Child abuse

Definition

Child abuse and neglect is “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.” (From the Child Abuse Prevention and Treatment Act; CAPTA – see http://nccanch.acf.hhs.gov/index.cfm). Child abuse is often synonymous with the term child maltreatment or the term child abuse and neglect.

There are different forms of neglect and abuse 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. 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.

Child Abuse and Corporal Punishment

Child abuse is sometimes closely connected with the term corporal punishment. “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.” (see http://www.childadvocate.org/1a.htm).

Corporal punishment can include spanking, slapping, smacking or paddling, and it defers from the child abuse in that it does not meet the legal requirement for the definition of abuse. The distinctive line between corporal punishment and abuse is sometimes very dim. Something that in one state or country can be characterized as corporal punishment in other can be seen as abuse. Because of this intricacy many countries completely ban use of corporal punishment.

Risk Factors in Child Abuse

Several factors are identified that increase the risk of child abuse.

TABLE 2 Risk Factors for Child Abuse Community/societal• High crime rate• Lack of or few social services• High poverty rate• High unemployment rate 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 Parent-related (continued)• 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 Child-related• Prematurity• Low birth weight• Handicap

Identifying Child Abuse

1) 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. Physical indicators of abuse are (from Medline [2]):

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
Survivors of childhood abuse often report feelings of anger and helplessness towards their abusers.

Some other types of injuries 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.

2) Emotional abuse

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

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

3) 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 child, making child watch pornographic material); watching or spying on the naked child; using child for pornographic purposes (films, photos); child prostitution.

Several myths exist about sexual abuse – a) Offender is a stranger to the child. This is a myth because the majority of child abusers know their victims, working as daycare workers or teachers, being even child’s relatives or parents. b) Dirty Old Man. In reality most of the sexual offenders are younger than 40, 80% commit their first offense by the age of 30. c) Sexual offenders are insane. This is not supported by research. d) Sexual offenders are also substance abusers. Only 30% are substance abusers e) Sexual offenders are 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 trust of the child, relating to the child as his favorite one, and alienating the child from the rest of the people. At the end of this stage boundaries between the child and the offender are violated. 2) Sexual Interaction – offender chooses time and place, uses bribes or threats to make child do what he wants child to do, and offense takes place. 3) Disclosure – child accidentally or purposefully discloses something about sexual abuse event. This usually results in some kind of family crisis. 4) Suppression – family system tries to maintain a status quo, belittling what happened through covert or overt pressure on the victim to retract the disclosure.

4) Neglect

Neglect can be defined as a failure of the caregiver to provide for the child's basic needs. Neglect thus can be a) Physical (failure to provide food, appropriate clothes, or housing; failure to provide adequate hygiene) b) Emotional (failure to provide affection or love; substance abuse or domestic violence in front of a child). c) Educational (failure to enroll or maintain child in mandatory school programs). d) Medical (failure to provide adequate medical attention or mental health needs) e) Safety (failure to provide adequate supervision; abandonment; expulsion from home; putting 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.

The 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 mental 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, perpetrating on that way sexual deviance.

Neglect may result in low self-esteem and the sense of worthlessness. Children who are neglected in the longer period 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 leave significant brain damage, due to insufficient stimuli that brain requires for normal development.

History of Child Abuse Laws in US

The first recorded case of child abuse was the one of 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. Interestingly enough, there were laws against animal cruelty. It was exactly due to those laws that Mary Ellen could be saved. However, it took more than a century that people started to recognize the importance of child abuse laws. In 1960s and 1980s some important legislation was brought to protect abused children. Finally child abuse was recognized as important social problem. Next ten years, however, took whole matter too far. The 1990s witnessed total hysteria in application of child abuse laws, with false accusations, child-abuse scandals in day-care centers or religious communities, and suggestibility of child witnesses, filling the newspaper columns. In 2000s, fortunately the pendulum swung one step beck. Child protective agencies seem to be more understanding toward both children and their parents, and child abuse is viewed more as family’s, than only as parent’s problem. The solutions and treatments against child abuse are also sought within the family system as a whole.

Today, it is still estimated that more than 3 million reports of child abuse and neglect, are received annually by state, and only in 2001 more than 900,000 children were found to be victims of child abuse.

Reporting abuse and neglect in the US

Anyone in the U.S. may make an anonymous report of abuse or neglect. Most states have a toll-free hotline staffed by trained call screeners. When you call, 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 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, someone will investigate 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, childcare 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. 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.

Depending on the state, different names are used for agencies responsible for investigating child abuse. These agencies may be called Child Protective Services (CPS), Department of Children and Family Services (DCFS), or any 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 caseworker.

Child Abuse in Other Countries

Conclusion

External links

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