Term Paper On Child Abuse In Bangladesh

Child Abuse In Bangladesh

Child abuse in Bangladesh is a silent crime.Day by day child sexual abuse is increase and itpermeates all the level of the Bangladeshi society. Child sexual abuse can occur inside the family, by a guardian, step-parent, siblings or other relative or outside the home, for example, by a friend, neighbor, child care person, instructor, or stranger and the workplace. Disable children is more vulnerable to abuse. When sexual abuse has happened, a child can create a variety of upsetting emotions, thoughts and behaviors. No child is mentally readied to adapt to rehashed sexual stimulation. Indeed an a few year old, who can't know the sexual action isn't right, will develop problems resulting about because of the powerlessness to adapt to the overstimulation. The child of five or more older who knows and looks after the abuser gets trapped between love or unwaveringness for the individual, and the feeling that the sexual exercises are horrendously off. In the event that the child tries to split far from the sexual relationship, the abuser may debilitate the child with savagery or misfortune of adoration. The point when sexual ill-use happens inside the family, the child may fear the indignation, envy or disgrace of other relatives, or be perplexed the family will split if the mystery is told. A child who is the casualty of delayed sexual ill-use generally creates low regard toward oneself, an inclination of uselessness and an atypical bended perspective of sex. The child may get withdrawn and doubtful of grown-ups, and can get to be suicidal. Some children who have been sexually mishandled experience issues identifying with others aside from on sexual terms. Some sexually ill-used children get to be child abusers or whores, or have different genuine issues when they achieve adulthood. The UN has defined child sex as 'contacts or interactions between a child and an older or more knowledgeable child or adult (a stranger, Sibling or person in a position of authority, such as a parent or caretaker) when the child is being used as an object of gratification for an older child's or adults sexual needs. These contacts or interactions are carried out against the child using force, trickery, bribes, threats or pressure'

Definition
Child abuse or maltreatment constitutes all forms of physical and emotional ill-treatment, sexual abuse, neglect or negligent treatment or commercial or other exploitation, resulting in actual or potential harm to the child's health, survival, development or dignity in the context of a relationship of responsibility, trust or power. Child abuse is the crime of harming a child in a physical, sexual or emotional way .All types of abuse and disregard leave enduring scars. Some of these could be physical; however enthusiastic scarring has long haul impacts in the Child's life. Most child ill-use happens in a child's home. Therefore, we cannot know these misuses. Child sexual misuse is a concealed type of ill-use, which happens both home and outside. It is extremely confused manifestation of ill-use in view of its liable.. In this nation, children are defenseless. Young ladies are significantly more at danger and disabled children are additionally powerless. Bangladesh is exceptionally poor with the goal that numerous child fills in as a work and some act as a servant, they are mishandled. Children are frightened thus. They have a terrible idea about social order. At the day of March 19, 2010, I got news from 'Daily ProthomAlo' that is about child abuse. One teacher tortured his student for color pencil. It is really shocking. Our government gave an announcement that teacher cannot torture his students. If he or she torture, he will be punished.

Main victims
The extent that we know from the perspective from Bangladesh. The significant classes are broken family children, Lack of family solidarity, sex laborers children, road children and child work and so on. Folks who got separate and don't take care of their child fittingly; those children are one of the significant victimized people. Folks, so they are one of the significant victimized people. The children of our nearby whores who do not have a positive environment to grow up additionally confront this sort of misuse. Our social order ignores them with the goal that they are truly ill-used. The children who exists in road or work extraordinarily as a house keeper in the home, they are additionally exploited people. Looking from our social order, with the goal that they are misused. Bangladesh is extremely poor nation. Government cannot furnish all of essential necessities to us, therefore children need to include lives up to expectations. However child specialist is disallowed. All things considered Female child are truly Influenced by sexual ill-use. Male children are likewise ill-used by sexual provocation from same sex and an alternate sex.

Reason behind child sexual abuse
There are several reasons of child abuse. Poverty is one of the principle reasons. From the Parts of Bangladesh we don't have enough facility from our government. Hence major Number of parts include in living up to expectations, so they are abused in their work place. An alternate thing is that in a few cases children are utilized as a whore within that time they are sexually abused. They are sold by agent. Sex separation is one of alternate reasons. We partition male also female child, then some individuals do wrong carry on with them. Our social order does not demonstrate a positive carry on for female child. They are truly disregard in our social order. The greater part of the individuals in Bangladesh are not cognizant about family arranging. Thus, they process a huge number of children and they cannot take care of them fittingly. Hence, their child may be abused. Something else is that most individuals are not conscious about children. They don't give a fitting rule to grow up children. In this reason Childs have no idea what would it be advisable for them to do? They are not mindful about inner and outside dangers of child. Principle reasons of child abuse. The greater part of the individuals in Bangladesh are uneducated. They don't have a clue the impacts of unanticipated marriage abused share additionally. It is truly stunning news since in the provincial zone, it is expanding step by step. Sometimes they have no idea family way so they are rationally tortured by her spouse too as the part of that crew.

Sexually abused children may also develop the following
' Unusual interest in or avoidance of all things of a sexual nature
' Sleep problems or nightmares
' Depression or withdrawal from friends or family
' Seductiveness
' Statements that their bodies are dirty or damaged, or fear that there is something wrong with them in the genital area
' Refusal to go to school
' Delinquency/conduct problems
' Secretiveness
' Aspects of sexual molestation in drawings, games, fantasies
' Unusual aggressiveness or
' Suicidal behavior

The Effects of Sexual Abuse on its Victim
Children enduring abuse create a reach of maladaptive, against social and self-damaging practices. There are different sorts of impacts of child abuse on children. We can see numerous physical muddling's as a result of child abuse. A few impacts of physical child abuse incorporate stomachaches, headaches, gut issues or other physical indications not specifically created by the abused children frequently feel depleted, starving, or diseased more often than not. One conceivable impact of physical child abuse is aloof combative conduct. Child abuse is one of the fundamental reasons of despondency around children. Outrage turned internal leads to sentiments of despondency, and 80% of discouraged adolescents don't get help. They're more inclined to endure an alternate episode of melancholy in their unanticipated 20s, and abuse medications and liquor. Casualties of child abuse are likewise experiencing confinement. Abused children are more averse to make companions and less averse to be rejected by their associates. Anyone recognizing, ceasing consuming without anybody minding, or investing time with individuals doing things better left fixed (these could be outcomes of disregard). Abused children's health, accomplishments, and adulthood are influenced by sexual and physical child abuse ' and not "simply" by sentiments of low self-esteem. Abused children are less averse to experience the ill effects of perpetual weariness syndrome, wretchedness, and post-traumatic anxiety issue. The side effects of physical child abuse don't close the point when the wounds fade. Being abused doesn't mean a child ' or mature person ' will immediately have a miserable life. It's not the abuse that can destroy everything ' it's the manner by which people bargain with issues that make or Sexual abuse of children and youth is covered in mystery, blame and trepidation. Guilty parties use intimidation and dangers to keep the child from telling, yet the most obvious reason In spite of the fact that there is boundless under-reporting of child attack by both male and female victimized people, guys are a great deal less likely to disclose. Notwithstanding contorting children's considerations, abuse additionally drives children into a position of needing to "conceal the family mystery". This avoids children from having true relationships and has long lasting impacts. Also since our capability to structure solid social relationships is scholarly, abused children are denied of numerous abilities important to explore the whole notion of a relationship is contorted. This prompts tricky relationships in life and even at work. An alternate irritating part of abuse is the experiential limitation it puts on children. Assuming that a child feelings of trepidation finishing anything new on account of the risk that it will lead to a vicious strike or since a damaging guardian keeps to a great degree tight control over them, the child will lose his or her feeling of interest and miracle at the world and will quit attempting new things and practicing his or her psyche. That child will never accomplish his or her scholarly potential. There is a long rundown of conclusions for children encountering abuse. They extend from mellow, practically unnoticeable disposition impacts to full-blown breakdowns in solid working. The fact is that abuse builds a child's danger of creating various health and mental issues.

Child Sexual Abuse Prevention and Risk Reduction

A few child sexual abuse counteractive action endeavors target folks and watchmen, given that they are in a remarkable position to teach and secure their children from sexual exploitation. if child sexual abuse aversion exertions proposed for folks and gatekeepers expansion folks' information of child sexual abuse. if such anticipation deliberations persuade folks to instruct and ensure their children from child sexual abuse and if such avoidance endeavors bring about more level rates of child sexual exploitation.

' Giving a brief idea about sexual abusive behavior to the children:
Teaching children what appropriate sexual behavior is and when to say 'no' if someone tries to touch sexual parts of their bodies or touch them in any way that makes them feel uncomfortable. Also, observing children when they interact with others to see if they are hesitant or particularly uncomfortable around certain adults. It is, sometimes, critical to provide adequate supervision for children and only leave them in the care of individuals.

' Support child abuse victim:
Children requirement to realize that they can talk unashamedly to a trusted grown-up and that they will be accepted. Children who are casualties of sexual abuse may as well dependably be consoled that they are not answerable for what has befallen them. Offer consolation for exploited people by supporting associations that help casualties of inbreeding or by essentially consoling casualties of sexual abuse that they ought not feel disgrace or blame. It is paramount to comprehend that grieved families can benefit from outside assistance and that everybody can have impact all the while.

' Teach other about child abuse:
Help make others familiar with sexual abuse by masterminding proficient visitor speakers to present to your associations or gatherings. Empower your neighborhood school board to create projects to teach both instructors and scholars about the issue.

' Report:
Bangladesh is a poor country and it has vast population. So it is difficult to protect children. So if any suspect sexual abuse and believe a child to be in imminent danger, report it to the local child protective service agency or police.

' Rising awareness about child sexual abuse via TV program, cartoon, and advertisements:
To get the attention of the mass people we need to develop some awareness program like cartoon, and advertisements, dramas. So that people get the idea about child abuse. Besides in countries like Bangladesh and its rural people do not have any idea about this activities. So awareness programs should be develop in such a way by which, the massage can reach to the rural people.

Child exploitation
The Declaration from the First World Congress against Commercial Sexual Exploitation of
Children defines commercial sexual exploitationas sexual abuse by the adult and remuneration incash or kind to the child or a third person orpersons. The child is treated as a sexual objectand as a commercial object. The commercialsexual exploitation of children constitutes a formof coercion and violence against children,amounts to forced labor and a contemporaryform of slavery.

The UNICEF definition further links child sexual abuse to sexual exploitation: Child sexual abuse becomes sexual exploitation when a second party benefits through a profit or through a quid pro quo through sexual activity involving a child. This may include prostitution, brothel and street-based sexual exploitation, trafficking for sexual purposes and child pornography.

Child sexual exploitation
Despite the fact that there is an absence of complete and correct facts on the real frequency confirmation to infer that this is a far reaching issue. The rate of commercial sexual exploitation of children (CSEC) in Bangladesh is joined with the issues of child work and trafficking in the nation, furthermore propagated by elements, for example, destitution, urbanization, social standards and patriarchy.
The Bangladesh Constitution guarantees protection from forced labor while national lawscriminalize the buying and selling of children for the purpose of prostitution . Then again, noteworthy crevices in the national enactment stay, with prostitution the main unequivocally distinguished type of sexual abuse. In this respect, laws are obliged to address the expanding issue of child obscenity. Also, it is worried that while national enactment does not criminalize female prostitution, casualties of such types of commercial sexual abuse are off and on again charged and subjected to detainment. International Development Law Organization (IDLO).
Article 20 of the Constitution refers to work as a right and a duty and a matter of honour of revery citizen who is capable of working. Article 28 of the Constitution empowers the State to make special provisions for the benefit of children.
The Government of Bangladesh through the Ministry of Labour and Employment has reviewed all fragmented laws related to child labour with a view to fixing a uniform age for admission to work and to prohibit their engagement in hazardous occupations. According to the Labour Act (2006) the minimum age for admission to work is 14 years and 18 years for hazardous work. Further, light work for children between the ages of 12 - 14 years is defined as non-hazardous work that does not impede education .

Child labor
Child labor is one of the worst forms of exploitation of girls, preventing them from exercising their most basic human rights. Girls living in the poorest households and in rural areas are most likely to be engaged in child labor.
According to the Labor Law of Bangladesh 2006, the minimum legal age for employment is 14. However, as 93 per cent of child laborers work in the informal sector ' in small factories and workshops, on the street, in home-based businesses and domestic employment ' the enforcement of labor laws is virtually impossible .
Thirteen percent (18 percent male; 8 percent female) of Bangladeshi children between the ages of 5 and 14 are working, amounting to nearly 5 million child laborers. The rate of child labor is slightly higher in rural areas. The rate of child labor in tribal areas stands at 18 percent. Forty five percent of child laborers do not attend school.
According to the National Child Labor Survey 2002/03, the total working child population between 5 and 17 years old is estimated to be 7.9 million. The survey found the following:

' The proportion of boy and girl child workers, in the age group of 5-17 years, is
73.5 percent and 26.5 percent, respectively;

' The total number of working children aged 5-17 years in rural areas is estimated at 6.4 million and 1.5 million in urban areas;

' As many as 93.3 percent of all working children in the age group of 5-17 years operate in the informal sector. Agriculture engages 4.5 million (56.4 percent children), while the services sector engages 2 million (25.9 percent), and industry 1.4 million (17.7 percent);

' A total of 1.3 million children are estimated to be working 43 hours or more per week.

Reason for child exploitation
' Poverty
' Illiteracy
' Family backups
' Lack of knowledge by parents about education
' Lack of social awareness
' Poor government rules and regulations

Dangers and risks
Extended periods, low or no wages, poor condition, detachment and dangers in the working environment can intensely influence children's physical and mental health. Child laborers are additionally helpless against different ill-uses, for example, racial segregation, abuse and sexual ill-use. Some work, for example, residential labor, is regularly viewed as a worthy vocation alternative for children, despite the fact that it excessively postures extensive dangers.

How to stop child exploitation
' Bangladesh government has an obligation to guarantee that they don't allow, or permit child labor or exploitation to exist inside their state. Moreover they have an obligation to guarantee that state orgs, corporate figures and additionally their suppliers and exchanging accomplices worldwide, are completely agreeable with the Convention on the Rights of the Child and other global understandings securing the privileges of the child.
As a feature of their corporate social obligation, all transnational and different business ventures utilizing child labor might as well make and execute an arrangement to uproot children from their workforce, including their store network, and enroll them in full time training.
In collaboration with the World Food Program (WFP), the Government started the Food for Education Program in 1993 with the aim to attract poor children and their families to primary education. With the setting-up of the Primary and Mass Education Division in 1992 and the Directorate of Non-Formal Education in 1996, the Government introduced another initiative to tackle the high drop out and low attendance rates in the formal school system .

' The end of child exploitation and the procurement of full time formal education are inseparably connected. The center of consideration must be to energetically coordinate and hold all 'out of school' children into formal instruction frameworks. Children have the right to education at any rate until the age they are permitted to work which is 14. Likewise exertions must be made to uproot all restraints to nearby schools and in addition guaranteeing the vital budgetary and infrastructural backing for the procurement of value training.

' The Convention on the Rights of the Child in addition to an assemblage of other global assertions unequivocally assert the right of all children to live in flexibility from exploitation. Methodologies to the issue have had a tendency to prioritize and isolate answers for diverse sorts of child labor hinging upon specific classifications. These extent from children working in risky businesses to children finishing alleged non-perilous work -including residential work- however passing up a major opportunity for school.
The Stop Child Labor fight accepts that such qualifications, while serving to throws a focus on the most exceedingly awful misuses, have a tendency to be excessively restricted in their center and offer just fractional results. Exertions to dispose of child labor may as well concentrate on all its structures, ideally pointing whatsoever children in a certain group .

' The destruction of child labor is nearly connected to the advancement of other labor gauges in the working environment: the right to organize and group haggling, flexibility from constrained labor, child labor and separation. A living pay, health and wellbeing at work, and the nonappearance of constrained unreasonable extra minutes are likewise essential. Child labor undermines the chances for grown-up livelihood and nice wages. Experience has indicated that child labor is exceptionally unrealistic to exist when a facilitated commerce union is available and where center labor measures are regarded.

' Most of the people in Bangladesh are not educated. So it is very difficult to eliminate the child sexual exploitation. Because they do not know about the sexual exploitation and other exploitation. So we need people awareness to eliminate this type of abuse. Bangladesh government and UNICEFtelecast some awareness program like TV show, drama, cartoon and so on. UNICEF try directly by the NGO to stop child exploitation.

Trafficking
Human trafficking in Bangladesh is accepted to be far reaching both inside the nation and to fortified servitude. Numerous young men have likewise been trafficked to the Middle East to end up camel racing jockeys. Children included in camel racing (CICR) are frequently harmed in the process of their work, are defenseless against abuse from their bosses and there are reports of superintendents Numerous children are brought with their folks' assent, having been hoodwinked by stories of well-paid employments or relational unions. Reintegration into standard social order is a tremendous issue for trafficked children, particularly for young ladies with the stigma and unthinkable connected with it. Assuming that they come back with a Sexually Transmitted Infection (STI) or HIV positive, it gets to be all the more trying for the family and group to acknowledge them. For children included in camel hustling, numerous can no more recollect their own dialect. They get to be strangers in their own particular area.

Bangladesh is a country of origin for trafficking in children. Human rights groups in Bangladesh estimate that between 10,000 and 20,000 girls are trafficked annually to India, Pakistan, Bahrain, Kuwait, and the United Arab Emirates . In Bangladesh, it is not only women and girls that are trafficked, but a significant number of boys are also trafficked internally and internationally for sexual exploitation.

Factors that contribute to the trafficking infrastructure
' Poverty is the main reason for trafficking. Bangladesh is a poor country and most of the people do not have own land and 45% of the population live below the poverty line. So they are always busy to their work place, and they cannot take care their child. So it is the time for the trafficker to trafficking the child.

' Poor infrastructure does little to prevent trafficking. Less than 10% of children are recorded at birth, making trafficking at ease. Also, official procedures for exiting and entering Bangladesh are infrequently enforced and there is no specific legislation addressing cross-border trafficking. Bangladesh and India share a land border of over 4,000 kilometers. The expansive and absorbent borders between these two countries are conducive to the external trafficking.

' Studies have found that just 57% of teen young ladies have even known about Hiv/aids in Bangladesh uncovering that there is a great deal of unprotected sex. The act of a dowry framework is yet an alternate system of trafficking. The point when a dowry has not been paid forthright, the spouse or other relatives may abuse the young lady to weight the young lady's family to speed along the dowry installment. Simultaneously, the young lady may escape to escape the abuse, therefore getting defenseless against trafficking and prostitution.

' According to the Bangladesh Bureau of Statistics (BBS), only 1 out of each 10 children under the age of 5 years was registered in 2006. A 2009 report produced by the United Nations Children's Fund (UNICEF) shows that the rate of birth registration in Bangladesh from 2000 to 2007 was 10 percent in total, with 13 percent and 9 percent in urban and rural regions, separately. Although the records on birth registration are not disaggregated by gender, it is clear that ahuge number of girls in the country remain unregistered.

How to stop trafficking

' Government respond

Bangladesh does not have a comprehensive anti-trafficking legislation but trafficking for the purpose of prostitution, or other immoral acts are covered in the Penal Code of 1860, the Suppression of Immoral Trafficking Act of 1933, the Children Act of 1974 and the Prevention of Repression against Women and Children Act of 2000 (as amended in 2003). Complementary laws that tend to create a preventive environment and mechanism against human trafficking also exist, in particular, the Child Marriage Restraint Act, 1929, the Dowry Prohibition Act, 1980, the Primary Education Act, 1990, and the Labour Act, 2006.

The Penal Code prohibits procurement of a girl under the age of 18 to illicit intercourse with another person. The Code also prohibits the selling, letting, hiring, or disposing of minors under the age of 18 for the purpose of prostitution, along with buying minors for the same purpose. In addition, the code prohibits abduction. The Bangladesh Constitution also prohibits forms of forced labor. The Factories Act of 1965, prohibits forced and underage labor and establishes an inspection system to enforce this. The Suppression of Immoral Traffic Act prohibits keeping a brothel or allowing premises to be used as brothels, soliciting for the purposes of prostitution, living on the money transacted in prostitution, procuring individuals for the purpose of prostitution, importing a female for the purpose of prostitution, prostitution, and detaining a woman for the purpose of prostitution. The act also prohibits encouraging a girl under 18 to engage in prostitution.

' Nongovernmental and international Organization Responses

There are a number of NGO's in Bangledesh working to combat human trafficking. Among them are: Bangladesh National Women Lawyers Association (BNWLA), Ain o Salish Kendro of Dhaka, UNICEF, and International Organization for Migration (IOM). Bangladesh National Women Lawyers Association (BNWLA) provides information for female victims of violence, contact with law enforcement organizations, phone counseling through their various hotline numbers. Their main mission is to improve the social, econominc, and legal status of women.

' Multilateral Initiatives

The SAARC forum is an organization of South Asian Nations dedicated to the economic, technological, social and cultural development with an emphasis on cooperative development since 1985. Its member states Bangladesh, Bhutan, India, Maldives, Nepal, Pakistan, and Sri Lanka. In January 2002, the Bangladeshi government signed the SAARC Convention on Prevention and Combating Trafficking in Women and Children for Prostitution. Resolutions were adopted to step up cooperation among law enforcement authorities to fight trafficking in women and children, terrorism, and drug trafficking. The 13th SAARC Summit, which took place in Dhaka in November 2005, reiterated the pledge made at the 11th conference to continue to work towards addressing the challenges faced by women and children in SAARC countries.
Moreover, USAID has been working to form coalitions with local organizations as well as providing a number of forums on trafficking in the U.S.

' Life skills
UNICEF attempts to upgrade the life abilities of children at danger. The Life Skills programmed employments a distributed methodology where accomplice NGO raise the limit of youthful associate pioneers for encouraging issue based life abilities sessions. These immature associate pioneers then pass these abilities on to their associates and encourage further exchanges with them. Different life abilities are produced through examining social issues that influence youths These sessions create interpersonal abilities to settle on educated choices, take care of issues, think basically and imaginatively, raise healthy connections, empathize with others, and adapt to and deal with their lives in a healthy and a beneficial way. The distributed systems give help and help fabricate self-regard, and improve the youths' capacity for anxiety administration. Group help for these children is additionally improved through introduction on life abilities for folks, government authorities, social laborers and group parts, for example, instructors and religious pioneers. Group based dowry boards and constrained marriage boards are shaped to make a move to secure children from this sort of violation of child rights.

Recommendation & suggestions
Bangladesh government should apply the laws and regulations against child abuse, trafficking and exploitation to raise conscious and awareness to the mass people. Children should provide with basic knowledge about this crimes and for this they need to get primary education in school. UNICEF are providing different campaign to send the message about this crimes. But this initiatives should be combined with the efforts of Bangladesh government. Besides we can follow the strategy of developed countries and implement this in our country. Different NGO's in Bangladesh are already working on it but it is not working well on Bangladesh. As they are not really focused on developing awareness on this certain issues. Most importantly parents need to play the vital role. Children need to get the primary idea and consciousness about this abusive behaviors and avoid this kind of scenarios.

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"Child Maltreatment" redirects here. For the journal, see Child Maltreatment (journal).


Child abuse or child maltreatment is physical, sexual, or psychological maltreatment or neglect of a child or children, especially by a parent or other caregiver. Child abuse may include any act or failure to act by a parent or other caregiver that results in actual or potential harm to a child, and can occur in a child's home, or in the organizations, schools or communities the child interacts with.

The terms child abuse and child maltreatment are often used interchangeably, although some researchers make a distinction between them, treating child maltreatment as an umbrella term to cover neglect, exploitation, and trafficking.

Different jurisdictions have developed their own definitions of what constitutes child abuse for the purposes of removing children from their families or prosecuting a criminal charge.

Definitions[edit]

Definitions of what constitutes child abuse vary among professionals, and between social and cultural groups, as well as across time.[1][2] The terms abuse and maltreatment are often used interchangeably in the literature.[3]:11Child maltreatment can also be an umbrella term covering all forms of child abuse and child neglect.[4] Defining child maltreatment depends on prevailing cultural values as they relate to children, child development, and parenting.[5] Definitions of child maltreatment can vary across the sectors of society which deal with the issue,[5] such as child protection agencies, legal and medical communities, public health officials, researchers, practitioners, and child advocates. Since members of these various fields tend to use their own definitions, communication across disciplines can be limited, hampering efforts to identify, assess, track, treat, and prevent child maltreatment.[3]:3[6]

In general, abuse refers to (usually deliberate) acts of commission while neglect refers to acts of omission.[4][7]Child maltreatment includes both acts of commission and acts of omission on the part of parents or caregivers that cause actual or threatened harm to a child.[4] Some health professionals and authors consider neglect as part of the definition of abuse, while others do not; this is because the harm may have been unintentional, or because the caregivers did not understand the severity of the problem, which may have been the result of cultural beliefs about how to raise a child.[8][9] Delayed effects of child abuse and neglect, especially emotional neglect, and the diversity of acts that qualify as child abuse, are also factors.[9]

The World Health Organization (WHO) defines child abuse and child maltreatment as "all forms of physical and/or emotional ill-treatment, sexual abuse, neglect or negligent treatment or commercial or other exploitation, resulting in actual or potential harm to the child's health, survival, development or dignity in the context of a relationship of responsibility, trust or power."[10] In the United States, the Centers for Disease Control and Prevention (CDC) uses the term child maltreatment to refer to both acts of commission (abuse), which include "words or overt actions that cause harm, potential harm, or threat of harm to a child", and acts of omission (neglect), meaning "the failure to provide for a child's basic physical, emotional, or educational needs or to protect a child from harm or potential harm".[3]:11 The United States federal Child Abuse Prevention and Treatment Act defines child abuse and neglect as, at minimum, "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".[11][12]

Types[edit]

The World Health Organization distinguishes four types of child maltreatment: physical abuse; sexual abuse; emotional and psychological abuse; and neglect.[13]

Physical abuse[edit]

Among professionals and the general public, people often do not agree on what behaviors constitute physical abuse of a child.[14] Physical abuse often does not occur in isolation, but as part of a constellation of behaviors including authoritarian control, anxiety-provoking behavior, and a lack of parental warmth.[15] The WHO defines physical abuse as:

Intentional use of physical force against the child that results in – or has a high likelihood of resulting in – harm for the child's health, survival, development or dignity. This includes hitting, beating, kicking, shaking, biting, strangling, scalding, burning, poisoning and suffocating. Much physical violence against children in the home is inflicted with the object of punishing.[13]

Joan Durrant and Ron Ensom write that most physical abuse is physical punishment "in intent, form, and effect".[16] Overlapping definitions of physical abuse and physical punishment of children highlight a subtle or non-existent distinction between abuse and punishment.[17] For instance, Paulo Sergio Pinheiro writes in the UN Secretary-General's Study on Violence Against Children:

Corporal punishment involves hitting ('smacking', 'slapping', 'spanking') children, with the hand or with an implement – whip, stick, belt, shoe, wooden spoon, etc. But it can also involve, for example, kicking, shaking or throwing children, scratching, pinching, biting, pulling hair or boxing ears, forcing children to stay in uncomfortable positions, burning, scalding or forced ingestion (for example, washing children's mouths out with soap or forcing them to swallow hot spices).[18]

Most nations with child abuse laws deem the deliberate infliction of serious injuries, or actions that place the child at obvious risk of serious injury or death, to be illegal[citation needed] bruises, scratches, burns, broken bones, lacerations, as well as repeated "mishaps," and rough treatment that could cause physical injury, can be physical abuse.[19] Multiple injuries or fractures at different stages of healing can raise suspicion of abuse.

The psychologist Alice Miller, noted for her books on child abuse, took the view that humiliations, spankings and beatings, slaps in the face, etc. are all forms of abuse, because they injure the integrity and dignity of a child, even if their consequences are not visible right away.[20]

Often, physical abuse as a child can lead to physical and mental difficulties in the future, including re-victimization, personality disorders, post-traumatic stress disorder, dissociative disorders, depression, anxiety, suicidal ideation, eating disorders, substance abuse, and aggression. Physical abuse in childhood has also been linked to homelessness in adulthood.[21]

Sexual abuse[edit]

Main articles: Child sexual abuse and child-on-child sexual abuse

Child sexual abuse (CSA) is a form of child abuse in which an adult or older adolescent abuses a child for sexual stimulation.[22] Sexual abuse refers to the participation of a child in a sexual act aimed toward the physical gratification or the financial profit of the person committing the act.[19][23] Forms of CSA include asking or pressuring a child to engage in sexual activities (regardless of the outcome), indecent exposure of the genitals to a child, displaying pornography to a child, actual sexual contact with a child, physical contact with the child's genitals, viewing of the child's genitalia without physical contact, or using a child to produce child pornography.[22][24][25]Selling the sexual services of children may be viewed and treated as child abuse rather than simple incarceration.[26]

Effects of child sexual abuse on the victim(s) include guilt and self-blame, flashbacks, nightmares, insomnia, fear of things associated with the abuse (including objects, smells, places, doctor's visits, etc.), self-esteem difficulties, sexual dysfunction, chronic pain, addiction, self-injury, suicidal ideation, somatic complaints, depression,[27]post-traumatic stress disorder,[28]anxiety,[29] other mental illnesses including borderline personality disorder[30] and dissociative identity disorder,[30] propensity to re-victimization in adulthood,[31]bulimia nervosa,[32] and physical injury to the child, among other problems.[33] Children who are the victims are also at an increased risk of sexually transmitted infections due to their immature immune systems and a high potential for mucosal tears during forced sexual contact.[34] Sexual victimization at a young age has been correlated with several risk factors for contracting HIV including decreased knowledge of sexual topics, increased prevalence of HIV, engagement in risky sexual practices, condom avoidance, lower knowledge of safe sex practices, frequent changing of sexual partners, and more years of sexual activity.[34]

In the United States, approximately 15% to 25% of women and 5% to 15% of men were sexually abused when they were children.[35][36][37] Most sexual abuse offenders are acquainted with their victims; approximately 30% are relatives of the child, most often brothers, sisters, fathers, mothers, uncles or cousins; around 60% are other acquaintances such as friends of the family, babysitters, or neighbours; strangers are the offenders in approximately 10% of child sexual abuse cases.[35] In over one-third of cases, the perpetrator is also a minor.[38]

In 1999 the BBC reported on the RAHI Foundation's survey of sexual abuse in India, in which 76% of respondents said they had been abused as children, 40% of those stating the perpetrator was a family member.[39]

Psychological abuse[edit]

Main article: Psychological abuse

There are multiple definitions of child psychological abuse:

  • In 2013, the American Psychological Association (APA) added Child Psychological Abuse to the DSM-5, describing it as "nonaccidental verbal or symbolic acts by a child's parent or caregiver that result, or have reasonable potential to result, in significant psychological harm to the child."[40]
  • In 1995, APSAC defined it as: spurning, terrorizing, isolating, exploiting, corrupting, denying emotional responsiveness, or neglect" or "A repeated pattern of caregiver behavior or extreme incident(s) that convey to children that they are worthless, flawed, unloved, unwanted, endangered, or only of value in meeting another's needs"[41]
  • In the United States, states laws vary, but most have laws against "mental injury"[42]
  • Some have defined it as the production of psychological and social defects in the growth of a child as a result of behavior such as loud yelling, coarse and rude attitude, inattention, harsh criticism, and denigration of the child's personality.[19] Other examples include name-calling, ridicule, degradation, destruction of personal belongings, torture or killing of a pet, excessive criticism, inappropriate or excessive demands, withholding communication, and routine labeling or humiliation.[43]

In 2014, the APA stated that:[44]

  • "Childhood psychological abuse [is] as harmful as sexual or physical abuse."
  • "Nearly 3 million U.S. children experience some form of [psychological] maltreatment annually."
  • Psychological maltreatment is "the most challenging and prevalent form of child abuse and neglect."
  • "Given the prevalence of childhood psychological abuse and the severity of harm to young victims, it should be at the forefront of mental health and social service training"

In 2015, additional research confirmed these 2014 statements of the APA.[45][46]

Victims of emotional abuse may react by distancing themselves from the abuser, internalizing the abusive words, or fighting back by insulting the abuser. Emotional abuse can result in abnormal or disrupted attachment development, a tendency for victims to blame themselves (self-blame) for the abuse, learned helplessness, and overly passive behavior.[43]

Neglect[edit]

Main article: Child neglect

Child neglect is the failure of a parent or other person with responsibility for the child, to provide needed food, clothing, shelter, medical care, or supervision to the degree that the child's health, safety or well-being may be threatened with harm. Neglect is also a lack of attention from the people surrounding a child, and the non-provision of the relevant and adequate necessities for the child's survival, which would be a lacking in attention, love, and nurture.[19]

Some observable signs of child neglect include: the child is frequently absent from school, begs or steals food or money, lacks needed medical and dental care, is consistently dirty, or lacks sufficient clothing for the weather.[47] The 2010 Child Maltreatment Report (NCANDS), a yearly United States federal government report based on data supplied by state Child Protective Services (CPS) Agencies in the U.S., states, "as in prior years, neglect was the most common form of maltreatment".[48]

Neglectful acts can be divided into six sub-categories:[7]

  • Supervisory neglect: characterized by the absence of a parent or guardian which can lead to physical harm, sexual abuse or criminal behavior;
  • Physical neglect: characterized by the failure to provide the basic physical necessities, such as a safe and clean home;
  • Medical neglect: characterized by the lack of providing medical care;
  • Emotional neglect: characterized by a lack of nurturance, encouragement and support;
  • Educational neglect: characterized by the caregivers lack to provide an education and additional resources to actively participate in the school system; and
  • Abandonment: when the parent or guardian leaves a child alone for a long period of time without a babysitter.

Neglected children may experience delays in physical and psychosocial development, possibly resulting in psychopathology and impaired neuropsychological functions including executive function, attention, processing speed, language, memory and social skills.[49] Researchers investigating maltreated children have repeatedly found that neglected children in foster and adoptive populations manifest different emotional and behavioral reactions to regain lost or secure relationships and are frequently reported to have disorganized attachments and a need to control their environment. Such children are not likely to view caregivers as being a source of safety, and instead typically show an increase in aggressive and hyperactive behaviors which may disrupt healthy or secure attachment with their adopted parents. These children have apparently learned to adapt to an abusive and inconsistent caregiver by becoming cautiously self-reliant, and are often described as glib, manipulative and disingenuous in their interactions with others as they move through childhood.[50] Children who are victims of neglect have a more difficult time forming and maintaining relationships, such as romantic or friendship, later in life due to the lack of attachment they had in their earlier stages of life.

Effects[edit]

Child abuse can result in immediate adverse physical effects but it is also strongly associated with developmental problems[51] and with many chronic physical and psychological effects, including subsequent ill-health, including higher rates of chronic conditions, high-risk health behaviors and shortened lifespan.[52][53]

Maltreated children may grow up to be maltreating adults.[54][55][56] A 1991 source reported that studies indicate that 90 percent of maltreating adults were maltreated as children.[57] Almost 7 million American infants receive child care services, such as day care, and much of that care is poor.[51]

Emotional[edit]

Child abuse can cause a range of emotional effects. Children who are constantly ignored, shamed, terrorized or humiliated suffer at least as much, if not more, than if they are physically assaulted.[58] According to the Joyful Heart Foundation, brain development of the child is greatly influenced and responds to the experiences with families, caregivers, and the community.[59] Abused children can grow up experiencing insecurities, low self-esteem, and lack of development. Many abused children experience ongoing difficulties with trust, social withdrawal, trouble in school, and forming relationships.[58]

Babies and young children can be affected differently by abuse than their older counterparts. Babies and pre-school children who are being emotionally abused or neglected may be overly affectionate towards strangers or people they haven't known for very long.[60] They can lack confidence or become anxious, appear to not have a close relationship with their parent, exhibit aggressive behavior or act nasty towards other children and animals.[60] Older children may use foul language or act in a markedly different way to other children at the same age, struggle to control strong emotions, seem isolated from their parents, lack social skills or have few, if any, friends.[60]

Children can also experience reactive attachment disorder (RAD). RAD is defined as markedly disturbed and developmentally inappropriate social relatedness, that usually begins before the age of 5 years.[61] RAD can present as a persistent failure to start or respond in a developmentally appropriate fashion to most social situations. The long-term impact of emotional abuse has not been studied widely, but recent studies have begun to document its long-term consequences. Emotional abuse has been linked to increased depression, anxiety, and difficulties in interpersonal relationships (Spertus, Wong, Halligan, & Seremetis, 2003).[61] Victims of child abuse and neglect are more likely to commit crimes as juveniles and adults.[62]

Domestic violence also takes its toll on children; although the child is not the one being abused, the child witnessing the domestic violence is greatly influential as well. Research studies conducted such as the "Longitudinal Study on the Effects of Child Abuse and Children's Exposure to Domestic Violence", show that 36.8% of children engage in felony assault compared to the 47.5% of abused/assaulted children. Research has shown that children exposed to domestic violence increases the chances of experienced behavioral and emotional problems (depression, irritability, anxiety, academic problems, and problems in language development).[63]

Overall, emotional effects caused by child abuse and even witnessing abuse can result in long-term and short-term effects that ultimately affect a child's upbringing and development.

Physical[edit]

The immediate physical effects of abuse or neglect can be relatively minor (bruises or cuts) or severe (broken bones, hemorrhage, or even death). In some cases the physical effects are temporary; however, the pain and suffering they cause a child should not be discounted. Rib fractures may be seen with physical abuse, and if present may increase suspicion of abuse, but are found in a small minority of children with maltreatment-related injuries.[64][65]

The long-term impact of child abuse and neglect on physical health and development can be:

  • Shaken baby syndrome. Shaking a baby is a common form of child abuse that often results in permanent neurological damage (80% of cases) or death (30% of cases).[66] Damage results from intracranial hypertension (increased pressure in the skull) after bleeding in the brain, damage to the spinal cord and neck, and rib or bone fractures.[67]
  • Impaired brain development. Child abuse and neglect have been shown, in some cases, to cause important regions of the brain to fail to form or grow properly, resulting in impaired development.[68][69] These alterations in brain maturation have long-term consequences for cognitive, language, and academic abilities.[70]
  • Poor physical health. In addition to possible immediate adverse physical effects, household dysfunction and childhood maltreatment are strongly associated with many chronic physical and psychological effects, including subsequent ill-health in childhood,[71] adolescence[72] and adulthood, with higher rates of chronic conditions, high-risk health behaviors and shortened lifespan.[52][53] Adults who experienced abuse or neglect during childhood are more likely to suffer from physical ailments such as allergies, arthritis, asthma, bronchitis, high blood pressure, and ulcers.[53][73][74][75] There may be a higher risk of developing cancer later in life,[76] as well as possible immune dysfunction.[77]
  • Exposure to violence during childhood is associated with shortened telomeres and with reduced telomerase activity.[78] The increased rate of telomere length reduction correlates to a reduction in lifespan of 7 to 15 years.[77]

Adverse Childhood Experiences Study[edit]

The Adverse Childhood Experiences Study is a long-running investigation into the relationship between childhood adversity, including various forms of abuse and neglect, and health problems in later life. The initial phase of the study was conducted in San Diego, California from 1995 to 1997.[79] The World Health Organization summarizes the study's findings as follows:

The Adverse Childhood Experiences (ACE) study, in which some 17,300 middle-aged, middle-class and mostly employed residents of the state of California participated, suggests that childhood maltreatment and household dysfunction contribute to the development – decades later – of the chronic diseases that are the most common causes of death and disability in the United States. The study examined the long-term effects of maltreatment and household dysfunction during childhood, including: psychological, physical and sexual abuse; violence against the mother; and living with household members who were either substance abusers, mentally ill or suicidal, or else had been in prison. A strong relationship was seen between the number of adverse experiences (including physical and sexual abuse in childhood) and self-reports of cigarette smoking, obesity, physical inactivity, alcoholism, drug abuse, depression, attempted suicide, sexual promiscuity and sexually transmitted diseases in later life. Furthermore, people who reported higher numbers of negative experiences in childhood were much more likely to exhibit multiple health-risk behaviours, which the study suggested were adopted as coping devices. Similarly, the more adverse childhood experiences reported, the more likely the person was to have heart disease, cancer, stroke, diabetes, skeletal fractures, liver disease and poor health as an adult. Maltreatment and other adverse childhood experiences may thus be among the basic factors that underlie health risks, illness and death, and could be identified by routine screening of all patients. Although the ACE study and its findings relate to a specific population within the United States, it is reasonable to assume that similar trends might be found in countries with different levels of economic and social development.[13]

A long-term study of adults retrospectively reporting adverse childhood experiences including verbal, physical and sexual abuse, as well as other forms of childhood trauma found 25.9% of adults reported verbal abuse as children, 14.8% reported physical abuse, and 12.2% reported sexual abuse. Data from the Centers for Disease Control and Prevention (CDC) and Behavioral Risk Factor Surveillance System corroborate these high rates.[80] There is a high correlation between the number of different adverse childhood experiences (A.C.E.s) and risk for poor health outcomes in adults including cancer, heart attack, mental illness, reduced longevity drug and alcohol abuse.[81] An anonymous self-reporting survey of Washington State students finds 6–7% of 8th, 10th and 12th grade students actually attempt suicide. Rates of depression are twice as high. Other risk behaviors are even higher.[82] There is a relationship between child physical and sexual abuse and suicide.[83] For legal and cultural reasons as well as fears by children of being taken away from their parents most childhood abuse goes unreported and unsubstantiated.

It has been discovered that childhood abuse can lead to the addiction of drugs and alcohol in adolescence and adult life. Studies show that any type of abuse experienced in childhood can cause neurological changes making an individual more prone to addictive tendencies. A significant study examined 900 court cases of children who had experienced sexual and physical abuse along with neglect. The study found that a large sum of the children who were abused are now currently addicted to alcohol. This case study outlines how addiction is a significant effect of childhood abuse.[84]

Psychological[edit]

Children who have a history of neglect or physical abuse are at risk of developing psychiatric problems,[85][86] or a disorganized attachment style.[87][88][89] In addition, children who experience child abuse or neglect are 59% more likely to be arrested as juveniles, 28% more likely to be arrested as adults, and 30% more likely to commit violent crime.[90] Disorganized attachment is associated with a number of developmental problems, including dissociative symptoms,[91] as well as anxiety, depressive, and acting out symptoms.[92][93] A study by Dante Cicchetti found that 80% of abused and maltreated infants exhibited symptoms of disorganized attachment.[94][95] When some of these children become parents, especially if they suffer from posttraumatic stress disorder (PTSD), dissociative symptoms, and other sequelae of child abuse, they may encounter difficulty when faced with their infant and young children's needs and normative distress, which may in turn lead to adverse consequences for their child's social-emotional development.[96][97] Additionally, children may find it difficult to feel empathy towards themselves or others, which may cause them to feel alone and unable to make friends.[63] Despite these potential difficulties, psychosocial intervention can be effective, at least in some cases, in changing the ways maltreated parents think about their young children.[98]

Victims of childhood abuse also suffer from different types of physical health problems later in life. Some reportedly suffer from some type of chronic head, abdominal, pelvic, or muscular pain with no identifiable reason.[99] Even though the majority of childhood abuse victims know or believe that their abuse is, or can be, the cause of different health problems in their adult life, for the great majority their abuse was not directly associated with those problems, indicating that sufferers were most likely diagnosed with other possible causes for their health problems, instead of their childhood abuse.[99] One long-term study found that up to 80% of abused people had at least one psychiatric disorder at age 21, with problems including depression, anxiety, eating disorders, and suicide attempts.[100] One Canadian hospital found that between 36% and 76% of women mental health outpatients had been sexually abused, as had 58% of women and 23% of men schizophrenic inpatients.[101] A recent study has discovered that a crucial structure in the brain's reward circuits is compromised by childhood abuse and neglect, and predicts Depressive Symptoms later in life.[102]

In the case of 23 of the 27 illnesses listed in the questionnaire of a French INSEE survey, some statistically significant correlations were found between repeated illness and family traumas encountered by the child before the age of 18 years. According to Georges Menahem, the French sociologist who found out these correlations by studying health inequalities, these relationships show that inequalities in illness and suffering are not only social. Health inequality also has its origins in the family, where it is associated with the degrees of lasting affective problems (lack of affection, parental discord, the prolonged absence of a parent, or a serious illness affecting either the mother or father) that individuals report having experienced in childhood.[103]

Many children who have been abused in any form develop some sort of psychological problem. These problems may include: anxiety, depression, eating disorders, OCD, co-dependency, or even a lack of human connections. There is also a slight tendency for children who have been abused to become child abusers themselves. In the U.S. in 2013, of the 294,000 reported child abuse cases only 81,124 received any sort of counseling or therapy. Treatment is greatly important for abused children.[104]

On the other hand, there are some children who are raised in child abuse, but who manage to do unexpectedly well later in life regarding the preconditions. Such children have been termed dandelion children, as inspired from the way that dandelions seem to prosper irrespective of soil, sun, drought, or rain.[105] Such children (or currently grown-ups) are of high interest in finding factors that mitigate the effects of child abuse.

Causes[edit]

Child abuse is a complex phenomenon with multiple causes.[106] No single factor can be identified as to why some adults behave violently toward children. The World Health Organization (WHO) and the International Society for Prevention of Child Abuse and Neglect (ISPCAN) identify multiple factors at the level of the individual, their relationships, their local community, and their society at large, that combine to influence the occurrence of child maltreatment. At the individual level, such factors include age, sex, and personal history, while at the level of society, factors contributing to child maltreatment include cultural norms encouraging harsh physical punishment of children, economic inequality, and the lack of social safety nets.[13] WHO and ISPCAN state that understanding the complex interplay of various risk factors is vital for dealing with the problem of child maltreatment.[13]

The American psychoanalyst Elisabeth Young-Bruehl maintains that harm to children is justified and made acceptable by widely held beliefs in children's inherent subservience to adults, resulting in a largely unacknowledged prejudice against children she terms childism. She contends that such prejudice, while not the immediate cause of child maltreatment, must be investigated in order to understand the motivations behind a given act of abuse, as well as to shed light on societal failures to support children's needs and development in general.[107]:4–6 Founding editor of the International Journal of Children's Rights, Michael Freeman, also argues that the ultimate causes of child abuse lie in prejudice against children, especially the view that human rights do not apply equally to adults and children. He writes, "the roots of child abuse lie not in parental psycho-pathology or in socio-environmental stress (though their influences cannot be discounted) but in a sick culture which denigrates and depersonalizes, which reduces children to property, to sexual objects so that they become the legitimate victims of both adult violence and lust".[108]

Parents who physically abuse their spouses are more likely than others to physically abuse their children.[109] However, it is impossible to know whether marital strife is a cause of child abuse, or if both the marital strife and the abuse are caused by tendencies in the abuser.[109] Sometimes, parents set expectations for their child that are clearly beyond the child's capability. When parents' expectations are far beyond what is appropriate to the child (e.g., preschool children who are expected to be totally responsible for self-care or provision of nurturance to parents) the resulting frustration caused by the child's non-compliance is believed to function as a contributory if not necessary cause of child abuse.[110]

Most acts of physical violence against children are undertaken with the intent to punish.[111] In the United States, interviews with parents reveal that as many as two thirds of documented instances of physical abuse begin as acts of corporal punishment meant to correct a child's behavior, while a large-scale Canadian study found that three quarters of substantiated cases of physical abuse of children have occurred within the context of physical punishment.[112] Other studies have shown that children and infants who are spanked by parents are several times more likely to be severely assaulted by their parents or suffer an injury requiring medical attention. Studies indicate that such abusive treatment often involves parents attributing conflict to their child's willfulness or rejection, as well as "coercive family dynamics and conditioned emotional responses".[16] Factors involved in the escalation of ordinary physical punishment by parents into confirmed child abuse may be the punishing parent's inability to control their anger or judge their own strength, and the parent being unaware of the child's physical vulnerabilities.[15]

Some professionals argue that cultural norms that sanction physical punishment are one of the causes of child abuse, and have undertaken campaigns to redefine such norms.[113][114][115]

Children resulting from unintended pregnancies are more likely to be abused or neglected.[116][117] In addition, unintended pregnancies are more likely than intended pregnancies to be associated with abusive relationships,[118] and there is an increased risk of physical violence during pregnancy.[119] They also result in poorer maternal mental health,[119] and lower mother-child relationship quality.[119]

There is some limited evidence that children with moderate or severe disabilities are more likely to be victims of abuse than non-disabled children.[120] A study on child abuse sought to determine: the forms of child abuse perpetrated on children with disabilities; the extent of child abuse; and the causes of child abuse of children with disabilities. A questionnaire on child abuse was adapted and used to collect data in this study. Participants comprised a sample of 31 pupils with disabilities (15 children with vision impairment and 16 children with hearing impairment) selected from special schools in Botswana. The study found that the majority of participants were involved in doing domestic chores. They were also sexually, physically and emotionally abused by their teachers. This study showed that children with disabilities were vulnerable to child abuse in their schools.[121]

Substance abuse can be a major contributing factor to child abuse. One U.S. study found that parents with documented substance abuse, most commonly alcohol, cocaine, and heroin, were much more likely to mistreat their children, and were also much more likely to reject court-ordered services and treatments.[122] Another study found that over two-thirds of cases of child maltreatment involved parents with substance abuse problems. This study specifically found relationships between alcohol and physical abuse, and between cocaine and sexual abuse.[123] Also parental stress caused by substance increases the likelihood of the minor exhibiting internalizing and externalizing behaviors.[124] Although the abuse victim does not always realize the abuse is wrong, the internal confusion can lead to chaos. Inner anger turns to outer frustration. Once aged 17/18, drink and drugs are used to numb the hurt feelings, nightmares and daytime flashbacks. Acquisitive crimes to pay for the chemicals are inevitable if the victim is unable to find employment.[125]

Unemployment and financial difficulties are associated with increased rates of child abuse.[126] In 2009 CBS News reported that child abuse in the United States had increased during the economic recession. It gave the example of a father who had never been the primary care-taker of the children. Now that the father was in that role, the children began to come in with injuries.[127]

Worldwide[edit]

Child abuse is an international phenomenon. Poverty and substance abuse are common social problems worldwide, and no matter the location, show a similar trend in the correlation to child abuse.[citation needed]

Although these factors can likely contribute to child maltreatment, differences in cultural perspectives play a significant role in the treatment of children. In certain nations, the battle for equality within the sexes plays a large part in a child’s upbringing. During the Soviet period, there were conflicts regarding the traditional housewife versus the emphasis on equality within the sexes. Some women felt a considerable amount of pressure to carry out their motherly duties, obtaining an "authoritarian" parenting style, acting dominating and emotionally distant towards her children while overly involved in her own career.[128] Many were encouraged to use more firm and direct disciplinary methods, as well as be overbearing and overprotective of their children.[128]

With the end of the Communist Era, many positive changes have followed. While there is a new openness and acceptance regarding parenting styles and close relationships with children, child abuse still remains a serious concern. Although it is now more publicly recognized, it has certainly not ceased to exist. While controlling parenting may be less of a concern, financial difficulty, unemployment, and substance abuse still remain to be dominating factors in child abuse throughout Eastern Europe.[128]

A study conducted by members from several Baltic and Eastern European countries, together with specialists from the United States, examined the causes of child abuse in the countries of Latvia, Lithuania, Macedonia and Moldova. In these countries, respectively, 33%, 42%, 18% and 43% of children reported at least one type of child abuse.[129] According to their findings, there was a series of correlations between the potential risk factors of parental employment status, alcohol abuse, and family size within the abuse ratings.[128] In three of the four countries, parental substance abuse was considerably correlated with the presence of child abuse, and although it was a lower percentage, still showed a relationship in the fourth country (Moldova).[128] Each country also showed a connection between the father not working outside of the home and either emotional or physical child abuse.[128]

These cultural differences can be studied from many perspectives. Most importantly, overall parental behavior is genuinely different in various countries. Each culture has their own "range of acceptability," and what one may view as offensive, others may seem as tolerable. Behaviors that are normal to some may be viewed as abusive to others, all depending on the societal norms of that particular country.[128]

Asian parenting perspectives, specifically, hold different ideals from American culture. Many have described their traditions as including physical and emotional closeness that ensures a lifelong bond between parent and child, as well as establishing parental authority and child obedience through harsh discipline.[130] Balancing disciplinary responsibilities within parenting is common in many Asian cultures, including China, Japan, Singapore, Vietnam and Korea.[130] To some cultures, forceful parenting may be seen as abuse, but in other societies such as these, the use of force is looked at as a reflection of parental devotion.[130]

The differences in these cultural beliefs demonstrate the importance of examining all cross-cultural perspectives when studying the concept of child abuse.

As of 2006[update], between 25,000 and 50,000 children in Kinshasa, Democratic Republic of the Congo, had been accused of witchcraft and abandoned.[131] In Malawi it is also common practice to accuse children of witchcraft and many children have been abandoned, abused and even killed as a result.[132] In the Nigeria, Akwa Ibom State and Cross River State about 15,000 children were branded as witches.[133]

In April 2015, public broadcasting showed that rate of child abuse in South Korea had increased to 13% compared with the previous year, and 75% of attackers were the children's own parents.[134]

Disclosure and diagnosis[edit]

Suspicion for physical abuse is recommended when an injury occurs in a child who does not yet move independently, injuries are in unusual areas, more than one injury at different stages of healing, symptoms of possible head trauma, and injuries to more than one body system.[135]

In many jurisdictions, abuse that is suspected, not necessarily proven, requires reporting to child protection agencies, such as the Child Protection Services in the United States. Recommendations for healthcare workers, such as primary care providers and nurses, who are often suited to encounter suspected abuse are advised to firstly determine the child’s immediate need for safety. A private environment away from suspected abusers is desired for interviewing and examining. Leading statements that can distort the story are avoided. As disclosing abuse can be distressing and sometimes even shameful, reassuring the child that he or she has done the right thing by telling and that they are not bad or that the abuse was not their fault helps in disclosing more information. Dolls are sometimes used to help explain what happened. For the suspected abusers, it is also recommended to use a nonjudgmental, nonthreatening attitude towards them and to withhold expressing shock, in order to help disclose information.[136]

Assessment[edit]

A key part of child abuse work is assessment.

A particular challenge arises where child protection professionals are assessing families where neglect is occurring. Professionals conducting assessments of families where neglect is taking place are said to sometimes make the following errors:[137]

  • Failure to ask the right types of question, including
    • Whether neglect is occurring;
    • Why neglect is occurring;
    • What the situation is like for the child;
    • Whether improvements in the family are likely to be sustained;
    • What needs to be done to ensure the long-term safety of the child?

Prevention[edit]

A support-group structure is needed to reinforce parenting skills and closely monitor the child's well-being. Visiting home nurse or social-worker visits are also required to observe and evaluate the progress of the child and the caretaking situation.

The support-group structure and visiting home nurse or social-worker visits are not mutually exclusive. Many studies have demonstrated that the two measures must be coupled together for the best possible outcome.[138]

Children's school programs regarding "good touch … bad touch" can provide children with a forum in which to role-play and learn to avoid potentially harmful scenarios. Pediatricians can help identify children at risk of maltreatment and intervene with the aid of a social worker or provide access to treatment that addresses potential risk factors such as maternal depression.[139] Videoconferencing has also been used to diagnose child abuse in remote emergency departments and clinics.[140] Unintended conception increases the risk of subsequent child abuse, and large family size increases the risk of child neglect.[117] Thus, a comprehensive study for the National Academy of Sciences concluded that affordable contraceptive services should form the basis for child abuse prevention.[117][141] "The starting point for effective child abuse programming is pregnancy planning," according to an analysis for US Surgeon General C. Everett Koop.[117][142]

April has been designated Child Abuse Prevention Month in the United States since 1983.[143] U.S. President Barack Obama continued that tradition by declaring April 2009 Child Abuse Prevention Month.[144] One way the Federal government of the United States provides funding for child-abuse prevention is through Community-Based Grants for the Prevention of Child Abuse and Neglect (CBCAP).[145]

Resources for child-protection services are sometimes limited. According to Hosin (2007), "a considerable number of traumatized abused children do not gain access to protective child-protection strategies."[146] Briere (1992) argues that only when "lower-level violence" of children[clarification needed] ceases to be culturally tolerated will there be changes in the victimization and police protection of children.[147]

Treatment[edit]

A number of treatments are available to victims of child abuse.[148] However, children who experience childhood trauma do not heal from abuse easily.[149] There are focused cognitive behavioral therapy, first developed to treat sexually abused children, is now used for victims of any kind of trauma. It targets trauma-related symptoms in children including post-traumatic stress disorder (PTSD), clinical depression and anxiety. It also includes a component for non-offending parents. Several studies have found that sexually abused children undergoing TF-CBT improved more than children undergoing certain other therapies. Data on the effects of TF-CBT for children who experienced only non-sexual abuse was not available as of 2006[update].[148] The purpose of dealing with the thoughts and feelings associated with the trauma is to deal with nightmares, flashbacks and other intrusive experiences that might be spontaneously brought on by any number of discriminative stimuli in the environment or in the individual’s brain. This would aid the individual in becoming less fearful of specific stimuli that would arouse debilitating fear, anger, sadness or other negative emotion. In other words, the individual would have some control or mastery over those emotions.[50]

Abuse-focused cognitive behavioral therapy was designed for children who have experienced physical abuse. It targets externalizing behaviors and strengthens prosocial behaviors. Offending parents are included in the treatment, to improve parenting skills/practices. It is supported by one randomized study.[148]

Rational Cognitive Emotive Behavior Therapy consists of ten distinct but interdependent steps. These steps fall into one of three theoretical orientations (i.e., rational or solution focused, cognitive emotive, and behavioral) and are intended to provide abused children and their adoptive parents with positive behavior change, corrective interpersonal skills, and greater control over themselves and their relationships. They are: 1) determining and normalizing thinking and behaving, 2) evaluating language, 3) shifting attention away from problem talk 4) describing times when the attachment problem isn't happening, 5) focusing on how family members "successfully" solve problematic attachment behavior; 6) acknowledging "unpleasant emotions" (i.e., angry, sad, scared) underlying negative interactional patterns, 7) identifying antecedents (controlling conditions) and associated negative cognitive emotive connections in behavior (reciprocal role of thought and emotion in behavioral causation), 8) encouraging previously abused children to experience or "own" negative thoughts and associated aversive emotional feelings, 9) modeling and rewarding positive behavior change (with themselves and in relationships), and 10) encouraging and rewarding thinking and behaving differently. This type of therapy shifts victims thoughts away from the bad and changes their behavior.[50]

Parent–child interaction therapy was designed to improve the child-parent relationship following the experience of domestic violence. It targets trauma-related symptoms in infants, toddlers, and preschoolers, including PTSD, aggression, defiance, and anxiety. It is supported by two studies of one sample.[148]

Other forms of treatment include group therapy, play therapy, and art therapy. Each of these types of treatment can be used to better assist the client, depending on the form of abuse they have experienced. Play therapy and art therapy are ways to get children more comfortable with therapy by working on something that they enjoy (coloring, drawing, painting, etc.). The design of a child's artwork can be a symbolic representation of what they are feeling, relationships with friends or family, and more. Being able to discuss and analyze a child's artwork can allow a professional to get a better insight of the child.[150]

Prevalence[edit]

Child abuse is complex and difficult to study. According to the World Health Organization (WHO), estimates of the rates of child maltreatment vary widely by country, depending on how child maltreatment is defined, the type of maltreatment studied, the scope and quality of data gathered, and the scope and quality of surveys that ask for self-reports from victims, parents, and caregivers. Despite these limitations, international studies show that a quarter of all adults report experiencing physical abuse as children, and that and 1 in 5 women and 1 in 13 men report experiencing childhood sexual abuse. Emotional abuse and neglect are also common childhood experiences.[151]

As of 2014[update], an estimated 41,000 children under 15 are victims of homicide each year. The WHO states that this number underestimates the true extent of child homicide; a significant proportion of child deaths caused by maltreatment are incorrectly attributed to unrelated factors such as falls, burns, and drowning. Also, girls are particularly vulnerable to sexual violence, exploitation and abuse in situations of armed conflict and refugee settings, whether by combatants, security forces, community members, aid workers, or others.[151]

United States[edit]

The National Research Council wrote in 1993 that "...the available evidence suggests that child abuse and neglect is an important, prevalent problem in the United States [...] Child abuse and neglect are particularly important compared with other critical childhood problems because they are often directly associated with adverse physical and mental health consequences in children and families".[152]:6

In 2012, Child Protective Services (CPS) agencies estimated that approximately 9 out of 1000 children in the United States were victims of child maltreatment. Most (78%) were victims of neglect. Physical abuse, sexual abuse, and other types of maltreatment, were less common, making up 18%, 9%, and 11% of cases, respectively ("other types" included emotional abuse, parental substance abuse, and inadequate supervision). However, CPS reports may underestimate the true scope of child maltreatment. A non-CPS study estimated that one in four children experience some form of maltreatment in their lifetimes, according to the Centers for Disease Control and Prevention (CDC).[153]

In Feb 2017, American Public Health Association published a Washington University study estimating 37% of American children experiencing a child protective services investigation by age 18 (or 53% if African American).[154]

David Finkelhor tracked Child Maltreatment Report (NCANDS) data from 1990 to 2010. He states that sexual abuse had declined 62% from 1992 to 2009. The long-term trend for physical abuse was also down by 56% since 1992. The decline in sexual abuse adds to an already substantial positive long-term trend. He states: "It is unfortunate that information about the trends in child maltreatment are not better publicized and more widely known. The long-term decline in sexual and physical abuse may have important implications for public policy."[155]

Douglas J. Besharov, the first Director of the U.S. Center on Child Abuse and Neglect, states "the existing laws are often vague and overly broad"[156] and there is a "lack of consensus among professionals and Child Protective Services

Dolls are sometimes used to help disclose abuse.

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