Child abuse

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Child abuse is an act, or failure to act, that endangers a child's physical or emotional health and development. Child abusers inflict physical, sexual, and emotional trauma on defenseless children. Victims of child abuse often become abusers themselves, continuing the cycle. While laws have been enacted in most countries making such abuse a crime, many cultures regard parenting as a private, family affair, which leads to significant underreporting. Even so, agencies designed to deal with child abuse victims and perpetrators are overwhelmed by the numbers of cases that are reported. Confusion with corporal punishment, which is disciplinary in nature and not intended to have severe or long-term effects, also hampers prevention and reporting.

Contents

Efforts to prevent child abuse involve support through social services, education, and counseling on the individual (child), family, community, and societal levels. The solution to the widespread phenomenon of child abuse cannot be found in legislation, or in merely stopping abuse that has already damaged a child. Human beings should develop the heart of true parents to properly raise children.

Definition

Child abuse and neglect, also known as cruelty to children or child maltreatment, is defined as:

any recent act or failure to act on the part of a parent or caretaker, which results in death, serious physical or emotional harm, sexual abuse or exploitation, or an act or failure to act which presents an imminent risk of serious harm.(Child Abuse Prevention and Treatment Act (CAPTA)

There are several different forms of neglect and abuse, and many governments have developed their own legal definitions of what constitutes child maltreatment for the purposes of removing a child and/or prosecuting a criminal charge. The United States Federal Government has published a full definition of child abuse and neglect, including a summary of each state's definition. (See Definitions of Child Abuse and Neglect: Summary of State Laws.)

Child Abuse and Corporal Punishment

Child abuse is sometimes closely connected with "corporal punishment" which is defined as follows:

Corporal punishment is any action on the part of an adult or caretaker that intentionally inflicts, or causes to result, pain or physiological discomfort in a person under the age of 18 for the purposes of punishment or containment (Couture 2000).

Corporal punishment can include spanking, slapping, smacking, paddling, or "strapping" with a belt. The results of such punishment should be only mild bruising and no permanent damage. Thus, it differs from child abuse in that it does not result in the level of harm to the child required to meet the legal definition of abuse. The distinctive line between corporal punishment and abuse is sometimes very slim. Something that in one state or country may be characterized as corporal punishment, in others might be regarded as abuse. Because of this, many countries have completely banned the use of corporal punishment.

Identifying Child Abuse

Child abuse can generally be divided into four types: Physical Abuse, Emotional Abuse, Sexual Abuse, and Neglect. However, it is often the case that children suffer more than one type of abuse from the same abuser.

Physical Abuse

Physical abuse is the easiest form of maltreatment to identify. The only challenge for the investigator is to determine whether the injuries are accidental or due to abuse. Typical indicators of abuse (from Medline [1]) include:

  • Injuries that do not fit the given explanation or time frames
  • Unusual and unexplained bone fractures
  • Bruise marks shaped like hands, fingers, or objects (such as a belt), or unexplained bruises in areas where normal childhood activities would not usually result in bruising
  • Specific patterns of scalding, seen when a child is immersed in hot water as a punishment—particularly "glove" or "sock" burn patterns
  • Burns from an electric stove, radiator, heater, or other hot objects, usually seen on the child's hands, arms, or buttocks
  • Cigarette burns on exposed areas or the genitals
  • Black eyes in an infant or a similar, unexplained injury in a child
  • Human bite marks
  • Lash marks
  • Choke marks around neck
  • Circular marks around wrists or ankles (indicating twisting or tying up)
  • Separated sutures
  • Bulging fontanelle
  • Evidence of unexplained abdominal injury (such as bruised or ruptured intestines due to punching)
  • Unexplained unconsciousness in infant

Typical injuries sustained by abused children include:

  • Bleeding in the back of the eye, seen with shaken baby syndrome or a direct blow to the head
  • Internal damage, such as bleeding or rupture of an organ from blunt trauma
  • Any fracture in an infant too young to walk or crawl
  • Evidence of fractures at the tip of long bones or spiral-type fractures that result from twisting
  • Fractured ribs, specially in the back
  • Evidence of skull fracture (multiple fractures of different ages may be present)
  • Subdural hematoma (collection of blood in the brain) without plausible explanation
  • Multiple bruises of different ages, especially in unusual areas of the body (e.g., not the shins) or in patterns suggesting choking, twisting, or severe beating with objects or hands.

Emotional Abuse

Emotional abuse is one of the hardest to identify. Generally speaking, emotional abuse can be described as the systematic, intentional, and slow process of breaking down a child’s self-concept. This includes rejecting the child, ignoring the child’s needs, isolating the child, enforcing deviant behavior, threatening or terrorizing the child, and name-calling or other verbal abuse. All these prevent the normal emotional development of the child.

Emotional abuse can be identified based on the parent’s behavior: describes child as “different,” belittles or humiliates the child in front of others, exhibits excessive demands, blames the child for different reasons, uses the child as a vehicle for marital fighting, makes the child watch violence, destroys the child’s possessions, etc.; or from the child’s behavior: manipulative, withdrawn, timid, disruptive, overly demanding, fearful of caregiver, depressed, willfully injuring animals, firesetting, etc.

Sexual Abuse

Main article: Sexual abuse

Sexual abuse can be defined as any sexual act between an adult and a child. It includes stroking or kissing a child's genitals or making a child do the same to the adult’s; intercourse, incest, rape, oral sex, or sodomy with the child; exposing the child to sexual content (undressing in front of the child, making the child watch pornographic material); watching or spying on the naked child; using the child for pornographic purposes (films, photos); child prostitution.

Several myths exist about sexual abuse:

  1. Offender is a stranger to the child. In fact the majority of child abusers know their victims, working as daycare workers or teachers, even the child’s relatives or parents.
  2. Dirty Old Man. In reality most sexual offenders are younger than 40, and 80 percent commit their first offense by the age of 30.
  3. Sexual offenders are insane. This is not supported by research.
  4. Sexual offenders are also substance abusers. Only 30 percent are substance abusers.
  5. Sexual offenders are always male. There are also female sex offenders.

Sexual abuse is often a slow and gradual process, rather than rape or forcible contact. It typically progresses through four stages:

  1. Engagement: Offender tries to build the child's trust, relating to the child as his favorite one, and alienating the child from other people. At the end of this stage, the boundaries between the child and the offender are violated.
  2. Sexual Interaction: Offender chooses time and place, uses bribes or threats to make the child do what he wants child to do, and the offense takes place.
  3. Disclosure: Child accidentally or purposefully discloses something about a sexual abuse event. This usually results in some kind of family crisis.
  4. Suppression: Family system tries to maintain the status quo, belittling what happened through covert or overt pressure on the victim to retract the disclosure.

Neglect

Neglect can be defined as a failure of the caregiver to provide for the child's basic needs. Neglect thus can be:

  1. Physical: Failure to provide food, appropriate clothes, housing, or adequate hygiene.
  2. Emotional: Failure to provide affection or love; substance abuse or domestic violence in front of the child.
  3. Educational: Failure to enroll or maintain the child in mandatory school programs.
  4. Medical: Failure to provide adequate medical attention or mental health needs.
  5. Safety: Failure to provide adequate supervision; abandonment; expulsion from home; putting the child in a dangerous situation.

Effects of Child Abuse

The effects of abuse depend on the severity and frequency, as well as the type of abuse.

Physical abuse may result not only in physical injuries and body defects, but in difficulties of children to build trustful relationships, or later to develop physical closeness and intimate personal relationships in adulthood. Such children may exhibit higher levels of anxiety or depression, accompanied with problems at school or work. Often they themselves become abusive parents or caregivers.

Emotional abuse often results in various behavioral, emotional, or psychological problems.

Sexual abuse may result in difficulties of the victim to relate sexually in intimate relationships. The victim may develop distorted views on sexuality, or even deviant sexual behavior, or various types of mental problems. Children who were sexually abused are seen to exhibit sexual behavior toward their peers, thus perpetrating sexual deviance.

Neglect may result in low self-esteem and the sense of worthlessness. Children who are neglected over long periods of time may have developmental delays (especially in language), or may exhibit higher levels of anxious attachment. Neglected children typically learn to be passive, and tend toward helplessness under stress. Neglect may result in significant brain damage, due to lack of sufficient stimulation required for normal development.

Risk Factors in Child Abuse

Since children may suffer more than one type of abuse, simple cause-and-effect models, asking only about the isolated set of personal characteristics that might cause parents to abuse or neglect their children, are too limited to provide accurate predictors of child abuse.

The National Research Council's Panel on Research on Child Abuse and Neglect has developed an "ecologic" model, that considers the origin of all forms of child abuse to be a complex interactive process, involving a system of risk and protective factors interacting across four levels: (1) the individual, (2) the family, (3) the community, and (4) the society (Bethea 1999). The factors thought to contribute to the development of physical and emotional abuse and neglect are listed below.

  1. Child-related
    • Prematurity
    • Low birth weight
    • Handicap
  2. Parent-related
    • Personal history of physical or sexual abuse as a child
    • Teenage parents
    • Single parent
    • Emotional immaturity
    • Poor coping skills
    • Low self-esteem
    • Personal history of substance abuse
    • Known history of child abuse
    • Lack of social support
    • Domestic violence
    • Lack of parenting skills
    • Lack of preparation for the extreme stress of having a new infant
    • History of depression or other mental health problems
    • Multiple young children
    • Unwanted pregnancy
    • Denial of pregnancy
  3. Community/societal

History of Child Abuse Laws in USA

The first recorded case of child abuse was of a nine-year-old girl, Mary Ellen Wilson, in 1874. Mary Ellen was severely neglected by her parents, but nobody could do anything about it since there were no laws to protect children. However, there were laws against animal cruelty, and it was due to those laws that Mary Ellen could be saved. Even so, it took more than a century for people to recognize the importance of child abuse laws. In the 1960s and 1980s important legislation was introduced to protect abused children. Finally, child abuse was recognized as an important social problem.

Unfortunately, however, the 1990s witnessed an excessive application of child abuse laws. False accusations, child-abuse scandals in day-care centers and religious communities, and situations involving the suggestibility of child witnesses were rampant.

By the beginning of the twenty-first century, fortunately, the pendulum swung one step back. Child protective agencies became more understanding toward both children and their parents, and child abuse was viewed more as a family problem, not just a problem of the parents. Solutions and treatments for child abuse were also sought within the family system as a whole.

Reporting abuse and neglect

Anyone in the U.S. may make an anonymous report of abuse or neglect to the appropriate agency, which may be called "Child Protective Services" (CPS), "Department of Children and Family Services" (DCFS), or a similar name. Most states have a toll-free hotline staffed by trained call screeners, who 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 enough to open a case, but a detailed report about a potentially serious case, or multiple reports (by different reporters), may be enough. At that point, a children's social worker (CSW) or a caseworker investigates the family. The investigators may determine: (1) that there is no evidence of maltreatment (unsubstantiated), (2) that there is enough evidence to offer support to the family in the home (supportive case), or (3) that there is evidence enough to remove the child from the home (protective case).

Some people who work with children are mandated reporters. Each U.S. State designates individuals, typically by professional 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 states also mandate animal control officers, veterinarians, commercial film or photograph processors, substance abuse counselors, and firefighters to report abuse or neglect.

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.

Child Abuse in Other Countries

Different countries around the world have developed various laws, all very similar in content, which protect children from abuse. The history of development of those laws is also very similar. UNICEF plays an important role in education about children’s rights, as well as detection and reporting of child abuse.

In Ireland, for example, children were protected by the Children’s Act of 1908, but that law was not effective in actually preventing abuse, since there was another law that gave parents the right to use corporal punishment in disciplining their children. Child abuse, as a frequent consequence of corporal punishment, was therefore often not reported. It was only in the 1980s that corporal punishment was banned from schools, and that its correlation with child abuse started to be investigated. Great Britain, Canada, and Australia also have well developed laws, similar to those in the USA, that protect children against abuse.

In Japan, the number of cases in which the National Child Guidance Clinic intervened increased from 1,171 in 1991 to 17,725 in 2000 (Kayama et al. 2004). This increase was the consequence of societal changes toward more open family systems. Traditional Japanese society was characterized by closed family systems, where outsiders were reluctant to interfere with others’ child-rearing practices. Families simply kept their family problems to themselves. Reporting child abuse was thus rare. However, as Japanese society changed, the approach toward child abuse identification and reporting also changed.

Similarly, most Asian, African, and South American cultures held that child-rearing is a private family matter, and thus should not be interfered with. Even though many countries from those areas have developed their own, or adopted Western legislation that protects children from child abuse, many of these laws exist only on paper, due to closed, rather traditional, family beliefs and practices.

Treatment and Prevention

Treatment

Despite the continued tendency for child abuse to be underreported, enormous numbers of child abuse cases are reported in the United States and other countries each year. The success of treatment of both victim and perpetrator depends on the causes, duration, and types of abuse. Victims of prolonged abuse of any type suffer serious consequences that are often irreversible. Long-term counseling is often needed to overcome emotional and psychological problems. Victims of sexual abuse often continue to have sexual difficulties throughout their lives.

Parents who abuse their children because of their own emotional difficulties, lack of parenting skills, or substance abuse problems may be successfully treated by receiving support, counseling, and parenting education. In cases where the victims have been removed from the home, parents may be required to complete parenting courses and undergo counseling prior to being reunited with their children. However, many parents are victims of abuse themselves, and repeat the pattern in the belief that such behavior is normal. Sexual abusers are also difficult to treat, having often suffered sexual abuse as children themselves.

Thus, treatment of both victims and perpetrators of child abuse has only limited success even with long-term programs which, coupled with the large number of cases, overwhelm the agencies responsible.

Prevention

Laws and reporting mechanisms are important to protect victims of abuse. However, they cannot be expected to succeed in preventing it. The treatment of perpetrators of child abuse is important not only for the well-being of the abusers, but also as preventive measures to protect victims from future occurrences. Removal of children from their home environment after abuse may prevent future occurrences by the same perpetrators, but separation from their parents is traumatic in itself. Unless an alternative, loving family is available, such children are at risk for failure to develop trusting, loving relationships for the rest of their lives. Given the suffering and long-term consequences caused by child abuse, and the limited efficacy of treatment options, the best solution is to prevent any occurrence of child abuse. This is known as primary prevention.

Primary prevention should be implemented on many levels before it can be successful. Strategies on the societal level include increasing the "value" of children, increasing the economic self-sufficiency of families, discouraging corporal punishment and other forms of violence, making health care more accessible and affordable, expanding and improving coordination of social services, improving the identification and treatment of psychological problems like alcohol and drug abuse, providing more affordable child care, and preventing the birth of unwanted children. Strategies on the familial level include helping parents meet their basic needs, identifying problems of substance abuse and spouse abuse, and educating parents about child behavior, discipline, safety, and development (Bethea 1999).

Conclusion

The twentieth century witnessed serious developments toward better understanding, identification, prevention, and treatment of victims of child abuse. Laws and reporting procedures have been put in place that protect the victims. We have gained important knowledge concerning the different factors that play a role in child abuse.

There is not only one cause that leads to child abuse, for example, the parent’s attitude, or the child’s temperament. Rather, child abuse is a complex result of various interacting risk factors. Four levels of factors are involved: individual (child), family, community, and the society as a whole. Understanding, preventing, and treating child abuse must take into consideration all four levels.

The solution to the widespread phenomenon of child abuse cannot be found in legislation. Primary prevention is the key; and successful primary prevention means that human beings should reach maturity and come to value all children as the future of humankind, giving them true, parental love.

Bibliography

  • Bethea, Lesa. 1999. Primary Prevention of Child Abuse. The American Academy of Family Physicians.
  • Couture, A. Laurie. 2000. Definitions.
  • Gabrielle, V.L. 2003. "Cross Cultural Transferability in Child Protection: Challenges and Opportunities" in Child Abuse Review, 12[4]: 238–250.
  • Kayama, M., A. Sagami, Y. Watanabe, E. Senoo, and M. Ohara. 2004. "Child Abuse Prevention in Japan: An Approach to Screening and Intervention with Mothers" in Public Health Nursing, 21[6]: 513–518.

External links

All links retrieved May 15, 2013.

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