Child Abuse and Neglect

Child abuse and neglect, also known as child maltreatment, refers to any way in which someone harms a child. It also includes neglecting to protect a child from harm or potential harm, or allowing a child to witness violence or abuse that is done to others. Harm to the child may or may not be intended. Abuse often occurs over a long period of time.

Children of abuse often have no one to turn to for help. Children often feel shame about their abuse or fear their abuser. The abuser may have threatened the child with consequences if he or she told anyone about the abuse. Adults who work with children, come into contact with them, or become aware of abuse have the responsibility to protect children.

If you believe a child is in immediate danger, call your local emergency services (911 in the U.S.).

What are the different kinds of abuse and neglect?

Physical abuse

Physical abuse is non-accidental injury caused by an adult or someone who is responsible for a child's welfare. It may be caused by:

Throwing objects at the child.
Pushing, grabbing, hitting, kicking, slapping, shaking, or burning.
Improperly using restraints or medicines.

Sexual abuse

This can include any sexual act that a child cannot understand or consent to. Sexual abuse ranges from improper viewing and touching to penetration. This includes sexual acts and non-touching sexual behavior between an adult and an adolescent or younger child, or between an older adolescent and a younger child. These activities are abuse, regardless of whether the activity is forced or voluntary.

Emotional and psychological abuse

Emotional and psychological abuse includes actions that impact a child's self-worth or emotional development, such as:

Name-calling, threatening, or intimidating.
Rejection or withholding love.
Humiliation or shaming.
Socially isolating a child.

Neglect

Neglect is a caregiver's failure to meet the needs of a child. Neglect often overlaps with other kinds of abuse. Neglect can include failure to provide:

Basic needs.
- Food.
- Shelter.
- Clothing.
Health needs.
- Means for personal hygiene.
- Medical and dental care.
Adult supervision that provides for:
- Education.
- Social stimulation.
- Appropriate structure and discipline.

How do I know if a child is being abused or neglected?

There are a variety of signs that a child may be going through abuse or neglect.

Physical signs

A child may be abused or neglected if the child has:

Cuts, scars, burns, excessive bruises, or bites. A child may wear clothing that is baggy to hide injuries.
An unusual number of broken bones.
Sores, rashes, or scarring.
Weight loss.
Injury to the genitals.

Often, the child may not have an explanation for the physical signs, or the explanation will change.

Behavioral signs

Child abuse and neglect can be difficult to detect. Sometimes children show very few signs. A child may be going through abuse or neglect if he or she:

Has major emotional changes toward others, such as the child:
- Seems afraid or avoidant of a caregiver or another adult.
- Seems to have a dramatic emotional change toward others.
- Shows signs of hostility toward people or animals.
- Seems to have lost confidence.
- Has little interest in activities that used to be fun.
Has noticeable behavioral changes, such as:
- Having problems eating or sleeping, or the child becomes depressed.
- Trying to run away.
- Reverting to young child behaviors. This may include bed-wetting or thumb-sucking.
- Developing destructive or self-destructive behavior, such as using alcohol or cutting himself or herself.
- Becoming very aggressive or very passive.
- Becoming very tearful or fearful.
- Acting in a sexually mature way that is not reflective of his or her age.
Has physical changes that seem unusual, such as:
- Complaining of unusual illnesses.
- Having unexplained abdominal pain or headaches.
- Having frequent absences or poor performance in school.
- Not developing at a normal weight and height.
- Having poor hygiene.

What should I do if I think a child is being abused or neglected?

If you believe a child is in immediate danger, call your local emergency services (911 in the U.S.).

If a child is being abused or neglected, contact:

Child Protective Services (CPS) in the United States. This state agency is usually part of social services or a department of human services (sometimes referred to as Department of Children and Families, or DCF).
A health care provider. Doctors, nurses, and other health care providers are required to report abuse or neglect and can make sure the child is healthy and safe. You can take the child to a local emergency department if you do not know where to go.
The police. Report your concerns to the local police station.
The 24-hour Childhelp National Child Abuse Hotline at 1-800-422-4453.

When abuse is reported:

The child is not always immediately removed from the home. CPS works to keep families together and to provide support for preventing abuse and strengthening the families whenever possible.
The report can be anonymous. In most states, you do not need to provide your name.
The report is confidential. The abuser is not entitled to know who reported him or her.

What are the treatment or care options for a child who is abused or neglected?

Treatment depends on the type of abuse or neglect. It usually involves the child and the family. The first step is to provide a safe environment and prevent further harm to the child. Treatment may include:

Medical treatment. Injuries from abuse or neglect may require medical attention.
Counseling and therapy.
Treatment teams. This often includes health professionals, social workers, mental health specialists, lawyers, and community workers.
Parenting classes and information on child development.

Where can I get more information?

Child Welfare Information Gateway: www.childwelfare.gov
Prevent Child Abuse America: preventchildabuse.org
Childhelp: www.childhelp.org
Your local health department, medical center, hospital, or other social service providers. They can refer you to an organization that provides specific services to help.

Summary

Child abuse and neglect, also called child maltreatment, can have lasting negative consequences for children's health and well-being.
There are many signs of child abuse, including scars, broken bones, bruises, weight loss, and withdrawal from regular activities.
Report abuse to child protective services, local law enforcement, doctors, nurses, or social workers.
If you believe a child is in immediate danger, call your local emergency services (911 in the U.S.) or your local child protective services.

This information is not intended to replace advice given to you by your health care provider. Make sure you discuss any questions you have with your health care provider.