Child Abuse Health Article

Definition

Child abuse is the 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 United States children. However, in recent years it has received close attention from the media, law enforcement, and the helping professions, and with increased public and professional awareness 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, experts suggest that its true prevalence is possibly much greater than the official data indicate. In 1996, more than three million victims of alleged abuse were reported to child protective services (CPS) agencies in the United States, and the reports were substantiated in more than one million cases. Put another way, 1.5% of the country's children were confirmed victims of abuse in 1996. Parents were the abusers in 77% of the confirmed cases, other relatives in 11%. Sexual abuse was more likely to be committed by males, whereas females were responsible for the majority of neglect cases. More than 1,000 United States children died from abuse in 1996.

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. Charles F. Johnson remarks, "More than 90% of abusing parents have neither psychotic nor criminal personalities. Rather they tend to be lonely, unhappy, angry, young, and single parents who do not plan their pregnancies, have little or no knowledge of child development, and have unrealistic expectations for child behavior." 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.

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 United States child abuse 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. Charles F. Johnson defines child 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." 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, "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, and accounted for only 6% of the confirmed 1996 cases.

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. 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. In 1996 neglect was the finding in 52% of the confirmed abuse cases.