9.2: Child Abuse

Child Abuse

Children are among the most helpless victims of abuse. In 2010, there were more than 3.3 million reports of child abuse involving an estimated 5.9 million children (Child Help 2011). Three-fifths of child abuse reports are made by professionals, including teachers, law enforcement personnel, and social services staff. The rest are made by anonymous sources, other relatives, parents, friends, and neighbors.

Child abuse may come in several forms, the most common being neglect (78.3 percent), followed by physical abuse (10.8 percent), sexual abuse (7.6 percent), psychological maltreatment (7.6 percent), and medical neglect (2.4 percent) (Child Help 2011). Some children suffer from a combination of these forms of abuse. The majority (81.2 percent) of perpetrators are parents; 6.2 percent are other relatives.

It is especially difficult to know how much child abuse occurs. Infants obviously cannot talk, and toddlers and older children who are abused usually do not tell anyone about the abuse. They might not define it as 'abuse,' they might be scared to tell on their parents, they might blame themselves for being abused, or they might not know whom they could talk to about their abuse. Whatever the reason, they usually remain silent, thus making it very difficult to know how much abuse takes place.

Using information from child protective agencies throughout the country, the US Department of Health and Human Services estimates that almost 800,000 children (2008 data) are victims of child abuse and neglect annually (Administration on Children Youth and Families 2010). This figure includes some 122,000 cases of physical abuse; 69,000 cases of sexual abuse; 539,000 cases of neglect; 55,000 cases of psychological maltreatment; and 17,000 cases of medical neglect. The total figure represents about one percent of all children under the age of 18. Obviously this is just the tip of the iceberg, as many cases of child abuse never become known. A 1994 Gallup poll asked adult respondents about physical abuse they suffered as children. Twelve percent said they had been abused (punched, kicked, or choked), yielding an estimate of 23 million adults in the US who were physically abused as children (Moore 1994). Some studies estimate that about 25% of girls and 10% of boys are sexually abused at least once before turning 18 (Garbarino 1989). In a study of a random sample of women in Toronto, Canada, 42% said they had been sexually abused before turning 16 (Randall & Haskell 1995). Whatever the true figure is, most child abuse is committed by parents, stepparents, and other people the children know, not by strangers.

Infants (children less than one year old) were the most victimized population with an incident rate of 20.6 per 1,000 infants. This age group is particularly vulnerable to neglect because they are entirely dependent on parents for care. Some parents do not purposely neglect their children; factors such as cultural values, standard of care in a community, and poverty can lead to hazardous level of neglect. If information or assistance from public or private services are available and a parent fails to use those services, child welfare services may intervene (U.S. Department of Health and Human Services).

Figure 14.9 Dr. Michael C. Irving’s monument for child abuse survivors is composed of handprints and messages of people who have been victims of abuse. (Credit: Harvey K/flickr)

Infants are also often victims of physical abuse, particularly in the form of violent shaking. This type of physical abuse is referred to as shaken-baby syndrome, which describes a group of medical symptoms such as brain swelling and retinal hemorrhage resulting from forcefully shaking or causing impact to an infant’s head. A baby’s cry is the number one trigger for shaking. Parents may find themselves unable to soothe a baby’s concerns and may take their frustration out on the child by shaking him or her violently. Other stress factors, such as a poor economy, unemployment, and general dissatisfaction with parental life, may contribute this type of abuse. While there is no official central registry of shaken-baby syndrome statistics, it is estimated that each year 1,400 babies die or suffer serious injury from being shaken (Barr 2007).

You may have heard that there is a chain of abuse passed from parent to child to grandchild. That may be true, but not if you don't want it to be in your case. Some estimates place it at 1 in 3 sexually abused children grow up to be abusers. Many abuse survivors are meticulous about marrying non-abusers and about over-protecting their children from potential abusers. Based on my professional and private research in the area of surviving abuse, I'd urge you to seek professional help and support for dealing with your childhood traumas. There are numerous free resources including: http://www.ascasupport.org/; www.sexualabusesurvivors.com/; and http://www.providentliving.org/ses/e...2112-1,00.html. Again, it is not your fault. But, healing is your responsibility. It is not enough to simply ignore or deny the abuse. That would be like trying to heal from a 2-inch wood sliver that is lodged in your leg by simply ignoring it.

Sexual abuse is a particularly sinister form of abuse. The American Academy of Child and Adolescent Psychiatry reported that 80,000 cases of child sexual abuse are reported each year in the US with many more cases unreported (retrieved 23 April, 2010 from Child Sexual Abuse, “Facts for Families,” No. 9 (5/08) www.aacap.org/galleries/Facts...xual_abuse.pdf). They list possible symptoms:

“Sexually abused children may also develop the following: unusual interest in or avoidance of all things of a sexual nature, sleep problems or nightmares, depression or withdrawal from friends or family, seductiveness, statements that their bodies are dirty or damaged, or fear that there is something wrong with them in the genital area, refusal to go to school, delinquency/conduct problems, secretiveness, aspects of sexual molestation in drawings, games, fantasies, unusual aggressiveness, or suicidal behavior”

Nowhere in this document (or any professional document based on treating survivors) does it blame the victim. Yet, it does urge adult and child survivors of abuse and their family members to seek out professional help and support.

One way to approach child abuse awareness and prevention as a parent or grandparent is to teach your child a simple rule about their safety. Many of the available programs on child sexual abuse prevention use the “No Touch” style of this rule. I teach my students to teach their children this simple rule-no one should touch you where your shirt and shorts cover your body! That is your “no touch zone.” Don't let anyone touch your chest, tummy, hips, buttocks, between the legs, or thighs. If anyone does, then scream “stop!” And tell your mom or dad, teacher, or other trusted adult. There is a useful PDF file on preventing sexual abuse provided by the Centers for Disease Control at www.cdc.gov/violencepreventio...hildAbuse.html Now you also have to teach them the difference in a family hug and unwanted inappropriate touch. But, teach it! That's where most parents fail in this regard. They don't want to talk about it (especially if their own wounds are unhealed) and they rarely bring it up. Of special concern to me as the father of 5 sons is the increasing trend of adult female to teen male sexual abuse trends. The news regularly broadcast stories of teachers, teacher's aids, coaches, and mothers of the teen's friends who are seducing and raping teen boys. Most states do not prosecute these abuse cases as they would a male adult to female minor case (often called forcible or statutory rape). Both boys and girls should be protected from sexual misconduct by adults with the threat of felony charges for the adult perpetrator.

Recent US data indicates that there were 3,200,000 alleged cases of child abuse in neglect in 2007 (retrieved 23 April, 2010 from www.cdc.gov/violencepreventio...ataSheet-a.pdf). After investigation, about 794,000 were classified as victims. It was reported that 59 percent were neglected, 4 percent suffered emotional abuse, 8 percent suffered sexual abuse, and 11 percent suffered physical abuse. They also reported that girls were slightly more abused than boys (52% to 48%) and that women abused slightly more than men (56% to 42% with some cases the sex of the perpetrator was unknown).

Figure 3 shows child abuse data from 2000-2007 for males, females and total. Again female children were slightly more likely to be abused than males. I find it comforting that the number of substantiated cases declined between 2006-7, but this drop still represents hundreds of thousands of cases. The actual number of cases may be 2 or 3 times that high, since many cases go unreported. Figure 4 shows the specific types of abuse that have occurred. These too are declining yet consistent in their relationship to one another.

Other national studies of child abuse report similar findings (see U.S. Department of Health and Human Services, Administration on Children Youth and Families. Child Maltreatment 2007 [Washington, DC: U.S. Government Printing Office, 2009] available at: www.childwelfare.gov.2.Finkelhor, Ormrod, H, Turner, H, Hamby, S. The Victimization of Children and Youth: A Comprehensive National Survey. Child Maltreatment 2005; 10:5-25.3.Theodore, AD, Chang, JJ, Runyan, DK, Hunter, WM, Bangdewala, SI, Agans,R. Epidemiologic Features of the Physical and Sexual Maltreatment of Children in the Carolinas. Pediatrics 2005; 115: e330-e337).

The US now has a national Child Abuse and Neglect Data System (NCANDS) which is designed to gather more accurate data on child maltreatment. Restricted usage files of state case-level data are available for researchers from the National Data Archive on Child Abuse and Neglect at www.ndacan.cornell.edu In addition, aggregated counts of key indicators by State are available for 1990-2007. The Child Maltreatment reports are available on the Internet at www.acf.hhs.gov programs/cb/stats_research/index.htm#can” (retrieved 23 April,2010 from www.acf.hhs.gov/programs/cb/pubs/cm07/cm07.pdf).

Figure \(\PageIndex{3}\). Numbers of US Child Abuse Cases Substantiated between 2000-2007

Figure \(\PageIndex{4}\). Numbers of US Child Abuse Cases Substantiated between 2000-2007

Figure 5 shows the numbers of child abuse victims by their ages. The 18+ category was less than 1,000 cases per year, but it still occurs. Even children who are old enough to vote get abused sometimes. The highest numbers of abuse cases were found among the 2-5 year olds with rates getting lower and lower for the older children. One website reported that 12 percent of high school girls and 3 percent of boys had been sexually abused (retrieved 23 April, 2010 from www.rainn.org/getinformation/statistics/sexual-assault-victims).

Figure \(\PageIndex{5}\). Numbers of US Child Abuse Cases Substantiated between 2000-2007

Over half of the reports of child maltreatment came from professionals (57%). This report stated that in 2007 about 1,760 children died, mostly from neglect. The World Health Organization published the “World Report on Violence and Health. In 2000 it was estimated that 57,000 children died from maltreatment worldwide (retrieved 23 April, 2010 from www.who.int/violence_injury_p...iolence/global campaign/en/chap3.pdf). 

Child abuse occurs at all socioeconomic and education levels and crosses ethnic and cultural lines. Just as child abuse is often associated with stresses felt by parents, including financial stress, parents who demonstrate resilience to these stresses are less likely to abuse (Samuels 2011). Young parents are typically less capable of coping with stresses, particularly the stress of becoming a new parent. Teenage mothers are more likely to abuse their children than their older counterparts. As a parent’s age increases, the risk of abuse decreases. Children born to mothers who are fifteen years old or younger are twice as likely to be abused or neglected by age five than are children born to mothers ages twenty to twenty-one (George and Lee 1997).

Drug and alcohol use is also a known contributor to child abuse. Children raised by substance abusers have a risk of physical abuse three times greater than other kids, and neglect is four times as prevalent in these families (Child Welfare Information Gateway 2011). Other risk factors include social isolation, depression, low parental education, and a history of being mistreated as a child. Approximately 30 percent of abused children will later abuse their own children (Child Welfare Information Gateway 2006).

The long-term effects of child abuse impact the physical, mental, and emotional wellbeing of a child. Injury, poor health, and mental instability occur at a high rate in this group, with 80 percent meeting the criteria of one or more psychiatric disorders, such as depression, anxiety, or suicidal behavior, by age twenty-one. Abused children may also suffer from cognitive and social difficulties. Behavioral consequences will affect most, but not all, of child abuse victims. Children of abuse are 25 percent more likely, as adolescents, to suffer from difficulties like poor academic performance and teen pregnancy, or to engage in behaviors like drug abuse and general delinquency. They are also more likely to participate in risky sexual acts that increase their chances of contracting a sexually transmitted disease (Child Welfare Information Gateway 2006). Other risky behaviors include drug and alcohol abuse. As these consequences can affect the health care, education, and criminal systems, the problems resulting from child abuse do not just belong to the child and family, but to society as a whole.

Social Policy and Debate

Corporal Punishment

Physical abuse in children may come in the form of beating, kicking, throwing, choking, hitting with objects, burning, or other methods. Injury inflicted by such behavior is considered abuse even if the parent or caregiver did not intend to harm the child. Other types of physical contact that are characterized as discipline (spanking, for example) are not considered abuse as long as no injury results (Child Welfare Information Gateway 2008).

This issue is rather controversial among modern-day people in the United States. While some parents feel that physical discipline, or corporal punishment, is an effective way to respond to bad behavior, others feel that it is a form of abuse. According to a poll conducted by ABC News, 65 percent of respondents approve of spanking and 50 percent said that they sometimes spank their child.

Tendency toward physical punishment may be affected by culture and education. Those who live in the South are more likely than those who live in other regions to spank their child. Those who do not have a college education are also more likely to spank their child (Crandall 2011). Currently, 23 states officially allow spanking in the school system; however, many parents may object and school officials must follow a set of clear guidelines when administering this type of punishment (Crandall 2011). Studies have shown that spanking is not an effective form of punishment and may lead to aggression by the victim, particularly in those who are spanked at a young age (Berlin 2009).

Children and Our Future: Is Spanking a Good Idea?

As the text discusses, spanking underlies many episodes of child abuse. Nonetheless, many Americans approve of spanking. In the 2010 General Social Survey, 69% of respondents agreed that “it is sometimes necessary to discipline a child with a good, hard, spanking.” Reflecting this “spare the rod and spoil the child” belief, most parents have spanked their children. National survey evidence finds that two-thirds of parents of toddlers ages 19–35 months have spanked their child at least once, and one-fourth spank their child sometimes or often.

The reason that many people approve of spanking and that many parents spank is clear: They believe that spanking will teach a child a lesson and improve a child’s behavior and/or attitude. However, most child and parenting experts believe the opposite is true. When children are spanked, they say, and especially when they are spanked regularly, they are more likely to misbehave as a result. If so, spanking ironically produces the opposite result from what a parent intends.

Spanking has this effect for several reasons. First, it teaches children that they should behave to avoid being punished. This lesson makes children more likely to misbehave if they think they will not get caught, as they’d not learn to behave for its own sake. Second, spanking also teaches children that it is okay to hit someone to solve an interpersonal dispute and even to hit someone if you love her or him, because that is what spanking is all about. Third, children who are spanked may come to resent their parents and thus be more likely to misbehave because their bond with their parents weakens.

This harmful effect of spanking is especially likely when spanking is frequent. As Alan Kazin, a former president of the American Psychological Association (APA) explains, “Corporal punishment has really serious side effects. Children who are hit become more aggressive.” When spanking is rare, this effect may or may not occur, according to research on this issue, but this research also finds that other forms of discipline are as effective as a rare spanking in teaching a child to behave. This fact leads Kazin to say that even rare spanking should be avoided. “It suppresses [misbehavior] momentarily. But you haven’t really changed its probability of occurring. Physical punishment is not needed to change behavior. It’s just not needed.”

Why does child abuse occur? Structurally speaking, children are another powerless group and, as such, are easy targets of violence. Moreover, the best evidence indicates that child abuse is more common in poorer families. The stress these families suffer from their poverty is thought to be a major reason for the child abuse occurring within them (Gosselin, 2010). As with spousal violence, then, economic inequality is partly to blame for child abuse. Cultural values and practices also matter. In a nation where spanking is common, it is inevitable that physical child abuse will occur, because there is a very thin line between a hard spanking and physical abuse: Not everyone defines a good, hard spanking in the same way. As two family violence scholars once noted, “Although most physical punishment [of children] does not turn into physical abuse, most physical abuse begins as ordinary physical punishment” (Wauchope & Straus 1990: 147).

Abused children are much more likely than children who are not abused to end up with various developmental, psychological, and behavioral problems throughout their life course. In particular, they are more likely to be aggressive, to use alcohol and other drugs, to be anxious and depressed, and to get divorced if they marry (Trickett, Noll, & Putnam 2011).