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Physical, sexual or long-lasting emotional damage to a child, most often perpetrated by parents, stepparents, a mother's male friend or a relative. (Adults and elderly people are also abused; however, the focus of this article is on abuse of children.) NEGLECT is also a form of child abuse.

According to the National Clearinghouse on Child Abuse and Neglect, more than three million children were reported as victims of abuse and neglect in 1996. Of these, about one million cases were substantiated by Child Protective Services workers.

About half (52%) of the substantiated or indicated incidents were cases of neglect and 24% were cases of physical abuse. About 12% of the children were sexually abused. Other forms of maltreatment included abandonment, threats to harm the child, medical neglect and emotional maltreatment. (The numbers do not add up to 100 percent because some of the children were victimized in different ways; for example, both physically and sexually.)

Age of child.??Children are least likely to be physically abused when they are under the age of three years (20%) and most likely to suffer physical abuse when they are age eight and over (about 53%). Neglect is more common with younger children. (See also NEGLECT.)

Sex of victim.??Boys are slightly more likely to be abused than girls, at about 52% of the total. However, when it comes to sexual abuse, the majority of victims, about 77%, are female. (See also SEXUAL ABUSE.)

Race and ethnicity.??The numbers of African-American abused children are out of proportion to the total child population and about twice the proportion of the national level for all children. However, African-American children were underrepresented in terms of sexual abuse.

Fatalities of abuse victims.??About 1,100 children died of abuse in the United States in 1996. Most of the deaths (76%) were of children ages three and under, and 14% were of children ages four through seven. As a result, young children are at greater risk than older children.

Perpetrators of abuse.??Adult females were the primary abusers and neglectors. Women were responsible for about 55% of physical abuse cases and 72% of neglect cases. However, male perpetrators committed about 72% of sexual abuse.

In looking at the age of perpetrators, the largest percentages were adults in the 30-39 age bracket (about 39%), followed by individuals ages 20-29, at 33%.

Do adoptive parents ever abuse children???Experts believe that the rate of abuse among adoptive parents is extremely low. For example, the American Humane Association and also Richard Barth, in his essay in Adoption Policy and Special Needs Children, have estimated that abuse occurs in about 1% of adoptive families.

This low rate of abuse may be due to the fact that adoptive parents intensely desired to become parents and were also screened before they were able to achieve this goal. The home study process almost invariably includes a complete report from one's physician. A person with a serious problem, such as drug abuse or alcohol abuse, is likely to be detected. Individuals with a history of abuse or violence would also not be allowed to adopt a child.

Placements with Relatives

Sometimes abused children are removed from their homes and placed with grandparents or in other KINSHIP CARE arrangements. This may be a good idea in many cases but in other cases could be very problematic because the extended family may have problems similar to the abusers'.

Attorney Howard A. Davidson, director of the American Bar Association Center on Children and the Law, advises caution with this approach. In an article for Trial, he wrote, "In recent years, federal and state laws and child welfare agency practices have reflected a preference for placement of abused, neglected, or abandoned children with extended family members rather than in foster homes with strangers. This 'kinship care' preference must be cautiously applied. Prospective homes, whether temporary or permanent, should be screened for safety and suitability. This should include screening the criminal records of adults in the home."

Children from orphanages are sometimes abused.??Families who adopt children from other countries, particularly children older than two or three years, should realize that sometimes children are abused and neglected in orphanages. Some groups, such as the NATIONAL COUNCIL FOR ADOPTION, say that one should be prepared to consider all children who have lived in overseas orphanages to have at least suffered neglect. The children may be abused by adults or by other children in the orphanage. As a result, they may experience many of the same emotional problems as foster children adopted in the United States.

Determining abuse.??Abusive parents are typically reported to police officers or to the state social service department, and a social worker is generally assigned to investigate. The abuse may have occurred only one time, but it is far more likely that it has been recurrent over a period of months or years. Often, abuse is not detected until a child enters kindergarten or first grade.

If a social worker or investigator determines that abuse has occurred to a child and that abuse was caused by a parent or relative with whom the child lives, the child is usually removed from the home and placed with relatives or in a state-approved foster home or group home.

The child will not be returned to the home until it is determined by social workers that the parent has been rehabilitated from the problem leading to the abuse, whether it was alcohol or drug use, emotional or mental problems in the abuser or some other cause.

Traditionally, however, a child can be removed from the home before the innocence or guilt of the alleged abuser is determined, for the sake of the child's safety. If the allegations of abuse prove to be false or their veracity cannot be determined, the child is returned to the home.

It may be extremely difficult for investigators to determine whether or not abuse has actually occurred, especially if injuries have healed or theoretically could have been caused by an accident. Investigators and physicians look for a pattern of "accidents" and also the type of injury that results from the alleged accident; for example, an injury incurred from a fall may be very different from an injury incurred by a parent violently jerking a child's arm. If the child has periodically "fallen" into scalding water or has wounds or lacerations that probably would not be the natural results of childhood mishaps, this is another indication of possible abuse. Witnesses to the abuse are extremely helpful, although many people may be reluctant or fearful of testifying against a violent person.

Abuse may be overtly violent and readily apparent, or it may be more covert and difficult to verify. In some cases, abuse is so extreme or so prolonged that it leads to the child's death. One mother force-fed her child large quantities of salt because the child stole a few cookies. The toddler died of sodium overdose. Other parents have shaken an infant so violently that brain hemorrhage and death have resulted.

In cases of severe abuse or when the social worker determines that it is unlikely the abusive parent can successfully raise the child in a healthy nonabusive atmosphere, the child will be permanently removed from the home, and parental rights will be terminated in a court of law. The child will then be in need of an adoptive family if authorities believe it is in the best interest of the child to be adopted.

Sometimes children are so damaged physically and/or psychologically by abuse that it is impossible to meet the child's needs. Consequently the child may be better off living in a group home or even in a psychiatric treatment setting. It has been speculated that many adults who are currently in prison were once abused children.

Sexual abuse can range from touching the child in the genital areas or requiring the child to touch another's genitals to forcing a child into full sexual intercourse. Adults have attempted intercourse with children as young as tiny infants with dire results. (See entry on SEXUAL ABUSE for further information.)

NEGLECT is also considered a form of child abuse. Neglectful parents may fail to feed their children or may feed them a grossly inadequate diet, may leave them alone for extended periods when they are very young or may otherwise fail to meet the normal needs of the child. For instance, a young child may be expected to watch an infant-social workers report that children as young as two or three have been left alone to watch an infant sibling.

ABANDONMENT refers to a parent or caretaker leaving a child alone for an extended period and with no apparent intention to ever return.

Psychologists often use dolls, puppets and other toys to try to draw very young children out and determine whether physical or sexual abuse has occurred or not. Some allegations of abuse are false, yet even when vindicated, a person once charged with child abuse is haunted by this charge for life. As a result, it is extremely important to make an accurate determination of whether or not child abuse did take place.

When adoption is being planned for an abused child, ethical social workers brief adopting parents completely in a nonidentifying way about the child's abusive treatment or the conditions of neglect under which the child has lived. However, social workers are often not fully aware of the extent of the abuse and in some cases may not even know abuse has indeed occurred. (The child may have been removed from the home for the reasons of overt abandonment or neglect.)

In some instances, social workers have failed to alert adopting parents to known severe problems that children faced in their past, and adoptive parents have successfully sued the state or agency for the withholding of information and the subsequent WRONGFUL ADOPTION. Adopting parents have generally argued in such cases that they would not have adopted the child had they known about problems or that they would have obtained therapy and treatment for the child had they been informed.

Abused children may also suffer physical handicaps resulting from their abuse. Consequently, it may be more difficult to locate a suitable adoptive family.

The effects of abuse are long-term, even when the abused child was only an infant or toddler at the time of abuse. Psychologists have found that love cannot always overcome the emotional and psychological effects of severe abuse and the internalized feelings of anger and guilt experienced even by very young children.

Abused children may "act out" their anger and aggression on adoptive parents and siblings. They may also behave in sexually precocious ways, based on what they have learned as "normal" behavior from their parents or the persons who sexually abused them.

Adoptive Parents of Abused Children

Adults who adopt sexually abused children must be very sensitive to this problem and comfortable with their own sexuality. Social workers report that children who are sexually abused are the hardest children to fit successfully into adoptive families.

When parents adopt abused children, they must realize the child may need therapy immediately or in 10 years. It is also possible that he or she could blossom in the adoptive home and never require counseling; however, adoptive parents should be open to the need for treatment. One precaution: not all counseling is competent-or needed. It is important to keep in mind, as Yale psychiatrist Sally Satel said in the New York Times, that "The grief industry is apparently booming: bereavement books, grief chat rooms, extensive workshops in grief education and exams for certification."

Many parents and adoption professionals agree that adoptive parent support groups can be very helpful to parents adopting older children if other members of the group have themselves adopted older children or children with special needs. But it is very difficult to find appropriate groups.

Gregory C. Keck, Ph.D., and Regina M. Kupecky, L.S.W., authors of Adopting the Hurt Child: Hope for Families with Special-Needs Kids, say that positive indicators of real changes in the abused child are: "abbreviated, although perhaps intense, retreats to old behavior; faster recovery time after the retreat; decreased frequency of retreats" and "child's acknowledgment of his responsibility for the retreat without blaming others."

They state, "Once these four features listed above are witnessed over a period of time, we can assume that the child's growth and development have been activated from an earlier dormant state. Subsequently, all other change is made with less resistance, reduced turmoil, and little complication. Getting 'unstuck' is the key to adjusting to a new life, and once this happens, the child will most likely continue to grow into a more integrated individual."

Abusers versus Nonabusers

Some researchers have compared and contrasted the "social network characteristics" of abusers with nonabusers. Researchers Sara J. Corse, Kathleen Schmid and Penelope K. Trickett compared and contrasted these characteristics, and their study was reported in the January 1990 issue of the Journal of Community Psychology. Studying 52 mothers, half of whom had been identified as abusers, the researchers discovered that community involvement was "positively related to enjoyment of the child." They also reported that in abusive families, "The nuclear family is perceived as nonsupportive and conflicted, while few opportunities exist outside the family to balance limited inner resources."

The researchers hypothesized that the abusing mothers might be more likely to offend individuals who could offer needed assistance. In addition, they also found abusing mothers were unaware of potential sources of help.

Abuse and Neglect and Adolescent Parents

Findings are mixed on whether adolescent single parents are more abusive or neglectful than other single parents, and some researchers say that it cannot and should not be presumed that a child is at greater risk from an adolescent mother than an older mother; however, there are factors that could theoretically predispose an adolescent to abuse her child.

For example, according to the Encyclopedia of Child Abuse, infants who are born prematurely and are of low birth weight may be at risk for abuse. Such infants are "more restless, distractible, unresponsive and demanding than the average child. Child-specific factors when combined with a parent who is inexperienced or easily frustrated greatly increase the risk of abuse." (Teenagers have a high rate of low birth weight infants. See TEENAGE PARENTS.)

Jerry S. Bigner, in Parent-Child Relations: An Introduction to Parenting, states that teenage parents have a very inaccurate idea of developmental norms. As a result, adolescent parents will often presume their children will achieve such goals as taking their first steps, attaining bladder control and understanding wrongdoing well before the children could be expected to achieve these developmental milestones. For example, teenage mothers in one study estimated their children would be able to achieve bowel control at 24 weeks, when the norm for this behavior is actually from 96 to 144 weeks.

Researchers hypothesize that when children fail to achieve these milestones, their teenage parents could become angry or frustrated as well as neglectful or even abusive.

It is possible that adolescent motherhood itself could predispose a parent to abuse or neglect at some point in a child's life. According to research by Susan J. Zuravin, Ph.D., at the School of Social Work and Community Planning, University of Maryland, Baltimore, "chronic stress" combined with teenage motherhood may lead to higher than normal rates of abuse.

Zuravin collected data from 237 abusive single women on public assistance in Maryland and with at least one child age 12 or under. About half had abused their children, and half had neglected them; 281 nonabusive single women on public assistance served as controls.

The researcher hypothesized that many births, a long history of unemployment and lack of education were measurable stressors that impacted on child maltreatment. Her hypothesis was proven by the research, and Zuravin also found that the number of births was the most critical factor in both abuse and neglect.

She also found that abusive or neglectful mothers were younger when their child was born than were the control mothers. The averages ages at the first birth were 17.9 years for the neglectful mother and 18.3 years for the abusive mother. The control mother's average age at the time of her first child's birth was 19.5 years.

Also, both neglectful and abusive mothers had more children, less education and less history of employment than did the control mothers. For example, the average number of live births for the neglectful mothers was 3.9, and the average education was 9.8 grades. For the abusive mother, the average number of live births was 3.0, and the average education was 10.4 grades. The average control mother had 1.9 live births and had completed 11.1 grades in school.


Rosemary J. Avery, ed. Adoption Policy and Special Needs Children, (Westport, Conn.: Auburn House, 1997).

Howard A. Davidson, "Protecting America's Children: A Challenge," Trial 35 (January 1999): 22.

Jerry J. Bigner, Parent-Child Relations: An Introduction to Parenting (New York: Macmillan, 1989).

F. G. Bolton Jr., Ph.D., Roy H. Laner, Ed. D., and Sandra P. Kane, B.S., "Child Maltreatment Risk Among Adolescent Mothers," American Journal of Orthopsychiatry, 50 (July 1980): 489-504.

Robin E. Clark and Judith Freeman Clark, The Encyclopedia of Child Abuse (New York: Facts On File, 1989).

Sara J. Corse, Kathleen Schmid, and Penelope K. Trickett, "Social Network Characteristics of Mothers in Abusing and Nonabusing Families and Their Relationships to Parenting Beliefs," Journal of Community Psychology 18 (January 1990): 44-58.

Gregory C. Keck, Ph.D. and Regina M. Kupecky, LSW, Adopting the Hurt Child: Hope for Families with Special-Needs Kids (Colorado Springs, Colo.: Pinon Press, 1995).

Sally L. Satel, "An Overabundance of Counseling?" New York Times, April?23, 1999, p. A25.

Susan J. Zuravin, Ph.D., "Child Maltreatment and Teenage First Births: A Relationship Mediated by Chronic Sociodemographic Stress?", American Journal of Orthopsychiatry, 58 (January 1988): 91-103.

U.S. Department of Health and Human Services, Administration on Children, Youth and Families, "Child Maltreatment 1996: Reports from the States to the National Child Abuse and Neglect Data System, 1998."

U.S. Department of Health and Human Services, Administration on Chlordane Youth and Families, National Center on Child Abuse and Neglect, "The Third National Incidence Study of Child Abuse and Neglect," September 1996.

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