Child neglect can include physical neglect failing to provide food, clothing, shelter, or other physical necessities , emotional neglect not providing love, comfort, or affection , and medical or educational neglect not providing access to needed medical care or education , or supervisory neglect failure to appropriately supervise.
Psychological or emotional abuse results from all of the above, but also can be associated with verbal abuse, which can harm a child's self-worth or emotional well-being. Most child abuse occurs within the family. Risk factors include parental depression or other mental health issues, a parental history of childhood abuse or neglect, parental substance abuse, and domestic violence.
Child neglect and other forms of maltreatment are also more common in families living in poverty and among parents who are teenagers or who abuse drugs or alcohol. It is not always easy to recognize when a child has been abused.
Children who have been maltreated are often afraid to tell anyone, because they think they will be blamed or that no one will believe them.
Sometimes they remain quiet because the person who abused them is someone they love very much, or because of fear, or both. Parents also tend to overlook signs and symptoms of abuse, because it is hard to believe it could happen or they fear what might happen if people found out. However, a child who has been abused needs special support and treatment as early as possible. The longer children continue to be abused or are left to deal with the situation on their own, the harder it is for them to be able to heal and develop optimally physically and mentally.
Here are some physical signs and behavioral changes in children who may have experienced abuse or neglect:. It is important to remember that the following changes are seen in many children as a result of many different kinds of stressful situations and are not specific to child abuse and neglect. Fearful behavior nightmares, depression , unusual fears. In most cases, children who are abused or neglected suffer greater mental health than physical health damage.
Emotional and psychological abuse, physical abuse, and neglect deny the child the tools needed to cope with stress , and to learn new skills to become resilient , strong, and successful. So a child who is maltreated or neglected may have a wide range of reactions and may even become depressed or develop suicidal , withdrawn, or violent behavior.
As they get older, they may show learning difficulties, use drugs or alcohol, try to run away, refuse discipline, or abuse others. As an adult, they may develop marital and sexual difficulties, depression, or suicidal behavior. Not all children who are abused have severe reactions. Usually the younger the child, the longer the abuse continues. The closer the child's relationship with the abuser, the more serious the mental health effects will be.
A close relationship with a very supportive adult can increase resiliency , reducing some of the impact. If you suspect your child has been abused, get help immediately through your pediatrician or a local child protective agency.
Physicians are legally obligated to report all suspected cases of abuse or neglect to state authorities. Your pediatrician also will detect and treat any medical injuries or conditions, recommend a therapist, and provide necessary information to investigators. The doctor also may testify in court if needed to secure legal protection for the child or criminal prosecution of the person suspected of perpetrating the abuse or neglect.
If your child has been abused, you may be the only person who can help them. There is no good reason to delay reporting your suspicions of abuse. Denying the problem will only make the situation worse. It allows the abuse or neglect to continue unchecked and lowers your child's chance for optimal physical and mental health and well-being. Protective factors are conditions in families and communities that, when present, increase the health and well-being of children and families.
They are attributes that serve as buffers, helping parents who might otherwise be at risk of abusing their children to find resources, supports, or coping strategies that allow them to parent effectively, even under stress.
Child Abuse Prevention Centers for Disease Control and Prevention Presents an overview of child abuse and neglect prevention and reviews child maltreatment statistics, how child abuse and neglect are preventable, and links to several resources on preventing child abuse and neglect as well as parenting essentials.
It outlines programs and strategies that are proving beneficial in reducing the likelihood of child maltreatment, such as public awareness efforts, parent education, home visitation, and community prevention efforts.
Adopting a public health approach in prevention strategies can strengthen community systems that decreases child maltreatment. Preventing Child Maltreatment: Defining the Problem, Discussing Solutions National Conference of State Legislatures Defines child abuse before presenting various strategies for preventing maltreatment, including increasing home visiting, promoting health literacy, and engaging community health workers.
Understanding and Preventing Child Abuse and Neglect American Psychological Association Defines child abuse and neglect and examines the factors that place a child at risk of child maltreatment, consequences of child maltreatment, factors that can help prevent child abuse and neglect, and types of prevention. Adult figures may be perpetrators of offensive incidents or mediators in intervention or prevention efforts. The importance of the social ecological framework of the child has only recently been recognized in studies of maltreatment.
Responses to child abuse and neglect involve a variety of social institutions, including commu-. Such groups and organizations present special intervention opportunities to reduce the scale and scope of the problem of child maltreatment, but their activities are often poorly documented and uncoordinated.
Finally, governmental offices at the local, state, and federal levels have legal and social obligations to develop programs and resources to address child maltreatment, and their role is critical in developing a research agenda for this field.
In the past, the research agenda has been determined predominantly by pragmatic needs in the development and delivery of treatment and prevention services rather than by theoretical paradigms, a process that facilitates short-term studies of specialized research priorities but impedes the development of a well-organized, coherent body of scientific knowledge that can contribute over time to understanding fundamental principles and issues.
As a result, the research in this field has been generally viewed by the scientific community as fragmented, diffuse, decentralized, and of poor quality. Despite this quantity of literature, researchers generally agree that the quality of research on child maltreatment is relatively weak in comparison to health and social science research studies in areas such as family systems and child development.
Only a few prospective studies of child maltreatment have been undertaken, and most studies rely on the use of clinical samples which may exclude important segments of the research population or adult memories. Both types of samples are problematic and can produce biased results. Clinical samples may not be representative of all cases of child maltreatment.
For example, we know from epidemiologic studies of disease of cases that were derived from hospital records that, unless the phenomenon of interest always comes to a service provider for treatment, there exist undetected and untreated cases in the general population that are often quite different from those who have sought treatment. Similarly, when studies rely on adult memories of childhood experiences, recall bias is always an issue. Longitudinal studies are quite rare, and some studies that are described as longitudinal actually consist of hybrid designs followed over time.
To ensure some measure of quality, the panel relied largely on studies that had been published in the peer-reviewed scientific literature. More rigorous scientific criteria such as the use of appropriate theory and methodology in the conduct of the study were considered by the panel, but were not adopted because little of the existing work would meet such selection. Given the early stage of development of this field of research, the panel believes that even weak studies contain some useful information, especially when they suggest clinical insights, a new perspective, or a point of departure from commonly held assumptions.
Thus, the report draws out issues based on clinical studies or studies that lack sufficient control samples, but the panel refrains from drawing inferences based on this literature. The panel believes that future research reviews of the child maltreatment literature would benefit from the identification of explicit criteria that could guide the selection of exemplary research studies, such as the following:.
The extent to which the study is guided by theory regarding the origins and pathways of child abuse and neglect;. The use of appropriate and replicable instrumentation including outcome measures in the conduct of the study; and. The selection of appropriate study samples, including the use of experimental and control groups in etiological studies or in the analysis of outcomes of child maltreatment or intervention efforts. For the most part, only a few studies will score well in each of the above categories.
It becomes problematic, therefore, to rate the value of studies which may score high in one category but not in others. The panel has relied primarily on studies conducted in the past decade, since earlier research work may not meet contemporary standards of methodological rigor.
However, citations to earlier studies are included in this report where they are thought to be particularly useful and when research investigators provided careful assessments and analysis of issues such as definition, interrelationships of various types of abuse, and the social context of child maltreatment.
A comparison with the field of studies on family functioning may illustrate another point about the status of the studies on child maltreatment. The literature on normal family functioning or socialization effects differs in many respects from the literature on child abuse and neglect.
Family sociology research has a coherent body of literature and reasonable consensus about what constitutes high-quality parenting in middle-class, predominantly White populations.
Family functioning studies have focused predominantly on large, nonclinical populations, exploring styles of parenting and parenting practices that generate different kinds and levels of competence, mental health, and character in children.
Studies of family functioning have tended to follow cohorts of subjects over long periods to identify the effects of variations in childrearing practices and patterns on children's. By contrast, the vast and burgeoning literature on child abuse and neglect is applied research concerned largely with the adverse effects of personal and social pathology on children. The research is often derived from very small samples selected by clinicians and case workers.
Research is generally cross-sectional, and almost without exception the samples use impoverished families characterized by multiple problems, including substance abuse, unemployment, transient housing, and so forth. Until recently, researchers demonstrated little regard for incorporating appropriate ethnic and cultural variables in comparison and control groups.
In the past decade, significant improvements have occurred in the development of child maltreatment research, but key problems remain in the area of definitions, study designs, and the use of instrumentation. As the nature of research on child abuse and neglect has evolved over time, scientists and practitioners have likewise changed. The psychopathologic model of child maltreatment has been expanded to include models that stress the interactions of individual, family, neighborhood, and larger social systems.
The role of ethnic and cultural issues are acquiring an emerging importance in formulating parent-child and family-community relationships. Earlier simplistic conceptionalizations of perpetrator-victim relationships are evolving into multiple-focus research projects that examine antecedents in family histories, current situational relationships, ecological and neighborhood issues, and interactional qualities of relationships between parent-child and offender-victim.
In addition, emphases in treatment, social service, and legal programs combine aspects of both law enforcement and therapy, reflecting an international trend away from punishment, toward assistance, for families in trouble. Department of Health and Human Services requested that the National Academy of Sciences convene a study panel to undertake a comprehensive examination of the theoretical and pragmatic research needs in the area of child maltreatment.
Review and assess research on child abuse and neglect, encompassing work funded by the Administration for Children, Youth, and Families and other known sources under public and private auspices;. The report resulting from this study provides recommendations for allocating existing research funds and also suggests funding mechanisms and topic areas to which new resources could be allocated or enhanced resources could be redirected.
By focusing this report on research priorities and the needs of the research community, the panel's efforts were distinguished from related activities, such as the reports of the U. Advisory Board on Child Abuse and Neglect, which concentrate on the policy issues in the field of child maltreatment. The request for recommendations for research priorities recognizes that existing studies on child maltreatment require careful evaluation to improve the evolution of the field and to build appropriate levels of human and financial resources for these complex research problems.
Through this review, the panel has examined the strengths and weaknesses of past research and identified areas of knowledge that represent the greatest promise for advancing understanding of, and dealing more effectively with, the problem of child maltreatment. In conducting this review, the panel has recognized the special status of studies of child maltreatment.
The experience of child abuse or neglect from any perspective, including victim, perpetrator, professional, or witness, elicits strong emotions that may distort the design, interpretation, or support of empirical studies. The role of the media in dramatizing selected cases of child maltreatment has increased public awareness, but it has also produced a climate in which scientific objectivity may be sacrificed in the name of urgency or humane service. Many concerned citizens, legislators, child advocates, and others think we already know enough to address the root causes of child maltreatment.
Critical evaluations of treatment and prevention services are not supported due to both a lack of funding and a lack of appreciation for the role that scientific analysis can play in improving the quality of existing services and identifying new opportunities for interventions. The existing research base is small in volume and spread over a wide variety of topics. The contrast between the importance of the problem and the difficulty of approaching it has encouraged the panel to proceed carefully, thoroughly distinguishing suppositions from facts when they appear.
We have arrived at a point where we can. We also recognize the limitations of our knowledge about the effects of different forms of social interventions e. The field of child maltreatment studies has often divided research into the types of child maltreatment under consideration such as physical and sexual abuse, child neglect, and emotional maltreatment.
Within each category, researchers and practitioners have examined underlying causes or etiology, consequences, forms of treatment or other interventions, and prevention programs. Each category has developed its own typology and framework of reference terms, and researchers within each category often publish in separate journals and attend separate professional meetings.
Commenting on the development of various government services for children, the report noted that observations of children's needs were increasingly distorted by the "unmanageably complex, expensive, and confusing" categorical service structure that had produced fragmented and sometimes contradictory programs to address child health and nutrition requirements p. The committee concluded that the actual experiences of children and their families in different segments of society and the conditions of their homes, neighborhoods, and communities needed more systematic study.
The report further noted that we need to learn more about who are the important people in children's lives, including parents, siblings, extended family, friends, and caretakers outside the family, and what these people do for children, when, and where. These same conclusions can be applied to studies of child maltreatment. Our panel considered, but did not endorse, a framework that would emphasize differences in the categories of child abuse or neglect.
We also considered a framework that would highlight differences in the current system of detecting, investigating, or responding to child maltreatment. In contrast to conceptualizing this report in terms of categories of maltreatment or responses of the social system to child maltreatment, the panel presents a child-oriented research agenda that emphasizes the importance of knowing more about the backgrounds and experiences of developing children and their families, within a broader social context that includes their friends, neighborhoods, and communities.
This framework stresses the importance of knowing more about the qualitative differences between children who suffer episodic experiences of abuse or neglect and those for whom mal-. And this approach highlights the need to know more about circumstances that affect the consequences, and therefore the treatment, of child maltreatment, especially circumstances that may be affected by family, cultural, or ethnic factors that often remain hidden in small, isolated studies.
The panel has adopted an ecological developmental perspective to examine factors in the child, family, or society that can exacerbate or mitigate the incidence and destructive consequences of child maltreatment.
In the panel's view, this perspective reflects the understanding that development is a process involving transactions between the growing child and the social environment or ecology in which development takes place. Positive and negative factors merit attention in shaping a research agenda on child maltreatment. We have adopted a perspective that recognizes that dysfunctional families are often part of a dysfunctional environment. The relevance of child maltreatment research to child development studies and other research fields is only now being examined.
New methodologies and new theories of child maltreatment that incorporate a developmental perspective can provide opportunities for researchers to consider the interaction of multiple factors, rather than focusing on single causes or short-term effects.
What is required is the mobilization of new structures of support and resources to concentrate research efforts on significant areas that offer the greatest promise of improving our understanding of, and our responses to, child abuse and neglect. Our report extends beyond what is, to what could be, in a society that fosters healthy development in children and families. We cannot simply build a research agenda for the existing social system; we need to develop one that independently challenges the system to adapt to new perspectives, new insights, and new discoveries.
The fundamental theme of the report is the recognition that research efforts to address child maltreatment should be enhanced and incorporated into a long-term plan to improve the quality of children's lives and the lives of their families.
By placing maltreatment within the framework of healthy development, for example, we can identify unique sources of intervention for infants, preschool children, school-age children, and adolescents. Each stage of development presents challenges that must be resolved in order for a child to achieve productive forms of thinking, perceiving, and behaving as an adult.
The special needs of a newborn infant significantly differ from those of a toddler or preschool child. Children in the early years of elementary school have different skills and distinct experiential levels from those of preadolescent years. Adolescent boys and girls demon-. Most important, developmental research has identified the significant influences of family, schools, peers, neighborhoods, and the broader society in supporting or constricting child development. Understanding the phenomenon of child abuse and neglect within a developmental perspective poses special challenges.
As noted earlier, research literature on child abuse and neglect is generally organized by the category or type of maltreatment; integrated efforts have not yet been achieved. For example, research has not yet compared and contrasted the causes of physical and sexual abuse of a preschool child or the differences between emotional maltreatment of toddlers and adolescents, although all these examples fall within the domain of child maltreatment.
A broader conceptual framework for research will elicit data that can facilitate such comparative analyses. By placing research in the framework of factors that foster healthy development, the ecological developmental perspective can enhance understanding of the research agenda for child abuse and neglect. The developmental perspective can improve the quality of treatment and prevention programs, which often focus on particular groups, such as young mothers who demonstrate risk factors for abuse of newborns, or sexual offenders who molest children.
There has been little effort to cut across the categorical lines established within these studies to understand points of convergence or divergence in studies on child abuse and neglect. The ecological developmental perspective can also improve our understanding of the consequences of child abuse and neglect, which may occur with increased or diminished intensity over a developmental cycle, or in different settings such as the family or the school.
Initial effects may be easily identified and addressed if the abuse is detected early in the child's development, and medical and psychological services are available for the victim and the family. Undetected incidents, or childhood experiences discovered later in adult life, require different forms of treatment and intervention. In many cases, incidents of abuse and neglect may go undetected and unreported, yet the child victim may display aggression, delinquency, substance addiction, or other problem behaviors that stimulate responses within the social system.
Finally, an ecological developmental perspective can enhance intervention and prevention programs by identifying different requirements and potential effects for different age groups.
Intervention programs need to consider the extent to which children may have already experienced some form of maltreatment in order to. In addition, the perspective facilitates evaluation of which settings are the most promising locus for interventions.
A series of national reports associated with the health and welfare of children have been published in the past decade, many of which have identified the issue of child abuse and neglect as one that deserves sustained attention and creative programmatic solutions. In their report, Beyond Rhetoric , the National Commission on Children noted that the fragmentation of social services has resulted in the nation's children being served on the basis of their most obvious condition or problem rather than being served on the basis of multiple needs.
Although the needs of these children are often the same and are often broader than the mission of any single agency emotionally disturbed children are often served by the mental health system, delinquent children by the juvenile justice system, and abused or neglected children by the protective services system National Commission on Children, In their report, the commission called for the protection of abused and neglected children through more comprehensive child protective services, with a strong emphasis on efforts to keep children with their families or to provide permanent placement for those removed from their homes.
In setting health goals for the year , the Public Health Service recognized the problem of child maltreatment and recommended improvements in reporting and diagnostic services, and prevention and educational interventions U.
Public Health Service, For example, the report, Health People , described the four types of child maltreatment and recommended that the rising incidence identified as These public health targets are stated as reversing increasing trends rather than achieving specific reductions because of difficulties in obtaining valid and reliable measures of child maltreatment. The report also included recommendations to expand the implementation of state level review systems for unexplained child deaths, and to increase the number of states in which at least 50 percent of children who are victims of physical or sexual abuse receive appropriate treatment and follow-up evaluations as a means of breaking the intergenerational cycle of abuse.
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