Family & Relationships: Child Abuse

As a general definition, child abuse comprises any physical or verbal behavior that is violent, negligent, demeaning, or invasive to a child. There are several different types of child abuse, including physical abuse, psychological abuse, and sexual abuse. Child neglect is also considered to be a type of child abuse. In many cases, child abuse is part of a general pattern of domestic violence (any action by one member of a family that causes physical harm to one or more members of his/her family). There are a number of signs and symptoms to watch for that may indicate an underlying pattern of child abuse. Further research is needed not only to define the various facets of child abuse but also to better understand its antecedents and to develop ways to prevent it.

Keywords Abuse; Caregiver; Child Abuse; Culture; Domestic Violence; Neglect; Physical Abuse; Psychological Abuse; Sexual Abuse

Child Abuse

Overview

In her review of the history of child abuse, Carolyn Hilarski [M1](2008) discusses the evidence of child abuse through written history. In some ways, child abuse is a matter of legal definition. Looked at through the lens of twenty-first-century sensibilities, actions that today would be considered outrageous examples of child abuse were at various times legally sanctioned and culturally accepted (e.g., at one point in time, a lying child could legally have his/her tongue cut out). However, as long ago as ancient Mesopotamia, the fact of child abuse was recognized, and laws were put into effect to reduce its incidence. For example, children, wives, animals, and slaves at that time were all considered to be the property of the male head of the household. Disrespectful children could be sold into slavery, physically punished, or even dismembered. However, there were limitations to what could be done to a child. For example, the code of Hammurabi limited the enslavement of children to a period no greater than three years. Similarly, in ancient Greece, infanticide was considered immoral unless the child was considered to be sickly. However, death by exposure to the elements was an acceptable practice for a female child, an injured child, or one with a birth defect. During the Roman Empire, male heads of household also had complete control over their entire family, and youths who disobeyed their fathers could be mutilated or even murdered. Further, most ancient Romans also considered pederasty to be an inconsequential sexual activity. During the Middle Ages, children were still sold into slavery or prostitution, murdered as infants, or forced to work as young as three or five years of age. At that time, killing or deserting infants continued to be common practice. Child abuse continued basically unabated through times considered to be much more civilized. For example, in colonial America, the cultural norm was to rear children under the philosophy of "spare the rod, spoil the child." The "Stubborn Child Law" in colonial Massachusetts allowed children to be put to death for any sort of non-compliant behavior. During the Industrial Revolution, many young children were forced to work twelve to fifteen-hour days or abandoned, and girls were frequently at risk for rape and boys at risk for sodomy.

Despite the pervasiveness of child abuse throughout the ages, however, it has been long recognized that it is unacceptable behavior. The Code of Hammurabi, circa 1750 BCE, attempted to stop the practice of exposing children to the elements or selling them into slavery. During the Christian era, Constantine outlawed the exposure of infants, and Justinian's legal codes forbade the sale or enslavement of children or the abandonment of infants and made these actions punishable by death. Despite such advances, however, routine infanticide persisted until well into the nineteenth century.

Contemporary Definition of Child Abuse

Civilization has progressed since the time that infants were routinely exposed on mountainsides to die. For most cultures and societies today, the practices of infanticide, enslavement, and even child labor are in the past. Yet, child abuse continues in many forms. In general, child abuse today is considered to comprise any physical or verbal behavior that is violent toward or demeaning or invasive of a child. Further, this general definition encompasses several different types of child abuse. The abuse of a child can be physical, psychological, or sexual in nature.

• Physical abuse includes any physical behavior that is violent toward another person (e.g., assault, battery, inappropriate restraint).

• Psychological abuse (also called emotional abuse) includes any verbal or other nonphysical behavior that is violent toward or demeaning or invasive of another person. Psychological abuse is the intentional infliction of mental or emotional anguish through the use of threats, humiliation or shaming, emotional control, withholding of affection or financial support, or other verbal or nonverbal means.

• Sexual abuse is the violation or exploitation of another person by sexual means. In the case of children, sexual abuse includes all sexual contact between a child and an adult.

• In addition, neglect (i.e., the failure to meet the basic needs of a person in one's care) is also considered to be a form of child abuse.

In many cases, the abuse of a child is part of a general pattern of domestic violence, which encompasses any action by one member of a family that causes physical harm to one or more members of his/her family. Domestic violence is typically an escalating pattern of violence by a spouse or intimate partner in which violence is used to express power and exert control over the other person.

Effects & Manifestations of Child Abuse

In many ways, the effects of child abuse are clear, particularly when the abuse is physical. However, although broken bones may heal, repeated beatings, intimidations, incest, and any other forms of child abuse have long-lasting psychological effects on an individual, not only in childhood but throughout his/her lifetime. For example, children who have been the victims of domestic violence may demonstrate more aggressive or oppositional behavior as adults and are more likely to experience anxiety disorders or depressive symptoms or have social problems or cognitive difficulties (Jouriles, McDonald, Slep, Heyman, & Garrido, 2008). The co-occurrence of domestic violence and child abuse can occur in a number of different ways. In some families, there is a single perpetrator (e.g., the father or mother) who abuses both the other parent and the child. In other families, the perpetration of violence and abuse is sequential, for example, with the father abusing the mother and the mother, in turn, abusing the child. In still other situations, there are dual perpetrators, with one parent abusing the other parent and both parents abusing the child at the same time. In some families, there is just a general pattern of marital violence with both parents abusing each other and the child or both parents abusing each other and one parent abusing the child. In other cases, child abuse or domestic violence may be perpetrated by a sibling, a stepparent, an aunt or uncle, a grandparent, or other close friends or caregivers.

Causes of Child Abuse

Several plausible hypotheses have been posited to explain the underlying causes of child abuse and domestic violence in families. The first hypothesis is that some individuals are naturally more aggressive than others. Although this theory is possible if the domestic violence is perpetrated by one individual in the family toward all other members of the family, it does not well explain the other scenarios of domestic violence. This theory is based on general theories of crime and violence, which suggest that aggressive individuals tend to be indiscriminately aggressive and do not discriminate between potential targets (e.g., spouse versus children). Another common explanation for the coexistence of child abuse and domestic violence is that both types of events are precipitated by stressful events in the perpetrator's life. According to this theory, an accumulation of stressful situations and circumstances within the perpetrator's life and a lack of adequate coping skills can lead to higher levels of aggressive behavior for all dyadic relationships within the family. This hypothesis has been at least partially borne out in the research literature, which shows that factors such as economic or parenting stress are typically correlated with both domestic violence and child abuse. A third explanation for the coexistence of child abuse and domestic violence that is frequently offered is that one type of abuse causes or sets the stage for another type of abuse. In this variation of the spillover hypothesis, it is hypothesized, for example, that violence and abuse in one relationship (e.g., between spouses or intimate partners) can spillover and result in violence in other relationships within the family (e.g., mother-to-child). Although each of these explanations is plausible for some of the domestic violence and child abuse scenarios discussed above, the relationship is a complex one, and more than one explanation may be operating at the same time. At this time, the state of knowledge about domestic violence and child abuse is insufficient to draw solid conclusions.

Applications

No discussion of child abuse would be complete without a concomitant discussion of how to recognize, stop, and prevent child abuse. Definitions of child abuse vary within the literature as well as from study to study and culture to culture. The lack of a consistent definition of many of these terms, however, does not mean that we cannot or should not do something about this significant social problem. Certainly, it is possible to suspect child abuse in situations where it does not exist (e.g., suspecting abuse based not on symptoms but because one does not approve of someone else's parenting or lifestyle). Further, one isolated warning sign does not make a family situation abusive. However, a warning sign is a potential symptom, and it is important to continue to monitor the situation and look for repeated evidence of possible abuse or larger patterns of abuse. If one believes that a pattern of abuse is present, it is important that these suspicions be reported to the appropriate authorities. True child abuse (as opposed to strict discipline) can have wide ramifications affecting not only the abused child during his/her childhood but well into adulthood or even for the rest of his/her life. Further, a pattern of abuse toward one child may also signal a similar pattern of abuse toward another child. Even if such is not currently the case, if the abused child is eventually extricated from the situation, the abuser's attention may be shifted to another child or family member, and the pattern of abuse continued.

Signs of Child Abuse

Child abuse can be difficult to identify, in part, because, in many situations, the child has been taught to obey the adult abuser. Similarly, abused children can sometimes believe that the abuse they receive is their fault and that they deserve it or that there is nothing wrong with the abusive attention or situation (particularly in the case of sexual abuse). Further, many abusers threaten or coerce their victim into keeping the abuse a secret. However, even when the child does not report being abused (which they often do not), there are some symptoms that can indicate an underlying pattern of child abuse. For example, according to the Child Welfare Information Gateway, abused children may show sudden changes in behavior or their performance at school. Similarly, learning problems or having difficulty concentrating can be a sign of child abuse if the symptoms cannot be attributed to a specific physical or psychological cause. Of course, as discussed above, such symptoms can be indicative of many other things. However, when observed in conjunction with other signs of child abuse, they may be indicative of the underlying pattern of abuse. For example, although some children may be by nature introverted and prone to do what they are told by adults, children who are overly compliant, passive, or withdrawn or who are always watchful and appeared to constantly be expecting something bad to happen may be being abused. Children who come to school or other activities early or are reluctant without reason to go home may be doing so in order to escape an abusive home situation.

The behavior of the parents can also be indicative of an abusive home situation. Parents or guardians who refuse to get their children the physical or medical help that they require, even when the need for such help has been brought to their attention, or otherwise pay little attention to their child may be either neglecting or abusing their children. Similarly, abusive parents may ask teachers or caregivers to use harsh physical discipline if the child misbehaves; act as if they believe that the child is a burden; demand a high level of physical or academic performance beyond the child's abilities; or expect the child to satisfy his/her physical or emotional needs. When the child and the abusive parent are together, they may rarely touch or look at each other.

In addition to these general signs of abuse or neglect, there are some more specific symptoms of the various types of child abuse. Physical abuse may be accompanied by such symptoms as unexplained burns, bites, broken bones, black eyes, fading bruises, or other physical marks that are not attributable to a readily apparent cause. Physically abused children may also shrink or flinch when approached by adults or report being injured by a parent or caregiver. Physically abusive adults may offer inconsistent or unconvincing explanations for the child's injury, apply harsh physical discipline toward the child, and often were abused as children themselves. A child who is being sexually abused may have difficulty walking or sitting; may refuse to change into his/her gym clothes; have nightmares or wet the bed; have a sudden change in appetite or behavior; demonstrate inappropriate, bizarre, or other unusual knowledge of sex for his/her age; run away from home; or report sexual abuse. Female victims of sexual abuse may also experience chronic urinary tract infections. A torn hymen or labial adhesions are also significant signs of sexual abuse. Abused children may also act inappropriately mature or inappropriately infantile, demonstrating behaviors such as thumb-sucking or rocking that are not appropriate for their age. Adults who sexually abuse children may be overly protective of the child or limit his/her contact with others, be secretive or isolated, or may show signs of jealousy or be controlling with family members. Psychologically abused children may show extreme behavior (e.g., being overly compliant or demanding, extremely passive or aggressive), act either inappropriately adult or inappropriately infantile, have delayed physical or emotional development, attempt suicide, or report a lack of attachment to his/her parent. Psychologically abusive adults may constantly belittle, berate, or blame the child, be unconcerned about the child or his/her problems, or overtly reject the child. Signs that a child is being neglected include frequent absences from school, begging for or stealing food or money, being consistently hungry or dehydrated, not receiving needed medical or dental care, being consistently dirty, not having weather-appropriate clothing, abusing drugs or alcohol, or stating that no one is at home to care for him/her. Neglectful adults may appear indifferent to the child, seem apathetic or depressed, behave irrationally or bizarrely, or abuse drugs or alcohol.

Putting an End to Child Abuse

Child abuse is often difficult to stop within the home. If child abuse is part of a greater pattern of domestic violence, for example, one parent may be afraid to step in to stop abuse perpetrated by the other parent or significant other for fear of becoming abused him/herself. Although some children will confide in a trusted adult outside the family, many will not for fear of reprisals at home or because they do not understand that their home life of abuse and violence is not normal. One way to help stop or even prevent abuse is to implement education programs so that children know what constitutes inappropriate behavior and how and to whom it should be reported. For those home situations where abuse is suspected, home visitation programs can help monitor the situation and identify abuse earlier rather than later. Even as adult survivors of childhood abuse, many victims can be helped to overcome the devastating effects of child abuse and learn to live more normal lives through counseling.

Conclusion

Child abuse appears to have been a problem throughout recorded history and is still a major social problem today. This long history, however, in no way diminishes the urgency of not only identifying child abuse but of preventing it in the first place. Children need to be protected, but children also need to be disciplined. Better definitions of each type of child abuse need to be developed, and professionals and laypeople alike need to be alert for symptoms of abuse. Social scientists also need to better understand abuse and its antecedents in order to develop better programs for the education of children and the community on how to spot signs of abuse and how it can be prevented. According to the World Health Organization, in 2022, 300 million children between the ages of two and four were subject to some sort of physical or psychological abuse perpetrated by a caregiver. This abuse has lifelong physical and psychological consequences that may, in turn, affect the economic and social development of emerging nations. Effective preventative and punitive actions to prevent child abuse continued to be explored (WHO, 2022).

Terms & Concepts

Abuse: Physical or verbal behavior that is violent, Demeaning, or invasive to another person.

Caregiver: (a) A medical or services professional who assists in identifying, preventing, or treating a disability or illness. (b) An individual (e.g., adult child or other family member, friend, or neighbor) who attends to the needs of a child or dependent adult and provides support and assistance. Support may be emotional, financial, or hands-on and may be done in person or long distance.

Child Abuse: Child abuse can be physical, psychological, or sexual in nature and also includes situations of neglect.

Correlation: The degree to which two events or variables are consistently related. Correlation may be positive (i.e., as the value of one variable increases, the value of the other variable increases), negative (i.e., as the value of one variable increases, the value of the other variable decreases), or zero (i.e., the values of the two variables are unrelated). Correlation does not imply causation.

Culture: A complex system of meaning and behavior that is socially transmitted and that defines a common way of life for a group or society. Culture includes the totality of behavior patterns, arts, beliefs, institutions, and other products of human work and thought of the society or group.

Domestic Violence: Any action by one member of a family that causes physical harm to one or more members of his/her family. Domestic violence is typically an escalating pattern of violence by a spouse or intimate partner in which violence is used to express power and exert control over the other person.

Dyad: A group with only two members (e.g., husband and wife, father and child).

Neglect: Failure to meet the basic needs of a person in one's care. Neglect may be material (e.g., the withholding of food or clothing), emotional (e.g., rejection of or apathy toward the person), or service-oriented (e.g., depriving the individual of medical care). In active neglect, the caregiver intentionally fails to meet the person's needs. In passive neglect, the caregiver is unable to meet the needs of the individual due to any number of reasons, including the caregiver's stress, ignorance, incompetence, lack of resources, or substance abuse problem.

Physical Abuse: A physical behavior that is violent toward another person (e.g., assault, battery, inappropriate restraint).

Psychological Abuse: Verbal or other nonphysical behavior that is violent toward or demeaning or invasive of another person. Psychological abuse is the intentional infliction of mental or emotional anguish through the use of threats, humiliation or shaming, emotional control, withholding of affection or financial support, or other verbal or nonverbal means. Psychological abuse is also called emotional abuse.

Sexual Abuse: The violation or exploitation of another person by sexual means. For adults, sexual abuse includes all nonconsensual sexual contact. Sexual abuse can arise in relationships of trust (e.g., between a caregiver and the person being cared for). In the case of children, sexual abuse includes all sexual contact between a child and an adult.

Society: A distinct group of people who live within the same territory, share a common culture and way of life, and are relatively independent of people outside the group. Society includes systems of social interactions that govern both culture and social organization.

Bibliography

Child maltreatment. (2022, Sept 19). World Health Organization (WHO). Retrieved May 17, 2023, from https://www.who.int/news-room/fact-sheets/detail/child-maltreatment

Child Welfare Information Gateway (2007). Recognizing child abuse and neglect: Signs and symptoms. Retrieved 13 August 2008, from http://www.childwelfare.gov/pubs/factsheets/signs.cfm

The far-reaching consequences of child abuse: Study shows link between early trauma experienced by mothers and health problems in their children. (2023, Feb. 24). ScienceDaily. Retrieved May 17, 2023, from https://www.sciencedaily.com/releases/2023/02/230224135044.htm

Flam, A. M., & Haugstvedt, E. (2013). Test balloons? Small signs of big events: A qualitative study on circumstance facilitating adults’ awareness of children’s first signs of sexual abuse. Child Abuse and Neglect, 37, 633–642. Retrieved November 4, 2013, from EBSCO online database SocINDEX with Full Text. http://search.ebscohost.com/login.aspx?direct=true&db=sih&AN=90303731

Guterman, N. B. & Taylor, C. A. (2005). Prevention of physical child abuse and neglect. In G. P. Mallon & P. M. Hess (Eds.), Child Welfare for the Twenty-First Century: A Handbook of Practices, Policies and Programs. Irvington, NY: Columbia University Press, 270-289. Retrieved August 13, 2008, from EBSCO Online Database SocINDEX with Full Text. http://search.ebscohost.com/login.aspx?direct=true&db=sih&AN=31473178&site=ehost-live

Hilarski, C. (2008). Child and adolescent sexual abuse. In C. Hilarski, J. S. Wodarski, & F. D. Feit (Eds.), Handbook of Social Work in Child and Adolescent Sexual Abuse. Philadelphia: The Haworth Press, 29-50. Retrieved August 12, 2008, from EBSCO Online Database SocINDEX with Full Text. http://search.ebscohost.com/login.aspx?direct=true&db=sih&AN=31324255&site=ehost-live

‗‗‗‗. (2008). Historical overview. In C. Hilarski, J. S. Wodarski, & F. D. Feit (Eds.), Handbook of Social Work in Child and Adolescent Sexual Abuse. Philadelphia: The Haworth Press, 1-27. Retrieved August 12, 2008, from EBSCO Online Database SocINDEX with Full Text. http://search.ebscohost.com/login.aspx?direct=true&db=sih&AN=31324254&site=ehost-live

Jouriles, E. N., McDonald, R., Slep, A. M. S., Heyman, R. E., & Garrido, E. (2008). Child abuse in the context of domestic violence: Prevalence, explanations, and practice implications. Violence and Victims, 23, 221-235. Retrieved August 12, 2008, from EBSCO Online Database SocINDEX with Full Text. http://search.ebscohost.com/login.aspx?direct=true&db=sih&AN=32507380&site=ehost-live

Putnam-Hornstein, E., Cleves, M. A., Licht, R., & Needell, B. (2013). Risk of fatal injury in young children following abuse allegations: evidence from a prospective, population-based study. American Journal of Public Health, 103, E39–E44. Retrieved November 4, 2013, from EBSCO online database SocINDEX with Full Text. http://search.ebscohost.com/login.aspx?direct=true&db=sih&AN=90152170

Softestad, S., Toverud, R., Jensen, T. K. (2013). Interactive regulation participation: children’s perspectives on child-parent interaction when suspicion of child sexual abuse is raised. Qualitative Social Work, 12, 603–619. Retrieved November 4, 2013, from EBSCO online database SocINDEX with Full Text. http://search.ebscohost.com/login.aspx?direct=true&db=sih&AN=90102376

Suggested Reading

Daro, D. & McCurdy, K. (1994). Preventing child abuse and neglect: Programmatic interventions. Child Welfare, 73, 405-430. Retrieved August 13, 2008, from EBSCO Online Database SocINDEX with Full Text. http://search.ebscohost.com/login.aspx?direct=true&db=sih&AN=24227346&site=ehost-live

Kenny, M. C., Capri, V., Thakkar-Kolar, R. R., Ryan, E. E., & Runyon, M. K. (2008). Child sexual abuse: From prevention to self-protection. Child Abuse Review, 17, 36-54. Retrieved August 12, 2008, from EBSCO Online Database SocINDEX with Full Text. http://search.ebscohost.com/login.aspx?direct=true&db=sih&AN=28699039&site=ehost-live

McIntyre, R. S., Soczynska, J. K., Mancini, D., Lam, C., Woldeyohannes, H. O., Moon, S., Konarski, J. Z., & Kennedy, S. H. (2008). The relationship between childhood abuse and suicidality in adult bipolar disorder. Violence and Victims, 23, 361-372. Retrieved August 12, 2008, from EBSCO Online Database SocINDEX with Full Text. http://search.ebscohost.com/login.aspx?direct=true&db=sih&AN=32507390&site=ehost-live

Rapoza, k. A. & Baker, A. T. (2008). Attachment styles, Alcohol, and childhood experiences of abuse: An analysis of physical violence in dating couples. Violence and Victims, 23, 52-65. Retrieved August 12, 2008, from EBSCO Online Database SocINDEX with Full Text. http://search.ebscohost.com/login.aspx?direct=true&db=sih&AN=31131096&site=ehost-live

Zhang, W., et al. (2013). Young children’s knowledge and skills related to sexual abuse prevention: A pilot study in Beijing, China. Child Abuse and Neglect, 37, 623–630. Retrieved November 4, 2013, from EBSCO online database SocINDEX with Full Text. http://search.ebscohost.com/login.aspx?direct=true&db=sih&AN=90303729 [M1]