Child Abuse and Neglect

Recognizing, Preventing, and Reporting Child Abuse

Child abuse is more than bruises and broken bones. While physical abuse might be the most visible, other types of abuse, such as emotional abuse and neglect, also leave deep, lasting scars. The earlier abused children get help, the greater chance they have to heal and break the cycle—rather than perpetuate it. By learning about common signs of abuse and what you can do to intervene, you can make a huge difference in a child’s life.

Understanding child abuse and neglect

Myths and facts about child abuse and neglect Child abuse is more than bruises or broken bones. While physical abuse is shocking due to the scars it leaves, not all child abuse is as obvious. Ignoring children’s needs, putting them in unsupervised, dangerous situations, or making a child feel worthless or stupid are also child abuse. Regardless of the type of child abuse, the result is serious emotional harm.

MYTH #1: It's only abuse if it's violent.

Fact: Physical abuse is just one type of child abuse. Neglect and emotional abuse can be just as damaging, and since they are more subtle, others are less likely to intervene.

MYTH #2: Only bad people abuse their children.

Fact: While it's easy to say that only "bad people" abuse their children, it's not always so black and white. Not all abusers are intentionally harming their children. Many have been victims of abuse themselves, and don’t know any other way to parent. Others may be struggling with mental health issues or a substance abuse problem.

MYTH #3: Child abuse doesn't happen in “good” families.

Fact: Child abuse doesn't only happen in poor families or bad neighborhoods. It crosses all racial, economic, and cultural lines. Sometimes, families who seem to have it all from the outside are hiding a different story behind closed doors.

MYTH #4: Most child abusers are strangers.

Fact: While abuse by strangers does happen, most abusers are family members or others close to the family.

MYTH #5: Abused children always grow up to be abusers.

Fact: It is true that abused children are more likely to repeat the cycle as adults, unconsciously repeating what they experienced as children. On the other hand, many adult survivors of child abuse have a strong motivation to protect their children against what they went through and become excellent parents.

Effects of child abuse and neglect

All types of child abuse and neglect leave lasting scars. Some of these scars might be physical, but emotional scarring has long lasting effects throughout life, damaging a child’s sense of self, ability to have healthy relationships, and ability to function at home, at work and at school. Some effects include:

Lack of trust and relationship difficulties. If you can’t trust your parents, who can you trust? Abuse by a primary caregiver damages the most fundamental relationship as a child—that you will safely, reliably get your physical and emotional needs met by the person who is responsible for your care. Without this base, it is very difficult to learn to trust people or know who is trustworthy. This can lead to difficulty maintaining relationships due to fear of being controlled or abused. It can also lead to unhealthy relationships because the adult doesn’t know what a good relationship is.
Core feelings of being “worthless” or “damaged.” If you’ve been told over and over again as a child that you are stupid or no good, it is very difficult to overcome these core feelings. You may experience them as reality. Adults may not strive for more education, or settle for a job that may not pay enough, because they don’t believe they can do it or are worth more. Sexual abuse survivors, with the stigma and shame surrounding the abuse, often especially struggle with a feeling of being damaged.
Trouble regulating emotions. Abused children cannot express emotions safely. As a result, the emotions get stuffed down, coming out in unexpected ways. Adult survivors of child abuse can struggle with unexplained anxiety, depression, or anger. They may turn to alcohol or drugs to numb out the painful feelings.

Types of child abuse

There are several types of child abuse, but the core element that ties them together is the emotional effect on the child. Children need predictability, structure, clear boundaries, and the knowledge that their parents are looking out for their safety. Abused children cannot predict how their parents will act. Their world is an unpredictable, frightening place with no rules. Whether the abuse is a slap, a harsh comment, stony silence, or not knowing if there will be dinner on the table tonight, the end result is a child that feel unsafe, uncared for, and alone.

Emotional child abuse

Sticks and stones may break my bones but words will never hurt me? Contrary to this old saying, emotional abuse can severely damage a child’s mental health or social development, leaving lifelong psychological scars. Examples of emotional child abuse include:

Constant belittling, shaming, and humiliating a child.
Calling names and making negative comparisons to others.
Telling a child he or she is “no good," "worthless," "bad," or "a mistake."
Frequent yelling, threatening, or bullying.
Ignoring or rejecting a child as punishment, giving him or her the silent treatment.
Limited physical contact with the child—no hugs, kisses, or other signs of affection.
Exposing the child to violence or the abuse of others, whether it be the abuse of a parent, a sibling, or even a pet.

Child neglect

Child neglect—a very common type of child abuse—is a pattern of failing to provide for a child's basic needs, whether it be adequate food, clothing, hygiene, or supervision. Child neglect is not always easy to spot. Sometimes, a parent might become physically or mentally unable to care for a child, such as with a serious injury, untreated depression, or anxiety. Other times, alcohol or drug abuse may seriously impair judgment and the ability to keep a child safe.

Older children might not show outward signs of neglect, becoming used to presenting a competent face to the outside world, and even taking on the role of the parent. But at the end of the day, neglected children are not getting their physical and emotional needs met.

Physical child abuse

Physical abuse involves physical harm or injury to the child. It may be the result of a deliberate attempt to hurt the child, but not always. It can also result from severe discipline, such as using a belt on a child, or physical punishment that is inappropriate to the child’s age or physical condition.

Many physically abusive parents and caregivers insist that their actions are simply forms of discipline—ways to make children learn to behave. But there is a big difference between using physical punishment to discipline and physical abuse. The point of disciplining children is to teach them right from wrong, not to make them live in fear.

Physical abuse vs. Discipline

In physical abuse, unlike physical forms of discipline, the following elements are present:

Unpredictability. The child never knows what is going to set the parent off. There are no clear boundaries or rules. The child is constantly walking on eggshells, never sure what behavior will trigger a physical assault.
Lashing out in anger. Physically abusive parents act out of anger and the desire to assert control, not the motivation to lovingly teach the child. The angrier the parent, the more intense the abuse.
Using fear to control behavior. Parents who are physically abusive may believe that their children need to fear them in order to behave, so they use physical abuse to “keep their child in line.” However, what children are really learning is how to avoid being hit, not how to behave or grow as individuals.

Child sexual abuse: A hidden type of abuse

While news stories of sexual predators are scary, what is even more frightening is that sexual abuse usually occurs at the hands of someone the child knows and should be able to trust—most often close relatives. And contrary to what many believe, it’s not just girls who are at risk. Boys and girls both suffer from sexual abuse. In fact, sexual abuse of boys may be underreported due to shame and stigma.Child sexual abuse is an especially complicated form of abuse because of its layers of guilt and shame. It's important to recognize that sexual abuse doesn't always involve body contact. Exposing a child to sexual situations or material is sexually abusive, whether or not touching is involved.

The problem of shame and guilt in child sexual abuse

Aside from the physical damage that sexual abuse can cause, the emotional component is powerful and far-reaching. Sexually abused children are tormented by shame and guilt. They may feel that they are responsible for the abuse or somehow brought it upon themselves. This can lead to self-loathing and sexual problems as they grow older—often either excessive promiscuity or an inability to have intimate relations.

The shame of sexual abuse makes it very difficult for children to come forward. They may worry that others won’t believe them, will be angry with them, or that it will split their family apart. Because of these difficulties, false accusations of sexual abuse are not common, so if a child confides in you, take him or her seriously. Don’t turn a blind eye!

Warning signs of child abuse and neglect

The earlier child abuse is caught, the better the chance of recovery and appropriate treatment for the child. Child abuse is not always obvious. By learning some of the common warning signs of child abuse and neglect, you can catch the problem as early as possible and get both the child and the abuser the help that they need.

Of course, just because you see a warning sign doesn’t automatically mean a child is being abused. It’s important to dig deeper, looking for a pattern of abusive behavior and warning signs, if you notice something off.

Warning signs of emotional abuse in children

Excessively withdrawn, fearful, or anxious about doing something wrong.
Shows extremes in behavior (extremely compliant or extremely demanding; extremely passive or extremely aggressive).
Doesn’t seem to be attached to the parent or caregiver.
Acts either inappropriately adult (taking care of other children) or inappropriately infantile (rocking, thumb-sucking, throwing tantrums).

Warning signs of physical abuse in children

Frequent injuries or unexplained bruises, welts, or cuts.
Is always watchful and “on alert,” as if waiting for something bad to happen.
Injuries appear to have a pattern such as marks from a hand or belt.
Shies away from touch, flinches at sudden movements, or seems afraid to go home.
Wears inappropriate clothing to cover up injuries, such as long-sleeved shirts on hot days.

Warning signs of neglect in children

Clothes are ill-fitting, filthy, or inappropriate for the weather.
Hygiene is consistently bad (unbathed, matted and unwashed hair, noticeable body odor).
Untreated illnesses and physical injuries.
Is frequently unsupervised or left alone or allowed to play in unsafe situations and environments.
Is frequently late or missing from school.

Warning signs of sexual abuse in children

Trouble walking or sitting.
Displays knowledge or interest in sexual acts inappropriate to his or her age, or even seductive behavior.
Makes strong efforts to avoid a specific person, without an obvious reason.
Doesn’t want to change clothes in front of others or participate in physical activities.
An STD or pregnancy, especially under the age of 14.
Runs away from home.

Child abuse and reactive attachment disorder

Severe abuse early in life can lead to reactive attachment disorder. Children with this disorder are so disrupted that they have extreme difficulty establishing normal relationships and attaining normal developmental milestones. They need special treatment and support. Learn more

Risk factors for child abuse and neglect

While child abuse and neglect occurs in all types of families—even in those that look happy from the outside—children are at a much greater risk in certain situations.

Domestic violence. Witnessing domestic violence is terrifying to children and emotionally abusive. Even if the mother does her best to protect her children and keeps them from being physically abused, the situation is still extremely damaging. If you or a loved one is in an abusive relationships, getting out is the best thing for protecting the children.
Alcohol and drug abuse. Living with an alcoholic or addict is very difficult for children and can easily lead to abuse and neglect. Parents who are drunk or high are unable to care for their children, make good parenting decisions, and control often-dangerous impulses. Substance abuse also commonly leads to physical abuse.
Untreated mental illness. Parents who suffering from depression, an anxiety disorder, bipolar disorder, or another mental illness have trouble taking care of themselves, much less their children. A mentally ill or traumatized parent may be distant and withdrawn from his or her children, or quick to anger without understanding why. Treatment for the caregiver means better care for the children.
Lack of parenting skills. Some caregivers never learned the skills necessary for good parenting. Teen parents, for example, might have unrealistic expectations about how much care babies and small children need. Or parents who were themselves victims of child abuse may only know how to raise their children the way they were raised. In such cases, parenting classes, therapy, and caregiver support groups are great resources for learning better parenting skills.
Stress and lack of support. Parenting can be a very time-intensive, difficult job, especially if you’re raising children without support from family, friends, or the community or you’re dealing with relationship problems or financial difficulties. Caring for a child with a disability, special needs, or difficult behaviors is also a challenge. It’s important to get the support you need, so you are emotionally and physically able to support your child.

Recognizing abusive behavior in yourself

Recognizing that you have a problem is the biggest step to getting help. If you yourself were raised in an abusive situation, that can be extremely difficult. Children experience their world as normal. It may have been normal in your family to be slapped or pushed for little to no reason, or that mother was too drunk to cook dinner. It may have been normal for your parents to call you stupid, clumsy, or worthless. Or it may have been normal to watch your mother get beaten up by your father.Do you see yourself in some of these descriptions, painful as it may be? Do you feel angry and frustrated and don’t know where to turn? Raising children is one of life’s greatest challenges and can trigger anger and frustration in the most even tempered. If you grew up in a household where screaming and shouting or violence was the norm, you may not know any other way to raise your kids.

It is only as adults that we have the perspective to step back and take a hard look at what is normal and what is abusive. Read the above sections on the types of abuse and warning signs. Do any of those ring a bell for you now? Or from when you were a child? The following is a list of warning signs that you may be crossing the line into abuse:

How do you know when you’ve crossed the line?

You can’t stop the anger. What starts as a swat on the backside may turn into multiple hits getting harder and harder. You may shake your child harder and harder and finally throw him or her down. You find yourself screaming louder and louder and can’t stop yourself.
You feel emotionally disconnected from your child. You may feel so overwhelmed that you don’t want anything to do with your child. Day after day, you just want to be left alone and for your child to be quiet.
Meeting the daily needs of your child seems impossible. While everyone struggles with balancing dressing, feeding, and getting kids to school or other activities, if you continually can’t manage to do it, it’s a sign that something might be wrong.
Other people have expressed concern. It may be easy to bristle at other people expressing concern. However, consider carefully what they have to say. Are the words coming from someone you normally respect and trust? Denial is not an uncommon reaction.

Breaking the cycle of child abuse

If you have a history of child abuse, having your own children can trigger strong memories and feelings that you may have repressed. This may happen when a child is born, or at later ages when you remember specific abuse to you. You may be shocked and overwhelmed by your anger, and feel like you can’t control it. But you can learn new ways to manage your emotions and break your old patterns.

Remember, you are the most important person in your child’s world. It’s worth the effort to make a change, and you don’t have to go it alone. Help and support are available.

Tips for changing your reactions

Learn what is age appropriate and what is not. Having realistic expectations of what children can handle at certain ages will help you avoid frustration and anger at normal child behavior. For example, newborns are not going to sleep through the night without a peep, and toddlers are not going to be able to sit quietly for extended periods of time.
Develop new parenting skills. While learning to control your emotions is critical, you also need a game plan of what you are going to do instead. Start by learning appropriate discipline techniques and how to set clear boundaries for your children. Parenting classes, books, and seminars are a way to get this information. You can also turn to other parents for tips and advice.
Take care of yourself. If you are not getting enough rest and support or you’re feeling overwhelmed, you are much more likely to succumb to anger. Sleep deprivation, common in parents of young children, adds to moodiness and irritability—exactly what you are trying to avoid.
Get professional help. Breaking the cycle of abuse can be very difficult if the patterns are strongly entrenched. If you can’t seem to stop yourself no matter how hard you try, it’s time to get help, be it therapy, parenting classes, or other interventions. Your children will thank you for it.
Learn how you can get your emotions under control. The first step to getting your emotions under control is realizing that they are there. If you were abused as a child, you may have an especially difficult time getting in touch with your range of emotions. You may have had to deny or repress them as a child, and now they spill out without your control.

Helping an abused or neglected child

What should you do if you suspect that a child has been abused? How do you approach him or her? Or what if a child comes to you? It’s normal to feel a little overwhelmed and confused in this situation. Child abuse is a difficult subject that can be hard to accept and even harder to talk about.

Just remember, you can make a tremendous difference in the life of an abused child, especially if you take steps to stop the abuse early. When talking with an abused child, the best thing you can provide is calm reassurance and unconditional support. Let your actions speak for you if you’re having trouble finding the words. Remember that talking about the abuse may be very difficult for the child. It’s your job to reassure the child and provide whatever help you can.

Tips for talking to an abused child

Avoid denial and remain calm. A common reaction to news as unpleasant and shocking as child abuse is denial. However, if you display denial to a child, or show shock or disgust at what they are saying, the child may be afraid to continue and will shut down. As hard as it may be, remain as calm and reassuring as you can.
Don’t interrogate. Let the child explain to you in his or her own words what happened, but don’t interrogate the child or ask leading questions. This may confuse and fluster the child and make it harder for them to continue their story.
Reassure the child that they did nothing wrong. It takes a lot for a child to come forward about abuse. Reassure him or her that you take what is said seriously, and that it is not the child’s fault.
Safety comes first. If you feel that your safety or the safety of the child would be threatened if you try to intervene, leave it to the professionals. You may be able to provide more support later after the initial professional intervention.

Reporting child abuse and neglect

If you suspect a child is being abused, it's critical to get them the help he or she needs. Reporting child abuse seems so official. Many people are reluctant to get involved in other families' lives.

Understanding some of the myths behind reporting may help put your mind at ease if you need to report child abuse.

I don’t want to interfere in someone else’s family. The effects of child abuse are lifelong, affecting future relationships, self-esteem, and sadly putting even more children at risk of abuse as the cycle continues. Help break the cycle of child abuse.
What if I break up someone’s home? The priority in child protective services is keeping children in the home. A child abuse report does not mean a child is automatically removed from the home - unless the child is clearly in danger. Support such as parenting classes, anger management or other resources may be offered first to parents if safe for the child.
They will know it was me who called. Reporting is anonymous. In most places, you do not have to give your name when you report child abuse. The child abuser cannot find out who made the report of child abuse.
It won’t make a difference what I have to say. If you have a gut feeling that something is wrong, it is better to be safe than sorry. Even if you don’t see the whole picture, others may have noticed as well, and a pattern can help identify child abuse that might have otherwise slipped through the cracks.

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Friday, April 12, 2013