Thursday, July 03, 2008

Child abuse

Child abuse takes many forms:

  • Physical abuse. Physical child abuse occurs when a child is purposefully injured. Physical abuse can be an act of direct physical harm or an act of omission that leads to injury.
  • Sexual abuse. Sexual child abuse is any sexual activity with a child, including fondling, oral-genital contact, intercourse and exposure to child pornography.
  • Emotional abuse. Emotional child abuse includes verbal and emotional assault — such as continually belittling or berating a child — as well as isolating, ignoring or rejecting a child.
  • Neglect. Child neglect is failure to provide a child adequate food, shelter, affection, supervision or medical care.

Most child abuse is inflicted by someone the child knows and trusts, often a parent or other relative. If you suspect child abuse, either in your own child or a close contact, report the abuse to the proper authorities. Your concern may provide an opportunity for healing.

A child who's being abused may feel guilty, ashamed or confused. He or she may be afraid to tell anyone about the abuse, especially if the abuser is a parent or other loved one. That's why it's vital to watch for red flags, such as:

  • Sudden changes in behavior or school performance
  • Untreated medical or dental problems
  • Unexplained bruises, cuts, burns or other injuries
  • Blood in the child's underwear
  • Inappropriate sexual behavior for the child's age
  • Behavior extremes, from overly aggressive to unusually passive
  • Nightmares or unusual fears
  • Withdrawal from friends or usual activities
  • Low self-esteem
  • Poor hygiene
  • Frequent absences from school

Sometimes a parent's demeanor or behavior also sends red flags about child abuse. Warning signs include a parent who:

  • Shows little concern for the child
  • Denies the existence of problems at home or school, or blames the child for the problems
  • Refuses offers of help to resolve problems at school
  • Consistently blames, belittles or berates the child
  • Describes the child with negative terms
  • Uses harsh physical discipline or asks teachers to do so
  • Demands an inappropriate level of physical or academic performance
  • Severely limits the child's contact with other children
  • Offers conflicting or unconvincing explanations for a child's injuries, or no explanation at all

Keep in mind that warning signs are just that — warning signs. The presence of warning signs doesn't necessarily mean that a child is being abused.

When to see a doctor
If you're concerned that your child or another child has been abused, seek help immediately. Contact the child's doctor, a local child protective agency or the local police department. Keep in mind that health care professionals are legally required to report all suspected cases of child abuse to state authorities.

Child abuse occurs across all socioeconomic levels and ethnic groups. For parents and other caregivers, factors that may increase the risk of becoming abusive include:

  • Low self-esteem
  • Poor impulse control
  • Depression
  • Anxiety
  • Marital conflict
  • Domestic violence
  • Financial stress
  • Social isolation
  • Alcoholism or other forms of substance abuse
  • A history of mistreatment as a child

Some children overcome the physical and psychological effects of child abuse, particularly those who have high self-esteem, an optimistic attitude and strong social support. For others, however, child abuse has lifelong consequences. For example, child abuse may lead to:

  • Physical disabilities
  • Learning disabilities
  • Low self-esteem
  • Depression
  • Difficulty establishing or maintaining relationships
  • Challenges with intimacy and trust
  • An unhealthy view of parenthood
  • Anxiety
  • Substance abuse
  • Eating disorders
  • Post-traumatic stress disorder
  • Personality disorders
  • Delinquent or violent behavior

You can take simple steps to protect your child from exploitation and child abuse, as well as prevent child abuse in your neighborhood or community. For example:

  • Offer your child love and attention. If you feel overwhelmed or out of control, take a break. Don't take out your anger on your child.
  • Think supervision. Don't leave young children home alone. In public, keep a close eye on your child. Don't allow your child to go anywhere or accept anything without your permission. When your child is old enough to leave home without parental supervision, encourage your child to hang out with friends rather than alone — and to tell you where he or she is at all times.
  • Know your child's caregivers. Check references for baby sitters and other caregivers. Make unannounced visits to observe what's happening.
  • Emphasize the importance of saying no. Make sure your child understands that he or she doesn't have to do anything that seems scary or uncomfortable. Encourage your child to leave a threatening or frightening situation immediately and seek help from a trusted adult. If something does happen, encourage your child to talk to you or another trusted adult about the episode. Assure your child that it's OK to talk, and that he or she won't get in trouble.
  • Teach your child how to stay safe online. The Internet is a tremendous tool, but it's important to use it safely. Cover ground rules such as not sharing personal information and not responding to inappropriate, hurtful or frightening messages. Don't allow your child to share photos or videos online or arrange to meet an online contact in person without your permission. Consider it a red flag if your child is secretive about his or her online activities.
  • Reach out. Meet the families in your neighborhood, including both parents and children. If a friend or neighbor seems to be struggling, offer to baby-sit or help in another way.

If you're concerned that you might abuse your child, seek help immediately. Start with your family doctor. He or she may offer a referral to a parent education class, counseling or a support group for parents. If you're abusing alcohol or drugs, ask your doctor about treatment options. Remember, child abuse is preventable — and often a symptom of a problem that may be treatable. Ask for help today.