Child abuse is a common term for four types of child maltreatment: sexual abuse, physical abuse, emotional or psychological abuse, and neglect. Children are usually victims of more than one type of abuse. They could be both sexually and emotionally abused or they could also be physically abused and neglected. In some severe cases, children may suffer from more than two forms of abuse.
Child abuse was once viewed as a minor social problem that only affected a handful of U.S. children. In recent years the media and law enforcement has paid close attention to the issue. More than 1,000 children died from abuse in 1996, in the U.S. (1).
Approximately 231 children are abused each day. That is 10 children every hour, and one child every six minutes. Each day in the United States, more than three children die as a result of child abuse, in the home. More children, age four and younger, die from child abuse and neglect than any other single, leading cause of death for infants and young children (1).
The abusers can be family members, parents, caretakers such as babysitters and teachers, and strangers. Abuse occurs among all ethnic, social, and income groups. Most parents don’t hurt or neglect their children intentionally. Many were themselves abused or neglected. Usually the cases that are reported involve poor families with little education. Also common in reports are young mothers, single-parent families, and parental drug or alcohol abuse. The frequency of child abuse is difficult to estimate, due to so many cases going unreported.
There are signs, symptoms, and causes to all four types of child abuse. When you have a concern for a child’s well-being, the signs or symptoms may help guide you in the process of reporting. Although, these signs, mentioned later, don’t necessarily indicate that a child is being abused. A professional, who would be able to determine the abuse, should investigate the possibility.
Determining the exact cause of child abuse is almost impossible. In general, the factors that influence whether abuse will happen is grouped into two categories- internal and external. Lack of social support, economic hardship, and chemical dependency are a few external factors. Some internal factors are: biological, emotional, and psychological. Some factors are as common as low intelligence and range to, as rare as, a severe personality disorder such as Schizophrenia.
Isolation is a factor contributing to abuse. When families have difficulties, perhaps from unemployment or other social problems, they may respond in a number of ways. The families that respond by isolating themselves, by withdrawing themselves from neighbors and friends, are the most likely to be abusive.
Charles F. Johnson defines 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.” Sexual abuse involves fondling, penetration, persuading a child to expose his or her sexual organs, and allowing a child to view pornography. In most of the reported cases the child knew the abuser, and one in five of the abusers were under age themselves. 12% of the confirmed cases reported in 1996 involved sexual abuse. An estimated 10-15% of males and 20-25% of females reported they were sexually abused by age 18 (2).
Most sexually abused children never come to the attention of the authorities. There may be no physical signs of harm, but there is always the intense shame, and secrecy is often maintained, even by the adults who know of the abuse, for fear of destroying a family.
There is evidence emerging that as many as one in three incidents of child sexual abuse are not remembered by adults who experience them, and that the younger the child was at the time of the abuse, and the closer the relationship to the abuser, the more likely one is not to remember, claims Linda Williams.
Convicted rape and sexual assault offenders serving time in State prisons report that two-thirds of their victims were under the age 18, and 58% of those (nearly 4 in 10 imprisoned violent sex offenders) said their victims were aged 12 or younger. In 90% of the rapes of children less than 12 years old, the child knew the offender. Sixty percent took place in the victim’s home or at the home of a friend, neighbor, or relative. Two-thirds of sex offenders in state prisons victimized a child. For offenders imprisoned for violent crimes against victims younger than 18 (1994), 15% were convicted of forcible rape, 57% were convicted of other types of sexual assault (lewd acts of forcible sodomy, statutory rape, etc.), about thirty percent reported attacks on more than one child, and more than half the victims were younger than 12.
Out of 277 inmate interviews of all prisoners convicted of rape or sexual assault, two-thirds victimized children. Three out of four child victims were female, prisoners convicted of attacking children were mostly male, 97%, and about 22% of the child sex offenders reported having been sexually abused themselves during childhood. Half of the women raped were younger than 18 and 20% were victimized by their father (3).
Children often fail to report because of the fear that disclosure will bring consequences even worse than being victimized again. The victim may fear consequences from the family or feel guilty for consequences to the perpetrator. Victims may also have a feeling that “something is wrong with me,” and that the abused is their fault.
The impact of child sexual abuse is tremendous. It is estimated that there are 60 million survivors of childhood sexual abuse in America, today. Approximately 31% of women in prison state they have been abused as children and about 95% of teenage prostitutes have been sexually abused. Young girls who are forced to have sex are three times more likely to develop psychiatric disorders or abuse alcohol and drugs in adulthood, than girls who are not sexually abused (4).
There are two different types of indicators of sexual abuse, physical indicators and behavioral indicators. Some of the physical indicators are:
1)Torn, stained or bloody underclothes.
2)Frequent, unexplained sore throats, yeast or urinary infections.
3) Bruises or bleeding from external genitalia, vagina, or anal region.
4) Sexual transmitted disease.
Some of the behavioral indicators are:
1)The victim’s disclosure of sexual abuse.
2)Disturbed sleeping pattern.
3)Difficulty in walking or sitting.
4)Avoidance of undressing or wearing extra layers of clothes.
5)Sudden decline in school performance.
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 the 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.
Often there is no physical evidence of sexual abuse for a doctor to find. In fact, physical examinations of children in cases suspected sexual abuse supply grounds for further suspicion only 15-20% of the time (4).
Physical abuse is the nonaccidental infliction of physical injury to a child, such as cut, bruises, welts, and broken bones. 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 U.S. child abuse involved physical abuse (4).
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.
Skulls and other bone fractures are often seen in young abused children, and in fact head injuries are the leading cause of death in abused children.
A few physical indicators of physical abuse are:
1)Unexplained welts or bruises on the face, upper arms, throat, thighs or lower back in unusual patterns or shapes which suggest use of an instrument (electric cord, belt buckle) on an infant in various stages of healing that are seen after absences, weekends, or vacations.
4)Refusal to undress for gym.
Some of the behavioral indicators of physical abuse are:
1)Behavioral extremes- withdrawal, aggression, depression.
2)Unbelievable or inconsistent explanation for the injury.
3)Fear of physical contact-shrinking back if touched.
4)Fear of medical help or examination.
The usual physical abuse scenario involves a parent who loses control and lashes out at a child. The trigger could be a dirty diaper or crying. Unlike nonabusive parent, who may become upset or angry with their children from time to time but are genuinely loving, abusive parents tend to harbor deep-rooted negative feelings toward their children.
Emotional abuse, also known as psychological abuse, according to Richard D. Krugman, “has been defined as the rejection, ignoring, criticizing, isolation, or terrorizing or children, all of which have the effect of eroding their self-esteem”. Emotional abuse usually expresses itself in verbal attacks involving rejection, belittlement, humiliation, and so forth.
Emotional abuse also includes bizarre forms of punishment, such as confinement of a child in a dark closet.
Often psychological abuse accompanies other types of abuse and is difficult to prove. It is rarely reported and accounted for only 6% of the confirmed 1996 cases (3).
A few physical indicators of emotional abuse are:
1)Eating disorders- obesity or anorexia.
2)Nervous disorders- rashes, facial tics, hives, etc.
3)Speech disorders- stuttering, stammering, etc.
4)Flat or bald spots on head (infants).
A few behavioral indicators of psychological abuse are:
1)Age inappropriate behaviors- bedwetting, soiling, etc.
2)Habit disorders- biting, rocking, etc.
3)Cruel behavior- seeming to get pleasure from hurting another child, adult, or animal.
4)Overreaction to mistakes.
Emotional abuse can happen in many different settings: at school, at home, on sports teams, and so on.
The forth and final forms of child abuse is neglect. Neglect is the failure to satisfy a child’s basic needs and can assume many forms. Emotional neglect is the failure to satisfy a child’s normal emotional needs or behavior that damages a child’s normal psychological and emotional development, physical neglect is the failure to provide adequate food, shelter, clothing, or supervision, and 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.
Failing to see that a child receives proper schooling or medical care is also considered neglect. In 1996, neglect was confirmed in over half of the abuse cases (3).
Some physical indicators of neglect include:
1)Poor hygiene- lice, diaper rash, body odor, etc.
2)Lack of immunizations.
3)Untreated injury or illness.
4)Poor state of clothing.
A few behavioral indicators of neglect include:
1)Chronic hunger or tiredness.
2)Assuming adult responsibilities.
3)Unusual school attendance.
4)No social relationships.
Many cases of neglect occur because the parent experiences strong negative feelings toward the child. At other times, the parent may truly care for the child, but lack the ability to adequately provide for the child’s needs due to being handicapped by drug abuse, depression, mental retardation, or other problems. As a result, their physical, emotional, social, and mental development is hindered.
Young children remain at high risk for loss of life. Between 1995 and 1997, 78% of these children were less than five years of age at the time of their death, while 38% were under one year of age. As for cause of death, 44% of deaths resulted from neglect, 51% from physical abuse, and 5% from a combination of neglectful and physically abusive parenting. Approximately 41% of these deaths occurred to children known to child protective service agencies as current or prior clients (5).
Abuse investigators are often a group effort involving medical personnel, police officers, social workers, and others. Careful questioning of the parents is crucial, as is interviewing the child. The investigators must ensure, however, that their questioning does not further traumatize the child. A physical examination for signs of abuse or neglect is, always necessary, and may also include blood tests, x-rays, and other procedures.
If the child has sisters or brothers, the authorities must determine whether they have been abused as well. Signs of physical abuse are discovered in about 20% of the sisters and brothers of abused children (4).
Child abuse can have lifelong consequences. Research shows that abused children and adolescents are more likely, for instance, suffer emotional problems, do poorly in school, abuse drugs and alcohol, and attempt suicide. As adults they have often have trouble establishing intimate relationships.
Notification of the appropriate authorities, treatment of the child’s injuries, and protecting the child from further harm are the immediate priorities in child abuse!
All Figures Based Upon The Following:
1.A Nation’s Shame: Fatal Child Abuse and Neglect in the United States.
2.Child Maltreatment 1998: Reports from the States to the National Child Abuse and Neglect Data System.
5.Wang, C.T. & Daro, D. (1998). Current Trends in Child Abuse Reporting and Fatalities: The results of the 1997 Annual Fifty State Survey.