1. Outline – Lecture 12 [April 8/03] Chapter 14: Child Abuse and Neglect
Child-Rearing and Maltreatment
Types of Maltreatment & Signs of Abuse
Prevalence of Child Maltreatment
Characteristics of Victims and Perpetrators
Developmental Consequences
Causes of Maltreatment
Prevention and Treatment

2. Healthy Child-Rearing and Families
Children need a balance of control and responsiveness
Healthy parenting includes knowledge of child development and expectations, adequate coping skills, healthy parent-child attachment and communication, home management skills, shared parental responsibilities, and provision of social services
Healthy parenting involves a gradual shift of control from parents to child and community

3. Child-Rearing and Maltreatment
Maltreatment represents major failures of the child’s expectable environment
for infants, an expectable environment includes protective and nurturing adults, and opportunities for socialization
older children require a supportive family, contact with peers, and plenty of opportunities to explore and master the environment
Definition of Maltreatment: Any interaction or lack of interaction between a caregiver & child that results in non-accidental harm to child’s physical or developmental state.

4. Types of Maltreatment & The Signs
Physical abuse: physically harmful acts including punching, beating, kicking, biting, burning, shaking
Signs in child: Unexplained injuries, bruises
Sexual abuse: acts ranging from sexual touching to exhibitionism, intercourse, and sexual exploitation
Signs in child: Fearful behavior, bedwetting
Abdominal pain, genital pain or bleeding, sexually transmitted disease or urinary tract infection
Extreme sexual behavior

5. Types of Maltreatment & The Signs
Emotional abuse: acts or omissions that could cause serious behavioral, cognitive, emotional, or mental disorders
Signs in child: Sudden change in self-confidence
Headaches or stomachaches with no medical cause
Abnormal fears, increased nightmares
Attempts to run away
Neglect: failure to provide for a child’s basic physical, educational, or emotional needs
Signs in child: Desperately affectionate behavior
Failure to gain weight (especially in infants)
Voracious appetite and stealing of food

6. Prevalence of Child Maltreatment
3 million suspected cases each year in U.S.
2000 to 5000 abuse-related deaths per year
Lifetime prevalence estimates:
Sexual abuse: 4.3% [males], 12.8% [females]
Physical abuse: 31.2% [males], 21.1% [females]
Physical and sexual abuse are found in all societies but higher incidence among economically & socially disadvantaged
Estimated that 40 million children under the age of 15 are victims of maltreatment each year worldwide

7. Incidence of Maltreatment
of all documented incidents:
60% involve neglect
25% involve physical abuse
12% involve sexual abuse
(25% involve more than one type)

8. Canadian Statistics
The Canadian Incidence Study of Reported Child Abuse and Neglect (CIS)
The first nation-wide study to examine the incidence of child maltreatment in Canada
Children who were reported to, and investigated by, child welfare services from October to December 1998
Based on 7,672 investigations from 51 sites in all provinces and territories
34% - 54% of investigations were found to be substantiated, depending on type of abuse.

9. Physical Abuse

10. Sexual Abuse

11. Neglect

12. Emotional Abuse

13. Characteristics of Victimized Children
Effects of age:
Younger children more at risk for physical neglect
Toddlers, preschoolers, and young adolescents at risk for physical and emotional abuse
Sexual abuse relatively constant after age 3
Effects of sex:
80% of sexual abuse victims are female
Boys more likely to be sexually abused by male non-family members, girls by male family members
Racial and ethnic background is not related to risk
A particular child is usually targeted – the child may display an interactional style that adversely interacts with parental characteristics & family stress

14. Characteristics of Family & Perpetrator
More common among poor and disadvantaged
Single-parent (especially father-only) homes and large families at risk
Majority are not psychiatrically disturbed
Typically began families in their teens
Child’s parent is perpetrator 80% of time, except in cases of sexual abuse (50% of time)
Mother is perpetrator of neglect 90% of time
Males are offenders in majority of sexual (90%), emotional (63%), and physical (58%) abuse

15. Resilience and Adaptation to Maltreatment
Maltreatment does not affect each child in a predictable or consistent way
Resilience factors include positive self-esteem and sense of self, and a positive relationship with at least one important and consistent person

16. Developmental Consequences
Problems with early attachment and affect regulation
Insecure-disorganized attachment
Difficulty understanding, labeling, regulating internal emotional states
Poor emotion regulation, which may lead to internalizing and externalizing problems
Disturbances in emerging views of self & others
Negative representational models of self and others
Feelings of betrayal and powerlessness, which may become part of the child’s self-identify
Sometimes internal attributions of blame for the maltreatment

17. Developmental Consequences
Problems with Peers and school adjustment
Tend to make hostile attributions for actions of others
Lack skill at recognizing distress in others, respond to others’ distress with fear, attack, or anger
Physically abused more physically & verbally aggressive with peers, more likely to be unpopular and rejected
Neglected children often withdraw from and avoid peer interaction
Neglected children have the most severe and wide-ranging problems in school & interpersonal adjustment
Sexually abused children more anxious, inattentive, and unpopular, have less autonomy & self-guidance in completing school work

18. Psychopathology and Adult Outcomes
Physically abused at risk for later interpersonal problems involving aggressive behavior (“cycle of violence”)
Sexually abused may develop chronic impairments in self-esteem, self-concept, and emotional and behavioral self-regulation, including PTSD, depression, dissociative states, and sexual maladjustment
Teens with a history of maltreatment are at much greater risk of substance abuse
History of maltreatment and criminal behavior
Most abused children do not go on to commit crimes
But there is a significant connection between maltreatment & subsequent arrests and sexual & physical violence

19. Causes of Maltreatment
Physical abuse and neglect
little exposure to positive parental models & supports
greater degree of stress in the family environment
information-processing disturbances may cause maltreating parents to misperceive or mislabel child’s behavior, leading to inappropriate responses
lack of awareness or understanding of developmentally appropriate expectations
conflict and marital violence may be implicated
Neglectful parents have more striking personality disorders, inadequate knowledge of children’s needs, & chronic social isolation than abusive parents

20. Causes of Maltreatment
Sexual abuse
Most offenders are males who meet the DSM-IV criteria for pedophilia
Victims are gradually indoctrinated into sexual activity, force is seldom used
A sense of entitlement and privilege may be involved
Offenders often have their own histories of abuse [but only 30% of abused become abusers]
Incestuous families characterized by factors that protect the family secret and maintain control and domination by the abuser
Certain situational factors increase children’s vulnerability to being sexually abused

21. Causes of Maltreatment
Social and Cultural Dimensions
Inequality is the major sociocultural factor contributing to abuse and neglect
Social & cultural disadvantage may result in an extra burden of stress and confusion, and limited alternatives
Maltreatment is often associated with limited opportunities to learn appropriate child-rearing and to receive needed supports
Poverty, social isolation, and acceptance of corporal punishment contribute to maltreatment
Our society condones and glorifies violence

22. Prevention and Treatment
Physical abuse and neglect
Enhancing positive experiences early in the development of the parent-child relationship may help to prevent maltreatment
Treatment for physical abuse aims to change how parents teach, discipline, & attend to their children
Cognitive-behavioral methods target anger patterns and distorted beliefs
Treatment for neglect focuses on parenting skills and expectations, and may include training in social competence and management of daily demands

23. Prevention and Treatment
Sexual abuse
treatment programs are few and difficult to devise as sexual abuse affects each child differently
treatment tries to restore child’s sense of trust, safety, guiltlessness through educational and cognitive-behavioral methods, as well as group therapy
Child needs to express feelings about the abuse, and may need specialized treatment if suffering from PTSD

24. Overview
Primary prevention would be treatment of choice since maladaptive patterns are hard to change.
Prevention/early intervention needs to be aimed at parent since child is too young for direct intervention.
Most successful early interventions involve both parent & child and are child-centred.

25. FINAL EXAM Gym: A – Nicholson Stage: Noble - Z
DATE: Saturday, April 19, 2003
TIME: 7:00 to 9:30 p.m.
PLACE: Alumni Hall
Gym: A – Nicholson
Stage: Noble - Z
GOOD LUCK & HAPPY HOLIDAYS!