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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.
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.
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.
John M. Leventhal
observes, "The two prerequisites for this form of maltreatment include
sexual arousal to children and the willingness to act on this arousal. Factors
that may contribute to this willingness include alcohol or drug abuse, poor
impulse control, and a belief that the sexual behaviors are acceptable and not
harmful to the child." The chances of abuse are higher if the child is
developmentally handicapped or vulnerable in some other way.
Genital or anal
injuries or abnormalities (including the presence of sexually
transmitted diseases) can be signs of sexual abuse, but often there is no
physical evidence for a doctor to find. In fact, physical examinations of
children in cases of suspected sexual abuse supply grounds for further
suspicion only 15–20% of the time. Anxiety, poor
academic performance, and suicidal conduct are some of the behavioral signs of
sexual abuse, but are also found in children suffering other kinds of stress. Excessive
masturbation and other unusually sexualized kinds of behavior are more closely
associated with sexual abuse itself.
Emotional
abuse
Emotional abuse can
happen in many settings: at home, at school, on sports teams, and so on. Some
of the possible symptoms include loss of self-esteem, sleep disturbances,
headaches or stomachaches, school avoidance, and running away from home.
Neglect
Many cases of
neglect occur because the parent experiences strong negative feelings toward
the child. At other times, the parent may truly care about the child, but lack
the ability or strength to adequately provide for the child's needs because he
or she is handicapped by depression, drug abuse, mental
retardation, or some other problem.
Neglected children
often do not receive adequate nourishment or emotional and mental stimulation.
As a result, their physical, social, emotional, and mental development is
hindered. They may, for instance, be
Child
Abuse: Signs And Symptoms
Although these
signs do not necessarily indicate that a child has been abused, they may help
adults recognize that something is wrong. The possibility of abuse should be
investigated if a child shows a number of these symptoms, or any of them to a
marked degree:
Sexual
Abuse
Being overly
affectionate or knowledgeable in a sexual way inappropriate to the child's age
Medical problems such as chronic itching, pain in the genitals, venereal diseases
Other extreme reactions, such as depression, self-mutilation, suicide attempts, running away, overdoses, anorexia
Personality changes such as becoming insecure or clinging
Regressing to younger behavior patterns such as thumb sucking or bringing out discarded cuddly toys
Sudden loss of appetite or compulsive eating
Being isolated or withdrawn
Inability to concentrate
Lack of trust or fear someone they know well, such as not wanting to be alone with a babysitter
Starting to wet again, day or night/nightmares
Become worried about clothing being removed
Suddenly drawing sexually explicit pictures
Trying to be "ultra-good" or perfect; overreacting to criticism
Medical problems such as chronic itching, pain in the genitals, venereal diseases
Other extreme reactions, such as depression, self-mutilation, suicide attempts, running away, overdoses, anorexia
Personality changes such as becoming insecure or clinging
Regressing to younger behavior patterns such as thumb sucking or bringing out discarded cuddly toys
Sudden loss of appetite or compulsive eating
Being isolated or withdrawn
Inability to concentrate
Lack of trust or fear someone they know well, such as not wanting to be alone with a babysitter
Starting to wet again, day or night/nightmares
Become worried about clothing being removed
Suddenly drawing sexually explicit pictures
Trying to be "ultra-good" or perfect; overreacting to criticism
Physical
Abuse
Unexplained
recurrent injuries or burns
Improbable excuses or refusal to explain injuries
Wearing clothes to cover injuries, even in hot weather
Refusal to undress for gym
Bald patches
Chronic running away
Fear of medical help or examination
Self-destructive tendencies
Aggression towards others
Fear of physical contact—shrinking back if touched
Admitting that they are punished, but the punishment is excessive (such as a child being beaten every night to "make him/her study")
Fear of suspected abuser being contacted
Improbable excuses or refusal to explain injuries
Wearing clothes to cover injuries, even in hot weather
Refusal to undress for gym
Bald patches
Chronic running away
Fear of medical help or examination
Self-destructive tendencies
Aggression towards others
Fear of physical contact—shrinking back if touched
Admitting that they are punished, but the punishment is excessive (such as a child being beaten every night to "make him/her study")
Fear of suspected abuser being contacted
Emotional
Abuse
Physical, mental,
and emotional development lags
Sudden speech disorders
Continual self-depreciation ("I'm stupid, ugly, worthless, etc.")
Overreaction to mistakes
Extreme fear of any new situation
Inappropriate response to pain ("I deserve this")
Neurotic behavior (rocking, hair twisting, self-mutilation)
Extremes of passivity or aggression
Sudden speech disorders
Continual self-depreciation ("I'm stupid, ugly, worthless, etc.")
Overreaction to mistakes
Extreme fear of any new situation
Inappropriate response to pain ("I deserve this")
Neurotic behavior (rocking, hair twisting, self-mutilation)
Extremes of passivity or aggression
Neglect
Constant hunger
Poor personal hygiene
No social relationships
Constant tiredness
Poor state of clothing
Compulsive scavenging
Emaciation
Untreated medical problems
Destructive tendencies
Poor personal hygiene
No social relationships
Constant tiredness
Poor state of clothing
Compulsive scavenging
Emaciation
Untreated medical problems
Destructive tendencies
A child may be
subjected to a combination of different kinds of abuse. It is also possible
that a child may show no outward signs and hide what is happening from
everyone.
underweight, develop
language skills less quickly than other children, and seem emotionally needy.
Diagnosis
Treatment
Notification of the
appropriate authorities, treatment of the child's injuries, and protecting the
child from further harm are the immediate priorities in abuse cases. If the
child does not require hospital treatment, protection often involves placing
him or her with relatives or in foster care. Once the immediate concerns are
dealt with, it becomes essential to determine how the child's longterm medical,
psychological, educational, and other needs can best be met, a process that
involves evaluating not only the child's needs but also the family's (such as
for drug abuse counseling or parental skills training). If the child has
brothers or sisters, the authorities must determine whether they have been
abused as well. On investigation, signs of physical abuse are discovered in
about 20% of the brothers and sisters of abused children.
Prognosis
Child abuse can
have lifelong consequences. Research shows that abused children and adolescents
are more likely, for instance, to do poorly in school, suffer emotional
problems, develop an antisocial personality, become promiscuous, abuse drugs
and alcohol, and attempt suicide. As adults they often have trouble establishing
intimate relationships. Whether professional treatment is able to moderate the
long-term psychological effects of abuse is a question that remains unanswered.
Prevention
Government efforts
to prevent abuse include homevisitor programs aimed at high-risk families and
school-based efforts to teach children how to respond to attempted sexual
abuse. Emotional abuse prevention has been promoted through the media.
When children reach
age three, parents should begin teaching them about "bad touches" and
about confiding in a suitable adult if they are touched or treated in a way
that makes them uneasy. Parents also need to exercise caution in hiring
babysitters and other caretakers. Anyone who suspects abuse should immediately
report those suspicions to the police or his or her local CPS agency, which
will usually be listed in the blue pages of the telephone book under
Rehabilitative Services or Child and Family Services, or in the yellow pages.
Round-the-clock crisis counseling for children and adults is offered by the
Childhelp USA/IOF Foresters National Child Abuse Hotline. The National
Committee to Prevent Child Abuse is an excellent source of information on the
many support groups and other organizations that help abused and at-risk
children and their families. One of these organizations, National Parents
Anonymous, sponsors 2,100 local self-help groups throughout the United States,
Canada, and Europe. Telephone numbers for its local groups are listed in the
white pages of the telephone book under Parents Anonymous or can be obtained by
calling the national headquarters.
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.
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.
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.
Child abuse
Child abuse is a
very complex and dangerous set of problems that include child neglect and the
physical, emotional, and sexual abuse of children.
Although most
people think first of physical abuse when they hear the term, physical abuse
makes us 25 percent of reported cases. It is defined as physical injury
inflicted upon the child with cruel and/or malicious intent, although the law
recognizes that in some cases the parent or caretaker may not have intended to
hurt the child; rather, the injury may have resulted from over-discipline or
physical punishment. Physical abuse includes punching, beating, kicking,
biting, burning, shaking, or otherwise harming a child. Fatal injuries from
maltreatment can result from many different acts, including severe head trauma,
shaken baby syndrome, trauma to the abdomen or chest, scalding, burns, drowning,
suffocation, poisoning, etc. Many physically abused children suffer multiple
injuries over the years, which may go untreated to cover up for the abuse.
Child
neglect
is the most frequently reported form of child abuse and the most lethal. This
form of abuse is defined as the failure to provide for the shelter, safety,
supervision and nutritional needs of the child. Child neglect can be physical,
educational, or emotional neglect.
Physical neglect
includes refusal of or delay in seeking health care, abandonment, expulsion
from the home or refusal to allow a runaway to return home, and inadequate
supervision.
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
includes such actions as marked inattention to the child's needs for affection,
refusal of or failure to provide needed psychological care, spouse abuse in the
child's presence, and permission of drug or alcohol use by the child.
Physical
abuse is
the second most frequently reported form of child abuse and is defined as
physical injury inflicted upon the child with cruel and/or malicious intent.
Physical abuse can be the result of punching, beating, kicking, biting,
burning, shaking, or otherwise harming a child. The parent or caretaker may not
have intended to hurt the child, rather the injury may have resulted from
over-discipline or physical punishment.
Emotional
abuse is
the third most frequently reported form of child abuse and includes acts or
omissions by the parents or other caregivers that could cause serious
behavioral, emotional, or mental disorders. For example, the parents/caregivers
may use extreme or bizarre forms of punishment, such as confinement of a child
in a dark closet.Emotional child abuse is also sometimes termed psychological
child abuse, verbal child abuse, or mental injury of a child.
Sexual
abuse is
the least frequently reported form of child abuse and is believed to be the
most under-reported type of child maltreatment 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.
Child Abuse
Definition
Child abuse is the
blanket term for four types of child mistreatment: physical abuse, sexual
abuse, emotional abuse, and neglect. In many cases children are the victims of
more than one type of abuse. The abusers can be parents or other family
members, caretakers such as teachers and babysitters, acquaintances (including
other children), and (in rare instances) strangers.
Description
Prevalence
of abuse
Child abuse was
once viewed as a minor social problem affecting only a handful of United States
children. However, in recent years it has received close attention from the
media, law enforcement, and the helping professions, and with increased public
and professional awareness has come a sharp rise in the number of reported
cases. But because abuse is often hidden from view and its victims too young or
fearful to speak out, experts suggest that its true prevalence is possibly much
greater than the official data indicate. In 1996, more than three million
victims of alleged abuse were reported to child protective services (CPS)
agencies in the United States, and the reports were substantiated in more than
one million cases. Put another way, 1.5% of the country's children were
confirmed victims of abuse in 1996. Parents were the abusers in 77% of the
confirmed cases, other relatives in 11%. Sexual abuse
was more likely to be committed by males, whereas females were responsible for
the majority of neglect cases. More than 1,000 United States children died from
abuse in 1996.
Although experts
are quick to point out that abuse occurs among all social, ethnic, and income
groups, reported cases usually involve poor families with little education.
Young mothers, single-parent families, and parental alcohol or drug abuse are
also common in reported cases. Charles F. Johnson remarks, "More than 90%
of abusing parents have neither psychotic nor criminal personalities. Rather
they tend to be lonely, unhappy, angry, young, and single parents who do not
plan their pregnancies, have little or no knowledge of child development, and
have unrealistic expectations for child behavior." About 10%, or perhaps
as many as 40%, of abusive parents were themselves physically abused as
children, but most abused children do not grow up to be abusive parents.
Types
of abuse
PHYSICAL ABUSE.
Physical abuse is the nonaccidental infliction of physical injury to a child.
The abuser is usually a family member or other caretaker, and is more likely to
be male. In 1996, 24% of the confirmed cases of United States child abuse
involved physical abuse.
A rare form of
physical abuse is Munchausen syndrome by proxy, in which a caretaker (most
often the mother) seeks attention by making the child sick or appear to be
sick.
SEXUAL ABUSE.
Charles F. Johnson defines child sexual abuse as "any activity with a
child, before the age of legal consent, that is for the sexual gratification of
an adult or a significantly older child." It includes, among other things,
sexual touching and penetration, persuading a child to expose his or her sexual
organs, and allowing a child to view pornography. In most cases the child is
related to or knows the abuser, and about one in five abusers are themselves
underage. Sexual abuse was present in 12% of the confirmed 1996 abuse cases. An
estimated 20–25% of females and 10–15% of males report that they were sexually
abused by age 18.
EMOTIONAL ABUSE.
Emotional abuse, according to Richard D. Krugman, "has been defined as the
rejection, ignoring, criticizing, isolation, or
terrorizing of children, all of which have the effect of eroding their
self-esteem." Emotional abuse usually expresses itself in verbal attacks
involving rejection, scapegoating, belittlement, and so forth. Because it often
accompanies other types of abuse and is difficult to prove, it is rarely
reported, and accounted for only 6% of the confirmed 1996 cases.
NEGLECT.
Neglect—failure to satisfy a child's basic needs—can assume many forms.
Physical neglect is the failure (beyond the constraints imposed by poverty) to
provide adequate food, clothing, shelter, or supervision. Emotional neglect is
the failure to satisfy a child's normal emotional needs, or behavior that
damages a child's normal emotional and psychological development (such as
permitting drug abuse in the home). Failing to see that a child receives proper
schooling or medical care is also considered neglect. In 1996 neglect was the
finding in 52% of the confirmed abuse cases.
Causes
and symptoms
Physical
abuse
The usual physical
abuse scenario involves a parent who loses control and lashes out at a child.
The trigger may be normal child behavior such as crying or dirtying a diaper.
Unlike nonabusive parents, who may become angry at or upset with their children
from time to time but are genuinely loving, abusive parents tend to harbor
deep-rooted negative feelings toward their children.
Unexplained or
suspicious bruises
or other marks on the skin are typical signs of physical abuse, as are burns. Skull and
other bone fractures
are often seen in young abused children, and in fact, head injuries are the
leading cause of death
from abuse. Children less than one year old are particularly vulnerable to
injury from shaking. This is called shaken
baby syndrome or shaken impact syndrome. Not surprisingly, physical abuse
also causes a wide variety of behavioral changes in children.
Sexual
abuse
John M. Leventhal
observes, "The two prerequisites for this form of maltreatment include
sexual arousal to children and the willingness to act on this arousal. Factors
that may contribute to this willingness include alcohol or drug abuse, poor
impulse control, and a belief that the sexual behaviors are acceptable and not
harmful to the child." The chances of abuse are higher if the child is
developmentally handicapped or vulnerable in some other way.
Genital or anal
injuries or abnormalities (including the presence of sexually
transmitted diseases) can be signs of sexual abuse, but often there is no
physical evidence for a doctor to find. In fact, physical examinations of
children in cases of suspected sexual abuse supply grounds for further
suspicion only 15–20% of the time. Anxiety, poor
academic performance, and suicidal conduct are some of the behavioral signs of
sexual abuse, but are also found in children suffering other kinds of stress. Excessive
masturbation and other unusually sexualized kinds of behavior are more closely
associated with sexual abuse itself.
Emotional
abuse
Emotional abuse can
happen in many settings: at home, at school, on sports teams, and so on. Some
of the possible symptoms include loss of self-esteem, sleep disturbances,
headaches or stomachaches, school avoidance, and running away from home.
Neglect
Many cases of
neglect occur because the parent experiences strong negative feelings toward the
child. At other times, the parent may truly care about the child, but lack the
ability or strength to adequately provide for the child's needs because he or
she is handicapped by depression, drug abuse, mental
retardation, or some other problem.
Neglected children
often do not receive adequate nourishment or emotional and mental stimulation.
As a result, their physical, social, emotional, and mental development is
hindered. They may, for instance, be
Child
Abuse: Signs And Symptoms
Although these
signs do not necessarily indicate that a child has been abused, they may help
adults recognize that something is wrong. The possibility of abuse should be
investigated if a child shows a number of these symptoms, or any of them to a
marked degree:
Sexual
Abuse
Being overly
affectionate or knowledgeable in a sexual way inappropriate to the child's age
Medical problems such as chronic itching, pain in the genitals, venereal diseases
Other extreme reactions, such as depression, self-mutilation, suicide attempts, running away, overdoses, anorexia
Personality changes such as becoming insecure or clinging
Regressing to younger behavior patterns such as thumb sucking or bringing out discarded cuddly toys
Sudden loss of appetite or compulsive eating
Being isolated or withdrawn
Inability to concentrate
Lack of trust or fear someone they know well, such as not wanting to be alone with a babysitter
Starting to wet again, day or night/nightmares
Become worried about clothing being removed
Suddenly drawing sexually explicit pictures
Trying to be "ultra-good" or perfect; overreacting to criticism
Medical problems such as chronic itching, pain in the genitals, venereal diseases
Other extreme reactions, such as depression, self-mutilation, suicide attempts, running away, overdoses, anorexia
Personality changes such as becoming insecure or clinging
Regressing to younger behavior patterns such as thumb sucking or bringing out discarded cuddly toys
Sudden loss of appetite or compulsive eating
Being isolated or withdrawn
Inability to concentrate
Lack of trust or fear someone they know well, such as not wanting to be alone with a babysitter
Starting to wet again, day or night/nightmares
Become worried about clothing being removed
Suddenly drawing sexually explicit pictures
Trying to be "ultra-good" or perfect; overreacting to criticism
Physical
Abuse
Unexplained
recurrent injuries or burns
Improbable excuses or refusal to explain injuries
Wearing clothes to cover injuries, even in hot weather
Refusal to undress for gym
Bald patches
Chronic running away
Fear of medical help or examination
Self-destructive tendencies
Aggression towards others
Fear of physical contact—shrinking back if touched
Admitting that they are punished, but the punishment is excessive (such as a child being beaten every night to "make him/her study")
Fear of suspected abuser being contacted
Improbable excuses or refusal to explain injuries
Wearing clothes to cover injuries, even in hot weather
Refusal to undress for gym
Bald patches
Chronic running away
Fear of medical help or examination
Self-destructive tendencies
Aggression towards others
Fear of physical contact—shrinking back if touched
Admitting that they are punished, but the punishment is excessive (such as a child being beaten every night to "make him/her study")
Fear of suspected abuser being contacted
Emotional
Abuse
Physical, mental,
and emotional development lags
Sudden speech disorders
Continual self-depreciation ("I'm stupid, ugly, worthless, etc.")
Overreaction to mistakes
Extreme fear of any new situation
Inappropriate response to pain ("I deserve this")
Neurotic behavior (rocking, hair twisting, self-mutilation)
Extremes of passivity or aggression
Sudden speech disorders
Continual self-depreciation ("I'm stupid, ugly, worthless, etc.")
Overreaction to mistakes
Extreme fear of any new situation
Inappropriate response to pain ("I deserve this")
Neurotic behavior (rocking, hair twisting, self-mutilation)
Extremes of passivity or aggression
Neglect
Constant hunger
Poor personal hygiene
No social relationships
Constant tiredness
Poor state of clothing
Compulsive scavenging
Emaciation
Untreated medical problems
Destructive tendencies
Poor personal hygiene
No social relationships
Constant tiredness
Poor state of clothing
Compulsive scavenging
Emaciation
Untreated medical problems
Destructive tendencies
A child may be
subjected to a combination of different kinds of abuse. It is also possible
that a child may show no outward signs and hide what is happening from
everyone.
underweight,
develop language skills less quickly than other children, and seem emotionally
needy.
Diagnosis
Doctors and many other
professionals who work with children are required by law to report suspected
abuse to their state's Child
Protective Services (CPS) agency. Abuse investigations are often a group
effort involving medical personnel, social workers, police officers, and
others. Some hospitals and communities maintain child protection teams that
respond to cases of possible abuse. Careful questioning of the parents is
crucial, as is interviewing the child (if he or she is capable of being
interviewed). The investigators must ensure, however, that their questioning
does not further traumatize the child. A physical
examination for signs of abuse or neglect is, of course, always necessary,
and may include x rays, blood tests, and other procedures.
Treatment
Notification of the
appropriate authorities, treatment of the child's injuries, and protecting the
child from further harm are the immediate priorities in abuse cases. If the
child does not require hospital treatment, protection often involves placing
him or her with relatives or in foster care. Once the immediate concerns are
dealt with, it becomes essential to determine how the child's longterm medical,
psychological, educational, and other needs can best be met, a process that
involves evaluating not only the child's needs but also the family's (such as
for drug abuse counseling or parental skills training). If the child has
brothers or sisters, the authorities must determine whether they have been
abused as well. On investigation, signs of physical abuse are discovered in
about 20% of the brothers and sisters of abused children.
Prognosis
Child abuse can
have lifelong consequences. Research shows that abused children and adolescents
are more likely, for instance, to do poorly in school, suffer emotional
problems, develop an antisocial personality, become promiscuous, abuse drugs
and alcohol, and attempt suicide. As adults they often have trouble
establishing intimate relationships. Whether professional treatment is able to
moderate the long-term psychological effects of abuse is a question that
remains unanswered.
Prevention
Government efforts
to prevent abuse include homevisitor programs aimed at high-risk families and
school-based efforts to teach children how to respond to attempted sexual
abuse. Emotional abuse prevention has been promoted through the media.
When children reach
age three, parents should begin teaching them about "bad touches" and
about confiding in a suitable adult if they are touched or treated in a way
that makes them uneasy. Parents also need to exercise caution in hiring
babysitters and other caretakers. Anyone who suspects abuse should immediately
report those suspicions to the police or his or her local CPS agency, which
will usually be listed in the blue pages of the telephone book under
Rehabilitative Services or Child and Family Services, or in the yellow pages.
Round-the-clock crisis counseling for children and adults is offered by the
Childhelp USA/IOF Foresters National Child Abuse Hotline. The National
Committee to Prevent Child Abuse is an excellent source of information on the
many support groups and other organizations that help abused and at-risk
children and their families. One of these organizations, National Parents
Anonymous, sponsors 2,100 local self-help groups throughout the United States,
Canada, and Europe. Telephone numbers for its local groups are listed in the
white pages of the telephone book under Parents Anonymous or can be obtained by
calling the national headquarters.
Child Abuse
Definition
Child abuse is the
blanket term for four types of child mistreatment: physical abuse, sexual
abuse, emotional abuse, and neglect.
Description
Prevalence
of Abuse
Child abuse was
once viewed as a minor social problem affecting only a handful of U.S.
children. However, in the late 1990s and early 2000s it has received close
attention from the media, law enforcement, and the helping professions, and
with increased public and professional awareness has come a sharp rise in the
number of reported cases. Because abuse is often hidden from view and its
victims too young or fearful to speak out, however, experts suggest that its
true prevalence is possibly much greater than the official data indicate. An
estimated 896,000 children across the country were victims of abuse or neglect
in 2002, according to national data released by the U.S. Department of Health and Human Services (HHS) in April 2004. Parents were
the abusers in 77 percent of the confirmed cases, other relatives in 11
percent. Sexual
abuse was more likely to be committed by males, whereas females were
responsible for the majority of neglect cases. The data show that child
protective service agencies received about 2,600,000 reports of possible
maltreatment in 2002. About 1,400 children died of abuse or neglect, a rate of
1.98 children per 100,000 children in the population. In many cases children
are the victims of more than one type of abuse. The abusers can be parents or
other family
members, caretakers such as teachers and babysitters,
acquaintances (including other children), and (in rare instances) strangers.
Although experts
are quick to point out that abuse occurs among all social, ethnic, and income
groups, reported cases usually involve poor families with little education.
Young mothers, single-parent families, and parental alcohol or drug abuse
are also common in reported cases. Statistics show that more than 90 percent of
abusing parents have neither psychotic nor criminal personalities. Rather they
tend to be lonely, unhappy, angry, young, and single parents who do not plan
their pregnancies, have little or no knowledge of child development, and have
unrealistic expectations for child behavior. From 10 percent to perhaps as many
as 40 percent of abusive parents were themselves physically abused as children,
but most abused children do not grow up to be abusive parents.
Types
of Abuse
PHYSICAL ABUSE.
Physical abuse is the non-accidental infliction of physical injury to a child.
The abuser is usually a family member or other caretaker and is more likely to
be male. One fourth of the confirmed cases of child abuse in the United States
involve physical abuse. A rare form of physical abuse is Munchausen
syndrome by proxy, in which a caretaker (most often the mother) seeks
attention by making the child sick or appear to be sick.
EMOTIONAL ABUSE.
Emotional abuse is the rejecting, ignoring, criticizing, isolating, or
terrorizing of children, all of which have the effect of eroding their self-esteem.
Emotional abuse usually expresses itself in verbal attacks involving rejection,
scapegoating, belittlement, and so forth. Because it often accompanies other
types of abuse and is difficult to prove, it is rarely reported and accounts
for only about 6 percent of the confirmed cases.
SEXUAL ABUSE.
Psychologists define child sexual abuse as any activity with a child, before
the age of legal consent, that is for the sexual gratification of an adult or a
significantly older child. It includes, among other things, sexual touching and
penetration, persuading a child to expose his or her sexual organs, and
allowing a child to view pornography. In most cases the child is related to or
knows the abuser, and about one in five abusers are themselves underage. Sexual abuse
accounts for 12 to 15 percent of confirmed abuse cases. In multiple surveys, 20
to 25 percent of females and 10 to 15 percent of males report that they were
sexually abused by age 18.
NEGLECT. Neglect,
the failure to satisfy a child's basic needs, can assume many forms. Physical
neglect is the failure (beyond the constraints imposed by poverty) to provide
adequate food, clothing, shelter, or supervision. Emotional neglect is the
failure to satisfy a child's normal emotional needs, or behavior that damages a
child's normal emotional and psychological development (such as permitting drug
abuse in the home). Failing to see that a child receives proper schooling or
medical care is also considered neglect. Slightly more than half of all
reported abuse cases involve neglect.
Infancy
and Toddlerhood
Infants who are
premature, mentally retarded, or have physical handicaps are more likely to
provoke abuse from their caregiver than are infants without such problems.
Similarly, nonhandicapped infants who are nonrhythmic (that is, have uneven sleep and eating
patterns) are more likely to be abused. It appears that the child's tendency to
learn slowly, to be less coordinated, or less affectionate—rather than any
physical problem—that promotes abuse. Infants, because of their fragility, are
more susceptible to injury from physical discipline
than older children. Infants are especially susceptible to head injury
from shaking or being thrown. A baby can be fatally injured by being thrown
even onto a soft mattress. The baby's brain hits the back of the skull if the
child is thrown with even mild force and intracranial bleeding can result.
Shaken
baby syndrome (SBS) is the leading cause of death in child abuse cases in
the United States. The syndrome results from injuries caused by someone
vigorously shaking an infant, usually for five to 20 seconds, which causes
brain damage. In some cases, the shaking is accompanied by a final impact to
the baby's head against a bed, chair, or other surface. Although SBS is
occasionally seen in children up to four years of age, the vast majority of
incidents occur in infants who are younger than one year; the average age of
victims is between three and eight months. Approximately 60 percent of shaken
babies are male, and children of families who live at or below the poverty
level are at an increased risk for SBS (and any other type of child abuse).
Preschool
Typically, abused
children show developmental delays by preschool age.
It is unclear whether these delays occur due to cumulative neurological damage
or due to inadequate stimulation and uncertainty in the child about the
learning environment and the absence of positive parental interactions that
would stimulate language and motor processes. These delays, in concert with
their parents' higher-than-normal expectations for their children's self-care
and self-control abilities, may provoke additional abuse. Abused preschoolers
respond to peers and other adults with more aggression and anger than do
non-abused children. A coercive cycle frequently develops in which parents and
children mutually control one another with threats of negative behavior.
School
Age
School-aged
children who are abused typically have problems academically and have poorer
grades and performance on standardized achievement tests. Studies of abused
children's intellectual performance find lower scores in both verbal and math
and visual-spatial areas. Abused children also tend to be distracted and
overactive, making school a very difficult environment for them. With their
peers, abused children are often more aggressive and more likely to be socially
rejected than nonabused children. Less mature socially, abused children show
difficulty in developing trusting relationships with others. The anger that is
often instilled in such children is likely to be incorporated into their
personality structures. Carrying an extra load of anger makes it difficult for
them to control their behavior and increases their risk for resorting to
violent action. To control their fears, children who live with violence may
repress feelings. This defensive maneuver takes its toll in their immediate
lives and can lead to further pathological development. It can interfere with
their ability to relate to others in meaningful ways and to feel empathy.
Individuals who cannot empathize with others' feelings are less likely to curb
their own aggression and more likely to become insensitive to brutality in
general.
As adolescents,
abused children are more likely to be in contact with the juvenile justice
system than nonabused children of comparable family constellation and income
level. Many of these children are labeled "ungovernable" for
committing offenses such as running away
and truancy. A
higher proportion of abused than nonabused delinquent youth are also involved
in crimes of assault. Follow-up studies on abused children in later adolescence show
that in addition to having problems with the law, they are also more likely to
be substance abusers or to have emotional disturbances such as depression.
Common
Problems
Physical
Abuse
The usual physical
abuse scenario involves a parent who loses control and lashes out at a child.
The trigger may be normal child behavior such as crying or dirtying a diaper.
Unlike nonabusive parents, who may become angry at or upset with their children
from time to time but are genuinely loving, abusive parents tend to harbor
deep-rooted negative feelings toward their children. Unexplained or suspicious bruises or other
marks on the skin are typical signs of physical abuse, as are burns. Skull and
other bone fractures
are often seen in young abused children, and in fact, head injuries are the
leading cause of death from abuse. Children less than one year old are
particularly vulnerable to injury from shaken baby syndrome. Physical abuse
also causes a wide variety of behavioral changes in children.
Emotional
Abuse
Emotional abuse can
happen in many settings: at home, at school, on sports teams, and
so on. Some of the possible symptoms include loss of self-esteem, sleep
disturbances, headaches or stomach aches, school avoidance, and running away
from home.
Sexual
Abuse
The two prerequisites
for this form of maltreatment are sexual arousal towards children and the
willingness to act on this arousal. Factors that may contribute to this
willingness include alcohol or drug abuse, poor impulse control, and a belief
that the sexual behaviors are acceptable and not harmful to the child. The
chances of abuse are higher if the child is developmentally handicapped or
vulnerable in some other way. Genital or anal injuries or abnormalities
(including the presence of sexuallytransmitted diseases) can be signs of sexual
abuse, but often there is no physical evidence for a doctor to find. In fact,
physical examinations of children in cases of suspected sexual abuse supply
grounds for further suspicion only 15 to 20 percent of the time. Anxiety, poor
academic performance, and suicidal conduct are some of the behavioral signs of
sexual abuse but are also found in children suffering other kinds of stress.
Excessive masturbation
and other unusually sexualized kinds of behavior are more closely associated
with sexual abuse itself.
Neglect
Many cases of
neglect occur because the parent experiences strong negative feelings toward
the child. At other times, the parent may truly care about the child but lacks
the ability or strength to adequately provide for the child's needs because
handicapped by depression, drug abuse, mental
retardation, or some other problem. Neglected children often do not receive
adequate nourishment or emotional and mental stimulation. As a result, their
physical, social, emotional, and mental development is hindered. They may, for
instance, be underweight, develop language skills less quickly than other
children, and seem emotionally needy.
Parental
Concerns
When children reach
age three, parents should begin teaching them about "bad touches" and
about confiding in a suitable adult if they are touched or treated in a way
that makes them uneasy. Parents also need to exercise caution in hiring
babysitters and other caretakers. Anyone who suspects abuse should immediately
report those suspicions to the police or their local child protection services
agency, which is usually listed in the blue pages of the telephone book under
Rehabilitative Services or Child and Family Services, or in the yellow pages.
Round-the-clock crisis counseling for children and adults is offered by the
Childhelp USA/IOF Foresters National Child Abuse Hotline. The National
Committee to Prevent Child Abuse is an excellent source of information on the
many support groups and other organizations that help abused and at-risk
children and their families. One of these organizations, National Parents
Anonymous, sponsors 2,100 local self-help groups throughout the United States,
Canada, and Europe. Telephone numbers for its local groups are listed in the
white pages of the telephone book under Parents Anonymous or can be obtained by
calling the national headquarters.
When
to Call the Doctor
Physical signs of
abuse may include bruises, especially those in different stages of healing,
bruises in the shape of an object, such as fingers, a ring, or a belt buckle;
unexplained burns, black eyes, or broken bones; vaginal or rectal bleeding,
pain, itching, swelling or discharge; a vacant stare or dazed appearance;
frequent attempts to run away; and sexual promiscuity.
Behavioral signs of
child abuse include: low self esteem; flinching or ducking from motion or
people moving towards them; eating disorders or loss of appetite; self
mutilation such as "cutting," biting oneself or pulling out hair;
unusual habits like rocking, sucking cloth; extreme changes in behavioral
patterns; poor interpersonal relationships or a lack of self-confidence;
clinginess, withdrawal or aggressiveness; regressing to infantile behavior such
as bedwetting, thumb sucking or excessive crying; recurrent nightmares,
disturbed sleep patterns, or a sudden fear of the dark;
unexplained fear of a particular person; unusual knowledge of sexual matters;
acting much younger or older than chronological age; frequent lying, or a fall in
grades at school; and depression.
It is important to
remember that some of these symptoms of child abuse can be normal
manifestations of play
and activity. Other symptoms could be the result of a traumatic event that is
not necessarily abuse, such as divorce. Still, others are definitely "red flag"
symptoms of abuse. If any physical signs of abuse appear, get medical help
immediately. Talk frankly with the doctor and share any concerns about possible
abuse. If there is physical proof of abuse, get a doctor's report in writing.
Any behavioral signs of abuse are cause for concern to a good parent, teacher,
or caregiver. A good first move is to open and nurture trusting lines of
communication. The parent should increase the time spent with the child and
increase the attention given to the child. The parent should show more interest
in the child's life and ask more questions. The parent needs to assure the
child of the parent's unqualified love and support, and make sure the children
know that the parent wants them to feel happy and confident. Children need to
know that no matter what has happened, their parents will always love them.
child abuse
Crime of inflicting
physical or emotional injury on a child. The term can denote the use of
inordinate physical violence or verbal abuse; the failure to furnish proper
shelter, nourishment, medical treatment, or emotional support; incest, rape,
or other instances of sexual molestation; and the making of child pornography.
Child abuse can cause serious harm to its victims. Estimates of the numbers of
children who suffer physical abuse or neglect by parents or guardians range
from about 1 percent of all children to about 15 percent, and figures are far
higher if emotional abuse and neglect are included. In many cases, the abuser
himself suffered abuse as a child. When abuse results in death, evidence of
child abuse or battered-child syndrome (e.g., broken bones and lesions, either
healed or active) is often used to establish that death was not accidental.
For more information on child abuse,
visit Britannica.com.
Child Abuse
Child Abuse refers to intentional or
unintentional physical, mental, or sexual harm done to a child. Child abuse is
much more likely to take place in homes in which other forms of domestic
violence occur as well. Despite a close statistical link between domestic
violence and child abuse, the American legal system tends to treat the two
categories separately, often adjudicating cases from the same household in
separate courts. Some think this practice has led to an inadequate
understanding of the overall causes and dynamics of child abuse, and interfered
with its amelioration.
The treatment of
child abuse in law has its origins in Anglo-American common law. Common law
tradition held that the male was head of the household and possessed the
authority to act as both disciplinarian and protector of those dependent on
him. This would include his wife and children as well as extended kin,
servants, apprentices, and slaves. While common law obligated the male to feed,
clothe, and shelter his dependents, it also allowed him considerable discretion
in controlling their behavior. In the American colonies, the law did define
extreme acts of violence or cruelty as crimes, but local community standards
were the most important yardstick by which domestic violence was dealt with.
Puritan parents in New England, for example, felt a strong sense of duty to
discipline their children, whom they believed to be born naturally depraved, in
order to save them from eternal damnation. Although Puritan society tolerated a
high degree of physicality in parental discipline, the community did draw a
line at which it regarded parental behavior as abusive. Those who crossed the
line would be brought before the courts.
In the nineteenth
century the forces of industrialization and urbanization loosened the community
ties that had traditionally served as important regulators of child abuse and
neglect. The instability of market capitalism and the dangers posed by
accidents and disease in American cities meant that many poor and working-class
families raised their children under extremely difficult circumstances. At the
same time, larger numbers of child victims now concentrated in cities rendered
the problems of child abuse and neglect more visible to the public eye. Many of
these children ended up in public almshouses, where living and working conditions
were deplorable.
An expanding middle
class viewed children less as productive members of the household and more as
the objects of their parents' love and affection. While child abuse did occur
in middle-class households, reformers working in private charitable
organizations began efforts toward ameliorating the problem as they observed it
in poor and working-class families. Although the majority of cases brought to
their attention constituted child neglect rather than physical abuse, reformers
remained remarkably unsympathetic to the social and economic conditions under
which these parents labored. Disadvantaged parents commonly lost parental
rights when found guilty of neglecting their children. The parents of many
institutionalized children labeled as "orphans" were actually alive
but unable to provide adequate care for them.
In 1853 the
Reverend Charles Loring Brace founded the New York Children's Aid Society.
Convinced that the unhealthy moral environment of the city irreparably damaged
children and led them to engage in vice and crime, Brace established evening
schools, lodging houses, occupational training, and supervised country outings
for poor urban children. In 1854 the Children's Aid Society began sending
children it deemed to be suffering from neglect and abuse to western states to
be placed with farm families. Over the next twenty-five years, more than 50,000
children were sent to the West. Unfortunately, the society did not follow up on
the children's care and many encountered additional neglect and abuse in their
new households.
Reformers of the
Progressive Era (circa 1880–1920) worked to rationalize the provision of social
welfare services and sought an increased role for the state in addressing the
abuse and neglect of dependent individuals under the doctrine of parens
patriae (the state as parent). In 1912 the White House sponsored the first
Conference on Dependent Children, and later that year the U.S. Children's
Bureau was established as the first federal child welfare agency. Child welfare
advocates in the Progressive Era viewed the employment of children in dangerous
or unsupervised occupations, such as coal mining and hawking newspapers, as a
particular kind of mistreatment and worked for state laws to prohibit it.
The increasing
social recognition of adolescence as a distinct stage of human development
became an important dimension of efforts to address child abuse. Largely
influenced by the work of psychologist G. Stanley Hall, reformers extended the
chronological boundaries of childhood into the mid-teens and sought laws
mandating that children stay in school and out of the workforce. Reformers also
worked for the establishment of a juvenile justice system that would allow
judges to consider the special psychological needs of adolescents and keep them
separated from adult criminals. In 1899, Cook County, Illinois, established the
nation's first court expressly dealing with minors. Juvenile courts began to
play a central role in adjudicating cases of child abuse and neglect. Over the following
decades the number of children removed from their homes and placed into foster
care burgeoned. The Great Depression magnified these problems, and in 1934 the
U.S. Children's Bureau modified its mission to concentrate more fully on aiding
dependents of abusive or inadequate parents.
By the
mid-twentieth century, the medical profession began to take a more prominent
role in policing child abuse. In 1961, the American Academy of Pediatrics held
a conference on "battered child syndrome," and a sub-sequent issue of
the Journal of the American Medical Association published guidelines for
identifying physical and emotional signs of abuse in patients. States passed
new laws requiring health care practitioners to report suspected cases of child
abuse to the appropriate authorities. The Child Abuse Prevention and Treatment
Act of 1974 gave federal funds to state-level programs and the Victims of Child
Abuse Act of 1990 provided federal assistance in the investigation and
prosecution of child abuse cases.
Despite the
erection of a more elaborate govern-mental infrastructure for addressing the
problem of child abuse, the courts remained reluctant to allow the state to
intrude too far into the private relations between parents and children. In
1989, the Supreme Court heard the landmark case DeShaney v. Winnebago County
Department of Social Services. The case originated in an incident in which
a custodial father had beaten his four-year old son so badly the child's brain
became severely damaged. Emergency surgery revealed several previous injuries
to the child's brain. Wisconsin law defined the father's actions as a crime and
he was sentenced to two years in prison. But the boy's noncustodial mother sued
the Winnebago County Department of Social Services, arguing that caseworkers
had been negligent in failing to intervene to help the child despite repeated
reports by hospital staff of suspected abuse. Her claim rested in the
Fourteenth Amendment, which holds that no state (or agents of the state) shall
"deprive any person of life, liberty, or property, without due process of
law; nor deny to any person within its jurisdiction the equal protection of the
laws." The Court, however, ruled that the Fourteenth Amendment protects
citizens' rights from violations arising from actions taken by the state—not
from actions it may fail to take. The boy had not been in the custody of the
state, such as in a state juvenile detention center or foster home, when the
violence occurred, and therefore, the Court said, no special relationship
existed between the child and the state. In other words, children did not enjoy
an affirmative right to be protected by the state from violence committed by
their custodial parents in the privacy of the home.
Many advocates for
victims of domestic violence criticized the ruling, arguing that it privileged
the rights of abusive parents over the best interests of children, and worked
toward reforming the law. The federal Adoption and Safe Families Act (ASFA) of
1997 established new guidelines for the states that included mandatory
termination of a parent's rights to all of his or her children when the parent
had murdered, committed a felony assault on, or conspired, aided, or abetted
the abuse of any of his or her children. Laws in all fifty states require parents
to protect their children from being murdered by another member of the
household; failure to do so may result in criminal liability and loss of rights
to other of their children. AFSA extended these liabilities to include a
parent's failure to protect a child from felony assault. While the act's intent
was to promote the best interests of children, critics have noted that this has
not necessarily been the result. Prosecutors, for example, have been able to
convict mothers who failed to protect their children from violence in the home
even though they were also victims of the abuser. Thus, children have been
taken from the custody of a parent who did not commit abuse and who could
conceivably provide appropriate care after the actual perpetrator was removed
from the home.
Causes
and Effects
There are many
interacting causes of child abuse and neglect. Characteristics or circumstances
of the abuser, the child, and the family may all contribute. In many cases the
abuser was abused as a child. Substance
abuse (see drug addiction and drug abuse) has been identified as a key
factor in a growing number of cases. In some cases abusers do not have the
education and skills needed to raise a child, thus increasing the likelihood of
abuse, and providing inadequate parental role models for future generations.
Children who are ill, disabled, or otherwise perceived as different are more
likely to be the targets of abuse. In the family, marital discord, domestic
violence, unemployment and poverty, and social isolation are all factors that
can precipitate abuse.
Patterns of abusive
behavior may result in the physical or mental impairment of the child or even
death. Small children are especially vulnerable to physical injury such as
whiplash or shaken infant syndrome resulting from battery. Abused children are
more likely to experience generalized anxiety, depression, truancy, shame and
guilt, or suicidal and homicidal thoughts or to engage in criminal activity,
promiscuity, and substance abuse.
Intervention
in Child Abuse Cases
In the United
States, New York became the first state to institute child protection laws
(1875) that made abuse against children a crime, and other states soon followed
with similar laws. In 1974 the U.S. Congress passed the Child Abuse Prevention
and Treatment Act, which encouraged remaining states to pass child protection
laws and created the National Center on Child Abuse and Neglect. In addition,
all states have their own reporting laws, juvenile and family court laws, and
criminal laws.
Cases of child
abuse are handled by an multidisciplinary team including medical personnel, law
enforcement officers, the schools, social workers, and the courts. School
personnel may be the first to notice and report signs of abuse. Child-abuse
cases are often coordinated by a community's child protective services unit,
which sends case workers to the home for evaluation and offers services to the
child and family. Medical professionals may report cases, provide treatment for
injured children, provide testimony in court, or help to educate parents. Law
enforcement personnel may be involved when cases are reported or when there is
a question of a criminal action. The courts provide emergency protective orders
or decide whether the child should be removed from the home. Child abuse may be
punished by incarceration of the perpetrator or by the denial of custody rights
to abusive parents or guardians.
Incidence
Despite efforts to
reduce child abuse in America, more than a million children are physically
abused each year; about 2,000 die. Although the magnitude of sexual abuse of
children in the United States is unknown, it is considered to be an escalating
problem, and one that can result in serious psychological damage among victims.
There are no reliable statistics available for emotional abuse and neglect, but
these types of child abuse are as potentially damaging to their victims as are
various forms of physical abuse. Child abuse extends across racial, ethnic, and
socioeconomic lines, but there are consistently more reports concerning
children born into poverty. The reporting of child abuse is complicated by the
private nature of the crime, the fearfulness of the child, and strong
motivation for denial in the abuser.
Child Abuse
Physical, sexual,
or emotional mistreatment or neglect of a child.
Child abuse has been
defined as an act or failure to act on the part of a parent or caretaker that
results in the death, serious physical or emotional harm, sexual abuse, or
exploitation of a child, or which places the child in an imminent risk of
serious harm (42 U.S.C.A. § 5106g). Child abuse laws raise difficult legal and
political issues, pitting the right of children to be free from harm against
the right of families to privacy and the rights of parents to raise and
discipline their children without government interference.
The mistreatment of
children at the hands of parents or caretakers has a long history. For
centuries, this behavior was shielded by a system of laws that gave children
few if any rights. Under English common law, children were treated as property
owned by the parents and parents, particularly fathers, had great latitude over
the treatment and discipline of children. This outlook was carried to the
American colonies and incorporated into early laws in the United States.
One of the first
cases to bring national attention to child abuse arose in the early 1870s. An
eight-year-old New York orphan named Mary Ellen Wilson complained of being
whipped and beaten nearly every day by her foster family. Her case captured the
attention of the American Society for the Prevention of Cruelty to Animals
(ASPCA). An attorney for the ASPCA took Wilson's case, arguing that as members
of the animal kingdom, children are entitled to the same legal protections from
cruelty as are animals. A judge heard evidence that Wilson's foster family, the
Connollys, routinely beat her, locked her in a bedroom, and made her sleep on
the floor. Charged with assault
and battery, Wilson's foster mother was convicted and sentenced to one year
of hard labor. Even more significantly, publicity surrounding Wilson's case led
to the establishment, in 1874, of the New York Society for the Prevention of
Cruelty to Children. The following year the New York Legislature passed a
statute that authorized such societies to file complaints of child abuse with
law enforcement agencies.
In 1962 an article
in a major medical journal again brought national attention to the issue by
identifying the symptoms that can indicate child abuse. The article, by Dr.
Henry Kempe, appeared in the Journal of the American Medical Association
and discussed a diagnosis for child abuse. The article resulted in widespread
awareness of child abuse and prompted further public discussion on how to
address the problem. By 1970, every state had enacted laws requiring certain
professionals, such as teachers and doctors, to report incidents of suspected
child abuse to law enforcement agencies. In 1974 the Federal Child Abuse
Prevention and Treatment Act (42 U.S.C.A. §§ 5105-5106) became law, authorizing
federal funding for states to identify child abuse and offer protective
services for abused children.
Statutes make up
one component of a state's child protective services; another component, the
child protective services agency, implements the statutes. Reporting statutes,
which vary from state to state, require that certain professionals report
suspected child abuse, whereas others, such as neighbors, are entitled but not
required to. Other statutes define child abuse. For example, in some states,
physical abuse occurs only when a child suffers a specified type of injury,
whereas in other states, any serious injury that is not accidental in nature is
considered abuse. Sexual abuse of children generally need not cause injury; any
sexual act performed on a child can be considered abuse. Similarly, state
statutes categorize as child abuse any neglect of a child that places the child
at risk, regardless of whether the child is actually injured. Before
substantiating a report of emotional abuse of a child, state statutes generally
require a finding of actual harm. Still other statutes specify procedures for
investigating child abuse, determining whether a report of abuse is
substantiated, intervening to protect an abused child from further harm, and
maintaining records of child abuse reports.
When allegations of
abuse meet the statutory definitions, the state child protective services
agency or a law enforcement agency steps in to investigate. Child protective
services agencies generally investigate allegations only when the child's
parent or guardian
is suspected of causing the abuse or allowing it to occur. There is a
presumption that the parent or guardian will protect the child from abuse by
other parties and will contact law enforcement agencies to investigate
incidents of abuse by other parties when the parent is not causing or allowing
the abuse.
Caseworkers for
child protective services investigate abuse allegations most commonly by
interviewing or visiting with the child, the child's parents or guardians, and
other sources such as physicians and teachers. If an agent finds evidence that
supports a conclusion that the child was abused, the agency deems the
allegations substantiated. The next step is intervention.
Intervention can
mean many different things. Frequently, when the risk of further abuse is
immediate and significant, child protective services agents will place the
child temporarily in a foster home. Alternatively, agents may monitor the
family or provide counseling to curb the threat of abuse. If a family does not cooperate
with the intervention efforts of child protective services, the agency may take
the case before a judge, who may determine that abuse or neglect has occurred
and issue a court order mandating the agency's intervention. In extreme cases,
agents may remove the child from the home permanently; following a judicial
termination of parental rights, the child is then placed for adoption.
Another function of
state child protective services is record keeping, which is accomplished
through a system known as the central registry. The central registry contains
information about child abuse reports—both substantiated and
unsubstantiated—such as the names of the child and of the suspected abuser and
the final determination made by the child protective services worker. This
system helps agents investigating current reports of abuse because it allows
them to compare any previous accusations, particularly within the same family.
The registry also supplies statistics about child abuse, which help the agency
and the state legislature enact appropriate laws and policies and provide
adequate funding for child protective services. Also, in some states, other
parties may have access to the registry. For example, a day care center may
check the registry before hiring child care employees, or an adoption agency
may check the registry before placing an infant with a family.
There is little
argument that state child protective services agencies provide a valuable service
by responding to allegations of child abuse. But such agencies also have their
critics. Many people accused of child abuse, particularly parents, object to
the way these agencies routinely remove children from their homes when child
abuse is suspected. Children are traumatized by being taken from their parents,
and allegations of abuse are frequently unfounded, these critics claim.
Contentious child custody battles sometimes prompt false accusations of
physical or sexual abuse, costing the accused time and money in the fight to
reclaim their children and their reputations. Others object to the names of the
accused being included on the central registry even when the accusations are
unsubstantiated. The backlash against child protective services spurred the
establishment, in 1984, of an information and support group known as Victims of
Child Abuse Laws (VOCAL). VOCAL claims to have thousands of members nationwide
and members lobby for new laws that protect not only children but also parents
who are falsely accused of being abusive or negligent.
Despite increased
legislation and penalties for child abuse, extreme cases continue to appear and
to sustain the debates over child abuse laws. Such cases include the Schoo case
in suburban Chicago, which received widespread media coverage. In December
1992, David Schoo, a forty-five-year-old electrical engineer, and his
thirty-five-year-old wife, Sharon Schoo, a homemaker, flew to Acapulco for a
Christmas vacation, leaving their daughters, nine-year-old Nicole Schoo and
four-year-old Diana Schoo, home alone. The Schoos provided their daughters only
cereal and frozen dinners to eat and a note telling them when to go to bed. One
day during their parents' absence, the girls left the house when a smoke alarm
sounded. As they stood barefoot in the snow, a neighbor found them, learned of
their plight, and called the police.
The Schoos were
arrested while still on the plane that returned them from Mexico nine days
after they left their children. Following their indictment on
various state charges of child endangerment and cruelty, a grand jury
also found evidence that the Schoos had beaten, kicked, and choked their
children to discipline them. In April 1993, the Schoos plea bargained, agreeing
to serve two years of probation and thirty days of house arrest while the girls
remained in foster care. In August 1993, the Schoos agreed to give up their
parental rights and placed their daughters for permanent adoption.
Another nationally
publicized case raised questions regarding the effectiveness of child protective
services and implicated social workers charged with protecting the victim.
Two-year-old Bradley McGee, of Lakeland, Florida, died in July 1989 from
massive head injuries after his stepfather, twenty-three-year-old Thomas E.
Coe, repeatedly plunged him headfirst into a toilet. Coe later testified that
he had become angry when the child soiled his pants. McGee's
twenty-one-year-old mother, Sheryl McGee Coe, pleaded no contest to
second-degree murder
and aggravated child abuse for allowing her husband to abuse McGee, and
received a thirty-year prison sentence. Thomas Coe, convicted of first-degree
murder and aggravated child abuse, received a sentence of life in prison.
The McGee case
alarmed the public not only because of the harsh physical abuse that caused the
toddler's death but also because of what many perceived to be a failure in the
system designed to protect children like McGee. Two months before his death,
McGee had been living with foster parents owing to allegations of abuse at the
hands of the Coes. Despite strong objections by the foster parents, caseworkers
for Florida's Health and Rehabilitative Services returned McGee to his mother
and stepfather, determining them to be fit parents.
Public reaction was
strong following the news of McGee's death. Four social workers were prosecuted
for negligently handling the case but only the main caseworker, Margaret
Barber, was convicted, for disregarding a report from a psychologist who warned
that the Coes were unfit parents. The publicity shed light on problems within
Florida's child protective services agency, including severe understaffing, and
led to new laws emphasizing keeping children safe over keeping families
together and increasing funding for more social workers. A Florida appellate
court later overturned Barber's felony conviction but left standing a misdemeanor
conviction for failing to report child abuse.
Legislation at the
state and federal levels continues to change to meet the goal of protecting
children from abuse and neglect while protecting families from the damage of
false accusations.
Child abuse
is the physical or psychological maltreatment
of a child by an
adult, often
synonymous with the term child maltreatment or the term child abuse
and neglect.
There are many
forms of abuse and neglect and many governments have developed their own legal
definition of what constitutes child maltreatment for the purposes of removing
a child and/or prosecuting a criminal charge. In the United States, the Federal
Government puts out a full definition of child abuse and neglect and creates a
summary of each State definition. To view, go to Definitions of Child Abuse and
Neglect: Summary of State Laws [1] that is
part of the 2005 State Statute series by the National Clearinghouse on Child
Abuse and Neglect Information.
Effects of child abuse on the child and development
The U.S. National
Adoption Center found that 52% of adoptable children (meaning those children in
U.S. foster
care freed for adoption) had symptoms of attachment
disorder. A study by Dante Cicchetti found that 80% of abused and maltread
infants exhibited attachment disorder symtoms (disorganized subtype). [1]
[2]
Children with
histories of maltreatment, such as physical and psychological neglect, physical
abuse, and sexual abuse, are at risk of developing severe psychiatric
problems [3]
[4].
These children are likely to develop Reactive
attachment disorder [5]
[6].
These children may be described as experiencing trauma-attachment problems. The
trauma experienced is the result of abuse or neglect, inflicted by a primary
caregiver, which disrupts the normal development of secure attachment. Such
children are at risk of developing a disorganized attachment [5]
[7]
[8].
Disorganized attachment is associated with a number of developmental problems,
including dissociative symptoms [9],
as well as depressive, anxiety, and acting-out symptoms [10]
[11].
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wikipedia
Causes
Circumstances that
place families under extraordinary stress - for instance, poverty, divorce,
sickness, disability, lack of parental skills - sometimes take their toll in
child maltreatment. Many of these factors may contribute to family stress that
can result in child abuse or neglect. Understanding the root causes of abuse
can help better determine the best methods of prevention and treatment. Most
parents don't hurt or neglect their children intentionally. Many were
themselves abused or neglected. Parents who abuse alcohol or other
drugs are more likely to abuse or neglect their children.
Prevention
Given these
possible causes, most professionals agree that there are three levels of
prevention services; primary prevention, secondary prevention, and tertiary
prevention.
Primary Prevention
Primary prevention
consists of activities that are targeted toward the community at large. These
activities are meant to impact families prior to any allegations of abuse and
neglect. Primary prevention services include public education activities,
parent education classes that are open to anyone in the community, and family
support programs. Primary prevention can be difficult to measure because you
are attempting to impact something before it happens, an unknown variable.
Secondary Prevention
Secondary
prevention consists of activities targeted to families that have one or more
risk factors including families with substance abuse, teen parents, parents of
special need children, single parents, and low income families. Secondary
prevention services include parent education classes targeted for high risk
parents, respite care for parents of a child with a disability, or home
visiting programs for new parents.
Tertiary Prevention
Tertiary prevention
consists of activities targeted to families that have confirmed or unconfirmed
child abuse and neglect reports. These families have already demonstrated the
need for intervention, either with or without court supervision.
Treatment
Treatment for those
experiencing Complex post-traumatic stress disorder, which is caused by
early chronic maltreatment, should address each dimension. Often treatment must
be multi-modal. Children who have experienced complex trauma caused by chronic
maltreatment can be treated effectively with Dyadic Developmental Psychotherapy[12]
[13].
In addition Cognitive Behavioral Therapy interventions, education, EMDR and other approaches can be effectively used.
Child Abuse Prevention Organizations
Childhelp USA
Founded in 1959 by
Sara O'Meara and Yvonne Fedderson, Childhelp USA is one of the largest and
oldest national nonprofit organizations dedicated to the prevention of child
abuse, neglect as well as to the treatment of its victims in the United States.
Childhelp's programs, which directly serve abused children and their families,
focus on meeting the children's physical, emotional, educational and spiritual
needs. In 2005, Sara and Yvonne were both nominated for the Nobel Peace
Prize.
Prevent Child Abuse America(PCA America)
Established in
1972, Prevent Child Abuse America works to bring awareness to and educate the
public about child abuse and neglect. PCA America works on the National, State
and Local levels with chapters in 40 States which work alongside the local
councils in each State. The mission statement of PCA America is: "To
prevent the abuse and neglect of our nation's children."
Reporting of Child Abuse
Reporting abuse and neglect in Australia
Child abuse and
neglect is the subject of mandatory
reporting in most Australian jurisdictions. Usually professional people
such as doctors, nurses and teachers are bound to report strong evidence of
abuse or neglect. State authorities, such as the Child Protection Unit of the
Department of Human Services (Victoria), have statutory authority to
investigate and deal with child abuse.
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