Prevalence and scale of child abuse

Child Abuse

How large is the problem of child abuse and what are we doing about it?

Children, today, are being abused at an alarming rate. The abuse can range from physical abuse to sexual abuse, psychological abuse or neglect (Righthand, Kerr, & Drach, 2003). Whichever the type of abuse inflicted on the child, he/she is affected in a negative way that many times can carry on into adulthood. Child abuse is a serious problem and statistics have shown that it is not a rare occurrence. According to Grapes (2001), "in 1997, an estimated 3,195,000 children were reported to child protective services (CPS) agencies as alleged victims of maltreatment" (p.16). This information was collected among 35 states, among the United States, which indicated that each state averaged a 1.7% increase in child abuse reports between 1997 and 1997 (Grapes, 2001). When the numbers are crunched, fifteen out of every 1,000 U.S. children were victims of child maltreatment in 1997; which was a similar rate among the prior three years. According to the National Clearing House on Child Abuse and Neglect information, a resource of the U.S. Department of Heath and Human Services, there were 2,806,000 reports of possible maltreatment in 1998 (Grapes, 2001). About one-third of these (34%) were "screened out" and about two-thirds (66%) were investigated. Of those investigated, about 540,000 (29.9%) resulted in findings of "either substantiated or indicated child maltreatment" (Grapes, 2001). On the other hand, according to Jim Hopper, a research associate at Boston University School of Medicine, asserts that the majority of child abuse victims are not counted in official statistics because "most abused and neglected children never come to the attention of authorities" (Grapes, 2001, p.12-13).

This maltreatment can lead to serious consequences in the child's character or cause psychological disorders that may affect them for years or even throughout life, such as depression, low self-esteem, school learning problems, withdrawal, opposition, compulsivity, anxiety, and/or pseudo-mature behavior (Calam & Franchi, 1987).

Law enforcement agencies must play a crucial role in protecting abused children. Almost every state has passed a law to protect these children who in most cases cannot speak for themselves. In addition, many professionals today, such as counselors and teachers, are required to report any suspected case of child abuse to the proper authorities, which is normally either the police or a child protective agency. These agencies have the same basic goal, which is the protection of endangered children. In order to fully investigate this issue, the following will be discussed: definitions of child abuse, types of and causes of child abuse, consequences of child abuse, society's response to child abuse, and a child's story.

Child abuse can be hard to define and may vary among researchers and authors; however, all of the definitions have one common theme and that is that the abuse of a child is wrong in any way, shape, or form. Before getting to the discussion the issue of defining child abuse, below are two stories of child abuse incidents (Grapes, 2001):

Story 1:

In November 2000, a San Jose man was riding in a female coworker's car when he thought he heard a child moaning. According to Sergeant Steve Dixon of the San Jose Police Department, the man "looked in the back seat." There was no one there. He looked at her [his coworker]. She looked very nervous. She began talking very loudly. He heard the moaning several times. She turned up the radio, apparently to drown out the sounds." The man later called the police, and the woman was arrested on suspicion of child endangerment after her two sons, ages five and seven, told authorities that their mother would sometimes lock them in the trunk of her Honda Civic when she went to work. In describing this incident, Dixon stated, "It's almost unbelievable."

Story 2:

In October 2000, a seventeen-year-old boy called 911 and reported that he and his twelve-year-old brother were chained in their bedroom. When authorities arrived at their home, located in a rural desert community in California, they found that the two boys were not in chains. However, dog chains were found attached to their bedposts, and the boys had marks on their wrists suggesting they had recently been restrained. In addition, they were filthy, underdeveloped mentally and physically, and had scars on their backs.

These stories are only but a few that tell the awful truth about child abuse. Child abuse has been defined in many ways. In our history, Parton (1979) gives a detailed account of a four-stage process by which child abuse came to be recognized and defined (Calam & Franchi, 1987). The four stages are as follows: (1) the discovery of the problem; (2) its diffusion as a problem; (3) the consolidation of the problem; and finally, (4) the stage of reification, with the problem being accepted as a natural phenomenon that should automatically receive professional attention (Calam & Franchi, 1987).

Three approaches to the management of child abuse are identified by Parton: (1) the penal, with emphasis on justice for the injured party and punishment of the offender; (2) the medical, which sees deviance as result of external forces requiring prevention and cure; and (3) the social welfare model, which is the traditional, compassionate, rehabilitation view which sees the parents as psychologically or emotionally inadequate and in need of therapy (Calam & Franchi, 1987).

In the year 1996, Congress changed the reading of the definition of child abuse from "child abuse and neglect" to "The term 'child abuse and neglect' means at a minimum, any recent act or failure to act on the part of a parent or caretaker, which results in death, serious physical or emotional harm, sexual abuse or exploitation, or an act or failure to act which presents an imminent risk of serious harm" (Schwartz-Kenney, McCauley, and Epstein, 2001, p.245). According to the Senate, the new definition is intended to protect the states child protective agencies from the perceived burden of unrealistic expectations and inadequate resources.

Barnett and colleagues (1994) developed research definitions and severity ratings for six types of child maltreatment. The subtypes were physical abuse, sexual abuse, failure to provide (physical neglect), lack of supervision (physical neglect), emotional maltreatment, and moral, legal and educational maltreatment (Righthand, Kerr, & Drach, 2003). Severity ratings ranged from level one being the least severe, to level five being the most severe.

Examples of level one physical abuse included minor marks on a child's body, inflicted by a hand or object, in the absence of marks to the child's neck or head. Level two included non-minor marks to the child's body. Level three included marks inflicted on the child's head, face, or neck, minor burns, serious bruises, minor lacerations, and parental handprints as a result of grabbing. Level four included hitting with an object likely to result in serious injury, non-minor lacerations, fractures, concussions, second degree burns, attempts to choke or smother that did not result in hospitalization, and injuries requiring hospitalization for less than twenty-four hours. Level five included injuries that necessitated hospitalization, resulted in permanent physical damage or disfigurement, or were fatal. Severity ratings for the other forms of child maltreatment were established as well (Righthand, Kerr, & Drach, 2003). Barnett and colleagues stressed that their objective was to develop operational definitions and severity ratings of child maltreatment for the purpose of research.

There are different types and perceived causes of child abuse. The types can range from physical abuse to sexual abuse, psychological abuse and neglect. Physical abuse involves acts that result in demonstrable harm or when combined with other abusive or neglectful acts, create a moderate risk of harm (Righthand, Kerr, & Drach, 2003). Physical acts of abuse can include hitting a hand, stick, strap, or other object, punching, kicking, shaking, throwing, burning, stabbing, or choking a child.

Sexual abuse is another type of child abuse. Sexual abuse includes three types forms of abusive behaviors: intrusion, genital molestation, and other or unspecified acts of sexual abuse. Intrusion includes oral, anal, or genital penile penetration. Genital molestation involves some form of genital contact, such as fondling the breasts or buttocks, genital exposure, and other sexual acts. On a side note, sexual abuse has been widespread in the Catholic Church among Catholic priests. It appears that the priesthood and religious life have an alarmingly high number of child molesters. This has been a topic of controversy among the church for many years. The Vatican has beared down and investigated a number of priests for this very reason. Society has spoken out for the children who have experienced child abuse at the hands of priests (Rossetti, 1990). In addition, sexual abuse is widespread, aside from priests, throughout the United States and the world.

Psychological abuse is another type of child abuse. It is a type of emotional abuse that children often experience at the hands of adults. There are three types of psychological abuse, according to Righthand, Kerr, and Drach (2003), the first includes close confinement, exemplified by severe forms of punishment such as tying or binding a child's arms or legs together to a piece of furniture or other object or confining a child to an enclosed area such as a closet or a basement. The second includes verbal and emotional assaults including persistent patterns of belittling, denigrating, scapegoating, and other nonphysical, but clearly hostile or rejecting behaviors, such as repeated threats of beatings, sexual assault, and abandonment. The third, residual, category includes other forms of emotional abuse such as attempted sexual or physical assaults; throwing something at a child but missing; withholding shelter, sleep, or other necessities as punishment, and economic exploitation (p.11).

According to Righthand, Kerr, and Drach (2003), psychological abuse can be technically defined as:

1. Verbal or emotional assault, exemplified by persistent patterns of belittling, denigrating, scapegoating, or other nonphysical but rejecting, hostile, and degrading behaviors.

2. Terrorizing the child, exemplified by threatening to physically hurt, kill, or abandon the child, or by exposing the child to chronic or extreme partner abuse or other forms of violent behaviors.

3. Exploiting or corrupting the child, exemplified by modeling criminal or antisocial behavior; encouraging and condoning delinquent behavior, substance abuse, or other maladaptive acts; or by promoting developmentally inappropriate behaviors.

4. Isolating the child, exemplified by placing unreasonable limits or restrictions on the child's developmental needs for peer and adult social interaction.

5. Other psychological abuses include withholding shelter, sleep, or other necessities as punishment; economic exploitation; attempted sexual or physical assaults; and intentionally disregarding the child's needs for love and affection and denying emotional responsiveness.

Neglect is another type of child abuse. Neglect is failing to care for the child's physical, emotional, and educational needs. Many parents and guardians have become neglectful with children these days. Children are feeling the consequences of this neglect, both physically and psychologically. Barnett and colleagues (1994) include failing to provide not only for the child's academic education but also for the child socially and morally. Neglected children may also experience more attachment and peer relationship difficulties, emotional, and behavioral problems, coping difficulties, and may have higher levels of psychopathology than children who are not maltreated. Neglected children often become listless and apathetic. As the children become more passive, they may provide fewer cues to their parents for engagement, which in leads to less stimulation and thus further neglect. The assessment of neglect often requires determining what is missing rather than what is occurring.

According to Barnett and colleagues (1994), physical neglect means failing to provide for a child's physical requirements, such as nutrition, health, medical, or cleanliness needs. Physical neglect includes the following actions or inactions (Righthand, Kerr, and Drach, 2003):

1. The failure to provide reasonable medical care that is recommended by health care professionals.

2. Failing to seek timely and appropriate medical services for serious health problems that would be recognizable as requiring medical attention by most laypersons.

3. Not attending to a child's needs for food, adequate clothing, hygiene, and immunizations.

4. Disregarding safety hazards.

5. Not adequately supervising the child as a result of drunkenness, drug abuse, or psychiatric disorders.

6. Leaving a child in the care of an inadequate "caregiver," such as someone with a history of child abuse, and failing to protect a child by permitting abusive people to have access to the child.

7. Abandoning a child or expelling a child from the home without arranging for reasonable care and supervision.

8. Repeatedly leaving a child with others for extended periods in a manner suggesting a dereliction of parental custodial responsibilities.

9. Leaving a child unsupervised.

On the other hand psychological neglect includes the following:

1. Inadequate nurturing and affection.

2. Not opposing a child's substance abuse.

3. Not opposing or permitting other problem behaviors such as assaultive behavior or chronic delinquency and, when aware of the problem, not attempting to intervene.

4. Failing to seek or provide needed treatment for a child's emotional or behavioral problems that would be recognizable as requiring professional attention by most laypersons, for example severe depression or a suicide attempt.

5. Failure to facilitate needed psychological treatment for a child's emotional or behavioral difficulties as reasonably recommended by a qualified professional.

6. Not attending to additional developmental and emotional needs not previously described such as by engaging in behaviors that foster immaturity or emotional overdependence, or by continuous, inappropriate expectations for the child's age or developmental level.

7. Failing to oppose or permitting chronic truancy.

8. Failing to enroll a child in school, causing a child to miss school excessively (at least one month), or causing or permitting a child to stay home for nonlegitimate reasons for an average for at least three days a month.

9. Failure to obtain recommended special education services or treatment for a child's diagnosed learning disorder or special education needs without reasonable cause.

When assessing physical or psychological neglect toward a child, parent's refusal of specific medical, psychological, or educational services may require careful evaluation. When such refusal occurs due to religious or cultural beliefs and in the context of an otherwise non-abusive or non-neglecting relationship, the act of refusal by itself may not constitute child neglect. The lists above are intended to provide and/or assist clinicians in becoming better at identifying and articulating behaviors that can and do cause harm to children, and to facilitate the clinician's abilities to identify causative factors and develop appropriate clinical interventions.

Perceived causes of child abuse can be the following, but are not limited to: Substance abuse, lack of child preservation, foster care abuse exposure, parental cohabitation, poverty, and parental history of abuse. According to Grapes (2001), parents who abuse drugs or alcohol are almost three times more likely to physically or sexually assault their children than are other parents (p.47). The rate of neglect for children for substance-abusing parents is more than four times the rate of neglect for children of non-substance abusing parents (Grapes, 2001).

Child preservation laws have put children at risk for abuse. Many abuse fatalities have been blamed as a result oversights by overworked, understaffed, and underfunded child protective agencies, whose workers let children to some extent slip through the cracks, as they say. Half of the 1,500 children of whom die each year as a result of abuse are already known to an agency (Grapes, 2001). These children are victims of a family preservation policy that consistently reunites vulnerable children with abusive parents who cannot be rehabilitated.

Foster care exposes children to abuse, many times. It may be thought that the child is very safe once taken out of an abusive home, but that may not always be the case. Research has shown that children in foster care are twice as likely to be abused as children who live with their natural parents.

Parental cohabitation is said to expose children to a greater risk of abuse. Many recent child abuse fatalities are the direct result of society's loosening of the taboo against cohabitation. Though other factors often contribute to a child's risk for being abused, studies have consistently shown that the presence of an unrelated man in the home greatly increases the chance that a child will be abused or assaulted (Grapes, 2001).

Poverty has been known to be a perceived cause of child abuse. The majority of incidents of child abuse that occur are of families from the lowest socioeconomic levels. Research has indicated that the problems of poverty, unemployment, substandard housing, insufficient money, food, and recreation cause the stressful situations that can precipitate child abuse and neglect.

Parental history of abuse is a major risk factor in child abuse. While not all parents who suffered abuse as children go on to abuse their own children, certain studies have found that as many as 67% of abused parents do mistreat their children (Grapes, 2001).

Child abuse may have many causes; however, what about the effects or consequences? Children who have been abused may experience some of the following, but are not limited to: Neurological, motor activity, and growth effects; learning and intelligence effects; language use effects, and school adjustment effects. Children may suffer head trauma and show evidence of a neurological dysfunction as a result of the abuse. Abused children have been found to show deficits in learning and intelligence, by some studies (Calam & Franchi, 1987). Some deficits in standard I.Q. tests have also resulted after the children's abuse.

The expressive language skills of abused children have often been found to be poor; however, environmental influences accompanying abuse are likely to be of major significance. Expressly, the caretaker who is not interested in the child is unlikely to spend a great deal of time talking to him or her, and therefore, there is inadequate input and practice for language skills for the child to be able to develop.

School adjustment is another issue that could be a serious consequence for the abused child. Successful adjustment in school involves a set of adjustment skills on the part of the child. Many times children who have been abused lack the coping skills to be able to complete academic work successfully. In addition, they may have trouble responding well to teachers and the various restraints of the school system, to exercise self-discipline and a sense of control, and finally to form good relationships with peers.

Society must respond to the fact that child abuse is still going on in the U.S. And the world today. Many different countries experience their own sting of child abuse in this day in age. In the book called Child abuse: A global view by Schwartz-Kenny, McCauley & Epstein (2001) experts from sixteen different countries are interviewed to discuss how the issues of child abuse and neglect, legal definitions of abuse, the prevalence of abuse, children's role in the legal system, and penalties for abusing a child (p. 1).

For example, Australia now recognizes that child abuse and neglect are more common that previously acknowledged. There has also been a growing realization that such abusive treatment endangers the physical, social, intellectual, and emotional development of affected children, and that corrective action is urgently required to minimize the long-term effects of abuse. Child abuse frequently goes unreported in Australia; therefore, there is a lack of data; however, a National Child Protection Council was introduced in 1993 by the National Child Protection Council. The main objectives of the National strategy are to identify and change attitudes and behaviors which are harmful to children, identify and change factors contributing to harmful parenting practices and teach children to form non-exploitive relationships and to develop their emotional care and personal safety skills (Schwartz-Kenny, McCauley & Epstein, 2001).

A second example, is India. Asha was eight years old when her parents sold her in Nepal for $175.00 to a "nice" man who promised to find her a good job in the bustling metropolis of Bombay. This was an unexpected opportunity for Asha and a relief to her overburdened parents, who had four other children in addition to Asha. Asha accompanied the supposedly nice man. As she traveled by train across India, Asha enjoyed the sights and vastness of the country. She was treated well and while she missed her parents, she was thrilled and happy to be able to have this type of experience. Upon her arrival in Bombay, she was placed in a house with several other young women and children. She was told that she would be working there, caring for men who visited the house in the evenings.

Instead of this she was physically and emotionally abused, as her tender young body was violated repeatedly each night. She sobbed uncontrollably and ached desperately for her family, but did not know how to return to Nepal or how to contact her parents. Over the next few months, Asha grew accustomed to these nighttime encounters. The woman who cared for the girls was not unkind, and Asha received sufficient food and adequate housing. The women made friends among themselves and developed a network of support, resigning themselves to their own fate (Schwartz-Kenny, McCauley & Epstein, 2001). In 1924 India passed the first Children's Act, calling for the protection of children against cruelty and indignity. In addition in 1974, National policy for children was devised and showed the nation's commitment to the protection of children fro neglect, exploitation, and cruelty (Schwartz-Kenny, McCauley & Epstein, 2001).