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Safety & Prevention

Nearly all mothers and fathers can point to incidents in which they fell short of their ideal as parents—per­haps a moment of frustration in which they believed they were somehow abusive to their youngsters when, in retrospect, they really hadn't been. Most parents will never actually be child abusers, and most chil­dren will never be abused.

By definition, child abuse includes a number of forms of severe maltreatment, including physical abuse, physical neglect, verbal abuse, emotional abuse, and sexual abuse. Some unfortunate children experi­ence multiple types of abuse. For instance, a child who experiences repeated in­stances of emotional abuse might also be victimized by occasional, deliberate physi­cal violence. Severe physical abuse—even if only a rare outburst by overwhelmed parents with out-of-control anger—can in­flict permanent damage on children and, in some cases, death.

Parental neglect—in which a child re­ceives little or no supervision in and around his home, for example—can have tragic consequences if injuries occur. Even when it poses no immediate threat to a child's safety, prolonged or repeated ne­glect—in which his basic needs for cloth­ing, nutrition, medical care, education, shelter, and nurturance are not met—can have adverse physical, social, developmen­tal, and emotional consequences.

The number of cases of child abuse is on the rise, with reports of abuse to child-protection agencies increasing dramati­cally in recent years. According to one study there were three reports of child abuse for each one hundred children in the United States in 1985 alone. With societal drug and alcohol problems so severe, and the number of children in poverty growing, the incidence of child abuse is likely to con­tinue to rise.

Most abusers are members of the child's family—if not a parent, then a close relative (such as an uncle or an older brother or sister), or a member of the household. And a number of factors can contribute to their abuse of children. Pressures on the family, both internal and external, can take a toll. When parents are feeling financial strain, job stress, or marital problems, their anger and frustration may make them more prone to strike out at their child. At certain times of the day—perhaps in the early evening after a hard day at work—parents may find it particularly difficult to control their tempers when youngsters misbehave or merely try their patience. Parents, who are socially isolated, without adequate sources of emotional support or a helping hand with daily tasks and responsibilities, are more likely to lose control and abuse their children.

Alcohol and other drug use by parents is often a contributor to child abuse. By reducing inhibitions, alcohol consumption often allows anger to explode in a parent who is confronted by his or her child's mis­behavior. Some drugs, such as ampheta­mines, can increase agitation and thus can contribute to an abusive situation in the home. Children who are abused are some­times those with learning or behavioral problems—conditions that themselves place more stress on and create more con­flict within the family.

Physical Abuse

Parents who were physically abused them­selves as children, or who were or are in­timidated verbally and physically by adults around them, often resort to similar means when they discipline their own youngsters.

The use of force, especially violence to­ward other people, is a behavior learned from parents and inflicted on children. And when life stresses—from poverty to illness to alcoholism—exist, they increase the risk of abuse. Some abused children live in fam­ilies replete with domestic violence—where spouses have physical battles and wives are often beaten.

If you suspect that a child you know is being abused—perhaps a niece or a nephew, a child in the neighborhood, or a classmate of your youngster—you have a responsibility to become involved. Teachers are often the first to see the changes in a child's physical appearance, emotional condition, and behavior, changes that suggest she is being hurt or is in trouble. In many states, teachers (as well as physicians, dentists, and other professionals) are legally obligated to report sus­pected cases of abuse—and for good rea­son: Every year, children die from abuse, often even after someone became aware that they were being victimized.

Use some common sense in trying to de­termine whether a child is actually being physically abused. For instance, normal, active children have some bruises and bumps that come from everyday playing. However, these routine bruises tend to oc­cur over bony areas such as knees, elbows, and shins. If you see a child who has in­juries on other parts of the body—the stomach, the cheeks, the ears, the but­tocks, the mouth, or the thighs—this should raise your suspicions. Black eyes, human bite marks, and burns in the shape of round cigarette butts are not symptoms of everyday play.

In the overwhelming majority of child-abuse cases, parents do not consciously in­tend to injure their children. Most abusive episodes arise when adults have difficulty coping with life situations and lose control. However, even if their intentions are not malicious, a parent who abuses a child may do it again, especially if his or her underly­ing stresses are not addressed. As a result, society often has to intervene in order to protect the child and assist the family.

Once a case has been investigated by law enforcement and social agencies, local so­cial service bureaus may institute various forms of services and treatment to help the family. However, the safety and protection of the child are the first priority, and thus children are sometimes removed from their family and placed in a foster home, at least temporarily; at the same time, efforts are made to work with the parents to ad­dress underlying problems and teach them coping skills to ensure that episodes of abuse are not repeated. If you have abused your own child or feel that such behavior may occur, talk with a trusted individual such as a physician or a clergyman. He or she may refer you to a professional or an agency where you can obtain help, includ­ing assistance in dealing with your own fears and guilt.

Both parents and children may benefit from some guidance and coun­seling, individually and together, perhaps at shelters for domestic violence that can help break the cycle. You will be guided to­ward dealing with your emotions without resorting to violence. You will have the op­portunity to discuss your own parenting experiences and your current life stresses. You will be shown ways to cope effectively with stresses so that you do not fall into in­flicting injuries upon your youngster. You have a responsibility to your child and to yourself to find ways to relate at home that are nonviolent, day after day.

If you feel that you are in the midst of a crisis, call your local chapter of Parents Anonymous or a crisis hotline, which can provide you with some prompt support. Thereafter, the more formal treatment process should begin.

Finally, you might also get involved to help reduce the incidence of child abuse in your community at large. You can become an advocate for a caring and respectful en­vironment for all children. True, some seg­ments of society still condone corporal punishment and even outwardly abusive behavior toward children—but this is wrong. You can work with local schools to eliminate physical punishment and to pro­mote and teach constructive ways to deal with anger and conflict.

Emotional Abuse

Not all abuse is physical. Neglecting your child's needs for emotional support, love, and caring is also a form of abuse. Emotional abuse is one of the most pervasive and damaging forms of child abuse. Belittling, ridiculing, name calling, and being disrespectful and unreasonably critical to­ward your youngster can have serious emotional consequences and long-term repercussions. Like more violent forms of abuse, emotional abuse can impair your child's self-image and self-esteem and in­terfere with his ability to function well in society. He may have difficulty making friends and relating to peers. In fact, he may avoid participating in activities with other children, and being in situations in which he's required to give and receive af­fection. Instead, he may be prone to being aggressive and oppositional. He might also develop learning difficulties or hyperactiv­ity or have problems such as bed-wetting or soiling. Or he might act "pseudo mature," becoming a caretaker for adults and others far beyond roles appropriate for his age and development.

When this emotional abuse occurs, espe­cially repeatedly over an extended period of time, it can have a lifelong impact, af­fecting a youngster's happiness, relation­ships, and success. He may become somber, unable to enjoy himself, and prone to self-defeating behaviors. At the extreme, he can become self-destructive, engaging in self-mutilation and even attempting suicide.

As with other types of abuse, emotional abuse is often inflicted by parents who themselves were raised in an environment where they experienced emotional mis­treatment by their own mothers and fa­thers. Being made aware of the way they are treating their children is an important first step for these parents in bringing their abusive behavior to a halt. Often they are not conscious that their behavior is dam­aging; if they knew what they were doing and were more sensitive to their child's pain, they would probably want to do something to stop it.

Visiting a physician or a clergyman is a good way to start looking for help with emotional abuse. You might be referred to a mental-health professional or to commu­nity organizations or churches that offer parenting classes aimed specifically at helping you talk to and problem-solve with your child.

Signs of Physical Abuse

These indicators may suggest a youngster has been physically abused:

  • The child has had repeated in­juries that are unexplainable or unusual.
  • He appears withdrawn, passive, depressed, and cries a lot.
  • Conversely, he is unusually aggres­sive, disruptive in the classroom, or destructive of his personal property and that of others. He throws toys across the room or be­comes violent toward a pet.
  • He seems overly tired and men­tions that he has trouble sleeping and frequent nightmares.
  • The child seems genuinely afraid of a parent or other caretaker.
  • He spends a lot of time at the play­ground and appears hesitant to go home after school, as if he were fearful of something there.
  • His parents seem to be isolated from other mothers and fathers in the neighborhood, do not partici­pate in school activities, and may have a drinking or other drug-abuse problem. They appear pre­occupied with their own lives at the expense of caring properly for their youngster.
  • The parent is unwilling to talk about his child's injuries, or is no­ticeably anxious when he or she does so.

 

Last Updated
8/7/2013
Source
Caring for Your School-Age Child: Ages 5 to 12 (Copyright © 2004 American Academy of Pediatrics)
The information contained on this Web site should not be used as a substitute for the medical care and advice of your pediatrician. There may be variations in treatment that your pediatrician may recommend based on individual facts and circumstances.

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