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July 04, 2019 Thursday 04:32:22 PM IST

Knowing the Warning Signs of Child Abuse and How to Protect Them

Health Monitor

Human development index (HDI) is a statistic composite index of life expectancy, education, and per capita income indicators. Worldwide, it is used to rank societies or countries into four tiers of human development. For many decades in the past, God’s Own Country has been a frontrunner to most other States of India in terms of HDI. This is an outstanding achievement considering the fact that this HDI is also on par with some developed nations.

So, is the high human development a reflection of Kerala’s civil society? In the words of Nelson Mandela, “The true character of society is revealed in how it treats its children”. If one extrapolates the value of HDI indicators to how our children are being treated, then the results should be satisfying. It is a matter of common knowledge that Kerala has been a role model in lowering infant mortality, eradicating malnutrition and reducing school drop-outs. Female foeticide, child labour, child trafficking and similar evils plaguing children have been curtailed in this intellectual society. But the question remains as to whether this society is truly great.

The answer could have been yes; however, in the midst of all these positive achievements, there seems to be a silent crisis that had been brewing. ‘Silent’ because, not until 2012 did it catch the attention of the society or media. ‘Crisis’ because the statistics published by the Kerala Police reveal numbers that are astonishing. These data reveal that in the year 2018, at least 10 crimes against children were reported each day in Kerala. (4008 cases, to be precise). These crimes pertain mostly to physical violence and to a lesser extent, homicide and others. In the same year, an additional 3179 cases were registered under the POCSO Act (Protection of Children from Sexual Offences). For the purpose of this Act, a child means a person who has not completed eighteen years of age. At first, one could find it hard to digest these numbers. However, what is more alarming, according to a recently retired chairperson of a District Child Welfare Committee, is that, these figures represent only the tip of the iceberg. He added that a larger number of cases actually go unreported or undetected as the offenders are more often from the inner circle of the victim, like a family member or a teacher or a senior or a neighbor.

Physical, mental, digital


Child abuse encompasses more than bruises and broken bones. According to UNICEF,child abuse can be physical, emotional, sexual, neglect, and exploitation. Any of these that are potentially or actually harmful to a child's health, survival, dignity and development are abuse. While physical abuse might be the most visible, other types of abuse, such as emotional abuse and neglect, also leave deep, lasting scars on kids. With the rapid advent of worldwide web, digital imaging, mobile phones and social media, newer avenues of child abuse have also been opened up. Child pornography, sexting, trafficking and blackmailing are constantly on the rise. 

Child abuse may take place in homes, schools, orphanages, residential care facilities, on the streets, in the workplace, in prisons and in places of detention. The child’s inability to express itself, lack of public awareness, social stigma attached with the abuse and fear among the family members regarding the consequences of reporting are other factors which have resulted in underreporting. Needless to say, the situation is alarming and if we do not act now and lift the veil off this menace, we may soon be looking at a dark face of our society.

The earlier the abused children get help, the greater chance they have to heal and break the cycle. By learning about common signs of abuse and how we can intervene, we might make a huge difference in a child’s life. First step towards making the difference is to identify that a child is in distress. Theaccompanying list is not exhaustive, but only indicative. If more than one element of this list is found in a child, then we have reasonable grounds to suspect that the child needs help. 

Warning signs of emotional abuse


Excessively withdrawn, fearful, or anxious about doing something wrong.

Shows extremes in behavior (extremely compliant, demanding, passive, aggressive).

Doesn’t seem to be attached to the parent or caregiver.

Acts either inappropriately adult-like (taking care of other children) or inappropriately infantile (thumb-sucking, throwing tantrums).


Warning signs of physical abuse

Frequent injuries or unexplained bruises, welts, or cuts.

Is always watchful and ‘on alert’, as if waiting for something bad to happen.

Injuries appear to have a pattern such as marks from a hand or belt.


Shies away from touch, flinches at sudden movements, or seems afraid to go home.

Inappropriate clothing- like long-sleeved shirts even on hot days to conceal the injuries

Warning signs of child neglect

Clothes are ill-fitting, filthy, or inappropriate for the weather.


Hygiene is consistently bad (unbathed, matted & unwashed hair, noticeable body odor).

Untreated illnesses and physical injuries.

Is frequently unsupervised or left alone or allowed to play in unsafe situations.

Is frequently late or missing from school.


Warning signs of sexual abuse in children

Trouble walking or sitting.

Displays knowledge of sexual acts inappropriate to their age, or even seductive behavior.

Makes strong efforts to avoid a specific person, without an obvious reason.


Doesn’t want to change clothes in front of others or participate in physical activities.

Anysexually transmitted disease or pregnancy, in person under the age of 18.

Runs away from home.

What next? Once we suspect that a child is being abused, or if a child confides in us, it is normal to feel a little overwhelmed and confused. Child abuse is a difficult subject. It may not only be hard to accept but even harder to talk about - for both the child and others. It is necessary to reassure the child or the informer and offer them unconditional support. A common reaction to news as unpleasant and shocking as child abuse is denial. However, if we display denial or express shock or disgust at what they are saying, the child may be afraid to continue and will shut down. It is important to remain calm and reassure the child that it not at fault. Let the child explain in their own words, don’t interrogate the child. This may confuse the child and make it harder for it to continue the story. It takes a lot for a child to come forward and share the dark experiences.


Safety comes first. Invariably, the safety of the child would be threatened. We have to ensure that the child is put in a secure location. A time-tested and reliable option is to inform the CHILDLINE telephonically on 1098. CHILDLINE India Foundation is India's first 24 hours helpline for children in distress and is a platform for bringing together the Ministry of Women & Child Development, Government of India, Department of Telecommunications, street and community youth, non-profit organizations, academic institutions, the corporate sector and concerned individuals. CHILDLINE works for the protection of child rights in general, but focus especially on all children in need of care and protection. The officers not only respond to the emergency needs of children but also link them to services for their long-term care and rehabilitation. If necessary, the officers take the child into their custody and produce it before the District Child Welfare Committee which shall then pass appropriate orders regarding further care and protection of the child.

Reporting to the Police: Sec. 19 of The Protection of Children from Sexual Offences Act (POCSO Act) 2012 makes it the legal duty of any person who has knowledge that a child has been sexually abused to report the offence to local police or special juvenile police unit. If he/she fails to do so, he/she may be punished with six months' imprisonment and/or a fine.

Suspected Child Sexual Abuse: The Protection of Children from Sexual Offences Act (POCSO Act) 2012 was formed to protect children from sexual abuse, sexual harassment and pornography. The Act defines different forms of sexual abuse, including penetrative and non-penetrative assault. Sexual abuse will be considered ‘aggravated’ when the abused child is mentally ill or when the abuse is committed by a member of the armed forces or security forces or a public servant or a person in a position of trust or authority of the child, like a family member, police officer, teacher, or doctor or a person-management or staff of a hospital. The Act also provides for imprisonment (for 5years) if any person is convicted of using a child for pornographic purpose. Even storage of such child pornographic material itself can attract upto 3years of imprisonment.

Emergency Medical Care:Sec. 25 of the Act makes it mandatory for all hospitals, whether public or private, to provide emergency medical care to the victim. Sec. 27 also makes it mandatory for the medical attendants to preserve evidence for Forensic purpose (like blood / body fluid samples, dress, DNA material, etc.)


Reporting of sexual abuse vs Confidentiality: The Act provides for safeguarding the child’s privacy at all times. Any person including medical attendants, media or police are not permitted to disclose any details that can identify the victim. 

Trial: According to the Act, the evidence of the child should be recorded within a period of thirty days of the Special Court taking cognizance of the offence and the Special Court shall complete the trial, as far as possible, within a period of one year from the date of taking cognizance of the offence. It also provides that the Special Court shall try cases in camera and in the presence of the parents of the child or any other person in whom the child has trust or confidence.

Punishment: The POCSO Act also provides provisions for punishment for false complaint or false information. However, the punishment is applicable only if the informant gives false information intentionally to put someone else in trouble. The Act prescribes stringent punishment according to the gravity of the offence and prescribes rigorous imprisonment for a term which shall not be less than ten years but which may extend to imprisonment for life and also fine as punishment for aggravated penetrative sexual assault.


To conclude, it is essential to accept that we are facing a crisis. To turn a blind eye now would only result in us waking up sooner or later to a cry. A cry that can not only be deafening but heart-stopping. As India’s Great Son, Nobel Peace laureate and child activist Kailash Satyarthi puts it “There is no greater violence than to deny the dreams of our children”.


Dr.N. Jayadev

(The writer is Consultant, Forensic Medicine & Toxicology, and Member Secretary, Institutional Ethics Committee, Rajagiri Hospital, Aluva )

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