children s health issues
Overview of Child Neglect and Abuse
Types of Child Neglect and Abuse
There are a number of different types of child neglect and abuse. The types sometimes occur at the same time. The four main types are Neglect None Physical abuse None Sexual abuse None Emotional abuse None Additionally, intentionally causing, lying about, or exaggerating medical symptoms in a child that results in potentially harmful medical interventions is a form of abuse called Child abuse in a medical setting . Neglect is the failure to provide for or meet a child’s basic physical, emotional, educational, and medical needs. Parents or caregivers may leave a child in the care of a person who is known to be abusive, or they may leave a young child unattended. There are many forms of neglect. Inphysical neglect,parents or caregivers may fail to provide adequate food, clothing, shelter, supervision, and protection from potential harm. Inemotional neglect,parents or caregivers may fail to provide affection or love or other kinds of emotional support. Children may be ignored or rejected or prevented from interacting with other children or adults. Inmedical neglect,parents or caregivers may not obtain appropriate care for the child, such as needed treatment for injuries or physical or mental health disorders. Parents may delay obtaining medical care when the child is ill, putting the child at risk of more severe illness and even death. Ineducational neglect,parents or caregivers may not enroll the child in school or may not make sure the child attends school in a conventional setting, such as a public or private school, or in their home. Neglect differs from abuse in that often parents and caregivers do not intentionally mean to harm children in their care. Neglect usually results from a combination of factors such as poor parenting, poor stress-coping skills, unsupportive family systems, and stressful life circumstances. Neglect often occurs in poor families experiencing financial and environmental stresses, particularly those in which parents also have untreated mental health disorders (typically Depression , Physically mistreating or harming a child, including inflicting excessive physical punishment, is physical abuse. Specific examples include shaking, dropping, striking, biting, and burning (for example, by scalding or touching with cigarettes). Children of any age may be physically abused, but infants and toddlers are particularly vulnerable. Infants and toddlers are particularly at risk of repeated episodes of abuse because these children cannot speak for themselves. Also, during these periods, caregivers encounter challenges because children are usually undergoing things that make it more likely that caregivers become frustrated and lose control of their impulses. Such frustrating things include Temper Tantrums , Physical abuse is the most common cause of serious head injury in infants. Abdominal injuries resulting from physical abuse are more common among toddlers than infants. Infants and toddlers are also at increased risk of head and spine injuries because their head is large compared to their body and because they have weaker neck muscles. Physical abuse (including homicide) is among the 10 leading causes of death in children. Generally, a child's risk of physical abuse decreases during the early school years. Poverty and young, single parenthood are associated with higher risks of physical abuse. Family stress contributes to physical abuse. Stress may result from unemployment, frequent moves, social isolation from friends or family members, or ongoing family violence. Parents may be more easily frustrated by and therefore may be more physically abusive toward children who have difficult behaviors (irritable, demanding, or hyperactive) or who have special needs (developmental or physical disabilities). Physical abuse is often triggered by a crisis in the midst of other stresses. A crisis may be a loss of a job, a death in the family, or a discipline problem. Parents who have a substance use disorder may behave impulsively and uncontrollably toward their children. Children whose parents have mental health problems are also at increased risk of being abused. Parents who were neglected or abused as children may not be emotionally mature or may have low self-esteem. Abusive parents may see their children as a source of unlimited and unconditional affection and look to them for the support that they never received. As a result, they may have unrealistic expectations of what their children can provide for them, they may become frustrated easily and have poor impulse control, and they may be unable to give what they never received. Any action with a child that is for the sexual gratification of an adult or a significantly older (developmentally or chronologically) or more powerful child is considered sexual abuse (see Pedophilic Disorder ). Sexual abuse includes Penetrating the child's vagina, anus, or mouth Touching the child with sexual intention but without penetration (molestation) Exposing the abuser's genitals or showing pornography to a child Sharing sexually charged messages or photographs (usually via cell phone) with (sexting) or posting pictures of a child Forcing a child to participate in a sex act with another person Using a child in the production of pornography Sexual abuse does not include sexual play. In sexual play, children who are close in age and development view or touch each other's genital area without force or intimidation. When trying to determine whether a particular situation between children should be considered sexual abuse, it is important to take into account differences in power, such as the children's age, strength, size, and popularity status. Laws differ from state to state about how age considerations help distinguish abuse from play. Both the actual ages and the age difference between the two children are factors in various state laws. The greater the age difference, the greater the difference in emotional and intellectual maturity and social status between the older child and the younger child. And, at some point (a 4-year difference in many jurisdictions), these differences are so large that the younger child cannot legitimately be said to "agree" to activity with an older child. By the age of 18, about 12 to 25% of girls and 8 to 10% of boys have been sexually abused. Most perpetrators of sexual abuse are people known by the children. Certain situations increase the risk of sexual abuse. Being socially isolated, having low self-esteem, having family members who were also sexually abused, or being associated with a gang also increases the risk. Using words or actions to psychologically mistreat a child is emotional abuse. Emotional abuse makes children feel that they are worthless, flawed, unloved, unwanted, in danger, or valuable only when they meet another person's needs. Emotional abuse includes Harshly scolding by yelling or screaming Belittling the child's abilities and accomplishments Encouraging deviant or criminal behavior, such as committing crimes or using alcohol or drugs Bullying, threatening, or frightening the child Emotional abuse tends to occur over a long period of time. In this less common type of child abuse (previously called Munchausen syndrome by proxy and now called Factitious Disorder Imposed on Another ), a caregiver intentionally tries to make doctors think that a healthy child is sick. The caregiver typically gives false information about the child's symptoms, for example, stating that the child has been vomiting or complaining of abdominal pain when the child has not been vomiting or complaining. However, caregivers sometimes also do things to Victims of this type of child abuse receive unnecessary and harmful or potentially harmful tests and treatments, including procedures or surgeries. Different cultures have different ways to discipline children. Some cultures use corporal punishment, which is any punishment that is physical and causes pain. Severe corporal punishment, which includes whipping, burning, and scalding, is physical abuse. However, for lesser degrees of corporal punishment, such as spanking, the line between socially accepted behavior and abuse is blurred between different societal norms. Medical practices also vary in different cultures. Some cultural practices (such as Female Genital Mutilation ) are considered abuse in the United States. However, certain folk remedies (such as coining and Members of certain religious groups have sometimes failed to obtain treatment for a child who has a life-threatening disorder (such as Diabetic ketoacidosis (DKA) or Additionally, in the United States, some caregivers refuse to have their children vaccinated because they think vaccines are not safe or because of religious reasons (see Childhood Vaccination Concerns ). It is not clear whether this refusal of vaccination, while potentially harmful to the child, can legally be considered medical neglect. 