National Child Abuse Prevention Month: Know the Signs and the Risks

April is National Child Abuse Prevention Month, and despite efforts to grow awareness, maltreatment remains a problem that affects millions. 

In 2019, child protective services agencies in the United States received nearly 4.4 million referrals for about 7.9 million children. The majority of mistreatment cases were reported by professionals, particularly education, law enforcement, and medical personnel. Family, friends, and neighbors also call in abuse, but at lower numbers.

Kinds of Abuse

Abuse can take on many forms, including physical, neglect, and sexual.

For 2019 the majority (84.5%) suffered one type of abuse. Broken down further, that amounted to:

• 61% neglected
• 10.3% physically abused
• 7.2% sexually abused (trafficking and otherwise)

The remainder of the cases surveyed (15.5%) experienced two or more types of abuse.

Prenatal substance exposure is measured as abuse, too: 38,625 children in 47 states were referred to CPS for such exposure. The majority (70.9%) were exposed to drugs, while 11.4% were exposed to drugs and alcohol. 

Emotional abuse (belittling, insulting, isolating, or rejecting) is another type of mistreatment. Abuse can also be medical in nature. This is when a parent gives false information about an illness, putting the child in danger of inadequate or incorrect treatment. 

Signs of Abuse

Knowing the signs of child abuse can be helpful, too. If a child’s behavior changes or they act withdrawn, anxious, depressed, rebellious, or avoid going home, that could point to a problem. Symptoms vary by the type of maltreatment, too, including:

• Physical: A child may have unexplained bruises, burns, or fractures. Injuries may not match the explanation.
• Sexual: A victim may act inappropriately or display sexual knowledge that’s not normal for their age. Blood in a child’s underwear, pregnancy, or a sexually transmitted infection are all warning signs.
• Emotional: Delayed development, poor self-esteem, acting withdrawn, being desperate for attention, or any sudden shift in behavior or drop in grades.
• Neglect: A child is malnourished or overweight, has poor hygiene, inadequate clothing, poor attendance, or takes food or money.

Parents can show signs of being abusive, too, by showing little interest, ignoring the child or their needs, belittling or harshly disciplining the child, and limiting contact.

Lives Lost to Maltreatment

For 2019, an estimated 1,840 children died due to abuse and neglect. (That’s up from 2018’s 1,780 fatalities.)

During the COVID-19 pandemic, emergency room visits stemming from child abuse and neglect went down but the percentage of visits requiring hospitalization went up, compared to 2019. Stress, isolation, and reduced income may be contributing factors.

Younger children are most often the victim of abuse:

• Nearly half of child fatalities occur among children younger than one.
• Boys die at a higher rate (2.98 per 100,000 males vs. 2.20 per 100,000 girls).
• African-American children die at more than double the rate (5.06 per 100,000 Black children) of white children (2.18 per 100,000 white children), and 2.7 times greater than that of Hispanic children (1.89 per 100,000).

Risk Factors

There’s no simple solution to reducing child maltreatment. Better household economic support and family-friendly work policies carry potential. 

Knowing risk factors can help, too. They include:

• Caregiver alcohol and/or drug abuse
• Domestic violence 
• Financial troubles
• Insufficient housing (substandard, overcrowded, homelessness)
• Public assistance
• Caregiver disability

The majority of perpetrators of abuse are a parent of the victim (77.5%). Most perpetrators (83%) are between the ages of 18 and 44. More than half (53%) are female, and 46.1% are male.

Those risk factors and numbers do not mean that a family with a high income (for example) never experiences abuse, but struggling with finances or a substance use disorder can raise the likelihood of maltreatment.

Raising Awareness

Raising awareness can shine a light on the problem. The Children’s Bureau, part of the U.S. Department of Health and Human Services, has a Child Welfare Information Gateway, with prevention and resource guides. 

There are long-term consequences of child abuse and neglect that not only affect the individual but society as a whole.

Abuse or neglect can interfere with a child’s brain development. Victims also may be more prone to a number of diseases and conditions, like diabetes, vision problems, malnutrition, cancers, stroke, and more.

Psychological problems like reduced cognitive skills, social difficulties, post-traumatic stress, and lowered self-esteem may also result.

Behaviorally, abuse can lead to unsafe sexual practices, juvenile delinquency, and continuing the cycle of mistreatment from one generation to the next.

Substance use is another potential outcome of abuse, possibly as a means to escape or self-medicate. Started at a younger age, that raises the likelihood of drug or alcohol addiction. That in turn can lead to a number of health problems including various diseases and cancers, a weakened immune system, and mental health problems.

Sources

acf.hhs.gov – Child Maltreatment 2019

mayoclinic.org – Child abuse

cdc.gov – Trends in U.S. Emergency Department Visits Related to Suspected or Confirmed Child Abuse and Neglect … 

childwelfare.gov – Risk Factors That Contribute to Child Abuse and Neglect

childwelfare.gov – April Is National Child Abuse Prevention Month 

childwelfare.gov – Long-Term Consequences of Child Abuse and Neglect

sunshinebehavioralhealth.com – Alcohol Awareness Month: Too Much Drink Can Do a Number on Your Immune System