How to recognise possible signs of abuse in pre-schoolers

Some children are more vulnerable to abuse, such as children who are not verbal or have special needs. PHOTO ILLUSTRATION: PIXABAY

SINGAPORE – Videos of teachers allegedly mistreating young children at Kinderland early education centres recently went viral on social media, shocking many parents.

For Ms Beverly Ang, who has an 18-month-old son, it was particularly concerning.

“It made me wonder about my son, if anything should happen to him, because he can’t really tell us what he hears and sees at school,” says the 32-year-old stay-at-home mum, who also has a four-year-old daughter.

Experts say such incidents highlight how important it is to recognise in time if a child has been abused.

Parenting coach Dawn Choy says that beyond physical abuse – which leaves physical marks such as bruises – there is also emotional or verbal abuse: shouting, threats and criticism directed against the kids.

Early childhood and allied health professional Kate Lim says some children are more vulnerable to abuse, such as children who are not verbal or have special needs.

Educators who are not trained to handle children with special needs may misinterpret their behaviour, which can be disruptive, she says.

“In the Asian context, many educators may still want to be in control of the children and have them comply by inducing fear rather than respecting them. So the teachers end up shouting and yelling.

“Children’s crying adds to the commotion and stress of the environment, and can be a trigger for both teachers and other kids. There must be enough manpower, and you need to be updated on current classroom management strategies to handle different children,” says Ms Lim. 

Impact of abuse 

Clinical psychologist Karen Pooh says abuse can affect young children in different ways – emotionally, psychologically, physically and socially.

The effects can persist into adulthood, if the child does not receive support to recover. 

“The longer and more severe the abuse, the greater the impact of the abuse,” she says, noting, however, that a child’s resilience and parents’ support can be mitigating factors.

Ms Pang Si Hui, senior psychologist from the department of psychological medicine at the National University Hospital (NUH), says: “After a highly stressful event, children may alternate between feeling numb and being overwhelmed by powerful feelings like fear and panic.”

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Over time, they may see themselves as weak and helpless, others around them as powerful and dangerous, and the world as unsafe and unpredictable, she says. 

“If bystanders were involved, or if the child had tried verbalising what had happened but was dismissed, the abuse may disrupt the young child’s trust in others as being dependable or willing to provide protection.”

Studies have found that abuse may cause children to experience low self-esteem, depression, anxiety and fear, says Ms Choy, and they may have difficulties in relationships with others later in life. 

Ms Pang adds that children who witness abuse may also be distressed.

Apart from common emotions such as fear, helplessness and confusion, they may also develop a sense of insecurity, not knowing when they may become victims themselves.

Signs of abuse

Young children, even if they are not verbal yet, can communicate through their behaviour, says Dr Pooh. 

“Parents need to investigate further if the child is exhibiting behavioural changes that are out of character.”

An example would be that of a child, who is typically open to new experiences, crying or having other emotional outbursts whenever it is time to go to school.

Children who have been abused may also act out violent themes in their pretend play, she adds. 

Ms Terri Chen, head of the psychology team under NUH’s department of psychological medicine, says abused children may be more emotionally reactive to usual situations in the form of whining, crying or shouting.

They may also be more withdrawn or easily startled when touched unexpectedly. 

Abused children with special needs may act similarly, says Ms Lim, and also exhibit stimming behaviour – repetitive body movements or sounds that help them calm down or manage their emotions. 

Ms Gloria Ng, deputy director and head of community services and programmes at the Singapore Children’s Society, says the signs can be broadly grouped into four categories: 

  • Behaviours: sleep difficulties, changes in appetite, startle reflex, new fears, increased irritability or separation anxiety, regression or re-enactment of the event in their play
  • Physical symptoms: complaints of stomach aches and headaches, increased heart rate or sweating
  • Feelings: children may seem fearful or more irritable, or be distressed when reminded of the event
  • Thoughts: they may avoid thinking about the event, have nightmares or difficulty concentrating

Ms Pang says: “It can be challenging to differentiate between distress that is due to relatively innocuous, day-to-day causes and distress due to more serious reasons, such as abuse or ill-treatment in school.

“It would be helpful for parents to track changes in a child’s behaviour across a time period.”

What can parents do

Pay attention to bruises or marks on the child, says Ms Ng.

“We also need to take into consideration the child’s developmental milestones. For example, a toddler who is learning to walk may have occasional bruises on the knees.”

For children who are able to speak, it is helpful to ask them about events chronologically, she says, like if something happened after breakfast or nap time. 

“This is to elicit details that put a timestamp on information,” she says. 

Ask open-ended questions to allow the children to relay what happened in their own words, she adds, and avoid questioning them repeatedly.

In the aftermath of abuse, Ms Chen says the most important thing children need is safe attachment, which requires their parents to be present and show concern towards them.

This includes validating their feelings before offering reassurance, and helping them make sense of feelings by labelling their emotions.

Create safe spaces for children to process what they observed, says Ms Ng, and help them learn certain coping strategies like deep breathing. Let them hold a safe object that soothes them, like a stuffed toy. 

Maintain or re-establish daily routines for the child as that creates safety, security and predictability, she says, along with ensuring he or she gets good sleep and rest so that the child can better regulate his or her emotions. 

“A warm, nurturing and supportive home environment that demonstrates respect and compassion to the child in his or her day-to day interaction can also validate the child’s difficult experience, reinforce his or her right to be protected and (help the child) retain his or her dignity,” she adds. 

Connect with your child

Check in with children about what goes on at school through role play, drawing or storytelling, says Ms Choy. 

“Spending time connecting with the children will help them to open up to their parents if they are in trouble,” she adds.

This also helps the parents detect any sudden changes in the mood or behaviour of their kids. 

“To broach the topic (of potential abuse), parents can ask their children to draw pictures of themselves playing with their friends, a typical day in school or an activity with their teacher,” she suggests. 

Ms Pang says parents can start discussions early about how to recognise abuse and what to do using age-appropriate language and examples.

They can teach their children to identify warning signs like threats, use of physical force and inappropriate touching. 

Younger children may learn better through stories, songs and pictures, while older kids can learn from role-playing, she says. 

Ms Ng says children should be taught that they have the right to feel safe at all times.  

“Parents are among the first adults to whom a child will reveal something personal or even potentially traumatic,” she says.

They should consistently act in a way that makes children feel confident that their parents will listen to, believe and help them. 

“If children find it hard to talk to their parents about day-to-day things, it will be even harder to go to their parents with regard to the big things in their life,” she says.

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