Until the end of the 1970s, child abuse, though undoubtedly pervasive in Hong Kong, was barely recognized. An occasional, heart-rending case would hit the headlines but concern would quickly subside. There were no exploratory studies, no specialized services. The phrase ‘child abuse’ was not often heard.

In the minds of many people, 1979 was not only the International Year of the Child but also the year when action against child abuse took centre stage. It was the year in which the first child protection agency in Hong Kong, Against Child Abuse, was born. It was the year in which the...

Intervening in family life carries the risk of irreversible damage despite the good intentions of those concerned. Investigating allegations of child abuse is an activity that is fraught with difficulty. It is extremely stressful for all concerned and the burn-out rate among workers is high.

Because of the seriousness of the decision-making, which is often concerned with matters of life and death, we search for instruments that will measure risk accurately, and make the right decision for us. However, because investigations are carried out in circumstances which lend themselves to confusion and doubt, uncertainty is very common. Professionals have to...

The story of Siu Ming illustrates some of the difficulties encountered in investigating cases of suspected child abuse and the decisions that workers have to make in the process. It also illustrates the very taxing decision workers sometimes have to reach, on whether or not to remove a child from home.

The case was first reported to the agency in September, 1991. According to the informant (who was a neighbour), Siu Ming was frequently punished by his grandmother by being locked out of doors. Sometimes Siu Ming was punished by having to stand for a long time in a dark...

The welfare of the child has to be the ultimate goal in any child abuse investigations. A decision needs to be reached during the very first contact with the child as to whether the child is safe and protected from immediate harm. This should always take precedence over assessing the family for its potential for change and planning of treatment strategies. While these latter issues are undoubtedly of great importance, their appraisal should be carried out only when the child’s safety is ensured. In practice, however, situations are not always clear-cut. To decide on what is the most appropriate plan...

In 1981, in response to a series of mismanaged cases, the Social Welfare Department (SWD) of Hong Kong distributed procedures for handling child abuse to different government departments and non-government organizations (NGOs) concerned. These procedures have been revised over the years, the most recent being in 1993 (Procedures for handling child abuse cases, SWD, 1993).¹ They vary somewhat depending on which agency is the first contact, but they basically outline intake procedures and subsequent action and these include: arranging for medical examination, reporting to the police, the calling of a case conference and other follow-up activities. In particular, the conference...

Differences in culture, time, social norms, personal and professional values and ideologies may lead to different definitions of child sexual abuse. From the legal aspect, in Hong Kong sexual abuse is classified as the criminal offence of indecent assault. From the medical frame of reference, the definition will be associated with consequences such as genital injuries, venereal diseases, or pregnancy. There is a range of definitions of sexual exploitation of children, with different emphases.

According to the ‘Guide to the Identification of Child Abuse’ (Health and Welfare Branch, 1991), sexually abusive behaviours include ‘exploitation of a child for sexual or...

The prevalence of child sexual abuse is high in Western countries. In the United States of America, the National Centre for Child Abuse and Neglect 1981 survey suggested that 5% of children are sexually abused by familiar adults. A national sampling by Finkelhor, Hotaling, Lewis and Smith (1990) indicated that 27% of women and 16% of men have a history of sexual abuse (broadly defined).

As seen from the definitions quoted in the case study, any sexual activity is included. Overseas, only a minority of abuse cases involve full sexual intercourse. Overseas population surveys suggest that the commonest form of...

Child abuse is a matter of community concern and that the problem needs multi-disciplinary collaboration, including personnel of the medical, social, educational, legal fields and the police is well recognized. However, of all forms of intervention, legislative and legal intervention are the least acceptable to the public. This is evident from the response to the Consultation Paper on Measures to Prevent Children from Being Left Unattended at Home at the end of 1991, when women’s groups and other sections of the public, including many legislators, protested so vociferously that the matter was dropped. More will be said about this issue...

The ‘Guide to the Identification of Child Abuse’ (Hong Kong Government 1991) defines gross neglect as a form of abuse involving ‘failure to provide a child with adequate food, clothing, shelter, health care, forcing a child to undertake duties inappropriate to his or her physical strength or age, leaving a child habitually unattended or unreasonably depriving a child of education’. This is a report of such a case.

A caller reported to an agency that two young boys were regularly left unattended for the whole day. The caller described the two boys as children who had to live on their...

Gross neglect is an act of child abuse where the caretakers omit, or fail to provide the child with an adequate physical, psychological and social environment in which he or she can grow healthily. The consequences of such neglect often lead to longstanding physical and psychological damage, thus impairing the person’s long-term development.

The US Department of Health and Human Services (1988) subdivided the definition of gross neglect into three components: physical neglect, educational neglect, and emotional neglect. Physical neglect includes the failure to provide the child with an adequate level of basic physical care, such as nutrition, hygiene, clothing,...

In March 1990, a six-year-old boy in Hong Kong suffered severe wounds to his head and body, and both his arms and legs were broken. He had allegedly been beaten with a broom at home. In August of the same year, a six-year-old girl was found with scald injuries over her abdomen, thighs and left ankle. There were also bruises over her left cheek and multiple marks on her body and limbs. She was too scared to testify against the family members into whose care she had been placed, leading to their acquittal on assault and cruelty charges. In November...

There is general acceptance that the more violence a child experiences while growing up, the greater the possibility that the child will become a violent adult. The main perpetrator in the following child abuse case is Terry, the elder brother. Tom, the younger brother is the victim. However, Terry has also been the abused victim of the father in the past. This case is an illustration of violence being the family norm and abusive acts being repeated from one generation to another.

The case also illustrates an incongruent family hierarchy, in which the older son, Terry has taken over the...

Physical abuse is the commonest kind of reported child abuse. Within the general definition of ‘any act of omission or commission that endangers or impairs a child’s physical/psychological health and development, emotional health and development’, the Hong Kong Guide to the Identification of Child Abuse defines physical abuse as ‘non-accidental use of force, burning or poisoning’ (Health and Welfare Branch, 1991).

In the United States of America, definitions nowadays tend to be more operationally specific. Based on ‘demonstrable harm’ done to a child, Zuravin and Taylor (1987) for instance state: ‘A physically abused child is one who has sustained injuries...

This case first came to an agency’s attention as a boy with behaviour problems who was being physically abused. However, in the following months of intervention, through observing the parent-child interaction and expression of feelings, the worker became aware that the acting out behaviour of the child was a result of long-term emotional deprivation. All the characteristics of psychological abuse identified by Garbarino, Guttman and Seely (1986, p.8) were found in the child’s immediate environment. The characteristics include:

denying emotional responsiveness (ignoring),

isolating,

rejecting,

encouraging deviant behaviour (corrupting),

inducing fear (terrorizing).

The case demonstrates how the worker established a trusting...

The Hong Kong Guide to the Identification of Child Abuse defines psychological abuse as ‘behaviour or attitudes that endanger or impair the emotional or intellectual development of a child’ (Health and Welfare Branch, 1991).

Psychological (or emotional) abuse is specifically a psychiatric matter, yet difficult to define specifically. It is useful, however, to consider two components that, if present, may lead the professional to fall on firm ground in diagnosing psychological abuse (Royal College of Psychiatrists 1982). The first is a persistent pattern of parental behaviour which appears unrelated to the needs of the child. The second is the presence...

In Hong Kong, official statistics reveal that in 1995 there were about 65 to 75 child abuse cases every quarter of a year. (Social Welfare Department, December, 1995). These include only those cases that are offically known; therefore, they are more than likely to be the ‘tip of the iceberg’. Not to mention cases that are not brought to the attention of the professionals, there are certainly plenty of stressed families which, reactive to rapid social changes, if unaided, could become abusive. For example, when quite a number of nuclear families in Hong Kong were relocated to the suburbs of...

The foregoing chapters give some idea of developments in child protection work in Hong Kong over the past 16 years. This final chapter picks up on some of the issues mentioned earlier, re-emphasizing some local trends and problems still to be tackled, and elaborates on further steps that need to be taken to ensure proper protection of children and proper respect for the rights of children.

Hong Kong has been moving gradually from the stage of denying that the problem of child abuse existed, to looking only at fatal and dramatic cases of abuse or neglect, to recognizing it as...