1. CHILD ABUSE AND NEGLECT: AN OVERVIEW Barbara L. Bonner, Ph.D. Center on Child Abuse and Neglect University of Oklahoma Health Sciences Center

2. DEFINE THE PROBLEM There is not a set of definitions for neglect, physical abuse, sexual abuse, or psychological maltreatment that is used consistently by local, state, and federal agencies or across the multiple disciplines that deal with this problem.

3. PSYCHOLOGICAL MALTREATMENT Definition Psychological Neglect - the consistent failure of a parent or caretaker to provide a child with appropriate support, attention, and affection. Psychological Abuse - a chronic pattern of behaviors such as belittling, humiliating, and ridiculing a child.

4. PSYCHOLOGICAL MALTREATMENT SHOULD BE CONSIDERED WHEN: Lack of attachment between infant and parent Lack of responsiveness to environment Failure-to-thrive Parent is highly critical and negative toward the infant/child

5. NEGLECT Definition Neglect is the chronic failure of a parent or caretaker to provide a child under 18 with basic needs such as food, clothing, shelter, medical care, educational opportunity, protection, and supervision.

6. NEGLECT SHOULD BE CONSIDERED WHEN: Significantly below height/weight for age Inappropriate clothing for weather Lack of safe, sanitary shelter Lack of necessary medical and dental care

7. NEGLECT SHOULD BE CONSIDERED WHEN: Reports no caretaker in the home Untreated illness or injury Poor hygiene, including lice, body odor, scaly skin Child abandoned or left with inadequate supervision

8. FAILURE TO THRIVE Definition Failure to thrive (FTT) is a condition in which children show a marked retardation or cessation of growth. FTT can result from: A medical condition Environmental factors or Combination of medical and environmental factors

9. PHYSICAL ABUSE Definition Physical abuse is any non-accidental injury to a child under the age of 18 by a parent or caretaker. These injuries may include beatings, shaking, burns, human bites, strangulation, or immersion in scalding water, with resulting bruises and welts, broken bones, scars, burns, retinal hemorrhage, or internal injuries.

10. PHYSICAL ABUSE SHOULD BE CONSIDERED WHEN: History given by parent does not match the injury Child gives unbelievable explanation for the injuries Child reports injury by parent Child is fearful to go home or requests to stay at school, daycare, hospital

11. CHILD SEXUAL ABUSE Definition Child sexual abuse is the exploitation of a child or adolescent for the sexual gratification of another person.

12. SEXUALLY ABUSIVE BEHAVIORS Voyeurism Fondling Child prostitution Child pornography Intercourse

13. SEXUALLY ABUSIVE BEHAVIORS Sodomy Oral-genital stimulation Verbal stimulation Exhibitionism

14. SEXUAL ABUSE SHOULD BE CONSIDERED WHEN: Injury to genital area or other medical indicators History of somatic complaints, including pain or irritation of the genitals Sexually transmitted disease

15. SEXUAL ABUSE SHOULD BE CONSIDERED WHEN: Pregnancy in young adolescent Frequent unexplained sore throats, yeast or urinary infections Child reports inappropriate sexual behavior Child engaged in highly inappropriate sexual behavior

16. 2001 NATIONAL FINDINGS 57% neglect (includes medical neglect) 19% physical abuse 10% sexual abuse 20% additional types of maltreatment, including 7% psychological maltreatment (overlapping cases, therefore does not equal 100%)

17. 2001 NATIONAL FINDINGS 3 million reports on 5 million children 903,000 child victims (12.4/1000children) Boys and girls equally at risk for maltreatment Children 3 and younger are more likely to be maltreated Almost 2 children per 100,000 died from abuse

18. 2001 NATIONAL FINDINGS 59% of perpetrators = females 41% of perpetrators = males 81% of perpetrators = one parent acting alone – 41% mother acting alone – 18% father acting alone

19. 2001 NATIONAL FINDINGS Based on the number of children under age 18, the percentage of abused children compared to the racial/ethnic distribution of the U.S. population: % Abused% of Population* - Caucasian: 50% 69% - African American: 25%12% - Hispanic: 15%13% - Native American: 2%1% -Asian/Pacific Islander: 1%4% -Multiple Races/Unknown 7%9% * Total does not equal 100% as some people claim membership in multiple racial/ethnic groups.

20. 2001 NATIONAL FINDINGS % of Referrals Professionals57% - Educational Personnel - Legal/Law Enforcement - Social Services/Mental Health - Medical Personnel Non-Professionals43% - Family Members - Neighbors - Other Community Members

21. CHILD ABUSE AND NEGLECT Etiological/Associated Physical SexualPsychological Factors Neglect Abuse Abuse Maltreatment Domestic Violence X XX X One Parent Household XX XX XX Poverty XX X x Stress X XX x x Lacking Education XX XX X Substance Abuse XX X x Family Patterns X XX X X Mental Disorders x x XX * ? - Parental Depression X XX ? Social Factors X X X X Social Isolation XX X X ? Unknown X X XX XX (Bonner, 2003) * Includes paraphilias

22. CHILD ABUSE CASES INVOLVE: Child Protective Services Law enforcement Physicians, Nurses Prosecutors, Defense Attorneys, Judges Mental health professionals

23. CHILD ABUSE CASES INVOLVE: Child advocates, CASA volunteers Foster parents Domestic violence staff Educators Community members, clergy

24. INTERDISCIPLINARY APPROACH Child Protection Teams Children’s Advocacy Centers Local and State Child Death Review Teams

25. WHEN TO REPORT A report should be made when there is reasonable cause to believe that a child or adolescent has been abused or neglected or is in danger of being abused. A report of suspected abuse is only a request for an investigation.

26. Remember: A report of suspected child abuse is a responsible attempt to protect a child.