INTRODUCTION

If you suspect that your child, or the child you care for, is being abused, you might need advice on what to do next. The steps you might want to take can vary, depending on the situation. The Royal College of Psychiatrists have an excellent article about child abuse that is worth reading as a general introduction. If you contact the NSPCC or Childline, they can offer support to worried parents or carers, children who are being abused or are worried about a friend. The police are also willing to help. Another source of confidential help is your GP or school or practice nurse. If abuse is proven or strongly suspected, the social services are informed and the case is always investigated.

WHAT IS CHILD ABUSE

There are four main types of child abuse: physical, sexual, and emotional abuse and neglect. In some cases, a child (or children) will be exposed to two or more types of abuse. To read more about what constitutes child abuse, go to Childline’s site, which also explains how children are affected, and things children should know if they are worried about abuse.

In the UK, the law regarding which physical punishments are allowed has recently been changed. If you are worried about disciplining your child read this article about effective, responsible discipline from the Royal College of Psychiatrists.

The National Society for the Prevention of Cruelty to Children information bank offers a summary of the government’s child maltreatment in the UK report, published in 2000. It includes the findings of a UK-wide survey of 2,869 young people between the age of 18 and 24 on all forms of abuse and gives an insight into the extent of child abuse in the UK.

Emotional abuse and neglect are often overlooked, but these types of abuse are perhaps even more predominant, as they are more difficult to detect and to resolve. Police usually have no authority to intervene in cases of emotional abuse and neglect, and it is up to the social services to get involved.

Whatever type of abuse the child you are concerned about is suffering, it is important to seek help. Any abuse has long-term adverse effect on children, and some of them will turn into abusers themselves. It is important to break the cycle.

Sometimes as a parent, although you love your children, they can drive you to anger, especially when you are tired. The best response to this situation is to walk away and calm down: a crying baby will come to no harm. If you do feel violent towards your child, can’t control your anger, or are worried that you have smacked them too hard, then please ask for help. You can call the Samaritans, or talk to your GP or health visitor. You may have post-natal depression, and asking for help is just a sign that you want the best for your child.

HOW DO YOU SPOT CHILD ABUSE

Abused children are usually made to feel guilty, as if they are to be blamed for what is happening to them. In addition, they are also asked to keep the abuse a secret. This makes it difficult for them to report abuse. Sometimes, they will say something. If you are not sure what the best way to proceed is, please contact professionals. The NSPCC is the leading organisation providing assistance. Helpline: .

Abused children usually behave differently in some way. Depending on the degree of abuse, they will display any or more than one of the following emotional and behavioural problems:

Abuse can change the way in which children relate to other people around them - kids and adults; it can affect their psychological and educational development; it can lead to long-term sexual and relationship problems; as well as post-traumatic stress disorder, serious depression or anxiety disorders.

The Coalition for Children, an American non-profit organisation, lists possible indicators of abuse on its Safe Child Program website.

If you are unsure what falls into the remits of usual child behaviour you can contact the NSPCC or Childline. The NSPCC site has two very useful publications (you need Adobe Acrobat Reader to access them but this is quick and easy to download) - 'Protecting Children from Sexual Abuse in the Community' and 'Protecting Children from Sexual Abuse in the Family'. There are also details of the NSPCC’s Fullstop Campaign, which aims to increase public awareness of the issues surrounding child abuse, change attitudes and bring about positive action.

GETTING HELP

It is usually best to consult your GP, health visitor, social worker or school nurse who can refer your child to a Child and Adolescent Mental Health Service, made up of a range of professionals, specialists in this area (e.g. psychologists, psychotherapists, psychiatrists). They can be particularly useful in providing either individual or group therapy. There may also be other organisations in your area that provide counselling and support that your GP or social worker can tell you about. Both the NSPCC and Childline can also provide help and point you in the right direction.

Refuge provides a safe place to stay if you are in immediate danger, as well as counselling and advocacy for women and children victims of domestic violence. Telephone hours) or contact 2-8 Maltravers Street, London WC2R 3EE.

The YoungMinds Parents' Information Service provides information and advice for anyone concerned about the mental health of a child or young person. Their booklet on child abuse offers helpful information. Telephone: .

If you are talking to a GP or other professional for the first time about a child who has been sexually abused, you need to be aware that he or she may inform your local social services department. Social services child protection teams have to investigate any case of child sexual abuse reported to them. This is when people such as a social worker, doctor or police officer try to find out what has happened, so it can be decided what should be done to help the family and protect the child.

While this might be a very difficult decision, you need to think very carefully about the effect on the child if you don't. This can be an upsetting time, but remember there are people who can help you through it.

You may feel that there are other difficulties in the family, which make it hard for you or the child to access help or to make the best use of it – for example:

Because child sexual abuse is against the law, some people worry that they will be punished for not reporting it sooner. Helplines can be very useful for getting advice anonymously on what to do next, and finding out what other support might be available. You could try raising these problems with your GP or health visitor, or you could contact one of the help agencies below.

In an emergency, always call the police by dialing 999 (Minicom: ).

The National Child Protection Helpline (NSPCC) is a free, confidential service for anyone concerned about children at risk, offering counselling, information and advice. Telephone: .

Careline is a national confidential counselling line for children, young people and adults on any issue including family, marital and relationship problems, child abuse, rape and sexual assault, depression and anxiety. Telephone: .

Shelterline provides emergency access to refuge services. Telephone: .

The Police: many kinds of domestic abuse are criminal offences, and the police take all domestic violence very seriously. Most forces have specially trained, experienced officers who will listen and speak to you separately from your partner. Women can ask to be seen by a female officer. The police can, if you wish, arrange medical aid, transport and a safe place for you to go. Their first priorities are the safety and well-being of your children, as well as yours.

The Samaritans offers 24-hour confidential emotional support for anyone in crisis. The number we give links up all their branches; or you can use the number of your local branch, which you will find in your phone book. Telephone: .

Victim Support offers information and support to victims of crime, whether or not they have reported the crime to the police. All help given is free and confidentially. You can contact Victim Support direct, or ask the police to put you in touch with your local group. The national helpline isfrom 9am to 9pm Monday to Friday and from 9am to 7pm on weekends and 9am to 5pm on Bank Holidays. Telephone: .

The Women's Aid National Domestic Violence helpline ) can give you support, help and information. All calls are taken in strictest confidence. The helpline is24 hours a day. You can contact your local Women's Aid service through the local phone book, or access the Women's Aid website, which lists other useful numbers.

Local Women's Aid refuge services have over 250 local refuge projects in the UK. Many local Women's Aid groups also run advice centers, drop-in centres or outreach services to more isolated areas, as well as local helplines. You can call in to see someone, or telephone for advice and support, without having to stay in a refuge.

Refuge’s 24-Hour National Crisis Line service provides information, support and practical help, 24 hours a day, 7 days a week, to women experiencing domestic violence. It can refer women and their children to refuges throughout the UK. Telephone: (run in partnership with Women's Aid).

Men's Advice Line and Enquiries offers information, support and advice to men experiencing domestic violence.from 9am to 10pm, Monday and Wednesday. Local projects for men are available in some areas. Telephone: .

Carers who are affected might want to consider contacting some of the organisations providing expert assistance for carers.

Dealing with child abuse can be extremely upsetting and difficult for everyone involved. It is also worth noting that the abuser needs help too: in most cases, the abusers were themselves victims of child abuse. There is help available through the mental health services and the first port of call for these is usually one’s GP.

LEGAL

The Children Act 1989 covers child abuse in part and you can read the main principles here.

It is worth noting that the Adoption and Children Act 2002 amends the Children Act 1989 definition of harm to a child, now "including, for example, impairment suffered from seeing or hearing the ill-treatment of another".

Even if the police don’t prosecute the abuser using criminal law, you can still use the civil law to get protection. Under the Family Law Act 1996, many people experiencing domestic violence can apply for court orders against their abusers. For example, you can apply for an order against someone you live with or have lived with (whether or not you have been married), someone you have agreed to marry, or someone with whom you share parental responsibility for a child.

These orders can stop the abusive behaviour itself, or in some cases prevent the abusive person from entering the home. Courts can attach a power of arrest so that if the order is not obeyed, the police can take the abuser to court.

The Home Office site provides information on dealing with domestic violence.

It is not easy to face the abuser in court, and many people are reluctant to pursue justice because of fear that the court process will cause further damage. A new initiative has been launched to ease the often-painful process of facing the abuser in court.

For more advice on law contact the Children's Legal Centre at the University of Essex. Telephone: .

If Social Services have taken over the care of your child to any extent and you have concerns about this, contact the Family Rights Group, an organisation providing advice and advocacy for parents or carers whose children are involved with social services. The Print House, 18 Ashwin Street, London E8 3DL Advice line: , E-mail: office.