Witnessing violence is harmful to the child and his/her development, even when the violence is not directed towards the child. Notwithstanding their obligation to secrecy, authorities must therefore submit child welfare notifications of such children. In addition, a report of an offence must be made to the police if violence directed at a child is suspected. If the person reporting the offence is unsure of his/her duty to report the case or about any other issues related to reporting, he/she may first consult the police without giving any data identifying the patient.
Adults who are either victims or perpetrators must always be asked whether they have minor children and whether the children are safe.
If a worker involved considers a pregnant woman's situation to be such that the baby will need support and protection by child welfare immediately after birth, the worker is obliged to make an anticipatory child welfare notification.
If violence occurs in one relationship within the family, e.g. between the parents, the risk of violence is clearly increased in other relationships as well, e.g. between siblings or between a parent and a child.
Notice that this article has been written in the Finnish context. Important differences, especially with regard to the legal framework, may apply between countries. Find out about local regulations.
Children who witness violence
Children and adolescents do not just witness violence outside the home or in the media. According to the Finnish Child Victim Survey, 7% of 9th grade respondents (about 15 years of age) had seen violence towards family members, most commonly between the parents. Children who have themselves been subjected to violence at home often also witness violence targeted at other family members at home.
Violence targeted at children is the most common form of domestic violence. Of 8th and 9th graders (about 14-15 years of age) responding to a school health survey in 2019, 12% had experienced physical violence and 28% emotional violence by their parents, or by other adults responsible for their care, during the previous year.
In the Finnish National Crime Victim Study, 10% of women and 6% of men reported having been subjected to violence by their partner.
Symptoms in children
Witnessing serious violence may trigger posttraumatic stress disorder (PTSD) in the child. Trauma symptoms have been identified in children as young as one year of age. Children have been noted to suffer from sleep disturbances, nightmares, problems with memory and concentration, hypervigilance, repeated episodes of re-experiencing the traumatic events, and simultaneous blunting of emotions.
Long-term exposure to violence may manifest itself as
various types of fear
behaviour disorders and aggressive behaviour
developmental regression
learning difficulties
depression and anxiety
withdrawal from social contacts
changes in appetite
bullying or being bullied.
Recognition of such symptoms in infants and small children is particularly important.
Recognition and treatment of an acute incident of domestic violence
You have to ask directly about violence.
A scared person is not necessarily able to bring up the subject but will need assistance.
Questions that could be asked (in the case of children, questions should be appropriate to their age):
Has a person close to you been violent to you at any time?
Is there violence in your intimate relationships at the moment?
If the victim has bruising or contusions, he/she should be asked how they were sustained even if the client is attending an appointment for other reasons.
Any suspicion of violence should be confirmed in private with the assumed victim. The victim's assessment of how dangerous the perpetrator is should be taken into account.
If children are present at the appointment, the situation should first be discussed with the adult and the children then included in the discussion, if this is possible and safe from the children's point of view.
The discussion should only concern the acute event. Ask open questions, do not lead the patient in a specific direction; you can record your questions and the answers given between inverted commas (quotation marks).
The children must be given an opportunity to talk about what they have seen, heard and felt during the incident also without their parent being present.
The children should be told that the family will receive help.
If the children are not present at the appointment, their whereabouts and safety must be established. For this task, local emergency social work services may be asked for assistance.
Take care of submitting the required notifications to the authorities.
The follow-up management of the children will be the responsibility of family guidance clinics, child psychiatry units and specialist units with expertise in violence-related problems. Variation may exist between countries. Treatment of domestic violence often requires wide-ranging co-operation. Child welfare authorities will build a network of health care, day care and school staff, as necessary.
Legal aspects, and reports to the authorities in case of violence
Notice that this chapter has been written in the Finnish context. Important differences may apply between countries. Find out about local regulations.
If there is reason to suspect that a child or adolescent has been maltreated, a request for investigation should be submitted to the police and a child welfare notification made without delay. This should be done notwithstanding secrecy regulations.
A child welfare notification should be submitted if the child has witnessed/seen violence. Violence is harmful to a child's mental development even when it is not directed towards the child.
An anticipatory child welfare notification should be made of any pregnant woman if it is justified to suspect that the family will need social services after the child has been born, if, for instance, the woman has been maltreated or there is an obvious risk of maltreatment.
Maltreatment of people of any age is a crime subject to public prosecution. This means that no consent is needed from the aggrieved party or his/her parent/guardian to initiate investigations by the police or to press charges.
Domestic or intimate partner violence often occurs in a private place. Since the beginning of 2011, in Finland even petty assault is subject to public prosecution if targeted at a person who is below 18 years of age or intimate with the offender. For example, police attending a house call have to report an offence if they suspect maltreatment.
Notwithstanding their obligation to secrecy, health care professionals have the right to notify the police of a threat to the life or health of people of any age, if they have reason to suspect that someone is in danger of violence, or there is a danger of familicide, for example.
To protect the victim and children, a restraining order may be imposed on the perpetrator. At a house call, the police may impose a temporary restraining order when removing the violent family member from the home. An application for a more permanent restraining order must be submitted to the district court. Social authorities, for example, can apply for a restraining order on the perpetrator if, for instance, the victim is afraid of submitting an application.
Municipal child welfare authorities or the police can be consulted without revealing the child's identity.
Domestic violence victim assistance and support
In a crisis situation, the family may be referred/directed to a domestic violence shelter. Various shelters are available and these provide their clients support in the acute situation, guidance for overcoming the violence and a temporary place of stay.
Various support services exist that can reached by phone or on the internet. Some of them focus on specific age groups (e.g. children or adolescents), sexes (women/men), groups of people (e.g. immigrants) or the position of the person as a victim or perpetrator/potential perpetrator.
A personal safety plan can be made with the victim to improve the victim's safety.
Find out about locally available shelters and other support services, as well as safety plan forms.
References
Ahmadabadi Z, Najman JM, Williams GM et al. Maternal intimate partner violence victimization and child maltreatment. Child Abuse Negl 2018;82():23-33. [PubMed]
Danielsson P, Salmi V. Suomalaisten kokema parisuhdeväkivalta 2012 - Kansallisen rikosuhritutkimuksen tuloksia. OPTL:n verkkokatsauksia 34/2013. http://helda.helsinki.fi/handle/10138/152609
Fagerlund M, Peltola M, Kääriäinen J, Ellonen N, Sariola H. Lasten ja nuorten väkivaltakokemukset 2013. Poliisiammattikorkeakoulun raportteja 110, 2014. http://urn.fi/URN:ISBN:978-951-815-270-8
Holt S, Buckley H, Whelan S. The impact of exposure to domestic violence on children and young people: a review of the literature. Child Abuse Negl 2008;32(8):797-810. [PubMed]
Levendosky AA, Bogat GA, Martinez-Torteya C. PTSD symptoms in young children exposed to intimate partner violence. Violence Against Women 2013;19(2):187-201. [PubMed]
Ikonen R, Helakorpi S. Well-being of children and young people : School Health Promotion Study 2019. Statistical Report 47/2020. National Institute for Health and Welfare (THL), Finland. http://www.julkari.fi/handle/10024/140694