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1. Assess child abuse risk factors 2. Evaluate the need for a Suspected Child Abuse Report 3. Become familiar with relevant child abuse statistics 4. Differentiate between the roles of mandated and non-mandated reporters 5. Identify the symptoms and warning signs of child abuse 6. Utilize applicable clinical assessment and treatment tools 7. Utilize applicable treatment interventions 8. Identify and have accessibility to relevant resources Table of Contents: 1. Definition 2. History and the Law 3. Types of Child Abuse 4. Statistics 5. Mandated Reporters 6. Child Abuse Symptoms 7. Clinical Assessment 8. Treatment 9. Resources 10. References 1.
Definition
Child abuse is the physical, psychological or sexual maltreatment of children. The
Centers for Disease Control and Prevention (CDC) defines child maltreatment as “any act or series of acts or commission or omission by a parent or other caregiver that results in harm, potential for harm, or threat of harm to a child”. Most child abuse occurs in the home, with a lesser amount occurring in the organizations, schools or community organizations. Currently, there are four widely recognized and identifiable categories of child abuse including neglect, physical abuse, psychological/emotional abuse, and sexual abuse. Different jurisdictions have developed their own definitions of what constitutes child abuse for the purposes of removing a child from his/her family and/or prosecuting a criminal charge. The Mental Health Journal defines child as “any recent act or failure to act on the part of a parent or caretaker which results in death, serious physical or emotional harm, sexual abuse or exploitation, an act or failure to act which presents an imminent risk of serious harm.”
2. History and the Law
Child sexual abuse is illegal in every civilized society with consequences often including severe criminal penalties, and in some jurisdictions, life imprisonment or capital punishment. A legal adult's sexual intercourse with a child below the legal age of consent is defined as statutory rape, based on the principle that a child is not capable of consent and that any apparent consent by a child is of course not considered to be legal consent. The United Nations Convention on the Rights of the Child (CRC) is an international treaty that legally obliges states to protect children's rights. Articles 34 and 35 of the CRC require states to protect children from all forms of sexual exploitation and sexual abuse. This includes outlawing the coercion of a child to perform sexual activity, the prostitution of children, and the exploitation of children in creating pornography. States are also required to prevent the abduction, sale, or trafficking of children. As of November 2008, 193 countries are bound by the CRC, including every member of the United Nations except the United States and Somalia. Child sexual abuse has gained increased public attention throughout the past few decades and has become one of the most high-profile crimes. Since the 1970s the sexual abuse of children and child molestation has increasingly been recognized as deeply damaging to children and thus unacceptable for society as a whole. While sexual use of children by adults has existed throughout history, it has only become the object of significant public attention in recent times. The first published work dedicated specifically to child sexual abuse appeared in France in 1857: Medical-Legal Studies of Sexual Assault (Etude Médico-Légale sur les Attentats aux Moeurs), by Auguste Ambroise Tardieu, the noted French pathologist and pioneer of forensic medicine (Masson, 1984, pp. 15–25). Prior to the 1970’s and 1980’s, sexual abuse remained secretive and socially unspeakable. Studies on child molestation did not emerge until the 1920s and the first national estimate of the number of child sexual abuse cases was published in 1948. By 1968 44 out of 50 U.S. states had enacted mandatory laws that required physicians to report cases of suspicious child abuse. Legal action began to become more prevalent in the 1970s with the enactment of the Child Abuse Prevention and Treatment Act in 1974 in conjunction with the creation of the National Center for Child Abuse and Neglect. Since the creation of the Child Abuse and Treatment Act, reported child abuse cases have increased dramatically. Finally, the National Abuse Coalition was created in 1979 to create pressure in congress to create more sexual abuse laws. Feminism contributed to increased awareness of child sexual abuse and violence against women, and made them public, political issues. Judith Lewis Herman, Harvard professor of psychiatry, wrote the first book ever on father-daughter incest when she discovered during her medical residency that a large number of the women she was seeing had been victims of father-daughter incest. Herman notes that her approach to her clinical experience grew out of her involvement in the civil rights movement. Her second book Trauma and Recovery, considered a classic and ground-breaking work coined the term complex post-traumatic stress disorder. "In it she defines this concept not only in terms of prolonged trauma, but in terms of what she calls "subjection to totalitarian control." Examples of this concept include:...hostages, prisoners of war, concentration-camp survivors, and survivors of some religious cults. Examples also include those subjected to totalitarian systems in sexual and domestic life, including survivors of domestic battering, childhood physical or sexual abuse, and organized sexual exploitation (In 1986, Congress passed the Child Abuse Victims' Rights Act, which allowed victims a civil claim in sexual abuse cases. The number of laws created in the 1980s and 1990s began to create greater prosecution and detection of child sexual abuse perpetrators. During the 1970s a large transition began in the legislature related to child sexual abuse. Megan's Law which was enacted in 2004, gives the public access to knowledge and identification of sex offenders nationwide. Anne Hastings described these changes in attitudes towards child sexual abuse as "the beginning of one history's largest social revolutions." According to John Jay College of Criminal Justice professor B.J. Cling, "By the early 21st century, the issue of child sexual abuse has become a legitimate focus of professional attention, while increasingly separated from second wave feminism...As child sexual abuse becomes absorbed into the larger field of interpersonal trauma studies, child sexual abuse studies and intervention strategies have become degendered and largely unaware of their political origins in modern feminism and other vibrant political movements of the 1970s. One may hope that unlike in the past, this rediscovery of child sexual abuse that began in the 70s will not again be followed by collective amnesia. The institutionalization of child maltreatment interventions in federally funded centers, national and international societies, and a host of research studies (in which the United States continues to lead the world) offers grounds for cautious optimism. Nevertheless, as Judith Herman argues cogently, 'The systematic study of psychological trauma...depends on the support of a political movement.'" Herman, Judith Lewis, 1997. Trauma and recovery: The aftermath of violence from domestic abuse to political terror. Basic Books). Increasing awareness of child sexual abuse in the United States has ignited civil lawsuits for monetary damages. Increased awareness of child sexual abuse has also encouraged more victims to step forward, whereas in the past victims were often secretive about their abuse. Some states have enacted specific laws lengthening the applicable statutes of limitations so as to allow victims of child sexual abuse to file suit sometimes years after they have reached the age of majority. Such lawsuits can be brought where a person or entity, such as a school, church or youth organization, was charged with supervising the child but failed to do so with child sexual abuse resulting. In the Catholic sex abuse cases the various Roman Catholic Dioceses in the
United States have paid out approximately $1 billion settling hundreds of these lawsuits since the early 1990s. Due to the fact that lawsuits often involve demanding procedures, concern exists that children or adults who file suit will be re-victimized by defendants through the legal process. The child sexual abuse plaintiff's attorney Thomas A. Cifarelli has written that children involved in the legal system, particularly victims of sexual abuse and molestation, should be afforded certain procedural safeguards to protect them from harassment during the legal process. A 2000 World Health Organization Geneva report, “World Report on Violence and Health (Chap 6 - Sexual Violence)” states, “Action in schools is vital for reducing sexual and other forms of violence. In many countries a sexual relation between a teacher and a pupil is not a serious disciplinary offence and policies on sexual harassment in schools either do not exist or are not implemented. In recent years, though, some countries have introduced laws prohibiting sexual relations between teachers and pupils. Such measures are important in helping eradicate sexual harassment in schools. At the same time, a wider range of actions is also needed, including changes to teacher training and recruitment and reforms of curricula, so as to transform gender relations in schools.” 3. Types of Child Abuse • Neglect, in which the responsible adult fails to adequately provide for various needs, including physical (failure to provide adequate food, clothing, or hygiene), emotional (failure to provide nurturing or affection) or educational (failure to enroll a child in school). • Physical abuse is physical aggression directed at a child by an adult. It can involve striking, burning, choking or shaking a child, and the distinction between discipline and abuse is often poorly defined. The transmission of toxins to a child through their mother (such as with fetal alcohol syndrome) can also be considered physical abuse in some jurisdictions. • Child sexual abuse is any sexual act between an adult and a child, including penetration, fondling, exposure to adult sexuality and violations of privacy. • Psychological abuse, also known as emotional abuse, which can involve belittling or shaming a child, inappropriate or extreme punishment and the withholding of affection.
Physical Abuse
Physical abuse is abuse involving contact intended to cause feelings of intimidation, pain, injury, or other physical suffering or harm. Forms of physical abuse include: • striking • punching • pushing, pulling • slapping • Whipping • striking with an object • locking in or out of a room or place/false imprisonment • excessive pinching • kicking • having someone fall • kneeing • strangling • head butting • drowning • sleep deprivation • exposure to cold, freezing • exposure to heat or radiation, burning • exposure to electric shock • placing in "stress positions" (tied or otherwise forced) • cutting or otherwise exposing somebody to something sharp • exposure to a dangerous animal • throwing or shooting a projectile • exposure to a toxic substance • infecting with a disease • withholding food or medication • assault • bodily harm • humiliation • torture
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