Child Abuse and Neglect: The Need for Courage
By Karen Polonko

True stories.
In India, a 3-year-old is exposed to hazardous substances while working in an unventilated room in a small village factory. Her fingers are wrapped so that the blood from her cuts will not interfere with her work. At the same moment, in Thailand, a child, age 8, is sold into sexual slavery. Forced to have sex with an average of 15 customers a day, she is likely to be infected with HIV within six months.

Closer to home, a 4-year-old boy labors in the grape fields in upstate New York alongside other migrant workers. He suffers chronic respiratory infections; his hands are in constant pain.

Meanwhile, in the Midwest, a desperate girl tells her mother that her father is molesting her. The father says that she is making this up to get even with him for something else. After the mom (who was sexually abused as a child herself) leaves, the father ties his daughter to a tree and partially buries her cat next to her. He then runs the lawn mower over the animal, as the child screams that she will be good and take everything back if he will let her cat live.

Elsewhere, a little boy, age 4, has his hands amputated after they were tied tightly behind his back as punishment for using his father’s paint. His father, an alcoholic, fell asleep and forgot to untie his son. When they finally return from the hospital, the son asks his father if he is really good, can he have his hands back. Later that day, the father kills himself.

These are the stories that we do not want to hear. We want to believe that all children are safe. We argue that these cases are the rare exception. It is too painful to believe otherwise.

Prevalence.
Unfortunately, child maltreatment is not rare. According to the latest UNICEF reports, literally hundreds of millions of children throughout the world are victims of abuse, neglect and exploitation. At the extremes, children are killed, abandoned, sold or given in “debt” bondage. Close to 6 million children work under conditions of virtual slavery. Every year, millions of girls are trafficked, exploited in the sex industry and/or genitally mutilated. Millions more at home and abroad are beaten, emotionally abused, molested and/or neglected by their parents.

In the United States alone, more than 3 million children are reported to official agencies for severe maltreatment in any given year. Surveys indicate that this figure grossly underestimates the true extent of the problem as more than one-third of adults in the United States report having experienced physical abuse, sexual abuse, emotional abuse and/or neglect as a child.

Definitions.
Like our need to believe that child maltreatment is rare, many people believe that only the most egregious forms of maltreatment could harm a child. The rest just “toughens them up,” “keeps them under control” and is “for their own good.” Unfortunately, the reality is that both extreme and less severe levels of maltreatment can harm children in profound ways.

Reflecting the myths, child abuse and neglect are typically distinguished from other levels of child maltreatment by severity and evidence of intentionally inflicted, observable injury or impairment, under the mistaken assumption that only such extremes indicate that a child has been harmed. So, for example, in a study that Old Dominion University colleague Lucien Lombardo, professor of sociology, and I conducted, titled “A Comparative Analysis of Human Rights’ and United States’ Law on Corporal Punishment: Implications for Understanding Human Rights and Colonial Models of Child-Adult Relationships,” we found that most U.S. statutes relating to corporal punishment are concerned with explicitly safeguarding the rights of parents to use violence against children. The exceptions are specified as excessive violence or “physical abuse” – i.e., violence that intentionally caused substantial injury such as the child’s death, disfigurement, or brain or spinal cord damage.

Similarly, other forms of child maltreatment are defined in terms of granting parents permission to inflict maximal harm on children, finding abuse only in the extremes that result in demonstrable injury. Child emotional abuse is an extreme or habitual pattern of hostile and aggressive parenting that results in mental or emotional injury. Emotional neglect is extreme lack of emotional responsiveness and involvement that causes mental or developmental harm. Child sexual abuse is extreme oral, genital or anal contact (or defined legally in terms of age difference, minor status and/or relationship to perpetrator). Child neglect is restricted to the extremes of parental lack of involvement and supervision, and failure to meet the child’s needs, which place the child’s life in serious danger.

Consequences.
Given the above, it is surprising that many people do not believe that child maltreatment has profoundly negative consequences that go beyond the specific childhood injury to impact the rest of the child’s life. Instead, people often mistakenly attribute the long-term consequences of child abuse to irrelevant factors. However, the reality is that the consequences of child maltreatment are enormous, not only for the survivor, but also for society.

Some consequences of maltreatment differ according to the child’s vulnerability. For instance, infants and toddlers are at greatest risk of fatal abuse, with a blow to the baby’s head as the most common cause of death. Some consequences for the child are greater for one type of maltreatment than another. For example, child neglect is most strongly associated with the child having a lower IQ and lower educational achievement; child physical abuse with the child engaging in violent crime as a teen and adult; and child emotional abuse with subsequent psychopathology. However, all forms of maltreatment are associated with adverse effects for children and the adults they become. As discussed in my paper “Causes and Consequences of Child Abuse: Shedding More Light on the Cycle of Violence and Neglect,” prior research points to the following:

Child physical and emotional abuse and neglect all increase the likelihood that the child will subsequently:
• Be cognitively impaired (including having a lower IQ and cognitive development; lower grades and educational achievement);
• Have impaired moral reasoning (including having less empathy, less compliance and less developed conscience);
• Engage in violence and crime (including higher rates of juvenile delinquency, teen and adult violent and nonviolent crime);
• Be violent in relationships (including being more likely to assault their siblings and other children as a child, and later to abuse their own children, spouse and elderly parents).
In addition, all types of child maltreatment – physical and emotional abuse and neglect and sexual abuse – increase the likelihood that the child will subsequently:
• Have mental health problems (including higher rates of depression, anxiety, dissociation, etc.);
• Become a substance abuser of both legal and illegal substances as a teenager and adult;
• Become pregnant as a teenager and engage in risky sexual behavior (including earlier first intercourse, exposure to sexually transmitted diseases and greater number of partners).

Aside from the obvious, part of the reason these effects are so profound is that much child maltreatment occurs before age 6, during “critical windows” of development. Being neglected early in life, for example, is linked to the underdevelopment of those parts of the brain responsible for cognitive development and empathy. Being the target of or witnessing physical violence early in life is more likely to result in the overdevelopment of parts of the brain that ultimately affect impulsivity, reactivity, anxiety and aggression. As research by Bruce D. Perry, M.D., Ph.D., senior fellow of the Child Trauma Academy, shows, both abuse and neglect physiologically predispose a child to a series of neurobiological problems and violent behavior. These physiological changes are compounded by the modeling effect of seriously inadequate parenting; the adoption of a belief system about self, others and the world as malevolent; and the defense mechanisms abused children must develop to cope with their terror, despair and hopelessness. For example, the child blames himself for the abuse or denies that the parent is maltreating him.

Causes.
The general belief is that parents who maltreat their children are rare, pathological and certainly not like us. The reality is that most parents engage in culturally permissible or low levels of child abuse and neglect. Inflicting these permissible levels of maltreatment not only harms children, but also often escalates to the more severe forms of maltreatment.

Many of the parents who abuse and neglect their children were themselves maltreated as children. They are the little ones we failed to protect a generation ago. Also, many of the harmful consequences that resulted from their abuse and neglect, such as mental health problems, substance abuse and teen pregnancy, caused them to maltreat their children, laying the foundation for a cycle of abuse and neglect across generations. As reviewed in “Causes and Consequences of Child Abuse,” research indicates the following.

First, parents who abuse or neglect their children are more likely to:
• Have been maltreated as a child;
• Have mental health problems, including parent depression;
• Have a violent marriage;
• Be a substance abuser;
• Be a teenage mother;
• Have lower levels of education and income.
Second, parents who abuse or neglect their children are also more likely to:
• Have serious parenting deficits (e.g., have unrealistic expectations for their children);
• Use harsh and aggressive parenting with their children (i.e., low levels of emotional abuse);
• Have low levels of parental involvement and supervision, and give their children very little positive attention and affection (i.e., low levels of physical and emotional neglect);
• Frequently use corporal punishment on their children (i.e., low levels of physical abuse);
• Have few cognitively stimulating materials in the home for their children (i.e., low levels of neglect).

The first group of factors provides insights into the cycle of abuse and neglect. Being maltreated as a child models parenting behaviors and leads to the adoption of beliefs and defenses that increase the survivor’s chances of harming his own children. In addition, being maltreated as a child increases the likelihood that one will suffer other outcomes such as lower IQ and educational attainment, more mental health problems, substance abuse and teen pregnancy – each of which, in turn, independently increases the risk of maltreating one’s own child.

The second set of factors shows that parents who severely maltreat their children are more likely than other parents to more frequently subject their children to low levels of abuse and neglect. In other words, when parents engage in “culturally acceptable” levels of harsh parenting, corporal punishment, verbal aggression, and minimal involvement and supervision, they are significantly more likely to proceed to more severe abuse and neglect of their children. Thus, in contrast to what is typically assumed, low levels of maltreatment are dangerous for children. Moreover, at least in the area of physical violence, more frequent corporal punishment has the same adverse consequences as physical abuse, from lower IQ to more violent behavior and mental problems, except to lesser degrees. (This includes a finding from a master’s-level study in Old Dominion’s Department of Sociology and Criminal Justice that the more frequently a girl is subjected to corporal punishment when young, the more likely she is to become pregnant as a teenager.)

As discussed in “Causes and Consequences of Child Abuse,” these findings help us to understand another important reason why children of teenage mothers and socioeconomically disadvantaged parents are more likely to be abused and neglected. These parents are also significantly more likely to use “low levels of abuse and neglect,” such as more hostile and aggressive parenting, more frequent corporal punishment, and less responsiveness and involvement. They also are less likely to get care and more likely to use both legal and illegal drugs while pregnant, which is related to premature birth and neurological and cognitive problems in the baby. In turn, substance-abusing mothers are also more likely to be young and impoverished. All of this is related to having been abused and neglected themselves as children.

Intervention.
Some people believe that intervention on behalf of maltreated children is so effective that even adequate parents now have to worry about outside interference. The reality is that intervention and prevention programs have not been effective in reducing the prevalence of child abuse and neglect.

As many researchers and practitioners acknowledge, few resources are committed; agencies have little power to intervene; and treatment is often low cost, short term and focused on keeping the family together, rather than ensuring that the child is safe from abuse and neglect. We refuse to acknowledge that both child abuse and neglect, as well as low levels of child maltreatment, have serious consequences for the child and society. Instead, we blame child maltreatment and its consequences (for example, delinquency and drug abuse), on people and conditions that fit preconceived stereotypes and political agendas, such as a common belief that maternal employment causes delinquency, even though there is no evidence to support this. In this country, we continue to spend hundreds of millions of dollars on programs like Abstinence Only or Just Say No that just don’t work because they don’t address the underlying problems.

The need to unite.
Discussions of child maltreatment are often polarized around issues of religion, class, race, ethnicity and culture, both within and across countries. Often, parents may believe that group status justifies how they treat their children. However, the reality that emerges from a multicultural look at child abuse and neglect is that while children of certain groups may experience different types of abuse, children of all religions, income levels, races, ethnic groups and countries suffer from maltreatment.

A review of research on rates in the United States indicates that incidences of child sexual abuse and emotional abuse do not differ significantly for African American, Caucasian and Hispanic girls. On the other hand, African American children have higher rates of physical abuse and neglect than Caucasians, although a significant portion of this difference is due to variations in education, income and poverty – i.e., factors that increase the child’s risk of maltreatment. However, with rare exception, research shows that children of all races and ethnic groups suffer adverse consequences when abused or neglected.

Lighting the way to concerted action on behalf of children, African American leaders like Dr. Alvin Poussaint and the Rev. Jesse Jackson have joined other leaders in the fight to end not only severe child abuse, but also lower levels of abuse and neglect, including corporal punishment.

Internationally, we are urged to look for ways that we have inadvertently supported child maltreatment, such as buying products made by young children, refusing to confront travel agencies that covertly advertise sex tours to Thailand for young virgins, and simply remaining silent.

Standing in the way of preventing child maltreatment is the power differential between parents and children. Parents are for the most part lawfully free to engage in child abuse and neglect, short of serious injury, as part of their parental prerogative. As discussed in several papers that I have written with Professor Lombardo, including “Cycles of Trauma and Cycles of Nurturing: The UN Convention on the Rights of the Child and the Path from Childhood to Adulthood” and “The Enlightened Witness: Reasserting Humanity in the Face of Violence at the Beginning of the 21st Century,” the key is to extend to children the rights of human beings.

As many scholars have stressed, the most logical way for the United States to begin this process of reducing child maltreatment is to join every other country (except for Somalia) in the United Nations that has adopted the UN Convention on the Rights of Children. This will take courage, for in granting children human rights, we must challenge not only the beliefs and laws which support the power parents have to hit, harm, ignore and exploit their children, but also the beliefs, defenses and behaviors that parents developed to survive their own childhood maltreatment. As Dr. Perry concludes in his paper “Incubated in Terror: Neurodevelopmental Factors in the ‘Cycle of Violence’”: “In order to solve the problems of violence, we need to transform our culture. We need to change our child rearing practices, we need to change the malignant and destructive view that children are the property of their biological parents. … Children belong to the community, they are entrusted to parents.”

As researchers and practitioners emphasize, we, as a society, must do everything in our power to prevent and treat child maltreatment, not only because of the suffering of the victims, or even because of the benefits that society stands to gain, but because it is the right thing to do. It is an ethical imperative. It is our moral responsibility.

For more information about child abuse and how you can help prevent it, visit UNICEF at www.unicef.org; Child Trauma Institute at www.childtrauma.com; In Support of Children, an ODU student organization devoted to ending child abuse, at http://groups.hamptonroads.com/SupportChildren; the Post Institute for Family Centered Therapy at www.postinstitute.com; and Child Abuse Prevention Network at http://child-abuse.com. Dr. Perry’s paper, “Incubated in Terror: Neurodevelopmental Factors in the ‘Cycle of Violence,’” is available at www.childtrauma.org/CTAMATERIALS/incubated.asp. An excellent sourcebook, The APSAC Handbook on Child Maltreatment, written in 2002, can be found at www.APSAC.org.

Karen Polonko is a professor in the Department of Sociology and Criminal Justice.


Quest Fall 2005 • Volume 8 Issue 2