Resource Library: Abuse

Protecting America's Children: It's Everybody's Business

Q. Do these numbers represent an increase?
A. Yes. The number of children reported has increased nearly 50% in the last ten years. The number of children involved in substantiated reports has grown by nearly 40%.

Q. What kinds of injuries did these children experience?
A. In 1995, abused and neglected children endured the following forms of maltreatment:

• More than half (54%) were neglected
• 25% were physically abused
• 11% were sexually abused
• The remaining children suffered from emotional and other forms of maltreatment. (NCPCA)

Q. How are abuse and neglect defined?
A. State and federal laws define what forms of child abuse and neglect must be reported to authorities. These definitions vary from state to state. The CWLA Standards for Services for Abused or Neglected Children and Their Families also provide the following generally accepted definitions of child maltreatment:

• Physical Abuse Physical acts by parents or care givers that caused, or could have caused, physical injury to the child. (These may include bruises and marks caused by punching, hitting with the hand or an object, fractures,scald marks and burns, injuries to the face and head, and internal injuries.)
• Neglect Failure of parents or care givers to provide needed, age-appropriate care including food, clothing, shelter, protection from harm, supervision appropriate to the child's development, hygiene, and medical care.
• Sexual Abuse Engagement by parents or care givers of a child in any kind of sexual activity with a child. It includes, but is not limited to forced or coerced sexual contact of any kind, exploitation through persistent sexual stimulation, child prostitution, sex rings, or pornography.
• Emotional Maltreatment Parental behavior, such as rejecting, terrorizing, berating, ignoring, or isolating a child, that causes, or is likely to cause, serious impairment of the physical, social, mental, or emotional capacities of the child.

Q. How many children are seriously injured or die because of abuse and neglect?
A. Every day at least three children die because of abuse and neglect--1215 such deaths occurred in 1995. Abuse related head injuries most often cause these deaths. (NCPCA) In 1993, more than a half million children endured serious abuse-related injuries--more than four times the number of serious injuries reported in 1986. Many experts believe that the number of abuse and neglect-related deaths may be much higher than the official figures. Ambiguous family and medical circumstances, or incomplete child death investigations can mean that some child abuse and neglect deaths are misclassified as deaths by natural causes.

Q. Who are these children?
A. Most victims of abuse and neglect (nearly 40%) are five years old or younger. Most are abused by their parents or other adult caretaker living in the home. Evidence suggests that school-aged children may be abused more often but younger children are at greatest risk because they cannot protect themselves or readily seek assistance. For example, in 1995, 85% of children who died from abuse where under age five and about half were less than one year old. Often, there has already been concern about the child's safety. Forty-six percent of these children were currently or previously involved with child protective services at the time of their death.

Q. Do these figures accurately tell us how many children are actually abused and neglected?
A. No. Most experts maintain that many abused children are not reported to authorities. It is also believed that many reported cases may not be substantiated because the harm to the child is less serious or less obvious to investigators. The Third National Incidence Study of Child Abuse and Neglect, conducted in 1995, estimates that the real incidence of abuse and neglect may be three times greater than the numbers reported to authorities. In 1995, the Gallup Organization polled parents nationwide. They too concluded that child maltreatment is far more prevalent than the official data suggests. Gallup estimated that three million children were victims of physical abuse alone--16 times greater than the number of children reports reported to authorities. An estimated one million children are believed to be victims of sexual abuse--ten times official figures.

Q. What agencies are currently responsible for responding to reports of abuse and neglect?
A. Government child protective service agencies, law enforcement and the courts all carry statutory mandates to respond to the concerns of abused and neglected children and their families. Other government services including certain public assistance programs, mental health, juvenile justice, public health and substance abuse supplement the work of these mandated agencies. Community-based programs also provide placements for abused and neglected children and their parents. Services assist children who cannot safely remain at home; parents needing support and training programs, and family members needing health, mental health and other treatment services.

Q. What happens when a child is reported abused or neglected?
A. Child protective services and/or law enforcement typically receive reports of maltreatment and determine what sort of response is warranted in each circumstance. Depending on the nature and seriousness of the report law enforcement and/or child protective services are responsible for an initial visit to the home to ensure the immediate safety of a child. In the most serious cases law enforcement will intervene to provide immediate safety for all parties and decide whether an arrest or further criminal investigation is warranted. Child protective services will also investigate and assess the situation to decide whether mandated services or civil court intervention is required. They are also responsible for helping construct and put in place a plan for safety and services to the children and families. This may include child care, medical care, parenting education, family supervision, drug treatment, and placement.

Q. Is child maltreatment a health issue for children and adults?
A. Yes! To begin with many abused and neglected children start their lives with significant health problems. For example, some are born with low birth weights because their mothers have not had adequate prenatal care. Other children are prenatally exposed to illegal drugs, alcohol, HIV/AIDS and other sexually transmitted diseases. Research has shown that children who are born with these and other health problems are especially vulnerable to maltreatment when their parents do not have the skills or when they cannot manage the stress that comes with providing for their special care needs. Some children require immediate medical assistance to treat the injuries that result from physical or sexual abuse. For example, infants who experience "shaken baby syndrome," slapping, hitting or tossing, are likely to require care for physical trauma leading to blindness, brain injury, and retardation. Children who are neglected often miss routine immunizations and pediatric care. Others have not been treated for illness or injuries that are minor in nature if treated promptly. Untreated these illnesses can result in hearing loss, impaired vision, and other impairments that affect a child's ability to learn and grow. Other neglected children experience drops in I.Q. due to lack of proper stimulation and care from adults. The health concerns of abused and neglected children are also growing. In one 1990 New York State study, abused and neglected children being placed in out-of-home care where more likely to suffer from upper respiratory infections, dental caries, malnutrition and dermatological disorders than those who entered care in 1984. (Schor, Simms) An estimated 30 to 40% of children in the child welfare system have chronic medical problems, including delayed growth and development, HIV infection, neurological disabilities, malnutrition and asthma. Twenty percent of children in foster care have serious developmental disabilities such as mental retardation, cerebral palsy, and learning disabilities.

Q. Are current policies or programs enough to keep children safe from maltreatment?
A. No. Americans are increasingly troubled by the many problems they see with the existing system of child protection. First, they are concerned that child deaths reported in the media are evidence that authorities are failing to protect all of the children in need of assistance. At the same time, they also believe that an uncalled for or disproportionate reaction to minor family problems has traumatized some families. Their concerns are well-founded. While the child protection system competently helps many children and families, current policies do not ensure that the right level of intervention reaches the right children at the right time.

Q. Why is child abuse still an issue?
A. State officials tell us that they are ill equipped to handle the range of concerns experienced by abused and neglected children and their families today. Their limited resources go to the most serious cases of maltreatment while other families with less serious problems receive little, if any, attention. Families where there is abuse and neglect experience a range of difficult social and health problems. For example, most states site parental alcohol and drug abuse as their most pervasive child safety concern. Poverty, economic stress, housing, mental health problems, and adult domestic abuse are also significant issues affecting the well-being of children. Parenting ability is also a concern, particularly for teen parents and inexperienced young families who have a poor understanding of child development. Limited community resources complicate these problems. Solving these vast social problems cannot be accomplished easily. They most certainly cannot be solved within the limited mandate and resources of government agencies. They must be tackled more broadly beginning with comprehensive community education and planning efforts that are only beginning to take shape in a few communities. These efforts must be supplemented by a strong response from government to the most serious child safety concerns.

Q. Are there better ways of preventing and addressing reports of child maltreatment?
A. Yes. CWLA believes that current child protection efforts must be improved so that no further harm is done to children who have already been abused and neglected. Equally, we believe that the only true child protection response will occur when we prevent abuse and neglect in the first place. Like most health concerns we must not confuse the treatment of the symptoms and even treatment of the disease with finding a cure. A comparable analogy might be our search for a cure for cancer. While we work to improve early detection, and we find quicker and more effective ways to treat cancer our real goal is to stop it altogether. To date our efforts in child abuse have not focused adequately on prevention. For example, we provide parenting education only after parents have failed. We provide placement only after children are hurt and we provide treatment for problems when correcting them has become nearly impossible.

Q. Is it possible to make changes that will keep children safe and help them to grow up healthy, loved and thriving?
A. Absolutely! We already know what it takes to raise healthy, safe children. Most parents do a pretty good job of raising their children--although most would like to do better. We also know that some will fail if they do no receive assistance early on and that a very few parents cannot and will never be able to provide adequately for their children. What is needed is a concerted national effort to ensure that those all of these families have support and resources available to them before they encounter problems. Healthy Families America is an excellent example of an approach designed to bolster all new families. More is needed, however, for families who are already experiencing problems or where serious harm cannot be averted. In these circumstances interventions must be swift and of sufficient intensity to ensure child safety.

Q. Can these changes in a few communities be replicated across the country?
A. Yes, changes in a few communities can and must be replicated across the country. On the national level, this can be accomplished through a skillfully executed public education that helps to inform Americans about what children need to grow up safe, healthy, and thriving. On the local level, changes will require a mobilization of new partners, including families, community agencies, public officials, civic organizations, businesses, and the citizenry at large.

If we all work together, we can effect large scale changes in attitude, behavior, and the way in which we currently conduct services to strengthen families, while at the same time protecting children from abuse and neglect.