G1309

Child Abuse: A Painful Secret

This publication examines causes and prevention of child abuse.

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Gail L. Brand and Marilyn S. Fox
Extension Educators

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• Nebraska Child Abuse Law
• What is Child Abuse and Neglect?
• Factors Leading To Child Abuse and Neglect
• Signs of Child Abuse and Neglect
• Signs of Child Sexual Abuse
• Impact of Child Abuse
• If You Suspect Child Abuse
• Combating Child Abuse
• Conclusion
• Resources
• Acknowledgment

Child abuse was not recognized as a serious problem in the United States until the 1960s. In 2004 almost 1,900,000 child abuse and neglect cases were reported in the U.S. Of those cases almost 480,000 (25.7 percent) were confirmed. Some statistics related to those cases include:

• 57.8 percent of the perpetrators were women and 42.2 percent were men. Many female abusers are single mothers who are facing poverty and raising children alone.
• Women typically were younger than men. The median age was 31 years for women and 34 years for men. Of the women who were perpetrators, more than 40 percent were under 30 years, compared with about 30 percent of the men.
• The racial distribution of perpetrators was similar to the race of their victims. More than one-half of perpetrators were White, one-fifth were African-American, and almost one-fifth were Hispanic.
• Nearly 80 percent of perpetrators were parents. Of this group, more than 90 percent were biological parents, 4.3 percent were stepparents and 0.7 percent were adoptive parents. Other relatives accounted for an additional 7 percent. Unmarried partners of parents accounted for almost 4 percent.
• More than one-half (61 percent) of all perpetrators were found to have neglected children. Slightly more than 10 percent of perpetrators physically abused children, and 7.7 percent sexually abused children. More than 10 percent of all perpetrators were associated with more than one type of maltreatment.

In Nebraska in 2005, approximately 14,000 cases of child abuse and neglect were investigated. Of those investigated a little over 3,000 Nebraska cases were substantiated. Cases could include more than one child, depending upon the size of the family. According to the Nebraska Department of Health and Human Services Office of Protection and Safety (2005):

• physical neglect was found in 72 percent of confirmed cases,
• physical abuse in 11 percent,
• sexual abuse in 8 percent of confirmed cases.
• emotional abuse in 6 percent and
• emotional neglect was found in 3 percent.

In some cases, more than one type of abuse was involved.

Nebraska Child Abuse Law A person commits child abuse if he or she knowingly, intentionally or negligently causes or permits a minor child to be:
(a)	placed in a situation that endangers his or her life or physical or mental health;
(b)	cruelly confined or cruelly punished;
(c)	deprived of necessary food, clothing, shelter, or care;
(d)	placed in a situation to be sexually exploited by allowing, encouraging, or forcing such minor child to solicit for or engage in prostitution, debauchery, public indecency, or obscene or pornographic photography, films, or depictions; or
(e)	placed in a situation to be sexually abused as defined in section 28-319, 28-319.01, or 28-320.01 (Sec. 15, Section 28-707 Nebraska Revised Statutes).

What is Child Abuse and Neglect?

Any action or lack of action that in any way may endanger or impair a child’s emotional, physical or psychological health and development is considered child abuse. There are several forms of abuse.

• Physical abuse is any physical injury to a child which is not accidental. It may be biting, pinching, hitting, kicking, pushing, twisting arms, choking, grabbing hair or punishment to dominate or control.
• Emotional and psychological abuse is the omission of or acts that cause or could cause serious conduct, cognitive, affective or other mental disorders as a result of parent or caretaker behavior and are almost always present when other forms of abuse are identified.
• Emotional abuse involves severe rejection, intimidation, humiliation, severe criticism, constant use of verbally abusive language; denigration; name calling; constant shaming; incessant teasing; terrorizing; threats of punishment, torture, or abandonment to cause fear; confinement, and failure to express any affection. This generally occurs as a result of the child’s inability to meet unrealistic demands made by parents.
• Psychological abuse occurs when children are not provided with the necessary environment to develop mentally. It might be controlling access to school, activities, peers, family and others.
• Sexual abuse is any sexual activity in which a child is allowed, encouraged, or forced to participate. This can include sexual touching and fondling, exhibitionism, sexual intercourse, incest, and pornography.

Neglect is just as detrimental to children’s well-being as is abuse. Neglect occurs when a child is deprived of essential needs.

• Physical neglect involves denying or leaving a child without nutrition, clothing, housing, health care, hygiene, education, or proper supervision as warranted by their age and development.
• Emotional neglect occurs when a child is neither nurtured nor provided with encouragement, love, or security. Also included in emotional neglect is the withholding of physical and emotional contact to the detriment of the child’s normal emotional development, and in extreme cases, physical development.

Factors Leading To Child Abuse and Neglect

Why does child abuse and neglect occur? There is no one single cause. It occurs in all types of families regardless of race, culture, ethnicity, socioeconomic status or religious group. Research does indicate that several risk factors are commonly associated with child abuse and neglect. Earlier findings closely mirror more recent theories which the Child Welfare Information Gateway suggests can be organized into four main systems: 1) the family, 2) the child, 3) the community, and 4) the society. (2007, http://www.childwelfare.gov/preventing/overview/risk.cfm)

Family Characteristics

Those factors in the family system which place children at a high risk for maltreatment are:

• History of substance abuse, including alcohol or drugs
• Parents having a history of childhood abuse as well as childhood sexual abuse
• Higher incidence of domestic violence
• Inadequacy of parenting and/or communication skills

Child Characteristics

Children are not responsible for the abuse they receive, but some of their characteristics are associated with higher risk:

• A child born after a difficult or unplanned pregnancy, who is of the “wrong” sex, or who is born outside of marriage
• A child exhibiting traits such as fussiness or hyperactivity that create stress
• A child with disabilities or mental retardation
• Age and gender may be predictive of abuse. Risk for sexual abuse increases with age and is more likely to be forced upon females

Community Characteristics

National studies have linked several community factors with increased child abuse and neglect:

• Higher poverty rate
• Increased incidences of violence
• Higher unemployment rate
• Social isolation with fewer friends and family who are close and less contact with them
• Lack of support systems which could include family and friends but also include outside support resources

Society Characteristics

Although this factor is the least understood and researched, it is thought there are social factors which might be linked:

• Narrow legal definitions of child abuse and neglect
• Social acceptance of violence through video games, television and films, and music lyrics
• Political or religious views that value noninterference in families

Signs of Child Abuse and Neglect

There are numerous indications in the child’s appearance or behavior that raise the possibility that child abuse or neglect has occurred or might occur. These signs individually are not predictors of child abuse, but if several are evident, suspicion of abuse may be warranted.

Child’s Appearance

• Unexplained or unusual bruises, welts, burns, cuts, bite marks or fractures
• Frequent injuries, even if explained as accidental
• Often dirty, tired, no energy, hungry
• Clothes dirty or not appropriate for weather conditions
• Wears concealing clothing (long sleeves, high neck) to hide injuries
• Needs glasses, dental care, or has other obvious medical needs
• Comes to school without breakfast, often does not have lunch or lunch money
• Child under the age of six left in a car unattended

Child’s Behavior

• Reports injury inflicted by parent
• Child’s story about how injury occurred is not believable
• Wary of physical contact; avoids other people, including children
• Appears too anxious to please; allows other people to say and do things to him/her without protest
• Hard to get along with, demanding, often doesn’t obey
• Frequently causes trouble; breaks or damages things
• Shows no enjoyment in other children or toys
• Cries often with little or no expectation of being comforted
• Avoids physical contact with adults — is shy, frightened of parents
• Seeks affection from any adult
• Frequently late or absent from school
• Engages in delinquent acts or runs away
• Begs or steals food
• Notably destructive or aggressive

Signs of Child Sexual Abuse

Sexual abuse is usually perpetrated by relatives or family members. A report from the U.S. Department of Justice indicated that girls are significantly more likely (more than six times) than boys to be victims of sexual abuse. Further, it indicated that males are significantly more likely to be perpetrators of sexual abuse/assault (96 percent of cases reported to law enforcement). The most common assault victims for female offenders (12 percent) were children under the age of 6 while male offenders perpetrated 88 percent of the sexual abuse/assaults for children in this same age group.

Child’s Appearance

• Torn, stained, or bloody underclothing
• Pain or itching in the genital area
• Sexually transmitted disease

Child’s Behavior

• Appears withdrawn or engages in fantasy or baby-like behavior
• Has poor relationships with other children
• Unwilling to participate in physical activities
• Engaged in delinquent acts or runs away
• States she/he has been sexually assaulted by parent/caregiver
• Reports sexual advances by adult, friend or sibling

Impact of Child Abuse

Effects of Physical and Verbal Abuse

Reviews of research on the effects of child abuse suggest the following:

1. Abused children tend to exhibit aggression, low self-esteem, depression and low academic achievement.
2. Severely abused children suffer more from intellectual deficits, communication problems and learning disabilities.
3. Adults who were physically abused as children may exhibit low self-esteem, depression, anxiety, suicidal tendencies, unhappiness, increased risk of alcohol abuse and are less able to intimately bond with others.
4. Physical injuries sustained by child abuse cause pain, disfigurement and scarring, physical disability and death.

Effects of Sexual Abuse

Child sexual abuse has serious, negative long-term consequences:

1. Among adolescent females, sexual abuse is associated with lower self-esteem, higher levels of depression, antisocial behavior (e.g., running away, illegal drug use) and suicide attempts.
2. The most devastating effects of being sexually abused occur when the sexual abuse is forceful, prolonged and involves intercourse, and when the abuse was perpetrated by the father or stepfather.
3. Sexually abused girls are more likely to experience teenage pregnancy.
4. Fear, guilt, shame, sleep disturbances and eating disorders have been associated with child sexual abuse.
5. Adult males who were sexually abused as children by their mothers revealed several problems, including difficulty establishing intimate relationships, depression and substance abuse.
6. Sexually abused males tended to develop negative self-perceptions, anxiety disorders, sleep and eating disturbances and sexual dysfunctions.

If You Suspect Child Abuse

If you observe or suspect child abuse or neglect, report it immediately to local law enforcement or the local Department of Health and Human Services office. Nebraska Statute 28-711 says: (1) When any physician, medical institution, nurse, school employee, social worker, or any other person has reasonable cause to believe that a child has been subjected to abuse or neglect or observes such child being subjected to conditions or circumstances which reasonably would result in abuse or neglect, he or she shall report such incident or cause a report to be made to the proper local law enforcement agency, the local Department of Health and Human Services or by calling the statewide hotline number at 1-800-652-1999.

You are not required to give your name. However, you will be asked to provide your name so that, if necessary, the child protective services worker can request additional information. You are protected from liability, provided that the report is made in good faith. Your report is confidential. It may only be released to law enforcement or to a court involving a judicial proceeding.

Nebraska Statute 28-716 says: Persons participating in an investigation or making a report of child abuse or neglect shall be immune from any liability, civil or criminal, that might otherwise be incurred or imposed, except for maliciously false statements.

The Nebraska Department of Health and Human Services (HHS) is required by law to investigate all reports of suspected child abuse and neglect. HHS and law enforcement work together on reports and law enforcement also may conduct an investigation. Due to the confidential and delicate nature of such situations, the person who reports an incidence of abuse cannot be informed of the action taken or of the result of the report.

Nebraska Statute 28-717 says: Any person who willfully fails to make any report required by the law shall be guilty of a Class III misdemeanor. This means: 1) that if you suspect child abuse or neglect, you must report it, 2) you should give as much information about the circumstances as possible, 3) you are immune from suit from any civil or criminal liability, and 4) if you know of abuse but are not reporting it, you are breaking the law.

Combating Child Abuse

There are many ways individuals and communities can work together to prevent child abuse and neglect. Two approaches are: the punitive approach, which views abuse and neglect as crimes for which parents or other adults should be punished, and the intervention approach, which views abuse as a family problem requiring learning appropriate parenting and child development skills and therapy. Usually a combination is used in preventing and treating child abuse.

Those who support the punitive approach believe that one or both parents should be held clearly (i.e. legally) responsible for abusing a child. The abuser should be tried in a court of law, and if convicted, suffer the penalty of violating the law. According to Nebraska statutes:

1. child abuse is a Class I misdemeanor if the offense is committed negligently;
2. child abuse is a Class IIIA felony if the offense is committed knowingly and intentionally and does not result in serious bodily injury;
3. child abuse is a Class III felony if the offense is committed knowing and intentionally and results in serious bodily injury; and
4. child abuse is a Class IB felony if the offense is committed knowingly and intentionally and results in death of such child.

The intervention approach may involve several interrelated strategies which may be either recommended or required:

• Family therapy may be used to improve overall family functioning and develop communication skills.
• Counseling or courses may be recommended to help parent’s increase their self-esteem. The parent or caretaker perpetrator often has low self-esteem, is immature, lacks empathy and is self-centered.
• Anger management training can help the caretaker or parent learn how to constructively deal with the anger and frustration of rearing children. Caretakers need to have the ability to deal effectively with stress and so need to build their capacity to cope.
• Parenting and child-rearing training can help the caretaker learn about age-appropriate behaviors and positive child-rearing techniques. By learning about parenting and child development, parents can encourage appropriate behaviors based on the child’s age and level of development.
• Community support networks for families under stress also may be used. These supports may include: a drop-in day care so caretakers can get relief in stressful times; a parent hot-line to call for information or when the situation becomes stressful; crisis caretakers; crisis child care providers; crisis nurseries; and/or crisis counseling.

Research has shown other protective factors also can be successful interventions. Those linked to lower incidence of child abuse and neglect include nurturing and attachment. Through home visits, support groups and classes, parents can learn strategies to develop a bond with their child. Building a bond helps a parent be more attentive and responsive and builds communications.

Helping parents build a social connection or network lessens the feelings of social isolation and perceived lack of support that have been linked to child abuse and neglect. Supportive family and community members can serve as a resource and help parents expand their social network. Parents also need concrete support beyond the parent-child relationship. Food, shelter, transportation, clothing, medical help and access to essential services that help fulfill those needs are critical.

If you are a parent or caretaker under stress and are at risk for abusing a child:

• Learn to let off steam safely and keep the difficult job of parenting under control. When your child’s behavior is troublesome, use the following stress reliever: count to ten, put the child in a safe area, take ten minutes to cool down and relax, take a walk or call a friend.
• Call a local hotline or community agency.
• Call Nebraska Parent Assistance at their toll-free hotline: 800-642-9909.
• Call the Child/Adult Abuse/Neglect Hotline at 800-652-1999.

If you are abusing alcohol or drugs, remove yourself from the area and seek help by calling the Alcohol and Drug Abuse Helpline at 800-252-6465.

Conclusion

Maltreatment of children is an insidious and destructive behavior pattern with both short-term and long-term consequences. The community, its organizations, churches, and people must get involved. If they are unwilling to get involved, the abuse will continue. If it continues, it gets worse and children will die or suffer permanent physical or emotional injury. The abusing parent or caregiver may go to jail or the family may break up; however, none of this needs to happen. The child must be able to live and grow in a nurturing environment. Most abusive adults know that hurting children is not acceptable and the abuse must stop. Reporting usually stops the abuse, and it forces the caregiver to get professional assistance and to learn more age-appropriate parenting skills. To prevent child abuse and neglect it is important to remember these ten most powerful two-letter words: If it is to be, it is up to me!

Resources

Beitchman, J.H., K.J. Zuker, J.E. Hood, G.A. daCosta, and E. Cassvia. (1992). A review of the long-term effects of child abuse. Child Abuse and Neglect, 19, 101-119.

Center for the Study of Social Policy. (2003). Protective factors literature review: Early care and education programs and the prevention of child abuse and neglect. Washington, D.C. www.cssp.org/uploadFiles/horton.pdf

Gelles, R.J. (1991). Domestic violence and sexual abuse of children: A review of research in the eighties. In A. Booth (Ed.), Contemporary families: Looking forward, looking back (pp. 327-340). Minneapolis: National Council on Family Relations.

Lloyd, S.A. & Emory, B.C. (1993). Abuse in the family: An ecological, life-cycle perspective. Family Relations: Challenges for the Future, T.H. Brubaker, ed. Newbury Park, CA: Sage Publications.

Snyder, H.N. (2000). Sexual assault of young children as reported to law enforcement: Victim, incident, and offender characteristics. U. S. Department of Justice, Bureau of Justice Statistics.

U. S. Department of Health and Human Services, Children’s Bureau. (2006). Child maltreatment 2004. Washington, DC: U.S. Government Printing Office. Retrieved April 2006 from http://www.acf.hhs.gov/programs/cb/pubs/cm04/index.htm

Acknowledgment

This is a major revision of the original NebGuide by this title, which was written by Herbert G. Lingren, Extension Family Specialist, and published in 1996.

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Index: Families
Relationships
1996, Revised January 2008