Child Abuse and Neglect - An Overview (page 2)
Child abuse in the United States continues to be a serious and ever-increasing problem. Although the media report extreme and tragic examples of abuse, many children are living in less newsworthy, but alarming circumstances. The statistics are shocking. An incident of child abuse is reported—on average—every 10 seconds. The most recent government national study reported that more than 2.9 million reports of possible maltreatment involving children were made to child protective services in 2003. The actual incidence of abuse and neglect, however, is estimated to be three times greater than the number reported to authorities. Every day more than 4 children die as a result of child abuse in the home. The types of reported maltreatment included: Neglect (61%), Physical Abuse (19%), Sexual Abuse (10%), Psychological Maltreatment (5%), Medical Maltreatment (2%), Other (17%). The consequences to the children and families involved and to society are incalculable.
Child abuse and neglect can take different forms
Following is a summary of the types of child abuse and neglect, but definitions may vary according to state, legal, medical, mental health, economic, and child welfare systems. The types of child abuse and neglect are usually found in combination rather than alone.
- Child physical abuse (CPA)–an injury to a child or adolescent by a parent or other caregiver after intentional physical contact. It is defined not by the act, but by the results of the act (e.g., bruises, burns, broken bones). The physical injury may result from different acts, including hitting, kicking, slapping, shaking, burning, choking, throwing, whipping, and/or paddling.
- Child sexual abuse (CSA)–any form of sexual activity with a child or adolescent in which consent is not or cannot be provided (e.g., significant disparity in age, development or size). The sexual activity often includes physical contact (e.g., penetration, touching) and may also reflect non-contact sexual acts (e.g., exposure to pornography). Examples of sexual abuse include: fondling, penetration, pornography, exhibitionism, child prostitution, and forced observation of sexual acts.
- Emotional or psychological abuse is assumed to be present in all other forms of abuse. It consists of any attitude or behavior which interferes with a child's mental health or social development, such as yelling, screaming, name calling, shaming, negative comparisons to others, telling children they are "bad" or "no good." Another aspect of emotional abuse is the failure to provide the affection and support necessary for the development a child's well being, such as ignoring, withdrawal of attention, lack of praise, and lack of positive reinforcement.
- Neglect, is defined by the absence of specific events. Five types of neglect are identified:
- Physical neglect–the failure to provide for a child's physical needs, including adequate food, clothing, and shelter.
- Emotional neglect–failure to provide for a child's emotional needs which, in extreme cases, can lead to non-organic failure to thrive and physical illness/abnormalities.
- Medical neglect–failure to provide or comply with prescribed medical treatment, such as immunization, surgery, medication.
- Mental health neglect–failure to provide or comply with recommended corrections or therapeutic procedures in cases of serious emotional or behavioral disorders. This is not widely accepted and investigated as a form of neglect.
- Educational neglect–failure to comply with state requirements for school attendance.
Child abuse and neglect occur for many reasons
Although specific causes are not known, a significant body of research has identified several risk and protective factors. Multiple risk factors are more likely to increase the probability of abuse. For example, lack of preparation or knowledge of the demands of parenting can lead to abusive or neglectful parenting. Parents may lack understanding of their children's developmental stages and hold unreasonable expectations for their abilities and behavior; they may be unaware of effective discipline or alternatives to corporal punishment and may also lack knowledge of the health, hygiene and nutritional needs of their children. Individuals who have difficulty in single parenting, in controlling anger in relationships, who have mental health or substance abuse problems, financial stress or housing problems can appear uninterested in the care of their children and are also at risk for abusive behavior.
Warning signs of abuse and neglect–abuse leaves a mark
Early identification and treatment make a difference. Children who have been abused may show:
- sexual acting out
- poor self image
- inability to trust or love others
- aggressive, disruptive and sometimes illegal behavior
- anger and rage
- self destructive or self abusive behavior, suicidal thoughts
- passive, withdrawn or clingy behavior
- fear of entering into new relationships or activities
- anxiety and fears
- school problems or failure
- feelings of sadness or other symptoms of depression
- flashbacks, nightmares
- drug or alcohol abuse
- inability to stay awake or to concentrate for extended periods
Some children are more at-risk than others for negative effects
Children are more vulnerable to psychological problems if the child:
- is abused severely, chronically, physically injurious, and by multiple abusers
- is younger when the abuse/neglect begins
- had a close relationship to the abuser
- was not functioning well before the abuse
- blames him/herself for the abuse and its consequences
- views the world as a dangerous place
Some children may deal more adaptively than others. Protective factors include the child's individual characteristics such as optimism, good self-esteem, intelligence, creativity, humor and independence. Factors such as the availability of social support and a relationship with a caring adult are important. Community well-being, neighborhood stability, and access to health care are also critical.
Reprinted with the permission of the NYU Child Study Center. © NYU Child Study Center.
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