Child Abuse

The act of harming children by neglect, physical force, violence, sexual attack, or by inflicting psychological or emotional distress.

For much of history, children were considered the property of parents. The family system was rarely, if ever, intervened upon by society. If a mother or father routinely abused their children, the abuse went unnoticed, or if noticed, merely ignored. It was largely considered a parent's prerogative to do whatever he or she wanted with their child.

Over the past several decades, however, the issue and, seemingly, the prevalence of child abuse have become widespread. Psychologists question whether the number of child abuse cases indicates increased occurrences of abuse or increased public awareness that encourages more reporting.

The first detailed account of the abuse of children was published in 1962 by Harry Hemke in an article titled "The Battered Child Syndrome," and since then there have been numerous articles and books published on this subject.

Over the years, child abuse has been categorized into four types, although many psychologists dispute the usefulness of doing so. In compiling statistics on abuse, the

HOTLINES

The following organizations operate hotlines or provide advice for family members where there are problems related to physical or other abuse.

• Childhelp National Abuse Hotline
  Telephone: toll-free (800) 422-4453
• National Coalition Against Domestic Violence
  Telephone: (303) 839-1852
• National Council on Child Abuse and Family Violence
  Telephone: toll-free (800) 222-2000
• National Victim Center
  Telephone: toll-free (800) FYI-CALL [394-2255]
• National Runaway Switchboard
  Telephone: toll-free (800) 621-4000

United States Department of Health and Human Services (HHS) considers four categories of abuse: neglect, physical abuse, sexual abuse, and emotional maltreatment. Obviously, these categories are not mutually exclusive (that is, any given child can experience one or all, and all types of abuse are forms of "emotional maltreatment").

Statistically, it is difficult to find reliable national figures for cases of child abuse because each state keeps its own records and has its own definitions of what constitutes abuse. Nonetheless, several organizations do compile national estimates of abuse and neglect. One of the most commonly cited reports comes from Prevent Child Abuse America, formerly known as the National Committee for the Prevention of Child Abuse headquartered in Chicago, which conducts an annual national survey of the 50 states to acquire the most current data available.

An estimated 3,154,000 children were reported to child protective service agencies as alleged victims of child abuse or neglect in 1998, with about 1 million of the reports confirmed. This means that 45 children out of 1,000 were reported as abused or neglected and 14 confirmed as abused or neglected in 1998. On average, three children died each day in the United States from abuse or neglect in 1997. While the nation's overall crime rate fell from 1993 to 1997 by 22 percent, reports of child abuse and neglect increased by 8 percent with confirmed cases increasing by 4 percent.

In 1998, 51 percent of the cases reported involved neglect, 25 percent involved physical abuse, 10 percent involved sexual abuse, 3 percent involved emotional abuse and 11 percent related to other forms of child maltreatment. These figures represent substantiated cases, meaning they were investigated by child protection services and found valid. Like any statistics on child abuse, these must be considered incomplete, since not all cases of abuse are reported.

Strong social and familial pressure may continue to exist to avoid the issue when abuse is seen; however, requirements that professionals, such as doctors, teachers, and therapists who work with children, report suspicions of abuse have helped to make public health system intervention more widely accepted by society.

Still, newly arrived immigrants not yet acculturated in the United States may, to their surprise, face social service intervention for their cultural practices toward children, deemed as child abuse in the United States.

Despite myths about its prevalence among lower-income populations, child abuse occurs throughout all strata of society. Physical abuse does appear more frequently in poor families. Since middle-class and wealthy families are more likely to have their children treated by a sympathetic personal physician who may be less likely

Child abuse symptoms. (Stanley Publishing. Reproduced with permission.)

to diagnose and report injuries as child abuse, numbers reported may be biased. Even with such reporting bias, however, poverty seems strongly linked to abuse.

Child abuse is also linked to parental use of alcohol or other drugs. Several studies conducted during the 1970s confirmed that nearly 70 percent of substantiated cases of abuse were related to alcohol.

Anger most frequently triggers abuse by parents. Abusive parents appear to have a lower threshold for childish behaviors than nonabusive parents. The same child cues triggers more upset in abusive parents than in nonabusive parents. Most abusers are likely to have been abused themselves and generally resort to violence to cope with life stressors. Their abusive actions can be seen as subconscious reactions to an array of stressful aspects of parenting, including disappointment in the gender or appearance of a child; a jealous reaction to the attention a child diverts from themselves; an attempt by the abuser to hurt the other parent; or a reaction against the child for failing to meet unrealistic expectations.

Pedophiles, or sexual abusers of children, occur across all economic and cultural groups. Psychologically, however, they share certain traits. Pedophiles often have a history of being abused themselves, and abusing other children seems to be triggered by increased life stressors, such as marital problems, job layoffs, or abuse of drugs.

About 60 percent of the major physical injuries inflicted by caregivers occur in children ages birth to 4, the age group most likely to be injured from abuse.

Typically, abused children show developmental delays by preschool age. It is unclear whether these delays occur due to cumulative neurological damage or due to inadequate stimulation and uncertainty in the child about the learning environment and the absence of positive parental interactions that would stimulate language and motor processes. These delays, in concert with their parents' higher-than-normal expectations for their children's self-care and self-control abilities, may provoke additional abuse. Abused preschoolers respond to peers and other adults with more aggression and anger than do non-abused children. A coercive cycle frequently develops where parents and children mutually control one another with threats of negative behavior.

School-aged children who are abused typically have problems academically with poorer grades and performance on standardized achievement tests. Studies of abused children's intellectual performance find lower scores in both verbal and performance (e.g., math, visual-spatial) areas. Abused children also toward distractibility and over activity, making school a very difficult environment for them. With their peers, abused children are often more aggressive and more likely to be socially rejected than nonabused children. Less mature socially, abused children show difficulty in developing trusting relationships with others.

Within the home, abused children are more disruptive and aggressive, frequently viewed by their parents as defiant and noncompliant. Although observational measures confirm higher levels of disruptiveness, the number and intensity of the problem behaviors seen by abusive parents in their children may be partially a function of the parents' lower threshold of tolerance for children's noncompliance.

As adolescents, abused children are more likely to be in contact with the juvenile justice system than nonabused children of comparable family constellation and income level. Many of these children are labeled "ungovernable" for committing offenses such as running away and truancy. A higher proportion of abused than nonabused delinquent youth are also involved in crimes of assault.

Follow-up studies on abused children in later adolescence show that in addition to having problems with the law, they are also more likely to be substance abusers or to have emotional disturbances such as depression.

Over the last several years, many consider the number of child abuse reportings to be at epidemic levels. As reported in The CQ Researcher in 1993, "Almost overnight, the national consciousness has been jolted into confronting a disturbing possibility: Incest and child molestation may be far more common than previously thought." This increased reporting of sexual abuse has become a highly contentious topic among the psychological community and in the media as well. Many find the reports a reflection of a sexually disturbed society, while others believe that increased reporting is the result of sensationalist media accounts, celebrity pronouncements about their own abuse, and over-zealous therapists who too readily suggest to patients that episodes of sexual abuse may lay at the heart of their other problems.

Another disturbing trend shows an increase in reports of ritual abuse, or satanic ritual abuse (SRA), in which, it is alleged, children are systematically and repeatedly tortured by friends and family members in elaborate Satanic ceremonies often involving human sacrifice and ritual rape. Writing in The Journal of Psychohistory in 1994, psychoanalyst David Lotto reported that at a recent convention of the American Psychological Association, 800 therapists reported that they were currently treating cases of ritual abuse. A 1988 study conducted by University of New Hampshire researcher David Finkelhor found that as many as 13% of child abuse allegations occurring at day care centers involved ritual abuse. Another report followed the cases of 24 ritual abuse trials and found that 23 people had been convicted of some kind of abuse. In looking at this phenomenon critically, however, please note, as did an FBI investigator at a 1991 conference of the American Psychological Association, that in several years of intensive investigation by local and federal law enforcement, there has never been any evidence of a network of satanic child abusers. Victims often report the existence of elaborate underground sacrificial altars where their abuse occurred, and yet no trace has ever been found of such a construction.

Putting aside the current controversy over the prevalence of child sexual abuse in this country, no one disputes that sexual abuse does in fact occur and takes a devastating toll on those abused. Sexually abused children may still be preoccupied in adulthood with events, trying to understand and repair the damage. Frequently, sexual abuse is a cited cause, for instance, of dissociative identity disorder. Sexual abuse, like severe physical and emotional abuse, can lead to other psychological disorders as well, such as depression, mood disorders, anxiety and panic disorders, and substance abuse.