Causes and Effects of Child Abuse - Some Contributing Factors To Child Abuse
children parents maltreatment neglect
The factors contributing to child maltreatment are complex. The Third National Incidence Study of Child Abuse and Neglect (NIS-3; Andrea J. Sedlak and Diane D. Broadhurst, U.S. Department of Health and Human Services [HHS], National Center on Child Abuse and Neglect, Washington, DC, 1996), the most comprehensive federal source of information about the incidence of child maltreatment in the United States, found that family structure and size, poverty, alcohol and substance abuse, domestic violence, and community violence are contributing factors to child abuse and neglect.
For example, under the Harm Standard of NIS-3 (see Chapter 4 for a definition of the Harm and Endangerment Standards), children in single-parent households were at a higher risk of physical abuse and all types of neglect than were children in other family structures. Children living with only their fathers were more likely to suffer the highest incidence rates of physical abuse and emotional and educational neglect. (See Figure 5.1.) Under the Endangerment Standard, higher incidence rates of physical and emotional neglect occurred among children living with only their fathers than among those living in other family structures. (See Figure 5.2.)
Sedlak and Broadhurst noted that the increase in illicit drug use since the second National Incidence Study of Child Abuse and Neglect (NIS-2), in 1986, may have contributed to the increased child maltreatment incidence reported in NIS-3. Children whose parents are alcohol and substance abusers are at very high risk of abuse and neglect because of the physiological, psychological, and sociological nature of addiction.
While several factors increase the likelihood of child maltreatment, they do not necessarily lead to abuse. It is important to understand that the causes of child abuse and the characteristics of families in which child abuse occurs are only indicators. The vast majority of parents, even in the most stressful and demanding situations, and even with a personal history that might predispose them to be more violent than parents without such a history, do not abuse their children.
Murray A. Straus and Christine Smith noted, in "Family Patterns and Child Abuse" (Physical Violence in American Families: Risk Factors and Adaptations to Violence in 8,145 Families), that one cannot simply single out an individual factor as the cause of abuse. The authors found that a combination of several factors is more likely to result in child abuse than is a single factor by itself. Also, the sum of the effects of individual factors taken together does not necessarily add up to what Straus and Smith called the "explosive combinations" of several factors interacting with one another. Nonetheless, even "explosive combinations" do not necessarily lead to child abuse.
POVERTY AND ABUSE: A COMPLEX RELATIONSHIP. Although the most comprehensive U.S. government report on the incidence of child maltreatment, NIS-3, found a correlation between family income and child abuse and neglect, most experts agree that the connection between poverty and maltreatment is not easily explained. According to Diana J. English, the stress that comes with poverty may predispose the parents to use corporal punishment that may lead to physical abuse ("The Extent and Consequences of Child Maltreatment," The Future of Children: Protecting Children from Abuse and Neglect, vol. 8, no. 1, Spring 1998).
English noted that most poor parents do not maltreat their children. Rather, the effects of poverty, such as
stress, may influence other risk factors, including depression, substance abuse, and domestic violence. These risk factors, in turn, may predispose the parents to violent behavior toward their children.
According to the National Center for Children in Poverty (NCCP), research has shown that the problems of depression, substance abuse, and domestic violence are interrelated and that these problems are more likely to be prevalent among low-income families (Sharmila Lawrence, Michelle Chau, and Mary Clare Lennon, Depression, Substance Abuse, and Domestic Violence: Little Is Known about Co-Occurrence and Combined Effects on Low-Income Families, June 2004). NCCP noted that federally funded and community-based programs, such as Early Head Start, designed to help low-income parents and their infants and toddlers, recognize the connection between poverty and parental and child well-being.
UNEMPLOYMENT. The 1975 National Family Violence Survey found rates of child abuse that were considerably higher among families suffering from unemployment than among those in which the husband was working full time. Families in which the husband was not working had a significantly higher rate of child abuse than other families (22.5 versus 13.9 per one hundred children). This finding did not recur, however, in the 1985 survey, although wives of unemployed husbands did have a higher rate of abuse than wives of husbands working full time (16.2 versus eleven per one hundred children). Straus and Smith ("Family Patterns and Child Abuse") thought that this higher rate for wives might have been caused by added family stress because the father was unemployed. Generally, workers in the lower economic class face greater stress because they often have less control over their employment situation, are more likely to find themselves unemployed, and have fewer resources to help ease their stress.
The rate of abuse in the 1985 National Family Violence Resurvey was considerably higher in families in which the husband was a blue-collar worker. Blue-collar fathers committed abuse at a rate of 11.9 per 100 children, compared with 8.9 per 100 children among white-collar workers. The abuse rate for the wives of blue-collar work-ers was even greater, 13.9 per 100 children versus 8.1 per 100 children among wives of white-collar workers.
There are no "vacations" from being a parent, and parenting stress has been associated with abusive behavior. When a parent who may be predisposed toward maltreating a child must deal with a particularly stressful situation, it is possible that little time, energy, or self-control is left for the children. In times of stress, the slightest action by the child can be "the last straw" that leads to violent abuse.
Often, when striking out at a child, the parent may be venting anger at his or her own situation rather than reacting to some misbehavior on the part of the child. Abused children have indicated that they never knew when their parents' anger would explode and that they were severely beaten for the most minor infractions. The child may also be hostile and aggressive, contributing to the stress.
Caring for Children with Disabilities
Children with disabilities are potentially at risk for maltreatment because society generally treats them as different and less valuable, thus possibly tolerating violence against them. These children require special care and attention, and parents may not have the social support to help ease stressful situations. A lack of financial resources further exacerbates the situation.
Some parents may feel disappointment at not having a "normal" child. Others may expect too much and feel frustrated if the child does not live up to their expectations. Children under the care of nonfamily members are at risk for maltreatment, not only from those caregivers who abuse their power or who feel no bond with them, but also from other children, especially in an institutional setting.
According to two committees of the American Academy of Pediatrics (AAP)—the Committee on Child Abuse and Neglect and the Committee on Children with Disabilities—children with disabilities may also be vulnerable to sexual abuse ("Assessment of Maltreatment of Children with Disabilities," Pediatrics, vol. 108, no. 2, August 2001). Dependent on caregivers for their physical needs, these children may not be able to distinguish between appropriate and inappropriate touching of their bodies. The opportunities for sexual abuse may also be increased if the child depends on several caregivers for his or her needs.
The AAP also noted that children with disabilities may not be intellectually capable of understanding that they are being abused. They may not have the communication skills to disclose the abuse. In addition, children who experience some pain when undergoing therapy may not be able to distinguish between inflicted pain and therapy pain.
Patricia M. Sullivan called attention to the fact that the federal government does not collect specific data on children with disabilities in its crime statistics systems nor in national incidence studies mandated by law ("Violence against Children with Disabilities: Prevention, Public Policy, and Research Implications," A Call to Action: Ending Crimes of Violence against Children and Adults with Disabilities: A Report to the Nation, State University of New York Upstate Medical University, Department of Physical Medicine and Rehabilitation, Syracuse, NY, 2003). Although the Child Abuse and Prevention Treatment Act (CAPTA; Public Law 93-247) required that national incidence studies of child maltreatment include data on children with disabilities, the latest survey, the Third National Incidence Study of Child Abuse and Neglect (NIS-3), published in 1996, did not satisfy that mandate. The fourth mandated incidence study, NIS-4, still being conducted as of late 2004, would not include such data. Moreover, the National Child Abuse and Neglect Data System (NCANDS), which releases annual state data on maltreated children, does not gather information relating to children's disability status.
Sullivan and her colleagues undertook two epidemiological studies on maltreated children with disabilities. (Epidemiological studies take into consideration individuals' sex, age, race, social class, and other demographics.) The incidence of maltreatment (the number of new cases during a given period, such as per week, per month, or per year) and its prevalence (the total number of maltreated children with disabilities at a given time) are then measured. The hospital-based study of six thousand abused children found a 64% prevalence rate of maltreatment among disabled children, twice the prevalence rate (32%) among nondisabled children. The school-based study included 4,954 children, of which 31% of disabled children had been maltreated, 3.4 times that of the nondisabled comparison group.
Toilet training can be one of the most frustrating events in the lives of parents and children. Researchers are now linking it to many of the more serious, even deadly, cases of abuse in children between the ages of one and four. Some parents have unrealistic expectations regarding bowel and bladder control for young children, and when their children are unable to live up to these standards, the parents explode in rage. Parental stress and inability to control emotions play a role in child abuse, but they require a trigger to set off the explosion. Soiled clothes and accidents frequently serve as this trigger.
When children are brought to the emergency room with deep, symmetrical scald burns on their bottoms, health care personnel conclude that they were deliberately immersed and held in hot water. This form of abuse is nearly always committed as the result of a toilet accident. Even a one-second contact with 147°F water can cause third-degree burns. Some parents think that immersing a child in hot water will make the child go to the bathroom.
Toileting accidents can be especially dangerous for children because the parent has to place his or her hands on the child to clean up the mess, making it easy for the parent's rage to be taken out on the child's body. This abuse is more common among less-educated, low-income mothers who mistakenly believe that children should be trained by twelve to sixteen months of age. Better-educated parents are more likely to be aware that successful training for girls happens at around two years of age and sometimes not until age three or later for boys.