people in Northern Ireland. Belfast: Department of Health.

Heilmann, A., Kelly, Y. and Watt, R.G. (2015) Equally protected?: a review of the evidence on the physical punishment of children. London: NSPCC.

HM Government (2008) Safeguarding children in whom illness is fabricated or induced: Supplementary guidance to Working Together to Safeguard Children (PDF). [London]: Department for Children, Schools and Families.

Jones, L. et al (2012) Prevalence and risk of violence against children with disabilities: a systematic review and meta-analysis of observational studies. Lancet, 380(9845): 899-907.

Miller-Perrin, C.L. and Perrin, R.D. (2013) Child maltreatment: an introduction. London: SAGE.

Norman, R. E. et al (2012) The long-term health consequences of child physical abuse, emotional abuse, and neglect: a systematic review and meta-analysis. PLOS Medicine 9(11).

Scottish Government (2014) National guidance for child protection in Scotland (PDF). Edinburgh: The Scottish Government. 

United Nations (1990) Convention on the Rights of the Child (PDF). [Accessed 26/07/2018]

United Nations (2006) Convention of the Rights of the Child:  Forty second session, Geneva, 15 May – 2 June 2006. General Comment no.8. [ Accessed 26/07/2018]

Welsh Government (2007) Safeguarding children: working together under the Children Act 2004 (PDF). Cardiff: Welsh Government.

Welsh Government (2018). Ending the physical punishment of children will protect their rights. [Accessed 06/08/2018]

Childline

If a child or young person needs confidential help and advice direct them to Childline. Calls to 0800 1111 are free and children can also contact Childline online or read about physical abuse on the Childline website. You can also download or order Childline posters and wallet cards.

Elearning

Our elearning courses can help develop your understanding of how to protect children from physical abuse and other abuse types.

Related NSPCC resources

Our Core Info leaflets give more detailed information about recognising the signs of physical abuse: 

> See all our research and resources on physical abuse

Further reading

For further reading about physical abuse, search the NSPCC Library catalogue using the keywords: "physical abuse" "physical punishment".

If you need more specific information, please contact our Information Service