Abuse, considered by the who as the use of force or physical power with intent to cause physical or psychological harm to itself or others, may occur in the family environment most often against vulnerable children, adolescents and the elderly. In 2014, Disque-Denuncia data revealed that the most frequent types of violence against children and adolescents are neglect, psychological violence, physical violence and sexual violence in this order, with the majority of victims being girls, Between 8 and 14 years old, who were raped inside the house or at the suspect’s house.
In Brazil, the physiotherapist working in primary health care, by attending the patient’s home, can learn about these situations of intrafamily child abuse and can be active in resolving these cases of violence. For this, it is fundamental that the professional is prepared to identify in the child the signs and symptoms resulting from physical, psychological or sexual abuse. However, health professionals are often unable to discern what can be an abuse or neglect of care from the low socioeconomic status of the family, or do not know how to act in health promotion and prevention actions, and do not notify the abuse. Or, they neglect abuse for fear of persecution by the aggressor, especially when they attend the family residence, and lack of protection and institutional support (Nunes CB et al., 2009).
The doubt in acting in these cases can also arise when it is not known if the child when removed from the environment of violence and transferred to an institutionalization will receive the care due or will be violated again, perhaps in a different way. Making this decision requires a careful analysis of the entire context of the child and the context of the aggression (Nunes CB et al., 2009).
Within my family context, and not as a student of physical therapy, I have already had to position myself regarding the notification of negligence, physical and psychological violence against two children who were between 5 and 8 years old at the time. My mother and I, when talking to the grandmother of the children and not receiving support to intervene in the situation, we decided to notify the guardianship council and request the removal of the custody of the mother’s children and give it to the father who lived in another city. This was done, however, two years later, one of the children asked to go back to live with her mother even with all the history of violence, showing how sometimes what we think is the right thing to do may not be the best for the child. And also showing how we do not know what attitudes to take in the face of abuse, what existing ways of intervening in these situations. Even so, my mother and I considered that our attitude was right, at least to serve as an alert to the children’s mother that her actions would henceforth be punished and neglected.
Números da Causa, Acesso em maio de 2017, http://www.childhood.org.br/numeros-da-causa
Nunes CB, Sarti CA, Ohara CVS, Profissionais de saúde e violência intrafamiliar contra a criança e adolescente, Acta Paul Enferm 2009;22(Especial – 70 Anos):903-8.