Child Abuse

CHILD ABUSE

What is child abuse? It is the physical or emotional abuse of a child by a parent, guardian, or other person. Reports of child abuse, including sexual abuse, beating, and murder, have climbed in the United States and some authorities believe that the number of cases is largely under reported. Child neglect is sometimes included in legal definitions of child abuse to cover instances of malnutrition, desertion, and inadequate care of a child's safety. When reported, child abuse cases are complicated by inadequate foster care services and a legal system that has trouble accommodating the suggestible nature of children, who are often developmentally unable to distinguish fact from make-believe (Hay, 1996).

In 1993, the United States Advisory Board on Child Abuse and Neglect declared a child protection emergency. Between 1985 and 1993, there was a 50 percent increase in reported cases of child abuse. Three million cases of child abuse are reported in the United States each year. Treatment of the abuser has had only limited success and child protection agencies are overwhelmed (Lewitt, 1997).

Recently, efforts have begun to focus on the primary prevention of child abuse. Primary prevention of child abuse must be implemented on many levels before it can be successful. Prevention plans on the social level include increasing the economic self-sufficiency of families, discouraging corporal punishment and other forms of violence, making health care more accessible and affordable, expanding and improving coordination of social services, improving the identification and treatment of psychological problems, and alcohol and drug abuse, providing more affordable child care and preventing the birth of unwanted children. Prevention plans on the family level include helping parents meet their basic needs, identifying problems of substance abuse and spouse abuse, and educating parents about child behavior, discipline, safety and development. Primary prevention is both the prevention of disease before it occurs, and the reduction of its incidence. In the case of child abuse, primary prevention is defined as any intervention designed for the purpose of preventing child abuse before it occurs (Hay, 1996).

Between 1985 and 1993, the number of cases of child abuse in the United States increased by 50 percent. In 1993, three million children in the United States were reported to have been abused. Thirty-five percent of these cases of child abuse were confirmed. Data from various reporting sources, indicates that improved reporting could lead to a significant increase in the number of cases of child abuse verified by child protection agencies. The lack of verification does not indicate that abuse did not occur, only that it could not be verified. The facts are that each year 160,000 children suffer severe or life-threatening injury and 1,000 to 2,000 children die as a result of abuse. Of these deaths, 80 percent involve children younger than five years of age, and 40 percent involve children younger than one year of age. One out of every 20 murder victims is a child. Murder is the fourth leading cause of death in children from one to four years of age and the third leading cause of death in children from five to fourteen years of age. Neonaticide, which is the murder of a baby during the first 24 hours of life, accounts for 45 percent of children killed during the first year of life (Lewitt, 1997).

As I stated above, deaths from abuse are under reported and some deaths classified as the result of accident and sudden infant death syndrome might be reclassified as the result of child abuse if comprehensive investigations were more routinely done. Most child abuse takes place in the home and is started by persons are know to and trusted by the child. Even though it has been widely publicized, abuse in day-care and foster-care settings accounts for only a small number of confirmed cases of child abuse. In 1996, only two percent of all confirmed cases of child abuse occurred in these settings. Child abuse if fifteen times more likely to occur in families where spousal abuse occurs. Children are three times more likely to be abused by their fathers than by their mothers. No differences have been found in the incidence of child abuse in rural versus urban areas. Following are the types of abuse and the percentages of the different types.

Neglect - 54%

Physical abuse - 25%

Sexual abuse - 11%

Emotional abuse - 3%

Other - 7%

(Davis, 1998).

Not only do children suffer from the physical and mental cruelty of child abuse, they endure many long-term consequences, including delays in reaching developmental milestones, refusal to attend school and separation anxiety disorders. Other consequences include an increased likelihood of future substance abuse, aggressive behaviors, high-risk health behaviors, criminal activity, depressive and affective disorders, personality disorders, post-traumatic stress disorder, panic attacks, schizophrenia and abuse of their own children and spouse. Research has shown that a loving, caring and stimulating environment during the first three years of a child's life is important for proper brain development (Davis, 1998).

There have been some recent changes in regards to the causes of child abuse. The results of research initiated by the National Research Council's Panel on Research on Child Abuse and Neglect showed the first important step away from the simple cause and effect patterns. The panel stated that the simple cause and effect patterns have certain limitations, mostly related to their narrow focus on the parents. These patterns are limited by asking only about the isolated set of personal characteristics that might cause parents to abuse their children. These patterns failed to account for the occurrence of different forms of abuse in one child. These patterns had very little explanatory power in weighing the value of various risk factors involved in child abuse. As a result, they were not very accurate in predicting future cases of child abuse. To replace the old static pattern, the panel has substituted what it calls an ecologic model. This model considers the origin of all forms of child abuse to be a complex interactive process. This ecologic model views child abuse within a system of risk and protective factors interacting across four levels: (1) the individual, (2) the family, (3) the community and (4) the society. Some factors are more closely linked with some forms of abuse than others. The following are factors thought to contribute to the development of