Child Abuse Health Article

Definition

Child abuse is a blanket term for four types of child mistreatment: physical abuse, sexual abuse, emotional abuse, and neglect. In many cases children are the victims of more than one type of abuse. The abusers can be parents or other family members, caretakers such as teachers and babysitters, acquaintances (including other children), and (in rare instances) strangers.

Prevalence of abuse

Child abuse was once viewed as a minor social problem affecting only a handful of children in the United States. In recent years, however, it has received close attention from the media, law enforcement, and the helping professions, and with this has come a sharp rise in the number of reported cases. But because abuse is often hidden from view and its victims too young or fearful to speak out, some experts suggest that its true prevalence may be much greater than the official data indicate. In 1999, Child Protective Service (CPS) agencies investigated 3 million reports that involved the maltreatment of approximately 4 million children.

The CPS ranks neglect as the most common form of child maltreatment, comprising an estimated 54% of investigations in 1997. Physical abuse accounted for 24%; sexual abuse, 13%; emotional maltreatment, 6%; and medical neglect, 2%. Many children suffer more than one type of maltreatment.

Although experts are quick to point out that abuse occurs among all social, ethnic, and income groups, reported cases usually involve poor families with little education. Young mothers, single-parent families, and parental alcohol or drug abuse are also common in reported cases. According to recent statistics, more than 90% of abusing parents have neither psychotic nor criminal personalities. Rather, they tend to be lonely, unhappy, angry, young, single parents who do not plan their pregnancies. About 10%, or perhaps as many as 40%, of abusive parents were themselves physically abused as children, but most abused children do not grow up to be abusive parents.

Additional factors that contribute to child abuse include lack of parenting skills, unrealistic expectations about children's behavior and capabilities, social isolation, and frequent family crises. Child abuse is a symptom that parents are having difficulty coping with their situation.

In 1999, the majority of child abusers (75%) were parents, and another 10% were other relatives of the victim. About 13% of all perpetrators were classified as noncaretakers or unknown. People who were in other caretaking relationships to the victim (e.g., child care providers, foster parents, and facility staff) accounted for only 2% of perpetrators. In many states, perpetrators of child maltreatment by definition must be in a caretaking role.

Types of abuse

PHYSICAL ABUSE. Physical abuse is the nonaccidental infliction of physical injury to a child. 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 child abuse in the United States involved physical abuse. 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.

SEXUAL ABUSE. Child sexual abuse is defined as any activity with a child under the age of legal consent that is for the sexual gratification of an adult or a significantly older child. It includes, among other things, sexual touching and penetration, persuading a child to expose his or her sexual organs, and allowing a child to view pornography. In most cases the child is related to or knows the abuser, and about one in five abusers are themselves underage. Sexual abuse was present in 12% of the confirmed 1996 abuse cases. An estimated 20–25% of females and 10–15% of males report that they were sexually abused by age 18.

EMOTIONAL ABUSE. Emotional abuse, according to Richard D. Krugman, director of the Kempe Center in Denver, "has been defined as the rejection, ignoring, criticizing, isolation, or terrorizing of children, all of which have the effect of eroding their self-esteem." Emotional abuse usually expresses itself in verbal attacks involving rejection, scapegoating, belittlement, and so forth. Because it often accompanies other types of abuse and is difficult to prove, it is rarely reported.

NEGLECT. Neglect—failure to satisfy a child's basic needs—can assume many forms. Physical neglect is the failure (beyond the constraints imposed by poverty) to provide adequate food, clothing, shelter, or supervision for a child. Emotional neglect is the failure to satisfy a child's normal emotional needs, or behavior that damages a child's normal emotional and psychological development (such as permitting drug abuse in the home). Failing to see that a child receives proper schooling or medical care is also considered neglect. Neglect was found in 52% of 1996 abuse cases.