AAMFT Consumer Update
Child Abuse & Neglect

Child maltreatment can be categorized as neglect, physical abuse, sexual abuse, and emotional abuse. Almost 3 million children are harmed or endangered by maltreatment each year. While girls are four times more likely to be sexually abused, boys are slightly more likely to be neglected and 24% more likely to be physically abused. Children with disabilities are almost four times more likely to be recipients of neglect and abuse. Further, poverty plays a major role in physical abuse and neglect, as parents who earn less than $15,000 per year are 44 times more likely to maltreat their children compared to parents earning more than $30,000. Statistics show that parental maltreatment accounts for nearly 80% of child deaths each year.  

Common problems suffered by abused and neglected children

Physical abuse and neglect cause a negative impact on social, emotional, behavioral, academic, and physical health throughout life. Abused children are 300% more likely to abuse drugs, self-mutilate, and act violently than their non-abused peers. They also demonstrate language and learning delays. In fact, the brain of an abused and/or neglected child can, in some cases, be 20% smaller than his or her non-maltreated counterparts. Complex processes in the young brain depend heavily on nurturing and supportive interactions with the primary caregiver. When these processes fail, any number of behavioral, emotional, learning and perception problems can arise throughout life.  

Children who suffer abuse and neglect are often diagnosed with: Oppositional Defiant Disorder (ODD), Conduct Disorder (CD), Post Traumatic Stress Disorder (PTSD), and depressive and anxiety related disorders. Some will act out sexually or be sexually abusive to others.

What type of help is available?

Mental healthcare professionals like marriage and family therapists (MFTs) will assess children, as well as their parent(s), and may ask in-depth questions about the adult, child, family, and social risk factors related to abuse or neglect (such as social isolation, depression, income level, every day stressors, drug and/or alcohol use and child abuse potentiality). Socially isolated mothers who are neglectful have few members in their support networks (few other adults to talk to) and receive little emotional support.

Questions about drug and alcohol use are relevant because parents with drug or alcohol disorders are statistically more likely to exhibit abusive and neglecting behaviors. Questions may arise about domestic violence between parents, as the rate of child abuse in these homes is 15 times higher than the average. A professional helper will guide the therapy session away from alienation of family members--not focusing on parental blame. Likewise, the parent must learn not to blame the child. Research suggests that many abusive parents have a distorted view of their child, believing the child intentionally antagonizes and holds power over the parent. As a result, the parent feels victimized and justified in implementing harsh punishments.

There are several programs and treatment methods in use today and a mental healthcare provider can make the best determination for treatment once assessment is complete. Some of the most well known programs offer case management, social support, life or parenting advice, therapy services, respite care, and financial assistance for basic living.

For children exhibiting symptoms of PTSD, therapists help the family process the trauma through psycho-education, skills training to manage distressing thoughts, feelings, behaviors, improving parenting skills and family communication. Some programs are specially built for multi-problem families and address parent training, stress reduction, basic skills for children, money management, social support, and home safety.

One program option begins at the prenatal stage, where expectant mothers receive home visitation services for the prenatal health of mother and child, parenting skills, family planning for future births, education attainment, and job acquisition. Positive outcomes include prenatal healthcare, improved child care and less punitive discipline, parental education and work attainment, fewer emergency room visits, and father involvement. Adolescents whose mothers participated in the program demonstrate fewer school failures, anti-social behaviors, and substance abuse.

Parents commonly have inaccurate and unhelpful thought processes. Children also tend to excuse the behaviors of their parents. This leads to an agreement of silence. Breaking this silence and “normalizing” the child’s feelings and reactions to abuse is an important step in therapy. The child begins to gain a sense of reassurance when others understand and verify that the chaotic world he or she is experiencing is indeed not the way it should be. With treatment, children learn skills to deal with emotional overload, to identify emotions, and to regulate them. This process helps the child facilitate a decrease in emotional reactivity, anxiety, fear, depression, and distorted thoughts. Adults must also learn to manage their anger, stress, and anxiety as well as their abusive and neglectful “triggers.”

How do I report suspected child abuse?

If you suspect a child is being abused or neglected, you should call your local Child Protective Services (CPS) agency or the CPS agency in the state in which the abuse occurred. As you identify the appropriate agency for making a report, remember the following: Not every state has a toll free hotline, or the hotline may not operate on a 24-hour basis. If a toll free (800 or 888) number is available, it may be accessible only from within that state. If you are unsure how to reach your local CPS, please call:

Childhelp^® USA National Child Abuse Hotline 1-800-4-A-CHILD^®

(1-800-422-4453) TDD: 1-800-2-A-CHILD

 Childhelp^® USA is a non-profit agency which can provide reporting numbers, and has counselors who can provide referrals.

 Consumer Resources

 Online

Child Welfare Information Gateway – www.childwelfare.gov/can

Resources about child maltreatment, including definitions, signs and symptoms, statistics and prevalence, types of child abuse and neglect, risk and protective factors, the impact on individuals and society, and child fatalities.

Medline Plus: Child Abuse – www.nlm.nih.gov/medlineplus/childabuse.html

Resource materials on child abuse and neglect including symptoms, prevention and screening, research, articles, organizations and latest news.

Books

No More Hurt: A Child's Workbook about Recovering from Abuse, by W. Deaton & K. Johnson, 2002. Hunter House.  

Think Good - Feel Good: A Cognitive Behaviour Therapy Workbook for Children, by P. Stallard, 2002. Wiley.

Understanding Child Abuse and Neglect, by C. Crosson-Tower, 2007. Allyn & Bacon.

Wayne: An Abused Child's Story of Courage, Survival, and Hope, by W. Theodore, 2003. Harbor Press, Inc.

The text of this brochure was written by Scott A. Ketring, PhD.

Keywords: physical abuse, neglect, child abuse, emotional abuse, failure to thrive, child and family services, child welfare.