Childhood is the age span ranging from birth to adolescence. According to Piaget's theory of cognitive development, childhood consists of two stages: preoperational stage and concrete operational stage. In developmental psychology, childhood is divided up into the developmental stages of toddlerhood (learning to walk), early childhood
(play age), middle childhood (school age), and adolescence (puberty
through post-puberty). Various childhood factors could affect a person's
attitude formation.
The concept of childhood emerged during the 17th and 18th
centuries, particularly through the educational theories of the
philosopher John Locke and the growth of books for and about children.[2] Previous to this point, children were often seen as incomplete versions of adults.
Time span, age ranges
The term childhood is non-specific in its time span and can imply a varying range of years in human development.
Developmentally and biologically, it refers to the period between infancy and adulthood.
In common terms, childhood is considered to start from birth, and as a concept of play and innocence, which ends at adolescence.
In the legal systems of many countries, there is an age of majority
when childhood legally ends and a person legally becomes an adult,
which ranges anywhere from 15 to 21, with 18 being the most common.
A global consensus on the terms of childhood is the Convention on the Rights of the Child (CRC).
Childhood expectancy indicates the time span, which a child has to experience childhood.
Eight life events ending childhood have been described as death,
extreme malnourishment, extreme violence, conflict forcing displacement,
children being out of school, child labor, children having children,
and child marriage.
Developmental stages of childhood
Early childhood
Teenage boys in India, 2009
Children playing the violin in a group recital, Ithaca, New York, 2011.
Early childhood follows the infancy stage and begins with toddlerhood when the child
begins speaking or taking steps independently. While toddlerhood ends
around age three when the child becomes less dependent on parental
assistance for basic needs, early childhood continues approximately
until the age of around eight. However, according to the National Association for the Education of Young Children,
early childhood also includes infancy, making it age 0-8 instead of age
3-8. At this stage children are learning through observing,
experimenting and communicating with others. Adults supervise and
support the development process of the child, which then will lead to
the child's autonomy. Also during this stage, a strong emotional bond is
created between the child and the care providers. The children also
start to begin kindergarten at this age to start their social lives.
Middle childhood
Middle
childhood begins at around age nine, approximating primary school age.
It ends around puberty, which typically marks the beginning of
adolescence. In this period, children develop socially and mentally.
They are at a stage where they make new friends and gain new skills,
which will enable them to become more independent and enhance their
individuality.
Adolescence
Adolescence
is usually determined by the onset of puberty. However, puberty may
also begin in preadolescence. Adolescence is biological distinct from
childhood, but it is accepted by some cultures as a part of social
childhood, because most of them are minors. The onset of adolescence
brings about various physical, psychological and behavioral changes. The
end of adolescence and the beginning of adulthood varies by country and
by function, and even within a single nation-state or culture there may
be different ages at which an individual is considered to be mature
enough to be entrusted by society with certain tasks.
During the European Renaissance, artistic depictions of children increased dramatically, which did not impact the social attitude to children much, however.
During the 1600s, the concept of childhood began to emerge in Europe.
Adults saw children as separate beings, innocent and in need of
protection and training by the adults around them. The English
philosopher John Locke was particularly influential in defining this new attitude towards children, especially with regard to his theory of the tabula rasa,
which considered the mind at birth to be a "blank slate". A corollary
of this doctrine was that the mind of the child was born blank, and that
it was the duty of the parents to imbue the child with correct notions.
During the early period of capitalism, the rise of a large, commercial middle class, mainly in the Protestant countries of the Dutch Republic and England, brought about a new family ideology centred around the upbringing of children. Puritanism stressed the importance of individual salvation and concern for the spiritual welfare of children.
The Age of Innocence c.1785/8. Reynolds emphasized the natural grace of children in his paintings
The modern notion of childhood with its own autonomy and goals began to emerge during the 18th century Enlightenment and the Romantic period that followed it.[citation needed]Jean Jacques Rousseau formulated the romantic attitude towards children in his famous 1762 novel Emile: or, On Education. Building on the ideas of John Locke
and other 17th-century thinkers, Jean-Jaques Rousseau described
childhood as a brief period of sanctuary before people encounter the
perils and hardships of adulthood. Sir Joshua Reynolds' extensive children portraiture demonstrated the new enlightened attitudes toward young children. His 1788 painting The Age of Innocence, emphasizes the innocence and natural grace of the posing child and soon became a public favourite.
With the onset of industrialisation
in England in 1760, the divergence between high-minded romantic ideals
of childhood and the reality of the growing magnitude of child
exploitation in the workplace, became increasingly apparent. By the late
18th century, British children were specially employed in factories and
mines and as chimney sweeps, often working long hours in dangerous jobs for low pay.
As the century wore on, the contradiction between the conditions on the
ground for children of the poor and the middle-class notion of
childhood as a time of innocence led to the first campaigns for the
imposition of legal protection for children.
British reformers attacked child labor from the 1830s onward, bolstered by the horrific descriptions of London street life by Charles Dickens. The campaign eventually led to the Factory Acts, which mitigated the exploitation of children at the workplace.
The modern attitude to children emerged by the late 19th century; the
Victorian middle and upper classes emphasized the role of the family
and the sanctity of the child, – an attitude that has remained dominant
in Western societies ever since.
The genre of children's literature took off, with a proliferation of humorous, child-oriented books attuned to the child's imagination. Lewis Carroll's fantasy Alice's Adventures in Wonderland,
published in 1865 in England, was a landmark in the genre; regarded as
the first "English masterpiece written for children", its publication
opened the "First Golden Age" of children's literature.
The latter half of the 19th century saw the introduction of
compulsory state schooling of children across Europe, which decisively
removed children from the workplace into schools.
The market economy of the 19th century enabled the concept of childhood
as a time of fun of happiness. Factory-made dolls and doll houses
delighted the girls and organized sports and activities were played by
the boys.
The Boy Scouts was founded by Sir Robert Baden-Powell in 1908, which provided young boys with outdoor activities aiming at developing character, citizenship, and personal fitness qualities.
In the 20th century, Philippe Ariès, a French historian specializing in medieval history, suggested that childhood was not a natural phenomenon, but a creation of society in his 1960 book Centuries of Childhood.
In 1961 he published a study of paintings, gravestones, furniture, and
school records, finding that before the 17th-century, children were
represented as mini-adults.
In 1966, the American philosopher George Boas published the book The Cult of Childhood.
Since then, historians have increasingly researched childhood in past times.
In 2006 Hugh Cunningham, published the book Invention of Childhood looking at British childhood from the year 1000, the Middle Ages to what he refers to as the Post War Period of the 1950s, 1960s and 1970s.
The concept of childhood appears to evolve and change shape as
lifestyles change and adult expectations alter. Some believe that
children should not have any worries and should not have to work; life
should be happy and trouble-free. Childhood is usually a mixture of
happiness, wonder, angst
and resilience. It is generally a time of playing, learning,
socializing, exploring, and worrying in a world without much adult
interference, aside from parents. It is a time of learning about
responsibilities without having to deal with adult responsibilities.
A "loss of innocence" is a common concept, and is often seen as an integral part of coming of age.
It is usually thought of as an experience or period in a child's life
that widens their awareness of evil, pain or the world around them. This theme is demonstrated in the novels To Kill a Mockingbird and Lord of the Flies. The fictional character Peter Pan was the embodiment of a childhood that never ends.
Geographies of childhood
The
geographies of childhood involves how (adult) society perceives the
idea of childhood, the many ways adult attitudes and behaviors affect
children's lives, including the environment which surrounds children and
its implications.
The geographies of childhood is similar in some respects to children's geographies which examines the places and spaces in which children live.
Nature deficit disorder
Nature Deficit Disorder, a term coined by Richard Louv in his 2005 book Last Child in the Woods, refers to the trend in the United States and Canada towards less time for outdoor play, resulting in a wide range of behavioral problems.
With increasing use of cellphones, computers, video games and
television, children have more reasons to stay inside rather than
outdoors exploring. “The average American child spends 44 hours a week
with electronic media”. Research in 2007 has drawn a correlation between the declining number of National Park visits in the U.S. and increasing consumption of electronic media by children. The media has accelerated the trend for children's nature disconnection by deemphasizing views of nature, as in Disney films.
Children's health includes the physical, mental and social well-being
of children. Maintaining children's health implies offering them
healthy foods, insuring they get enough sleep and exercise, and
protecting their safety. Children in certain parts of the world often suffer from malnutrition, which is often associated with other conditions, such diarrhea, pneumonia and malaria.
Play is essential to the cognitive, physical, social, and emotional well-being of children.
It offers children opportunities for physical (running, jumping,
climbing, etc.), intellectual (social skills, community norms, ethics
and general knowledge) and emotional development (empathy, compassion,
and friendships). Unstructured play encourages creativity and
imagination. Playing and interacting with other children, as well as
some adults, provides opportunities for friendships, social
interactions, conflicts and resolutions. However, adults tend to (often
mistakenly) assume that virtually all children's social activities can
be understood as "play" and, furthermore, that children's play
activities do not involve much skill or effort.
It is through play that children at a very early age engage and
interact in the world around them. Play allows children to create and
explore a world they can master, conquering their fears while practicing
adult roles, sometimes in conjunction with other children or adult
caregivers.
Undirected play allows children to learn how to work in groups, to
share, to negotiate, to resolve conflicts, and to learn self-advocacy
skills. However, when play is controlled by adults, children acquiesce
to adult rules and concerns and lose some of the benefits play offers
them. This is especially true in developing creativity, leadership, and
group skills.
Play is considered to be so important to optimal child development that it has been recognized by the United Nations Commission on Human Rights as a right of every child.
Children who are being raised in a hurried and pressured style may
limit the protective benefits they would gain from child-driven play.
The initiation of play in a classroom setting allows teachers and
students to interact through playfulness associated with a learning
experience. Therefore, playfulness aids the interactions between adults
and children in a learning environment. “Playful Structure” means to
combine informal learning with formal learning to produce an effective
learning experience for children at a young age.
Even though play is considered to be the most important to
optimal child development, the environment affects their play and
therefore their development. Poor children confront widespread
environmental inequities as they experience less social support, and
their parents are less responsive and more authoritarian. Children from
low income families are most likely to have less access to books and
computers which affects their development as they do not have access to
resources that would enhance their development.
Street culture
Children in front of a movie theatre, Toronto, 1920s.
Children's street culture refers to the cumulative culture created by young children and is sometimes referred to as their secret world. It is most common in children between the ages of seven and twelve. It is strongest in urban working classindustrial districts
where children are traditionally free to play out in the streets for
long periods without supervision. It is invented and largely sustained
by children themselves with little adult interference.
Young children's street culture usually takes place on quiet
backstreets and pavements, and along routes that venture out into local parks, playgrounds,
scrub and wasteland, and to local shops. It often imposes imaginative
status on certain sections of the urban realm (local buildings, kerbs,
street objects, etc.). Children designate specific areas that serve as
informal meeting and relaxation places (see: Sobel, 2001). An urban area
that looks faceless or neglected to an adult may have deep 'spirit of place' meanings in to children. Since the advent of indoor distractions such as video games, and television, concerns have been expressed about the vitality – or even the survival – of children's street culture.
Children's rights
Older teenagers at the Bannu jail in Khyber Pakhtunkhwa, Pakistan
Children's rights are the human rights
of children, with particular attention to the rights of special
protection and care afforded to minors, and provision of basic
necessities. Children's rights are not respected in all countries.
Globally, millions of children are subjected to exploitation, including
deprivation of education, child labour, forced military service, or imprisonment in institutions or detention centers where they endure poor conditions and violence.
Research in social sciences
In recent years there has been a rapid growth of interest in the
sociological study of adulthood. Reaching on a large body of
contemporary sociological and anthropological research, people have developed key links between the study of childhood and multiple disciplines including social theory, exploring its historical, political, and cultural dimensions internationally.
Child abuse or child maltreatment is physical, sexual, or psychological maltreatment or neglect
of a child or children, especially by a parent or other caregiver.
Child abuse may include any act or failure to act by a parent or other
caregiver that results in actual or potential harm to a child, and can
occur in a child's home, or in the organizations, schools or communities
the child interacts with.
The terms child abuse and child maltreatment are often used interchangeably, although some researchers make a distinction between them, treating child maltreatment as an umbrella term to cover neglect, exploitation, and trafficking.
Different jurisdictions
have developed their own definitions of what constitutes child abuse
for the purposes of removing children from their families or prosecuting
a criminal charge.
Meaning Of Child Abuse
Definitions
of what constitutes child abuse vary among professionals, and between
social and cultural groups, as well as across time. The terms abuse and maltreatment are often used interchangeably in the literature. Child maltreatment can also be an umbrella term covering all forms of child abuse and child neglect. Defining child maltreatment depends on prevailing cultural values as they relate to children, child development, and parenting. Definitions of child maltreatment can vary across the sectors of society which deal with the issue, such as child protection agencies, legal and medical communities, public health officials, researchers, practitioners, and child advocates.
Since members of these various fields tend to use their own
definitions, communication across disciplines can be limited, hampering
efforts to identify, assess, track, treat, and prevent child
maltreatment.
In general, abuse refers to (usually deliberate) acts of commission while neglect refers to acts of omission. Child maltreatment
includes both acts of commission and acts of omission on the part of
parents or caregivers that cause actual or threatened harm to a child. Some health professionals and authors consider neglect as part of the definition of abuse,
while others do not; this is because the harm may have been
unintentional, or because the caregivers did not understand the severity
of the problem, which may have been the result of cultural beliefs
about how to raise a child.
Delayed effects of child abuse and neglect, especially emotional
neglect, and the diversity of acts that qualify as child abuse, are also
factors.
The World Health Organization (WHO) defines child abuse and child maltreatment
as "all forms of physical and/or emotional ill-treatment, sexual abuse,
neglect or negligent treatment or commercial or other exploitation,
resulting in actual or potential harm to the child's health, survival,
development or dignity in the context of a relationship of
responsibility, trust or power." In the United States, the Centers for Disease Control and Prevention (CDC) uses the term child maltreatment
to refer to both acts of commission (abuse), which include "words or
overt actions that cause harm, potential harm, or threat of harm to a
child", and acts of omission (neglect), meaning "the failure to provide
for a child's basic physical, emotional, or educational needs or to
protect a child from harm or potential harm". The United States federal Child Abuse Prevention and Treatment Act defines child abuse and neglect
as, at minimum, "any recent act or failure to act on the part of a
parent or caretaker which results in death, serious physical or
emotional harm, sexual abuse or exploitation" or "an act or failure to
act which presents an imminent risk of serious harm".
Among professionals and the general public, people often do not agree on what behaviors constitute physical abuse of a child.
Physical abuse often does not occur in isolation, but as part of a
constellation of behaviors including authoritarian control,
anxiety-provoking behavior, and a lack of parental warmth. The WHO defines physical abuse as:
Intentional use of physical force
against the child that results in – or has a high likelihood of
resulting in – harm for the child's health, survival, development or
dignity. This includes hitting, beating, kicking, shaking, biting,
strangling, scalding, burning, poisoning and suffocating. Much physical
violence against children in the home is inflicted with the object of
punishing.
Joan Durrant and Ron Ensom write that most physical abuse is physical punishment "in intent, form, and effect". Overlapping definitions of physical abuse and physical punishment of children highlight a subtle or non-existent distinction between abuse and punishment. For instance, Paulo Sergio Pinheiro writes in the UN Secretary-General's Study on Violence Against Children:
Corporal punishment involves
hitting ('smacking', 'slapping', 'spanking') children, with the hand or
with an implement – whip, stick, belt, shoe, wooden spoon, etc. But it
can also involve, for example, kicking, shaking or throwing children,
scratching, pinching, biting, pulling hair or boxing ears, forcing
children to stay in uncomfortable positions, burning, scalding or forced
ingestion (for example, washing children's mouths out with soap or
forcing them to swallow hot spices).
Most nations with child abuse laws deem the deliberate infliction of
serious injuries, or actions that place the child at obvious risk of
serious injury or death, to be illegal.
Bruises, scratches, burns, broken bones, lacerations - as well as
repeated "mishaps," and rough treatment that could cause physical
injury - can be physical abuse. Multiple injuries or fractures at different stages of healing can raise suspicion of abuse.
The psychologist Alice Miller,
noted for her books on child abuse, took the view that humiliations,
spankings and beatings, slaps in the face, etc. are all forms of abuse,
because they injure the integrity and dignity of a child, even if their
consequences are not visible right away.
Often, physical abuse as a child can lead to physical and mental
difficulties in the future, including re-victimization, personality
disorders, post-traumatic stress disorder, dissociative disorders,
depression, anxiety, suicidal ideation, eating disorders, substance
abuse, and aggression. Physical abuse in childhood has also been linked
to homelessness in adulthood.
Sexual abuse
Child sexual abuse (CSA) is a form of child abuse in which an adult or older adolescent abuses a child for sexual stimulation.
Sexual abuse refers to the participation of a child in a sexual act
aimed toward the physical gratification or the financial profit of the
person committing the act. Forms of CSA include asking or pressuring a child to engage in sexual activities (regardless of the outcome), indecent exposure of the genitals to a child, displaying pornography to a child, actual sexual contact
with a child, physical contact with the child's genitals, viewing of
the child's genitalia without physical contact, or using a child to
produce child pornography. Selling the sexual services of children may be viewed and treated as child abuse rather than simple incarceration.
Effects of child sexual abuse on the victim(s) include guilt and self-blame, flashbacks, nightmares, insomnia, fear of things associated with the abuse (including objects, smells, places, doctor's visits, etc.), self-esteem difficulties, sexual dysfunction, chronic pain, addiction, self-injury, suicidal ideation, somatic complaints, depression, post-traumatic stress disorder, anxiety, other mental illnesses including borderline personality disorder and dissociative identity disorder, propensity to re-victimization in adulthood, bulimia nervosa, and physical injury to the child, among other problems.
Children who are the victims are also at an increased risk of sexually
transmitted infections due to their immature immune systems and a high
potential for mucosal tears during forced sexual contact. Sexual victimization at a young age has been correlated with several
risk factors for contracting HIV including decreased knowledge of sexual
topics, increased prevalence of HIV, engagement in risky sexual
practices, condom avoidance, lower knowledge of safe sex practices,
frequent changing of sexual partners, and more years of sexual activity.
In the United States, approximately 15% to 25% of women and 5% to 15% of men were sexually abused when they were children.
Most sexual abuse offenders are acquainted with their victims;
approximately 30% are relatives of the child, most often brothers,
sisters, fathers, mothers, uncles or cousins; around 60% are other
acquaintances such as friends of the family, babysitters, or neighbours;
strangers are the offenders in approximately 10% of child sexual abuse
cases. In over one-third of cases, the perpetrator is also a minor.
In 1999 the BBC reported on the RAHI Foundation's survey of sexual abuse in India, in which 76% of respondents said they had been abused as children, 40% of those stating the perpetrator was a family member.
Psychological abuse
There are multiple definitions of child psychological abuse:
In 2013, the American Psychiatric Association (APA) added Child Psychological Abuse to the DSM-5,
describing it as "nonaccidental verbal or symbolic acts by a child's
parent or caregiver that result, or have reasonable potential to result,
in significant psychological harm to the child."
In 1995, APSAC defined it as: spurning, terrorizing, isolating,
exploiting, corrupting, denying emotional responsiveness, or neglect" or
"A repeated pattern of caregiver behavior or extreme incident(s) that
convey to children that they are worthless, flawed, unloved, unwanted,
endangered, or only of value in meeting another's needs"
In the United States, states laws vary, but most have laws against "mental injury"
Some have defined it as the production of psychological and social
defects in the growth of a child as a result of behavior such as loud
yelling, coarse and rude attitude, inattention, harsh criticism, and
denigration of the child's personality. Other examples include name-calling, ridicule, degradation, destruction of personal belongings, torture or killing of a pet, excessive criticism, inappropriate or excessive demands, withholding communication, and routine labeling or humiliation.
In 2014, the APA stated that:
"Childhood psychological abuse [is] as harmful as sexual or physical abuse."
"Nearly 3 million U.S. children experience some form of [psychological] maltreatment annually."
Psychological maltreatment is "the most challenging and prevalent form of child abuse and neglect."
"Given the prevalence of childhood psychological abuse and the
severity of harm to young victims, it should be at the forefront of
mental health and social service training"
In 2015, additional research confirmed these 2014 statements of the APA.
Victims of emotional abuse may react by distancing themselves
from the abuser, internalizing the abusive words, or fighting back by insulting the abuser. Emotional abuse can result in abnormal or disrupted attachment development, a tendency for victims to blame themselves (self-blame) for the abuse, learned helplessness, and overly passive behavior.
Neglect
Child neglect is the failure of a parent or other person with
responsibility for the child, to provide needed food, clothing, shelter,
medical care, or supervision to the degree that the child's health,
safety or well-being may be threatened with harm. Neglect is also a lack
of attention from the people surrounding a child, and the non-provision
of the relevant and adequate necessities for the child's survival,
which would be a lacking in attention, love, and nurture.
Some observable signs of child neglect include: the child is
frequently absent from school, begs or steals food or money, lacks
needed medical and dental care, is consistently dirty, or lacks
sufficient clothing for the weather. The 2010 Child Maltreatment Report (NCANDS), a yearly United States federal government report based on data supplied by state Child Protective Services (CPS) Agencies in the U.S., states, "as in prior years, neglect was the most common form of maltreatment".
Neglectful acts can be divided into six sub-categories:
Supervisory neglect: characterized by the absence of a parent or
guardian which can lead to physical harm, sexual abuse or criminal
behavior;
Physical neglect: characterized by the failure to provide the basic physical necessities, such as a safe and clean home;
Medical neglect: characterized by the lack of providing medical care;
Emotional neglect: characterized by a lack of nurturance, encouragement and support;
Educational neglect: characterized by the caregivers lack to provide
an education and additional resources to actively participate in the
school system; and
Abandonment: when the parent or guardian leaves a child alone for a long period of time without a babysitter.
Neglected children may experience delays in physical and psychosocial development, possibly resulting in psychopathology and impaired neuropsychological functions including executive function, attention, processing speed, language, memory and social skills.
Researchers investigating maltreated children have repeatedly found
that neglected children in foster and adoptive populations manifest
different emotional and behavioral reactions to regain lost or secure
relationships and are frequently reported to have disorganized
attachments and a need to control their environment. Such children are
not likely to view caregivers as being a source of safety, and instead
typically show an increase in aggressive and hyperactive behaviors which
may disrupt healthy or secure attachment with their adopted parents.
These children have apparently learned to adapt to an abusive and
inconsistent caregiver by becoming cautiously self-reliant, and are
often described as glib, manipulative and disingenuous in their
interactions with others as they move through childhood. Children who are victims of neglect have a more difficult time forming
and maintaining relationships, such as romantic or friendship, later in
life due to the lack of attachment they had in their earlier stages of
life.
Effects
Child abuse can result in immediate adverse physical effects but it is also strongly associated with developmental problems
and with many chronic physical and psychological effects, including
subsequent ill-health, including higher rates of chronic conditions,
high-risk health behaviors and shortened lifespan.
Maltreated children may grow up to be maltreating adults. A 1991 source reported that studies indicate that 90 percent of maltreating adults were maltreated as children. Almost 7 million American infants receive child care services, such as day care, and much of that care is poor.
Emotional
Child
abuse can cause a range of emotional effects. Children who are
constantly ignored, shamed, terrorized or humiliated suffer at least as
much, if not more, than if they are physically assaulted. According to the Joyful Heart Foundation, brain development of the
child is greatly influenced and responds to the experiences with
families, caregivers, and the community.
Abused children can grow up experiencing insecurities, low self-esteem,
and lack of development. Many abused children experience ongoing
difficulties with trust, social withdrawal, trouble in school, and
forming relationships.
Babies and young children can be affected differently by abuse
than their older counterparts. Babies and pre-school children who are
being emotionally abused or neglected may be overly affectionate towards
strangers or people they haven't known for very long.
They can lack confidence or become anxious, appear to not have a close
relationship with their parent, exhibit aggressive behavior or act nasty
towards other children and animals.
Older children may use foul language or act in a markedly different way
to other children at the same age, struggle to control strong emotions,
seem isolated from their parents, lack social skills or have few, if
any, friends.
Children can also experience reactive attachment disorder
(RAD). RAD is defined as markedly disturbed and developmentally
inappropriate social relatedness, that usually begins before the age of 5
years.
RAD can present as a persistent failure to start or respond in a
developmentally appropriate fashion to most social situations. The
long-term impact of emotional abuse has not been studied widely, but
recent studies have begun to document its long-term consequences.
Emotional abuse has been linked to increased depression, anxiety, and
difficulties in interpersonal relationships (Spertus, Wong, Halligan,
& Seremetis, 2003). Victims of child abuse and neglect are more likely to commit crimes as juveniles and adults.
Domestic violence
also takes its toll on children; although the child is not the one
being abused, the child witnessing the domestic violence is greatly
influential as well. Research studies conducted such as the
"Longitudinal Study on the Effects of Child Abuse and Children's
Exposure to Domestic Violence", show that 36.8% of children engage in
felony assault compared to the 47.5% of abused/assaulted children.
Research has shown that children exposed to domestic violence increases
the chances of experienced behavioral and emotional problems
(depression, irritability, anxiety, academic problems, and problems in
language development).
Overall, emotional effects caused by child abuse and even
witnessing abuse can result in long-term and short-term effects that
ultimately affect a child's upbringing and development.
The immediate physical effects of abuse or neglect can be relatively
minor (bruises or cuts) or severe (broken bones, hemorrhage, or even
death). In some cases the physical effects are temporary; however, the
pain and suffering they cause a child should not be discounted. Rib
fractures may be seen with physical abuse, and if present may increase
suspicion of abuse, but are found in a small minority of children with
maltreatment-related injuries.
The long-term impact of child abuse and neglect on physical health and development can be:
Shaken baby syndrome.
Shaking a baby is a common form of child abuse that often results in
permanent neurological damage (80% of cases) or death (30% of cases).
Damage results from intracranial hypertension (increased pressure in
the skull) after bleeding in the brain, damage to the spinal cord and
neck, and rib or bone fractures.
Impaired brain development.
Child abuse and neglect have been shown, in some cases, to cause
important regions of the brain to fail to form or grow properly,
resulting in impaired development. These alterations in brain maturation have long-term consequences for cognitive, language, and academic abilities.
Poor physical health. In addition to possible immediate adverse
physical effects, household dysfunction and childhood maltreatment are
strongly associated with many chronic physical and psychological
effects, including subsequent ill-health in childhood, adolescence and adulthood, with higher rates of chronic conditions, high-risk health behaviors and shortened lifespan.
Adults who experienced abuse or neglect during childhood are more
likely to suffer from physical ailments such as allergies, arthritis,
asthma, bronchitis, high blood pressure, and ulcers. There may be a higher risk of developing cancer later in life, as well as possible immune dysfunction.
Exposure to violence during childhood is associated with shortened telomeres and with reduced telomerase activity. The increased rate of telomere length reduction correlates to a reduction in lifespan of 7 to 15 years.
Data from a recent study supports previous findings that specific
neurobiochemical changes are linked to exposure to violence and abuse,
several biological pathways can possibly lead to the development of
illness, and certain physiological mechanisms can moderate how severe
illnesses become in patients with past experience with violence or
abuse.
Recent studies give evidence of a link between stress occurring early in life and epigenetic modifications that last into adulthood.
Adverse Childhood Experiences Study
Possible
ways for adverse childhood experiences such as abuse and neglect to
influence health and well-being throughout the lifespan, according to
the Centers for Disease Control and Prevention.
The Adverse Childhood Experiences Study
is a long-running investigation into the relationship between childhood
adversity, including various forms of abuse and neglect, and health
problems in later life. The initial phase of the study was conducted in San Diego, California from 1995 to 1997. The World Health Organization summarizes the study's findings as follows:
The Adverse Childhood Experiences
(ACE) study, in which some 17,300 middle-aged, middle-class and mostly
employed residents of the state of California participated, suggests
that childhood maltreatment and household dysfunction contribute to the
development – decades later – of the chronic diseases that are the most
common causes of death and disability in the United States. The study
examined the long-term effects of maltreatment and household dysfunction
during childhood, including: psychological, physical and sexual abuse;
violence against the mother; and living with household members who were
either substance abusers, mentally ill or suicidal, or else had been in
prison. A strong relationship was seen between the number of adverse
experiences (including physical and sexual abuse in childhood) and
self-reports of cigarette smoking, obesity, physical inactivity,
alcoholism, drug abuse, depression, attempted suicide, sexual
promiscuity and sexually transmitted diseases in later life.
Furthermore, people who reported higher numbers of negative experiences
in childhood were much more likely to exhibit multiple health-risk
behaviours, which the study suggested were adopted as coping devices.
Similarly, the more adverse childhood experiences reported, the more
likely the person was to have heart disease, cancer, stroke, diabetes,
skeletal fractures, liver disease and poor health as an adult.
Maltreatment and other adverse childhood experiences may thus be among
the basic factors that underlie health risks, illness and death, and
could be identified by routine screening of all patients. Although the
ACE study and its findings relate to a specific population within the
United States, it is reasonable to assume that similar trends might be
found in countries with different levels of economic and social
development.
A long-term study of adults retrospectively reporting adverse
childhood experiences including verbal, physical and sexual abuse, as
well as other forms of childhood trauma found 25.9% of adults reported
verbal abuse as children, 14.8% reported physical abuse, and 12.2%
reported sexual abuse. Data from the Centers for Disease Control and Prevention (CDC) and Behavioral Risk Factor Surveillance System corroborate these high rates.
There is a high correlation between the number of different adverse
childhood experiences (A.C.E.s) and risk for poor health outcomes in
adults including cancer, heart attack, mental illness, reduced longevity
drug and alcohol abuse.
An anonymous self-reporting survey of Washington State students finds
6–7% of 8th, 10th and 12th grade students actually attempt suicide.
Rates of depression are twice as high. Other risk behaviors are even
higher. There is a relationship between child physical and sexual abuse and suicide.
For legal and cultural reasons as well as fears by children of being
taken away from their parents most childhood abuse goes unreported and
unsubstantiated.
It has been discovered that childhood abuse can lead to the addiction
of drugs and alcohol in adolescence and adult life. Studies show that
any type of abuse experienced in childhood can cause neurological
changes making an individual more prone to addictive tendencies. A
significant study examined 900 court cases of children who had
experienced sexual and physical abuse along with neglect. The study
found that a large sum of the children who were abused are now currently
addicted to alcohol. This case study outlines how addiction is a
significant effect of childhood abuse.
Psychological
Children who have a history of neglect or physical abuse are at risk of developing psychiatric problems, or a disorganized attachment style.
In addition, children who experience child abuse or neglect are 59%
more likely to be arrested as juveniles, 28% more likely to be arrested
as adults, and 30% more likely to commit violent crime. Disorganized attachment is associated with a number of developmental problems, including dissociative symptoms, as well as anxiety, depressive, and acting out symptoms. A study by Dante Cicchetti found that 80% of abused and maltreated infants exhibited symptoms of disorganized attachment. When some of these children become parents, especially if they suffer from posttraumatic stress disorder (PTSD),
dissociative symptoms, and other sequelae of child abuse, they may
encounter difficulty when faced with their infant and young children's
needs and normative distress, which may in turn lead to adverse
consequences for their child's social-emotional development.
Additionally, children may find it difficult to feel empathy towards
themselves or others, which may cause them to feel alone and unable to
make friends.
Despite these potential difficulties, psychosocial intervention can be
effective, at least in some cases, in changing the ways maltreated
parents think about their young children.
Victims of childhood abuse also suffer from different types of
physical health problems later in life. Some reportedly suffer from some
type of chronic head, abdominal, pelvic, or muscular pain with no
identifiable reason.
Even though the majority of childhood abuse victims know or believe
that their abuse is, or can be, the cause of different health problems
in their adult life, for the great majority their abuse was not directly
associated with those problems, indicating that sufferers were most
likely diagnosed with other possible causes for their health problems,
instead of their childhood abuse.
One long-term study found that up to 80% of abused people had at least
one psychiatric disorder at age 21, with problems including depression,
anxiety, eating disorders, and suicide attempts.
One Canadian hospital found that between 36% and 76% of women mental
health outpatients had been sexually abused, as had 58% of women and 23%
of men schizophrenic inpatients.
A recent study has discovered that a crucial structure in the brain's
reward circuits is compromised by childhood abuse and neglect, and
predicts Depressive Symptoms later in life.
In the case of 23 of the 27 illnesses listed in the questionnaire of a French INSEE
survey, some statistically significant correlations were found between
repeated illness and family traumas encountered by the child before the
age of 18 years. According to Georges Menahem,
the French sociologist who found out these correlations by studying
health inequalities, these relationships show that inequalities in
illness and suffering are not only social. Health inequality also has
its origins in the family, where it is associated with the degrees of
lasting affective problems (lack of affection, parental discord, the
prolonged absence of a parent, or a serious illness affecting either the
mother or father) that individuals report having experienced in
childhood.
Many children who have been abused in any form develop some sort
of psychological problem. These problems may include: anxiety,
depression, eating disorders, OCD, co-dependency,
or even a lack of human connections. There is also a slight tendency
for children who have been abused to become child abusers themselves. In
the U.S. in 2013, of the 294,000 reported child abuse cases only 81,124
received any sort of counseling or therapy. Treatment is greatly
important for abused children.
On the other hand, there are some children who are raised in
child abuse, but who manage to do unexpectedly well later in life
regarding the preconditions. Such children have been termed dandelion children, as inspired from the way that dandelions seem to prosper irrespective of soil, sun, drought, or rain. Such children (or currently grown-ups) are of high interest in finding factors that mitigate the effects of child abuse.
Causes
Child abuse is a complex phenomenon with multiple causes.
No single factor can be identified as to why some adults behave
violently toward children. The World Health Organization (WHO) and the International Society for Prevention of Child Abuse and Neglect
(ISPCAN) identify multiple factors at the level of the individual,
their relationships, their local community, and their society at large,
that combine to influence the occurrence of child maltreatment. At the
individual level, such factors include age, sex, and personal history,
while at the level of society, factors contributing to child
maltreatment include cultural norms encouraging harsh physical
punishment of children, economic inequality, and the lack of social
safety nets.
WHO and ISPCAN state that understanding the complex interplay of
various risk factors is vital for dealing with the problem of child
maltreatment.
The American psychoanalyst Elisabeth Young-Bruehl
maintains that harm to children is justified and made acceptable by
widely held beliefs in children's inherent subservience to adults,
resulting in a largely unacknowledged prejudice against children she
terms childism. She contends that such prejudice, while not the
immediate cause of child maltreatment, must be investigated in order to
understand the motivations behind a given act of abuse, as well as to
shed light on societal failures to support children's needs and
development in general. Founding editor of the International Journal of Children's Rights,
Michael Freeman, also argues that the ultimate causes of child abuse
lie in prejudice against children, especially the view that human rights
do not apply equally to adults and children. He writes, "the roots of
child abuse lie not in parental psycho-pathology or in
socio-environmental stress (though their influences cannot be
discounted) but in a sick culture which denigrates and depersonalizes,
which reduces children to property, to sexual objects so that they
become the legitimate victims of both adult violence and lust".
Parents who physically abuse their spouses are more likely than others to physically abuse their children.
However, it is impossible to know whether marital strife is a cause of
child abuse, or if both the marital strife and the abuse are caused by
tendencies in the abuser.
Sometimes, parents set expectations for their child that are clearly
beyond the child's capability. When parents' expectations are far beyond
what is appropriate to the child (e.g., preschool children who are
expected to be totally responsible for self-care or provision of
nurturance to parents) the resulting frustration caused by the child's
non-compliance is believed to function as a contributory if not
necessary cause of child abuse.
Most acts of physical violence against children are undertaken with the intent to punish.
In the United States, interviews with parents reveal that as many as
two thirds of documented instances of physical abuse begin as acts of
corporal punishment meant to correct a child's behavior, while a
large-scale Canadian study found that three quarters of substantiated
cases of physical abuse of children have occurred within the context of physical punishment. Other studies have shown that children and infants who are spanked
by parents are several times more likely to be severely assaulted by
their parents or suffer an injury requiring medical attention. Studies
indicate that such abusive treatment often involves parents attributing
conflict to their child's willfulness or rejection, as well as "coercive
family dynamics and conditioned emotional responses".
Factors involved in the escalation of ordinary physical punishment by
parents into confirmed child abuse may be the punishing parent's
inability to control their anger or judge their own strength, and the
parent being unaware of the child's physical vulnerabilities.
Some professionals argue that cultural norms that sanction
physical punishment are one of the causes of child abuse, and have
undertaken campaigns to redefine such norms.
Children resulting from unintended pregnancies are more likely to be abused or neglected. In addition, unintended pregnancies are more likely than intended pregnancies to be associated with abusive relationships, and there is an increased risk of physical violence during pregnancy. They also result in poorer maternal mental health, and lower mother-child relationship quality.
There is some limited evidence that children with moderate or
severe disabilities are more likely to be victims of abuse than
non-disabled children.
A study on child abuse sought to determine: the forms of child abuse
perpetrated on children with disabilities; the extent of child abuse;
and the causes of child abuse of children with disabilities. A
questionnaire on child abuse was adapted and used to collect data in
this study. Participants comprised a sample of 31 pupils with
disabilities (15 children with vision impairment and 16 children with
hearing impairment) selected from special schools in Botswana. The study
found that the majority of participants were involved in doing domestic
chores. They were also sexually, physically and emotionally abused by
their teachers. This study showed that children with disabilities were
vulnerable to child abuse in their schools.
Substance abuse
can be a major contributing factor to child abuse. One U.S. study found
that parents with documented substance abuse, most commonly alcohol, cocaine,
and heroin, were much more likely to mistreat their children, and were
also much more likely to reject court-ordered services and treatments.
Another study found that over two-thirds of cases of child maltreatment
involved parents with substance abuse problems. This study specifically
found relationships between alcohol and physical abuse, and between
cocaine and sexual abuse.
Also parental stress caused by substance increases the likelihood of
the minor exhibiting internalizing and externalizing behaviors.
Although the abuse victim does not always realize the abuse is wrong,
the internal confusion can lead to chaos. Inner anger turns to outer
frustration. Once aged 17/18, drink and drugs are used to numb the hurt
feelings, nightmares and daytime flashbacks. Acquisitive crimes to pay
for the chemicals are inevitable if the victim is unable to find
employment.
Unemployment and financial difficulties are associated with increased rates of child abuse. In 2009 CBS News reported that child abuse in the United States had increased during the economic recession.
It gave the example of a father who had never been the primary
care-taker of the children. Now that the father was in that role, the
children began to come in with injuries.
Legality of corporal punishment of minors in Europe
Corporal punishment illegal in both schools and the home
Corporal punishment illegal in schools only
Corporal punishment legal in schools and in the home
Child abuse is an international phenomenon. Poverty and substance abuse are common social problems worldwide, and no matter the location, show a similar trend in the correlation to child abuse.
Although these factors can likely contribute to child maltreatment,
differences in cultural perspectives play a significant role in the
treatment of children. Laws may influence the population's views on what
is acceptable - for example whether child corporal punishment is legal or not.
A study conducted by members from several Baltic and Eastern European countries, together with specialists from the United States, examined the causes of child abuse in the countries of Latvia, Lithuania, Macedonia and Moldova. In these countries, respectively, 33%, 42%, 18% and 43% of children reported at least one type of child abuse.
According to their findings, there was a series of correlations between
the potential risk factors of parental employment status, alcohol abuse, and family size within the abuse ratings.
In three of the four countries, parental substance abuse was
considerably correlated with the presence of child abuse, and although
it was a lower percentage, still showed a relationship in the fourth
country (Moldova).
Each country also showed a connection between the father not working
outside of the home and either emotional or physical child abuse. After the fall of the communism regime, some positive changes have
followed with regard to tackling child abuse. While there is a new
openness and acceptance regarding parenting styles
and close relationships with children, child abuse still remains a
serious concern. Although it is now more publicly recognized, it has
certainly not ceased to exist. While controlling parenting may be less
of a concern, financial difficulty, unemployment, and substance abuse still remain to be dominating factors in child abuse throughout Eastern Europe.
These cultural differences can be studied from many perspectives.
Most importantly, overall parental behavior is genuinely different in
various countries. Each culture
has their own "range of acceptability," and what one may view as
offensive, others may seem as tolerable. Behaviors that are normal to
some may be viewed as abusive to others, all depending on the societal norms of that particular country.
Asian parenting perspectives, specifically, hold different ideals from American culture. Many have described their traditions as including physical and emotional closeness that ensures a lifelong bond between parent and child, as well as establishing parental authority and child obedience through harsh discipline. Balancing disciplinary responsibilities within parenting is common in many Asian cultures, including China, Japan, Singapore, Vietnam and Korea.
To some cultures, forceful parenting may be seen as abuse, but in other
societies such as these, the use of force is looked at as a reflection
of parental devotion.
The differences in these cultural beliefs demonstrate the importance of examining all cross-cultural perspectives when studying the concept of child abuse.
As of 2006, between 25,000 and 50,000 children in Kinshasa, Democratic Republic of the Congo, had been accused of witchcraft and abandoned. In Malawi
it is also common practice to accuse children of witchcraft and many
children have been abandoned, abused and even killed as a result. In the Nigeria, Akwa Ibom State and Cross River State about 15,000 children were branded as witches.
In April 2015, public broadcasting showed that rate of child
abuse in South Korea had increased to 13% compared with the previous
year, and 75% of attackers were the children's own parents.
Suspicion for physical abuse is recommended when an injury occurs in a
child who does not yet move independently, injuries are in unusual
areas, more than one injury at different stages of healing, symptoms of
possible head trauma, and injuries to more than one body system.
In many jurisdictions, abuse that is suspected, not necessarily proven, requires reporting to child protection agencies, such as the Child Protection Services in the United States. Recommendations for healthcare workers, such as primary care providers and nurses,
who are often suited to encounter suspected abuse are advised to
firstly determine the child’s immediate need for safety. A private
environment away from suspected abusers is desired for interviewing and
examining. Leading statements that can distort the story are avoided. As
disclosing abuse can be distressing and sometimes even shameful,
reassuring the child that he or she has done the right thing by telling
and that they are not bad or that the abuse was not their fault helps in
disclosing more information. Dolls
are sometimes used to help explain what happened. For the suspected
abusers, it is also recommended to use a nonjudgmental, nonthreatening
attitude towards them and to withhold expressing shock, in order to help
disclose information.
Assessment
A key part of child abuse work is assessment.
A particular challenge arises where child protection
professionals are assessing families where neglect is occurring.
Professionals conducting assessments of families where neglect is taking
place are said to sometimes make the following errors:
Failure to ask the right types of question, including
Whether neglect is occurring;
Why neglect is occurring;
What the situation is like for the child;
Whether improvements in the family are likely to be sustained;
What needs to be done to ensure the long-term safety of the child?
Prevention
A
support-group structure is needed to reinforce parenting skills and
closely monitor the child's well-being. Visiting home nurse or
social-worker visits are also required to observe and evaluate the
progress of the child and the caretaking situation.
The support-group structure and visiting home nurse or
social-worker visits are not mutually exclusive. Many studies have
demonstrated that the two measures must be coupled together for the best
possible outcome.
Children's school programs regarding "good touch … bad touch" can
provide children with a forum in which to role-play and learn to avoid
potentially harmful scenarios. Pediatricians can help identify children
at risk of maltreatment and intervene with the aid of a social worker or
provide access to treatment that addresses potential risk factors such
as maternal depression. Videoconferencing has also been used to diagnose child abuse in remote emergency departments and clinics. Unintended conception increases the risk of subsequent child abuse, and large family size increases the risk of child neglect. Thus, a comprehensive study for the National Academy of Sciences concluded that affordable contraceptive services should form the basis for child abuse prevention. "The starting point for effective child abuse programming is pregnancy planning," according to an analysis for US Surgeon General C. Everett Koop.
Child sexual abuse prevention programmes were developed in the
United States of America during the 1970s and originally delivered to
children. Programmes delivered to parents were developed in the 1980s
and took the form of one-off meetings, two to three hours long. In the last 15 years, web-based programmes have been developed.
April has been designated Child Abuse Prevention Month in the United States since 1983. U.S. President Barack Obama continued that tradition by declaring April 2009 Child Abuse Prevention Month. One way the Federal government of the United States
provides funding for child-abuse prevention is through Community-Based
Grants for the Prevention of Child Abuse and Neglect (CBCAP).
Resources for child-protection services are sometimes limited.
According to Hosin (2007), "a considerable number of traumatized abused
children do not gain access to protective child-protection strategies." Briere (1992) argues that only when "lower-level violence" of children ceases to be culturally tolerated will there be changes in the victimization and police protection of children.
Findings from recent research support the importance of family
relationships in the trajectory of a child’s life: family-targeted
interventions are important for improving long-term health, particularly
in communities that are socioeconomically disadvantaged.
Treatment
A number of treatments are available to victims of child abuse. However, children who experience childhood trauma do not heal from abuse easily.
There are focused cognitive behavioral therapy, first developed to
treat sexually abused children, is now used for victims of any kind of
trauma. It targets trauma-related symptoms in children including post-traumatic stress disorder (PTSD), clinical depression and anxiety.
It also includes a component for non-offending parents. Several studies
have found that sexually abused children undergoing TF-CBT improved
more than children undergoing certain other therapies. Data on the
effects of TF-CBT for children who experienced only non-sexual abuse was
not available as of 2006.
The purpose of dealing with the thoughts and feelings associated with
the trauma is to deal with nightmares, flashbacks and other intrusive
experiences that might be spontaneously brought on by any number of
discriminative stimuli in the environment or in the individual’s brain.
This would aid the individual in becoming less fearful of specific
stimuli that would arouse debilitating fear, anger, sadness or other
negative emotion. In other words, the individual would have some control
or mastery over those emotions.
Parenting training can prevent child abuse in the short term, and
help children with a range of emotional, conduct and behavioural
challenges, but there is insufficient evidence about whether it treat
parents who already abuse their children.
Abuse-focused cognitive behavioral therapy
was designed for children who have experienced physical abuse. It
targets externalizing behaviors and strengthens prosocial behaviors.
Offending parents are included in the treatment, to improve parenting
skills/practices. It is supported by one randomized study.
Rational Cognitive Emotive Behavior Therapy consists of ten
distinct but interdependent steps. These steps fall into one of three
theoretical orientations (i.e., rational or solution focused, cognitive
emotive, and behavioral) and are intended to provide abused children and
their adoptive parents with positive behavior change, corrective
interpersonal skills, and greater control over themselves and their
relationships. They are: 1) determining and normalizing thinking and
behaving, 2) evaluating language, 3) shifting attention away from
problem talk 4) describing times when the attachment problem isn't
happening, 5) focusing on how family members "successfully" solve
problematic attachment behavior; 6) acknowledging "unpleasant emotions"
(i.e., angry, sad, scared) underlying negative interactional patterns,
7) identifying antecedents (controlling conditions) and associated
negative cognitive emotive connections in behavior (reciprocal role of
thought and emotion in behavioral causation), 8) encouraging previously
abused children to experience or "own" negative thoughts and associated
aversive emotional feelings, 9) modeling and rewarding positive behavior
change (with themselves and in relationships), and 10) encouraging and
rewarding thinking and behaving differently. This type of therapy shifts
victims thoughts away from the bad and changes their behavior.
Parent–child interaction therapy
was designed to improve the child-parent relationship following the
experience of domestic violence. It targets trauma-related symptoms in
infants, toddlers, and preschoolers, including PTSD, aggression,
defiance, and anxiety. It is supported by two studies of one sample.
Other forms of treatment include group therapy, play therapy, and
art therapy. Each of these types of treatment can be used to better
assist the client, depending on the form of abuse they have experienced.
Play therapy and art therapy are ways to get children more comfortable
with therapy by working on something that they enjoy (coloring, drawing,
painting, etc.). The design of a child's artwork can be a symbolic
representation of what they are feeling, relationships with friends or
family, and more. Being able to discuss and analyze a child's artwork
can allow a professional to get a better insight of the child.
Prevalence
Child
abuse is complex and difficult to study. According to the World Health
Organization (WHO), estimates of the rates of child maltreatment vary
widely by country, depending on how child maltreatment is defined, the
type of maltreatment studied, the scope and quality of data gathered,
and the scope and quality of surveys that ask for self-reports from
victims, parents, and caregivers. Despite these limitations,
international studies show that a quarter of all adults report
experiencing physical abuse as children, and that and 1 in 5 women and 1
in 13 men report experiencing childhood sexual abuse. Emotional abuse
and neglect are also common childhood experiences.
As of 2014, an estimated 41,000 children under 15 are victims of homicide each year. The WHO states that this number underestimates the true extent of child homicide;
a significant proportion of child deaths caused by maltreatment are
incorrectly attributed to unrelated factors such as falls, burns, and
drowning. Also, girls are particularly vulnerable to sexual violence,
exploitation and abuse in situations of armed conflict and refugee settings, whether by combatants, security forces, community members, aid workers, or others.
United States
The National Research Council
wrote in 1993 that "...the available evidence suggests that child abuse
and neglect is an important, prevalent problem in the United States
[...] Child abuse and neglect are particularly important compared with
other critical childhood problems because they are often directly
associated with adverse physical and mental health consequences in
children and families".
In 2012, Child Protective Services
(CPS) agencies estimated that approximately 9 out of 1000 children in
the United States were victims of child maltreatment. Most (78%) were
victims of neglect. Physical abuse, sexual abuse, and other types of
maltreatment, were less common, making up 18%, 9%, and 11% of cases,
respectively ("other types" included emotional abuse, parental substance
abuse, and inadequate supervision). However, CPS reports may
underestimate the true scope of child maltreatment. A non-CPS study
estimated that one in four children experience some form of maltreatment
in their lifetimes, according to the Centers for Disease Control and
Prevention (CDC).
In Feb 2017, American Public Health Association published a
Washington University study estimating 37% of American children
experiencing a child protective services investigation by age 18 (or 53%
if African American).
David Finkelhor
tracked Child Maltreatment Report (NCANDS) data from 1990 to 2010. He
states that sexual abuse had declined 62% from 1992 to 2009. The
long-term trend for physical abuse was also down by 56% since 1992. The
decline in sexual abuse adds to an already substantial positive
long-term trend. He states: "It is unfortunate that information about
the trends in child maltreatment are not better publicized and more
widely known. The long-term decline in sexual and physical abuse may
have important implications for public policy."
Douglas J. Besharov, the first Director of the U.S. Center on
Child Abuse and Neglect, states "the existing laws are often vague and
overly broad" and there is a "lack of consensus among professionals and Child Protective Services (CPS), personnel about what the terms abuse and neglect mean".
Susan Orr, former head of the United States Children's Bureau U.S.
Department of Health and Services Administration for Children and
Families, 2001–2007, states that "much that is now defined as child
abuse and neglect does not merit governmental interference".
A child abuse fatality occurs when a child's death is the result
of abuse or neglect, or when abuse or neglect are contributing factors
to a child's death. In the United States, 1,730 children died in 2008
due to factors related to abuse; this is a rate of 2 per 100,000 U.S.
children.
Family situations which place children at risk include moving,
unemployment, and having non-family members living in the household. A
number of policies and programs have been put in place in the U.S. to
try to better understand and to prevent child abuse fatalities,
including: safe-haven laws, child fatality review teams, training for investigators, shaken baby syndrome prevention programs, and child abuse death laws which mandate harsher sentencing for taking the life of a child.
A one off judicial decision found that parents failing to
sufficiently speak the national standard language at home to their
children was a form of child abuse by a judge in a child custody matter.
Examples
History
The
whole of recorded history contains references to acts that can be
described as child abuse or child maltreatment, but professional inquiry
into the topic is generally considered to have begun in the 1960s. The July 1962 publication of the paper "The Battered Child-Syndrome" authored principally to pediatric psychiatrist C. Henry Kempe and published in The Journal of the American Medical Association
]represents the moment that child maltreatment entered mainstream
awareness. Before the article's publication, injuries to children—even
repeated bone fractures—were not commonly recognized as the results of
intentional trauma. Instead, physicians often looked for undiagnosed bone diseases or accepted parents' accounts of accidental mishaps such as falls or assaults by neighborhood bullies.
The study of child abuse and neglect emerged as an academic discipline in the early 1970s in the United States. Elisabeth Young-Bruehl
maintains that despite the growing numbers of child advocates and
interest in protecting children which took place, the grouping of
children into "the abused" and the "non-abused" created an artificial
distinction that narrowed the concept of children's rights
to simply protection from maltreatment, and blocked investigation of
the ways in which children are discriminated against in society
generally. Another effect of the way child abuse and neglect have been
studied, according to Young-Bruehl, was to close off consideration of
how children themselves perceive maltreatment and the importance they
place on adults' attitudes toward them. Young-Bruehl writes that when
the belief in children's inherent inferiority to adults is present in
society, all children suffer whether or not their treatment is labeled
as "abuse".
Child labor
Child labor refers to the employment of children in any work that
deprives children of their childhood, interferes with their ability to
attend regular school, or is mentally, physically, socially or morally
dangerous and harmful. The International Labour Organization considers such labor to be a form of exploitation and abuse of children.
Child labor refers to those occupations which infringe the development
of children (due to the nature of the job or lack of appropriate
regulation) and does not include age appropriate and properly supervised
jobs in which minors may participate. According to ILO, globally,
around 215 million children work, many full-time. Many of these children
do not go to school, do not receive proper nutrition or care, and have
little or no time to play. More than half of them are exposed to the
worst forms of child labor, such as child prostitution, drug trafficking, armed conflicts and other hazardous environments. There exist several international instruments protecting children from child labor, including the Minimum Age Convention, 1973 and the Worst Forms of Child Labour Convention.
More girls under 16 work as domestic workers than any other category of child labor, often sent to cities by parents living in rural poverty such as in restaveks in Haiti.
Child trafficking is the recruitment, transportation, transfer,
harbouring or receipt of children for the purpose of exploitation.
Children are trafficked for purposes such as of commercial sexual
exploitation, bonded labour, camel jockeying, child domestic labour,
drug couriering, child soldiering, illegal adoptions, begging.
It is difficult to obtain reliable estimates concerning the number of
children trafficked each year, primarily due to the covert and criminal
nature of the practice. The International Labour Organization estimates that 1.2 million children are trafficked each year.
In Switzerland,
between the 1850s and the mid-20th century, hundreds of thousands of
children were forcefully removed from their parents by the authorities,
and sent to work on farms, living with new families. These children
usually came from poor or single parents, and were used as free labor by
farmers, and were known as contract children or Verdingkinder.
Under
natural conditions, mortality rates for girls under five are slightly
lower than boys for biological reasons. However, after birth, neglect
and diverting resources to male children kills an approximate 230,000
girls under five in India each year.
While sex-selective abortion is more common among the higher income
population, who can access medical technology, abuse after birth, such
as infanticide and abandonment, is more common among the lower income
population. Female infanticide in Pakistan is a common practice.
Methods proposed to deal with the issue are baby hatches to drop off unwanted babies and safe-haven laws, which decriminalize abandoning babies unharmed.
Female genital mutilation
A map showing the prevalence of FGM, according to a 2013 UNICEF report.
Female genital mutilation (FGM) is defined by the World Health Organization
(WHO) as "all procedures that involve partial or total removal of the
external female genitalia, or other injury to the female genital organs
for non-medical reasons." It is practiced mainly in 28 countries in Africa, and in parts of Asia and the Middle East.
FGM is mostly found in a geographical area ranging across Africa, from
east to west – from Somalia to Senegal, and from north to south – from
Egypt to Tanzania. FGM is most often carried out on young girls aged between infancy and 15 years. FGM is classified into four types, of which type 3 – infibulation – is the most extreme form. The consequences of FGM include physical, emotional and sexual problems, and include serious risks during childbirth. In Western countries this practice is illegal and considered a form of child abuse. The countries which choose to ratify the Istanbul Convention, the first legally binding instrument in Europe in the field of violence against women and domestic violence, are bound by its provisions to ensure that FGM is criminalized. In Australia, all states and territories have outlawed FGM. In the United States, performing FGM on anyone under the age of 18 became illegal in 1996 with the Federal Prohibition of Female Genital Mutilation Act.
In some parts of the world, girls are strongly discouraged from
attending school, which some argue is because they fear losing power to
women. They are sometimes attacked by members of the community if they do so. In parts of South Asia, girls schools are set on fire by vigilante groups. Such attacks are common in Afghanistan and Pakistan. Notable examples include the kidnapping of hundreds of female students in Chibok in 2014 and Dapchi in 2018.
Child marriage
A child marriage is a marriage between two minors, or between an adult and a minor, often before the minor has reached puberty. Child marriages are common in many parts of the world, especially in parts of Asia and Africa.
Since children under the age of 18 are not capable of giving "free and
full consent" to marriage, child marriages are considered a type of forced marriage. Such marriages have significant potential to constitute a form of child abuse. In many countries such practices are lawful, and even where laws prohibit child marriage, they are often unenforced.
Sacred prostitution often involves girls being pledged to priests or those of higher castes, such as the practice of Devadasi in South Asia or fetish slaves in West Africa. Bride kidnapping,
also known as marriage by abduction or marriage by capture, is a
practice in which a male abducts the female he wants to marry. In most
countries, bride kidnapping is considered a criminal offense rather than
a valid form of marriage. In many cases, the groom also rapes his kidnapped bride, in order to prevent her from returning to her family due to shame.
Bride kidnapping has been practiced around the world and throughout
history. It is still practiced in parts of Central Asia, the Caucasus
region, and some African countries such as Ethiopia. In Ethiopia,
marriage by abduction is widespread, and many young girls are kidnapped
for marriage.
India has more child brides than any nation in the world with 40% of the world total happening here. The countries with the highest rates of child marriage are: Niger (75%), Central African Republic and Chad (68%), and Bangladesh (66%).
Violence against children with superstitious accusations
Customary beliefs in witchcraft are common in many parts of the
world, even among the educated. Anthropologists have argued that the
disabled are often viewed as bad omens as raising a child with a
disability in such communities are an insurmountable hurdle. This is found in Africa and in communities in the Amazon. Children who are specifically at risk include orphans, street-children, albinos, disabled children, children who are unusually gifted, children who were born prematurely or in unusual positions, twins, children of single mothers and children who express gender identity issues. Consequently, those accused of being a witch are ostracized and subjected to punishment, torture and even murdered, often by being buried alive or left to starve. For example, in southern Ethiopia, children with physical abnormalities are considered to be ritually impure or mingi,
the latter are believed to exert an evil influence upon others, so
disabled infants have traditionally been disposed of without a proper
burial. Reports by UNICEF, UNHCR, Save The Children and Human Rights Watch have highlighted the violence and abuse towards children accused of witchcraft in Africa. A 2010 UNICEF
report describes children as young as eight being burned, beaten and
even killed as punishment for suspected witchcraft. The report notes
that accusations against children are a recent phenomenon; women and the
elderly were formerly more likely to be accused. UNICEF attributes the
rise in vulnerable children being abused in this way to increased
urbanization and social disruption caused by war.
Ethics
One of
the most challenging ethical dilemmas arising from child abuse relates
to the parental rights of abusive parents or caretakers with regard to
their children, particularly in medical settings. In the United States, the 2008 New Hampshire case of Andrew Bedner
drew attention to this legal and moral conundrum. Bedner, accused of
severely injuring his infant daughter, sued for the right to determine
whether or not she remain on life support; keeping her alive, which
would have prevented a murder charge, created a motive for Bedner to act
that conflicted with the apparent interests of his child. Bioethicists Jacob M. Appel
and Thaddeus Mason Pope recently argued, in separate articles, that
such cases justify the replacement of the accused parent with an
alternative decision-maker.
Child abuse also poses ethical concerns related to confidentiality,
as victims may be physically or psychologically unable to report abuse
to authorities. Accordingly, many jurisdictions and professional bodies
have made exceptions to standard requirements for confidentiality and legal privileges
in instances of child abuse. Medical professionals, including doctors,
therapists, and other mental health workers typically owe a duty of
confidentiality to their patients and clients, either by law or the
standards of professional ethics, and cannot disclose personal information without the consent
of the individual concerned. This duty conflicts with an ethical
obligation to protect children from preventable harm. Accordingly,
confidentiality is often waived when these professionals have a good
faith suspicion that child abuse or neglect has occurred or is likely to
occur and make a report to local child protection
authorities. This exception allows professionals to breach
confidentiality and make a report even when children or their parents or
guardians have specifically instructed to the contrary. Child abuse is
also a common exception to physician–patient privilege:
a medical professional may be called upon to testify in court as to
otherwise privileged evidence about suspected child abuse despite the
wishes of children or their families.
Some child abuse policies in Western countries have been criticized
both by some conservatives, who claim such policies unduly interfere in
the privacy of the family, and by some feminists of the left wing, who
claim such policies disproportionally target and punish disadvantaged
women who are often themselves in vulnerable positions. There has also been concern that ethnic minority families are disproportionally targeted.
Organizations
There are organizations at national, state, and county levels in the
United States that provide community leadership in preventing child
abuse and neglect. The National Alliance of Children's Trust Funds and Prevent Child Abuse America are two national organizations with member organizations at the state level.
Many investigations into child abuse are handled on the local level by Child Advocacy Centers. Started over 25 years ago at what is now known as the National Children's Advocacy Center
in Huntsville, Alabama by District Attorney Robert "Bud" Cramer these
multi-disciplinary teams have met to coordinate their efforts so that
cases of child abuse can be investigated quickly and efficiently,
ultimately reducing trauma to the child and garnering better
convictions. These Child Advocacy Centers (known as CACs) have standards set by the National Children's Alliance.
NICHD, also known as the National Institute of Child Health & Human Development
is a broad organization, but helps victims of child abuse through one
of its branches. Through the Child Development and Behavior (CDB)
Branch, NICHD raises awareness efforts by supporting research projects
to better understand the short- and long-term impacts of child abuse and
neglect. They provide programs and observe National Child Abuse
Prevention Month every April since 1984. The United States Children's Bureau
leads activities for the Month, including the release of updated
statistics about child abuse and neglect, candlelight vigils, and
fundraisers to support prevention activities and treatment for victims.
The Bureau also sponsors a "Blue Ribbon Campaign," in which people wear
blue ribbons in memory of children who have died from abuse, or in honor
of individuals and organizations that have taken important steps to
prevent child abuse and neglect.