The Problem of Child Abuse and Neglect in the Home

What This Guide Does and Does Not Cover

This guide begins by describing the problem of child abuse and neglect in the home, and reviewing factors that increase its risks. It then identifies a series of questions to help you analyze your local child maltreatment problem. Finally, it reviews responses to the problem and what is known about them from evaluative research and police practice. This guide is not intended to provide specific guidance on investigative techniques.

See American Prosecutors Research Institute, National Center for Prosecution of Child Abuse (2004), California Commission on Peace Officer Standards and Training (1998), and Sahonchik, Columbo, and Boggis (1996) for detailed guidance on investigating allegations of child abuse and neglect.

Child abuse and neglect in the home is but one aspect of the larger set of problems related to child maltreatment that occurs in a variety of places and by people with varied relationships to the victim. This guide is limited to addressing the particular harms created by child abuse and neglect that occurs in the home, typically by the child's caretaker or someone close to the caretaker (e.g., the mother's boyfriend). Related problems not directly addressed in this guide, each of which requires separate analysis, include:

• child physical and sexual abuse in institutions (e.g., correctional facilities, churches, youth organizations, foster care);
• commercial sexual exploitation of children and organized child sex rings;
• child pornography on the Internet;
• child fatalities (including shaken-baby deaths and Munchausen syndrome by proxy);
• child abuse among immigrant populations (e.g., excessive discipline of children or other instances in which cultural norms conflict with child welfare laws);
• exposure of children to hazardous materials (see, also, Clandestine Methamphetamine Labs in this series);
• abandoned children; and
• juvenile runaways.

See the National Center for Victims of Crime, www.ncvc.org, for additional guidance on the policevictim relationship.

Some of these related problems are covered in other guides in this series, all of which are listed at the end of this guide. For the most up-to-date listing of current and future guides, see www.popcenter.org.

General Description of the Problem

Child maltreatment is a leading cause of childhood serious injuries and fatalities. As the most widely available helping professionals in communities, police have a natural role in preventing and responding to child abuse and neglect. Not only are police legally mandated to enforce the law and protect residents' safety, but also they are generally committed to children's welfare.

Child abuse and neglect are very difficult problems. The injuries sustained often resemble those caused by unintentional or accidental situations, and police must carefully evaluate all reasonable explanations. The stakes are highif police misdiagnose the cause of injuries, the potential for future victimization exists. Further, the victim is always a child, and some are very young. Police need to understand children's developmental capacitiestheir language and cognitive abilitiesto be able to communicate with the victims of these crimes. Finally, unlike many other crimes that occur in public places, child abuse and neglect usually occurs in private places, and the victims may try to hide evidence of the abuse or deny that it took place. As a result, collecting sufficient evidence to determine whether a crime occurred and to identify effective responses to the problem is very difficult.

Types of Child Abuse and Neglect

No single, universally accepted definition of child maltreatment exists. Each state constructs its own definition, which can be found using a combination of mandatory child-abuse reporting laws, criminal statutes, and juvenile court statutes. There are three main types of child maltreatment, which often co-occur:1,

• Physical abuse, which may range in severity from minor bruising to death.
• Sexual abuse, involving varying degrees of coercion and violence.
• Neglect, ranging from the failure to provide food, clothing, or shelter to the failure to provide medical care, supervision, or schooling. Exposing a child to dangerous conditions or hazards, including crime, may also be considered neglect.

Some practitioners recognize a fourth type of abuseemotionalwhichentails a pattern of caregiver behavior that negatively impacts a child's cognitive, emotional, and/or behavioral development. Emotional abuse is the most difficult form to identify. However, no one has widely studied emotional abuse, so this guide does not address it extensively.

Prevalence

The U.S. Department of Health and Human Services maintains the National Child Abuse and Neglect Data System, a voluntary, national database that provides information on the incidence of child abuse and neglect. Each state's child protective agency provides data. During the 1990s, the number of child abuse allegations decreased significantly (sexual abuse allegations decreased by 47 percent and physical abuse decreased by 36 percent). The rate of child neglect has remained relatively stable, likely because neglect is more difficult to identify and influence and has not been subject to the same vigorous prevention efforts as other forms of maltreatment.2

In 2006, child protective agencies received an estimated 3.6 million referrals involving the alleged maltreatment of 6 million children.3 Approximately one-quarter resulted in a substantiated finding of abuse or neglect. In other words, approximately 905,000 children were determined to be victims of abuse or neglect in 2006.

Neglect is the most common form of child maltreatment, comprising approximately 64 percent of all substantiated findings. Approximately 16 percent of the substantiated cases involved physical abuse, 9 percent involved sexual abuse, and 7 percent involved emotional abuse. Child fatalities are the most tragic outcomes of maltreatment. Of the approximately 1,500 children who died from abuse or neglect in 2006, over three-fourths were under four years old. Compounding the problem of the high incidence of child abuse and neglect, many families who come to the attention of child protective services have subsequent referrals for suspected maltreatment. Thus, it is essential for police and child protective services to identify the situations in which child abuse and neglect are likely to occur so that they can implement appropriate responses.

Reporting Mechanisms

Child abuse is revealed in a variety of ways.4 The child may disclose the abuse intentionally or accidentally. Family members who observe caregivers interacting with children may suspect or witness abuse. Professionals involved with the child may suspect abuse based on behavioral, emotional, or verbal clues. Neighbors may see, hear, or suspect maltreatment based on their observations of the family.

Although they may suspect or be aware of abuse, many people are ambivalent about reporting their suspicions. They may not want to get involved, may believe that parents have the right to treat their children however they choose, or may not want to accept the implications of their suspicions about people they know and like. Some professionals may worry about compromising their rapport with their clients if they report suspected abuse.

Beginning in the 1960s, all states established mandatory child abuse reporting laws that were designed to ensure that the agencies tasked with protecting children's welfare (i.e., police and child protective services agencies) were made aware of situations in which child maltreatment is suspected. While laws vary across states, most specify the following:5

• Categories of people required to report suspected abuse or neglect. These commonly include medical personnel, teachers, mental health professionals, social workers, law enforcement officers, and other professionals who routinely contact children. Some states require any person to report suspected abuse.
• Conditions under which a professional must make a report. Most often, professionals must make a report when they suspect maltreatment has occurred. Certainty is not required.
• Immunity from legal liability for reporters, and penalties for the failure to report suspected abuse.
• Timelines within which people must make a report, often within 24 hours of the event that triggered the suspicion.
• Agencies responsible for receiving and investigating reports. Some states require all reports to be made to child protective services, some require certain reports to be made to the local law enforcement agency, and some give the reporter discretion whether to report to child protective services or to law enforcement. Very few states require all reports to be made to a law enforcement agency.

Most child protective services have a 24-hour, toll-free hotline to receive suspected child abuse reports. Reports to law enforcement agencies are usually made to 911 dispatchers. Many states' reporting laws require child protective services to relay at least a subset of reports to police (e.g., in the case of serious injury or death of the victim). Whether legally mandated to do so or not, most police relay reports of suspected abuse to child protective services.

Police Role

Police play a variety of roles in the identification of and response to child abuse and neglect. Their contact with children in schools, homes, and the community place them in an ideal position to identify situations in which maltreatment may be occurring. Police will also receive reports of suspected abuse, either through calls to the police agency or through their routine contacts with community members. Incidents of child abuse may also lurk behind the scenes of domestic violence calls; thus police should ask about and interview any children at the scene.6

Police may also be the first responders to the scene of suspected abuse or neglect. While child protective services may be the intended recipient of a suspected child abuse report, an agency representative may not be available when an immediate response is needed. When police arrive on the scene, typical investigatory protocols (e.g., completing reports, taking photographs, conducting interviews) apply. Police are also involved in securing needed medical treatment for the child's injuries or in obtaining forensic medical examinations to determine the presence of injuries. Police may also need to brief medical staff on the facts, allegations, and types of evidence to be collected.7

In some cases, police may need to protect child protective services staff. Staff members often need to visit homes in isolated or dangerous areas and deal with unstable or violent people. Accused caretakers may refuse entry to the home or access to the possible victim, both of which are essential to determining whether abuse occurred and whether the child is still at risk of harm. Most people more widely accept police authority than they do that of child protective services. If immediate danger exists, police need to temporarily remove the child from the home. Police are needed both for their authority to remove children at risk of immediate harm and to defuse the tensions removals may cause. Police presence can often have a stabilizing effect.

Child abuse is a crime and therefore police have an obvious role in investigating allegations, arresting suspects, and preparing cases for prosecution, if warranted. Whether a case will be prosecuted or not, police are obligated to coordinate with other professionals (child protective services workers, prosecutors, medical professionals, social service providers, victim advocates, etc.) involved with the case.

Harms Caused by Child Abuse and Neglect in the Home

Children who suffer abuse and neglect may sustain a variety of devastating physical, psychological, cognitive, and behavioral problems. The effects vary with the age and personality of the victim and also with the type and duration of the abuse. Physical consequences may range from minor injuries to severe brain damage, while psychological harms range from lack of self-esteem to learning disorders to serious mental illnesses. Many abused and neglected children develop behavioral problems that interfere with their education and lead to their involvement in delinquency. Maltreated children may run away from home, get involved with drugs and alcohol, experience intimacy problems, and self-harm. Research has shown that significant proportions of adults who were abused as children go on to abuse their own children.8 Serious negative outcomes are more likely if the abuse occurs over a long period of time, if it involves violence, or if offender is the victim's father or father figure.9 While many maltreated children experience immediate and lifelong problems, many do not. Research on promoting resiliency in children has found that abuse's negative effects can be buffered when children can form trusting relationships with adults, have structure and rules at home, are encouraged to be autonomous, and have access to health, education, welfare, and social services.10

Not only does child abuse and neglect harm the victims themselves, but also it harms families and communities. Nonoffending parents not only must help their children recover from maltreatment, but also must deal with their own complicity in permitting the maltreatment to occur, or in failing to recognize the signs of abuse in their children. The presence of child abuse and neglect in a community reflects attitudes about child rearing, punishment, and acceptance of violence as a solution to problems.

Finally, because many forms of child maltreatment are crimes, and because the effects of child abuse and neglect include delinquency, substance abuse, and violence, efforts to reduce the incidence of child abuse and neglect are essential to long-term public health and public safety efforts.

Factors Contributing to Child Abuse and Neglect in the Home

Understanding the factors that contribute to your problem will help you frame your own local analysis questions, determine good effectiveness measures, recognize key intervention points, and select appropriate responses.

Victims

In 2005, across all types of maltreatment, newborns to three-year-olds had the highest victimization rates.11 More than half were seven or younger. About half of all victims were boys, and half girls. White and Hispanic children have lower victimization rates than children of other ethnicities. The victim profile is somewhat different depending on the individual type of maltreatment:12

• Physical abuse. The risk of physical abuse decreases as the child gets older, although adolescents are also victims of it. Boys and girls are equally at risk of minor physical abuse, although boys are slightly more likely to sustain serious injuries. Physical abuse occurs disproportionately among economically disadvantaged families. Income also affects the severity of abuse.
• Sexual abuse. Children are at highest risk of sexual abuse from ages seven to 12, although sexual abuse among very young children does occur and is often undetected because of their inability to communicate what is happening to them. Sexual abuse victims tend to be selected because they are vulnerable in some way (e.g., very young, passive, quiet, needy). Girls are significantly more likely to be sexually abused than boys, although it is possible that boys are simply less likely to report their victimization.
• Neglect. The risk of neglect generally declines with age. The mean age of victims of neglect is six years old. Boys and girls are equally at risk of neglect.

Children are never responsible for their victimization, but certain characteristics increase their vulnerability. Children's need for attention and affection is their single most exploitable characteristic.13 Particularly in the case of sexual abuse, a trusted adult may take advantage of a child's natural curiosity, desire to be included, and need for affection. The relationship between children and their caretakers makes it difficult for children to interpret what is happening to them as "abuse." A victim may also feel a sense of loyalty to the abuser, and while the victim may want the abuse to stop, he or she may not want the perpetrator to be punished. Children with disabilities are extremely dependent on adults, and this dependence limits their ability to protect themselves and, in some situations, their ability to disclose what is happening to them.

Repeat Victimization

For many children who have experienced maltreatment, the efforts of police, child protective services, and other social services have been insufficient to prevent repeat victimization. In 2005, approximately 6 percent of victims experienced another incident of abuse or neglect within six months of a substantiated finding of maltreatment.14 One study found that the highest risk of subsequent abuse was within 30 to 60 days after the initial report. Situations that increased the risk of subsequent victimization included caretaker substance abuse and criminal behavior, and the lack of police involvement in the initial investigation.15

Perpetrators

Child abuse occurs in all cultural, ethnic, occupational, and socioeconomic groups. A parent's likelihood of mistreating his or her children is rarely the result of any single factor, but rather results from a combination of circumstances and personality types. While certain factors may be prevalent among perpetrators, the mere presence of a situation or particular trait does not mean that maltreatment will always occur.16

• Physical abuse.17Caretakers who physically abuse their children tend to experience high stress (e.g., from single-parenting, health problems, unemployment, poverty) and may have poorly developed coping skills. They may also struggle with personality factors such as low self-esteem, poor impulse control, depression, anxiety, and low frustration tolerance. Their expectations for their child may exceed the child's developmental capacity. As a result, they may not interact well with their child and tend to use more punitive discipline. Perhaps because mothers spend more time with their children, perpetrators are slightly more likely to be female than male. Further, normal adolescent defiance and rebellion increases family tension and may frustrate parents, who respond with excessive punishment. When confronted, physically abusive caretakers tend to offer illogical, unconvincing, or contradictory explanations for the child's injury.
• Sexual abuse. Sexual abusers are usually in a position of authority or trust over their victims. They are usually male and typically in their early 30s, although a significant proportion are adolescents (e.g., siblings or babysitters).18 Offenders who victimize family members tend to have only one or two victims (usually female), while non-relative offenders tend to have a much larger number of victims (usually male).19 Their feelings of inadequacy, depression, isolation, rigid values, and deviant arousal patterns contribute to their offending. Once they have selected a vulnerable victim, perpetrators generally "groom" the victim by progressing from nonsexual touching to sexual activity. They may use their authority to force their victims to participate, or may use various forms of enticements and coercion. Using bribes, threats, isolation, or physical aggression, perpetrators also persuadetheir victims to remain silent about the abuse so that other adults cannot intervene. Sexual abusers tend to rationalize and minimize their behavior, deny the sexual intent, or project blame onto the victim.20 That said, most sexual abusers are not attracted exclusively to children (that is, they are also sexually attracted to adults), and they have relatively low recidivism rates, particularly as they get older.21
• Neglect. Single female caretakers are mostly likely to be reported for neglecting their children. Younger mothers, those with large families, and those who experienced neglect themselves are also more likely to neglect their children's needs. Economic hardship and isolation from social activities and peers are also contributing factors. They may also have a substance abuse problem that limits their ability to care for themselves and creates a chaotic lifestyle that compromises their parenting abilities.

Family Factors 22

Children in single-parent families may be at higher risk of physical abuse and neglect, although the effects of poverty, stress, social isolation, and lack of support are all contributing factors. Risk is reduced for the children of single mothers when the children have a relationship with their fathers. In two-parent families, the risk of maltreatment is greater if marital conflict or domestic violence is also present. Neglectful parents tend to have more children and more people living in the household. Neglected children's homes are characterized by chaos and an ever-changing constellation of adult and child residents.

Environmental Factors23

Families living in areas challenged by poverty and unemployment, particularly when coupled with the individual and family factors described above, are at higher risk of child abuse and neglect. The degree of social support available to parents, along with community attitudes about raising children and using punishment, can also contribute to the risk of child maltreatment.