CHILD ABUSE AND NEGLECT:

AN OVERVIEW

Barbara L. Bonner, Ph.D.

Center on Child Abuse and Neglect
University of Oklahoma Health Sciences Center
 DEFINE THE PROBLEM

There is not a set of definitions for neglect, physical

abuse, sexual abuse, or psychological maltreatment
that is used consistently by local, state, and federal
agencies or across the multiple disciplines that deal
with this problem.
PSYCHOLOGICAL MALTREATMENT
Definition

• Psychological Neglect - the consistent failure of a

parent or caretaker to provide a child with
appropriate support, attention, and affection.

• Psychological Abuse - a chronic pattern of

behaviors such as belittling, humiliating, and
ridiculing a child.
PSYCHOLOGICAL MALTREATMENT
SHOULD BE CONSIDERED WHEN:

• Lack of attachment between infant and parent

• Lack of responsiveness to environment

• Failure-to-thrive

• Parent is highly critical and negative toward the

infant/child
 NEGLECT
Definition

Neglect is the chronic failure of a parent or caretaker

to provide a child under 18 with basic needs such as

food, clothing, shelter, medical care, educational

opportunity, protection, and supervision.

NEGLECT SHOULD BE CONSIDERED
WHEN:

• Significantly below height/weight for age

• Inappropriate clothing for weather

• Lack of safe, sanitary shelter

• Lack of necessary medical and dental care

NEGLECT SHOULD BE CONSIDERED
WHEN:

• Reports no caretaker in the home

• Untreated illness or injury

• Poor hygiene, including lice, body odor, scaly skin

• Child abandoned or left with inadequate

supervision
 FAILURE TO THRIVE
Definition
Failure to thrive (FTT) is a condition in which
children show a marked retardation or cessation of
growth.

FTT can result from:

• A medical condition
• Environmental factors or
• Combination of medical and environmental
factors
 PHYSICAL ABUSE
Definition

Physical abuse is any non-accidental injury to a child

under the age of 18 by a parent or caretaker. These
injuries may include beatings, shaking, burns, human
bites, strangulation, or immersion in scalding water,
with resulting bruises and welts, broken bones, scars,
burns, retinal hemorrhage, or internal injuries.
 PHYSICAL ABUSE SHOULD BE
CONSIDERED WHEN:
• History given by parent does not match the injury

• Child gives unbelievable explanation for the

injuries

• Child reports injury by parent

• Child is fearful to go home or requests to stay at

school, daycare, hospital
 CHILD SEXUAL ABUSE
Definition

Child sexual abuse is the exploitation of a child or

adolescent for the sexual gratification of another
person.
 SEXUALLY ABUSIVE BEHAVIORS

• Voyeurism

• Fondling

• Child prostitution

• Child pornography

• Intercourse
SEXUALLY ABUSIVE BEHAVIORS

• Sodomy

• Oral-genital stimulation

• Verbal stimulation

• Exhibitionism
 SEXUAL ABUSE SHOULD BE
CONSIDERED WHEN:

• Injury to genital area or other medical indicators

• History of somatic complaints, including pain or

irritation of the genitals

• Sexually transmitted disease

 SEXUAL ABUSE SHOULD BE
CONSIDERED WHEN:
• Pregnancy in young adolescent

• Frequent unexplained sore throats, yeast or urinary

infections

• Child reports inappropriate sexual behavior

• Child engaged in highly inappropriate sexual

behavior
2001 NATIONAL FINDINGS

• 57% neglect (includes medical neglect)

• 19% physical abuse

• 10% sexual abuse

• 20% additional types of maltreatment, including 7%

psychological maltreatment

(overlapping cases, therefore does not equal 100%)

 2001 NATIONAL FINDINGS

• 3 million reports on 5 million children

• 903,000 child victims (12.4/1000children)

• Boys and girls equally at risk for maltreatment

• Children 3 and younger are more likely to be maltreated

• Almost 2 children per 100,000 died from abuse

2001 NATIONAL FINDINGS
• 59% of perpetrators = females

• 41% of perpetrators = males

• 81% of perpetrators = one parent acting alone

– 41% mother acting alone
– 18% father acting alone
 2001 NATIONAL FINDINGS
• Based on the number of children under age 18, the
percentage of abused children compared to the racial/ethnic
distribution of the U.S. population:
% Abused % of Population*
- Caucasian: 50% 69%
- African American: 25% 12%
- Hispanic: 15% 13%
- Native American: 2% 1%
-Asian/Pacific Islander: 1% 4%
-Multiple Races/Unknown 7% 9%

* Total does not equal 100% as some people claim membership in multiple racial/ethnic groups.
 2001 NATIONAL FINDINGS
% of Referrals
• Professionals 57%
- Educational Personnel
- Legal/Law Enforcement
- Social Services/Mental Health
- Medical Personnel
• Non-Professionals 43%
- Family Members
- Neighbors
- Other Community Members
 CHILD ABUSE AND NEGLECT
Etiological/Associated Physical Sexual Psychological
Factors Neglect Abuse Abuse Maltreatment
Domestic Violence X XX X
One Parent Household XX XX XX
Poverty XX X x
Stress X XX x x
Lacking Education XX XX X
Substance Abuse XX X x
Family Patterns X XX X X
Mental Disorders x x XX* ?
- Parental Depression X XX ?
Social Factors X X X X
Social Isolation XX X X ?
Unknown X X XX XX
* Includes paraphilias (Bonner, 2003)
CHILD ABUSE CASES INVOLVE:

• Child Protective Services

• Law enforcement

• Physicians, Nurses

• Prosecutors, Defense Attorneys, Judges

• Mental health professionals

CHILD ABUSE CASES INVOLVE:

• Child advocates, CASA volunteers

• Foster parents

• Domestic violence staff

• Educators

• Community members, clergy

 INTERDISCIPLINARY APPROACH

• Child Protection Teams

• Children’s Advocacy Centers

• Local and State Child Death Review Teams

 WHEN TO REPORT

• A report should be made when there is reasonable

cause to believe that a child or adolescent has been
abused or neglected or is in danger of being abused.

• A report of suspected abuse is only a request for

an investigation.
Remember:

A report of suspected child abuse is

a responsible attempt to protect a

child.