Materi ESS 2
Materi ESS 2
Children are suffering from a hidden epidemic of child abuse and neglect. Every year 3.3
million reports of child abuse are made in the United States involving nearly 6 million
children (a report can include multiple children). The United States has the worst record in
the industrialized nation – losing five children every day due to abuse-related deaths. 1
General Statistics
Top ↑
It was not until the 19th century that children were granted the same legal status as
domesticated animals with regard to protection against cruelty and/or neglect. In 1962, the
term "battered child syndrome" became part of the medical vocabulary and by 1976 all of the
states in the United States had adopted laws mandating the reporting of suspected child
abuse.
Child abuse is a worldwide problem affecting children from birth to 18 years of age. The
most recent U.S. data dates from 2005, during which 3.3 million reports of abuse and neglect
were filed. About 60% of these reports warranted investigation with one-half of these
allegations substantiated. These data indicate the incidence of child abuse and neglect to be
12.1 per 1,000 children; 1,460 children (four children/day) died in 2005 as a result of inflicted
trauma with more than 77% of these deaths in children less than 4 years of age.
While "reports" of alleged child abuse are not always substantiated during the investigation
process, most authorities believe that a large underreporting bias is inherent in the data. There
is much more child abuse than gets reported.
All ages of children suffer from child abuse and neglect. Research has shown, however, that
risk factors exist making it more likely that certain children may be abused. These risk factors
include
1. age: 67% of abused children are less than 1 year old; 80% are less than 3 years old;
2. past history of abuse: Repeated abuse has been shown to occur more than 50% of the
time; repeatedly abused children have a 10% chance of sustaining a lethal event;
3. children with learning disabilities, speech/language disorders and mental retardation;
4. children with congenital anomalies (malformations) and chronic/recurrent conditions;
and
5. adopted and foster children.
Complicating the collection of data is the general underreporting of child abuse. Very young
children are incapable of verbally communicating the harm inflicted on them. Other factors
such as fear, guilt, or confusion about the abuser's erratic behavior may also hinder younger
children from informing on their abuser.
Yes. Girls are somewhat more likely to be abused. According to statistics published in 1996,
about 52% of victims of maltreatment were female and 48% were male. Data obtained in the
federally funded 2005 study demonstrate no significant change in these values.
Studies have shown a consistent pattern regarding the abuse and neglect inflicted on children
of different genders. Approximately 75% of sexual abuse is inflicted upon girls. Girls also are
more likely to suffer from emotional abuse and neglect. Boys, on the other hand, are more
likely to experience physical trauma (other than sexual abuse). When focusing solely on
cause of death, studies indicate fathers are more likely to kill their child via physical abuse,
while mothers kill by neglect (for example, starvation).
Over 75% of inflicted abuse is a result of parental action. Parental risk factors include young
or single parents, those who did not graduate from high school, and those who either were
abused themselves as children or endured a severely dysfunctional home life. Adults using
drugs, abusing alcohol, and those with psychiatric disease (for example, depression, impulse-
control disorders) are more likely to abuse children. Females account for 61% of perpetrators.
While children of families in all income levels suffer maltreatment, research suggests that
family income is strongly related to incidence rates. Children from families with annual
incomes below $15,000 per year are more than 25 times more likely than children from
families with annual income above $30,000 to be harmed or endangered by abuse or neglect.
Poverty clearly predisposes to child abuse. Currently, social scientists are questioning the
previous interpretation of such data. Recently new research is challenging this belief. Some
argue that poor families have increased contact with reporting agencies -- social workers,
police, etc. Some also argue that affluent families are more often given the "benefit of the
doubt" by those who might be more suspicious of poorer means. In addition, wealthier
families are felt to have a better access to legal counsel that, realistically or not, provide an
"escape hatch" from investigation and prosecution.
According to the statistics, the majority of perpetrators of child mistreatment (77%) are
parents and another 11% are other relatives of the victim. People who are in other caretaking
relationships to the victim (for example, child-care providers, foster parents, and facility
staff) account for only 2% of the offenders. About 10% of all perpetrators are classified as
non-caretakers or unknown. In many states, child abusers by definition must be in a
caretaking role.
An estimated 81% of all offenders are under age 40. Overall, approximately 61% of
perpetrators are female, although the gender of the abuser differs by the type of mistreatment.
Neglect and medical neglect are most often attributed to female caretakers, while sexual
abuse is most often associated with male offenders.
A broad definition of child abuse implies purposeful and serious injury inflicted upon a child
by a caregiver. Specific countries and ethnic groups have developed sometimes widely
divergent definitions. In the United States, each state is responsible for drafting definitions
for child abuse and neglect consistent with federal law. The Child Abuse Prevention and
Treatment Act, amended in October 1996, provides the basis from which individual states
may structure their legislation.
1. neglect (63%);
2. physical abuse (16%);
3. sexual abuse (10%) and;
4. emotional abuse (7%) (2005 national data).
Child neglect is the most frequently reported form of child abuse (63% of all cases) and the
most lethal.
Neglect is defined as the failure to provide for the shelter, safety, supervision, and nutritional
needs of the child. Child neglect may be physical, educational, or emotional. The assessment
of child neglect requires the consideration of cultural values and standards of care as well as
the recognition that the failure to provide the necessities of life may be related to poverty.
Physical neglect includes the refusal or delay in seeking health care, abandonment,
inadequate supervision, expulsion from the home, or refusal to allow a runaway to return
home.
Educational neglect includes the allowance of chronic truancy, failure to enroll a child of
mandatory school age in school, and failure to attend to a special educational need.
Emotional neglect involves a marked inattention to the child's needs for affection, refusal of
or failure to provide needed psychological care, spousal abuse or parental substance abuse in
the child's presence, and permission of drug or alcohol use by the child.
Physical abuse is the second most frequently reported form of child abuse (16% of all cases).
This form of mistreatment is defined as willful (as opposed to accidental) physical injury
inflicted upon the child. Physical abuse can be the result of punching, beating, kicking, biting,
burning, shaking, or otherwise harming the child's body. The parent or caretaker may not
have intended to hurt the child; rather, the injury may have resulted from excessive
disciplinary efforts or physical punishment.
There exists a significant controversy regarding physical methods of discipline (for example,
spanking) and their relationship to more orthodox forms of physical abuse. A unique form of
physical child abuse is Munchausen syndrome by proxy. In this situation, a parent will
purposely either invent symptoms and falsify records (for example, fever) resulting in
unnecessary tests, hospitalizations, and even surgical procedures. This psychiatric illness of
the parent(s) requires a high index of suspicion, and its consideration is part of the
investigation of any child with recurrent complaints that are not supported by physical or
laboratory findings.
Isolated emotional abuse is the least frequently reported form of child abuse (7% of all cases).
This form is felt to be markedly underreported since it can be difficult to detect and
document.
However, since it is a component of all forms of child abuse, it is the most pervasive of all
the previously listed forms of child abuse. There are several categories of emotional abuse
and they may occur as unique experiences or together in the same child. They include
1. rejecting (for example, refusing to acknowledge the child's worth and emotional
needs),
2. isolation (denying the child social experiences: locking child in the closet is an
extreme example),
3. terrorizing (verbal assault with or without weapons),
4. ignoring (refusing to show affection),
5. corrupting (reinforcing destructive, antisocial, or sexually exploitative behaviors),
6. verbal assault (extreme sarcasm, name calling, public humiliation), and
7. over-pressuring (criticism of age-appropriate behaviors/skills as inadequate).
Emotional child abuse is also sometimes termed psychological child abuse, verbal child
abuse, or mental injury of a child.
Sexual abuse is the third most frequently reported form of child mistreatment (10% of all
cases). Experts believe that sexual abuse may be the most underreported type of abuse
because of the secrecy or "conspiracy of silence" that so often characterizes these cases. A
generally accepted definition of sexual abuse is that of a child involved in sexual activity for
which consent cannot be given, is outside of the victim's developmental age, is unable to
comprehend, and/or "violates the law or social taboos of society." Examples include fondling
and any form of genital, anal, or oral-genital contact with a child that are unwarranted. These
acts may occur whether the child is clothed or unclothed. Non-touching child sexual abuse
would include exhibitionism, voyeurism, and the involvement of a child in prostitution or
pornography.
The most lethal form of child abuse is neglect. Deaths from neglect can, for example, be
caused by accidents due to lack of supervision or abandonment or from the failure to seek
medical attention for an injury, illness, or condition.
Fatal injuries from mistreatment can and do result from many different acts. Children may die
from severe head trauma (injury), shaken baby syndrome, trauma to the abdomen or chest,
scalding, burns, drowning, suffocation, poisoning, starvation, etc.
Specialists evaluating an abused child's environment and family background have noted
several risk factors for potential abuse:
Specific "trigger" events that occur just before many fatal parental assaults on infants and
young children include an infant's inconsolable crying, feeding difficulties, a toddler's failed
toilet training, and exaggerated parental perceptions of acts of "disobedience" by the child.
A thorough nonjudgmental history of the immediate events as well as a review of past similar
experiences are often independently done by a physician, social worker, and/or the police
department. The child may be interviewed separately from the parents as part of this
information-gathering process.
A complete physical exam of the child (which may include the taking of photographs to
document physical/sexual abuse) is often followed by radiologic studies (x-rays, CT and MRI
scans) and/or laboratory tests to support the potential diagnosis of inflicted trauma and to rule
out the possibility of medical conditions which could account for the physical findings noted
during the examination. A complete eye examination is indicated in all infants to evaluate to
possibility of retinal hemorrhages associated with the shaken baby syndrome.
Steps which are often taken to correct child abuse are as follows:
The safety of the abused child and any other potential victim of abuse in the
household is paramount. Removal of the victim and placement in protective custody
in a group home or foster care is often necessary.
Effective counseling for the child, family, and the abuser is essential to deal with the
associated emotional and psychological stress and trauma.
In the event of neglect, establishing realistic expectations of the child's needs and
capabilities is required.
Parental high-risk behaviors such as substance/alcohol abuse must be addressed.
Law-enforcement evaluation is performed, followed by the filing of charges, court
appearance, and (if found guilty) sentencing as indicated.
Pedophiles (people who have sexually abused children) often require intense
psychological and pharmacological therapy prior to release into the community
because of the high rate of repeat offenders.
Are people who were abused as children more likely to become criminals later
in life?
According to a 2005 study sponsored by the National Institute of Justice (NIJ), maltreatment
in childhood increases the likelihood of arrest as a juvenile by 59% and as an adult by 28%.
Abuse as a child also increases the prospect of arrest for a violent crime by 30%.
For females, being abused or neglected in childhood raises the likelihood of arrest by 77%. A
related 1994 NIJ study indicated that children who were sexually abused were 28 times more
likely than a control group of non-abused children to be arrested for prostitution as an adult.
A 1997 U.S. Department of Justice study sampled 1,000 urban youths in seventh and eighth
grades. Childhood abuse and neglect provided a 25% increased risk factor for serious
delinquency (assaults, drug use), poor school performance, symptoms of mental illness, and
pregnancy. Interestingly, the risk of lesser forms of delinquency (for example, underage
drinking) were not increased.
Child abuse is a serious national problem involving all economic, ethnic, racial, and
religious groups.
Children are abused predominantly by parents, but other caregivers (babysitter) are
not infrequent offenders.
The major types of child abuse are physical, emotional, sexual, and neglect. Child
neglect is the most frequent type of child abuse and the most lethal.
If any suspicion of child abuse or neglect exists, a report should be filed with the
appropriate agency. Good-faith reports are immune from prosecution. A local system
for timely investigation and evaluation should be incorporated in all cases of child
maltreatment.
Prevention (education and counseling) is the best approach for the management of
child abuse and neglect.
Child Abuse Index
Child abuse falls into four categories: neglect, physical abuse, sexual abuse, and emotional abuse.
There are certain risk factors that predispose a child to being abused and an adult to abusing a child.
Risk factors for children are age, children with learning disabilities, adopted and foster children,
children with congenital abnormalities, and a past history of abuse. Parental risk factors include
young or single parents, those who suffered abuse themselves, adults with substance-abuse
problems or psychiatric disease, and those who didn't graduate from high school.