Child Abuse

Child abuse or child maltreatment is physical, sexual, and/or psychological maltreatment or neglect of a child or children, especially by a parent or a caregiver. Child abuse may include any act or failure to act by a parent or a caregiver that results in actual or potential harm to a child, and can occur in a child’s home, or in the organizations, schools or communities the child interacts with.

The terms child abuse and child maltreatment are often used interchangeably, although some researchers make a distinction between them, treating child maltreatment as an umbrella term to cover neglect, exploitation, and trafficking.

Different jurisdictions have developed their own definitions of what constitutes child abuse for the purposes of removing children from their families or prosecuting a criminal charge.

Child Person Containing Abuse Rape Torture


The whole of recorded history contains references to acts that can be described as child abuse or child maltreatment, but professional inquiry into the topic is generally considered to have begun in the 1960s.[1] The July 1962 publication of the paper “The Battered Child-Syndrome” authored principally to pediatric psychiatrist C. Henry Kempe and published in The Journal of the American Medical Association represents the moment that child maltreatment entered mainstream awareness. Before the article’s publication, injuries to children—even repeated bone fractures—were not commonly recognized as the results of intentional trauma. Instead, physicians often looked for undiagnosed bone diseases or accepted parents’ accounts of accidental mishaps such as falls or assaults by neighborhood bullies.[2]:100–103

The study of child abuse and neglect emerged as an academic discipline in the early 1970s in the United States. Elisabeth Young-Bruehl maintains that despite the growing numbers of child advocates and interest in protecting children which took place, the grouping of children into “the abused” and the “non-abused” created an artificial distinction that narrowed the concept of children’s rights to simply protection from maltreatment, and blocked investigation of the ways in which children are discriminated against in society generally. Another effect of the way child abuse and neglect have been studied, according to Young-Bruehl, was to close off consideration of how children themselves perceive maltreatment and the importance they place on adults’ attitudes toward them. Young-Bruehl writes that when the belief in children’s inherent inferiority to adults is present in society, all children suffer whether or not their treatment is labeled as “abuse”.[2]:15–16


Definitions of what constitutes child abuse vary among professionals, between social and cultural groups, and across time.[3][4] The terms abuse and maltreatment are often used interchangeably in the literature.[5]:11Child maltreatment can also be an umbrella term covering all forms of child abuse and child neglect.[1] Defining child maltreatment depends on prevailing cultural values as they relate to children, child development, and parenting.[6] Definitions of child maltreatment can vary across the sectors of society which deal with the issue,[6] such as child protection agencies, legal and medical communities, public health officials, researchers, practitioners, and child advocates. Since members of these various fields tend to use their own definitions, communication across disciplines can be limited, hampering efforts to identify, assess, track, treat, and prevent child maltreatment.[5]:3[7]Shame Child Small Criticism Self-Criticism

In general, abuse refers to (usually deliberate) acts of commission while neglect refers to acts of omission.[1][8] Child maltreatment includes both acts of commission and acts of omission on the part of parents or caregivers that cause actual or threatened harm to a child.[1] Some health professionals and authors consider neglect as part of the definition of abuse, while others do not; this is because the harm may have been unintentional, or because the caregivers did not understand the severity of the problem, which may have been the result of cultural beliefs about how to raise a child.[9][10] Delayed effects of child abuse and neglect, especially emotional neglect, and the diversity of acts that qualify as child abuse, are also factors.[10]

The World Health Organization (WHO) defines child abuse and child maltreatment as “all forms of physical and/or emotional ill-treatment, sexual abuse, neglect or negligent treatment or commercial or other exploitation, resulting in actual or potential harm to the child’s health, survival, development or dignity in the context of a relationship of responsibility, trust or power.”[11] In the United States, the Centers for Disease Control and Prevention (CDC) uses the term child maltreatment to refer to both acts of commission (abuse), which include “words or overt actions that cause harm, potential harm, or threat of harm to a child”, and acts of omission (neglect), meaning “the failure to provide for a child’s basic physical, emotional, or educational needs or to protect a child from harm or potential harm”.[5]:11 The United States federal Child Abuse Prevention and Treatment Act defines child abuse and neglect as, at minimum, “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”.[12][13]


The World Health Organization distinguishes four types of child maltreatment: physical abuse; sexual abuse; emotional (or psychological) abuse; and neglect.[14]

Physical abuse

Among professionals and the general public, there is disagreement as to what behaviors constitute physical abuse of a child.[15] Physical abuse often does not occur in isolation, but as part of a constellation of behaviors including authoritarian control, anxiety-provoking behavior, and a lack of parental warmth.[16] The WHO defines physical abuse as:

Intentional use of physical force against the child that results in – or has a high likelihood of resulting in – harm for the child’s health, survival, development or dignity. This includes hitting, beating, kicking, shaking, biting, strangling, scalding, burning, poisoning and suffocating. Much physical violence against children in the home is inflicted with the object of punishing.[14]

Joan Durrant and Ron Ensom write that most physical abuse is physical punishment “in intent, form, and effect”.[17] Overlapping definitions of physical abuse and physical punishment of children highlight a subtle or non-existent distinction between abuse and punishment.[18] For instance, Paulo Sergio Pinheiro writes in the UN Secretary-General’s Study on Violence Against Children:

Corporal punishment involves hitting (‘smacking’, ‘slapping’, ‘spanking’) children, with the hand or with an implement – whip, stick, belt, shoe, wooden spoon, etc. But it can also involve, for example, kicking, shaking or throwing children, scratching, pinching, biting, pulling hair or boxing ears, forcing children to stay in uncomfortable positions, burning, scalding or forced ingestion (for example, washing children’s mouths out with soap or forcing them to swallow hot spices).[19]

Most nations with child abuse laws deem the deliberate infliction of serious injuries, or actions that place the child at obvious risk of serious injury or death, to be illegal. Bruises, scratches, burns, broken bones, lacerations — as well as repeated “mishaps,” and rough treatment that could cause physical injuries — can be physical abuse.[20] Multiple injuries or fractures at different stages of healing can raise suspicion of abuse.

The psychologist Alice Miller, noted for her books on child abuse, took the view that humiliations, spankings and beatings, slaps in the face, etc. are all forms of abuse, because they injure the integrity and dignity of a child, even if their consequences are not visible right away.[21]

Often, physical abuse as a child can lead to physical and mental difficulties in the future, including re-victimization, personality disorders, post-traumatic stress disorder, dissociative disorders, depression, anxiety, suicidal ideation, eating disorders, substance abuse, and aggression. Physical abuse in childhood has also been linked to homelessness in adulthood.[22]

Sexual abuse

Main article: Sexual Abuse

Child sexual abuse (CSA) is a form of child abuse in which an adult or older adolescent abuses a child for sexual stimulation.[23] Sexual abuse refers to the participation of a child in a sexual act aimed toward the physical gratification or the financial profit of the person committing the act.[20][24] Forms of CSA include asking or pressuring a child to engage in sexual activities (regardless of the outcome), indecent exposure of the genitals to a child, displaying pornography to a child, actual sexual contact with a child, physical contact with the child’s genitals, viewing of the child’s genitalia without physical contact, or using a child to produce child pornography.[23][25][26] Selling the sexual services of children may be viewed and treated as child abuse rather than simple incarceration.[27]

Effects of child sexual abuse on the victim(s) include guilt and self-blame, flashbacks, nightmares, insomnia, fear of things associated with the abuse (including objects, smells, places, doctor’s visits, etc.), self-esteem difficulties, sexual dysfunction, chronic pain, addiction, self-injury, suicidal ideation, somatic complaints, depression,[28] post-traumatic stress disorder,[29] anxiety,[30] other mental illnesses including borderline personality disorder[31] and dissociative identity disorder,[31] propensity to re-victimization in adulthood,[32] bulimia nervosa,[33] and physical injury to the child, among other problems.[34] Children who are the victims are also at an increased risk of sexually transmitted infections due to their immature immune systems and a high potential for mucosal tears during forced sexual contact.[35] Sexual victimization at a young age has been correlated with several risk factors for contracting HIV including decreased knowledge of sexual topics, increased prevalence of HIV, engagement in risky sexual practices, condom avoidance, lower knowledge of safe sex practices, frequent changing of sexual partners, and more years of sexual activity.[35]

In the United States, approximately 15% to 25% of women and 5% to 15% of men were sexually abused when they were children.[36][37][38] Most sexual abuse offenders are acquainted with their victims; approximately 30% are relatives of the child, most often brothers, sisters, fathers, mothers, uncles or cousins; around 60% are other acquaintances such as friends of the family, babysitters, or neighbours; strangers are the offenders in approximately 10% of child sexual abuse cases.[36] In over one-third of cases, the perpetrator is also a minor.[39]

In 1999 the BBC reported on the RAHI Foundation’s survey of sexual abuse in India, in which 76% of respondents said they had been abused as children, 40% of those stating the perpetrator was a family member.[40]

Psychological abuse

There are multiple definitions of child psychological abuse:

  • In 2013, the American Psychiatric Association (APA) added Child Psychological Abuse to the DSM-5, describing it as “nonaccidental verbal or symbolic acts by a child’s parent or caregiver that result, or have reasonable potential to result, in significant psychological harm to the child.”[41]
  • In 1995, APSAC defined it as: spurning, terrorizing, isolating, exploiting, corrupting, denying emotional responsiveness, or neglect” or “A repeated pattern of caregiver behavior or extreme incident(s) that convey to children that they are worthless, flawed, unloved, unwanted, endangered, or only of value in meeting another’s needs”[42]
  • In the United States, states laws vary, but most have laws against “mental injury”[43]
  • Some have defined it as the production of psychological and social defects in the growth of a child as a result of behavior such as loud yelling, coarse and rude attitude, inattention, harsh criticism, and denigration of the child’s personality.[20] Other examples include name-calling, ridicule, degradation, destruction of personal belongings, torture or killing of a pet, excessive criticism, inappropriate or excessive demands, withholding communication, and routine labeling or humiliation.[44]

In 2014, the APA stated that:[45]

  • “Childhood psychological abuse [is] as harmful as sexual or physical abuse.”
  • “Nearly 3 million U.S. children experience some form of [psychological] maltreatment annually.”
  • Psychological maltreatment is “the most challenging and prevalent form of child abuse and neglect.”
  • “Given the prevalence of childhood psychological abuse and the severity of harm to young victims, it should be at the forefront of mental health and social service training”

In 2015, additional research confirmed these 2014 statements of the APA.[46][47]

Victims of emotional abuse may react by distancing themselves from the abuser, internalizing the abusive words, or fighting back by insulting the abuser. Emotional abuse can result in abnormal or disrupted attachment development, a tendency for victims to blame themselves (self-blame) for the abuse, learned helplessness, and overly passive behavior.[44]


Child neglect is the failure of a parent or other person with responsibility for the child, to provide needed food, clothing, shelter, medical care, or supervision to the degree that the child’s health, safety or well-being may be threatened with harm. Neglect is also a lack of attention from the people surrounding a child, and the non-provision of the relevant and adequate necessities for the child’s survival, which would be a lack of attention, love, and nurturing.[20]

Some observable signs of child neglect include: the child is frequently absent from school, begs or steals food or money, lacks needed medical and dental care, is consistently dirty, or lacks sufficient clothing for the weather.[48] The 2010 Child Maltreatment Report (NCANDS), a yearly United States federal government report based on data supplied by state Child Protective Services (CPS) Agencies in the U.S., states, “as in prior years, neglect was the most common form of maltreatment”.[49]

Neglectful acts can be divided into six sub-categories:[8]

  • Supervisory neglect: characterized by the absence of a parent or guardian which can lead to physical harm, sexual abuse or criminal behavior;
  • Physical neglect: characterized by the failure to provide the basic physical necessities, such as a safe and clean home;
  • Medical neglect: characterized by the lack of providing medical care;
  • Emotional neglect: characterized by a lack of nurturance, encouragement and support;
  • Educational neglect: characterized by the caregivers lack to provide an education and additional resources to actively participate in the school system; and
  • Abandonment: when the parent or guardian leaves a child alone for a long period of time without a babysitter.

Neglected children may experience delays in physical and psychosocial development, possibly resulting in psychopathology and impaired neuropsychological functions including executive function, attention, processing speed, language, memory and social skills.[50] Researchers investigating maltreated children have repeatedly found that neglected children in foster and adoptive populations manifest different emotional and behavioral reactions to regain lost or secure relationships and are frequently reported to have disorganized attachments and a need to control their environment. Such children are not likely to view caregivers as being a source of safety, and instead typically show an increase in aggressive and hyperactive behaviors which may disrupt healthy or secure attachment with their adopted parents. These children have apparently learned to adapt to an abusive and inconsistent caregiver by becoming cautiously self-reliant, and are often described as glib, manipulative and disingenuous in their interactions with others as they move through childhood.[51] Children who are victims of neglect have a more difficult time forming and maintaining relationships, such as romantic or friendship, later in life due to the lack of attachment they had in their earlier stages of life.


Child abuse can result in immediate adverse physical effects but it is also strongly associated with developmental problems[52] and with many chronic physical and psychological effects, including subsequent ill-health, including higher rates of chronic conditions, high-risk health behaviors and shortened lifespan.[53][54]

Maltreated children may grow up to be maltreating adults.[55][56][57] A 1991 source reported that studies indicate that 90 percent of maltreating adults were maltreated as children.[58] Almost 7 million American infants receive child care services, such as day care, and much of that care is poor.[52]


Child abuse can cause a range of emotional effects. Children who are constantly ignored, shamed, terrorized or humiliated suffer at least as much, if not more, than if they are physically assaulted.[59] According to the Joyful Heart Foundation, brain development of the child is greatly influenced and responds to the experiences with families, caregivers, and the community.[60] Abused children can grow up experiencing insecurities, low self-esteem, and lack of development. Many abused children experience ongoing difficulties with trust, social withdrawal, trouble in school, and forming relationships.[59]

Babies and other young children can be affected differently by abuse than their older counterparts. Babies and pre-school children who are being emotionally abused or neglected may be overly affectionate towards strangers or people they haven’t known for very long.[61] They can lack confidence or become anxious, appear to not have a close relationship with their parent, exhibit aggressive behavior or act nasty towards other children and animals.[61] Older children may use foul language or act in a markedly different way to other children at the same age, struggle to control strong emotions, seem isolated from their parents, lack social skills or have few, if any, friends.[61]

Children can also experience reactive attachment disorder (RAD). RAD is defined as markedly disturbed and developmentally inappropriate social relatedness, that usually begins before the age of 5 years.[62] RAD can present as a persistent failure to start or respond in a developmentally appropriate fashion to most social situations. The long-term impact of emotional abuse has not been studied widely, but recent studies have begun to document its long-term consequences. Emotional abuse has been linked to increased depression, anxiety, and difficulties in interpersonal relationships (Spertus, Wong, Halligan, & Seremetis, 2003).[62]Victims of child abuse and neglect are more likely to commit crimes as juveniles and adults.[63]

Domestic violence also takes its toll on children; although the child is not the one being abused, the child witnessing the domestic violence is greatly influential as well. Research studies conducted such as the “Longitudinal Study on the Effects of Child Abuse and Children’s Exposure to Domestic Violence”, show that 36.8% of children engage in felony assault compared to the 47.5% of abused/assaulted children. Research has shown that children exposed to domestic violence increases the chances of experienced behavioral and emotional problems (depression, irritability, anxiety, academic problems, and problems in language development).[64]

Overall, emotional effects caused by child abuse and even witnessing abuse can result in long-term and short-term effects that ultimately affect a child’s upbringing and development.

Rib fractures in an infant secondary to child abuse


The immediate physical effects of abuse or neglect can be relatively minor (bruises or cuts) or severe (broken bones, hemorrhage, or even death). In some cases the physical effects are temporary; however, the pain and suffering they cause a child should not be discounted. Rib fractures may be seen with physical abuse, and if present may increase suspicion of abuse, but are found in a small minority of children with maltreatment-related injuries.[65][66]

The long-term impact of child abuse and neglect on physical health and development can be:

  • Shaken baby syndrome. Shaking a baby is a common form of child abuse that often results in permanent neurological damage (80% of cases) or death (30% of cases).[67]Damage results from intracranial hypertension (increased pressure in the skull) after bleeding in the brain, damage to the spinal cord and neck, and rib or bone fractures.[68]
  • Impaired brain development. Child abuse and neglect have been shown, in some cases, to cause important regions of the brain to fail to form or grow properly, resulting in impaired development.[69][70] These alterations in brain maturation have long-term consequences for cognitive, language, and academic abilities.[71]
  • Poor physical health. In addition to possible immediate adverse physical effects, household dysfunction and childhood maltreatment are strongly associated with many chronic physical and psychological effects, including subsequent ill-health in childhood,[72] adolescence[73] and adulthood, with higher rates of chronic conditions, high-risk health behaviors and shortened lifespan.[53][54] Adults who experienced abuse or neglect during childhood are more likely to suffer from physical ailments such as allergies, arthritis, asthma, bronchitis, high blood pressure, and ulcers.[54][74][75][76] There may be a higher risk of developing cancer later in life,[77] as well as possible immune dysfunction.[78]
  • Exposure to violence during childhood is associated with shortened telomeres and with reduced telomerase activity.[79] The increased rate of telomere length reduction correlates to a reduction in lifespan of 7 to 15 years.[78]
  • Data from a recent study supports previous findings that specific neurobiochemical changes are linked to exposure to violence and abuse, several biological pathways can possibly lead to the development of illness, and certain physiological mechanisms can moderate how severe illnesses become in patients with past experience with violence or abuse.[80]
  • Recent studies give evidence of a link between stress occurring early in life and epigenetic modifications that last into adulthood.[70][81]

Adverse Childhood Experiences Study

Possible ways for adverse childhood experiences such as abuse and neglect to influence health and well-being throughout the lifespan, according to the Centers for Disease Control and Prevention.[82]

The Adverse Childhood Experiences Study is a long-running investigation into the relationship between childhood adversity, including various forms of abuse and neglect, and health problems in later life. The initial phase of the study was conducted in San Diego, California from 1995 to 1997.[82] The World Health Organization summarizes the study as: “childhood maltreatment and household dysfunction contribute to the development – decades later – of the chronic diseases that are the most common causes of death and disability in the United States… A strong relationship was seen between the number of adverse experiences (including physical and sexual abuse in childhood) and self-reports of cigarette smoking, obesity, physical inactivity, alcoholism, drug abuse, depression, attempted suicide, sexual promiscuity and sexually transmitted diseases in later life.”[14]

A long-term study of adults retrospectively reporting adverse childhood experiences including verbal, physical and sexual abuse, as well as other forms of childhood trauma found 25.9% of adults reported verbal abuse as children, 14.8% reported physical abuse, and 12.2% reported sexual abuse. Data from the Centers for Disease Control and Prevention (CDC) and Behavioral Risk Factor Surveillance System corroborate these high rates.[83] There is a high correlation between the number of different adverse childhood experiences (A.C.E.s) and risk for poor health outcomes in adults including cancer, heart attack, mental illness, reduced longevity drug and alcohol abuse.[84] An anonymous self-reporting survey of Washington State students finds 6–7% of 8th, 10th and 12th grade students actually attempt suicide. Rates of depression are twice as high. Other risk behaviors are even higher.[85] There is a relationship between child physical and sexual abuse and suicide.[86] For legal and cultural reasons as well as fears by children of being taken away from their parents most childhood abuse goes unreported and unsubstantiated.

It has been discovered that childhood abuse can lead to the addiction of drugs and alcohol in adolescence and adult life. Studies show that any type of abuse experienced in childhood can cause neurological changes making an individual more prone to addictive tendencies. A significant study examined 900 court cases of children who had experienced sexual and physical abuse along with neglect. The study found that a large sum of the children who were abused are now currently addicted to alcohol. This case study outlines how addiction is a significant effect of childhood abuse.[87]


Children who have a history of neglect or physical abuse are at risk of developing psychiatric problems,[88][89] or a disorganized attachment style.[90][91][92] In addition, children who experience child abuse or neglect are 59% more likely to be arrested as juveniles, 28% more likely to be arrested as adults, and 30% more likely to commit violent crime.[93] Disorganized attachment is associated with a number of developmental problems, including dissociative symptoms,[94] as well as anxiety, depressive, and acting out symptoms.[95][96] A study by Dante Cicchetti found that 80% of abused and maltreated infants exhibited symptoms of disorganized attachment.[97][98] When some of these children become parents, especially if they suffer from posttraumatic stress disorder (PTSD), dissociative symptoms, and other sequelae of child abuse, they may encounter difficulty when faced with their infant and young children’s needs and normative distress, which may in turn lead to adverse consequences for their child’s social-emotional development.[99][100] Additionally, children may find it difficult to feel empathy towards themselves or others, which may cause them to feel alone and unable to make friends.[64] Despite these potential difficulties, psychosocial intervention can be effective, at least in some cases, in changing the ways maltreated parents think about their young children.[101]

Victims of childhood abuse also suffer from different types of physical health problems later in life. Some reportedly suffer from some type of chronic head, abdominal, pelvic, or muscular pain with no identifiable reason.[102] Even though the majority of childhood abuse victims know or believe that their abuse is, or can be, the cause of different health problems in their adult life, for the great majority their abuse was not directly associated with those problems, indicating that sufferers were most likely diagnosed with other possible causes for their health problems, instead of their childhood abuse.[102] One long-term study found that up to 80% of abused people had at least one psychiatric disorder at age 21, with problems including depression, anxiety, eating disorders, and suicide attempts.[103] One Canadian hospital found that between 36% and 76% of women mental health outpatients had been sexually abused, as had 58% of women and 23% of men schizophrenic inpatients.[104] A recent study has discovered that a crucial structure in the brain’s reward circuits is compromised by childhood abuse and neglect, and predicts Depressive Symptoms later in life.[105]

In the case of 23 of the 27 illnesses listed in the questionnaire of a French INSEE survey, some statistically significant correlations were found between repeated illness and family traumas encountered by the child before the age of 18 years. According to Georges Menahem, the French sociologist who found out these correlations by studying health inequalities, these relationships show that inequalities in illness and suffering are not only social. Health inequality also has its origins in the family, where it is associated with the degrees of lasting affective problems (lack of affection, parental discord, the prolonged absence of a parent, or a serious illness affecting either the mother or father) that individuals report having experienced in childhood.[106]

Many children who have been abused in any form develop some sort of psychological problem. These problems may include: anxiety, depression, eating disorders, OCD, co-dependency, or even a lack of human connections. There is also a slight tendency for children who have been abused to become child abusers themselves. In the U.S. in 2013, of the 294,000 reported child abuse cases only 81,124 received any sort of counseling or therapy. Treatment is greatly important for abused children.[107]

On the other hand, there are some children who are raised in child abuse, but who manage to do unexpectedly well later in life regarding the preconditions. Such children have been termed dandelion children, as inspired from the way that dandelions seem to prosper irrespective of soil, sun, drought, or rain.[108] Such children (or currently grown-ups) are of high interest in finding factors that mitigate the effects of child abuse.


Child abuse is a complex phenomenon with multiple causes.[109] No single factor can be identified as to why some adults behave abusively or neglectfully toward children. The World Health Organization (WHO) and the International Society for Prevention of Child Abuse and Neglect (ISPCAN) identify multiple factors at the level of the individual, their relationships, their local community, and their society at large, that combine to influence the occurrence of child maltreatment. At the individual level, such factors include age, sex, and personal history, while at the level of society, factors contributing to child maltreatment include cultural norms encouraging harsh physical punishment of children, economic inequality, and the lack of social safety nets.[14] WHO and ISPCAN state that understanding the complex interplay of various risk factors is vital for dealing with the problem of child maltreatment.[14]

The American psychoanalyst Elisabeth Young-Bruehl maintains that harm to children is justified and made acceptable by widely held beliefs in children’s inherent subservience to adults, resulting in a largely unacknowledged prejudice against children she terms childism. She contends that such prejudice, while not the immediate cause of child maltreatment, must be investigated in order to understand the motivations behind a given act of abuse, as well as to shed light on societal failures to support children’s needs and development in general.[2]:4–6 Founding editor of the International Journal of Children’s Rights, Michael Freeman, also argues that the ultimate causes of child abuse lie in prejudice against children, especially the view that human rights do not apply equally to adults and children. He writes, “the roots of child abuse lie not in parental psycho-pathology or in socio-environmental stress (though their influences cannot be discounted) but in a sick culture which denigrates and depersonalizes, which reduces children to property, to sexual objects so that they become the legitimate victims of both adult violence and lust”.[110]

A girl who was burned during religious violence in Orissa, India.

Parents who physically abuse their spouses are more likely than others to physically abuse their children.[111] However, it is impossible to know whether marital strife is a cause of child abuse, or if both the marital strife and the abuse are caused by tendencies in the abuser.[111] Sometimes, parents set expectations for their child that are clearly beyond the child’s capability. When parents’ expectations are far beyond what is appropriate to the child (e.g., preschool children who are expected to be totally responsible for self-care or provision of nurturance to parents) the resulting frustration caused by the child’s non-compliance is believed to function as a contributory if not necessary cause of child abuse.[112]

Most acts of physical violence against children are undertaken with the intent to punish.[113] In the United States, interviews with parents reveal that as many as two thirds of documented instances of physical abuse begin as acts of corporal punishment meant to correct a child’s behavior, while a large-scale Canadian study found that three quarters of substantiated cases of physical abuse of children have occurred within the context of physical punishment.[114] Other studies have shown that children and infants who are spanked by parents are several times more likely to be severely assaulted by their parents or suffer an injury requiring medical attention. Studies indicate that such abusive treatment often involves parents attributing conflict to their child’s willfulness or rejection, as well as “coercive family dynamics and conditioned emotional responses”.[17] Factors involved in the escalation of ordinary physical punishment by parents into confirmed child abuse may be the punishing parent’s inability to control their anger or judge their own strength, and the parent being unaware of the child’s physical vulnerabilities.[16]

Some professionals argue that cultural norms that sanction physical punishment are one of the causes of child abuse, and have undertaken campaigns to redefine such norms.[115][116][117]

Children resulting from unintended pregnancies are more likely to be abused or neglected.[118][119] In addition, unintended pregnancies are more likely than intended pregnancies to be associated with abusive relationships,[120] and there is an increased risk of physical violence during pregnancy.[121] They also result in poorer maternal mental health,[121] and lower mother-child relationship quality.[121]

There is some limited evidence that children with moderate or severe disabilities are more likely to be victims of abuse than non-disabled children.[122] A study on child abuse sought to determine: the forms of child abuse perpetrated on children with disabilities; the extent of child abuse; and the causes of child abuse of children with disabilities. A questionnaire on child abuse was adapted and used to collect data in this study. Participants comprised a sample of 31 pupils with disabilities (15 children with vision impairment and 16 children with hearing impairment) selected from special schools in Botswana. The study found that the majority of participants were involved in doing domestic chores. They were also sexually, physically and emotionally abused by their teachers. This study showed that children with disabilities were vulnerable to child abuse in their schools.[123]

Substance abuse can be a major contributing factor to child abuse. One U.S. study found that parents with documented substance abuse, most commonly alcohol, cocaine, and heroin, were much more likely to mistreat their children, and were also much more likely to reject court-ordered services and treatments.[124] Another study found that over two-thirds of cases of child maltreatment involved parents with substance abuse problems. This study specifically found relationships between alcohol and physical abuse, and between cocaine and sexual abuse.[125] Also parental stress caused by substance increases the likelihood of the minor exhibiting internalizing and externalizing behaviors.[126] Although the abuse victim does not always realize the abuse is wrong, the internal confusion can lead to chaos. Inner anger turns to outer frustration. Once aged 17/18, drink and drugs are used to numb the hurt feelings, nightmares and daytime flashbacks. Acquisitive crimes to pay for the chemicals are inevitable if the victim is unable to find employment.[127]

Unemployment and financial difficulties are associated with increased rates of child abuse.[128] In 2009 CBS News reported that child abuse in the United States had increased during the economic recession. It gave the example of a father who had never been the primary care-taker of the children. Now that the father was in that role, the children began to come in with injuries.[129]

Parental mental health has also been seen as a factor towards child maltreatment.[130] According to a recent Children’s Health Watch study, mother’s positive symptoms of depression display a greater rate of food insecurity, poor health care for their children, and greater number of hospitalizations.[131]


Child abuse is an international phenomenon. Poverty and substance abuse are common social problems worldwide, and no matter the location, show a similar trend in the correlation to child abuse. Although these factors can likely contribute to child maltreatment, differences in cultural perspectives play a significant role in the treatment of children. Laws may influence the population’s views on what is acceptable – for example whether child corporal punishment is legal or not.

A study conducted by members from several Baltic and Eastern European countries, together with specialists from the United States, examined the causes of child abuse in the countries of Latvia, Lithuania, Macedonia and Moldova. In these countries, respectively, 33%, 42%, 18% and 43% of children reported at least one type of child abuse.[132]According to their findings, there was a series of correlations between the potential risk factors of parental employment status, alcohol abuse, and family size within the abuse ratings.[133] In three of the four countries, parental substance abuse was considerably correlated with the presence of child abuse, and although it was a lower percentage, still showed a relationship in the fourth country (Moldova).[133] Each country also showed a connection between the father not working outside of the home and either emotional or physical child abuse.[133] After the fall of the communism regime, some positive changes have followed with regard to tackling child abuse. While there is a new openness and acceptance regarding parenting styles and close relationships with children, child abuse still remains a serious concern. Although it is now more publicly recognized, it has certainly not ceased to exist. While controlling parenting may be less of a concern, financial difficulty, unemployment, and substance abuse still remain to be dominating factors in child abuse throughout Eastern Europe.[133]

These cultural differences can be studied from many perspectives. Most importantly, overall parental behavior is genuinely different in various countries. Each culture has their own “range of acceptability,” and what one may view as offensive, others may seem as tolerable. Behaviors that are normal to some may be viewed as abusive to others, all depending on the societal norms of that particular country.[133]

Asian parenting perspectives, specifically, hold different ideals from American culture. Many have described their traditions as including physical and emotional closeness that ensures a lifelong bond between parent and child, as well as establishing parental authority and child obedience through harsh discipline.[134] Balancing disciplinary responsibilities within parenting is common in many Asian cultures, including China, Japan, Singapore, Vietnam and Korea.[134] To some cultures, forceful parenting may be seen as abuse, but in other societies such as these, the use of force is looked at as a reflection of parental devotion.[134]

The differences in these cultural beliefs demonstrate the importance of examining all cross-cultural perspectives when studying the concept of child abuse.

As of 2006, between 25,000 and 50,000 children in Kinshasa, Democratic Republic of the Congo, had been accused of witchcraft and abandoned.[135] In Malawi it is also common practice to accuse children of witchcraft and many children have been abandoned, abused and even killed as a result.[136] In the Nigeria, Akwa Ibom State and Cross River Stateabout 15,000 children were branded as witches.[137]

In April 2015, public broadcasting showed that rate of child abuse in South Korea had increased to 13% compared with the previous year, and 75% of attackers were the children’s own parents.[138]

Disclosure and diagnosis

Suspicion for physical abuse is recommended when an injury occurs in a child who does not yet move independently, injuries are in unusual areas, more than one injury at different stages of healing, symptoms of possible head trauma, and injuries to more than one body system.[139]

In many jurisdictions, abuse that is suspected, not necessarily proven, requires reporting to child protection agencies, such as the Child Protection Services in the United States. Recommendations for healthcare workers, such as primary care providers and nurses, who are often suited to encounter suspected abuse are advised to firstly determine the child’s immediate need for safety. A private environment away from suspected abusers is desired for interviewing and examining. Leading statements that can distort the story are avoided. As disclosing abuse can be distressing and sometimes even shameful, reassuring the child that he or she has done the right thing by telling and that they are not bad or that the abuse was not their fault helps in disclosing more information. Dolls are sometimes used to help explain what happened. For the suspected abusers, it is also recommended to use a nonjudgmental, nonthreatening attitude towards them and to withhold expressing shock, in order to help disclose information.[140]


A key part of child abuse work is assessment.

A few methods of assessment include projective tests, clinical interviews, and behavioral observations.

  • Projective tests allow for the child to express themselves through drawings, stories, or even descriptions in order to get help establish an initial understanding of the abuse that took place
  • Clinical interviews are comprehensive interviews performed by professionals to analyze the mental state of the one being interviewed
  • Behavioral observation gives an insight into things that trigger a child’s memory of the abuse through observation of the child’s behavior when interacting with other adults or children

A particular challenge arises where child protection professionals are assessing families where neglect is occurring. Professionals conducting assessments of families where neglect is taking place are said to sometimes make the following errors:[141]

  • Failure to ask the right types of question, including
    • Whether neglect is occurring;
    • Why neglect is occurring;
    • What the situation is like for the child;
    • Whether improvements in the family are likely to be sustained;
    • What needs to be done to ensure the long-term safety of the child?


A support-group structure is needed to reinforce parenting skills and closely monitor the child’s well-being. Visiting home nurse or social-worker visits are also required to observe and evaluate the progress of the child and the caretaking situation.

The support-group structure and visiting home nurse or social-worker visits are not mutually exclusive. Many studies have demonstrated that the two measures must be coupled together for the best possible outcome.[142]

Studies show that if health and medical care personnel in a structured way ask parents about important psychosocial risk factors in connection with visiting pediatric primary care and, if necessary, offering the parent help may help prevent child maltreatment.

Children’s school programs regarding “good touch … bad touch” can provide children with a forum in which to role-play and learn to avoid potentially harmful scenarios. Pediatricians can help identify children at risk of maltreatment and intervene with the aid of a social worker or provide access to treatment that addresses potential risk factors such as maternal depression.[145] Videoconferencing has also been used to diagnose child abuse in remote emergency departments and clinics.[146] Unintended conception increases the risk of subsequent child abuse, and large family size increases the risk of child neglect.[119] Thus, a comprehensive study for the National Academy of Sciences concluded that affordable contraceptive services should form the basis for child abuse prevention. “The starting point for effective child abuse programming is pregnancy planning,” according to an analysis for US Surgeon General C. Everett Koop.

Child sexual abuse prevention programmes were developed in the United States of America during the 1970s and originally delivered to children. Programmes delivered to parents were developed in the 1980s and took the form of one-off meetings, two to three hours long. In the last 15 years, web-based programmes have been developed.

April has been designated Child Abuse Prevention Month in the United States since 1983.[155] U.S. President Barack Obama continued that tradition by declaring April 2009 Child Abuse Prevention Month.[156] One way the Federal government of the United States provides funding for child-abuse prevention is through Community-Based Grants for the Prevention of Child Abuse and Neglect (CBCAP).[157]

Resources for child-protection services are sometimes limited. According to Hosin (2007), “a considerable number of traumatized abused children do not gain access to protective child-protection strategies.”[158] Briere (1992) argues that only when “lower-level violence” of children ceases to be culturally tolerated will there be changes in the victimization and police protection of children.[159]

Findings from recent research support the importance of family relationships in the trajectory of a child’s life: family-targeted interventions are important for improving long-term health, particularly in communities that are socioeconomically disadvantaged.[160]


A number of treatments are available to victims of child abuse.[161] However, children who experience childhood trauma do not heal from abuse easily.[162] There are focused cognitive behavioral therapy, first developed to treat sexually abused children, is now used for victims of any kind of trauma. It targets trauma-related symptoms in children including post-traumatic stress disorder (PTSD), clinical depression and anxiety. It also includes a component for non-offending parents. Several studies have found that sexually abused children undergoing TF-CBT improved more than children undergoing certain other therapies. Data on the effects of TF-CBT for children who experienced only non-sexual abuse was not available as of 2006.[161] The purpose of dealing with the thoughts and feelings associated with the trauma is to deal with nightmares, flashbacks and other intrusive experiences that might be spontaneously brought on by any number of discriminative stimuli in the environment or in the individual’s brain. This would aid the individual in becoming less fearful of specific stimuli that would arouse debilitating fear, anger, sadness or other negative emotion. In other words, the individual would have some control or mastery over those emotions.[51]

Parenting training can prevent child abuse in the short term, and help children with a range of emotional, conduct and behavioural challenges, but there is insufficient evidence about whether it treat parents who already abuse their children.[163]

Abuse-focused cognitive behavioral therapy was designed for children who have experienced physical abuse. It targets externalizing behaviors and strengthens prosocial behaviors. Offending parents are included in the treatment, to improve parenting skills/practices. It is supported by one randomized study.[161]

Rational Cognitive Emotive Behavior Therapy consists of ten distinct but interdependent steps. These steps fall into one of three theoretical orientations (i.e., rational or solution focused, cognitive emotive, and behavioral) and are intended to provide abused children and their adoptive parents with positive behavior change, corrective interpersonal skills, and greater control over themselves and their relationships. They are: 1) determining and normalizing thinking and behaving, 2) evaluating language, 3) shifting attention away from problem talk 4) describing times when the attachment problem isn’t happening, 5) focusing on how family members “successfully” solve problematic attachment behavior; 6) acknowledging “unpleasant emotions” (i.e., angry, sad, scared) underlying negative interactional patterns, 7) identifying antecedents (controlling conditions) and associated negative cognitive emotive connections in behavior (reciprocal role of thought and emotion in behavioral causation), 8) encouraging previously abused children to experience or “own” negative thoughts and associated aversive emotional feelings, 9) modeling and rewarding positive behavior change (with themselves and in relationships), and 10) encouraging and rewarding thinking and behaving differently. This type of therapy shifts victims thoughts away from the bad and changes their behavior.[51]

Parent–child interaction therapy was designed to improve the child-parent relationship following the experience of domestic violence. It targets trauma-related symptoms in infants, toddlers, and preschoolers, including PTSD, aggression, defiance, and anxiety. It is supported by two studies of one sample.[161]

Other forms of treatment include group therapy, play therapy, and art therapy. Each of these types of treatment can be used to better assist the client, depending on the form of abuse they have experienced. Play therapy and art therapy are ways to get children more comfortable with therapy by working on something that they enjoy (coloring, drawing, painting, etc.). The design of a child’s artwork can be a symbolic representation of what they are feeling, relationships with friends or family, and more. Being able to discuss and analyze a child’s artwork can allow a professional to get a better insight of the child.[164]


Child abuse is complex and difficult to study. According to the World Health Organization (WHO), estimates of the rates of child maltreatment vary widely by country, depending on how child maltreatment is defined, the type of maltreatment studied, the scope and quality of data gathered, and the scope and quality of surveys that ask for self-reports from victims, parents, and caregivers. Despite these limitations, international studies show that a quarter of all adults report experiencing physical abuse as children, and that 1 in 5 women and 1 in 13 men report experiencing childhood sexual abuse. Emotional abuse and neglect are also common childhood experiences.[165]

As of 2014, an estimated 41,000 children under 15 are victims of homicide each year. The WHO states that this number underestimates the true extent of child homicide; a significant proportion of child deaths caused by maltreatment are incorrectly attributed to unrelated factors such as falls, burns, and drowning. Also, girls are particularly vulnerable to sexual violence, exploitation and abuse in situations of armed conflict and refugee settings, whether by combatants, security forces, community members, aid workers, or others.[165]

United States

The National Research Council wrote in 1993 that “…the available evidence suggests that child abuse and neglect is an important, prevalent problem in the United States […] Child abuse and neglect are particularly important compared with other critical childhood problems because they are often directly associated with adverse physical and mental health consequences in children and families”.[166]:6

In 2012, Child Protective Services (CPS) agencies estimated that approximately 9 out of 1000 children in the United States were victims of child maltreatment. Most (78%) were victims of neglect. Physical abuse, sexual abuse, and other types of maltreatment, were less common, making up 18%, 9%, and 11% of cases, respectively (“other types” included emotional abuse, parental substance abuse, and inadequate supervision). However, CPS reports may underestimate the true scope of child maltreatment. A non-CPS study estimated that one in four children experience some form of maltreatment in their lifetimes, according to the Centers for Disease Control and Prevention (CDC).[167]

In Feb 2017, American Public Health Association published a Washington University study estimating 37% of American children experiencing a child protective services investigation by age 18 (or 53% if African American).[168]

David Finkelhor tracked Child Maltreatment Report (NCANDS) data from 1990 to 2010. He states that sexual abuse had declined 62% from 1992 to 2009. The long-term trend for physical abuse was also down by 56% since 1992. The decline in sexual abuse adds to an already substantial positive long-term trend. He states: “It is unfortunate that information about the trends in child maltreatment are not better publicized and more widely known. The long-term decline in sexual and physical abuse may have important implications for public policy.”[169]

Douglas J. Besharov, the first Director of the U.S. Center on Child Abuse and Neglect, states “the existing laws are often vague and overly broad”[170] and there is a “lack of consensus among professionals and Child Protective Services (CPS), personnel about what the terms abuse and neglect mean”.[171] Susan Orr, former head of the United States Children’s Bureau U.S. Department of Health and Services Administration for Children and Families, 2001–2007, states that “much that is now defined as child abuse and neglect does not merit governmental interference”.[172]

A child abuse fatality occurs when a child’s death is the result of abuse or neglect, or when abuse or neglect are contributing factors to a child’s death. In the United States, 1,730 children died in 2008 due to factors related to abuse; this is a rate of 2 per 100,000 U.S. children.[173] Family situations which place children at risk include moving, unemployment, and having non-family members living in the household. A number of policies and programs have been put in place in the U.S. to try to better understand and to prevent child abuse fatalities, including: safe-haven laws, child fatality review teams, training for investigators, shaken baby syndrome prevention programs, and child abuse death laws which mandate harsher sentencing for taking the life of a child.[174]

A one off judicial decision found that parents failing to sufficiently speak the national standard language at home to their children was a form of child abuse by a judge in a child custody matter.[175]


Child labor

Child labor refers to the employment of children in any work that deprives children of their childhood, interferes with their ability to attend regular school, or is mentally, physically, socially or morally dangerous and harmful.[176] The International Labour Organization considers such labor to be a form of exploitation and abuse of children. Child labor refers to those occupations which infringe the development of children (due to the nature of the job or lack of appropriate regulation) and does not include age appropriate and properly supervised jobs in which minors may participate. According to ILO, globally, around 215 million children work, many full-time. Many of these children do not go to school, do not receive proper nutrition or care, and have little or no time to play. More than half of them are exposed to the worst forms of child labor, such as child prostitution, drug trafficking, armed conflicts and other hazardous environments. There exist several international instruments protecting children from child labor, including the Minimum Age Convention, 1973 and the Worst Forms of Child Labour Convention.

More girls under 16 work as domestic workers than any other category of child labor, often sent to cities by parents living in rural poverty such as in restaveks in Haiti.

Child trafficking

A child soldier in El Salvador, 1990.

Child trafficking is the recruitment, transportation, transfer, harbouring or receipt of children for the purpose of exploitation. Children are trafficked for purposes such as of commercial sexual exploitation, bonded labour, camel jockeying, child domestic labour, drug couriering, child soldiering, illegal adoptions, begging. It is difficult to obtain reliable estimates concerning the number of children trafficked each year, primarily due to the covert and criminal nature of the practice. The International Labour Organization estimates that 1.2 million children are trafficked each year.

In Switzerland, between the 1850s and the mid-20th century, hundreds of thousands of children were forcefully removed from their parents by the authorities, and sent to work on farms, living with new families. These children usually came from poor or single parents, and were used as free labor by farmers, and were known as contract children or Verdingkinder.

Other policies of organized child abduction and selling of children in the 20th century include the Lost children of Francoism (in Spain) and the disappearance of the children of Mothers of the Plaza de Mayo (in Argentina).

Forced adoption

In some Western countries throughout the 20th century and until the 1970s, children from certain ethnic minority origins were forcefully removed from their families and communities by state and church authorities and forced to “assimilate”. Such policies include the Stolen Generations (in Australia for Australian Aboriginal and Torres Strait Islander children) and the Canadian Indian residential school system (in Canada for First Nations, Métis and Inuit), with such children often suffering severe abuse.

Gender based violence against girls


Under natural conditions, mortality rates for girls under five are slightly lower than boys for biological reasons. However, after birth, neglect and diverting resources to male children can lead to some countries having a skewed ratio with more boys than girls, with such practices killing an approximate 230,000 girls under five in India each year. While sex-selective abortion is more common among the higher income population, who can access medical technology, abuse after birth, such as infanticide and abandonment, is more common among the lower income population. Female infanticide in Pakistan is a common practice. Methods proposed to deal with the issue are baby hatches to drop off unwanted babies and safe-haven laws, which decriminalize abandoning babies unharmed.

Female genital mutilation

Female genital mutilation (FGM) is defined by the World Health Organization (WHO) as “all procedures that involve partial or total removal of the external female genitalia, or other injury to the female genital organs for non-medical reasons.” It is practiced mainly in 28 countries in Africa, and in parts of Asia and the Middle East. FGM is mostly found in a geographical area ranging across Africa, from east to west – from Somalia to Senegal, and from north to south – from Egypt to Tanzania. FGM is most often carried out on young girls aged between infancy and 15 years. FGM is classified into four types, of which type 3 – infibulation – is the most extreme form. The consequences of FGM include physical, emotional and sexual problems, and include serious risks during childbirth. In Western countries this practice is illegal and considered a form of child abuse. The countries which choose to ratify the Istanbul Convention, the first legally binding instrument in Europe in the field of violence against women and domestic violence, are bound by its provisions to ensure that FGM is criminalized. In Australia, all states and territories have outlawed FGM. In the United States, performing FGM on anyone under the age of 18 became illegal in 1996 with the Federal Prohibition of Female Genital Mutilation Act.

Sexual initiation of virgins

A tradition often performed in some regions in Africa involves a man initiating a girl into womanhood by having sex with her, usually after her first period, in a practice known as “sexual cleansing“. The rite can last for three days and there is an increased risk of contracting sexually transmitted infections as the ritual requires condoms not be worn.[214]

Breast ironing

The practice of using hot stones or other implements to flatten the breast tissue of pubescent girls is widespread in Cameroon and exists elsewhere in West Africa as well. It is believed to have come with that diaspora to Britain, where the government declared it a form of child abuse and said that it could be prosecuted under existing assault laws.

Violence against girl students

In some parts of the world, girls are strongly discouraged from attending school, which some argue is because they fear losing power to women. They are sometimes attacked by members of the community if they do so. In parts of South Asia, girls schools are set on fire by vigilante groups. Such attacks are common in Afghanistan and Pakistan. Notable examples include the kidnapping of hundreds of female students in Chibook in 2014 and Dapchi in 2018.

Child marriage

A child marriage is a marriage in which one or both participants are minors, often before the age of puberty. Child marriages are common in many parts of the world, especially in parts of Asia and Africa. The United Nations considers those below the age of 18 years to be incapable of giving valid consent to marriage and therefore regards such marriages as a form of forced marriage; and that marriages under the age of majority have significant potential to constitute a form of child abuse. In many countries, such practices are lawful or — even where laws prohibit child marriage — often unenforced. India has more child brides than other nation, with 40% of the world total. The countries with the highest rates of child marriage are: Niger (75%), Central African Republic and Chad (68%), and Bangladesh (66%).

Bride kidnapping is common in Central Asia

Bride kidnapping, also known as marriage by abduction or marriage by capture, has been practiced around the world and throughout history, and sometimes involves minors. It is still practiced in parts of Central Asia, the Caucasus region, and some African countries. In Ethiopia, marriage by abduction is widespread, and many young girls are kidnapped this way. In most countries, bride kidnapping, in which a male abducts the female he wants to marry, is considered a criminal offense rather than a valid form of marriage. In many cases, the groom also rapes his kidnapped bride, in order to prevent her from returning to her family due to shame.

Sacred prostitution often involves girls being pledged to priests or those of higher castes, such as the practice of devadasi in South Asia or fetish slaves in West Africa.

Violence against children with superstitious accusations

Customary beliefs in witchcraft are common in many parts of the world, even among the educated. Anthropologists have argued that the disabled are often viewed as bad omens as raising a child with a disability in such communities are an insurmountable hurdle. This is found in Africa and in communities in the Amazon. Children who are specifically at risk include orphans, street-children, albinos, disabled children, children who are unusually gifted, children who were born prematurely or in unusual positions, twins, children of single mothers and children who express gender identity issues. Consequently, those accused of being a witch are ostracized and subjected to punishment, torture and even murdered, often by being buried alive or left to starve. For example, in southern Ethiopia, children with physical abnormalities are considered to be ritually impure or mingi, the latter are believed to exert an evil influence upon others, so disabled infants have traditionally been disposed of without a proper burial. Reports by UNICEF, UNHCR, Save The Children and Human Rights Watch have highlighted the violence and abuse towards children accused of witchcraft in Africa. A 2010 UNICEF report describes children as young as eight being burned, beaten and even killed as punishment for suspected witchcraft. The report notes that accusations against children are a recent phenomenon; women and the elderly were formerly more likely to be accused. UNICEF attributes the rise in vulnerable children being abused in this way to increased urbanization and social disruption caused by war.


One of the most challenging ethical dilemmas arising from child abuse relates to the parental rights of abusive parents or caretakers with regard to their children, particularly in medical settings.In the United States, the 2008 New Hampshire case of Andrew Bedner drew attention to this legal and moral conundrum. Bedner, accused of severely injuring his infant daughter, sued for the right to determine whether or not she remain on life support; keeping her alive, which would have prevented a murder charge, created a motive for Bedner to act that conflicted with the apparent interests of his child. Bioethicists Jacob M. Appeland Thaddeus Mason Pope recently argued, in separate articles, that such cases justify the replacement of the accused parent with an alternative decision-maker.

Child abuse also poses ethical concerns related to confidentiality, as victims may be physically or psychologically unable to report abuse to authorities. Accordingly, many jurisdictions and professional bodies have made exceptions to standard requirements for confidentiality and legal privileges in instances of child abuse. Medical professionals, including doctors, therapists, and other mental health workers typically owe a duty of confidentiality to their patients and clients, either by law or the standards of professional ethics, and cannot disclose personal information without the consent of the individual concerned. This duty conflicts with an ethical obligation to protect children from preventable harm. Accordingly, confidentiality is often waived when these professionals have a good faith suspicion that child abuse or neglect has occurred or is likely to occur and make a report to local child protection authorities. This exception allows professionals to breach confidentiality and make a report even when children or their parents or guardians have specifically instructed to the contrary. Child abuse is also a common exception to physician–patient privilege: a medical professional may be called upon to testify in court as to otherwise privileged evidence about suspected child abuse despite the wishes of children or their families. Some child abuse policies in Western countries have been criticized both by some conservatives, who claim such policies unduly interfere in the privacy of the family, and by some feminists of the left wing, who claim such policies disproportionally target and punish disadvantaged women who are often themselves in vulnerable positions. There has also been concern that ethnic minority families are disproportionally targeted.


There are organizations at national, state, and county levels in the United States that provide community leadership in preventing child abuse and neglect. The National Alliance of Children’s Trust Funds and Prevent Child Abuse America are two national organizations with member organizations at the state level.

Many investigations into child abuse are handled on the local level by Child Advocacy Centers. Started over 25 years ago at what is now known as the National Children’s Advocacy Center in Huntsville, Alabama by District Attorney Robert “Bud” Cramer these multi-disciplinary teams have met to coordinate their efforts so that cases of child abuse can be investigated quickly and efficiently, ultimately reducing trauma to the child and garnering better convictions. These Child Advocacy Centers (known as CACs) have standards set by the National Children’s Alliance.

Other organizations focus on specific prevention strategies. The National Center on Shaken Baby Syndrome focuses its efforts on the specific issue of preventing child abuse that is manifested as shaken baby syndrome. Mandated reporter training is a program used to prevent ongoing child abuse.

NICHD, also known as the National Institute of Child Health & Human Development is a broad organization, but helps victims of child abuse through one of its branches. Through the Child Development and Behavior (CDB) Branch, NICHD raises awareness efforts by supporting research projects to better understand the short- and long-term impacts of child abuse and neglect. They provide programs and observe National Child Abuse Prevention Month every April since 1984. The United States Children’s Bureau leads activities for the Month, including the release of updated statistics about child abuse and neglect, candlelight vigils, and fundraisers to support prevention activities and treatment for victims. The Bureau also sponsors a “Blue Ribbon Campaign,” in which people wear blue ribbons in memory of children who have died from abuse, or in honor of individuals and organizations that have taken important steps to prevent child abuse and neglect.


  1. McCoy, M.L.; Keen, S.M. (2013). “Introduction”Child Abuse and Neglect (2 ed.). New York: Psychology Press. pp. 3–22. ISBN978-1-84872-529-4OCLC863824493Archived from the original on 23 February 2017. Retrieved 4 February 2016.
  2. Young-Bruehl, Elisabeth (2012). Childism: Confronting Prejudice Against Children. New Haven, Connecticut: Yale University Press. ISBN978-0-300-17311-6.
  3. Coghill, D.; Bonnar, S.; Duke, S.; Graham, J.; Seth, S. (2009). Child and Adolescent PsychiatryOxford University Press. p. 412. ISBN978-0-19-923499-8Archived from the original on 24 February 2017. Retrieved 8 March 2016.
  4. Wise, Deborah (2011). “Child Abuse Assessment”. In Hersen, Michel (ed.). Clinician’s Handbook of Child Behavioral AssessmentAcademic Press. p. 550. ISBN978-0-08-049067-0Archived from the original on 23 February 2017. Retrieved 8 March 2016.
  5. Leeb, R.T.; Paulozzi, L.J.; Melanson, C.; Simon, T.R.; Arias, I. (January 2008). Child Maltreatment Surveillance: Uniform Definitions for Public Health and Recommended Data Elements, Version 1.0(PDF). Atlanta, Georgia: Centers for Disease Control and Prevention, National Center for Injury Prevention and Control. Archived(PDF) from the original on 29 August 2017.
  6. Conley, Amy (2010). “2. Social Development, Social Investment, and Child Welfare”. In Midgley, James; Conley, Amy (eds.). Social Work and Social Development: Theories and Skills for Developmental Social WorkOxford University Press. pp. 53–55. ISBN978-0-19-045350-3Archived from the original on 24 February 2017. Retrieved 8 March 2016.
  7. Bonnie S. Fisher; Steven P. Lab, eds. (2010). Encyclopedia of Victimology and Crime PreventionSage Publications. pp. 86–92. ISBN978-1-4522-6637-4Archived from the original on 23 February 2017. Retrieved 8 March 2016.
  8. “What is Child Abuse and Neglect?”. Australian Institute of Family Studies. September 2015. Archivedfrom the original on 15 September 2015.
  9. Mehnaz, Aisha (2013). “Child Neglect: Wider Dimensions”. In RN Srivastava; Rajeev Seth; Joan van Niekerk (eds.). Child Abuse and Neglect: Challenges and Opportunities. JP Medical Ltd. p. 101. ISBN978-9350904497Archived from the original on 23 February 2017. Many do not consider neglect a kind of abuse especially in a condition where the parents are involved as it is often considered unintentional and arise from a lack of knowledge or awareness. This may be true in certain circumstances and often it results in insurmountable problem being faced by the parents.
  10. Friedman, E; Billick, SB (June 2015). “Unintentional child neglect: literature review and observational study”. Psychiatric Quarterly86 (2): 253–9. doi:10.1007/s11126-014-9328-0PMID25398462[T]he issue of child neglect is still not well understood, partially because child neglect does not have a consistent, universally accepted definition. Some researchers consider child neglect and child abuse to be one in the same [sic], while other researchers consider them to be conceptually different. Factors that make child neglect difficult to define include: (1) Cultural differences; motives must be taken into account because parents may believe they are acting in the child’s best interests based on cultural beliefs (2) the fact that the effect of child abuse is not always immediately visible; the effects of emotional neglect specifically may not be apparent until later in the child’s development, and (3) the large spectrum of actions that fall under the category of child abuse.
  11. “Child abuse and neglect by parents and other caregivers”(PDF)World Health Organization. p. 3. Archived(PDF) from the original on 4 March 2016. Retrieved 8 March 2016.
  12. Herrenkohl RC (2005). “The definition of child maltreatment: from case study to construct”. Child Abuse and Neglect29 (5): 413–24. doi:10.1016/j.chiabu.2005.04.002PMID15970317.
  13. “Definitions of Child Abuse and Neglect in Federal Law” Children’s Bureau, Administration for Children and Families, U.S. Department of Health and Human Services. Archived from the original on 16 May 2016. Retrieved 20 February 2016.
  14. World Health Organization and International Society for Prevention of Child Abuse and Neglect (2006). “1. The nature and consequences of child maltreatment”(PDF)Preventing child maltreatment: a guide to taking action and generating evidence. Geneva, Switzerland. ISBN978-9241594363.
  15. Noh Anh, Helen (1994). “Cultural Diversity and the Definition of Child Abuse”, in Barth, R.P. et al., Child Welfare Research Review, Columbia University Press, 1994, p. 28. ISBN0-231-08074-3
  16. “Corporal Punishment”Archived 31 October 2010 at the Wayback MachineInternational Encyclopedia of the Social Sciences. 2008.
  17. Durrant, Joan; Ensom, Ron (4 September 2012). “Physical punishment of children: lessons from 20 years of research”Canadian Medical Association Journal184 (12): 1373–1377. doi:10.1503/cmaj.101314PMC3447048PMID22311946.
  18. Saunders, Bernadette; Goddard, Chris (2010). Physical Punishment in Childhood: The Rights of the Child. Chichester, West Sussex, UK: John Wiley & Sons. pp. 2–3. ISBN978-0-470-72706-5.
  19. Pinheiro, Paulo Sérgio (2006). “Violence against children in the home and family”(PDF)World Report on Violence Against Children. Geneva, Switzerland: United Nations Secretary-General’s Study on Violence Against Children. ISBN978-92-95057-51-7Archived from the original on 11 January 2016.
  20. Theoklitou D, Kabitsis N, Kabitsi A (2012). “Physical and emotional abuse of primary school children by teachers”. Child Abuse Negl36 (1): 64–70. doi:10.1016/j.chiabu.2011.05.007PMID22197151.
  21. “Alice Miller – Child Abuse and Mistreatment”Archived from the original on 9 January 2016. Retrieved 5 March 2015.
  22. “Effects of child abuse and neglect for adult survivors”. 16 June 2014. Archived from the original on 10 November 2016. Retrieved 19 December 2016.
  23. “Child Sexual Abuse”Medline Plus. U.S. National Library of Medicine. 2 April 2008. Archived from the original on 5 December 2013.
  24. “Guidelines for psychological evaluations in child protection matters. Committee on Professional Practice and Standards, APA Board of Professional Affairs”. The American Psychologist54 (8): 586–93. August 1999. doi:10.1037/0003-066X.54.8.586PMID10453704Abuse, sexual (child): generally defined as contacts between a child and an adult or other person significantly older or in a position of power or control over the child, where the child is being used for sexual stimulation of the adult or other person.
  25. Martin J, Anderson J, Romans S, Mullen P, O’Shea M (1993). “Asking about child sexual abuse: methodological implications of a two stage survey”. Child Abuse & Neglect17 (3): 383–92. doi:10.1016/0145-2134(93)90061-9PMID8330225.
  26. NSPCC. “Search”NSPCC. Archived from the original on 13 February 2010. Retrieved 5 March 2015.
  27. Brown, Patricia Leigh (23 May 2011). “In Oakland, Redefining Sex Trade Workers as Abuse Victims”The New York TimesArchived from the original on 26 May 2011. Retrieved 24 May 2011Once viewed as criminals and dispatched to juvenile centers, where treatment was rare, sexually exploited youths are increasingly seen as victims of child abuse, with a new focus on early intervention and counseling.
  28. Roosa MW, Reinholtz C, Angelini PJ (1999). “The relation of child sexual abuse and depression in young women: comparisons across four ethnic groups”Journal of Abnormal Child Psychology27 (1): 65–76. PMID10197407. Archived from the original on 14 December 2004.
  29. Widom CS (1999). “Post-traumatic stress disorder in abused and neglected children grown up”American Journal of Psychiatry156 (8): 1223–1229. doi:10.1176/ajp.156.8.1223 (inactive 20 August 2019). PMID10450264.
  30. Levitan R. D.; Rector N. A.; Sheldon T.; Goering P. (2003). “Childhood adversities associated with major depression and/or anxiety disorders in a community sample of Ontario: Issues of co-morbidity and specificity”. Depression and Anxiety17 (1): 34–42. doi:10.1002/da.10077PMID12577276.
  31. Coons, Philip M. (August 1994). “Confirmation of Childhood Abuse in Child and Adolescent Cases of Multiple Personality Disorder and Dissociative Disorder Not Otherwise Specified”The Journal of Nervous and Mental Disease182 (8): 461–4. doi:10.1097/00005053-199408000-00007PMID8040657Archived from the original on 10 July 2015. Retrieved 5 March 2015.
  32. Messman-Moore, T. L.; Long, P. J. (2000). “Child Sexual Abuse and Revictimization in the Form of Adult Sexual Abuse, Adult Physical Abuse, and Adult Psychological Maltreatment”. Journal of Interpersonal Violence15 (5): 489–502. doi:10.1177/088626000015005003.
  33. Hornor, G (2010). “Child sexual abuse: consequences and implications”. Journal of Pediatric Health Care24(6): 358–364. doi:10.1016/j.pedhc.2009.07.003PMID20971410.
  34. Dinwiddie S, Heath AC, Dunne MP, Bucholz KK, Madden PA, Slutske WS, Bierut LJ, Statham DB, Martin NG (2000). “Early sexual abuse and lifetime psychopathology: a co-twin-control study”. Psychological Medicine30(1): 41–52. doi:10.1017/S0033291799001373PMID10722174.
  35. Thornton, Clifton P.; Veenema, Tener Goodwin (2015). “Children seeking refuge: A review of the escalating humanitarian crisis of child sexual abuse and HIV/AIDS in Latin America”. Journal of the Association of Nurses in AIDS Care26 (4): 432–442. doi:10.1016/j.jana.2015.01.002PMID25769757.
  36. Whealin, Julia (23 February 2016). “Child Sexual Abuse”. National Center for Post Traumatic Stress Disorder, US Department of Veterans Affairs. Archived from the original on 8 December 2016.
  37. Finkelhor D (1994). “Current information on the scope and nature of child sexual abuse”(PDF)The Future of Children4 (2): 31–53. doi:10.2307/1602522JSTOR1602522PMID7804768Archived(PDF)from the original on 13 October 2008.
  38. Gorey KM, Leslie DR (April 1997). “The prevalence of child sexual abuse: integrative review adjustment for potential response and measurement biases”. Child Abuse & Neglect21 (4): 391–8. CiteSeerX10.1.1.465.1057doi:10.1016/S0145-2134(96)00180-9PMID9134267.
  39. Finkelhor, David; Richard Ormrod; Mark Chaffin (2009). “Juveniles Who Commit Sex Offenses Against Minors”(PDF)Washington, DC: Office of Juvenile Justice and Delinquency Prevention. Office of Justice Programs, Department of JusticeArchived(PDF) from the original on 16 February 2010. Retrieved 25 February 2012.
  40. “India’s hidden incest”BBC News. 22 January 1999. Archived from the original on 8 May 2013.
  41. Donald Black (1 February 2014). DSM-5® Guidebook: The Essential Companion to the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition. p. 423. ISBN978-1-58562-465-2.
  42. John E. B. Myers (2011). The APSAC Handbook on Child Maltreatment. SAGE Publications Inc. pp. 126–130ISBN978-1-4129-6681-8.
  43. “Child Abuse Laws State-by-State”findLawArchived from the original on 8 October 2015. Retrieved 25 September 2015.
  44. “Child Abuse”. The National Center for Victims of Crime. Archived from the original on 27 July 2011.
  45. “Childhood Psychological Abuse as Harmful as Sexual or Physical Abuse”. The American Psychological Association. 8 October 2014. Archived from the original on 8 December 2015.
  46. McGill University. “Different types of child abuse: Similar consequences”Science NewsArchived from the original on 18 December 2015. Retrieved 11 December 2015.
  47. Loudenback, Jeremy (25 October 2015). “Is Emotional Abuse as Harmful as Physical and Sexual Abuse?”Chronicle of Social ChangeArchived from the original on 22 December 2015. Retrieved 11 December 2015.
  48. “Chronic Neglect”(PDF). Archived from the original(PDF) on 11 October 2007. Retrieved 10 October2012.
  49. “Child Maltreatment 2010: Summary of Key Findings”(PDF). Children’s Bureau, Child Welfare Information Gateway, Protecting Children Strengthening Families. Archived(PDF) from the original on 16 September 2012.
  50. “Neurocognitive impacts for children of poverty and neglect”. July 2012. Archived from the original on 31 January 2013. Retrieved 24 December 2012.
  51. Golden J.A., Prather W. (2009). “A behavioral perspective of childhood trauma and attachment issues: toward alternative treatment approaches for children with a history of abuse”. International Journal of Behavioral and Consultation Therapy5: 56–74. doi:10.1037/h0100872.
  52. Cohn Jonathan (2011). The Two Year Window.” (Cover story)”New Republic242 (18): 10–13. Archived from the original on 10 September 2015.
  53. Middlebrooks, J.S.; Audage, N.C. (2008). The Effects of Childhood Stress on Health Across the Lifespan(PDF). Atlanta, Georgia (USA): Centers for Disease Control and Prevention, National Center for Injury Prevention and Control. Archived from the original(PDF) on 5 February 2016.
  54. Dolezal, T.; McCollum, D.; Callahan, M. (2009). Hidden Costs in Health Care: The Economic Impact of Violence and Abuse. Academy on Violence and Abuse.
  55. Thornberry TP, Henry KL (2013). “Intergenerational continuity in maltreatment”J Abnorm Child Psychol41(4): 555–569. doi:10.1007/s10802-012-9697-5PMC3640695PMID23192742.
  56. Ertem IO, Leventhal JM, Dobbs S (2000). “Intergenerational continuity of child physical abuse: how good is the evidence?”. Lancet356 (9232): 814–9. doi:10.1016/S0140-6736(00)02656-8PMID11022929.
  57. Thornberry TP, Knight KE, Lovegrove PJ (2012). “Does maltreatment beget maltreatment? A systematic review of the intergenerational literature”Trauma, Violence, & Abuse13 (3): 135–52. doi:10.1177/1524838012447697PMC4035025PMID22673145.
  58. Starr RH, Wolfe DA (1991). The Effects of Child Abuse and Neglect (pp. 1–33). New York: The Guilford Press. ISBN978-0-89862-759-6
  59. “Emotional Abuse”American Humane Association. Archived from the original on 22 April 2015.
  60. “” Retrieved 22 January 2018.
  61. “Emotional abuse: Signs, symptoms and effects”NSPCCArchived from the original on 26 April 2015.
  62. “Reactive attachment disorder”Archived from the original on 11 May 2015. (subscription required)
  63. “Impact of child abuse”Adults Surviving Child Abuse (ASCA). Archived from the original on 24 April 2015. Retrieved 21 April 2015.
  64. “Behind Closed Doors: The Impact of Domestic Violence on Children”(PDF)UNICEF. 2006.
  65. Kemp AM, Dunstan F, Harrison S, Morris S, Mann M, Rolfe K, Datta S, Thomas DP, Sibert JR, Maguire S (2008). “Patterns of skeletal fractures in child abuse: systematic review”BMJ337 (oct02 1): a1518. doi:10.1136/bmj.a1518PMC2563260PMID18832412.
  66. Lee, Joseph Jonathan; Gonzalez-Izquierdo, Arturo; Gilbert, Ruth (31 October 2012). “Risk of Maltreatment-Related Injury: A Cross-Sectional Study of Children under Five Years Old Admitted to Hospital with a Head or Neck Injury or Fracture”PLoS ONE7 (10): e46522. Bibcode:2012PLoSO…746522Ldoi:10.1371/journal.pone.0046522ISSN1932-6203PMC3485294PMID23118853.
  67. Morad Y, Wygnansky-Jaffe T, Levin AV (2010). “Retinal haemorrhage in abusive head trauma”. Clin Exp Ophthalmol38 (5): 514–520. doi:10.1111/j.1442-9071.2010.02291.xPMID20584025.
  68. “Shaken Baby Syndrome information page”. National Institute of Neurological Disorders and Stroke. 14 February 2014. Archived from the original on 29 May 2014.
  69. De Bellis MD, Thomas LA (2003). “Biologic findings of post-traumatic stress disorder and child maltreatment”. Curr Psychiatry Rep5 (2): 108–17. doi:10.1007/s11920-003-0027-zPMID12685990.
  70. Raabe FJ, Spengler D (7 August 2013). “Epigenetic risk factors in PTSD and depression”Frontiers in Psychiatry4 (80): 80. doi:10.3389/fpsyt.2013.00080PMC3736070PMID23966957.
  71. Tiffany Watts-English T, Fortson BL, Gibler N, Hooper SR, De Bellis MD Journal of Social Issues 2006 Volume 62, Issue 4, pages 717–736 doi=10.1111/j.1540-4560.2006.00484.x “Archived copy”(PDF)Archived(PDF) from the original on 24 December 2012. Retrieved 29 May 2014.
  72. Flaherty EG; Thompson R; Litrownik AJ; et al. (December 2006). “Effect of early childhood adversity on child health”. Arch Pediatr Adolesc Med160 (12): 1232–8. doi:10.1001/archpedi.160.12.1232PMID17146020.
  73. Flaherty EG, Thompson R, Dubowitz H, et al Adverse childhood experiences and child health in early adolescence. JAMA Pediatr. 2013 Jul;167(7):622-9. doi=10.1001/jamapediatrics.2013.22 PMID23645114
  74. Springer KW, Sheridan J, Kuo D, Carnes M (2007). “Long-term physical and mental health consequences of childhood physical abuse: results from a large population-based sample of men and women”Child Abuse Negl31 (5): 517–30. doi:10.1016/j.chiabu.2007.01.003PMC3031095PMID17532465.
  75. Long-Term Consequences of Child Abuse and Neglect. Child Welfare Information Gateway, U.S. Department of Health and Human Services 2013. FactsheetArchived 13 November 2010 at the Wayback Machine
  76. Felitti VJ, Anda RF, Nordenberg D, Williamson DF, Spitz AM, Edwards V, Koss MP, Marks JS (1998). “Relationship of childhood abuse and household dysfunction to many of the leading causes of death in adults. The Adverse Childhood Experiences (ACE) Study”. American Journal of Preventive Medicine14 (4): 245–58. doi:10.1016/S0749-3797(98)00017-8PMID9635069.
  77. Fuller-Thomson E, Brennenstuhl S (July 2009). “Making a link between childhood physical abuse and cancer: results from a regional representative survey”. Cancer115 (14): 3341–50. doi:10.1002/cncr.24372PMID19472404.
  78. Kolassa, Iris – Tatjana (2012). “Biological memory of childhood maltreatment – current knowledge and recommendations for future research”(PDF)Ulmer Volltextserver – Institutional Repository der Universität Ulm1262 (1): 93–100. Bibcode:2012NYASA1262…93Sdoi:10.1111/j.1749-6632.2012.06617.xPMID22823440Archived(PDF) from the original on 27 May 2014. Retrieved 30 March 2014.
  79. Shalev I, Moffitt TE, Sugden K, Williams B, Houts RM, Danese A, Mill J, Arseneault L, Caspi A (2013). “Exposure to violence during childhood is associated with telomere erosion from 5 to 10 years of age: a longitudinal study”Mol. Psychiatry18 (5): 576–81. doi:10.1038/mp.2012.32PMC3616159PMID22525489.
  80. Keeshin BR, Cronholm PF, Strawn JR. Physiologic changes associated with violence and abuse exposure: An examination of related medical conditions. Trauma, Violence, & Abuse, 2012; 13(1): 41-56
  81. Matosin N, Cruceanu C, Binder EB (February 2017). “Preclinical and Clinical Evidence of DNA Methylation Changes in Response to Trauma and Chronic Stress”Chronic Stress (Thousand Oaks, Calif.) (Review). 1: 247054701771076. doi:10.1177/2470547017710764PMC5831952PMID29503977.
  82. Division of Violence Prevention (12 December 2017). “The Adverse Childhood Experiences (ACE) Study” Centers for Disease Control and Prevention. Archived from the original on 31 December 2015. Retrieved 31 January 2016.
  83. “Adverse Childhood Experiences Reported by Adults — Five States, 2009”Archived from the original on 11 March 2015. Retrieved 5 March 2015.
  84. “Adverse Childhood Experiences (ACE) Study -Child Maltreatment-Violence Prevention-Injury Center-CDC”. 12 December 2017. Archived from the original on 19 May 2014. Retrieved 5 March 2015.
  85. “Washington State Healthy Youth Survey 2010 Analytic Report”(PDF) (Report). Washington State Department of Health. June 2011. Archived from the original(PDF) on 20 January 2015.
  86. Miller AB; et al. (2013). “The Relation Between Child Maltreatment and Adolescent Suicidal Behavior: A Systematic Review and Critical Examination of the Literature”Clin Child Fam Psychol Rev16 (2): 146–72. doi:10.1007/s10567-013-0131-5PMC3724419PMID23568617.
  87. Enoch, Marry-Anne (2011). “The role of early life stress as a predictor for alcohol and drug dependence”Psychopharmacology214 (1): 17–31. doi:10.1007/s00213-010-1916-6PMC3005022PMID20596857.
  88. Gauthier L, Stollak G, Messé L, Aronoff J (July 1996). “Recall of childhood neglect and physical abuse as differential predictors of current psychological functioning”. Child Abuse & Neglect20 (7): 549–59. doi:10.1016/0145-2134(96)00043-9PMID8832112.
  89. Malinosky-Rummell R, Hansen DJ (July 1993). “Long-term consequences of childhood physical abuse”Psychological Bulletin114 (1): 68–79. doi:10.1037/0033-2909.114.1.68PMID8346329.
  90. Lyons-Ruth, K.; Jacobvitz, D. (1999). “Attachment disorganization: unresolved loss, relational violence and lapses in behavioral and attentional strategies”. In Cassidy, J.; Shaver, P. (eds.). Handbook of Attachment. New York: Guilford Press. pp. 520–554.
  91. Solomon, J.; George, C., eds. (1999). Attachment Disorganization. New York: Guilford Press. ISBN978-1-57230-480-2.[
  92. Main, M.; Hesse, E. (1990). “Parents’ Unresolved Traumatic Experiences are related to infant disorganized attachment status”. In Greenberg, M.T.; Ciccehetti, D; Cummings, E.M. (eds.). Attachment in the Preschool Years: Theory, Research, and Intervention. University of Chicago Press. pp. 161–184.
  93. “Child Abuse Statistics”Childhelp. Archived from the original on 12 November 2014. Retrieved 5 March2015.
  94. Carlson EA (August 1998). “A prospective longitudinal study of attachment disorganization/disorientation”. Child Development69 (4): 1107–28. doi:10.1111/j.1467-8624.1998.tb06163.xJSTOR1132365PMID9768489.
  95. Lyons-Ruth K (February 1996). “Attachment relationships among children with aggressive behavior problems: the role of disorganized early attachment patterns”. Journal of Consulting and Clinical Psychology64 (1): 64–73. CiteSeerX10.1.1.463.4585doi:10.1037/0022-006X.64.1.64PMID8907085.
  96. Lyons-Ruth K, Alpern L, Repacholi B (April 1993). “Disorganized infant attachment classification and maternal psychosocial problems as predictors of hostile-aggressive behavior in the preschool classroom”. Child Development64 (2): 572–85. doi:10.2307/1131270JSTOR1131270PMID8477635.
  97. Carlson, V.; et al. (1995). “Finding order in disorganization: Lessons from research on maltreated infants’ attachments to their caregivers”. In Cicchetti, D.; Carlson, V. (eds.). Child Maltreatment: Theory and research on the causes and consequences of child abuse and neglect. Cambridge University Press. pp. 135–157.
  98. Cicchetti, D.; et al. (1990). “An organizational perspective on attachment beyond infancy”. In Greenberg, M.; Cicchetti, D; MCummings, M. (eds.). Attachment in the Preschool Years. University of Chicago Press. pp. 3–50. ISBN978-0-226-30629-2.
  99. Schechter DS, Coates SW, Kaminer T, Coots T, Zeanah CH, Davies M, Schonfeld IS, Marshall RD, Liebowitz MR, Trabka KA, McCaw JE, Myers MM (2008). “Distorted maternal mental representations and atypical behavior in a clinical sample of violence-exposed mothers and their toddlers”Journal of Trauma and Dissociation9 (2): 123–149. doi:10.1080/15299730802045666PMC2577290PMID18985165.
  100. Schechter DS, Zygmunt A, Coates SW, Davies M, Trabka K, McCaw J, Kolodji A, Robinson J (2007). “Caregiver traumatization adversely impacts young children’s mental representations of self and others”Attachment & Human Development9 (3): 187–205. doi:10.1080/14616730701453762PMC2078523PMID18007959.
  101. Schechter DS, Myers MM, Brunelli SA, Coates SW, Zeanah CH, Davies M, Grienenberger JF, Marshall RD, McCaw JE, Trabka KA, Liebowitz MR (2006). “Traumatized mothers can change their minds about their toddlers: Understanding how a novel use of video feedback supports positive change of maternal attributions”Infant Mental Health Journal27 (5): 429–448. doi:10.1002/imhj.20101PMC2078524PMID18007960.
  102. Takele Hamnasu, MBA. Impact of Childhood Abuse on Adult Health. Amberton University.[
  103. “Factsheets”childwelfare.govArchived from the original on 13 November 2010.
  104. “Childhood Sexual Abuse: A Mental Health Issue”. Here to Help. Archived from the original on 5 October 2012. Retrieved 24 December 2012.
  105. Hanson, Jamie L; Hariri, Ahmad R; Williamson, Douglas E (2015). “Blunted Ventral Striatum Development in Adolescence Reflects Emotional Neglect and Predicts Depressive Symptoms”Biological Psychiatry78 (9): 598–605. doi:10.1016/j.biopsych.2015.05.010PMC4593720PMID26092778Emotional neglect is associated with multiple negative outcomes, particularly increased risk for depression. Motivated by increasing evidence of reward-related ventral striatum (VS) dysfunction in depression, we investigated the role of developmental changes in VS activity on the emergence of depressive symptomatology as a function of emotional neglect. … We found that greater levels of emotional neglect were associated with blunted development of reward-related VS activity.
  106. “Study of Living Conditions 1986–1987” INSEE survey with a sample of 13–154 individuals, cf. Menahem G., “Problèmes de l’enfance, statut social et santé des adultes”, IRDES, biblio No 1010, pp. 59–63, Paris.
  107. “National Statistics on Child Abuse”National Children’s Alliance. Archived from the original on 2 May 2014.
  108. Ellis, Bruce J.; Boyce, W. Thomas (2008). “Biological Sensitivity to Context”. Current Directions in Psychological Science17 (3): 183–187. doi:10.1111/j.1467-8721.2008.00571.x.
  109. Fontana VJ (October 1984). “The maltreatment syndrome of children”. Pediatric Annals13 (10): 736–44. PMID6504584.
  110. Freeman, Michael (1997). “Beyond conventions—towards empowerment”The Moral Status of Children: Essays on the Rights of the Child. Netherlands: Martinus Nijhoff Publishers. p. 76. ISBN978-9041103772Archived from the original on 13 January 2016.
  111. Ross, S. (1996). “Risk of physical abuse to children of spouse abusing parents”. Child Abuse & Neglect20 (7): 589–598. doi:10.1016/0145-2134(96)00046-4.
  112. Twentyman CT, Plotkin RC (1982). “Unrealistic expectations of parents who maltreat their children: an educational deficit that pertains to child development”. J Clin Psychol38 (3): 497–503. doi:10.1002/1097-4679(198207)38:3<497::aid-jclp2270380306>;2-xPMID7107912.
  113. Durrant, Joan (March 2008). “Physical Punishment, Culture, and Rights: Current Issues for Professionals”Journal of Developmental & Behavioral Pediatrics29 (1): 55–66. doi:10.1097/DBP.0b013e318135448aPMID18300726Archived from the original on 5 February 2016.
  114. Gershoff, Elizabeth T. (Spring 2010). “More Harm Than Good: A Summary of Scientific Research on the Intended and Unintended Effects of Corporal Punishment on Children”Law & Contemporary Problems73(2): 31–56. Archived from the original on 20 June 2017.
  115. Haeuser, A. A. (1990). “Banning parental use of physical punishment: Success in Sweden”. International Congress on Child Abuse and Neglect. Hamburg[.
  116. Barth, Richard (1994). Child Welfare Research Review, Volume 1. Columbia University Press. pp. 49–50. ISBN978-0-231-08075-0. Retrieved 25 May 2012.
  117. Durrant, Joan E. (1996). “The Swedish Ban on Corporal Punishment: Its History and Effects”. In Detlev Frehsee; Wiebke Horn; Kai-D. Bussmann (eds.). From Family Violence Against Children: A Challenge for Society. New York: Walter de Gruyter & Co. pp. 19–25. ISBN978-3-11-014996-8Archived from the original on 13 January 2016.
  118. Lesa Bethea (1999). “Primary Prevention of Child Abuse”American Family Physician59 (6): 1577–85, 1591–2. PMID10193598Archived from the original on 28 December 2010.
  119. Eisenberg, Leon; Brown, Sarah Hart (1995). The Best Intentions: Unintended Pregnancy and the Well-Being of Children and Families. Washington, D.C.: National Academy Press. pp. 73–74. ISBN978-0-309-05230-6.
  120. Hathaway J.E.; Mucci L.A.; Silverman J.G.; et al. (2000). “Health status and health care use of Massachusetts women reporting partner abuse”. Am J Prev Med19 (4): 302–307. doi:10.1016/s0749-3797(00)00236-1.
  121. “Family Planning – Healthy People 2020”. Archived from the original on 28 December 2010. Retrieved 18 August 2011Which cites: * Logan, C.; Holcombe, E.; Manlove J.; et al. (May 2007). “The consequences of unintended childbearing: A white paper”(PDF). Washington, D.C.: Child Trends. * Cheng D.; Schwarz, E.; Douglas, E.; et al. (March 2009). “Unintended pregnancy and associated maternal preconception, prenatal and postpartum behaviors”. Contraception79 (3): 194–198. doi:10.1016/j.contraception.2008.09.009PMID19185672. * Kost K, Landry DJ, Darroch JE (1998). “Predicting maternal behaviors during pregnancy: does intention status matter?”. Fam Plann Perspect30 (2): 79–88. doi:10.2307/2991664JSTOR2991664PMID9561873. * D’Angelo DV, Gilbert BC, Rochat RW, Santelli JS, Herold JM (2004). “Differences between mistimed and unwanted pregnancies among women who have live births”. Perspect Sex Reprod Health36 (5): 192–7. doi:10.1363/3619204PMID15519961.
  122. Jones, L, Bellis, MA, Wood, S et al. (8 September 2012). “Prevalence and risk of violence against children with disabilities: a systematic review and meta-analysis of observational studies”. The Lancet380 (9845): 899–907. doi:10.1016/S0140-6736(12)60692-8PMID22795511.
  123. Shumba, A.; Abosi, O.C. (2011). “The Nature, Extent and Causes of Abuse of Children with Disabilities in Schools in Botswana”. International Journal of Disability, Development & Education58 (4): 373–388. doi:10.1080/1034912X.2011.626664.
  124. Murphy JM, Jellinek M, Quinn D, Smith G, Poitrast FG, Goshko M (1991). “Substance abuse and serious child mistreatment: prevalence, risk, and outcome in a court sample”. Child Abuse & Neglect15 (3): 197–211. doi:10.1016/0145-2134(91)90065-LPMID2043972.
  125. Famularo R, Kinscherff R, Fenton T (1992). “Parental substance abuse and the nature of child maltreatment”. Child Abuse & Neglect16 (4): 475–83. doi:10.1016/0145-2134(92)90064-XPMID1393711.
  126. Burlew, Kathleen (4 November 2013). “Parenting and problem behaviors in children of substance abusing parents”Children and Adolescence Mental Health: n/a. doi:10.1111/camh.12001. Retrieved 8 December2015.[dead link]
  127. Garsden, Peter (June 2009). “Does child abuse cause crime?”insidetime. Archived from the original on 29 December 2011.
  128. “Child Abuse”. Florida Performs. Archived from the original on 13 January 2010.
  129. Hughes, Sandra (20 May 2009). “Child Abuse Spikes During Recession”CBS NewsArchived from the original on 19 September 2009.
  130. Conron, Kerith J.; Beardslee, William; Koenen, Karestan C.; Buka, Stephen L.; Gortmaker, Steven L. (5 October 2009). “A Longitudinal Study of Maternal Depression and Child Maltreatment in a National Sample of Families Investigated by Child Protective Services”. Archives of Pediatrics & Adolescent Medicine163 (10): 922–30. doi:10.1001/archpediatrics.2009.176ISSN1072-4710PMID19805711.
  131. Casey, Patrick; Goolsby, Susan; Berkowitz, Carol; Frank, Deborah; Cook, John; Cutts, Diana; Black, Maureen M.; Zaldivar, Nieves; Levenson, Suzette (February 2004). “Maternal depression, changing public assistance, food security, and child health status”. Pediatrics113 (2): 298–304. doi:10.1542/peds.113.2.298ISSN1098-4275PMID14754941.
  132. Sebre S, Sprugevica I, Novotni A, Bonevski D, Pakalniskiene V, Popescu D, Turchina T, Friedrich W, Lewis O (2004). “Cross-cultural comparisons of child-reported emotional and physical abuse: Rates, risk factors and psychosocial symptoms”Child Abuse & Neglect, the International Journal28 (1): 113–127. doi:10.1016/j.chiabu.2003.06.004PMID15019442.
  133. Sebre S, Sprugevica I, Novotni A, Bonevski D, Pakalniskiene V, Popescu D, Turchina T, Friedrich W, Lewis O (2004). “Cross-cultural comparisons of child-reported emotional and physical abuse: Rates, risk factors and psychosocial symptoms”. Child Abuse & Neglect, the International Journal28 (1): 113–127. doi:10.1016/j.chiabu.2003.06.004PMID15019442.
  134. Lau, A. S., Takeuchi, D. T., & Alegría, M. (2006). Parent-to-child aggression among Asian American parents: Culture, context, and vulnerability. Journal of Marriage and Family, 68(5), 1261–1275. Retrieved
  135. Dowden, Richard (12 February 2006). “Thousands of child ‘witches’ turned on to the streets to starve”Archived 15 November 2016 at the Wayback MachineThe Observer (London).
  136. Byrne, Carrie (16 June 2011). “Hunting the vulnerable: Witchcraft and the law in Malawi”Archived 29 March 2012 at the Wayback Machine. Consultancy Africa Intelligence.
  137. “Abuse of child ‘witches’ on rise, aid group says”Archived 6 November 2012 at the Wayback Machine. CNN. 18 May 2009.
  138. YTN (16 March 2016). “지난해 아동학대 17% 증가…가해자 75% 친부모”Archived from the original on 5 April 2016.
  139. Christian, C. W. (27 April 2015). “The Evaluation of Suspected Child Physical Abuse”. Pediatrics135 (5): e1337–e1354. doi:10.1542/peds.2015-0356PMID25917988.
  140. Wilson, S.F.W, Giddens, J.F.G. (2009) Health Assessment for Nursing Practice. St.Louis: Mosby Elsevier, page 506.
  141. Williams, M. (2015) Evidence based decisions in child neglect: An evaluation of an exploratory approach to assessment using the North Carolina Family Assessment ScaleArchived 22 November 2015 at the Wayback Machine, London, NSPCC.
  142. “Child Abuse Symptoms, Causes, Treatment – How can child abuse be prevented? on MedicineNet”. Archived from the original on 21 December 2012. Retrieved 24 December 2012.
  143. Dubowitz, Howard; Lane, Wendy G.; Semiatin, Joshua N.; Magder, Laurence S. (July 2012). “The SEEK Model of Pediatric Primary Care: Can Child Maltreatment Be Prevented in a Low-Risk Population?”Academic Pediatrics12 (4): 259–268. doi:10.1016/j.acap.2012.03.005PMC5482714PMID22658954.
  144. Dubowitz, H.; Lane, W. G.; Semiatin, J. N.; Magder, L. S.; Venepally, M.; Jans, M. (1 April 2011). “The Safe Environment for Every Kid Model: Impact on Pediatric Primary Care Professionals”Pediatrics127 (4): e962–e970. doi:10.1542/peds.2010-1845ISSN0031-4005PMC3387892PMID21444590.
  145. “Pediatrician Training and In-Office Support Significantly Reduce Instances of Child Maltreatment”. Agency for Healthcare Research and Quality. 22 May 2013. Archived from the original on 13 January 2016. Retrieved 17 October 2013.
  146. “Child Abuse Experts Provide Videoconference-Enabled Consultations to Providers in Remote Emergency Departments and Clinics, Leading to More Accurate Diagnosis”. Agency for Healthcare Research and Quality. 26 March 2014. Archived from the original on 13 January 2016. Retrieved 26 March 2014.
  147. Baumrind (1993). Optimal Caregiving and Child Abuse: Continuities and Discontinuities. National Academy of Sciences Study Panel on Child Abuse and Neglect (Report). Washington, DC: National Academy Press.
  148. Cron T (1986). The Surgeon General’s Workshop on Violence and Public Health: Review of the recommendations. Public Health Rep. (Report). 101. pp. 8–14.
  149. Babatsikos, Georgia (2010). “Parents’ knowledge, attitudes and practices about preventing child sexual abuse: a literature review”. Child Abuse Review19 (2): 107–129. doi:10.1002/car.1102ISSN0952-9136.
  150. Hébert, Martine; Lavoie, Francine; Parent, Nathalie (1 June 2002). “An Assessment of Outcomes Following Parents’ Participation in a Child Abuse Prevention Program”. Violence and Victims17 (3): 355–372. doi:10.1891/vivi.17.3.355.33664ISSN0886-6708.
  151. Wurtele, Sandy K.; Moreno, Tasha; Kenny, Maureen C. (2008). “Evaluation of a Sexual Abuse Prevention Workshop for Parents of Young Children”. Journal of Child & Adolescent Trauma1 (4): 331–340. doi:10.1080/19361520802505768ISSN1936-1521.
  152. Wurtele, Sandy K.; Kenny, Maureen C. (2010). “Partnering with parents to prevent childhood sexual abuse”. Child Abuse Review19 (2): 130–152. doi:10.1002/car.1112ISSN0952-9136.
  153. Williams, Mike (2018). “Four Steps to the Prevention of Child Sexual Abuse in the Home”(PDF)NSPCC.
  154. Williams, Mike (2018). “Working with a community to prevent child sexual abuse in the home”(PDF)NSPCC. Retrieved 1 August 2018.
  155. Child Welfare Information GatewayArchived 28 August 2010 at the Wayback Machine, History of National Child Abuse Prevention Month. 3 April 2009.
  156. Presidential Proclamation Marking National Child Abuse Prevention MonthArchived 31 August 2009 at the Wayback Machine. The White House – Press Room, 1 April 2009.
  157. U.S. Administration for Children and FamiliesArchived 30 August 2009 at the Wayback Machine. Department of Health and Human Services. Children’s Bureau.
  158. Hosin, A.A., ed. (2007). Responses to traumatized children. Basingstoke: Palgrave Macmillan. p. 211. ISBN978-1-4039-9680-0.
  159. Briere, John (1992). Child abuse trauma. Sage. p. 7. ISBN978-0-8039-3713-0.
  160. Wade R Jr, Cronholm PF, Fein JA, Forke CM, Davis MB, Harkins-Schwarz M, Pachter LM, Bair-Merritt MH. Household and community-level Adverse Childhood Experiences and adult health outcomes in a diverse urban population. Child Abuse & Neglect, 2016;52:135-45. doi: 10.1016/j.chiabu.2015.11.021
  161. Cohen, J.A.; Mannarino, A.P.; Murray, L.K.; Igelman, R. (2006). “Psychosocial Interventions for Maltreated and Violence-Exposed Children”. Journal of Social Issues62 (4): 737–766. CiteSeerX10.1.1.578.243doi:10.1111/j.1540-4560.2006.00485.x.
  162. Evans, Jane (8 October 2014). “Children Who Experience Early Childhood Trauma Do Not ‘Just Get Over ItSocial Work HelperArchived from the original on 18 May 2015. Retrieved 13 May 2015.
  163. “Parent training works for child and adolescent mental health”. 19 January 2017.
  164. Schechter DS, Zygmunt A, Trabka KA, Davies M, Colon E, Kolodji A, McCaw JE (2007). “Child mental representations of attachment when mothers are traumatized: The relationship of family-drawings to story-stem completion”Journal of Early Childhood and Infant Psychology3: 119–141. PMC2268110PMID18347736.
  165. “Child maltreatment: Fact sheet No. 150”. World Health Organization. December 2014. Archived from the original on 17 July 2015.
  166. Panel on Research on Child Abuse and Neglect; Commission on Behavioral and Social Sciences and Education, National Research Council (1993). Understanding Child Abuse and Neglect. Washington, D.C.: National Academy Press. doi:10.17226/2117ISBN978-0-309-04889-7Archived from the original on 24 March 2016.
  167. “Child Maltreatment: Facts at a Glance”(PDF). Atlanta, GA: Centers for Disease Control and Prevention. 2014. Archived(PDF) from the original on 29 August 2017.
  168. Kim, Hyunil; Wildeman, Christopher; Jonson-Reid, Melissa; Drake, Brett (1 February 2017). “Lifetime Prevalence of Investigating Child Maltreatment Among US Children”American Journal of Public Health107(2): 274–280. doi:10.2105/ajph.2016.303545PMC5227926PMID27997240.
  169. Finkelhor, David; Lisa Jones; Anne Shuttuch. “Updated Trends in Child Maltreatment, 2010”(PDF). University of New Hampshire, Crimes Against Children Research Center. Archived(PDF) from the original on 10 October 2012. Retrieved 19 December 2011.
  170. Besharov, Douglas J. (1 January 1998). “Fixing Child Protection”. Philanthropy Roundtable. pp. 1–4. Archived from the original on 14 March 2013.
  171. Krason, Stephen M. “The Critics of Current Child Abuse Laws and the Child Protective System: A Survey of the Leading”(PDF). The Catholic Social Science Review. pp. 307–350. Archived from the original(PDF)on 27 April 2014.
  172. Orr, Susan (1 October 1999). “Policy Study 262 Child Protection at the Crossroads: Child Abuse, Child Protection and Recommendations for Reform”(PDF). Archived from the original(PDF) on 24 May 2013.
  173. Child Maltreatment 2008Archived 5 July 2010 at the Wayback Machine, U.S. Department of Health and Human Services, p. 55.
  174. For a review of this literature, see, Douglas, E.M., 2005, Child maltreatment fatalities: What do we know, what have we learned, and where do we go from here?,pp 4.1–4.18, in Child Victimization, edited by K. Kendall-Tackett & S. Giacomoni, published by Civic Research Institute, Kingston, N.J.
  175. “SPEAKING ONLY SPANISH AT HOME IS ABUSE, TEXAS JUDGE RULES”. 29 August 1995. Archived from the original on 22 October 2012. Retrieved 21 March 2011.

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