Child Abuse

Additional signs of abuse 

Sometimes it is difficult to know the difference between physical signs of abuse and just normal scrapes and bruises that all children experience. Plus, there is no specific sign that reveals if a child is being abused, although bruises, black eyes or broken bones could be strong indicators for physical abuse, as well as the explanation not fitting the injury. With that in mind, the following list provides the observer with more signs suggesting abuse may be occurring: the child has nightmares or trouble sleeping; has a sudden drop in school performance; acts out in the classroom; displays intense anger or rage; acts out sexually; becomes self-destructive, self-abusive or suicidal; uses drugs and alcohol; avoids going home after school; shows a fear of certain adults; has a poor self-image; is unable to love or trust others; feels sad, passive, withdrawn or depressed; and has difficulty forming new relationships. 

Prevalence of abuse 

From 1980 to 1990, reported cases of child sexual abuse reached epidemic proportions in the United States (a 322% increase). In 2000, almost a million cases of child maltreatment were reported. Sixty-three percent of those were for neglect, 19% were for physical abuse, 10% were for sexual abuse, and 8% were for emotional/psychological abuse. Rates are similar for males and females (11.2% and 12.8% per 1000 children), except for sexual abuse (1.7 victims per 1,000 female children and .4 victims per 1,000 male children). Based on 2001 data, five to six children die each day as a result of child abuse or neglect. 
 
9 Source: US Department of Health and Human Services, Administration for Children and Families, National Clearinghouse on Child Abuse and Neglect, 2000 

Who abusers are 

In 2001 U.S. data, 60% of the perpetrators were female with an average age of 31, and 40% were male with an average age of 34. Approximately 84% of abused children were abused by a parent. Mothers alone were responsible for 47% of neglect and 32% of the physical abuse of abused children. Child abuse occurs in all cultural, ethnic, occupational and socio-economic groups.

Why people abuse

It is hard to understand how a parent or adult could intentionally inflict harm on a child. One explanation is that parents give excessive discipline or physical punishment that is inappropriate to the child’s age. Although most parents want to be good caretakers, at times they have difficulty coping with stress in their own life, lose control, and become unaware of the force with which they strike a child. “Factors which contribute to child abuse include the immaturity of parents, lack of parenting skills, unrealistic expectations about children’s behavior and capabilities, a parent’s own negative childhood experience, social isolation, frequent family crisis, and drug or alcohol problems. Child abuse is a symptom that parents are having difficulty coping with their situation.” 

Long-term effects of abuse 

Long-term effects of child abuse can vary based on the circumstances of the abuse, its frequency, type and duration, along with other factors. For many, the long-term effects shape their behavior. Thirty-one percent of women in prison say they have been abused as children. Ninety-five percent of teenage prostitutes have been sexually abused. For most there is low self-esteem, and a perpetual sense that there is something seriously wrong with them. This is frequently accompanied by anxiety, fear, depression, hostility, inappropriate sexual behavior, poor self-esteem, tendency toward substance abuse, and difficulty with close relationships. 
 
10 Source: National Exchange Club Foundation, About Child Abuse. Accessed at www.preventchildabuse.com 

What you can do if you suspect a child is being abused 

Contact your local child protective services agency, police, hospital or emergency hotline (see resource section). If you suspect a caregiver or babysitter is abusing a child, protect the child by limiting or supervising contact with that person. Speak to the child in a way that makes them comfortable and determine what has been occurring. If you have abused your own child, speak to a trusted friend, relative or doctor. Keep asking for help until you get the assistance needed. 

What to do if your child discloses that he/she has been abused

No matter how shocking the information may be, remain calm and listen carefully so the child senses that he/she is being heard. Encourage your child to tell you everything, but do not pressure the child by requesting too many details. Let the child lead you in how you acquire the specifics. Assure your child that he/she has done the right thing by telling you and that you will do all you can to prevent it from happening again. Do not blame your child or make him/her feel responsible for what happened. Do not say anything negative about the perpetrator since this may be someone the child cares for. 
 
If your child has been sexually molested or physically injured, he/she will need medical care. Taking your child to a hospital, even if signs of abuse are not evident, would be the wise thing to do. Keep your child safe and assume what your child is telling you is true until proven otherwise. At some point, psychological help may be needed to allow your child to heal from the trauma experienced.  

Shaken Baby Syndrome  

Shaken Baby Syndrome occurs when a baby is shaken vigorously. When its head moves back and forth, internal bleeding and increased pressure on the brain can result. The brain pulls apart and results in injury to the child. Infants are susceptible because their head and neck muscles are not fully developed and the brain tissue is very fragile. Rarely are there any signs of injury. Shaking a baby even for a few moments can injure a child for life. Some frustrated parents believe that shaking a baby is a harmless way to make a child stop crying. Almost 25% of all babies with this syndrome die. It is estimated that 25-50% of parents and caretakers are not aware of the effects of shaking a baby.  

Difference between discipline and abuse 

Discipline can be defined as training expected to produce a specific character or pattern of behavior, especially training that produces moral or mental improvement. Training involves learning, and rarely does punishment or fear produce the kind of learning that brings the long-lasting results most parents desire (e.g. a responsible adult that is able and willing to contribute to society). Discipline should teach a child to do the right thing, not because of fear, but because he/she has internalized standards of right and wrong that, when followed, benefit the child and promote self-confidence and a positive self-image. 
 
Abuse thwarts proper training and child development. It usually is the result of a parent selfishly satisfying his/her own needs, or finding relief by physically or verbally expressing negative feelings. It may appear to work in the short-term, but typically results in acting out behavior driven by hatred, revenge, and hostility the child has learned from his/her parent. Children will exhibit all sorts of behavior to avoid further abuse (e.g., lying, running away, etc.). Low self-esteem is the usual result.
 
11 Source: National Exchange Club Foundation, About Child Abuse. Accessed at www.preventchildabuse.com 

Treatment for abused children12 

Some research suggests that neglected and severe physical or sexual abuse during childhood impacts brain development and contributes to an unhealthy psychological response. Psychological trauma is usually accompanied by release of stress hormones which may affect certain areas of the brain related to short-term memory and possibly encoding and retrieval of long-term memory. Psychological treatment following abuse may minimize the impact of the trauma by allowing the child to organize and process the experience before dysfunctional responses take hold.  
 
12 Source: Mukerjee (1995). Hidden Scars. Scientific American, 10, (pp. 14).