In the USA, over 900,000 children are victims of abuse & neglect every year. Child abuse is so common, yet shocking . Whether the abuse is physical, emotional, sexual, or neglect, the scars can be deep and long-lasting, often leading to future child abuse. Learning the signs and symptoms of child abuse can help break the cycle, finding out where to get help for the children and their caregivers.



Why would someone abuse an innocent child? Child abuse happens in all social groups and all ethnicities. Sadly, the abuse is overwhelmingly caused by those who are supposed to be protecting the child- the parents.

There are many forms of abuse, but the result is the same- serious physical or emotional harm. Physical or sexual abuse may be the most striking types of abuse, since they often unfortunately leave physical evidence behind. However, emotional abuse and neglect are serious types of child abuse that are often more subtle and difficult to spot. Child neglect is the most common type of child abuse.

Risk factors for child abuse include:

History of child abuse. Unfortunately, the patterns we learn in childhood are often what we use as parents. Without treatment and insight, sadly, the cycle of child abuse often continues.

Stress and lack of support. Parenting can be a very time intensive, difficult job. Parents caring for children without support from family, friends or the community can be under a lot of stress. Teen parents often struggle with the maturity and patience needed to be a parent. Caring for a child with a disability, special needs or difficult behaviors is also a challenge. Caregivers who are under financial or relationship stress are at risk as well.

Alcohol or drug abuse. Alcohol and drug abuse lead to serious lapses in judgment. They can interfere with impulse control making emotional and physical abuse more likely. Due to impairment caused by being intoxicated, alcohol and drug abuse frequently lead to child neglect Domestic violence. Witnessing domestic violence in the home, as well as the chaos and instability that is the result, is emotional abuse to a child. Frequently domestic violence will escalate to physical violence against the child as well.

All types of child abuse and neglect leave lasting scars. Some of these scars might be physical, but emotional scarring has long lasting effects throughout life, damaging a child's sense of self and ability to have healthy relationships.

Physical child abuse: Warning signs and how to help

Many physically abusive parents and caregivers insist that their actions are simply forms of discipline, ways to make children learn to behave. But there's a big difference between giving an unmanageable child a swat on the backside and twisting the child's arm until it breaks. Physical abuse can include striking a child with the hand, fist, or foot or with an object, burning, shaking, pushing, or throwing a child; pinching or biting the child, pulling a child by the hair or cutting off a child's air. Another form of child abuse involving babies is shaken baby syndrome, in which a frustrated caregiver shakes a baby roughly to make the baby stop crying, causing brain damage that often leads to severe neurological problems and even death.

Warning signs of physical abuse

Physical signs. Sometimes physical abuse has clear warning signs, such as unexplained bruises, welts, or cuts. While all children will take a tumble now and then, look for age-inappropriate injuries, injuries that appear to have a pattern such as marks from a hand or belt, or a pattern of severe injuries.

Behavioral signs. Other times, signs of physical abuse may be more subtle. The child may be fearful, shy away from touch or appear to be afraid to go home. A child's clothing may be inappropriate for the weather, such as heavy, long sleeved pants and shirts on hot days.

Caregiver signs. Physically abusive caregivers may display anger management issues and excessive need for control. Their explanation of the injury might not ring true, or may be different from an older child's description of the injury.

Emotional child abuse

"Sticks and stones may break my bones but words will never hurt me". This old saying could not be farther from the truth. Emotional child abuse may seem invisible. However, because emotional child abuse involves behavior that interferes with a child's mental health or social development, the effects can be extremely damaging and may even leave deeper lifelong psychological scars than physical abuse.

Words. Examples of how words can hurt include constant belittling, shaming, and humiliating a child, calling names and making negative comparisons to others, or constantly telling a child he or she is "no good", "worthless," "bad," or "a mistake." How the words are spoken can be terrifying to a child as well, such as yelling, threatening, or bullying.

Actions. Basic food and shelter may be provided, but withholding love and affection can have devastating effects on a child. Examples include ignoring or rejecting a child, giving him or her the silent treatment. Another strong component of emotional abuse is exposing the child to inappropriate situations or behavior. Especially damaging is witnessing acts that cause a feeling of helplessness and horror, such as in domestic violence or watching another sibling or pet be abused.

Signs of emotional child abuse

Behavioral signs. Since emotional child abuse does not leave concrete marks, the effects may be harder to detect. Is the child excessively shy, fearful or afraid of doing something wrong?

Caregiver signs. Does a caregiver seem unusually harsh and critical of a child, belittling and shaming him or her in front of others? Has the caregiver shown anger or issues with control in other areas? A caregiver may also seem strangely unconcerned with a child's welfare or performance. Keep in mind that there might not be immediate caregiver signs. Tragically, many emotionally abusive caregivers can present a kind outside face to the world, making the abuse of the child all the more confusing and scary.

Sexual child abuse

Sexual abuse, defined as any sexual act between an adult and a child, has components of both physical and emotional abuse. Sexual abuse can be physical, such as inappropriate fondling, touching and actual sexual penetration. It can also be emotionally abusive, as in cases where a child is forced to undress or exposing a child to adult sexuality. Aside from the physical damage that sexual abuse can cause, the emotional component is powerful and far reaching. The layer of shame that accompanies sexual abuse makes the behavior doubly traumatizing. While news stories of sexual predators are scary, what is even more frightening is that the adult who sexually abuses a child or adolescent is usually someone the child knows and is supposed to trust: a relative, childcare provider, family friend, neighbor, teacher, coach, or clergy member. Children may worry that others won't believe them and will be angry with them if they tell. They may believe that the abuse is their fault, and the shame is devastating and can cause lifelong effects.

Signs of sexual child abuse

Behavioral signs. Does the child display knowledge or interest in sexual acts inappropriate to his or her age, or even seductive behavior? A child might appear to avoid another person, or display unusual behavior- either being very aggressive or very passive. Older children might resort to destructive behaviors to take away the pain, such as alcohol or drug abuse, self-mutilation, or suicide attempts.

Physical signs. A child may have trouble sitting or standing, or have stained, bloody or torn underclothes. Swelling, bruises, or bleeding in the genital area is a red flag. An STD or pregnancy, especially under the age of 14, is a strong cause of concern.

Caregiver signs. The caregiver may seem to be unusually controlling and protective of the child, limiting contact with other children and adults. Again, as with other types of abuse, sometimes the caregiver does not give outward signs of concern. This does not mean the child is lying or exaggerating.

Child neglect

Child neglect is the most frequent form of child abuse. Neglect is a pattern of failing to provide for a child's basic needs, endangering a child's physical and psychological well-being. Child neglect is not always deliberate. Sometimes, a caregiver becomes physically or mentally unable to care for a child, such as in untreated depression or anxiety. Other times, alcohol or drug abuse may seriously impair judgment and the ability to keep a child safe. The end result, however, is a child who is not getting their physical and/or emotional needs met.

Warning signs of child neglect

Physical signs. A child may consistently be dressed inappropriately for the weather, or have ill-fitting, dirty clothes and shoes. They might appear to have consistently bad hygiene, like appearing very dirty, matted and unwashed hair, or noticeable body odor. Another warning sign is untreated illnesses and physical injuries.

Behavioral signs. Does the child seem to be unsupervised? School children may be frequently late or tardy. The child might show troublesome, disruptive behavior or be withdrawn and passive.

Caregiver signs. Does the caregiver have problems with drugs or alcohol? While most of us have a little clutter in the home, is the caregivers home filthy and unsanitary? Is there adequate food in the house? A caregiver might also show reckless disregard for the child's safety, letting older children play unsupervised or leaving a baby unattended. A caregiver might refuse or delay necessary health care for the child.

What to do if a child reports abuse

You may feel overwhelmed and confused if a child begins talking to you about abuse. It is a difficult subject and hard to accept, and you might not know what to say. The best help you can provide is calm, unconditional support and reassurance. Let your actions speak for you if you are having trouble finding the words. Remember that it is a tremendous act of courage for children to come forward about abuse. They might have been told specifically not to tell, and may even feel that the abuse is normal. They might feel they are to blame for the abuse. The child is looking to you to provide support and help- don't let him or her down.

Avoid denial and remain calm. A common reaction to news as unpleasant and shocking as child abuse is denial. However, if you display denial to a child, or show shock or disgust at what they are saying, the child may be afraid to continue and will shut down. As hard as it may be, remain as calm and reassuring as you can.

Don't interrogate. Let the child explain to you in his/her own words what happened, but don't interrogate the child or ask leading questions. This may confuse and fluster the child and make it harder for them to continue their story.

Reassure the child that they did nothing wrong. It takes a lot for a child to come forward about abuse. Reassure him or her that you take what is said seriously, and that it is not the child's fault.

Reporting child abuse and neglect

Reporting child abuse seems so official. Many people are reluctant to get involved in other families lives. However, by reporting, you can make a tremendous difference in the life of a child and the child's family, especially if you help stop the abuse early. Early identification and treatment can help mitigate the long-term effects of abuse. If the abuse is stopped and the child receives competent treatment, the abused child can begin to regain a sense of self-confidence and trust. Some parents may also benefit from support, parent training and anger management.

Reporting child abuse: Myths and Facts

I don't want to interfere in some one else's family. The effects of child abuse are lifelong, affecting future relationships, self esteem, and sadly putting even more children at risk of abuse as the cycle continues. Help break the cycle of child abuse.

What if I break up someone's home? The priority in child protective services is keeping children in the home. A child abuse report does not mean a child is automatically removed from the home - unless the child is clearly in danger. Support such as parenting classes, anger management or other resources may be offered first to parents if safe for the child.

They will know it was me who called. Reporting is anonymous. In most states, you do not have to give your name when you report child abuse. The child abuser cannot find out who made the report of child abuse.

It won't make a difference what I have to say. If you have a gut feeling that something is wrong, it is better to be safe than sorry. Even if you don't see the whole picture, others may have noticed as well, and a pattern can help identify child abuse that might have otherwise slipped through the cracks.

Child Abuse Hotlines: Where to call to get help or report abuse

If you suspect a child is in immediate danger contact law enforcement as soon as possible.

To get help in the U.S., call:

1-800-4-A-CHILD (1-800-422-4453) ? Childhelp National Child Abuse Hotline

To get help for child sexual abuse, call:

1-888-PREVENT (1-888-773-8368) ? Stop It Now

1-800-656-HOPE Rape, Abuse & Incest National Network (RAINN)

Child abuse prevention

Reducing the incidence of child abuse is a matter of intervention and education.

Intervention

In some cases, as in cases of extreme cruelty, sexual abuse, and severe alcohol and drug abuse, children are safer away from the caregiver. Not all abusive parents intend harm to their children, however. Some parents need help to realize that they are hurting their children, and can work on their problems. Some examples include:

Domestic violence. A mother might be trying to do her best to protect her children from an abusive husband, not realizing that the children are being emotionally abused even if they are not physically abused. Helping a mother leave an abusive relationship and getting supportive counseling can help stop these children from being abused.

Alcohol and drug abuse. Alcohol and drug abusers may be so focused on their addiction that they are hurting their children without realizing it. Getting appropriate help and support for alcohol and drug abuse can help parents focus back on their children.

Untreated mental illness. A depressed mother might not be able to respond to her own needs much less her children's. A caregiver suffering from emotional trauma may be distant and withdrawn from her children, or quick to anger without understanding why. Treatment for the caregiver means better care for the children.

In some cases, you might be able to provide support for parents/caregivers who need help yourself. What if a parent or caregiver comes to you? The key is not to be self-righteous or judgmental, which can alienate caregivers, but offer support and concrete offers of help, such as helping them connect with community resources. If you feel that your safety or the safety of the child would be threatened if you try to intervene, leave it to the professionals. You may be able to provide more support later after the initial professional intervention.

For caregivers

Do you see yourself in some of these descriptions, painful as it may be? Do you feel angry and frustrated and don't know where to turn? Caring for children can be very difficult. Don't go it alone. Ask for help if you need it. If you don't have a friend or family to turn to, call the child abuse hotline, 1-800-4-A-CHILD, yourself. The hotline is also designed to get you support and find resources in the community that can help you.