Child Abuse

Injury, or even death, of a child through abuse is frightfully common. Child abuse can result from physical, emotional, or sexual harm; and it can even result from neglect. There are multiple causes, including households that suffer alcoholism, anger issues, and substance abuse.

Definition

Child abuse is widespread and can occur in any cultural, ethnic, and income group. Child abuse can be physical, emotional, verbal, or sexual. It can also result from neglect. Abuse can result in serious injury to the child and possibly even death.

Studies show that one in four girls and one in eight boys are sexually abused before the age of 18, and that approximately one in 20 children are physically abused each year. Physical abuse involves harming a child by, for example, burning, beating, or breaking their bones. Child sexual abuse is the deliberate exposure of a minor child to sexual activity that the child cannot comprehend or consent to. This means a child is forced or talked into sex or sexual activities by another person. This behavior includes acts such as inappropriate touching of a child's breasts or genitalia, someone exposing their genitalia to a child, fondling, oral-genital contact, genital and anal intercourse, as well as exhibitionism, voyeurism, and exposure to pornography.

Child neglect occurs when someone does not provide the necessities of life to a child, either intentionally or with reckless disregard for the child's well being. This can include physical neglect, such as withholding food, clothing, shelter, or other necessities. Emotional neglect includes withholding love or comfort or affection. Medical neglect occurs when medical care is withheld.

Symptoms

It's not always easy to recognize when a child has been abused. Children who are abused are often afraid to complain because they are fearful that they will be blamed or that no one will believe them or because the person who abused them is someone they love very much. Parents are often unable to recognize symptoms of abuse because they may not want to face the truth.

If you suspect a child has been sexually abused, the child should be examined as soon as possible by a trained health care professional; it can't be stressed enough that an abused child needs access to special support and treatment as soon as possible. A doctor's exam should not be delayed for any reason. Many signs of injury related to sexual abuse are temporary. Ideally, the exam should occur within 72 hours of the event or discovery. A complete physical exam must always be performed, so that the examiner can look for any signs of physical and sexual abuse. The two forms of abuse may coexist. The longer the abuse continues, the less likely the child will make full recovery.

Watch out for unexplained changes in your child's body or behavior. Conduct a formal examination only if you have reason to suspect your child has been abused. Otherwise, the child may become fearful. Be alert to any of the following changes:

Signs of Physical Abuse: Any injury (bruise, burn, fracture, abdominal or head injury) that cannot be explained

Signs of Sexual Abuse: Fearful behavior (nightmares, depression, unusual fears, attempts to run away); abdominal pain, bedwetting, urinary tract infection, genital pain or bleeding, sexually transmitted disease; extreme sexual behavior that seems inappropriate for the child's age

Signs of Emotional Abuse: Sudden change in self-confidence; headaches or stomachaches with no medical cause; abnormal fears, increased nightmares or attempts to run away

Signs of Emotional Neglect: Failure to gain weight (especially in infants), desperately affectionate behavior, voracious appetite and stealing food

Causes

Risk Factors

A combination of individual, relational, community, and societal factors contribute to the risk of child maltreatment and abuse. Although children are not responsible for the harm inflicted upon them, certain individual characteristics have been found to increase their risk of being maltreated. Risk factors are contributing factors—not direct causes.

Examples of risk factors:

  • Disabilities or mental retardation in children that may increase caregiver burden
  • Social isolation of families
  • Parents' lack of understanding of children's needs and child development
  • Parents' history of domestic abuse
  • Poverty and other socioeconomic disadvantages, such as unemployment
  • Family disorganization, dissolution, and violence, including intimate partner violence
  • Lack of family cohesion
  • Substance abuse in family
  • Young, single nonbiological parents
  • Poor parent-child relationships and negative interactions
  • Parental thoughts and emotions supporting maltreatment behaviors
  • Parental stress and distress, including depression or other mental health conditions
  • Community violence

Treatments

If you suspect a child has been abused, contact a pediatrician or a local child protective agency for help. Physicians are legally obligated to report all suspected cases of abuse or neglect to authorities. They can also recommend a therapist and provide the necessary information for investigators. Doctors may also testify in court to obtain legal protection for the child or to help criminally prosecute an individual suspected of engaging in child sexual abuse.

Whatever the nature of the abuse, steps should be taken immediately to report the abuse and obtain help. Delaying a report decreases the child's chances for full recovery.

If he or she has been abused, your child will benefit from the services of a qualified mental health professional. You and other members of the family may be advised to seek counseling so that you'll be able to provide the support and comfort your child needs. If someone in your family is responsible for the abuse, a mental health professional may be able to treat that person successfully, as well.

If your child has been abused, you may be the only person who can help him or her. Do not delay reporting your suspicions of abuse. Denying the problem will only worsen the situation; allowing the abuse to continue decreases the child's chance for full recovery. In any case of child abuse, the safety of the abused youngster is of primary concern. He or she needs to be in a safe environment free of the potential for continuing abuse.

In most cases, children who are abused or neglected suffer greater emotional than physical damage. A child who has been abused or otherwise severely mistreated may become depressed or develop suicidal, withdrawn, or violent behavior. An older child may use drugs or alcohol, try to run away, or abuse others. The younger the child is and the closer the child's relationship to the abuser, the more serious the emotional damage will be. As adults, they may develop marital and sexual difficulties, depression or suicidal behavior.

Sources

  • American Psychiatric Association
  • National Library of Medicine
  • Administration for Children and Families
  • American Academy of Pediatrics
  • Department of Health and Human Services
  • National Institutes of Health
Last reviewed 11/24/2014