Posted by Nurse Linda in Life After Paralysis on February 24, 2021 # Health

Abuse is an uncomfortable topic to discuss. However, it is present in all populations of society. It comes in a variety of forms. People often look back and think, ‘why did I ever allow this to happen?’ That is just what the abuser is attempting to achieve. You see, part of the abuse is making you think you are the one responsible for it. That it is all your fault or even that you asked for it. This is just not true. Abuse is the fault of the abuser, not the receiver.gray and white image of hands

When talking with individuals who have been abused or those that care for someone who has been abused, they have a difficult time identifying when the abuse began. If someone flies into a tirade or purposely harms someone else, abuse is seen right away. The abuser will apologize, and the person on the receiving end all too often accepts the excuses.

However, most abuse is not so evident. Abuse is insidious. It typically does not appear at one time. Instead, abusers are experts in their ability to make the receiver feel less than they are. Individuals who are abused cannot pinpoint exactly when the abuse began. It comes on slowly with just a small event. Once the abuser sees that they can keep the receiver under their domination, the events become more severe and more frequent. Abuse tends to build over time.

It is critically important to know that you can stop abuse in your life. You can stop abuse in your child’s life. YOU CAN.

Abusers typically follow a pattern. Often, they were the receiver of abuse. They may have been abused as a child. Abuse can develop as a coping mechanism to keep other people from hurting them. Abuse can be such a part of their life that they do not recognize how harmful their actions are. The real goal is their power over another. This is not an excuse for abusive people. It might help you understand the why behind the behavior. But it is not up to you as a receiver of abuse to analyze the abuser or to help them. Leave that to professionals. Your role is to keep yourself and your child safe from abuse.

Anyone can be the recipient of abuse. It is in all aspects of society. Even the most powerful people in the world have had abuse in their lives. Individuals who have vulnerabilities are especially at risk for abuse. This includes children, the elderly, those with differing abilities, even those who have a specific goal for their lives. Children believe in the authority of people who are older as well as other children. The elderly is often subjected to abuse due to limitations or for money. Individuals of any age with differing abilities are often targets for abusers as they are sometimes thought to be vulnerable. People with particular dreams or goals can be abused as they may confuse abuse with the opportunity to reach their dreams.

Examples of dreams or goal seekers are actors who are told they are required to do favors for people who can get the parts in movies or on TV. A famous but horrible abuse situation was with the US Gymnastic team. The doctor, a person in a position of power, was sexually abusing the gymnasts, often with their parents right on the other side of a divider in the gym. The abuser never acknowledged his part as he cited some unusual therapy technique that is not approved practice but devised for his self-gratification. The women were quite heroic. There was the risk of losing their dream, public shaming (because often the receiver of abuse is the one blamed) and challenging the authority of the ’expert.’ Abuse is ugly on many levels, both hidden and right out in the open.

Types of child abuse are child neglect, physical abuse, sexual abuse, and emotional abuse.

Child Neglect is the failure of a parent or caregiver to provide for a child’s basic needs. This can include physical care such as shelter, food, or lack of appropriate supervision. Emotional care is the failure by inattention to a child’s emotional needs, failure to provide psychological care or counseling, or permitting a child to use alcohol or other drugs. Educational needs might not be met, including special education. Not providing medical treatment, medication, or performing activities that lead to medical issues is child neglect.

Physical abuse is nonaccidental physical harm caused by anyone, an adult, or another child. There may or may not be physical signs ranging from no visible physical injury to scratches, bruises, broken bones, even shaking. Other abuse activity examples might include punching, beating, kicking, biting, shaking, throwing, stabbing, choking, hitting (with a hand, stick, strap, or other objects), burning, or other physical attacks. Physical abusers sometimes do so without leaving any signs on the child’s body.

An adult or another child can inflict sexual abuse. It consists of things such as fondling a child’s genitals, penetration, incest, rape, sodomy, indecent exposure, and exploitation through prostitution or the production of pornographic materials. Sexual trafficking is included in this definition.

Emotional abuse or psychological abuse is the most difficult to discern and prove. It includes constant criticism, threats, or rejection as well as withholding love, support, or guidance.

Other types of abuse include abandonment which is the desertion of a child. The parent or caregiver may be physically present with the child, but no physical or emotional support is provided. In other cases, the responsible adult deserts the child by leaving them at a safe place, leaves them with someone, and does not come back or just leaves.

Parental substance abuse is considered a form of child abuse in many but not all states. This includes prenatal use of drugs, manufacturing, selling, or taking a controlled substance that inhibits the ability of the adult to care for the child.

Abuse might be hidden by the child. Abusers typically start by grooming the child with kind words, attention, and gifts. The abuser will teach the child that they are special and that their relationship is special, so it should be kept secret. Abuse can sometimes be hard to detect because of the secrecy and because it typically does not appear as a sudden activity.

We often think of abusers as adults but remember, other children can be abusive as well. This can be because they are abused or from neglect by their parents. Older children can abuse younger children. Abusers can be family members. Abusers can be people in authority, such as teachers, religious leaders, and, yes, even health care professionals. Do not be blinded to abuse by your own relationship with a spouse or significant other. You might even be reading about yourself.

Children might exhibit these behaviors if they are being abused: sudden changes in behavior or school performance, not getting help for physical or medical problems, concentrating or learning problems that are not from a diagnosed condition, hypervigilance, watchful or waiting for something bad to happen, lacking adult supervision, overly compliant, passive or withdrawn, comes to school or activities early and stays late, does not want to go home or to another activity, reluctant to be around a particular person.

Sometimes, children in a healthy relationship with a parent, teacher, or healthcare professional will tell them about an abusive situation. They most likely will not identify it as abuse, but as an adult, you will recognize it. At least think that it is possible in slightly ‘off’ situations.

As a parent or caregiver, you will want to remove your child immediately from the situation if you have any suspicion of child abuse. This is not the time to think you may have misinterpreted the situation or that you really do not have evidence. If you have a hint that something is not right, remove the child from the situation. This may cause difficulty with childcare or other issues but is worth it for the safety of your child. It is not up to you to identify the abuse or discuss the situation with the abuser. Just get your child to safety.

Determination of child abuse is not quick and is not easy. There are specially educated individuals that can determine what is and is not abuse. If you suspect any abuse of a child, call the Child Welfare Department in your State. Requesting investigation is not making an accusation. It means there is something that needs to be checked. It will benefit the child and adult to ensure the safety of both. Do not let your child return to the suspected abusive situation. Notify Child Welfare immediately. Sometimes people in power over the abuser have been lulled into passivity by the abuser. Let the professionals at Child Welfare manage the investigation.

Reading this blog can be difficult. It can make you suspicious of everything and everyone. As a parent or caregiver, we want the best life for our children. Start with an open and honest relationship with your child so they will confide in you. Be aware. Know what is happening in your child’s life, who they associate with and what they are doing both in-person and online.

The safety of your child is your priority. Nurse Linda

Linda Schultz, Ph.D., CRRN, a leader and provider of rehabilitation nursing for over 30 years, and a friend of the Christopher & Dana Reeve Foundation for close to two decades. Within our online community, she writes about and answers your SCI-related healthcare questions in our Heath & Wellness discussion.

The National Paralysis Resource Center website is supported by the Administration for Community Living (ACL), U.S. Department of Health and Human Services (HHS) as part of a financial assistance award totaling $8,700,000 with 100 percent funding by ACL/HHS. The contents are those of the author(s) and do not necessarily represent the official views of, nor an endorsement, by ACL/HHS, or the U.S. Government.