Information via accrediting organization American Association for Marriage and Family Therapy.
Child maltreatment can be categorized as neglect, physical abuse, sexual abuse, and emotional abuse. Almost 3 million cases of child abuse and neglect are reported each year, and 1 million of these are substantiated. Neglect is the most common form of abuse and can cause the most severe long term damage to the child. Boys and girls experience abuse and neglect at the same rates, although girls experience sexual abuse approximately four times more often than boys.
Further, poverty plays a major role in physical abuse and neglect, as parents who earn less than $15,000 per year are 44 times more likely to maltreat their children compared to parents earning more than $30,000. Statistics show that parental maltreatment accounts for nearly 80% of child deaths each year.
Child neglect can include parents or caretakers not providing proper, age appropriate care for the child. This can include shelter, food, clothing, supervision, medical care, education, and other basic necessities. Physical neglect includes not adequately keeping the child safe, kicking the child out of the house, and abandoning the child. Educational neglect can be seen with chronic truancy and not enrolling the child in school, as well as neglecting special educational needs. Emotional neglect includes chronic domestic violence, allowing the child to use drugs and alcohol, and withholding affection. Medical neglect is not getting needed healthcare for the child and can be a result of religious beliefs in some states.
Emotional abuse includes verbal attacks on the child as well as rejection, ignoring, isolating, and terrorizing the child. Parents or caretakers might also expose the child to drug or alcohol use and other illegal activities such as theft, prostitution, assault and gambling.
Sexual assault is any sexual contact between an adult and a child, any behavior that is intended to provide sexual stimulation for the abusing person or the child, and sexual contact by someone who is in an older developmental stage than the child. Sexual assault can be physical, visual or verbal in nature.
Physical abuse is any act that results in non-accidental trauma or physical injury. This can be severe corporal punishment or punishment for no reason. The parent or caregiver can hit, shake, beat, kick, bite, burn, or throw a child to cause physical injury.
Physical abuse and neglect cause a negative impact on social, emotional, behavioral, academic, and physical health throughout life. Abused children are more likely to abuse drugs, self-mutilate, and act violently than their non-abused peers. They also demonstrate language and learning delays. In fact, the brain of an abused and/or neglected child can, in some cases, be 20% smaller than his or her non-maltreated counterparts. Complex processes in the young brain depend heavily on nurturing and supportive interactions with the primary caregiver. When these processes fail, any number of behavioral, emotional, learning and perception problems can arise throughout life.
Children who suffer abuse and neglect are often diagnosed with: Oppositional Defiant Disorder (ODD), Conduct Disorder (CD), Post Traumatic Stress Disorder (PTSD), and depressive and anxiety related disorders. Some will act out sexually or be sexually abusive to others. Physical injuries are related to physical abuse, while starvation and slow growth are related to neglect.
Parent and caregiver education, home visits, and parent support groups are great ways to teach new ways to discipline and care for children, as well as understanding about children’s developmental phases. Looking on the internet for local sources is a good way to find out what is available in your area, as is talking with the child’s doctor or school.
Mental healthcare professionals like marriage and family therapists (MFTs) will assess children, as well as their parent(s), and may ask in-depth questions about the adult, child, family, and social risk factors related to abuse or neglect (such as social isolation, depression, income level, every day stressors, drug and/or alcohol use and child abuse potentiality). Socially isolated mothers who are neglectful have few members in their support networks (few other adults to talk to) and receive little emotional support.
Questions about drug and alcohol use are relevant because parents with drug or alcohol disorders are statistically more likely to exhibit abusive and neglecting behaviors. Questions may arise about domestic violence between parents, as the rate of child abuse in these homes is 15 times higher than the average. Other areas to question include animal cruelty in the home, as this is an indicator of violence in the home.
A professional helper will guide the therapy session away from alienation of family members–not focusing on parental blame. Likewise, the parent must learn not to blame the child. Research suggests that many abusive parents have a distorted view of their child, believing the child intentionally antagonizes and holds power over the parent. Thus, the parent feels victimized and justified in implementing harsh punishments. If parents have had trauma in their lives, it is important that they work through their own trauma concerns so that they can see their children’s behavior as independent from the parent’s trauma. Often, the behavior can be multigenerational and if parents have not worked through their own experiences, they may personalize their child’s acting out behavior that this could harm the parent/child attachment.
There are several programs and treatment methods in use today and a mental healthcare provider can make the best determination for treatment once the assessment is complete. Some of the most well-known programs offer case management, social support, life or parenting advice, therapy services, respite care, and financial assistance for basic living.
For children exhibiting symptoms of PTSD, therapists help the family process the trauma through psycho-education, skills training to manage distressing thoughts, feelings, behaviors, improving parenting skills and family communication. Some programs are specially built for multi-problem families and address parent training, stress reduction, basic skills for children, money management, social support, and home safety.
One program option begins at the prenatal stage, where expectant mothers receive home visitation services for the prenatal health of mother and child, parenting skills, family planning for future births, education attainment, and job acquisition. Positive outcomes include prenatal healthcare, improved childcare, and less punitive discipline, parental education and work attainment, fewer emergency room visits, and father involvement. Adolescents whose mothers participated in the program demonstrate fewer school failures, anti-social behaviors, and substance abuse.
Parents commonly have inaccurate and unhelpful thought processes. Children also tend to excuse the behaviors of their parents. This leads to an agreement of silence. Breaking this silence and “normalizing” the child’s feelings and reactions to abuse is an important step in therapy. The child begins to gain a sense of reassurance when others understand and verify that the chaotic world he or she is experiencing is indeed not the way it should be. With treatment, children learn skills to deal with emotional overload, to identify emotions, and to regulate them. This process helps the child facilitate a decrease in emotional reactivity, anxiety, fear, depression, and distorted thoughts. Adults must also learn to manage their anger, stress, and anxiety as well as their abusive and neglectful “triggers.”
With therapy, a child begins to gain a sense of reassurance and verify that the chaotic world he or she is experiencing is indeed not the way it should be.
Warning signs of child abuse or neglect include unexplained bruises or injuries, shaken baby syndrome, unsupervised children, poor hygiene, sexually inappropriate behavior, poor sleep behaviors, and aggression towards others.
If you suspect a child is being abused or neglected, you should call your local Child Protective Services (CPS) agency or the CPS agency in the state in which the abuse occurred. As you identify the appropriate agency for making a report, remember the following: Not every state has a toll-free hotline, or the hotline may not operate on a 24-hour basis. If a toll-free (800 or 888) number is available, it may be accessible only from within that state. If you are unsure how to reach your local CPS, please call:
Childhelp USA National Child Abuse Hotline: 1-800-4-A-CHILD (1-800-422-4453) TDD: 1-800-2-A-CHILD. Childhelp USA is a non-profit agency which can provide reporting numbers, and has counselors who can provide referrals.
Child Welfare Information Gateway: Resources about child maltreatment, including definitions, signs and symptoms, statistics and prevalence, types of child abuse and neglect, risk and protective factors, the impact on individuals and society, and child fatalities.
Medline Plus: Child Abuse: Resource materials on child abuse and neglect including symptoms, prevention and screening, research, articles, organizations, and latest news.
Information via accrediting organization American Association for Marriage and Family Therapy.
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