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 Table of Contents  
ORIGINAL ARTICLE
Year : 2019  |  Volume : 4  |  Issue : 2  |  Page : 50-53

Knowledge and awareness of child abuse and neglect among children in pondicherry


1 Department of Pedodontics and Preventive Dentistry, Thai Moogambigai Dental College and Hospital, Chennai, Tamil Nadu, India
2 From the Department of Pedodontics and Preventive Dentistry, Thai Moogambigai Dental College and Hospital, Chennai, Tamil Nadu, India

Date of Submission10-Sep-2019
Date of Acceptance27-Sep-2019
Date of Web Publication26-Dec-2019

Correspondence Address:
Dr. Sherin Sarah Stephen
Department of Pedodontics and Preventive Dentistry, Thai Moogambigai Dental College and Hospital, Chennai, Tamil Nadu
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/ijfo.ijfo_16_19

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  Abstract 


Context: Child abuse and neglect (CAN) is a social malady that is gaining much importance in the present world. Studies had been conducted to assess the knowledge about CAN among parents, teachers, and medical professionals. However, there is a paucity of literature about the knowledge and awareness among children regarding this social problem.
Aims: The aim of this study is to assess the knowledge and awareness regarding CAN among schoolchildren in Puducherry.
Subjects and Methods: A structured questionnaire with nine questions regarding CAN was distributed among children from two schools, aged 10–15 years, in Puducherry. The data from filled questionnaires were analyzed using the SPSS software.
Statistical Analysis Used: Chi-square test, t-test, ANOVA, and Pearson's correlation test.
Results: Majority of the children were aware of the acts constituting CAN. A positive correlation was seen between the age of children and awareness of CAN. Furthermore, the girls had better knowledge about CAN when compared to boys.
Conclusions: Although the children had a good knowledge about CAN, further studies have to be conducted to generalize these findings in Puducherry.

Keywords: Awareness, child abuse, child neglect, knowledge


How to cite this article:
Stephen SS, Krishnan G, Pinni J, Moses J. Knowledge and awareness of child abuse and neglect among children in pondicherry. Int J Forensic Odontol 2019;4:50-3

How to cite this URL:
Stephen SS, Krishnan G, Pinni J, Moses J. Knowledge and awareness of child abuse and neglect among children in pondicherry. Int J Forensic Odontol [serial online] 2019 [cited 2020 Jun 1];4:50-3. Available from: http://www.ijofo.org/text.asp?2019/4/2/50/274048




  Introduction Top


Childhood is a crucial period among all stages of human development. Most of the foundation for one's personality develops during this golden period.[1],[2] The children's perception of themselves and their relationship with others are molded based on the experiences and relationships that they come across during their childhood.[3],[4] Further, these experiences become internalized in a manner that they affect a person's quality of life. One of the most devastating childhood events that have significant long term and often lifelong consequences are child abuse and neglect (CAN).[4]

“Child maltreatment” is a comprehensive term which includes both abuse and neglect of children. In 1999, the WHO defined child abuse as “All forms of physical and/or emotional ill-treatment, 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.”[5] This indicates that there are predominantly four types of child maltreatment' namely physical abuse' sexual abuse' emotional abuse, and neglect (physical, medical, emotional, and educational neglect).

CAN has a disastrous effect on the physical, psychological, cognitive, behavioral, and social development of children with extended upshot on the individual's families and communities.[6] Children from all sections of society irrespective of age, gender, race, or socioeconomic condition may be victims of CAN.[7] According to the WHO an estimate of 40 million children worldwide are victims of child abuse every year.[8]

India accommodates 19% of the world's child population and 42% of the Indian population is below the age of 18 years.[9] A national study from India in 2007 found that more than half (53%) of children were physically and/or sexually abused.[10] Although India is a signatory to various international instruments and declarations concerning with the rights of children to protection, security, and dignity, the prevalence of all manifestations of child abuse is extremely high (physical abuse (66%), sexual abuse (50%), and emotional abuse (50%).[10],[11]

As Zig Zigler said, “the first step in solving a problem is to recognize that it does exist.” Since children are the key sufferers of abuse and neglect, assessment of the awareness among them helps in formulating measures to safeguard the children from all forms of violence.

While there are many studies conducted among medical professionals, mothers and teachers, there is a paucity of studies that have been conducted among children in regard to their knowledge and awareness toward child maltreatment in India. Furthermore, it is doubtful if the children know about the agencies which they can approach and if they are being maltreated. This study aimed to find if the children in Puducherry were aware of the identification of various types of CAN.


  Subjects and Methods Top


The study was conducted among schoolchildren of age group 10–15 years who were attending school in Puducherry, India, in the month of October 2018. Prior permission was obtained from the administrators of the schools where the study was conducted.

Study design and participants

An observational cross-sectional study was adopted to examine the children's knowledge and awareness about CAN. The sample was chosen from two schools and may be considered as convenience sample. A total of 427 students had participated in the study, but 27 questionnaires were subsequently discarded as they were only partially answered. Hence, 400 completed questionnaires (93.67% response rate) were analyzed.

Data collection tool

A structured questionnaire written in English was used to collect the data. The questionnaire consisted of two demographic questions and nine questions with binomial options. The questions were asked to measure the knowledge among the following subdomains:

  • Knowledge of the acts constituting abuse and neglect[12]
  • Reporting the incidents of CAN[3]
  • Attitude regarding education on CAN.[1]


Procedure

Prior permission was obtained from the administrators of the schools where the study was conducted. Only one investigator distributed the questionnaire. The questionnaires were distributed to the students class-wise in a group setting in a commonplace (classrooms). The investigator verbally explained about the method of this research study and how to complete the questionnaire. The questionnaire was then read to all children in Tamil, and the children marked their own answers. The participants completed the questionnaire in about 15 min.

Statistical analysis

The data were collected and compiled using Microsoft Excel software 2007 and analyzed with the SPSS 20.0 software (IBM Corporation, Armonk, New York, United States). Descriptive statistics were used to describe the categorical variables (gender) by proportion and continuous variables (age and CAN score) were described by mean and standard deviations. The tests employed were Chi-square test, t-test, ANOVA, and Pearson's correlation test.


  Results Top


Of 400 children, 184 children were males (46%) and 216 were females (54%). According to age, the highest percentage of children (19.3%) was 13 years old, while the least percentage (15%) belongs to 10 years age group [Table 1].
Table 1: Demographic data of participants

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A majority of the children were aware of the acts that constitute physical abuse (95.3%); sexual abuse (85%); emotional abuse (96%); and medical neglect (85.5%). About 84.8% of the students reported that they would inform their elders if they were abused, and 71% of the students were aware of the child-helpline number. Majority of the students (76.8%) positively reported that they must be taught about CAN mandatorily [Table 2].
Table 2: Total response of children to each question

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[Table 3] represents the mean total awareness of the children about CAN according to their age. The answers given by the students were given a score of 1 for the correct response and 0 for the incorrect response. The mean total awareness score was the highest (7.78) in 14 years age group and least (5.74) in 11 years age group children, which is statistically significant.
Table 3: Mean total awareness score according to age

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[Table 4] explains the correlation between mean age and total awareness scores of CAN, which yielded a positive correlation of 0.195 implying that as the age increases, there was an increase in the knowledge and awareness among children, about CAN.
Table 4: Correlation between age and knowledge of child abuse and neglect

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Statistically significant increase in the mean total awareness score among females (7.38) than males (6.63) is presented in [Table 5].
Table 5: Mean total score according to sex

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Based on the total scores obtained, children were categorized into three groups, i.e., inadequate knowledge (<50%), moderate knowledge (50%–75%), and adequate knowledge (>75%) groups. [Table 6] shows that females had better knowledge about CAN than males.
Table 6: Level of knowledge

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  Discussion Top


CAN has been prevalent in the world since the beginning of civilization. The graveness of child abuse, however, was brought to the attention of the medical community and subsequently the general public after the publication of “the battered child syndrome” by Kempe et al.[13]

A 6-month study by the World Studies of Abuse in the Family Environment reported that 36% of the Indian children were hit with an object, 58% were slapped and spanked on the buttocks.[14] In the present study, majority of the children (95.3%) were aware that being hit by the stick, belt, whip etc., is unacceptable. This was in contrast to the findings by Bussien, who reported that most of the children thought that their abuse was a normal proceeding.[15]

The various forms of sexual abuse include forcing the child to exhibit and touch private parts, nude photography, exposure to pornographic material, sexual assault, etc.[10] The concept of “safe touch” was brought about to educate the children about sexual abuse. This concept teaches the children that the different parts of their body have different levels of security. It further enlightens them about safety by stating that any parts of the body which is covered by their swimsuits/underwear were private parts, which should not be touched or seen by anyone else other than themselves. This study reflects that 85% of the children who participated, were aware of “safe touch.” This finding was in accordance with the study conducted by Hurtado et al. that the children were quiet knowledgeable about sexual abuse.[16]

Emotional abuse is defined as “Any act by a person having the care of a child which results in the child suffering any kind of significant emotional deprivation or trauma.”[17] The American Professional Society on the Abuse of Children describes six forms of psychological maltreatment: spurning, terrorizing, exploiting, denying emotional responsiveness, isolating the children, and mental/health/medical and educational neglect.[18] The questions in this study were posed based on the instructions for children about CAN, by the child abuse prevention unit of the UNICEF.[19] Majority of the children (96%) in the present study were firm in their viewpoint that being ignored, locked in the room, or denied food was not acceptable. This pointed out to the fact that children would be aware if they are being emotionally abused.

Medical neglect encompasses a parent or guardian's denial or delay in seeking needed health care for a child, whereas dental neglect according to the American Academy of Pediatric Dentistry (AAPD) is the “failure by a parent or guardian, to seek treatment for visually untreated caries, oral infections, and pain; or failure of the parent or guardian to follow through the treatment once informed that the above condition(s) exists.”[20],[21] A study by the US Department of Health and Human Services reported that more than 15,000 children experienced medical neglect in 2011.[22] In the present study, 85.5% of the students reported that medical and dental visits must not be delayed.

Children who were abused do not tell an adult due to various reasons such as fear of not being believed, shame, and fear of causing trouble to the family.[23],[24] However, 84.8% of the children who participated in the study stated that they would approach an adult if they were abused and 83.3% of them pronounced that the adults would believe the allegations made by them.

In the present study, 56.9% of females had adequate knowledge on CAN as compared to males. Although, the overall prevalence of child abuse was high in both genders, studies suggest that girls are at more risk of abuse than boys.[10] A survey by the UNICEF on demographic and health was conducted during the period of 2005–2013, which stated that nearly 42% of Indian girls have gone through the trauma of abuse before their teenage.[25] This could be the reason for a higher level of knowledge among the female children regarding abuse in this study.

The present study showed that there was a positive correlation between the age of the children and awareness of CAN. Dr. Jean Piaget was the first psychologist who made a systematic study on the cognitive development of children. It was stated that with increased age of the children, analytical and deductive reasoning capability increases, which could be one of the reasons for the increase in the awareness of CAN in the older children.[26]

In the present study, 76.8% of the children positively responded that they need further education about CAN. A meta-analysis by Davis and Gidycz reported that children who participated in school-based child abuse programs had better knowledge on this issue.[27] It is our duty to empower the children with knowledge about child maltreatment and the measures to be taken if they are abused.

Limitations

The limitations of this study include a small sample size, convenience sampling, and the sample restricted only to two schools and thus making it difficult to generalize the findings.


  Conclusions Top


Every child should have the opportunity to grow up in a safe and healthy environment. They must enjoy their life in all respects and develop cognitively, emotionally, and socially. It is our responsibility to protect them from the evils of child maltreatment. The study revealed that the children in Puducherry had a good knowledge regarding CAN. However, further studies with larger sample size and stratified random sampling design are needed to generalize these findings to the children in Puducherry.

Acknowledgment

The author would like to take this opportunity to thank the Principals of Vidya Niketan Higher Secondary School and Government Higher Secondary School, Puducherry for their consent and support to conduct the study. I would also like to thank Dr. Porchelvan Swaminathan, statistician for his help with statistics.

.Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
  References Top

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    Tables

  [Table 1], [Table 2], [Table 3], [Table 4], [Table 5], [Table 6]



 

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