Recognizing Child Abuse and Neglect

But whoever causes one of these little ones who believe in Me to sin, it would be better for him if a millstone were hung around his neck, and he were drowned in the depth of the sea. Matthew 18:6

Reasons For Abuse/Neglect

Child abuse and neglect occurs in all cultural, ethnic, occupational, and socioeconomic groups. Although abuse and neglect of children is rarely willful or deliberate, there are certain known factors which, when combined, increase the likelihood of abuse or neglect. They include:

parental predisposition towards maltreatment (perhaps as a result of being abused or neglected as a child)
stress within the home, such as marital, employment, or financial problems
parental substance abuse
lack of parenting knowledge or skills
poor impulse control and low level of frustration tolerance
isolation from the support of family and friends

Legal Definitions

According to Virginia law, an abused or neglected child is any child under 18 years of age whose parents or any person responsible for his or her care (such as a child provider, foster parent, or anyone responsible for the welfare of a child receiving residential care at an institution):

causes or threatens to cause a nonaccidental physical or mental injury
neglects or refuses to provide adequate food, clothing, shelter, emotional nurturing, or health care
abandons the child
neglects or refuses to provide adequate supervision in relation to a child's age and level of development
commits or allows to be committed any illegal sexual act upon a child, including incest, rape, indecent exposure, prostitution, or allows a child to be used in any sexually explicit visual material

Operational Definitions

Many people think "child abuse" is limited to physical harm. In reality, child abuse includes:

physical abuse
physical neglect
sexual abuse
emotional maltreatment

Physical injuries, severe neglect, and malnutrition are more readily detectable than the subtle, less visible injuries which result from emotional maltreatment or sexual abuse. However, all categories of abuse endanger or impair a child's physical or emotional health and development and, therefore, demand attention.

Physical Abuse

Physical abuse may be defined as any act which, regardless of intent, results in a nonaccidental physical injury. Inflicted physical injury most often represents:

unreasonably severe corporal punishment. This usually happens when the caretaker is frustrated or angry and strikes, shakes, or throws the child.
intentional, deliberate assault, such as burning, biting, cutting, and the twisting of limbs.
slapping, poking, or pinching are also included in this category.

Physical Neglect

Physical neglect may be defined as the failure to provide for a child's physical survival needs to the extent that there is harm or risk of harm to the child's health or safety.

Physical neglect may include, but is not limited to:

abandonment
lack of supervision
lack of adequate bathing and good hygiene
lack of adequate nutrition
lack of adequate shelter
lack of medical or dental care
lack of required school enrollment or attendance

Sexual Abuse

Sexual abuse is defined as the exposure of a child to any sexual information, knowledge, or stimulation that is inappropriate to their age, developmental level, or role in the family. Sexual abuse encompasses a broad range of behavior and may consist of many acts over a long period of time or a single incident. Victims range in age from less than one year through adolescence. Specifically, sexual abuse includes:

incest
rape
intercourse
oral-genital contact
fondling
sexual propositions or enticement
exposure to pornography
indecent exposure
child pornography
child prostitution

The nature of sexual abuse, the shame of the child victim, and the possible involvement of trusted parents, stepparents, or other persons in a caretaker role make it extremely difficult for children to come forward to report sexual abuse.

Mental/Emotional Maltreatment

Just as physical injuries can scar and incapacitate a child, emotional maltreatment can similarly cripple a child emotionally, behaviorally, and intellectually. Varying degrees of emotional and behavioral problems are common among children who have been emotionally abused.

Emotional maltreatment can include patterns of:

verbal assaults (e.g., screaming, intimidating, rejecting, or blaming)
humor that is sarcastic or detrimental to the child's self-image
teasing, taunting, belittling, or ridiculing
name calling
ignoring and indifference
deliberately setting up a competitive situation in which the child is sure to lose
overpowering a child, so that you cause them to feel helpless or captive (eg. tickling until breathless)
constant family conflict

Emotional abuse can be seen as a self-fulfilling prophecy. If a child is degraded enough, the child will begin to live up to the image communicated by the abusing parent or caretaker.

INDICATORS OF PHYSICAL ABUSE

A combination or pattern of indicators should alert you to the possibility of physical abuse.

Physical Indicators

Questionable Bruises and Welts:

on face, lips, mouth
on torso, back, buttocks, thighs
in various stages of healing
clustered, forming regular patterns
reflecting shape of article used to inflict (electric cord, belt buckle)
on several different surface areas
regularly appear after absence, weekend, or vacation
human bite marks

Questionable Burns:

cigar, cigarette burns, especially on soles, palms, back, or buttocks
immersion burns (sock-like, glove-like, doughnut shaped on buttocks or genitalia)
patterned like electric burner, iron, etc.
rope burns on arms, legs, neck, or torso

Questionable Fractures:

to skull, nose, facial structure (e.g., blackeyes, bruising behind ears )
in various stages of healing
multiple or spiral (twisting) fractures

Questionable Lacerations or Abrasion:

to mouth, lips, gums, eyes
to external genitalia

Child Behavioral Indicators

uncomfortable with physical contact
wary of adult contacts
apprehensive when other children cry
behavioral extremes: aggressiveness, or withdrawal
frightened of parents
afraid to go home
arrives at school early or stays late as if afraid to be at home
reports injury by parents
complains of soreness or moves uncomfortably
wears clothing inappropriate to weather to cover body
chronic runaway (adolescents)
reluctance to change clothes for gym activities (attempt to hide injuries, bruises, etc.)

Caretaker Characteristics

history of abuse as a child
uses harsh discipline inappropriate to child's age, transgression, and condition
offers illogical, unconvincing, contradictory, or no explanation of child's injury
significantly misperceives child (e.g., sees him as bad, stupid, different, etc.)
psychotic or psychopathic personality
misuses alcohol or other drugs
attempts to conceal child's injury or to protect identity of person responsible
unrealistic expectations of child, beyond child's age or ability

INDICATORS OF PHYSICAL NEGLECT

A combination or pattern of indicators should alert you to the possibility of physical neglect.

Physical Indicators

consistent hunger, poor hygiene, inappropriate dress
consistent lack of supervision, especially in dangerous activities or long periods
unattended physical problems or medical needs
abandonment

Child Behavior Indicators

begging, stealing food
extended stays at school (early arrival and late departure)
constant fatigue, listlessness, or falling asleep in class
alcohol or drug abuse
delinquency
states there is no caretaker
frequently absent or tardy
shunned by peers

Caretaker Characteristics

misuses alcohol or other drugs
maintains chaotic home
evidence of apathy or hopelessness
mentally ill or diminished intelligence
history of neglect as a child
consistent failure to keep appointments

INDICATORS OF SEXUAL ABUSE

A combination or pattern of indicators should alert you to the possibility of sexual abuse.

Physical Indicators

difficulty in walking or sitting
torn, stained, or bloody underclothing
pain or itching in genital area
bruises or bleeding in external genitalia, vaginal, or anal areas
venereal disease, especially in pre-teens
pregnancy

Child Behavioral Indicators

unwilling to change for gym or participate in physical education class
withdrawal, chronic depression, or infantile behavior
bizarre or unusual sexual behavior or knowledge
detailed and age-inappropriate understanding of sexual behavior (especially younger children)
unusually seductive behaviors with peers and adults
poor peer relationships
delinquent or run away (especially adolescents)
reports sexual assault by caretaker
threatened by physical contact
suicide attempt (especially adolescents)
role reversal, overly concerned for siblings
unexplained money or "gifts"

Caretaker Characteristics

extremely protective or jealous of child
encourages child to engage in prostitution or sexual acts in the presence of caretaker
sexually abused as a child
misuses alcohol or other drugs
non-abusing caretaker/spouse is frequently absent from the home, permitting access to child by abusing caretaker/spouse

INDICATORS OF EMOTIONAL MALTREATMENT

A combination or pattern of indicators should alert you to the possibility of emotional maltreatment.

Physical Indicators

speech disorders
lags in physical development
failure-to-thrive

Child Behavioral Indicators

habit disorders (sucking, biting, rocking in an older child)
conduct disorders (antisocial, destructive)
neurotic traits (sleep disorders, inhibition of play)
behavior extremes: compliant, passive, undemanding aggressive, demanding, rageful
overly adaptive behavior: inappropriately adult (e.g. parents, other children), inappropriately infantile or emotionally needy
development lags (emotional or intellectual)
delinquent behavior (especially adolescents)
self-destructive, attempted suicide

Caretaker Characteristics

blames or belittles child
ignores or rejects
withholds love
treats siblings unequally
seems unconcerned about child's problems
unreasonable demands or impossible expectations without regard to child's developmental capacity

Please Keep In Mind

Some of the indicators may indicate types of problems other than abuse, but repeated occurrences of an indicator or presence of several indicators warrants further investigation.

And you, fathers, do not provoke your children to wrath, but bring them up in the training and admonition of the Lord. Ephesians 6:4