Definition

What is child abuse?

Any intentional harm or mistreatment to a child under 18 years old is considered child abuse. Child abuse takes many forms, which often occur at the same time.

  • Physical abuse. Physical child abuse occurs when a child is purposely physically injured or put at risk of harm by another person.
  • Sexual abuse. Sexual child abuse is any sexual activity with a child, such as fondling, oral-genital contact, intercourse or exposure to child pornography.
  • Emotional abuse. Emotional child abuse means injuring a child’s self-esteem or emotional well-being. It includes verbal and emotional assault — such as continually belittling or berating a child — as well as isolating, ignoring or rejecting a child.
  • Medical abuse. When someone purposely makes a child sick, requiring medical attention, it puts the child in serious danger of injury and unnecessary medical care. This may be due to a mental disorder called factitious disorder imposed on another, such as a parent harming a child.
  • Child neglect is failure to provide adequate food, shelter, affection, supervision, education or medical care.

In many cases, child abuse is done by someone the child knows and trusts — often a parent or other relative. If you suspect child abuse, report the abuse to the proper authorities.

How common is child abuse?

Approximately 5 children die every day because of child abuse. 1 out of 3 girls and 1 out of 5 boys will be sexually abused before they reach age 18. Boys (48.5%) and girls (51.2%) become victims at nearly the same rate. Please discuss with your doctor for further information.

Symptoms

What are the symptoms of child abuse?

The common symptoms of child abuse are:

  • Withdrawal from friends or usual activities
  • Changes in behavior — such as aggression, anger, hostility or hyperactivity — or changes in school performance
  • Depression, anxiety or unusual fears or a sudden loss of self-confidence
  • An apparent lack of supervision
  • Frequent absences from school or reluctance to ride the school bus
  • Reluctance to leave school activities, as if he or she doesn’t want to go home
  • Attempts at running away
  • Rebellious or defiant behavior
  • Attempts at suicide

Specific signs and symptoms depend on the type of abuse and can vary. Keep in mind that warning signs are just that — warning signs. The presence of warning signs doesn’t necessarily mean that a child is being abused.

Physical abuse signs and symptoms

  • Unexplained injuries, such as bruises, fractures or burns
  • Injuries that don’t match the given explanation
  • Untreated medical or dental problems

Sexual abuse signs and symptoms

  • Sexual behavior or knowledge that’s inappropriate for the child’s age
  • Pregnancy or a sexually transmitted infection
  • Blood in the child’s underwear
  • Statements that he or she was sexually abused
  • Trouble walking or sitting or complaints of genital pain
  • Abuse of other children sexually

Emotional abuse signs and symptoms

  • Delayed or inappropriate emotional development
  • Loss of self-confidence or self-esteem
  • Social withdrawal or a loss of interest or enthusiasm
  • Depression
  • Headaches or stomachaches with no medical cause
  • Avoidance of certain situations, such as refusing to go to school or ride the bus
  • Desperately seeks affection
  • A decrease in school performance or loss of interest in school
  • Loss of previously acquired developmental skills

Neglect signs and symptoms

  • Poor growth or weight gain
  • Poor hygiene
  • Lack of clothing or supplies to meet physical needs
  • Taking food or money without permission
  • Eating a lot in one sitting or hiding food for later
  • Poor record of school attendance
  • Lack of appropriate attention for medical, dental or psychological problems or lack of necessary follow-up care
  • Emotional swings that are inappropriate or out of context to the situation
  • Indifference

Parental behavior

Sometimes a parent’s demeanor or behavior sends red flags about child abuse. Warning signs include a parent who:

  • Shows little concern for the child
  • Appears unable to recognize physical or emotional distress in the child
  • Denies that any problems exist at home or school, or blames the child for the problems
  • Consistently blames, belittles or berates the child and describes the child with negative terms, such as “worthless” or “evil”
  • Expects the child to provide him or her with attention and care and seems jealous of other family members getting attention from the child
  • Uses harsh physical discipline or asks teachers to do so
  • Demands an inappropriate level of physical or academic performance
  • Severely limits the child’s contact with others
  • Offers conflicting or unconvincing explanations for a child’s injuries or no explanation at all

Although most child health experts condemn the use of violence in any form, some people still use corporal punishment, such as spanking, as a way to discipline their children. Any corporal punishment may leave emotional scars. Parental behaviors that cause pain or physical injury — even when done in the name of discipline — could be child abuse.

There may be some symptoms not listed above. If you have any concerns about a symptom, please consult your doctor.

When should I see my doctor?

If you have any signs or symptoms listed above or have any questions, please consult with your doctor. Everyone’s body acts differently. It is always best to discuss with your doctor what is best for your situation.

Causes

What causes child abuse?

There is not any single fact which causes child abuse; abuse usually occurs in families where there is a combination of risk factors. Abuse and neglect occur most often in families who are under pressure and lack support. Most abuse other than sexual abuse occurs in families to which some, or all, of the following apply:

  • Poverty
  • Lack of education
  • Serious marital problems
  • Frequent changes of addresses
  • Violence between family members
  • Lack of support from the extended family
  • Loneliness and social isolation
  • Unemployment
  • Inadequate housing

In some cases the abuser may also display the following:

  • Very high expectations of the child and what the child should achieve
  • The parent may have been abused as a child
  • A lack of knowledge and skills in bringing up children
  • Low self esteem and self confidence
  • Depression
  • Alcohol and/or drug abuse
  • Mental or physical ill health
  • Work pressures

Certain community attitudes may encourage child abuse. These include:

  • Acceptance of the use of violence and force
  • Acceptance of physical punishment of children
  • Acceptance of parents “ownership” of children and their right to treat children as they see fit
  • Racism
  • Inequality between men and women

Risk factors

What increases my risk for child abuse?

There are many risk factors for child abuse, such as:

  • A history of being abused or neglected as a child
  • Physical or mental illness, such as depression or post-traumatic stress disorder (PTSD)
  • Family crisis or stress, including domestic violence and other marital conflicts, single parenting, or young children in the family, especially several children under age 5
  • A child in the family who is developmentally or physically disabled
  • Financial stress or unemployment
  • Social or extended family isolation
  • Poor understanding of child development and parenting skills
  • Alcoholism or other forms of substance abuse

Diagnosis & treatment

The information provided is not a substitute for any medical advice. ALWAYS consult with your doctor for more information.

How is child abuse diagnosed?

An abused or neglected child who is taken to a doctor will first have a general physical exam. The doctor will review the child’s medical history and ask parents or caregivers questions about the child’s condition.

A child who is able to talk will be separated from the caregiver during the interview.

The law requires doctors to consider the possibility of abuse or neglect. Along with seeing signs of physical abuse or neglect, a doctor may become suspicious when:

  • The injury is unusual or is not likely to be an accident, especially for the child’s age.
  • The parents or caregivers don’t have a good explanation, or the explanation changes.
  • The parents or caregivers say no one saw the injury happen.
  • Medical records show that similar injuries or patterns of neglect have occurred in the past.
  • The parents or caregivers put off taking the child to the doctor without a good reason.
  • The doctor finds signs of sexual abuse.

Other children in the care of the same person may also be examined and have X-rays if police or doctors think it’s needed.

Common tests

Tests that are often used to help confirm or rule out abuse or neglect include:

  • Imaging tests such as X-ray, CT scan, or MRI. These types of tests can help determine whether a child’s injuries include any broken bones. Some tests may also show signs of past injuries.
  • Blood tests. Prothrombin time, partial thromboplastin time, and platelet count can help determine whether the child has a bleeding disorder. Other blood tests can be used to look for signs of organ damage.
  • UrinalysisUrinalysis, to check for blood in the urine. This can be a sign of internal injuries.
  • Specialized lab tests. For example, the doctor may take skin or hair samples or samples of fluids in or around the vagina to be tested.
  • Lumbar puncture, also called spinal tap, which may reveal blood from a brain injury.
  • Eye exam , to find out if damage has occurred that points to shaken baby syndrome.

Other tests

Other exams and tests depend on the specific medical problem suspected or observed. For example:

  • Psychological testing may be requested for some children.
  • Victims of suspected sexual abuse may be tested for sexually transmitted infections.

Tracking a child’s injuries

Information about a child’s injuries is carefully recorded. A detailed account of the injuries goes into the child’s permanent health record.

This record usually includes photographs and drawings of the injuries.

Measurements such as weight, height, and head circumference are also taken and recorded to help establish a child’s baseline growth pattern. Recording these measurements on growth charts can help identify failure to thrive that sometimes is related to neglect.

How is child abuse treated?

Early treatment gives an abused or neglected child the best chance for recovery.

Treatment for the child

The first step is to provide a safe environment to prevent further harm. The sooner this happens, the better the child’s chance for physical and emotional recovery. This includes separating the child, as well as any other children in the household, from the person suspected of abuse.

Any physical injuries will be treated, either in a hospital or at a doctor’s office, depending on how serious they are.

Counseling is always recommended for abused or neglected children. It usually focuses on:

  • How they feel about themselves.
  • Their past experiences.
  • Fears and concerns they may have about the present and future.
  • For very young children, counseling may involve play therapy.

Treatment for parents or caregivers

Parents or caregivers who have abused or neglected a child also need treatment. The type of treatment depends on the specific abuse that occurred.

Some people need to learn more about how to raise and care for children. Others may need treatment for other serious problems, such as:

  • Drug or alcohol abuse.
  • Depression or other mental health problems.
  • Low self-esteem.
  • Violent behavior.

Parents who have lost custody of their children can sometimes regain it. It depends on how bad the abuse or neglect was and how far they have come in realizing what their problems are and how to prevent them.

In severe cases, the parent can see the child only when someone else is present. Sometimes a judge permanently ends the parent-child relationship.

Lifestyle changes & home remedies

What are some lifestyle changes or home remedies that can help me manage child abuse?

The following lifestyles and home remedies might help you cope with child abuse:

  • Encourage the child to tell you what happened. Remain calm as you assure the child that it’s OK to talk about the experience, even if someone has threatened him or her to keep silent. Focus on listening, not investigating. Don’t ask leading questions — allow the child to explain what happened and leave detailed questioning to the professionals.
  • Remind the child that he or she isn’t responsible for the abuse. The responsibility for child abuse belongs to the abuser. Say “It’s not your fault” over and over again.
  • Offer comfort. You might say, “I’m so sorry you were hurt,” “I’m glad that you told me,” and “I’ll do everything I can to help you.” Let the child know you’re available to talk or simply listen at any time.
  • Report the abuse. Contact a local child protective agency or the police department. Authorities will investigate the report and, if necessary, take steps to ensure the child’s safety.
  • Seek medical attention. If necessary, help the child seek appropriate medical care. Seek immediate medical attention if a child has signs of an injury or a change in consciousness.
  • Help the child remain safe. Ensure the child’s safety by separating the abuser and the child, and by providing supervision if the child is in the presence of the abuser.
  • Consider additional support. You might help the child seek counseling or other mental health treatment. Age-appropriate support groups also can be helpful.
  • If the abuse has occurred at school, make sure the principal of the school is aware of the situation, in addition to reporting it to the local or state child protection agency.

If you have any questions, please consult with your doctor to better understand the best solution for you.

Hello Health Group does not provide medical advice, diagnosis or treatment.

Sources

Review Date: September 19, 2017 | Last Modified: September 19, 2017

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