Child Abuse (cont.)

Medical Author:

John Mersch, MD, FAAP

John Mersch, MD, FAAP

Dr. Mersch received his Bachelor of Arts degree from the University of California, San Diego, and prior to entering the University Of Southern California School Of Medicine, was a graduate student (attaining PhD candidate status) in Experimental Pathology at USC. He attended internship and residency at Children's Hospital Los Angeles.

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Medical Editor:

William C. Shiel Jr., MD, FACP, FACR

William C. Shiel Jr., MD, FACP, FACR

Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.

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In this Article

• What is the scope of the child abuse problem?
• What age child is abused?
• Are girls more often abused than boys?
• Is the pattern of abuse different for girls and boys?
• What is known about the perpetrators of child abuse?
• Is there an association between poverty and child abuse?
• Who abuses children?
• What is child abuse?
• What does the term child neglect include?
• What actions are viewed as physical child abuse?
• What constitutes emotional child abuse?
• What is sexual child abuse?
• What causes child abuse deaths?
• What factors predispose a person to child abuse?
• How is alleged child abuse evaluated?
• How is child abuse treated?
• How can child abuse be prevented?
• What more can be done to prevent child neglect?
• Are people who were abused as children more likely to become criminals later in life?
• Child Abuse At A Glance
• Patient Comments: Child Abuse - Experience
• Child Abuse Index

A broad definition of child abuse implies purposeful and serious injury inflicted upon a child by a caregiver. Specific countries and ethnic groups have developed sometimes widely divergent definitions. In the United States, each state is responsible for drafting definitions for child abuse and neglect consistent with federal law. The Child Abuse Prevention and Treatment Act, amended in October 1996, provides the basis from which individual states may structure their legislation.

Four broad categories are generally recognized:

1. neglect (63%);



2. physical abuse (16%);



3. sexual abuse (10%) and;



4. emotional abuse (7%) (2005 national data).

Child neglect is the most frequently reported form of child abuse (63% of all cases) and the most lethal.

Neglect is defined as the failure to provide for the shelter, safety, supervision, and nutritional needs of the child. Child neglect may be physical, educational, or emotional. The assessment of child neglect requires the consideration of cultural values and standards of care as well as the recognition that the failure to provide the necessities of life may be related to poverty.

Physical neglect includes the refusal or delay in seeking health care, abandonment, inadequate supervision, expulsion from the home, or refusal to allow a runaway to return home.

Educational neglect includes the allowance of chronic truancy, failure to enroll a child of mandatory school age in school, and failure to attend to a special educational need.

Emotional neglect involves a marked inattention to the child's needs for affection, refusal of or failure to provide needed psychological care, spousal abuse or parental substance abuse in the child's presence, and permission of drug or alcohol use by the child.