child abuse

What do I need to know about child abuse?

Child abuse is common. The news is so full of reports about child mistreatment that you can?t help but wonder how safe your child really is. Although it?s a mistake to become overprotective and make your child fearful, it is important to recognize the actual risks and familiarize yourself with the signs of abuse. More than 2.5 million cases of child abuse and neglect are reported each year. Of these, thirty-five of one hundred involve physical abuse, fifteen of one hundred involve sexual abuse, and fifty of one hundred involve neglect. Studies show that one in four girls and one in eight boys will be sexually abused before they are eighteen years old. About one in twenty children are physically abused each year.

Where abuse occurs

Most child abuse occurs within the family, often by parents or relatives who themselves were abused as children. Neglect and mistreatment of children is also more common in families living in poverty and among parents who are teenagers or are drug or alcohol abusers. Although there has been a recent increase in child abuse outside the home, it is still true that most often children are abused by a caregiver or someone they know, not a stranger.

Types of abuse

Sexual abuse is any sexual activity that a child cannot comprehend or consent to. It includes acts such as fondling, oral-genital contact, and genital and anal intercourse, as well as exhibitionism, voyeurism, and exposure to pornography.

Physical abuse involves injuring a child?s body. This could include bruising, burns, bone injury, head injury, and injury to an internal organ. Because a bruise indicates that body tissue has been damaged and blood vessels have broken, any discipline method that leaves bruises is by definition physical abuse.

Child neglect can include physical neglect (withholding food, clothing, shelter, or other physical necessities), emotional neglect (withholding love, comfort, or affection), or medical neglect (withholding needed medical care).

Psychological abuse results from all of the above, but also can be associated with verbal abuse.

Signs and symptoms

It?s not always easy to recognize when a child has been abused. Children who have been mistreated are often afraid to tell anyone, because they think they will be blamed or that no one will believe them, or because the person who abused them is someone they love very much. Parents also tend to overlook symptoms, because they don?t want to face the truth. This is a serious mistake. A child who has been abused needs special support and treatment as early as possible. The longer he continues to be abused or is left to deal with the situation on his own, the less likely he is to make a full recovery.

The best way to check for signs of abuse is to be alert to any unexplainable changes in your child?s body or behavior. Don?t conduct a formal ?examination? unless you have reason for suspicion, as this may make the child fearful, but do look further if you notice any of the following:

Physical abuse

• Any injury (bruise, burn, fracture, abdominal or head injury) that cannot be explained

Sexual abuse

• Fearful behavior (nightmares, depression, unusual fears)
• Abdominal pain, bedwetting (especially if the child had already been toilet trained), genital pain or bleeding, sexually transmitted disease
• Attempts to run away
• Extreme sexual behavior that seems inappropriate for the child?s age

Psychological maltreatment

• Sudden change in self-confidence
• Headaches or stomachaches with no medical cause
• Abnormal fears, increased nightmares
• Attempts to run away
• School failure

Emotional neglect

• Failure to gain weight (especially in infants)
• Desperately affectionate behavior
• Voracious appetite and stealing of food

Getting help

If you suspect your child has been abused, get help immediately through your pediatrician or a local child protective agency. Physicians are legally obligated to report all suspected cases of abuse or neglect to state authorities. Your pediatrician also will detect and treat any medical injuries or ailments, recommend a therapist, and provide necessary information to investigators. The doctor also may testify in court if necessary to obtain legal protection for the child or criminal prosecution of a sexual abuse suspect. Criminal prosecution is rarely sought in mild physical abuse cases but will occur in cases involving sexual abuse.

If he has been abused, your child will benefit from the services of a qualified mental health professional. You and other members of the family may be advised to seek counseling so that you?ll be able to provide the support and comfort your child needs. If someone in your family is responsible for the abuse, a mental health professional may be able to treat that person successfully, as well.

If your child has been abused, you may be the only person who can help him. There is no good reason to delay reporting your suspicions of abuse. Denying the problem will only make the situation worse, allowing the abuse to continue unchecked and decreasing your child?s chance for a full recovery. In any case of child abuse, the safety of the abused youngster is of primary concern. He or she needs to be in a safe environment free of the potential for continuing abuse.