Abstract
Neglect and child abuse are acute worldwide problems and can take the form of sexual, physical, emotional, neglect in giving the child the basic needs. These issues can leave the child with severe long-lasting physical and psychological damage. It is a significant problem in the United States of America. Child abuse refers to non-accidental behavior by caregivers, parents or other adults in a child’s life that are outside the societal norms of conduct and can lead to emotional or physical damage to a child or a young adult. Every year, over four million children are reported to be abused or neglected. Research has indicated that children who have experienced abuse suffer from various psychological conditions including anxiety, depression, post-traumatic stress disorder, substance abuse, learning disorders as well as sexual behavior issues. The paper will examine the prevalence of child abuse in the society today and its psychological and general health consequences in a child as well as the measures that the community has taken to prevent child abuse and neglect.
Introduction
Child abuse and neglect are well developed as a vital concern in the society with significant outcomes for the children who are affected, their families, as well as the community as a whole. In today’s world, children are being abused at a rate that is alarming. The damage ranges from sexual assault to physical violence, neglect or psychological abuse. Child abuse is a universal issue that is deeply founded in economic, cultural as well as social practices. It affects children negatively, and the effects can even extend to adulthood.
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Child abuse is an acute problem and statistics have indicated that it is not an unusual occurrence. Following research, roughly 3,195,000 children in 1997 were reported to agencies of child protective services as alleged maltreatment victims. The information was gathered from 35 states in the United States which showed that each state averaged a two percent increase in the reports of child abuse in 1997. When the numbers are divided, fifteen children out of every 1,000 children in the United States were victims of maltreatment in 1997; which was the same rate among the three years before. In accordance to the National Clearing House on information concerning child abuse and neglect, a resource of the department of health and Human services in the U.S, there were approximately 2,806,000 reports of potential maltreatment in 1998. About thirty-four percent of these were screened out, and about sixty-six percent were investigated (Abdulaziz Al Odhayani, 2013). Of the cases that were investigated, thirty-percent concluded in findings of either substantiated or showed child abuse.
Following Jim Hopper, a researcher working at Boston University School of Medicine affirms that most victims of child abuse are not included in official statistics since most neglected and abused children never come to the authorities’ attention. Maltreatment can result in grave consequences in the character of the children or can even cause psychological conditions that may impact them throughout their life or for many years. Children who face abuse and neglect may suffer from mental conditions like depression, anxiety, low self-esteem, and withdrawal, school learning difficulties, pseudo-mature behavior or compulsivity.
There are many types of child abuse, each with ramifications that can seriously harm the development of a child. A child who is regularly abused suffers from more than one form of ill-treatment. Nonetheless, some forms of abuse are more commonly seen than others. The first commonly known form of maltreatment is physical abuse. It is the direct harm to the body of a child. The act may occur singly handily or repeatedly. The physical injuries incurred might be external, for instance, burn or laceration, or internal like bruised organs. There are a variety of methods of administering physical abuse, for example, hitting a child, emphatically shaking a baby, cutting the skin of a child, or using a hot instrument to burn the child’s skin. Moreover, in some social cultures, a particular abusive behavior is allowed by religious beliefs, such as inserting very sharp objects into the body of a child or burning a child to remove evil spirits or to heal a particular disease.
There is emotional abuse where it is inflicted by dismissing or ignoring the emotional reaction of a child or by humiliating or shaming a child (Chaahal May 2008). The abuse might be verbal which may take the form of bad names or derogatory words. One can also put a child down by comparing the child with a friend or sibling. Also, emotional abuse could be nonverbal. For example, by not acknowledging the needs of the child, treating the child as a bad child or unlovable or even ignoring cries for assistance.
Neglect is the most prevalent form of child abuse. Failing to give a child enough food, shelter, clothing to grow and to survive has severe impacts on the future of the child and puts him or her at a greater risk of infection, disease, retardation, or even demise. Neglect also involves not supplying access to educational and health services. Emotional neglect is also prevalent and can cause adverse long-term impacts on the development of the brain and future mental health.
Sexual abuse is seen as engaging in any act of a sexual nature with a minor. It can be penetration or acts that are considered to be sexually suggestive, like inappropriate kissing or touching. Some particular examples of sexual abuse involve coercing or inducing a child to take part in any form of sexual activity, using a child as a prostitute or involving a child in child pornography. Children are typically abused by individuals they know, usually close relatives.
Effects of child abuse on behavioral development stages
The infancy stage is an immediate period in the elaboration of a child. During early childhood, the brain which is roughly a quarter of the size of the brain of an adult is among the most undeveloped organs, and it is susceptible to both the negative as well as the positive aftereffects of the external environment (Andrea J. Sedlak, 2008). For example, the physical abuse of shaking a baby destroys the structure of the brain, which can have a harsh outcome for the infant’s health. The child may suffer from mental retardation, problems with hearing and seeing, cognitive dysfunction as well as learning disabilities. Some researchers have indicated that children who suffer from physical abuse have structural brain changes, lateral ventricles that are smaller and smaller corpora callosa. The aftermath of abuse might not be seen clinically until the later stages of life. For instance, the repercussions for infants who experience brain damage as a result of shaking can range from no illusive impacts to permanent disability, including delay in development, paralysis or seizures, blindness and even demise.
Survivors of shaken baby syndrome might have considerably delayed after-effects of neurologic injury leading to a variety of impairments viewed over the course of their lives. The disabilities may include behavioral problems and cognitive deficits. Recent data on children in Canada hospitalized for shaken baby syndrome indicated that 59% suffered from neurologic deficits, visual or other effects in health, 19% died, and only 22% seemed well at that period of discharge. Also, data shows that babies who look well when they are released from the hospital might demonstrate evidence of behavioral or cognitive difficulties later on in life, probably by school age. High levels of catecholamine and cortisol, which arise as a response to stress that comes from abuse, have been connected to brain cell’s disruption and the interference of healthy brain connections, therefore impacting the behavioral development of children. Signs of infant abuse might include night terrors, sleep disturbances as well as nightmares (Kempe, 2013).
When it comes to the toddler age or two years, a child will usually react to stress with a demonstration of emotional and angry expression. Stress that accompanies any abuse leads children to feel frustration as well as distress. The excess anger is showcased in the form of fighting and aggressive behavior with peers or caregivers. This type of response s increased more with physical abuse. When it comes to the preschool age, children have the same reactions to a variety of forms of abuse as children who are young do. Nonetheless, by the age of 5, there is a possibility that children might exhibit their reaction to abuse via different behavior. Boys are likely to externalize their emotion via the expression of aggression, anger, together with verbal bullying. Girls tend to internalize their attitudes in behavior by being socially withdrawn and depressed, and experiencing physical signs like abdominal pain as well as constant headaches.
In the primary school age, children grow through interaction by peers and friends. Children that have gone through abuse regularly have problems with school. The problems may include poor performance in academics, lack of concentration during classes, reduced interest in school and limited friendships. They often do not attend classes. Adolescents who have undergone abuse might suffer from anxiety, depression or even social withdrawal. Moreover, adolescents who reside in violent environments are likely to run away to what they think to be safer conditions. They involve themselves in risky behaviors, for instance, drugs, drinking alcohol, smoking, involvement in gangs, fornication, homelessness, prostitution as well as carrying guns. Psychological disorders are regularly seen in abused adolescents. In one research, eighty percent of teens who had suffered from child abuse met the diagnostic manual for at least one psychological condition by 21 years of age.
Typical Behavioral Signs of Abuse
Identifying signs of child abuse is typically challenging. Family physicians and family members should pay close attention to children who have unusual behavioral changes or psychosomatic complaints. In those cases, a full assessment of the household and child might be pointed out (Linda M. Richter, 2008). It is important to note that not all maladaptive behavior is a sign of abuse. Behavioral signs of abuse include, the child might refuse to go home or even run away. Secondly, the abused child might show abnormal aggression, or he or she may flinch when touched. Thirdly, there may be withdrawal from friends, family, as well as activities that were earlier enjoyed. The child may also lack self-esteem, for example, she or he may describe herself or himself as a bad person and feel that punishment is deserved. Lastly, the child may have suicidal thoughts or showcase behavior that is self-destructive, such as the attempt of suicide as well as self-mutilation.
Children who experience physical abuse might have abnormal injuries to specific body sites that are not frequently subject to injury, like genital wounds, around the eyes, or on the thighs. Physical abuse might also materialize as acute trauma without enough justification, like fracture with the slightest injury. In clinical practice, children who suffer from abuse might stare at their caregivers or parents and seem apprehensive, like they are waiting for the next abusive event to happen. Furthermore, the manner in which clothing is worn can show physical abuse. For instance, a child who is seen to be wearing a dress that is long-sleeved or clothing that covers the whole body including hands, necks, and legs primarily in hot weather.
Emotional impacts of abuse often come from relationships that are insecure with caregivers and affect the attachment development of the child. Such aftermath might be destructive to their self-esteem and confidence and relationships with peers or partners later in life (John Devaney, 2009). Also, children who have undergone emotional abuse might continue with habits that are age-inappropriate and repetitive behavior like thumb-sucking together with rocking. When emotional abuse is continuous and interminable, it can lead to emotional harm to the child. A child is seen to be emotionally damaged if she or he shows severe depression, anxiety, aggressive behavior, withdrawal or self-destructive behavior.
The behavior and condition of the child, in general, might indicate abuse. The history might show multiple visits and multiple emergency admissions to a variety of physicians. Furthermore, an undue setback in getting treatment of injury should bring up concern. In the event of neglect, a child might display poor hygiene like unwashed hair or body, or body odor that is unpleasant. She or he might reside in unhealthy conditions, be allowed to play in situations that are not safe or be left unsupervised. Such children are always late for school or even fail to attend classes.
Also, sexual abuse has severe aftermath throughout the lives of children, diverging from physical injuries to emotional destruction. Children who experience sexual abuse might have difficulties in sitting or walking due to disabling injuries or pain. Moreover, they might be scared of changing their clothes in front of other individuals. Additionally, they might also be afraid of sitting with peers or involving themselves in physical exercises that could result in being touched. At times, they behave in a manner that is seductive, which indicates knowledge about relationships that are of a sexual nature. Pregnancy among teens and a history of sexually transmitted infections might be symptoms of ongoing sexual abuse.
Role of The Family Physician
Family doctors are required to be sensitive when getting history concerning child abuse as well as domestic violence. Due to continuous and ongoing contact with families and children over time, family physicians will normally have intimate knowledge of the challenges and strengths faced by the families under their guardianship. They also can supply educational intervention as well as anticipatory guidance in all sectors of parent and child development (Kempe, Sexual abuse, another hidden pediatric problem: the 1977 C. Anderson Aldrich lecture, 2013). Physicians are also required to have an understanding of some of the risk factors for child abuse and neglect for the children and families in their practices, like drug addiction, maternal depression, and previous contact with child protection agencies.
Physicians should know that negative behavior modifies in a child, for instance, aggressive behavior might be a clear indicator of neglect, child abuse and domestic violence involving other family members. More focus should be directed to other kids in the family, and the right screening should be finished. Lastly, there is an essential requirement for the physician to have knowledge concerning resources of mental health in their communities for giving treatment and supporting families. The utilization of a multidisciplinary team method produces the most efficient results.
What We Are Doing to Prevent Child Abuse
Some of the most beneficial responses for preventing the abuse of children and neglect concentrate on the rearing of children, relationships between the parents and children as well as the family environment. There is the availability of training for parents which supplies them with information concerning child development and bonding together with attachment. Parents are also taught to utilize consistent methods of child-rearing and how to manage family conflict. There are also home visitation programs. Such programs involve routine visits from a nurse or other health care givers to the homes of families in particular need of support with childcare or in situations where there is a recognized risk of child abuse (Radford, 2011). Interventions can involve counseling, training as well as referrals to experts or other agencies.
Programs that concentrate mainly on maintaining the family unit intact without fundamentally discussing the underlying causes of the issue, nonetheless, are not sufficient. Those programs that involve a high degree of participant involvement, utilizing a method that concentrates on the family strengths, and that include an element of societal support, appear to come up with better results than those that lack these components. Health care workers have a critical role to play in pinpointing, treating as well as referring cases of child abuse and neglect and in reporting questionable cases of maltreatment to the right authorities. To expedite the detection and reporting of child abuse, many organizations of health care have come up with training programs.
While evaluations of programs indicate improvements in the knowledge of health care workers of ill-treatment and neglect, the effect of training programs on other results, like enhanced attention and referral for children, is not recognized (Stephen Smallbone, 2013). Other methods to prevent child abuse and neglect pay attention to therapy and other services for abused children. They also focus on treatment programs for perpetrators and legal help like arrest as well as prosecution policies, voluntary and mandatory reporting systems, and child protection services to assist in the identification of child abuse cases. The current evidence of the effectiveness of these methods is quite limited. Most of them have not been sufficiently evaluated.
Initiatives that are community-based are also being utilized to deal with the problem. Some of them are school-based which show children how to realize threatening situations and supplying them with skills to safeguard them against abuse. Other initiatives involve the collaboration of some sectors to increase awareness and knowledge and enhance services. The media and other forms of prevention campaigns have also been utilized to stimulate the actions of the community and change patterns of behavior. A lot can be done at the societal level to inhibit child abuse and neglect including ways to deal with poverty, improve employment and educational opportunities as well as increase the availability of quality child care. There is a good chance that these measures can offset economic and social inequalities and enhance child outcomes (MacMillan, 2013).
Conclusion
In a nutshell, child abuse is a big problem globally, and its psychosocial and physical impacts are felt by children who suffer from abuse, their families as well as their communities. It has been connected to changes in the victims’ behavioral and mental development throughout their lives, placing them at risk of involving themselves in possibly dangerous behavior in the future. Family physicians have a paramount role in recognizing child abuse cases in their practices, reporting child abuse cases to agencies of child welfare, inhibit more harm to identified children and other children in their families, and supplying more continuous support and education to families. The types of child abuse include physical abuse, emotional abuse, neglect as well as sexual assault. Children who suffer from abuse may suffer psychologically including conditions like depression and anxiety. Among the most beneficial responses for inhibiting the abuse of children and neglect concentrate on the rearing of children, relationships between the parents and children as well as the environment of the family.
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