CHILD ABUSE CHAPTER 4 DR GINNA BABCOCK INTRODUCTION • Historical accounts tell us that some children have always been abused and neglected by one or both parents; it is not uncommon or new • Child protective service (CPS) generally refers to agencies that are authorized by law to act on behalf of a child when parents are unable or unwilling to do so • In all states, these agencies are required to investigate reports of child abuse and neglect and to offer services to families when maltreatment has occurred CHILD ABUSE AND NEGLECT TODAY • “Battered child syndrome” refers to repeated mistreatment or beating of a child resulting in physical and psychological injuries • Millions of children are victims of fatal and non-fatal abuse and neglect each year • An estimated 31,000 deaths were attributed to homicide in the year 2002 • Global data show that: • 20% of women and 5 to 10% of men report having been sexually abused as children • Infanticide a problem in contemporary society • Children < 1 year at highest risk of death due to abuse and neglect • Fatalities rates for both boys and girls tend to decrease with age TYPES OF ABUSE • • According to the Administration on Children, Youth, and Families: • 64.1 percent of child abuse victims experienced neglect; • 16.0 percent were physically abused; • 8.8 percent were sexually abused; • 6.6 percent were psychologically abused • 2.2 percent were medically neglected It is not unusual for a victim to experience more than one form of abuse at the same time EXAMPLES OF ABUSE AND NEGLECT • Physical assault (including excessive corporal punishment) • Sexual abuse or exploitation: forcible or consensual rape, incest, intercourse, sexual molestation, promoting prostitution, etc • Close confinement: tying or binding (or keeping children in a dog kennel, box, etc) • Abandonment or refusal to maintain custody (desertion) Permitting/encouraging chronic maladaptive behavior: truancy, delinquency, prostitution, serious drug/alcohol abuse Refusal to seek treatment for diagnosed physical, educational, emotional, or behavioral problem, or failure to follow the advice of a competent professional Failure to seek or delay in seeking medical care for a serious injury, illness, or impairment • Consistent or extreme inattention to child’s physical/emotional needs, including needs for food, clothing, supervision, safety, affection, and reasonably hygienic living conditions • Failure to register or enroll the child in school STATE DEFINITIONS • Child maltreatment subject to state laws and administrative regulations • Definitions of child abuse and neglect located primarily in three places: • Mandatory reporting statutes (civil laws); • Criminal statutes define those forms of child abuse and neglect that are criminally punishable; and • Juvenile court jurisdiction statutes EMOTIONAL/PSYCHOLOGICAL ABUSE • Most states include emotional maltreatment in definitions of abuse and neglect • Typical language: “injury to the psychological capacity or emotional stability of the child as evidenced by an observable or substantial change in behavior, emotional response, or cognition” • …or as evidenced by anxiety, depression, withdrawal, or aggressive behavior” • Mildest form occurs when a caretaker belittles or ridicules a child frequently WITNESSING FAMILY VIOLENCE • A child is witness to family violence when they hear or see an act of family violence occurring • Legal definitions vary from state to state • 15.5 million American children live in dualparent families with some form of violence in the previous year • Almost 30 percent of the total number of children living in married or cohabiting opposite-sex households witness DV • These children are at greater risk for psychological, behavioral, social and educational problems • Increased risk for physical abuse • Increased risk for being murdered NEGLECT • Defined in terms of deprivation of adequate food, clothing, shelter, medical care, or supervision • Can be failure or refusal to provide care or services for a person when there is an obligation to do so • This form of abuse carries with it a resulting harm due to the action or inaction of the caregiver • Neglect is the most common form of abuse EDUCATIONAL NEGLECT • Approximately 21 states include failure to educate in their definition of neglect • All states have mandatory formal educational requirements that a child must attend school until age 16 • Includes failure to enroll a child in school, allowing chronic truancy, and the failure to attend to a special education need EMOTIONAL NEGLECT • May include the following: • Exposure to chronic or extreme intimate partner violence —witnessing of family violence • Permitted drug or alcohol abuse • Delay in psychological care MEDICAL NEGLECT • Parents have duty to seek medical care for child • Withholding medical treatment • Failure to fill prescriptions • A religious exemption from medical neglect is permitted in some states if based on religious grounds • Investigate the phenomenon of Munchausen Syndrome by Proxy PHYSICAL NEGLECT • Involves the failure to provide adequate food, clothing, shelter, hygiene, protection, or supervision • Typically, abandonment is when the parents whereabouts are unknown, the child has been left in circumstances in which he suffers serious harm, or the parent has failed to provide reasonable support for a specified time • Parental substance abuse is an element of the definition of child abuse or neglect in some states PHYSICAL ABUSE • Any non-accidental physical injury to the child • To include: • Striking, kicking, burning, biting the child, or any action that results in a physical impairment or death of the child such as shaking or throwing • Includes acts or circumstances that threaten child with harm or create a substantial risk of harm • Some cultural practices not generally defined as physical abuse – coining, cupping, moxibustion CHILD FATALITIES • Estimated 1,530 children died of abuse or neglect in 2006 • Most frequent cause of death: Neglect (> 40%) • Studies estimate that 50 to 60 percent child deaths from abuse or neglect are not recorded • Child fatality review teams appear to be among the most promising current approaches SEXUAL ABUSE • • Includes the following: • Persuasion, inducement, enticement, or coercion of any child to engage in, or assist any other person in any sexually explicit conduct or simulation of conduct for the purpose of producing a visual depiction of such conduct • The rape, and in cases of caretaker or interfamilial relationships, statutory rape, molestation, prostitution, or other form of sexual exploitation of children, or incest with children Child sexual abuse refers to sexual acts, sexually motivated behaviors involving children, such as: • Oral, anal, or genital penetration; • Anal or genital digital or other penetration; • Genital contact with no intrusion; • Fondling a child’s breast or buttocks; • Indecent exposure; • Inadequate or inappropriate supervision of child sexual activities; • Prostitution, pornography, and internet crimes CHILD ABUSE VICTIMS • Victims found throughout society with no regard to age or sex • Children younger than 1 year have highest rates of victimization • Girls slightly more victimized than boys (52% to 48%) • All age groups at risk for some form of maltreatment • Victimization rates vary by race and ethnicity • Highest rates of victimization: • African American children; • American Indian; • Alaska Native children; and • Children of multiple races MANDATED REPORTING • Any person with duty to care for or protect a child may be considered a mandated reporter • Typical mandated reporters include: • Physicians; • Child care givers; • Police officers; and • Teachers CHILD VICTIMS AND CRIMINAL LAW • Majority of states have extended statute of limitations for child sexual abuse and other crimes against children • Examples of criminal justice provisions provided: • Allowing the judge to close the courtroom during a child victim’s testimony • Allowing leading questions to be asked of child witnesses • Allowing the use of anatomical dolls in child abuse trials • Videotaping child’s testimony so that the child only tells it once DOMESTIC VIOLENCE AND CHILD-CUSTODY • Court may order an investigation when allegations of abuse surface during custody hearings • Child witnesses and expert testimony: • considerations of the fitness of a parent who abuses a spouse • impact of family violence on the battered spouse’s capacity to parent add to the complexity of these hearings • In many states, the court will appoint a guardian ad litem (GAL) or attorney to speak for the child • Investigate CASA and consider training to become a volunteer!