Child Abuse: An Overview

Child Abuse Prevalence is Under Reported

Even the National Center on Child Abuse and Neglect, the primary organization responsible for collecting data on child abuse and neglect, states that the incidence numbers they report are underestimates.21 The reality is that all forms of child abuse are greatly under reported and underestimated in current research. Accurate statistics on the prevalence of abuse are impossible to gather at this point. The problems are under-recognition, under reporting, and a lack of one comprehensive definition of what constitutes abuse.4,7,18,19

In every state, the following people are required by law to report suspected abuse: Doctors; nurses; dentists; mental health professionals; social workers; teachers; day care workers; law enforcement personnel. In some states, clergy, foster parents, attorneys, and camp counselors also are required to report abuse. In about 18 states, any person who suspects abuse is required to report it.6,15,20,24

There is no more a way to determine by how much abuse is under reported than there is a way to determine how much abuse is occurring. Still, a look at several studies gives us a hint at the extent of the problem. In a ten-year review of medical examiners’ reports in North Carolina, it was found that state vital records under reported child deaths due to abuse by almost 60 percent.18 Goldman et al, report that “recognition rates by physicians in a variety of settings have been as low as 5 percent (i.e., the physician identifies abuse as a problem in only one abuse victim in twenty who presents for care)”.15 In a 10-year study of hospital emergency departments across the country, it was found that “child abuse accounted for 10.6% of all blunt trauma to patients younger than 5 years. Children injured by child abuse were significantly younger (mean, 12.8 vs 25.5 months) and were more likely to have preinjury medical history (53% vs 14.1%) and retinal hemorrhages (27.8% vs 0.06%) than children with unintentional injuries”.13

The reasons for the under reporting are a mixture of the obvious and the not so obvious. It’s obvious that victims almost never tell people about their abuse. They have very reasonable and rational fears of retaliation, as well as more complicated emotional reasons for not reporting.2,4,19 Victims of abuse often deny abuse even after it has been reported. Especially in cases of abuse in which no physical injury can be verified, the victim’s denial basically stops any CPS investigation in it’s tracks. It’s also obvious that it can be hard to tell if an injury is a result of abuse or a result of an honest accident.19,21 Still, given the number of people who are required to report abuse, it would seem that fewer children would fall through the cracks of the system.

Abused children don’t just show up in the doctor’s office or at school with injuries once in a blue moon. Their injuries are repeated, even chronic, and they are usually accompanied by obvious emotional and psychological effects. So why do they slip through the cracks? Three reasons: there is little enforcement of the mandatory reporting laws; people don’t think reporting abuse will help; our government doesn’t fund child welfare agencies nearly enough.

“…it costs $33,000 to hospitalize an abused child compared with $3,000 to provide an at-risk family with a home visitor to teach them parenting skills for one year.”25

It is very uncomfortable to accuse a person of abuse, so the cost of not telling should be made even more uncomfortable. On talk shows, people talk about how “terrible” it is to be accused of abusing a child and how children “manipulate” their parents by making accusations. On any given day you can hear parents describing how they are afraid to even discipline their children for fear of being reported to CPS for child abuse. It seems at times that people use that scenario as an excuse for not making a report of abuse. They don’t want to falsely accuse a parent. If a child is falsely accusing a caretaker of abuse, that family has problems which can only benefit from involvement with CPS, even if only to prove the parent’s or caretaker’s innocence and to get help for the accuser.

This last statement is probably a challenge to most of your beliefs about what CPS is capable of accomplishing, and research shows that CPS doesn’t even investigate almost 70% of reported and confirmed abuse.27 Still, it is your duty to report, and in many states it’s the law.20 When I think back over the past 5 years, every time I heard about CPS in the news in Illinois, it was in connection with some disastrous outcome or some scandal. All I can say is you have to have a higher calling to work for CPS. Compared with other similarly qualified professionals, CPS workers have larger caseloads, more bureaucracy to deal with, have more depressing cases, and make less money. Then they are crucified in the press whenever one of them screws up. Still, it is on the shoulders of CPS that we place the responsibility for the health of our abused and neglected children. We should double the number of CPS workers immediately and do it by hiring the best people we can find. To do that, we have to increase their pay across the board.

Child Abuse Introduction   |   Signs of Child Abuse
Child Abuse Statistics   |   It’s Under Reported
Effects of Child Abuse on Children: Abuse General
Effects of Child Abuse on Children: Child Sexual Abuse
Injuries to Children: Physical and Sexual Abuse
Effects of Child Abuse on Adults: Childhood Abuse
Effects of Child Abuse on Adults: Childhood Sexual Abuse
Definition of Physical Abuse   |   Signs of Physical Abuse
Definition of Sexual Abuse   |   Signs of Sexual Abuse
Definition of Child Neglect   |   Signs of Child Neglect
Definition of Emotional Abuse   |   Signs of Emotional Abuse
Abusers   |   Pedophiles
Child Physical Abuse and Corporal Punishment
Treatment for Child Abuse
Costs to Society
State Child Abuse Laws
Nationwide Crisis Line and Hotline Directory

Referring to this article:
“Child Abuse: An Overview” was written by C. J. Newton, MA, Learning Specialist and published in the Find (formerly Mental Health Journal in April, 2001.

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