volume 7 • number 4 march / april 2003 education • clinical care • professional training • scientific research • school outreach • information update
CHILD ABUSE AND NEGLECT Definitions, consequences, and treatment
A recent national study (2003) by the Child Welfare League, the nation’s largest child advocacy group, revealed that the child welfare system is overwhelmed with a record number of abuse claims. The costs of child abuse – psychological, educational, social and economical -- are enormous, in both the short and long-term. Abuse and/or neglect can have a damaging effect a child’s ability to develop adaptively in a broad range of areas – academic performance, family relationships, social interactions and psychological functioning. Abused and/or neglected children are vulnerable to developing mental health problems such as social skills deficits, posttraumatic stress disorder and other anxiety disorders, depression, or behavior problems. Understanding the nature and extent of abuse and neglect and their consequences for children is critical to the design of prevention and treatment programs. In this issue of the NYU Child Study Center Letter, we discuss definitions and manifestations of the various types of child maltreatment, incidence, psychological effects, which children are vulnerable to being abused, available services, and mental health treatments that have been found to be effective for those who have been maltreated. AG/HSK
Amber, a 6-year-old underweight, unkempt girl, was brought to a pediatric emergency room with a shoulder fracture and numerous old scars. When questioned, she told a vague story of a fall occurring several days earlier, but she acknowledged that her dad often hit her with an electrical cord and had pushed her down a staircase. Jenny, aged 7, was described by her teacher as a withdrawn, quiet child who seemed somewhat distant from her peers. Although she had been an excellent student in the first grade, her second grade performance was below average. On several occasions, the teacher had observed her masturbating while she was working at her desk. Jenny complained that she was tired, had trouble falling asleep at night and was often awakened by nightmares. When the psychologist spoke with Jenny, she learned that her mother had recently remarried and worked on the weekend, at which time Jenny was cared for by her step-father. Further exploration revealed that Jenny’s stepfather would often have a "funny smell on his breath" and then he would engage Jenny in mutual genital stimulation. Sean, 15 years old, is constantly berated by his parents. Neighbors report that Sean’s parents tell him they’re sorry he was ever born and call him stupid and ugly. They threaten to send him to a "reform school" because they don’t like his friends. Sean attends school only when forced to and does not respond to overtures by his teacher, stating that he’s afraid she’ll tell his parents that he’s “bad.”
Situations like these are happening every day in the United States and around the world. The psychological, educational, and economic costs of child abuse and neglect are tremendous. In spite of the fact that 90% of Americans think child abuse is a serious problem, only 1 in 3 report abuse when confronted with an actual situation. These children and the system that serves them are in need of attention.
What are child abuse and neglect? How often do they occur?
Definitions of child abuse and neglect vary across systems (e.g., legal, medical, mental health, economic, child welfare, cultural). Even within one system, such as the legal system, definitions vary across states. New York State law specifies that "Child maltreatment involves any act of commission or omission which endangers or impairs a child’s physical or emotional health and development" (ChildhelpUSA. org). Types of maltreatment include physical abuse, sexual abuse,...