most common form of child abuse is neglect

Child Abuse

I

INTRODUCTION

Child Abuse, intentional acts that result in physical or emotional harm to children. The term child abuse covers a wide range of behavior, from actual physical assault by parents or other adult caretakers to neglect of a child’s basic needs. Child abuse is also sometimes called child maltreatment.

Although the extent of child abuse is difficult to measure, it is recognized as a major social problem, especially in industrialized nations. It occurs in all income, racial, religious, and ethnic groups and in urban and rural communities. It is, however, more common in some groups, especially those below the poverty line.

Cultures around the world have different standards in deciding what constitutes child abuse. In Sweden, for example, the law prohibits any physical punishment of children, including spanking. By contrast, in some countries of Asia, Africa, and the Caribbean, parents are expected to punish their children by hitting them.

II

TYPES

There are several different types of child abuse, and some children experience more than one form. Physical abuse includes deliberate acts of violence that injure or even kill a child. Unexplained bruises, broken bones, or burn marks on a child may be signs of physical abuse. Sexual abuse occurs when adults use children for sexual gratification or expose them to sexual activities. Sexual abuse may begin with kissing or fondling and progress to more intrusive sexual acts, such as oral sex and vaginal or anal penetration. Emotional abuse destroys a child’s self-esteem. Such abuse commonly includes repeated verbal abuse of a child in the form of shouting, threats, and degrading or humiliating criticism. Other types of emotional abuse are confinement, such as shutting a child in a dark closet, and social isolation, such as denying a child friends.

The most common form of child abuse is neglect. Physical neglect involves a parent’s failure to provide adequate food, clothing, shelter, or medical care to a child. It may also include inadequate supervision and a consistent failure to protect a child from hazards or danger. Emotional neglect occurs when a parent or caretaker fails to meet a child’s basic needs for affection and comfort. Examples of emotional neglect include behaving in a cold, distant, and unaffectionate way toward a child, allowing a child to witness chronic or severe spousal abuse, allowing a child to use alcohol or drugs, and encouraging a child to engage in delinquent behavior. Another form of neglect involves failing to meet a child’s basic education needs, either by failing to enroll a child in school or by permitting a child to skip school frequently.

III

PREVALENCE

According to the National Center on Child Abuse and Neglect, in 1997 about 3 million children in the United States were reported as abused or neglected to government agencies that investigate child abuse. Investigators substantiated abuse or neglect for nearly 1 million of the children reported. Among substantiated cases, 56 percent involved physical or emotional neglect, 25 percent involved physical abuse, 13 percent involved sexual abuse, 6 percent involved emotional abuse, and 13 percent involved other abuse, such as educational neglect or abandonment. Some children experienced multiple forms of abuse.

Many researchers believe that statistics based on official reports do not accurately reflect the prevalence of child abuse. Definitions of maltreatment vary from state to state and among agencies, making such statistics unreliable. Professionals who interact with children—such as teachers, day-care workers, pediatricians, and police officers—may fail to recognize or report abuse. In addition, acts of abuse usually occur in the privacy of a family’s home and often go unreported. Surveys of families, another way of estimating abuse, indicate that 2.3 percent of children in the United States—or about 1.5 million children—experience abusive violence each year.

The U.S. Advisory Board on Child Abuse and Neglect estimates that 2000 children under the age of 18 are killed by parents or caretakers each year. Annually, more children under the age of four die from abuse and neglect than from falls, choking on food, drowning, fires, or motor vehicle accidents. More than 18,000 children suffer permanent disabilities from abuse or neglect annually.

IV

CAUSES

Many people have difficulty understanding why any person would hurt a child. The public often assumes that people who abuse their children suffer from mental disorders, but fewer than 10 percent of abusers have mental illnesses. Most abusers love their children but tend to have less patience and less mature personalities than other parents. These traits make it difficult to cope with the demands of their children and increase the likelihood of physical or emotional abuse.

However, there is no single explanation for child maltreatment. Child abuse results from a complex combination of personal, social, and cultural factors. These may be grouped into four primary categories: (1) intergenerational transmission of violence, (2) social stress, (3) social isolation and low community involvement, and (4) family structure.

A

Intergenerational Transmission of Violence

Many children learn violent behavior from their parents and then grow up to abuse their own children. Thus, the abusive behavior is transmitted across generations. Studies show that some 30 percent of abused children become abusive parents, whereas only 2 to 3 percent of all individuals become abusive parents. Children who experience abuse and violence may adopt this behavior as a model for their own parenting.

However, the majority of abused children do not become abusive adults. Some experts believe that an important predictor of later abuse is whether the child realizes that the behavior was wrong. Children who believe they behaved badly and deserved the abuse become abusive parents more often than children who believe their parents were wrong to abuse them.

B

Social Stress

Stress brought on by a variety of social conditions raises the risk of child abuse within a family. These conditions include unemployment, illness, poor housing conditions, a larger-than-average family size, the presence of a new baby or a disabled person in the home, and the death of a family member. A large majority of reported cases of child abuse come from families living in poverty. Child abuse also occurs in middle-class and wealthy families, but it is better reported among the poor for several reasons. Wealthier families have an easier time hiding abuse because they have less contact with social agencies than poor families. In addition, social workers, physicians, and others who report abuse subjectively label children from poor families as victims of abuse more often than children from rich families.

Alcohol and drug use, common among abusive parents, may aggravate stress and stimulate violent behavior. Certain characteristics of children, such as mental retardation or physical or developmental disabilities, can also increase the stress of parenting and the risk of abuse.

C

Social Isolation and Low Community Involvement

Parents and caretakers who abuse children tend to be socially isolated. Few violent parents belong to any community organizations, and most have little contact with friends or relatives. This lack of social involvement deprives abusive parents of support systems that would help them deal better with social or family stress. Moreover, the lack of community contacts makes these parents less likely to change their behavior to conform with community values and standards.

Cultural factors often determine the amount of community support a family receives. In cultures with low rates of child abuse, child care is usually considered the responsibility of the community. That is, neighbors, relatives, and friends help with child care when the parents are unwilling or unable. In the United States, parents often shoulder child-care demands by themselves, which may result in a higher risk of stress and child abuse.

D

Family Structure

Certain types of families have an increased risk of child abuse and neglect. For example, single parents are more likely to abuse their children than married parents. However, single-parent families usually earn less money than other families, so this may account for the increased risk of abuse. Families with chronic marital discord or spousal abuse have higher rates of child abuse than families without these problems. In addition, families in which either the husband or wife dominates in making important decisions—such as where to live, what jobs to take, when to have children, and how much money to spend on food and housing—have higher rates of child abuse than families in which parents share responsibility for these decisions.

V

EFFECTS ON CHILDREN

The consequences of child abuse and neglect can be devastating and far-reaching. Physical injuries can range from bruises, scrapes, and burns to brain damage, permanent disabilities, and death. The psychological effects of abuse and neglect can last a lifetime and may include a lowered sense of self-worth, an inability to relate to peers, reduced attention span, and learning disorders. In severe cases, abuse may result in psychiatric disorders like depression, excessive anxiety, or dissociative identity disorder, as well as an increased risk of suicide. Behavior problems often develop after abuse, including violence and juvenile crime.

Children who are sexually abused initially may show an unusual interest in sexual organs. They may demonstrate abnormal behavior, such as public masturbation or public display of their genitals. Long-term effects may include depression, low self-esteem, and sexual problems, such as avoidance of sexual contact, confusion about sexuality, or involvement in prostitution.

Despite being abused, the majority of maltreated children do not show signs of extreme disturbance, and many can cope with their problems. A number of factors help insulate children from the effects of maltreatment. These include high intelligence, good scholastic achievement, good temperament, and having close personal relationships.

VI

PROTECTING CHILDREN

Since the 1960s efforts to ensure that abused children are identified have increased greatly in the United States. From 1962 to 1967 all 50 states and the District of Columbia enacted laws that required professionals in law enforcement, medicine, education, and other fields to report suspected cases of child abuse. As a result, the number of children reported as abused or neglected has increased substantially, from about 700,000 in 1976 to about 2.9 million in 1995. Today, each state has a toll-free telephone hotline to receive child abuse and neglect reports from these individuals and the general public.

In 1974 the United States government enacted the Child Abuse Prevention and Treatment Act. This legislation provided a federal definition of child maltreatment and established the National Center on Child Abuse and Neglect. As part of the Department of Health and Human Services, the center collects data on child abuse, assists states in implementing prevention programs, and funds research on the causes, treatment, and prevention of child abuse.

A

Care of Abused Children

Child-welfare workers who confirm that a child has been abused or neglected usually have two options. These are (1) separate the child from the parents and place him or her with a relative, foster home, or state institution, or (2) keep the child with the parents and provide the family with social support, such as counseling, food stamps, and child-care services.

Public concern over placement of abused children in the United States grew in the 1970s as the number of children placed in foster homes continued to increase. The Adoption Assistance and Child Welfare Act of 1980 placed special emphasis on reducing the number of children in foster care and on ensuring safe and permanent living conditions for children. As a result of this law, child-welfare agencies work to avoid out-of-home placements and to reunify children in foster care with their biological parents.

The decision to separate one or more children from an abusive parent or parents must be weighed against the risks. The children may not understand why they are being removed from their home. Children may not realize they are being abused or neglected, so the removal might seem like another instance of them doing something wrong and being punished. Also, child-welfare agencies often have difficulty finding suitable placement for abused children because such children frequently require special care. If they become a burden for any foster parent or institution, the risk of abuse might actually be greater than in the home of the biological parents.

There are also risks to keeping children in abusive homes. The support services may not resolve the problems that led to the abuse and the child may be abused again or killed. Of children killed by parents or caretakers, from 30 to 50 percent have been previously identified by child-welfare agencies and either left in their home or returned home after a short-term removal.

B

Prevention and Treatment Programs

In the United States many types of social programs, usually at the county or state levels, have attempted to reduce and prevent child abuse. Current approaches involve identifying high-risk parents—such as young, single, first-time mothers—and providing parental skills training, counseling, education, and social support. Often trained social workers or nurses provide this support by visiting the family’s home on a regular basis, encouraging community contact, and expanding the caretaker’s knowledge about available social services.

Some home visitation programs have shown promise in reducing abuse among high-risk families. The most successful strategies provide home visitation that begins at or before the child’s birth and continues for two or more years. In one such program for unmarried teenage mothers, only 4 percent of mothers had abused or neglected their children after two years, contrasted to 19 percent of a comparison group not in the program.

Other programs, known as intensive family preservation programs, try to preserve families in which abuse has occurred rather than send the child to foster care. A caseworker visits the family’s home frequently and intensively over a period of weeks and provides counseling and practical assistance for such issues as finding employment and obtaining child care.

However, many prevention and treatment programs may not reduce the incidence of child abuse significantly. Studies indicate that the more intervention services a family receives, the more abuse occurs in the family. Intensive family preservation programs, for example, provide short-term relief, but they do not seem to reduce placement of children in foster homes or lower the risk of maltreatment.