Defining child abuse

In order to fight against child abuse, it is necessary to define it. Although definitions already exist, it remains difficult to set the boundaries of abuse and to get everyone to agree.

According to the World Health Organization (WHO), "Child abuse refers to the abuse and neglect of any person under the age of 18. It includes all forms of physical and/or emotional mistreatment, sexual abuse, neglect or negligent treatment, or commercial or other exploitation, resulting in actual or potential harm to the child's health, survival, development or dignity, in the context of a relationship of responsibility, trust or power". Thus, there are several types of abuse that can be categorized into acts of commission (physical, sexual, psychological/emotional abuse) and acts of omission (neglect). In the guide on prevention of child abuse, the WHO defines these different types of abuse. Physical abuse is characterized by the intentional use of physical force that causes harm to the health, survival, development or dignity of the child. Sexual abuse refers to the participation of a child in sexual activity that the child does not understand, cannot give informed consent to, is not developmentally prepared for, or violates the laws or social taboos of society. Emotional abuse refers to actions that have a high likelihood of causing harm to the child's mental health, physical, mental, spiritual, moral or social development. Neglect refers to the failure of parents or guardians to provide for the child's development and well-being in terms of health, education, nutrition, living conditions or emotional development.

Several signs may indicate that a child is being abused : physical signs (bruises, lesions, fractures, burns, bites, etc.), signs of neglect (feeding, sleeping patterns, hygiene, medical care, education, safety in and out of the home), signs of psychological abuse (disrupted/discontinued interactions, repeated humiliation, etc.), signs of sexual abuse (sexual abuse, sexual harassment, etc.), behavioral signs displayed by the child (unexplained behavioral changes, fear, withdrawal, sleep disorders, eating disorders, aggressiveness, affection-seeking, unpredictability of behavior) and behavioral signs of the child's entourage (intrusiveness, indifference, exaggerated bodily closeness, opposition to the child's care, follow-up and proper nutrition, contestation of symptoms, denigration, hyper-reliance on care, aggressiveness).

There are several risk factors that may contribute to child abuse : child-related factors (under 4 years of age or adolescent, unwanted or "disappointing" child, atypical child, child with an intellectual disability or neurological disorder, LGBT child), parent/guardian-related factors (childhood abuse, lack of connection to or attention for the child, lack of knowledge about child development, alcohol or drug abuse, lack of self-esteem, difficulty controlling emotions, mental or neurological disorder, involvement in criminal activity, financial difficulties), relational factors (family breakdown, intra-family violence, isolation, loss of extended family support for child rearing)  and community and societal factors (gender or social inequalities, lack of appropriate housing or support services, precariousness, easy access to alcohol and drugs, poor government legislation and actions in terms of abuse and crime, violent or liberticidal social norms, socioeconomic inequalities).

The evolution of the notions of childhood and abuse

The notion of childhood has evolved a lot throughout history, the child being perceived in a more or less positive or negative way depending on the period. During Antiquity, childhood is seen as a process to pass from an animal state to a full human one. The child and his games are then considered futile, uninteresting. In Sparta, the weakest children are eliminated and education is very strict. Aristotle also says, in his History of Animals, that children were not given their names until seven days after birth, because at this moment they had a better chance of survival. In Rome, the child is also seen as an imperfect being, under the total domination of the father of the family who will recognize him/her or not and who has the right of life and death on him/her. The Latin term infans means "the one who doesn't speak", which sums up the vision of the child during the ancient period : that of a not yet "finished" being, halfway between the animal and the human, and who is entirely subjected to the law of the parents and the society to which he belongs.

Under the Roman Empire, an emotional and institutional attention towards the child develops. Two visions of childhood were to oppose each other at the end of the Roman Empire and the beginning of the Middle Ages : one in the line with the ancient vision, perceiving the child in a negative way, putting forward its imperfection and comparing it to a dwarf, a madman or a drunkard  and the other more positive, in the line of the Roman Empire and adopted by Christianity, which praises the innocence and the purity of the child which is devoid of any sin. This second vision finally prevailed and certain rules were adopted to protect children (prohibition of infanticide, abandonment and abolition of the father's right to life and death over his children in the 4th century). In the Middle Ages, the child depends on the family domain and is educated/trained to play his/her social role. If there is then an affection and a concern for the education of the child in the family, the child is not however distinguished from the adult in the eyes of the society and childhood is then only an age of life like another.

The view of childhood began to change in the 18th century under the influence of Jean-Jacques Rousseau who published Emile/De l'éducation in 1762. Rousseau then put forward the specificity of childhood as an age of life and advocated the preservation of the child to allow its development. It thus allows us to reflect on the different stages of childhood. However, at the beginning of the 20th century, Sigmund Freud theorized the idea that the child would be an impulsive being, easily perverted and subject to the Oedipus complex, thus taking up this idea of a child with animal impulses. This vision of childhood still marks our society in the 21st century with this idea of a necessary parent-child power and authority relationship, even if it means physically punishing the child. In the middle of the 20th century, the Swiss biologist, logician, psychologist and epistemologist Jean Piaget described four stages of child development : the sensory-motor stage (0 to 2 years old), the pre-operational stage (2 to 7 years old), the concrete operational stage (7 to 12 years old) and the formal stage (12 to 16 years old). His work and others will revolutionize child psychology and bring society, in the legacy of Rousseau, to take into consideration the specificity of childhood and the stages of development of the child.

The notion of child welfare also evolved significantly in the 19th and 20th centuries. For example, infant mortality in France went from 151.1/1000 in 1901 to 3.7/1000 in 2016. This infant mortality was due to malformations, prematurity, poor health of mothers and difficult deliveries of newborns on the one hand, and to the frequency of digestive, respiratory or epidemic diseases in older children on the other. The development of medicalization of the first moments of life has reduced infant mortality among newborns and the improvement of sanitary conditions (vaccines, hygiene, food, sanitation, etc.) of the population has reduced infant mortality among older children. This reduction in child mortality and of "natural" violence of life on the child has also contributed to changing society's view of child welfare and child abuse.

Abuse used to be normal, as the upbringing of the child regarded his/her family and the use of physical violence was accepted by society. It was Auguste Ambroise Tardieu, a French forensic scientist, who made the first clinical descriptions of the battered child syndrome in 1860. Almost a century later, in 1953, Frederic Silverman, an American pediatric radiologist, made the first radiological observations of multiple fractures in battered children of different ages. With the development of neuroscience, psychological abuse was also taken into account. Moreover, the arrival of the Internet also brought new forms of violence against children, such as cyber harassment and cyber crime.

To keep pace with these evolving notions, states have progressively legislated on children's rights. For example, laws progressively prohibited child labor in France between the 19th and early 20th centuries. At the same time, the importance of education in society also led to laws making school compulsory until a certain age. In 1989, the International Convention on the Rights of the Child (ICRC) was ratified by almost all of the UN members. It sets out the fundamental rights of the child and is based on four principles : non-discrimination, the best interests of the child, the right to life, survival and development and respect for the views of the child in all matters affecting the child.

The difficulty of agreeing on a universal definition

The main difficulty in developing a universal definition of child maltreatment concerns the issue of abuse itself. How does one define child  abuse ? What are the boundaries of abuse? While some elements of child abuse may be universally accepted, others may not be considered as abuse in some cultures.

A first example is child labor. In Europe, the 19th century and the industrial revolution led to children working in factories and mines. In France and the United Kingdom, children - especially those from poor backgrounds - represented 15 to 20% of the workforce in factories and plants in the mid-19th century. Subsequently, the law gradually prohibited child labor under a certain age, as education became more widespread in the late 19th and early 20th centuries. Child labor is now considered as child abuse by the international community. According to the International Labor Organization (ILO), "The term “child labour” is often defined as work that deprives children of their childhood, their potential and their dignity, and that is harmful to physical and mental development.". Despite this, the same organization estimates that in 2020 "160 million children worldwide are involved in child labor, an increase of 8.4 million children over the past four years [...]". So the problem is still far from being solved. But if forced labor and child exploitation are condemned, the issue becomes more complex when it comes to work in the family environment. Indeed, depending on the culture, children may be required to help their parents at home to participate in family life without this affecting their education. The question then arises as to the type and amount of time that this domestic work represents.

Another example is education. Articles 28 and 29 of the ICRC enshrine the right of children to have access to primary and secondary education, with respect for their dignity. However, according to UNICEF, "millions of school-age children around the world are not enrolled in school : 58 million do not attend elementary school and 63 million do not attend secondary school. Even if the disparities are reducing, girls are more affected than boys.". The abuse in this area is therefore still present. But even when children are in school, the question arises of the education they receive. Education should indeed be a source of emancipation, as advocated by Rousseau, because it allows learning, development, socialization, openness, knowledge, etc. However, in some cultures, education is more an instrument of control (as in China) or an instrument that pushes for ultra performance (as in South Korea), to the detriment of the child's well-being.

Depending on the culture and societal norms, it is therefore difficult to define what corresponds to the child's well-being and to set limits to abuse. Despite this, it seems necessary to attempt to define child abuse so that all countries worldwide can fight it and raise awareness. The Chair is currently working on a definition that takes into account the different points mentioned in this article.
 

Gauthier Pichevin