Child Abuse

It was not until the 19th century that children were granted the same legal status as domesticated animals with regard to protection against cruelty and/or neglect. In 1962, the term "battered child syndrome" became part of the medical vocabulary and by 1976 all of the states in the United States had adopted laws mandating the reporting of suspected child abuse.
What is the scope of the child abuse problem?From the early 1970's when a national data bank was created, the yearly number of reports of child abuse has risen progressively. Initially, 700,000 incidents of child abuse were reported annually. Now there are approximately 2 million cases reported every year. While "reports" of alleged child abuse are not always substantiated during the investigation process, most authorities believe that a large under reporting bias is inherent in the data. There is much more child abuse than gets reported.

What age child is abused?All ages. The frequency of documented child abuse increases with the age of the victim: children less than 2 years of age (6 per 1000) versus 15 to 17 years of age (14 per 1000). This statistic may reflect a true increase in mistreatment with the age of the child or it may at least in part reflect a rise in reporting. Obviously, very young children are incapable of verbally communicating the harm inflicted on them. Other factors such as fear, guilt, or confusion about the abuser's erratic behavior may also hinder younger children from informing on their abuser.
Are girls more often abused than boys?Yes. Girls are somewhat more likely to be abused. According to statistics published in 1996, about 52% of victims of maltreatment were female and 48% were male.
Is the pattern of abuse different for girls and boys?Yes. Some differences exist in the types of maltreatment experienced by female and male children. A review of data from 11 states in the U.S. reveals that 77% of sexual abuse victims were girls compared to 23% boys. Victims of emotional mistreatment were also more likely to be female (53%) than male (47%).
Conversely, a slightly greater proportion of victims of other types of maltreatment were male. Males comprised approximately 51% of neglect victims and 52% of both physical abuse and medical neglect victims.
Is there an association between poverty and child abuse?While children of families in all income levels suffer maltreatment, research suggests that family income is strongly related to incidence rates. Children from families with annual incomes below $15,000 per year are more than 25 times more likely than children from families with annual income above $30,000 to be harmed or endangered by abuse or neglect. Poverty clearly predisposes to child abuse.

Who abuses children?According to the statistics, the majority of perpetrators of child mistreatment (77%) are parents and another 11% are other relatives of the victim. People who are in other care taking relationships to the victim (e.g., child care providers, foster parents, and facility staff) account for only 2 percent of the offenders. About 10% of all perpetrators are classified as non-caretakers or unknown. In many states, child abusers by definition must be in a care taking role.
An estimated 81% of all offenders are under age 40. Overall, approximately 61% of perpetrators are female, although the gender of the abuser differs by the type of mistreatment. Neglect and medical neglect are most often attributed to female caretakers, while sexual abuse is most often associated with male offenders.
What is child abuse?The term child abuse encompasses four basic types of mistreatment: child neglect, physical abuse of a child, emotional abuse of a child, and sexual abuse of a child.
What does the term child neglect include?Child neglect is the most frequently reported form of child abuse (60% of all cases) and the most lethal.
Neglect is defined as the failure to provide for the shelter, safety, supervision, and nutritional needs of the child. Child neglect may be physical, educational, or emotional. The assessment of child neglect requires the consideration of cultural values and standards of care as well as the recognition that the failure to provide the necessities of life may be related to poverty.
Physical neglect includes the refusal or delay in seeking health care, abandonment, inadequate supervision, expulsion from the home, or refusal to allow a runaway to return home.
Educational neglect includes the allowance of chronic truancy, failure to enroll a child of mandatory school age in school, and failure to attend to a special educational need.
Emotional neglect involves a marked inattention to the child's needs for affection, refusal of or failure to provide needed psychological care, spousal abuse or parental substance abuse in the child's presence, and permission of drug or alcohol use by the child.

What actions are viewed as physical child abuse?Physical abuse is the second most frequently reported form of child abuse (25% of all cases).
This form of mistreatment is defined as willful (as opposed to accidental) physical injury inflicted upon the child. Physical abuse can be the result of punching, beating, kicking, biting, burning, shaking, or otherwise harming the child's body. The parent or caretaker may not have intended to hurt the child; rather, the injury may have resulted from excessive disciplinary efforts or physical punishment.
There exists a significant controversy regarding physical methods of discipline (e.g. spanking) and their relationship to more orthodox forms of physical abuse.
What constitutes emotional child abuse?Emotional abuse is the third most frequently reported form of child abuse (17% of all cases). This form is felt to be markedly under reported since it can be difficult to detect and document.
Emotional abuse includes acts or omissions by the parents or other caregivers that could cause serious behavioral, emotional, or mental disorders. Verbal assaults on the child or on other members of the family in the child's presence is a common form of emotional abuse. In some cases of emotional abuse, the acts of the parents or other caregivers alone, without any harm evident in the child's behavior or condition, are sufficient to warrant child protective services intervention. For example, the parents/caregivers may use extreme or bizarre forms of punishment, such as confinement of the child in a dark closet.
Emotional child abuse is also sometimes termed psychological child abuse, verbal child abuse, or mental injury of a child.
What is sexual child abuse?Sexual abuse is the least frequently reported form of child mistreatment (6% of all cases). Experts believe that sexual abuse may be the most under-reported type of abuse because of the secrecy or "conspiracy of silence" that so often characterizes these cases.
Sexual abuse includes fondling a child's genitals, intercourse, incest, rape, sodomy, exhibitionism, and commercial exploitation through prostitution or the production of pornographic materials.

How is alleged child abuse evaluated?A thorough nonjudgmental history of the immediate events as well as a review of potential similar experiences are often independently done by a physician, social worker, and/or the police department. The child may be interviewed separately from the parents as part of this information gathering process.
A complete physical exam of the child (which may include the taking of photographs to document physical/sexual abuse) is often followed by x-rays and/or laboratory tests to support the potential diagnosis of inflicted trauma and to rule out the possibility of medical conditions which could account for the physical findings noted during the examination.
How is child abuse treated?Steps which are often taken to correct child abuse are as follows:
The safety of the abused child and any other potential victim of abuse in the household is paramount. Removal of the victim and placement in protective custody in a group home or foster care are often necessary.
Effective counseling for the child, family, and the abuser is essential to deal with the associated emotional and psychological stress and trauma.
In the event of neglect, establishing realistic expectations of the child's needs and capabilities is required.
Parental high-risk behaviors such as substance/alcohol abuse must be addressed.
Pedophiles (people who have sexually abused children) often require intense psychological and pharmacological therapy prior to release into the community, because of the high rate of repeat offenders.
How can child abuse be prevented?This, too, is a very complex matter and includes these measures:
A support group structure is needed to reinforce parenting skills and closely monitor the child's well-being.
Visiting home nurse or social worker visits are also required to Observe and evaluate the progress of the child and his/her caretaking situation.
The support group structure and visiting home nurse or social worker visits are not mutually exclusive. Many studies have demonstrated that the two measures must be coupled together for the best possible outcome.
Children's school programs regarding "good touch...bad touch" can provide children with a forum in which to role-play and learn to avoid potentially harmful scenarios.
Parents should make sure that their child's daycare center is licensed and has an open door policy regarding parental visitation.

What more can be done to prevent child neglect?As children's advocates, we wish to remind parents about the importance of preventative child health care, including:
Proper use of car seats and seat belts;
Consistent use of helmets for bicycling and skateboarding;
Pool and water safety;
Firearm safety; and
Poisoning prevention.
Are persons who were abused as children more likely to become criminals later in life?According to a 1992 study sponsored by the National Institute of Justice (NIJ), maltreatment in childhood increases the likelihood of arrest as a juvenile by 53% and as an adult by 38%. Abuse as a child also increases the prospect of arrest for a violent crime by 38%.
For females, being abused or neglected in childhood raises the likelihood of arrest by 77%. A related 1994 NIJ study indicated that children who were sexually abused were 28 times more likely than a control group of non-abused children to be arrested for prostitution as an adult.
Child Abuse At A Glance
Child abuse is a significant and dangerous problem.
It is in fact a series of serious problems.
These problems include child neglect and abuse -- whether it be physical, emotional, or sexual.
Neglect is the most frequently reported form of child abuse and the most lethal.
Poor nutrition is a form of child abuse.
Failure to provide a child with appropriate schooling is a type of educational child abuse.
Children can be neglected and abused by parents, other caregivers, or society.
Poverty is a factor which contributes to child abuse.
Child abuse should be reported, investigated, and evaluated.
Prevention is the best strategy for the management of child abuse.