What is child abuse and neglect? Understanding warning signs and getting help

Children depend on many adults as they grow up. Parents, relatives, teachers and child care workers all provide children with love, support and guidance.

No one wants to see children grow up with fear, anger or neglect. But no one is born knowing how to care for children. Sometimes we make mistakes that hurt them.

Whether you are a parent, a teacher, a relative or a caregiver, you can make a difference and help the children you love grow up in a caring, loving environment. Adults don't have to be perfect, just willing to listen, learn, grow and change.

Carlos came home from work in a foul mood. Seven-year-old Miguel ran out of the kitchen just as his father walked in, and they ran into each other. Carlos cursed and grabbed his son. He shook Miguel hard while yelling at him, and then shoved him out of the way. The next day, Miguel's arms and back had bruises.

It takes a lot to care for a child. A child needs food, clothing and shelter as well as love and attention. Parents and caregivers want to provide all those things, but they have other pressures, too. Sometimes adults just can't provide everything their children need.

Adults may not intend to hurt the children they care for. But sometimes adults lose control, and sometimes they hurt children.

Adults may hurt children because they:

• Lose their tempers when they think about their own problems.

• Don't know how to discipline a child.

• Expect behavior that is unrealistic for a child's age or ability.

• Have been abused by a parent or a partner.

• Have financial problems.

• Lose control when they use alcohol or other drugs.

This is an example of physical child abuse.

Teresa had just changed 18-month-old Dale's dirty diaper when he had another messy diaper; this made Teresa angry. She thought that putting him in hot water would punish him for the dirty diaper. When she put him in the tub, he cried loudly. Teresa slapped him to stop the crying and didn't notice the scald marks until after the bath was over.

Examples of physical child abuse

• Shaking or shoving.

• Slapping or hitting.

• Beating with a belt, shoe or other object.

• Burning a child with matches or cigarettes.

• Scalding a child with water that is too hot.

• Pulling a child's hair out.

• Breaking a child's arm, leg, or other bones.

• Not letting a child eat, drink or use the bathroom.

This is an example of sexual child abuse.

Nine-year-old Susan's mother works at night. Her stepfather James is around when she goes to bed, so many evenings James lies down beside Susan. As she goes to sleep, he rubs her breasts and genital area.

Examples of sexual child abuse

• Fondling a child's genitals.

• Having intercourse with a child.

• Having oral sex with a child.

• Having sex in front of a child.

• Having a child touch an older person's genitals.

• Using a child in pornography.

• Showing X-rated books or movies to a child.

This is an example of neglect.

John worked nights at the grocery store, but the family needed more money. Ellen looked for work, but the only job she could find required her to leave home at 3 a.m. The children, ages two and six, were alone for a few hours until John got home.

Examples of child neglect

• Not meeting a child's need for food, clothing, shelter or safety.

• Leaving a child unwatched.

• Leaving a child in an unsafe place.

• Not seeking necessary medical attention for a child.

• Not having a child attend school.

Parents and caretakers don't always know that they are being abusive or neglectful. Few adults actually intend to hurt or neglect children.

Sometimes a caretaker just doesn't know a better way to discipline a child. Sometimes an adult is just too frustrated with life and takes it out on a child.

An adult is more likely to abuse or neglect a child:

• If the caretaker was abused as a child.

• If the caretaker is being abused by a spouse or partner.

• If the caretaker uses alcohol or other drugs.

• If the adult expects too much of a child.

• If the child is the result of an unplanned pregnancy.

Some adults don't know how to correct a child without causing physical harm. An adult who has this problem can learn new ways to discipline without hurting a child.

• Look for times when the child is behaving well. Praise that behavior.

• Agree on a code word to use when things reach the boiling point. The code word signals that everyone needs some time to cool down before talking about the problem.

• When a child misbehaves, give the child a "time-out", a few minutes alone to think about what happened.

• Talk to the child about the misbehavior and its effects.

Sometimes, parents and caretakers need to learn to control their own anger. They need to identify the things that make them more likely to hurt the children in their care.

Caretakers who abuse or neglect a child might be:

• Worried about not having enough money.

• Having problems with spouses or partners.

• Coping with a family member's illness or death.

• Acting the way their parents acted.

• Stressed from their jobs or other problems.

• Expecting unrealistic behavior for example, thinking a five-year-old can handle the same tasks as a nine-year-old, and do them as well.

Often people who abuse or neglect children experience more than one of these situations at the same time.

Hurting a child or not filling a child's basic needs never makes things better. No matter what the problem, help is available.

Brenda's teacher saw signs of neglect.

In the preschool class, four-year-old Brenda always seemed tired. Brenda never brought food for snack time, and she looked hungrily at other children's sandwiches. Her classmates teased her because her hair was always dirty.

Paul saw signs of physical child abuse.

Paul lived next door to the Harris family, where someone always seemed to be yelling or crying. One night Paul heard glass break, then a man's shouting and a loud thump. Ten-year-old Keisha ran out the door a few seconds later, crying. Her face was swollen with the start of a black eye.

The effects of child abuse can last a lifetime. An abused or neglected child needs help right away. Is a child you know being abused or neglected?

Warning signs of abuse and neglect

• Cuts and bruises.

• Broken bones or internal injuries.

• Burns.

• Constant hunger or thirst.

• Lack of interest in surroundings.

• Dirty hair or skin, frequent diaper rash.

• Lack of supervision.

• Pain, bruising, or bleeding in the genitals.

• More knowledge about sex than is normal for the child's age.

• Hard-to-believe stories about how accidents occurred.

Abuse and neglect have harmful effects on children. At worst, a child could die. More often, abused or neglected children live with fear or pain.

Abused or neglected children often experience:

• Frequent injuries.

• Learning problems.

• Fear or shyness.

• Bad dreams.

• Behavior problems.

• Depression.

• Fear of certain adults or places.

The effects don't end when the abuse or neglect stops. When abused or neglected children grow up, they are more likely to:

• Abuse their own families.

• Use violence to solve their problems.

• Have trouble learning.

• Have emotional difficulties.

• Attempt suicide.

• Use alcohol or other drugs.

Abuse and neglect are hard on the whole family. Some families need help in dealing with practical problems—for example, getting help to buy groceries or learning how to discipline a child without resorting to violence. In other cases, a child protection agency might move abused or neglected children away from their parents to a safe, temporary home. If abuse or neglect is severe, or if it continues, the children can be permanently moved away from their parents into a safe situation.

Sometimes, people are afraid to report abuse or neglect because they don't want to break up a family. Sometimes, people are afraid to get involved in someone else's problem.

When you report suspected child abuse or neglect, you could be saving that child's life

The goal of stopping abuse and neglect is to keep children safe. Part of keeping children safe is finding help for the adults who have hurt them. Adults who have abused or neglected a child have many places to turn for help.

• The child's doctor can explain children's needs at every age. He or she can recommend places to learn more about parenting and child care.

• Local health and social service departments often have parenting classes. Social service workers also can help parents get assistance to ease their financial situations.

• Hospitals and community centers often have classes on stress reduction, parenting, discipline, and nutrition.

• Psychologists, counselors, and social workers can help parents and caregivers deal with problems like drug use, anger and previous experiences of abuse.

• Religious groups often provide food, counseling, and other types of support for anyone in the community—not just their members.

If you see that a relative, neighbor or friend is under a lot of stress and might hurt children in their care, suggest that the person get help from one of these services. Stop the problem before it starts.

What should I do if I suspect a child is being hurt?

Report your suspicion to a local, county or state child protection agency. Call a crisis hotline or find the agency number in the blue government pages of a telephone directory.

Who must report abuse?

In every state, the following people are required by law to report suspected abuse:

• Doctors

• Nurses

• Dentists

• Mental health professionals

• Social workers

• Teachers

• Day care workers

• Law enforcement personnel

When you make a report, the agency will make a judgment about how serious the situation is. If necessary, a child protection worker will visit the family to see whether abuse or neglect has occurred and to determine what needs to be done. The goals of child protection are to:

• Stop the abuse.

• Give needed services to the family.

• Help the family become safe and loving.

No child should have to live in fear of abuse or neglect.

Protect the children you love—help stop child abuse and neglect.

Bullying occurs among children from all walks of life and can take many forms e.g., teasing, physical assault, harassment based on race, gender, sexual orientation, religion and/or weight.

APA has a number of resources available.

• Resolution on Bullying (PDF, 40KB)opens in new window

• Bullying topic page

• Resilience Guide for Parents and Teachers

Several organizations can provide information and advice about child abuse and neglect:

• American Humane Associationopens in new window

• Child Help USAopens in new window

• American Bar Association Center on Children and the Lawopens in new window

• American Professional Society on the Abuse of Childrenopens in new window

• Child Welfare Information Gateway Children's Bureau/ACYF/ACF/HHSopens in new window

• Institute on Violence, Abuse and Traumaopens in new window

• National Organization for Victim Assistanceopens in new window

• PreventChildAbuse.orgopens in new window

• Rape, Abuse, and Incest National Networkopens in new window