What is Child Abuse?
Child abuse, neglect or maltreatment is a global issue that is confronting all countries of the world including the United States. This paper will use the term abuse/maltreatment exchangeable to mean the same, referencing to children. Child abuse, neglect, and trauma are global problems, but abuse of a child will be the focus of this paper. Abuse according to (Chan, Elliott, Chow, & Thomas, 2002, p.361) as cited by (Westby, 2007) is defined as when "a person willfully or unreasonably does, or cause a child or young person to do, any act that endangers or causes or is likely to cause a child or young person (a) any unnecessary physical pain, suffering or injury; (b) any emotional injury; or (c) any injury to his or her health or development".
The United Nations (UN) maintains that violence is one of the most serious problems affecting children today. The World Health Organization (WHO) estimates that 40 million children below the age of 15 experiences abuse and neglect requiring health and social care (Westby, 2007). According to Westby (2007), 300,000 child soldiers, some as young as 8 years are in armed conflicts in more than 30 countries at any given time. In Central and Eastern Europe, 1.5 million children live in orphanages that provide minimal care; two million are exploited through prostitution and pornography, according to (UNICEF, n.d.) as cited by (Westby). According to Children's Defense Fund, 1999 as cited by Westby, child abuse and neglect in the United States have been increasing by approximately 10% a year since 1976.
The Children's Defense Fund, 1999 reported that 5% of parents in the United States admitted to disciplining their children by hitting the child with an object, kicking the child, beating the child or threatening the child with a knife or gun as cited by Westby (2007). Violence has severe implications for children's development, even when it does not lead to obvious physical injury or death. According to Lynch, 1976; and Martin, 1976 as cited by Westby, 2007, abuse is more common among children who were born premature or low birth weight, who have had prolonged illnesses, or who have developmental disabilities. Abused children cognition and language abilities are more likely to develop poorly. There are different types of abuse, namely, neglect, or emotional, physical, or sexual. Neglect is the most common form of reported abuse (60% of all cases) and is the most common cause of death in abused children, and it is define by the Office on Child Abuse and Neglect as failure to provide for a child's basic physical, emotional, educational/cognitive, or medical needs. (McDonald, 2007) Emotional abuse may be the most difficult form of abuse to recognize in clinical practice, because it develops as a result of repeated damaging interaction, and is define by the Office on Child Abuse and Neglect as abuse the results in demonstrable harm (e.g., impaired psychological growth and development) of a child. Sexual abuse is define as the employment, use, persuasion, inducement, enticement, or coercion of any child to engage in, any sexually explicit conduct or stimulation of such conduct for the purpose of producing a visual depiction of such conduct; or the rape, molestation, prostitution, or other form of sexual exploitation of children, or incest with children. (McDonald, 2007) Watson and Westby (2003) found that teachers who were not aware that children were from environments where they were likely prenatally and postnatally exposed to drugs and alcohol abuse assumed that the children's poor behavior was intentional.
As a result, these teachers were more likely to employ disciplinary rather than educational strategies in coping with the children's inattentive behaviors and learning difficulties. According to Perry, Pollard, Blakley, Baker, & Vigilante, 1995 as cited by Westby, 2007, early abuse, neglect, or trauma results in biochemical and structural changes in the brain that lead to a variety of learning and behavioral difficulties. Charlow, 2001-2002, as cited by Westby, 2007, rates of child abuse in community samples are generally similar across ethnic groups, but African American, Native American, and Latino Children are over represented in the child welfare system and foster care in reported cases of child maltreatment as compared to their percentages in the population at large and even their representation among people of lower income. According to the U.S. Department of Health and Human Services, Administration for Children and Families, 2002, as cited by Westby, 2007, African American children make up 26% of reported cases (they are 12% of the child population), Hispanic children 11% (they are 13% of the child population, Native American and Alaskan natives 2% (7% of child population), and Asian Pacific Islanders 1% (4% of the child population). These differences in representation may be due to true differences in maltreatment levels based on differences in poverty levels, cultural differences, or neighborhood deterioration (Coulton, Korbin, & Su, 1999); to biases in the reporting, substantiating, and handling of suspected child abuse (Ards, Chung, & Myers, 1998); and to lack of social services and outreach in certain communities as cited by Westby, 2007. According to Fontes, 2005; Park, 2001; Weil & Lee, 2004, as cited by Westby, 2007, children in immigrant families may be at somewhat greater risk for abuse related to the disorienting, stressful effects of migration.
Traditional gender roles may become reversed, disrupting typical family dynamics. Fontes, 2005 as cited by Westby, 2007 suggested that the tendency of some immigrant families to discipline their children in public when they see them acting disobediently or disrespectfully may bring them to the attention of protection and advocacy services. The Child Abuse Prevention and Treatment Act (CAPTA, Jan. 1996 version) mandates all fifty states to passed laws making the reporting of child abuse mandatory in order for them to receive funding. All states require that certain professionals such as health care providers, mental health providers of all types, teachers, and other school personnel, social workers, day care providers, and law enforcement personnel report suspected child abuse. Eighteen states have broad statutes that require "any person" to report. Some statutes require reporting based on "reasonable cause to believe" or "reasonable suspicion" failure to report abuse can result in criminal liability that is typically punishable by a fine or jail term (Westby).
There are a lot of influences on child maltreatment, but three levels were of major concern by professional. Korbin (1981) identified these three levels as; (1) accepted cultural practices; (2) idiosyncratic practices and (3) societal issues. Korbin, 1981 identified the first level as the ability for people to accept the cultural differences in childrearing practices and belief, practice that may be viewed as appropriate and acceptable in one culture but as neglectful and harmful in another. For example, many cultures consider the mainstream American practice of infants and young children sleeping alone in their own bed and rooms as neglectful, while the mainstream American find it inappropriate for adults to sleep with children. All cultures employ some type of healing practices, the Vietnamese practice of cao gio and the Chinese cheut sah, in which parent rubs the edge of a coin or applies a hot spoon to a child's skin to treat a variety of symptoms (Davis, 2000). The Hispanic practice of putting petroleum jelly on children's eyes when children have difficulty sleeping, reddened and crusty eye margin, and the East Asian and Eastern European countries practice cupping, which involves lowering a ceramic cup, turned upside down with a candle underneath, down to the skin of the afflicted area of the body will all be seen as abuse if one is not of those culture.
(Westby, 2007) Level two of the influence of child maltreatment according to Korbin, 1981 is idiosyncratic practices, which involves a caregiver claiming that his method of disciple if strictly cultural and the third level of influence of child maltreatment is societal issues, which referred to the harm children experience due to poverty, inadequate housing, poor health care, inadequate nutrition, and unemployment of parents. Variations in discipline practices are particularly to raise concern of abuse, but disciple is part of a cultural system, and as such, they are difficult to change. Even though a disciple method or a healing method may be culturally based, this does not mean that it is not harmful to the child and should be permitted. Professionals must find ways to handle parents' rights to punish children in a way that fits with their culture and values while at the same time protecting the children (Westby). Professionals should be culturally competent in order to change these disciplinary techniques, because without culture sensitivity, professionals frequently insult and alienate parents who are from culture that are different than their own when they discuss concerns about disciplinary techniques and raise concerns about abuse (Westby). Preventive efforts are more likely to be effective if they are tailored to the needs of the group they are meant to address.
Fontes, (2002), suggested that when working with families who use corporal punishment or other practices that may be questionable in the United States, professionals should explain the laws in the United States regarding behaviors that are considered abusive and neglectful and the consequences of parents being charge with abuse as cited by Westby. Fontes also suggest that professionals explore with families what their goals are with their discipline and discuss with them it their approaches are being effective. She also recommends using cultural norms to promote resistance to corporal punishment cited by Westby, 2007. Dealing with the issues of child abuse is never easy, but it becomes further complicated when dealing with families from culturally diverse backgrounds. We as professionals in training are obligated to prevent children from being harm, therefore we must be alert to signs of maltreatment, but at the same time be culturally competent, understanding the cultural beliefs about childrearing that may underlie practices that may be harmful. We must also respect the difference in families' discipline strategies in culturally acceptable ways. We must communicate effectively with one another and be consistent in the messages that we give to families (Westby, 2007).
References :
Davis, R. E. (2000). Cultural Health Care or Child Abuse: The Southeast Asians Practice of Cao Gio. Journal of the American Academy of Nurse Practitioners, 12, 89-95.
Korbin, J. E (Ed.). (1981). Child Abuse & Neglect: Cross-Cultural Perspective. University of California Press: Berkeley. McDonald,
Kelly C. (2007). Child Abuse: Approach and Management. American Academy of Family Physicians, 75(2), 221-8. Retrieved June 6, 2007, from http://www.aafp.org/afp
Rogers-Adkinson, D. L., & Stuart, S. K. (2007). Collaborative Services: Children Experiencing Neglect and the Side Effects of Prenatal Alcohol Exposure. LSHSS, 38, 149-156.
Westby, C. E. (2007). Child Maltreatment: A Global Issue. Language, Speech, and Hearing Services in School, 38(140-148),
The United Nations (UN) maintains that violence is one of the most serious problems affecting children today. The World Health Organization (WHO) estimates that 40 million children below the age of 15 experiences abuse and neglect requiring health and social care (Westby, 2007). According to Westby (2007), 300,000 child soldiers, some as young as 8 years are in armed conflicts in more than 30 countries at any given time. In Central and Eastern Europe, 1.5 million children live in orphanages that provide minimal care; two million are exploited through prostitution and pornography, according to (UNICEF, n.d.) as cited by (Westby). According to Children's Defense Fund, 1999 as cited by Westby, child abuse and neglect in the United States have been increasing by approximately 10% a year since 1976.
The Children's Defense Fund, 1999 reported that 5% of parents in the United States admitted to disciplining their children by hitting the child with an object, kicking the child, beating the child or threatening the child with a knife or gun as cited by Westby (2007). Violence has severe implications for children's development, even when it does not lead to obvious physical injury or death. According to Lynch, 1976; and Martin, 1976 as cited by Westby, 2007, abuse is more common among children who were born premature or low birth weight, who have had prolonged illnesses, or who have developmental disabilities. Abused children cognition and language abilities are more likely to develop poorly. There are different types of abuse, namely, neglect, or emotional, physical, or sexual. Neglect is the most common form of reported abuse (60% of all cases) and is the most common cause of death in abused children, and it is define by the Office on Child Abuse and Neglect as failure to provide for a child's basic physical, emotional, educational/cognitive, or medical needs. (McDonald, 2007) Emotional abuse may be the most difficult form of abuse to recognize in clinical practice, because it develops as a result of repeated damaging interaction, and is define by the Office on Child Abuse and Neglect as abuse the results in demonstrable harm (e.g., impaired psychological growth and development) of a child. Sexual abuse is define as the employment, use, persuasion, inducement, enticement, or coercion of any child to engage in, any sexually explicit conduct or stimulation of such conduct for the purpose of producing a visual depiction of such conduct; or the rape, molestation, prostitution, or other form of sexual exploitation of children, or incest with children. (McDonald, 2007) Watson and Westby (2003) found that teachers who were not aware that children were from environments where they were likely prenatally and postnatally exposed to drugs and alcohol abuse assumed that the children's poor behavior was intentional.
As a result, these teachers were more likely to employ disciplinary rather than educational strategies in coping with the children's inattentive behaviors and learning difficulties. According to Perry, Pollard, Blakley, Baker, & Vigilante, 1995 as cited by Westby, 2007, early abuse, neglect, or trauma results in biochemical and structural changes in the brain that lead to a variety of learning and behavioral difficulties. Charlow, 2001-2002, as cited by Westby, 2007, rates of child abuse in community samples are generally similar across ethnic groups, but African American, Native American, and Latino Children are over represented in the child welfare system and foster care in reported cases of child maltreatment as compared to their percentages in the population at large and even their representation among people of lower income. According to the U.S. Department of Health and Human Services, Administration for Children and Families, 2002, as cited by Westby, 2007, African American children make up 26% of reported cases (they are 12% of the child population), Hispanic children 11% (they are 13% of the child population, Native American and Alaskan natives 2% (7% of child population), and Asian Pacific Islanders 1% (4% of the child population). These differences in representation may be due to true differences in maltreatment levels based on differences in poverty levels, cultural differences, or neighborhood deterioration (Coulton, Korbin, & Su, 1999); to biases in the reporting, substantiating, and handling of suspected child abuse (Ards, Chung, & Myers, 1998); and to lack of social services and outreach in certain communities as cited by Westby, 2007. According to Fontes, 2005; Park, 2001; Weil & Lee, 2004, as cited by Westby, 2007, children in immigrant families may be at somewhat greater risk for abuse related to the disorienting, stressful effects of migration.
Traditional gender roles may become reversed, disrupting typical family dynamics. Fontes, 2005 as cited by Westby, 2007 suggested that the tendency of some immigrant families to discipline their children in public when they see them acting disobediently or disrespectfully may bring them to the attention of protection and advocacy services. The Child Abuse Prevention and Treatment Act (CAPTA, Jan. 1996 version) mandates all fifty states to passed laws making the reporting of child abuse mandatory in order for them to receive funding. All states require that certain professionals such as health care providers, mental health providers of all types, teachers, and other school personnel, social workers, day care providers, and law enforcement personnel report suspected child abuse. Eighteen states have broad statutes that require "any person" to report. Some statutes require reporting based on "reasonable cause to believe" or "reasonable suspicion" failure to report abuse can result in criminal liability that is typically punishable by a fine or jail term (Westby).
There are a lot of influences on child maltreatment, but three levels were of major concern by professional. Korbin (1981) identified these three levels as; (1) accepted cultural practices; (2) idiosyncratic practices and (3) societal issues. Korbin, 1981 identified the first level as the ability for people to accept the cultural differences in childrearing practices and belief, practice that may be viewed as appropriate and acceptable in one culture but as neglectful and harmful in another. For example, many cultures consider the mainstream American practice of infants and young children sleeping alone in their own bed and rooms as neglectful, while the mainstream American find it inappropriate for adults to sleep with children. All cultures employ some type of healing practices, the Vietnamese practice of cao gio and the Chinese cheut sah, in which parent rubs the edge of a coin or applies a hot spoon to a child's skin to treat a variety of symptoms (Davis, 2000). The Hispanic practice of putting petroleum jelly on children's eyes when children have difficulty sleeping, reddened and crusty eye margin, and the East Asian and Eastern European countries practice cupping, which involves lowering a ceramic cup, turned upside down with a candle underneath, down to the skin of the afflicted area of the body will all be seen as abuse if one is not of those culture.
(Westby, 2007) Level two of the influence of child maltreatment according to Korbin, 1981 is idiosyncratic practices, which involves a caregiver claiming that his method of disciple if strictly cultural and the third level of influence of child maltreatment is societal issues, which referred to the harm children experience due to poverty, inadequate housing, poor health care, inadequate nutrition, and unemployment of parents. Variations in discipline practices are particularly to raise concern of abuse, but disciple is part of a cultural system, and as such, they are difficult to change. Even though a disciple method or a healing method may be culturally based, this does not mean that it is not harmful to the child and should be permitted. Professionals must find ways to handle parents' rights to punish children in a way that fits with their culture and values while at the same time protecting the children (Westby). Professionals should be culturally competent in order to change these disciplinary techniques, because without culture sensitivity, professionals frequently insult and alienate parents who are from culture that are different than their own when they discuss concerns about disciplinary techniques and raise concerns about abuse (Westby). Preventive efforts are more likely to be effective if they are tailored to the needs of the group they are meant to address.
Fontes, (2002), suggested that when working with families who use corporal punishment or other practices that may be questionable in the United States, professionals should explain the laws in the United States regarding behaviors that are considered abusive and neglectful and the consequences of parents being charge with abuse as cited by Westby. Fontes also suggest that professionals explore with families what their goals are with their discipline and discuss with them it their approaches are being effective. She also recommends using cultural norms to promote resistance to corporal punishment cited by Westby, 2007. Dealing with the issues of child abuse is never easy, but it becomes further complicated when dealing with families from culturally diverse backgrounds. We as professionals in training are obligated to prevent children from being harm, therefore we must be alert to signs of maltreatment, but at the same time be culturally competent, understanding the cultural beliefs about childrearing that may underlie practices that may be harmful. We must also respect the difference in families' discipline strategies in culturally acceptable ways. We must communicate effectively with one another and be consistent in the messages that we give to families (Westby, 2007).
References :
Davis, R. E. (2000). Cultural Health Care or Child Abuse: The Southeast Asians Practice of Cao Gio. Journal of the American Academy of Nurse Practitioners, 12, 89-95.
Korbin, J. E (Ed.). (1981). Child Abuse & Neglect: Cross-Cultural Perspective. University of California Press: Berkeley. McDonald,
Kelly C. (2007). Child Abuse: Approach and Management. American Academy of Family Physicians, 75(2), 221-8. Retrieved June 6, 2007, from http://www.aafp.org/afp
Rogers-Adkinson, D. L., & Stuart, S. K. (2007). Collaborative Services: Children Experiencing Neglect and the Side Effects of Prenatal Alcohol Exposure. LSHSS, 38, 149-156.
Westby, C. E. (2007). Child Maltreatment: A Global Issue. Language, Speech, and Hearing Services in School, 38(140-148),
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