child abuse

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.

Distribution of child abuse and neglect in the United States[2]

By perpetrator characteristics

The majority (78%) of maltreated children were maltreated by their birth parents. Birth parents were responsible for 62% of the abuse cases and 91% of the neglect cases.

Birth parents were the most closely related perpetrators for 72% of physically abused children and 81% of emotionally abused children. Of the children who were abused by their birth parents the majority (75%) were abused by their mothers and a sizable minority (46%) were abused by their father (some children were abused by both parents). By contrast, children who were abused by other parents or parent-substitutes were more likely to be mistreated by a male (80-85%) than by females (14-41%)

The pattern was distinctly different for child sexual abuse. Almost half of sexually abused children were sexually abused by someone other than a parent or a parent-substitute. Just over a quarter were sexually abused by a birth parent and a quarter were sexually abused by parent-substitute (corrected NIS-3 typo). A sexually abused child was most likely to sustain serious injury or impairment when a birth parent was the perpetrator (see incest). Male perpetrators committed 89% of known child sexual abuse versus only 12% by females but this statistic fails to include non-contact forms of child sexual abuse that females often prefer (see covert incest) which causes serious psychological injury and impairment. It also fails to mention social double standards, lack of research, reporting biases and other serious obstacles that hinder the gathering of credible data on overt (contact) female sexual abuse of children.

Neglected children were more often neglected by female perpeprators (87%) than by male perpetrators 43%. Since the vast majority (91%) of neglected children were neglected by their birth parents, this means that birth mothers committed the majority of neglect cases as opposed to birth fathers. This finding is congruent with the fact that mothers tend to be the primary caretakers and are the primary parents held accountable for any omissions and/or failings in caretaking. This knowledge was summarized from the NIS-3 Executive Summary which was written by two women and which makes no mention of commissions, omissions, and/or failings in parental caretaking which is no a less essential criteria for child health.

By family characteristics

Children of single parents were at higher risk of physical abuse and all types of neglect and were over-represented among seriously injured, moderately injured and endangered children. Compared with their counterparts living with both parents, children in single-parent families had:

• a 77-percent greater risk of being harmed by physical abuse.
• an 87-percent greater risk of being harmed by physical neglect.
• a 74-percent greater risk of being harmed by emotional neglect.
• a 220-percent (or more than three times) greater risk of being educationally neglected.
• a 120-percent greater (more than two times) greater risk of being endangered by some type of child abuse or neglect.

Among children in single parent households, those living with only their father were approximately one and two-thirds more likely to be sexually abused than those living only with their mothers. Based on the data above, children living only with their mother were far more likely to be neglected than those living only with their fathers.

Children in families with income below $15,000 dollars a year were 14-56 times more likely to suffer specific forms of serious child abuse vs children from families with incomes of $30,000 per year or more. Family income was significantly related to incidence rate of nearly every category of maltreatment. Children from families with income below $15,000 are over 31 times more likely to be considered endangered, although not yet injured, by some type of abusive or neglectful treatment than those from families with incomes of $30,000 per year or more.

Family size was connected with a huge increases in the levels of educational and physical neglect. Children in the largest families (those with four or more children) were almost three times more likely to be educationally neglected and nearly two and two fifths more likely to be physically neglected. Surprisingly 'only' children suffered more neglect than children in families of two-three children. However, children in the largest families were physically neglected at nearly three times the rate of those who came from 'only' child households.

By child characteristics

Girls were sexually abused about three times more often than boys. However, this data is based on definitonal guidelines that permit inference of injury of harm to girls that occurred in connection with more extreme forms of sexual abuse. In addition, there is evidence to suggest (see rape and incest) that women commit sexual abuse against their own children in far greater numbers than are being reported, often with covert, non-contact methods, and that they can conceal both overt and covert child sexual abuse much more easily inside their families than can men. Given that female sexual abuse of children is rarely reported (see incest links) it is impossible to know how many boys versus girls are sexually abused by birth mothers and other female caretakers.

Boys were at significantly (24%)l greater risk of serious injury than girls. In addition, the trends in fatal injuries moved in opposite directions between NIS-2 and NIS-3 studies with the incidence of fatally injured girls declining slightly while the incidence of fatally injured boys rose. Boys are also significantly more likely to be emotionally neglected than girls (boys' risk was 18% greater than girls').

Children under age 12, and especially those ages 6-11 were at highest risk for all forms of mistreatment. However, one form of abuse, the sexual abuse of children has a strikingly low age transition in the distribution of incidence rates. The rate of child sexual abuse was very low for 0-2 year olds, but then relatively constant for children ages 3 and older, indicating a very wide range of vulnerability from pre-school age on.

This study found no race-related differences in maltreatment incidence.

Reporting abuse and neglect in the United States

Anyone in the United States may make an anonymous report of abuse, neglect or sexual abuse by reporting to the emergency services by dialing 911 or calling the local police department. The National Child Abuse Hotline (1-800-4-A-Child) is another resource for citizens wishing to report abuse. Hotline counselors provide local reporting information and will stay on the phone while a three-way call is placed to local authorities.

Abuse and neglect may only be reported at the state or local level, not to the U.S. Federal government. Most states have a toll-free hotline staffed by trained call screeners. When contacted, they will either open the case for investigation or log the report. Depending on available resources and the department's legal mandate, one report may not be sufficient to open a case, but a detailed report about a potentially serious case, or multiple reports (by different reporters), may suffice. At that point, someone from a legally designated agency will investigate the report. The investigators may determine there is no evidence of maltreatment, that there is evidence enough to offer support to the family in the home, or that there is evidence enough to remove the child from the home.

Some professionals who work with children are mandatory reporters. Each U.S. state and territory designates individuals, typically by occupational group, who are mandated by law to report child maltreatment. Such individuals often include health care workers, school personnel, child care providers, social workers, law enforcement officers, and mental health professionals.

Some U.S. states also mandate animal control officers, veterinarians, commercial film or photograph processors, substance abuse counselors, and firefighters to report abuse or neglect. Four states--Alaska, Arkansas, Connecticut, and South Dakota--include domestic violence workers on the list of mandated reporters. Approximately eighteen states require all citizens to report suspected abuse or neglect regardless of profession.

In any state, an adult in charge of a child who has actual knowledge of child abuse (for example, who sees a stranger, a friend, or a family member abusing the child), and fails to report the abuse, can be charged with one or more crimes. However, prosecutions under "mandated reporter" statutes remain uncommon.

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.

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.

Reporting abuse and neglect in United Kingdom

Childline is a telephone contact agency provided for children to discuss any concerns they have with a team of trained volunteers.

NSPCC is the umbrella organisation now funding this project. The NSPCC also provides a telephone helpline for anyone to contact professionally trained social workers regarding concerns about children, as well as a variety of other projects.

The NSPCC forward any concerns they receive on to the relevant Local Authority (where the child concerned lives) which would then make enquiries regarding those concerns.

Authorities

Main article: Child Protective Services

Depending on the country, the agencies responsible for investigating child abuse may be run nationally, regionally, or locally. These agencies may be called Child Protective Services (CPS), Department of Children and Family Services (DCFS), or by other similar names. In the U.S., these agencies are usually listed in the state government section of the telephone book under "Children" or "Health" or "Human Services". In a few instances in the U.S., some of the functions of these agencies are outsourced to private individuals or companies.

People who investigate claims of child abuse may be called a "children's social worker" (CSW) or a case worker.

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]}.

Understanding and preventing child abuse and neglect

Root Causes

Many factors may contribute to family stress that results 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. Very young or inexperienced parents might not know how to take care of their babies or what they can reasonably expect from children at different stages of development. Circumstances that place families under extraordinary stress - for instance, poverty, divorce, sickness, disability - sometimes take their toll in child maltreatment. 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

Main article: Complex post-traumatic stress disorder

Main article: Dyadic Developmental Psychotherapy

Main article: Cognitive Behavioral Therapy

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.

See also

Attachment disorder

Adoption

Attachment theory

Child Welfare

Complex post-traumatic stress disorder

Dyadic Developmental Psychotherapy

Emotional dysregulation

Foster care

Emotional abuse

Notable incidents of child abuse

• The death of Marcela Hope Yellowbear
• The death of Elisa Izquierdo
• The death of Nixzmary Brown
• The death of Joseph Wallace
• The death of Nadine Lockwood
• The Joel Steinberg Case
• The death of Dennis Jurgens
• The Tulasa Thapa Case
• The death of Justina Morales
• The death of Candace Newmaker
• The David Pelzer Case
• The death of Jeffrey Baldwin
• The death of Victoria Climbie [3]
• The deaths of Suesan and Sheila Knorr [4]
• The Paul & Paula McLaughlin's Case [5]

References

1. ^ Carlson, V., Cicchetti, D., Barnett, D., & Braunwald, K. (1995). Finding order in disorganization: Lessons from research on maltreated infants’ attachments to their caregivers. In D. Cicchetti & V. Carlson (Eds), Child Maltreatment: Theory and research on the causes and consequences of child abuse and neglect (pp. 135-157). NY: Cambridge University Press.
2. ^ Cicchetti, D., Cummings, E.M., Greenberg, M.T., & Marvin, R.S. (1990). An organizational perspective on attachment beyond infancy. In M. Greenberg, D. Cicchetti, & M. Cummings (Eds), Attachment in the Preschool Years (pp. 3-50). Chicago: University of Chicago Press.
3. ^ Gauthier, L., Stollak, G., Messe, L., & Arnoff, J. (1996). Recall of childhood neglect and physical abuse as differential predictors of current psychological functioning. Child Abuse and Neglect 20, 549-559
4. ^ Malinosky-Rummell, R. & Hansen, D.J. (1993) Long term consequences of childhood physical abuse. Psychological Bulletin 114, 68-69
5. ^ ^a b Lyons-Ruth K. & Jacobvitz, D. (1999) Attachment disorganization: unresolved loss, relational violence and lapses in behavioral and attentional strategies. In J. Cassidy & P. Shaver (Eds.) Handbook of Attachment. (pp. 520-554). NY: Guilford Press
6. ^ Greenberg, M. (1999). Attachment and Psychopathology in Childhood. In J. Cassidy & P. Shaver (Eds.). Handbook of Attachment (pp.469-496). NY: Guilford Press
7. ^ Solomon, J. & George, C. (Eds.) (1999). Attachment Disorganization. NY: Guilford Press
8. ^ Main, M. & Hesse, E. (1990) Parents’ Unresolved Traumatic Experiences are related to infant disorganized attachment status. In M.T. Greenberg, D. Ciccehetti, & E.M. Cummings (Eds), Attachment in the Preschool Years: Theory, Research, and Intervention (pp161-184). Chicago: University of Chicago Press
9. ^ Carlson, E.A. (1988). A prospective longitudinal study of disorganized/disoriented attachment. Child Development 69, 1107-1128
10. ^ Lyons-Ruth, K. (1996). Attachment relationships among children with aggressive behavior problems: The role of disorganized early attachment patterns. Journal of Consulting and Clinical Psychology 64, 64-73
11. ^ Lyons-Ruth, K., Alpern, L., & Repacholi, B. (1993). Disorganized infant attachment classification and maternal psychosocial problems as predictors of hostile-aggressive behavior in the preschool classroom. Child Development 64, 572-585
12. ^ Becker-Weidman, A., & Shell, D., (Eds.) (2005) Creating Capacity For Attachment, Wood 'N' Barnes, OK. ISBN 1885473729
13. ^ Becker-Weidman, A., (2006). Treatment for Children with Trauma-Attachment Disorders: Dyadic Developmental Psychotherapy, Child and Adolescent Social Work Journal. Vol. 13 #1, April 2006.

External links

• The Adverse Childhood Experiences Study is an ongoing study of the long-term damage abuse during childhood causes to adult health. The study is conducted by Robert F. Anda, MD, MS, of the Centers for Disease Control and Prevention, and Vincent J. Felitti, MD, of Kaiser Permanente.
• Alice Miller is a psychologist noted for her work on child abuse and its effects upon society as well as the lives of individuals.
• Preventing Child Abuse from The Directory of Children's Issues. Summer 2006.
• Abuse in America's orphanages-Author, Roger Dean Kiser exposes the truth about the abuse of children in many American orphanages.
• Building BLOCK - Building Better Lives for Our Communities and Kids
• Executive Summary of the Third National Incidence Study of Child Abuse and Neglect (US Department of Health and Human Services)
• The History of Child Abuse from The Journal of Psychohistory 25 (3) Winter 1998
• Treating Dissociative, Abused and Ritually Abused, Children BEWARE OF THIS LINK: THE RITUAL ABUSE IN ITSELF AND AS CAUSE OF MULTIPLE PERSONALITY DISEASE, OR DISSOCIATIVE DISORDER, HAS BEEN STRONGLY OBJECTED. EVIDENCE IS GIVEN IN THE PBS Frontline Documentary entitled “The Search for Satan” aired October 24, 1995 ". The phenomenon is also referred to as 'the satanic abuse hysteria'.
• Child Abuse Types, Signs, Symptoms, Causes and Help
• Child Abuse: Statistics, Research, and Resources
• Fight 4 Kids Reporting Child Abuse
• NSPCC report on child maltreatment in the UK (November 2000)
• The Safeguarding Children Partnership, a UK charity dedicated to child protection training.
• http://www.afterfostercare.ca - Canadians affected by foster care helping each other.
• Maltreatment and the Developing Child.
• Anti-sex hysteria in Wisconsin
• Child Abuse and the Handicapped Child
• Counseling Abused Children
• Teaching the Abused Migrant Child: What's a Teacher To Do?
• Classroom Strategies for Teaching Migrant Children about Child Abuse
• Therapeutic Child Protection Work
• Best Practices in Child Protection Investigation
• The Free E-Mail Journal of Therapeutic Child Protection Work
• National Association to Protect Children
• The Support Committee for Iran's Street Children
• DCFWatch - a non profit organization monitoring civil rights abuses by U.S. Child Protection Agencies
• National Coalition for Child Protection Reform
• 'What to do if You're Worried a Child is Being Abused', leaflet published by the UK Department of Health
• Hell is for Children - An on-line book that is autobiographical in nature and deals with a person's experience of child abuse and neglect.
• Childhelp USA's National Child Abuse Website
• cpsabuse - providing support and advocacy to families falsely accused of child abuse
• GW Medical Publishing - Resources for social, medical, legal, and law enforcement professionals who deal with child abuse
• Family Tree Healing
• Stepchildren of the state - A Swedish association for fosterchildren and statehomechildren
• Institute on Violence, Abuse and Trauma at Alliant International University
• Resources on Children Exposed to Domestic Violence a form of child abuse in many jurisdictions
• Liberated From Abuse Sexual Abuse Education
• Maltreatment and the Developing Child by Dr. Bruce Perry

• Information on the evaluation and treatment of maltreated/abused children.]
• Singer, Songwriter, Actor Paul Williams has set up a page with information and links for those who are in abuse relationships or know of someone who may be