Chapter 6

1. Chapter 6 Abuse, Neglect, and Children’s Rights

2. Types of Maltreatment • Physical Abuse • Attacks child physically, injuring child • Emotional (psychological) Abuse • Attacks child’s self-esteem, self-confidence, and well being. Occurs necessarily with physical abuse but can be independent • Verbal assault • Confinement • Exploitation

3. Prevalence of Maltreatment • Homicide is one of five leading causes of child mortality in US • Neglect is most frequent form of abuse • Infants and toddlers have highest rate of maltreatment • Boys usually suffer physical abuse more frequently while girls are more frequently sexually abused

4. Defining Physical Abuse • Strongly principled disagreements exist regarding what physical abuse is • Is physical punishment (spanking) abuse? • Research suggests mild physical punishment can be effective when used with restraint and according to a plan or family rule

5. Inappropriate Physical Punishment Should not be used: • To punish children under 2, who cannot understand, or older than 6, for whom reasoning and loss of privileges are better • To punish child impulsively • To punish child overly severely (to point of injury, or using an object)

6. The Roots of Child Abuse • Various sources of child abuse • Traditional social or cultural practices • Unhealthy family relationships • Ignorance, cruelty or mental disturbance of perpetrator

7. Cultural Differences: Corporal Punishment • Continental European government view it as unacceptable while the UK does not • In US certain conservative religious groups and cultural groups (African Americans) support it • African American parents use spanking more frequently and with more positive effects • When spanking is customary, children may resent it less and learn more from it than when it is not

8. Family Factors Associated with Maltreatment • Abuse does not usually stem from parental mental illness, and abusing parents rarely have diagnosable mental disorders • Abusers may have difficult lives with many problems • Domestic violence • Burdensome childcare responsibilities • History of child abuse • desertion

9. Parent’s resentment of childcare responsibilities (self-centered or unemployed parents) • Parents’ limited education, resources or opportunities • Family’s social isolation • Family’s characteristic interaction style (yelling, fighting, roughness) • Stressful family transitions • Parental abuse as a child (one factor, but significance frequently exaggerated)

10. Characteristics of Victimized Children • Children not all equally vulnerable • High-risk children may have physical / behavioral characteristics that annoy caretakers (chronic illness, disability, hyperactivity, frequent misbehavior) etc.) • Not clear whether distinguishing child characteristics precede or are caused by abuse

11. Child Sexual Abuse • Child sexual abuse victims 12% of all maltreated children each year • Absence of clear definition impedes study, treatment and prevention

12. Sexual Abuse: age-inappropriate sexual exploitation of a child for perpetrator’s benefit • Direct - sexual contact • Indirect – exhibitionism or exposure to pornography • Some forms are less obvious than others

13. Different opinions of definitions and effects • Strong-faith based, morality based conviction • All adult-child sexual interactions of any type are criminally depraved and permanently harmful • Moderate view • Repulsed by adult sexual interactions with children but consider it has ranges of effects

14. Publicity has increased public vigilance but also has negative effects • People who work closely with children afraid of false accusation

15. Sexual Abuse Victims and Perpetrators • Victims usually younger than 12 (easier for perpetrators to go undetected) • Perpetrators take advantage of position (caregiver, teacher, etc.) • Younger children less able to understand what is happening and less able to explain what happened.

16. Majority of victims are girls • Lack of maternal protection seems to endanger girls more than boys • Less is known about abuse of boys, because it is reported less • Usually nonwhite, not living with father • May be underreported because boys are expected to be able to protect themselves

17. Assessment of Child Abuse • Child abuse frequently leaves physical evidence • Identification of physical and psychological abuse by health professionals has advanced

18. Assessing Sexual Abuse • Sexual abuse has inherent problems that make diagnosis difficult • Often concealed and happens mostly in private settings • Usually only abuser and child know about it with certainty • Power disparity (physical and social) between abusers and victims • Abusers’ supervisory role discourages others’ suspicions and confuses children

19. Interviewing Children • Clinicians relay on informal interviews and play observation • Unknown accuracy • Can be susceptible to examiner bias • Anatomically correct dolls • Child can identify parts of doll • Or demonstrate experience

20. Consensus on child suggestibility maintains that children’s accuracy varies widely especially about personal bodily experiences

21. Problematic Child interview techniques • Interview children repeatedly under emotionally charged circumstances • Bribes and threats – calling child “smart” when they say what interviewer wants • Telling children other children have already reported abuse • Asking children about events several years in past • Appearing more enthusiastic, supportive when child says something interviewer wants to hear • Refusing to tape interview session

22. Standards for Accurate Testing • Must take into account child’s cognitive and social immaturity, which make them poor informants • Pointed, suggestive questioning can alter account • Children are frequently nervous or frightened at being questioned by adults

23. 5 key steps • Interviewer must be trained professional • Developmentally appropriate tests are needed • Age-appropriate open-ended questions must be used • Must happen as soon as possible after incident • Multiple informants and information sources are necessary

24. Neglect • Physical – refusal of or delay in healthcare, abandonment, expulsion, inadequate supervision • Educational – permission of chronic truancy, failure to enroll, inattention to special education need • Emotional – chronic domestic abuse in child’s presence, permission of substance abuse or refusal to provide psychological care

25. Characteristics of Neglectful Families • Some types of patterns statistically more likely to neglect • Very low family income • Under educated parents • Large families • Deteriorating neighborhoods

26. Effects of Maltreatment on infants and young children • Attachment problems, of a disorganized disoriented nature • Delays in cognitive development. Girls more likely than boys to become wary and withdrawn • Inappropriate sexual behavior if sexually abused • Posttraumatic stress disorder common among sexually abused

27. Effects during Middle Childhood • Low self-esteem, high rates of adjustment problems • Academic deficiencies

28. Maltreated Adolescents • Internalizing and externalizing problems, poor peer relations • Long-term adjustment problems leading to substance abuse, self-injurious and suicidal behavior, depression • Low self-esteem, low social competence

29. Prevention of Physical Abuse • Abuse part of national and global climate that tolerates and encourages violence as a solution to human problems • Youngsters may copy violent media and real life models and improvise violent solutions to interpersonal conflicts

30. Protection from Weapons • Canada is much less violent society than US, and there is easier access to guns in US • Are present efforts sufficient? • Gun locks • Gun safety courses • Should more be done to restrict gun use and availability?

31. Improve Parenting Skills • Successful programs address parents with problems that lead to abuse: • Emotional disturbance • Young, risk-taking substance • abusing parents • Parents that have unrealistic expectations of their children • Home-visit programs

32. Self-Control Training for Older Children • Teach potential child victim skills to avoid abuse • Teach children to avoid back-talk or negative interactions at high-risk times • Teach relaxation skills, positive self-directed talk, problem solving techniques

33. Prevention of Neglect • Cognitive behavior therapy techniques • Training in self-observation, self-reinforcement, problem solving strategies • Research suggests neglect may stem from mother’s deficits in relevant parenting skills or motivation • Because of size of problem, less labor-intensive, less costly approaches are also needed

34. Prevention of Sexual Abuse • School based programs focus on how to prevent attacks by strangers • Majority of cases are committed by adults known to children, not strangers • Much attention and research is needed in this area

35. Treatment of Abused Children • If maltreatment is not severe, most children improve over time • Family cohesion and adaptability and parents reactions to abuse important factors in recovery • When parent is treatment-resistant, parental right should be terminated

36. Psychoeducational Programs • Psychoeducational interventions offer child and non abusing parent an opportunity to discuss occurrence with case worker • Important even when children display no discernable psychological harm from being abused

37. Foster Home Placement • Reserved for severe cases with persistent abuse or where child’s physical safety is threatened • Most state agencies attempt to preserve families • Foster care can also endanger children

38. Psychotherapy • CBT (cognitive-behavioral therapy) consistently more effective in treating physical or sexual abuse • Clearly effective when child shows clear signs of anxiety, panic or depression • Less is known about how to treat sexual victimization that doesn’t involve trauma and extreme fear

39. Children’s Moral and Legal Rights • Sometimes conflict with rights of parents • Are children persons just as adults or property of their parents? • What happens when parents and children disagree about whether a child has a problem? • Should children’s rights be more restricted than adults?

40. Legal rights – guaranteed by the US Constitution or by statute or state laws • Human rights – more broadly and less precisely defined • Pertain to conditions necessary for children to become healthy, well-adjusted, competent, and productive citizens

41. Bill of Rights for World’s Children • UN adopted a declaration that children are persons who are entitled to respect and protection • US did not ratify declaration • Parents groups oppose it because they feel it undermines parents traditional power to determine rules for the family

42. Children’s Legal Rights • Three principles guide legal codes for children • Autonomy – ability to make personal decisions based on adequate understanding of circumstances • Beneficence – working to benefit children, not intentionally harming them • Justice – juvenile rights should only be limited by their still-maturing judgment and intelligence

43. Children have rights but need special protection • Prohibited from harmful activities (smoking drinking, drug use, dangerous employment) • According to law and custom, family is the best and most appropriate source of socialization and protection