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INTRODUCTION
1.3 Abuse in childhood
Aim . To explain how sexual abuse affects child development .
The World Health Organisation ( WHO ) distinguishes between three different types of abuse in childhood . Sexual abuse ( SA ) occurs when a child is involved in sexual activity that it does not fully understand , to which it cannot give informed consent , for which it is not developmentally prepared , or that violates the standards of the society in which the child lives . Physical abuse ( PA ) occurs when a caregiver or another person inflicts actual or potential physical harm on a child . Emotional abuse ( EA ) occurs when a caregiver or another person fails to provide a developmentally appropriate or supportive environment in which a child can develop a stable and full range of emotional and social competencies , taking account of the child ’ s potential and the social context in which the child grows up .
Because different types of maltreatment often occur together and affect many areas of children ’ s health and development , we have used the concept of ‘ nurturing care ’ to assess children ’ s needs and rights . Nurturing care occurs in a relatively stable environment that is sensitive to the child ’ s health and nutritional needs ; that protects the child from threats ; and that includes responsive and emotionally supportive interactions as well as opportunities to play and explore . The domains of nurturing care include health , nutrition , security and safety , early learning , and responsive caregiving . A child that is mistreated may be developmentally affected in all the above domains and all should be considered when support is provided . It is also evident that a child ’ s needs evolve with age , maturity and functional capacity . This too must be considered . In addition to knowing the child ’ s social context , therefore , helpers and carers must understand child development . The nurturing care framework assists helpers and caregivers to position the child in relation to several domains , assess risks and protective factors , and identify entry points and resources .
Guidelines for mental health and psychosocial interventions in humanitarian settings are also relevant when helping children who have experienced sexual abuse or violence . Relevant guidelines describe the human rights-based approach , the Do No Harm principle , and good practices in relation to co-ordination and integrated services . In general , it is good to avoid standalone interventions that focus on a single group or topic . Ideally , psychological interventions to support child survivors of sexual violence and abuse should be integrated with physical health care , legal support , financial support and other relevant services . The following ethical and human rights principles should guide work with children :
• Do no harm .
• The best interest of the child .
• The evolving capacities of the child .
• Non-discrimination .
• Respect .
• Integrity .
• Participation .
When applying these principles , the concept of nurturing care can help you to consider and take into account a child ’ s age and maturity , as well as relevant values , norms and resources .