Child Abuse: A National Epidemic

"Child abuse and neglect in the United States now represents a national emergency... Protection of children from harm is not just an ethical duty; it is a matter of national survival" (U.S. Advisory Board on Child Abuse and Neglect, 1990). For too many children, child abuse is what they know every day of their lives. Over 2.9 million cases of child abuse were reported last year in this country. Figures do not tell the whole story. Evidence is mounting that child mistreatment is the precursor to many of the major social problems in this culture. Consider these figures:

95% of child abusers were themselves abused as children;

80% of substance abusers were abused as children;

80% of runaways cite child abuse as a factor;

78% of our prison population were abused as children;

95% of prostitutes were sexually abused as children.

Not every child who is abused has problems of this magnitude, but we know child abuse robs far too many children of their ability to freely reach their full potential. Their loss is society's loss and "band-aid" measures are inadequate to address this epidemic.

Community resistance to prevention programs has fallen away as awareness has increased and as programs have become more appropriate to the developmental needs and abilities of children.

90% of the public believe that all elementary schools should offer prevention of child abuse programming.

92% of all teachers believe such instruction is effective.

60% of all elementary school districts mandate prevention instruction.
The need is obvious.

Epidemic as defined by the Merriam-Webster dictionary is something affecting or tending to affect a disproportionately large number of individuals within a population, community, or region at the same time or something that is excessively prevalent. With the number of reported child abuse cases reaching over 2.9 million cases in this country last year alone, it safe to call this maltreatment of children a national epidemic. Child abuse can rear its ugly head in a variety of ways that can be organized into 3 categories: physical abuse; sexual abuse; and emotional abuse.

Physical Abuse is characterized by the infliction of physical injury as a result of punching, beating, kicking, biting, burning, shaking or otherwise harming a child. The parent or caretaker may not have intended to hurt the child; rather, the injury may have resulted from over-discipline or physical punishment.
Sexual Abuse includes fondling a child's genitals, intercourse, incest, rape, sodomy, exhibitionism, and commercial exploitation through prostitution or the production of pornographic materials. Many experts believe that sexual abuse is the most under-reported form of child maltreatment because of the secrecy or "conspiracy of silence" that so often characterizes these cases. Emotional Abuse (psychological/verbal abuse/mental injury) includes acts or omissions by the parents or other caregivers that have caused, or could cause, serious behavioral, cognitive, emotional, or mental disorders. In some cases of emotional abuse, the acts of parents or other caregivers alone, without any harm evident in the child's behavior or condition, are sufficient to warrant child protective services (CPS) intervention.

Although any of the forms of child maltreatment may be found separately, they often occur in combination. Emotional abuse is almost always present when other forms are identified.

Physical Abuse
The statistics on physical child abuse are alarming. It is estimated hundreds of thousands of children are physically abused each year by a parent or close relative. Thousands die. For those who survive, the emotional trauma remains long after the external bruises have healed. Communities and the courts recognize that these emotional "hidden bruises" can be treated. Early recognition and treatment is important to minimize the long term effect of physical abuse.
Children who have been abused may display:

a poor self image

sexual acting out

inability to trust or love others

aggressive, disruptive, and sometimes illegal behavior

anger and rage

self destructive or self abusive behavior, suicidal thoughts

fear of entering into new relationships or activities

school problems or failure

feelings of sadness or other symptoms of depression

flashbacks, nightmares

drug and alcohol abuse

Children know that parents have bad days, that they have problems and that sometimes they take their problems out on their kids. This doesn't make them bad people. At the same time, children should know that there are limits to acceptable behavior. Equally important is that children learn that this type of treatment is never deserved or "their fault." Children tend to believe that they cause the things that happen to them. This is part of what keeps them from telling.

Often the severe emotional damage to abused children does not surface until adolescence or later, when many abused children become abusing parents. An adult who was abused as a child often has trouble establishing intimate personal relationships. These men and women may have trouble with physical closeness, touching, intimacy, and trust as adults. They are also at higher risk for anxiety, depression, substance abuse, medical illness, and problems at school or work. Without proper treatment, physically abused children can be damaged for life.

Early identification and treatment is important to minimize the long-term consequences of abuse. Child and adolescent psychiatrists provide comprehensive evaluation and care for children who have been abused. The family can be helped to learn new ways of support and communicating with one another. Through treatment, the abused child begins to regain a sense of self-confidence and trust.

Sexual Abuse

The nature of the crime constituting child sexual abuse is intertwined with the issue of victim secrecy. There are many factors relating to the dynamics of the insufferable crime that may impact victim failure to disclose. Victims of sexual abuse frequently experience feelings of shame, guilt, isolation, powerlessness, embarrassment, and inadequacy. They may even accept responsibility for the abuse by blaming themselves. Victims may also have a feeling that "something is wrong with me," or that the abuse is their fault. They may be embarrassed or reluctant to answer questions about sexual aspects of the abuse.

Children often fail to report because of fear that disclosure will bring consequences even worse than being victimized again. The victim may feel guilty for creating consequences to the perpetrator and may fear subsequent retaliatory actions from the perpetrator. Based on research, it could be expected that victims' perceptions of guilt and self-blame would interfere with their decision to identify themselves through disclosure.

Sexual abuse research suggests at least an associative relationship between sexual abuse and other disorders. A sexual abuse victim may develop serious psychological problems as a result of the victimization.

The effects of the molestation may be delayed into adulthood. Long-term effects that are frequently reported and associated with sexual abuse include depression, self-destructive behavior, anxiety, feelings of isolation and stigma, poor self-esteem, difficulty in trusting others, tendency towards being victimized more than once, substance abuse, and sexual maladjustment.

Early identification of sexual abuse victims appears crucial to reduction of suffering, enhancement of psychological development, and for healthier adult functioning. Experts suggest that policies and procedures geared only to those children who have disclosed fail to recognize the needs of the majority of victims.
As long as disclosure continues to be a problem for young victims, then fear, suffering, and psychological distress will, like the secret, remain with the victim.

Emotional Abuse
Emotional abuse is more than just verbal abuse. It is an attack on a child's emotional and social development, and is a basic threat to healthy human development. Emotional abuse can take many forms: Belittling; Coldness; Corrupting; Cruelty; Extreme Inconsistency; Harassment; Ignoring; Inappropriate Control; Isolating; Rejecting; and Terrorizing.

Emotional abuse is the core of all forms of abuse, and the long-term effects of child abuse and neglect in general stem mainly from the emotional aspects of abuse. Actually, it is the psychological aspect of most abusive behaviors that defines them as abusive.

Despite the fact that the long-term harm from abuse is most often caused by the emotional aspects of the abuse, emotional abuse is the most difficult of the forms of abuse to substantiate and prosecute. Actual physical injury is often required before the authorities can step in and assist a child. Also, the effects of abuse are very similar to symptoms of many childhood mental and physical disorders, which make identifying emotionally abused children difficult.

The Reality of the Epidemic

Last year, 52 percent of victims of child maltreatment were girls and 48 percent were boys. While rates of most types of maltreatment were similar for both sexes, more girls than boys were sexually abused. The youngest and most vulnerable children (under the age of 3) had the highest victimization rate. Overall, rates of victimization declined as children's age increased. While children of every race and ethnicity were abused, victimization rates varied. Out of all children reported as abused:

50.6 percent of victims were White;

24.7 percent of victims were African American;

14.2 percent of victims were Hispanic;

1.6 percent of victims were American Indian-Alaska Native;

1.4 percent of victims were Asian-Pacific Islander.

A parent abused the majority of the victims that were reported. Approximately three-fifths of perpetrators of abuse were women. Nearly 42 percent of that group of women perpetrators were younger than 30. While mothers were more frequently identified as perpetrators of physical abuse, fathers were more frequently identified as the perpetrators of sexual abuse.

Not all victims of abuse are reported and not all reports are verifiable. As such, the statistics likely under-represent the true scope of child maltreatment. That being said, the severity of the problem becomes staggering.

There is no single known cause of child maltreatment. Nor is there any single description that captures all families in which children are victims of abuse. Child maltreatment occurs across socio-economic, religious, cultural, racial, and ethnic groups.

While the specific causes that lead a parent to abuse a child have not been definitively identified - research has recognized a number of attributes commonly associated with abuse. Some of these attributes are: personality characteristics and psychological well being of the parents; substance abuse by the parents; family structure; stress; parent-child interaction; poverty and unemployment; and violent communities.

The consequences of child abuse can be profound and may endure long after the abuse occurs. The effects can appear in childhood, adolescence, or adulthood, and may affect various aspects of an individual's development. These effects range in consequence from minor physical injuries, low self-esteem, attention disorders, and poor peer relations to severe brain damage, extremely violent behavior, and death.

The seriousness of the effects of abuse outlines the importance for professionals, along with concerned community members, to help prevent child abuse. To break the cycle of abuse, communities across the country must continue to develop and implement strategies that prevent abuse from happening.

Prevention efforts most commonly occur before a problem develops so that the problem itself, or some variation of the problem, can be stopped. Child abuse prevention covers a broad spectrum of services (such as public awareness, parent education, and home visitation) for audiences ranging from the general public to individuals who have abused or neglected a child. Community groups, social services agencies, schools, and other concerned citizens may provide these services. Typically, prevention activities attempt to eliminate predictable problems, protect existing health, and promote desired goals. More specifically, family support services, a major component of child abuse prevention, are designed to strengthen and stabilize families, increase parental abilities, provide a safe and stable family environment, and enhance child development.

Child Abuse is a national epidemic. The number of our nation's children that are being robbed of a fair start in life is hard to fathom. We as parents, educators, and concerned citizens have an obligation to the nation's children to break the cycle-to stop child abuse before it starts. We have an obligation to make it easier and safer for our children to report child abuse incidents. We have a duty to prosecute offenders to the fullest extent of the law.

Many of us as adults know or have seen victims of child abuse. Unfortunately, there are many more that we are not aware of right in front of us everyday. It is reprehensible that a child should have to deal with such an occurrence. All of us need to live up to our obligation to these victims. This country has far too many resources to allow this to continue. We have stopped numerous epidemics during our history. This epidemic needs to be stopped as well.

References
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Child abuse and neglect in California. Retrieved from Legislative Analyst's Office on
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http://www.fightcrime.org/releases.php?id=53
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