Virtually every week, chilling accounts of child abuse make headlines nationwide — from children reportedly chained to beds and starved by their parents to hundreds of gymnasts accusing their doctor of molesting them.
Beyond the details of these nightmarish incidents, the same questions emerge: How many more cases lurk in the shadows, in quiet homes on tree-lined streets? Why do parents hurt their kids? How is justice done for the abused?
Two national efforts, the National Incidence Study of Child Abuse and Neglect (NIS) and the National Child Abuse and Neglect Data System (NCANDS), attempt to document the incidence of child abuse.
NCANDS consists of data submitted by Child Protective Services (CPS) agencies across the country. The Department of Health and Human Services publishes a report summarizing the findings from NCANDS annually.
According to this data, in 2015, CPS investigated or responded to 3.4 million children and determined that 683,000 were victims of abuse, which translates to 9.2 victims per 1,000 children nationwide. This represents a 3.8 percent increase since 2011. These cases were roughly split between boys and girls. Children younger than 3 years old comprised 27.7 percent of victims. By race, African-American children had the highest rate of victimization, though most cases of abuse — 43 percent — occurred among white children.
NCANDS reports that roughly 75 percent of abused children referred to CPS were neglected, about 17 percent were physically abused, 7 percent suffered other kinds of maltreatment, and 8 percent were sexually abused. Worldwide estimates for child sexual abuse published in the International Journal of Public Health range from about 8 to 31 percent for girls and 3 to 17 percent for boys; other research has focused on all forms of maltreatment globally.
In the Journal of Child and Adolescent Trauma, researchers have put a finer point on forms of child abuse, defining child torture as severe, repeated abuse through the analysis of numerous cases.
NCANDS data documented 1,670 child fatalities in 2015. Three-quarters of these children were younger than 3 years old. Nearly 80 percent of these deaths involved parents, though in 19 percent of fatalities someone else was to blame
A look into case files from the Cook County Medical Examiner’s Office in Chicago, Illinois spanning 2007 to 2012 found that head injuries were the leading cause of death in child abuse homicides. A national review of child deaths from 2005 to 2009 found similarly that 30 percent of child maltreatment deaths had head trauma.
Many abuse fatalities likely were preceded by a history of maltreatment. Research on the link between child maltreatment and death finds that “children with a prior allegation of maltreatment died from intentional injuries at a rate that was 5.9 times greater than unreported children.”
The National Incidence Study of Child Abuse and Neglect (NIS) also collects data from CPS along with “sentinel” agencies such as schools and health and law enforcement organizations. The latest NIS report, referred to as NIS-4, was published in 2010, and reviews data from 2004 to 2009. NIS estimates of abuse are higher than NCANDS figures. Its data suggests approximately 1.25 million children — or 1 in 58 nationally — experienced maltreatment in the study year, 2005 to 2006. The agency reports that 61 percent were neglected and 44 percent were abused. About 58 percent of these cases of abuse were physical, 24 percent were sexual and 27 percent were emotional. Neglect was primarily educational (e.g., truancy) — 47 percent of cases — but also physical (38 percent) and emotional (25 percent).
Some studies put children’s rates of exposure to violence and maltreatment even higher. A 2011 phone survey, the National Survey of Children’s Exposure to Violence, found that over 40 percent of children experienced physical assault in the previous year, and nearly 14 percent were maltreated by caregivers.
What puts kids at risk of abuse and neglect? Most abuse occurs in the home. NCANDS found that only 13.3 percent of maltreated children were victimized by a perpetrator other than a parent. Accordingly, research has focused on the specific social and environmental factors at play, including personal and family dynamics, socioeconomic status and parenting styles. The American Professional Society on the Abuse of Children suggests corporal punishment increases the risk of abuse.
NCANDS identifies three main risk factors, including caregiver drug and alcohol abuse and domestic violence. Caregiver mental illness can pose a risk as well. One study published in Children and Youth Services Review found that among impoverished families, children with depressed caregivers were twice as likely to suffer physical neglect compared with those whose caregivers were not depressed. Some children suffer abuse through Munchausen syndrome by proxy, a psychological disorder in which caregivers induce in others the signs and symptoms of illness or injury. Some parents withhold essential care for their children on religious grounds.
Other research published in Child Abuse and Neglect suggests an association between impoverishment, dense housing and increased risk of maltreatment. An analysis of NCANDS data by researchers at Bridgewater State University suggests that families in which fatal maltreatment occurs experience more financial and housing instability and use fewer social services as compared with families in which non-fatal child maltreatment occurs. Another study that looked at patterns of abuse and neglect in recent history suggests a link between increased risk of child abuse and the Great Recession. The researchers indicate that economic stress might explain this association.
Whatever the cause, child maltreatment has profound effects on mental, physical and emotional well-being. This includes disruptions in brain development, poor social functioning in childhood, and increased risk of mental disorders, psychosis and attachment anxiety in adulthood.
Despite this, research published in Trauma, Violence, and Abuse indicates that child maltreatment is less likely to lead to filing criminal charges and incarceration than many other alleged felonies. Other academics suggest this might be due in part to the difficulties of procuring evidence and working with child victims.
An investigation by The Denver Post found that sentences for child homicide resulting from abuse tended to be less severe than comparable felony charges for adults, which Post journalists suggest might also stem from challenges relating to evidence. An academic study of child abuse homicide in Utah, however, found no significant differences in conviction levels or sentence severity for perpetrators whether their victims were children or adults.
The legal system provides opportunities not just for punishment but also for prevention of child abuse. Over the past few decades, lawmakers have attempted to enact policies targeting child maltreatment, including the Child Abuse Prevention and Treatment Act (CAPTA), which was signed into law in 1974. It funds programs that work to prevent, investigate, and prosecute abuse and neglect. Parenting programs are one such intervention shown to reduce the risk of future abuse. Other state laws and policies that, according to researchers, have had some success, include home-visiting programs that provide support to parents.
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