Child Abuse and Neglect:
Types, Signs, Symptoms, Causes and Getting Help
Each year, tens of thousands of children are traumatized by physical, sexual, and emotional abusers or by caregivers who neglect them, making child abuse as common as it is shocking. The scars can be deep and long-lasting, affecting not just abused children but society. You can learn the signs and symptoms of child abuse and find out where to get help for the children and their caregivers.
In This Article:
Child abuse facts
Physical child abuse
Sexual abuse in children
Emotional child abuse
Causes of child abuse
Effects of child abuse
Getting help for an abused child
Preventing or stopping child abuse
Child abuse facts
Most of us can’t imagine what would make an adult use violence against a child, and the worse the behavior is, the more unimaginable it seems. But the incidence of parents and other caregivers consciously, even willfully, committing acts that harm the very children they’re supposed to be nurturing is a sad fact of human society that cuts across all lines of ethnicity and class. Whether the abuse is rooted in the perpetrator’s mental illness, substance abuse, or inability to cope, the psychological result for each abused child is often the same: deep emotional scars and a feeling of worthlessness.
In the United States, the federal legislation that sets minimum standards for how states handle child abuse defines child abuse and neglect as “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.” In 2005, the most recent year for which the U.S. government has figures, 12.1 of every 1,000 American children, almost 900,000 in all, suffered abuse by adults, with parents of victims accounting for almost 80 percent of the abusers. Every day, about four children die in the U.S. because of abuse or neglect, most of them babies or toddlers. And those are just the cases authorities know about: for every incidence of child abuse or neglect that gets reported, it’s estimated that two others go unreported.
There are four primary types of child abuse:
emotional abuse (i.e. dumping your children day and night on "holiday")
neglect (i.e. leaving tiny tots without a babysitter)
While the first two categories get the most attention, perhaps because they involve physical violence, neglect is far and away the most common form of child abuse, accounting for more than 60 percent of all cases of child maltreatment.
Child neglect: types and warning signs
Neglect is a pattern of failing to provide for a child's basic needs, to the extent that the child’s physical and/or psychological well-being are damaged or endangered. In child neglect, the parents or caregivers are simply choosing not to do their job. There are three basic types of neglect.
Failure to provide adequate food, clothing, or hygiene
Reckless disregard for the child’s safety, such as inattention to hazards in the home, drunk driving with kids in the car, leaving a baby unattended
Refusal to provide or delay in providing necessary health care for the child
Abandoning children without providing for their care or expelling children from the home without arranging for their care
Failure to enroll a child in school
Permitting or causing a child to miss too many days of school
Refusal to follow up on obtaining services for a child’s special educational needs
Inadequate nurturing or affection
Exposure of the child to spousal abuse
Permitting a child to drink alcohol or use recreational drugs
Failure to intervene when the child demonstrates antisocial behavior
Refusal of or delay in providing necessary psychological care
Some signs of child neglect:
Clothes that are dirty, ill-fitting, ragged, and/or not suitable for the weather
Unwashed appearance; offensive body odor
Indicators of hunger: asking for or stealing food, going through trash for food, eating too fast or too much when food is provided for a group
Apparent lack of supervision: wandering alone, home alone, left in a car
Colds, fevers, or rashes left untreated; infected cuts; chronic tiredness
In schoolchildren, frequent absence or lateness; troublesome, disruptive behavior or its opposite, withdrawal
In babies, failure to thrive; failure to relate to other people or to surroundings
A single occurrence of one of these indicators isn’t necessarily a sign of child neglect, but a pattern of behaviors may demonstrate a lack of care that constitutes abuse.
Physical child abuse: types and warning signs
Physical child abuse is an adult’s physical act of aggression directed at a child that causes injury, even if the adult didn’t intend to injure the child. Such acts of aggression include striking a child with the hand, fist, or foot or with an object; burning the child with a hot object; shaking, pushing, or throwing a child; pinching or biting the child; pulling a child by the hair; cutting off a child’s air. Such acts of physical aggression account for between 15 and 20 percent of documented child abuse cases each year.
Many physically abusive parents and caregivers insist that their actions are simply forms of discipline, ways to make children learn to behave. But there’s a big difference between giving an unmanageable child a swat on the backside and twisting the child’s arm until it breaks. Physically abusive parents have issues of anger, excessive need for control, or immaturity that make them unable or unwilling to see their level of aggression as inappropriate.
Sometimes the very youngest children, even babies not yet born, suffer physical abuse. Because many chemicals pass easily from a pregnant woman’s system to that of a fetus, a mother’s use of drugs or alcohol during pregnancy can cause serious neurological and physiological damage to the unborn child, such as the effects of fetal alcohol syndrome; mothers can also pass on drugs or alcohol in breast milk. A woman who drinks or uses drugs when she knows she’s pregnant can be charged with child abuse in many jurisdictions if her baby is born with problems because of the substance use.
Another form of child abuse involving babies is shaken baby syndrome, in which a frustrated caregiver shakes a baby roughly to make the baby stop crying. The baby’s neck muscles can’t support the baby’s head yet, and the brain bounces around inside its skull, suffering damage that often leads to severe neurological problems and even death. While the person shaking the baby may not mean to hurt him, shaking a baby in a way that can cause injury is a form of child abuse.
An odd form of physical child abuse is Munchausen’s syndrome by proxy, in which a parent causes a child to become ill and rushes the chlld to the hospital or convinces doctors that the child is sick. It’s a way for the parent to gain attention and sympathy, and its dangers to the child constitute child abuse.
Is corporal punishment the same as physical abuse?
Corporal punishment, the use of physical force with the intent of inflicting bodily pain, but not injury, for the purpose of correction or control, used to be a very common form of discipline: most of us know it as spanking or paddling. And many of us were spanked as children without damage to body or psyche.
The widespread use of physical punishment, however, doesn’t make it a good idea. Most child-care experts have come to agree that corporal punishment sends the message to children that physical force is an appropriate response to problems or opposition. The level of force used by an angry or frustrated parent can easily get out of hand and lead to injury. Even if it doesn’t, what a child learns from being hit as punishment is less about why conduct is right or wrong than about behaving well — or hiding bad behavior — out of fear of being hit.
Signs of physical child abuse include visible marks of maltreatment, such as cuts, bruises, welts, or well-defined burns, and reluctance to go home. If you ask a child about how he or she got hurt and the child talks vaguely or evasively about falling off a fence or spilling a hot dish, think hard before you accept the child’s story at face value.
Sexual abuse in children: types and warning signs
Sexual abuse, which accounts for about 10 percent of child abuse, is any sexual act between an adult and a child. Such acts include:
Behavior involving penetration – vaginal or anal intercourse and oral sex
Fondling – Touching or kissing a child's genitals, making a child fondle an adult's genitals.
Violations of privacy – Forcing a child to undress, spying on a child in the bathroom or bedroom.
Exposing children to adult sexuality – Performing sexual acts in front of a child, exposing genitals, telling "dirty" stories, showing pornography to a child.
Exploitation – Selling a child’s services as a prostitute or a performer in pornography.
The adult who sexually abuses a child or adolescent is usually someone the child knows and is supposed to trust: a relative, childcare provider, family friend, neighbor, teacher, coach, or clergy member. More than 80 percent of sex offenders are people the child or adolescent victims know. It’s important to understand that no matter what the adult says in defense of his or her actions, the child did not invite the sexual activity and the adult’s behavior is wrong. Sexual abuse is never the child's fault.
Children are psychologically unable to handle sexual stimulation. Even toddlers, who haven’t formulated the idea that the sexual abuse is wrong, will develop problems resulting from the overstimulation. Older children who know and care for their abusers know that the sexual behavior is wrong, but they may feel trapped by feelings of loyalty and affection. Abusers warn their victims not to tell, threatening children with violence or ostracism, and the shame associated with the sexual activity makes the child especially reluctant to tell. When sexual abuse occurs within the family, children may worry that other family members won’t believe them and will be angry with them if they tell — as is often the case. The layer of shame that accompanies sexual abuse makes the behavior doubly traumatizing.
Some signs of sexual child abuse
Often children who have suffered sexual abuse show no physical signs, and the abuse goes undetected unless a physician spots evidence of forced sexual activity. However, there are behavioral clues to sexual abuse, including:
Inappropriate interest in or knowledge of sexual acts
Reluctance or refusal to undress in front of others
Extra aggression or, at the other end of the spectrum, extra compliance
Fear of a particular person or family member
Children who use the Internet are also vulnerable to come-ons by adults online. Among the warning signs of online sexual child abuse are these:
Your child spends large amounts of time online, especially at night.
You find pornography on your child's computer.
Your child receives phone calls from people you don't know, or makes calls, sometimes long distance, to numbers you don't recognize.
Your child receives mail, gifts, or packages from someone you don't know.
Your child turns the computer monitor off or quickly changes the screen on the monitor when you come into the room.
Your child becomes withdrawn from the family.
Your child is using an online account belonging to someone else.
Emotional child abuse: types and warning signs
Emotional child abuse involves behavior that interferes with a child’s mental health or social development: one website calls it “the systematic tearing down of another human being.” Such abuse can range from verbal insults to acts of terror, and it’s almost always a factor in the other three categories of abuse. While emotional abuse by itself doesn’t involve the infliction of physical pain or inappropriate physical contact, it can have more long-lasting negative psychological effects than either physical abuse or sexual abuse.
Examples of emotional child abuse include:
Belittling or shaming the child: name-calling, making negative comparisons to others, telling the child he or she is “no good," "worthless," "a mistake."
Habitual blaming: telling the child that everything is his or her fault.
Ignoring or disregarding the child
Lack of affection and warmth: Failure to hug, praise, express love for the child
These are actions that are meant to isolate and terrorize a child, such as tying the child to a fixture or piece of furniture or locking a child in a closet or dark room.
This involves causing a child to witness or participate in inappropriate behavior, such as criminal activities, drug or alcohol abuse, or acts of violence.
Emotional abuse can come not only from adults but from other children: siblings, neighborhood or schoolyard bullies, peers in schools that permit a culture of social ostracism (the “mean girl” syndrome). The signs of emotional child abuse include apathy, depression, and hostility. If it happens at school, the child may be reluctant to go to school and develop or fake a physical complaint.
Causes of child abuse
Why would someone abuse a defenseless child? What kind of person abuses a child? Not all child abuse is deliberate or intended. Several factors in a person's life may combine to cause them to abuse a child:
Stress, including the stress of caring for children, or the stress of caring for a child with a disability, special needs, or difficult behaviors
Lack of nurturing qualities necessary for child care
Immaturity: a disproportionate number of parents who abuse their children are teenagers
Difficulty controlling anger
Personal history of being abused
Isolation from the family or community
Physical or mental health problems, such as depression and anxiety
Alcohol or drug abuse
Personal problems such as marital conflict, unemployment, or financial difficulties.
No one has been able to predict which of these factors will cause someone to abuse a child. A significant factor is that abuse tends to be intergenerational – those who were abused as children are more likely to repeat the act when they become parents or caretakers.
In addition, many forms of child abuse arise from ignorance. Sometimes a cultural tradition leads to abuse. Such beliefs include:
Children are property.
Parents (especially fathers) have the right to control their children in any way they wish.
Children need to be toughened up to face the hardships of life.
Girls need to be genitally mutilated to assure virginity and later marriage.
Effects of child abuse
Child abuse can produce dire consequences during the victim’s childhood and adulthood. Some effects of child abuse are obvious: a child is malnourished or has a cast on her arm; a nine-year-old develops a sexually transmitted disease. But some physiological effects of child abuse, such as cognitive difficulties or lingering health problems, may not show up for some time or be clearly attributable to abuse. Other effects of child abuse are invisible or go off like time bombs later in life.
Emotional Effects of Child Abuse
Just as all types of child abuse have an emotional component, all affect the emotions of the victims. These effects include
Depression and anxiety
Aggressive behavior/anger issues
Alienation and withdrawal
Flashbacks and nightmares
Many adults who were abused as children find it difficult to trust other people, endure physical closeness, and establish intimate relationships.
Behavioral Effects of Child Abuse
Child abuse can play itself out not only in how its victims feel but in what they do years later. Children who suffer abuse have much greater chances of being arrested later as juveniles and as adults. Significant percentages of inmates in U.S. prisons were abused as children. One of every three abused or neglected children will grow up to become an abusive parent.
Other behavioral effects include
Problems in school and work
Criminal or antisocial behavior
Alcohol and drug abuse
Getting help for an abused child
Although many people are reluctant to get involved in other families’ lives, when it comes to child abuse, you don’t have the option of keeping mum. If you know of a child being abused or even suspect abuse, you have the responsibility to report it. In the United States, Canada, and Australia, the concept of mandatory reporting of suspected child abuse is well established and is beginning to catch on in other countries around the world. Laws on mandatory reporters designate classes of professionals — typically school personnel, social workers, health care workers, mental health professionals, childcare providers, and law enforcement personnel, but in some states also clergy, film processors, and drug abuse counselors — who must report suspected child abuse. Eighteen states and Puerto Rico require all citizens to report suspected abuse or neglect.
By reporting, you can make a tremendous difference in the life of a child and the child’s family, especially if you help stop the abuse early. Early identification and treatment can help mitigate the long-term effects of abuse. If the abuse is stopped and the child receives competent treatment, the abused child can begin to regain a sense of self-confidence and trust. Parents may also benefit from support, parent training and anger management.
The best first place to call to report suspected child abuse is:
The Childhelp National Child Abuse Hotline: 1-800-4-A-CHILD (1-800-422-4453)
Staffers at the hotline can help:
Victims: children and teens who have been abused
Survivors of child abuse
Abusers: people who have abused a child or who are afraid that they may abuse a child
Witnesses to child abuse
Childhelp cannot make a report of child abuse for you, but it can set up a three-way call with your local enforcement agency. You can also call your local enforcement agency directly to report child abuse. Childhelp has a list of local phone numbers you can call for your county or state in the U.S.
Reporting is anonymous. In most states, you do not have to give your name when you report child abuse. The child abuser cannot find out who made the report of child abuse.