One of the major public health problems and the societal concerns these days is the maltreatment of children which impacts millions of children all over the world. There are a variety of long and short-term health consequences of child abuse and neglect which leaves a long-lasting impact on the mental and social growth and development of the children. Child abuse does not just mean broken bones or bruises, it impacts the safety, physical, social, mental, emotional and educational needs of the children. Child abuse and neglect as defined by the Child Abuse Prevention and Treatment Act (CAPTA) of 2010, states “Any recent act or failure to act on the part of a parent or caretaker which results in death, serious physical or emotional harm, sexual abuse or exploitation; or an act or failure to act which presents an imminent risk of serious harm.”.
Child abuse includes the physical, emotional, sexual or psychological abuse of the children under the age of 18 years by the caregiver, may be parents themselves or any other person having the responsibility of the child. The physical abuse includes the use of physical force like kicking, hitting, beating, choking, throwing, punching, biting, burning or harming the child by some other means that may result in physical injury to the child. All such injuries are abuse regardless of whether they were done with the intention of hurting the child. Child abuse includes sexual abuse also which means the sexual exploitation of the child (sexual interaction completed or non-completed, or sexual contact) by the caretaker. The ruthless behavior of the caregiver that makes the children feel that they are unwanted, worthless, non-valuable and unloved leads to the psychological abuse of the children. According to a report by CPS agencies, in 2012, 3.4 million reports of child abuse were reported in the United States.
Child neglect is also one of the forms of the child abuse which indicates the failure of the caregiver to prevent a child from any harm and providing any basic needs like clothing, health care, housing, food, nutrition, affection, education, and supervision. For a child to grow emotionally, socially and physically, caregivers must provide these basic needs to the children. Child neglect happens due to failure to provide supervision by the caregiver and failure to provide the safety to the child outside and within the home. The developmental and emotional needs of the child are not satisfied. According to a review by Gilbert, it has been reported that in higher income countries, physical abuse happens with 4-16 percent of the children and child neglect happens with 10 percent of the children every year.
Issues and Consequences of Child Abuse/Neglect
In the United states in FY 2011, it was reported by the US Department of health and Human Services 2012, that child abuse and neglect had impacted 676,569 children in the States. Worldwide, the child physical abuse alone is prevalent at around 22.6 percent. While it may be possible that physical injuries are not visible, child abuse and neglect may have the long-lasting impact on the children, society, and families. The way child is affected by the abuse and neglect depends a lot on the duration and frequency of the maltreatment and also on the simultaneous occurrence of different forms of abuse. Repeated incidents of abuse over a longer period of time are found to have worse outcomes and higher levels of symptoms of trauma than the single incidents of abuse or neglect.
Factors affecting the Consequences of Child Abuse and Neglect: There are various factors which affect how the child would be impacted by child abuse and neglect in his/her life like:
the developmental stage and age at which the abuse occurred.
the duration and severity of abuse.
the type of abuse or neglect that has happened with the child.
the perception of the child for the abuse.
Depending on all the factors mentioned above, child abuse and neglect can have critical consequences on the brain development of the child and thereby impacting his/her whole life. The effects of child abuse can appear at any stage like childhood, adulthood or adolescence and have a great impact on the physical, psychological, cognitive and behavioral development of the child. The consequences can vary from mental problems to brain dysfunction, chronic diseases and in some cases, even death of the child. Some of the consequences of the child abuse and neglect are listed below:
Physical Health: Child abuse and neglect have a long-term impact on the physical health of the abused child. In a study done by Widom, Czaja, Bentley and Johnson , physical health outcomes were investigated in abused and neglected children and it was found that the abused children had high risk for lung diseases, eye problems, malnutrition, diabetes and they were in the need of health care prevention at the earliest. The direct impacts of the physical abuse, neglect or sexual abuse include sexually transmitted diseases, bruises, and broken bones, especially in young children and infants who are so vulnerable to the physical abuse. Serious outcomes like vision impairment, cognitive impairment are very common in children below 5 years of age and they may even suffer from head trauma due to abuse that may lead to their death.
In another study conducted by Palusci and Covington, the number of deaths due to child maltreatment in the US national child death review case have been reported. It was found that 30 percent of the cases had head trauma due to child abuse which leads to their death and over one-half of them died due to neglect. All these cases had certain child and offender characteristics associated with them and recommended several prevention activities in these communities. Merrick and Latzman indicate that abuse and child cause dysfunction in important regions of the brain which affect all the developmental areas. "Hyperarousal" response may be caused due to chronic abuse which may lead to disturbances in sleep and may cause hyperactivity as well. The stress due to abuse may also lead to aggressive behavior and anxiousness in children. Long-term consequences may lead to depression and more susceptibility to alcohol and smoking use.
A longitudinal study conducted by Shin and Miller has revealed that childhood neglect leads to the obesity development in the adolescence. A significant faster rate is observed in the body mass indexes of the children who have experienced neglect as compared to the children who have never suffered from neglect. In 'The Long-Term Health Consequences of Child Physical Abuse, Emotional Abuse, and Neglect: A Systematic Review and Meta-Analysis' by Rosana et al. , it has been indicated that a causal relationship exists between child abuse and neglect and attempts of suicide, usage of drugs, mental disorders and sexually transmitted diseases. Children can be prevented from all these violence by the development of efficient interventive methods.
Psychological Consequences: The psychological consequences of child abuse and neglect can be lifelong which may convert from fear, isolation, and loss of trust to depression, difficulties in establishing relationships and low self-esteem. In a study done by , it has been reported that the children who have experienced trauma and emotional abuse in childhood, suffer from certain mental disorders like social phobia, major depression, schizoid, dysthymia, personality disorders, schizotypal and borderline. Due to all these disorders, they suffer from social withdrawal and have difficulties in interpersonal relationships. According to DSM (Diagnostic and Statistical Manual) of the Mental disorder by American Psychological Association, children who have been emotionally abused or neglected in the childhood suffer from psychological disorders like mood, anxiety, substance abuse, and even personality disorders and mental retardation.
It has also been reported that neglected child on growing up develop antisocial activities and especially, children neglected by their own parents develop borderline personality disorder. Child neglect often lead to aggression, attachment and affectionate issues, and a wrong exhibit of adult behavior. Maltreated children also have cognitive problems and they experience difficulties in school performance and learning. Family violence like physical abuse, sexual abuse have very bad impact on the cognitive processes like processing speed, memory, listening attention etc. of the abused child as compared to their peers who have suffered any abuse in their childhood.
Behavioral Consequences: It is possible that all the victims of child abuse and neglect may not experience the behavioral problems, but the problems are more common in this group. Children in this group have an increased risk of experiencing alcoholism, smoking and substance abuse on growing up. They are also actively involved in risky sexual behavior.
Studies have also found that problems like teen pregnancy, delinquency, poor academic performance are more common with children who have experienced child abuse and neglect. In a longitudinal study which was conducted on 574 children between the age group of 5 and 21, it was found that children who have been physically abused have more chances of failing in graduate high school, being a parent in their teens and being arrested when they are juveniles only. The chances of criminal behavior in adulthood and doing a violent crime is also more in the abused and neglected children.
Causes of Child Abuse and Neglect
Child abuse and neglect is caused not just be one factor but by the combination of various risk factors. Abuse and neglect are mostly observed in families who are not well off, who do not have enough support and who are under pressure of one or the other thing. Some of the leading causes of child abuse and neglect are domestic violence, substance abuse, lack of parenting skills, adults being abused in their childhood themselves, poverty, family stress and unrealistic expectations of the parents and their emotional disorders.
Domestic Violence: It has been reported that higher chances of child abuse and neglect exist in homes with frequent domestic violence. It may be without intention or with intention that the children are harmed and abused. Normally what happens is the abusing parent after abusing their partner turn on to the children. Some children are abused when they try to save their mothers from their father's abuse.
Substance Abuse: Another leading cause of the child abuse and neglect is the substance abuse. As reported by the PCANY, 70 percent of the cases of the child abuse occurs due to parents being addicted to drugs or alcohol. People normally loose self-control due to the consumption of drugs and alcohol which leads to child abuse. As reported by the Child Welfare League of America, the percentage of child abuse is about three times more with the children whose parents are addicted to substance abuse. Also, they are more likely to be neglected, around four times more than other children whose parents do not abuse alcohol and drugs. Substance abuse has been rated amongst the top two causes of child abuse and neglect.
Lack of Parenting Skills: Some parents do the parenting in the same way as they were parented. They are not aware of the fact that this could be abusive or neglecting. As for example, teen parents would not understand the needs of the young children so well. These parents have unrealistic expectations from their children and when they are not fulfilled, they abuse them.
Adults abused in their own childhood: Adults who have been abused in their own childhood follow the same family habits and have higher chances of abusing their own children. Likewise, the adults who have grown up in a very strict environment are found to be violent with the children and abuse them.
Poverty and Family Stress: One of the most important factors of the child abuse is the family stress and it happens that due to stress, people become prone to anxiety, depression, and aggression and hence may abuse their children. The poverty and financial difficulties increase the levels of the stress in the household which may lead to ultimately increasing the abuse with the children. Other problems like single parenting, behavioral problems of the children or children with special needs also increases the risk of abuse with the children.
Emotional Disorders of the adults: Adults who suffer from emotional disorders like anxiety, bipolar, depression or other mental problems are not able to handle the pressure of parenting and may end up abusing their children. Since they are not able to take care of themselves properly, they find it difficult to take care of others and may engage in child abusing then. These people are generally neglectful and get angry very easily and have no hesitation in physical violence also. These people should be properly treated in order to prevent the chances of the child abuse and neglect as their handling capabilities would be improved.
Interventions of Child Abuse and Neglect
Child abuse and neglect is such a crucial health problem that requires interventions so that the next generation is prevented from any kind of abuse and violence. The goal of child abuse and neglect is very straight and clear i.e. stop the violence from happening. The safe and healthy environment should be developed for all the children and families so that abuse is prevented and children are able to reach the potential they deserve. A comprehensive approach is needed to prevent child abuse and neglect, that should influence all the level of society, its culture, the behavior of an individual, relationships among neighbors and families, and the involvement of the community as a whole. Some of the strategies are:
The programs to strengthen the financial conditions of the households. The economic strength is provided to the families so that the stress level is lowered down and the parents or adults are not subjected to the abuse of any kind. In a study conducted by Levey et al., the intervention programs are designed to prevent the risk of child abuse and neglect in high-risk families. The mothers of infants and pregnant women who find it difficult to fulfill their parenting duties are provided support and education through intervention programs. It has been found that this particular group with low-income families became responsive to all these interventions and harsh parenting and self-reported aggression has been decreased to a greater extent.
Home visiting intervention is very popular in the United States and their popularity is growing widely to provide parenting interventions. The home-visiting interventions have been used widely in the treatment of depression post-partum, to improve the connection between the infant/child and the parents, to reduce child abuse and neglect and to improve the results of the child development. In a meta-analysis of 156 home interventions, it was found that interventions had a greater impact on the high-risk group as compared to the general population. Another intervention to save children from child abuse and neglect is that on finding symptoms of abuse and neglect with any child, it must be reported immediately either to the police or to the concerned welfare associations so that appropriate steps can be taken at the right time. The symptoms of the child abuse can be:
suddenly getting lower grades in schools
development of the child is slower than normal
less weight gain, mental health problems, inappropriate behavior
unusual interaction with parents and others
On seeing any of these symptoms of child abuse and neglect, it should be reported immediately without waiting for its confirmation so that the child gets all the needed attention at the correct time.
Another intervention is the changing of the social norms to support positive parenting in the favor of the children through educational campaigns and public engagement. As studied by Prinz in 'Assessing child maltreatment prevention via administrative data systems', it has been found that the implementation of family support and positive parenting intervention program has a country-wide impact in the United States and as a function of intervention the cases of child maltreatment and out-of-home placements were decreased. Through education and quality care intervention, and through interventions to lessen harms caused by abuse and neglect, child abuse and neglect can be prevented to a much greater extent.
Conclusion
Based on the study conducted above, it can now be safely concluded that child abuse and neglect is one of major public health problems which has a long-lasting impact on the mental and social growth and development of the children. It impacts the safety, physical, social, mental, emotional and educational needs of the children. Child abuse and neglect happen due to various factors like domestic violence, substance abuse, lack of parenting skills, adults being abused in their childhood themselves, poverty, family stress, unrealistic expectations of the parents and their emotional disorders. The effects of child abuse can appear at any stage like childhood, adulthood or adolescence and have a great impact on the physical, psychological, cognitive and behavioral development of the child. The consequences can vary from mental problems to brain dysfunction, chronic diseases and in some cases, even death of the child. Thus, a comprehensive approach is needed to prevent child abuse and neglect, that should influence all the level of society, its culture, the behavior of an individual, relationships among neighbors and families, and the involvement of the community as a whole.
References
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