What are child abuse and neglect?

Child abuse is anything done by a person that causes serious risk or harm to a child. Abuse may be physical, emotional, or sexual.

• Physical abuse may include kicking, shaking, biting, throwing, stabbing, and choking. It may also include beating a child with objects like a belt or paddle or purposely burning a child with hot water, cigarettes, or a stove. Head injury caused by abuse is often called shaken baby syndrome. This problem is more common with babies but a child’s brain can be injured by shaking up to age 5 years. A caregiver may violently shake a baby to get him to stop crying or to punish him. It may happen when the caregiver is tired, frustrated, or angry.
• Emotional abuse may include making fun of a child, blaming them for things that are not their fault, or swearing at them. It may also include punishments, such as locking a child in a closet or threatening to abandon them if they do not behave.
• Sexual abuse may include physical touch, forcing a child to have sex, or showing genitals to a child. It may also include showing sexual pictures to a child or taking pictures of a child who is not wearing clothes or who is having sex. Any sexual activity between a child and an adult, even if the child consents, is sexual abuse.

Neglect is a type of abuse when a child’s caregiver—for example, a parent–does not meet the child’s physical, emotional, or educational needs. Child neglect means a child is not provided a safe home, proper clothing, healthy food, schooling, or medical care.

Abuse and neglect can happen at the same time.

What increases the risk of abuse?

Child abuse can happen at any age. A child under 1 year of age is at greatest risk for harm from child abuse. The reasons a caregiver abuses a child are often very complex and may be caused by more than one problem. Abuse is more likely when:

• Children have physical or mental disabilities.
• Children have personality or behavioral problems.
• Caregivers are angry, frustrated, or unhappy, or they expect too much from the child.
• Caregivers were themselves abused as children.
• Caregivers use drugs or alcohol, are depressed or anxious, or have trouble controlling their own behavior.
• Caregivers are unemployed, homeless, or living in poverty.

What are signs of child abuse?

Not all abused children have the same symptoms. All children have accidents, but child abuse is often an injury or a series of injuries that cannot be explained as an accident. Signs of physical abuse may include:

• Bruises, cuts, or burns on the buttocks or genitals
• Injuries with an obvious pattern or many injuries that are the same shape and size, such as a footprint or multiple burns that are the shape of the end of a cigarette
• Many injuries in different stages of healing
• Injuries that are hard or impossible to get by accident for the age of the child

Symptoms of a head injury caused by shaken baby syndrome can be mild to severe. The baby may be sleepy and less alert or very irritable. Other symptoms include poor feeding, vomiting, or seizures. If a child is severely injured, he may lose consciousness or stop breathing.

A child who has been abused may be nervous around adults or very aggressive toward other people. The child may also have a sudden change in the way they think, feel, or act.

Signs of sexual abuse may not be easy to see. It may not cause any clear physical injury, or there may be injuries to the bottom or genitals of the child. The child may not tell anyone what has happened because the abuser has threatened the child or told them to keep it secret.

Signs of neglect may include being hungry and very thin, being poorly groomed, or smelling bad because the child is not allowed to bathe or have clean clothes.

What if I think a child might be abused or neglected?

Know where to call for help. You can contact your healthcare provider or a mental health professional. Most states have a child protective agency that you can call. Be prepared to give the child’s name, address, age, and to say what is happening. Usually, you don’t have to give your name to make a report.

All states require healthcare providers to report suspected child abuse. The goals of child protection teams are to stop the abuse and help the family be safe for the children. Sometimes a child needs to live with a foster family for a while.

If you suspect that a child is being abused or neglected, take action right away. Don’t wait until you have proof. This delay may put the child’s life in danger.

Many states and cities have hotlines you can call if you feel that you might abuse a child. Counseling can help both you and the child. You can get help from:

• Hospitals, community centers, and clinics that offer classes on parenting, discipline, and stress management
• Social services departments that have parenting classes and community referrals to help with finances and other things that can cause stress
• Healthcare providers who can give information and referrals
• Mental health professionals who can provide counseling and parenting classes

You can get more information from:

• Childhelp: National Child Abuse Hotline
  800-422-4453
  http://www.childhelp.org