Child Abuse: Types, Signs, Symptoms, Causes

By: The Rotary Club Of Santa Monica and Center For Healthy Aging

Child abuse is both shocking and commonplace. Child abusers inflict physical, sexual, and emotional trauma on defenseless children every day. The scars can be deep and long-lasting. Unfortunately, the more subtle forms of child abuse such as neglect and emotional abuse can be just as traumatizing as violent physical abuse. Focused support can help both the victims of child abuse and the child abusers themselves.

What is the definition of child abuse?

Child abuse consists of any act or failure to act that endangers a child's physical or emotional health and development. A person caring for a child is abusive if he or she fails to nurture the child, physically injures the child, or relates sexually to the child.

What are the types of child abuse?

The four major types of child abuse are:

• Physical abuse
• Sexual abuse
• Emotional abuse
• Neglect

Another type of abuse is child exploitation (distinct from sexual exploitation). This is the use of a child in work or other activities for the benefit of others. Child labor is an example of child exploitation for commercial reasons. Using a child in this way detracts from their own physical, mental, and social development.

What is physical abuse?

Physical abuse is any non-accidental physical injury to a child. Even if the parent or caretaker who inflicts the injury might not have intended to hurt the child, the injury is not considered an accident if the caretaker's actions were intentional. This injury may be the result of any assault on a child's body, such as:

• beating, whipping, paddling, punching, slapping, or hitting
• pushing, shoving, shaking, kicking or throwing
• pinching, biting, choking, or hair-pulling
• burning with cigarettes, scalding water, or other hot objects.
• severe physical punishment that is inappropriate to child's age.

Corporal (physical) punishment is distinguished from physical abuse in that physical punishment is the use of physical force with the intent of inflicting bodily pain, but not injury, for the purpose of correction or control. Physical abuse is an injury that results from physical aggression. However, physical punishment easily gets out of control and can become physical abuse. Corporal punishment is against the law in schools in some states, but not in others. In many families, physical punishment is the norm.

Hundreds of thousands of children are physically abused each year by someone close to them, and thousands of children die from the injuries. For those who survive, the emotional scars are deeper than the physical scars.

What is sexual abuse?

Sexual abuse of a child is any sexual act between an adult and a child. This includes:

• fondling, touching, or kissing a child's genitals
• making the child fondle the adult's genitals
• penetration, intercourse, incest, rape, oral sex or sodomy
• exposing the child to adult sexuality in other forms (showing sex organs to a child, forced observation of sexual acts, showing ornographic material, telling "dirty" stories, group sex including a child)
• other privacy violations (forcing the child to undress, spying on a child in the bathroom or bedroom)
• sexual exploitation
• enticing children to pornographic sites or material on the Internet
• luring children through the Internet to meet for sexual liaisons
• exposing children to pornographic movies or magazines
• child prostitution
• using a child in the production of pornography, such as a film or magazine

The above acts are considered child abuse when they are committed by a relative or by a caretaker, such as a parent, babysitter, or daycare provider, whether inside the home or apart from the home. (If a stranger commits the act, it is called sexual assault.)

The legal age of consent for two people to have sexual relations ranges from twelve to twenty-one, and varies by state within the United States and by country. In most states, having sex with a person younger than the legal age of consent is against the law. Even if the two parties agree to the sexual relationship, it is still against the law. Each state is very specific as to its laws about sex with minors.

Sexual abuse is especially complicated because of the power differential between the adult and child, because of the negotiations that must occur between adult and child, and because the child has no way to assimilate the experience into a mature understanding of intimacy. Regardless of the child's behavior or reactions, it is the responsibility of the adult not to engage in sexual acts with children. Sexual abuse is never the child's fault.

Sexual abusers can be:

• parents, siblings, or other relatives
• childcare professionals
• clergy, teachers, or athletic coaches
• neighbors or friends
• strangers

What is emotional abuse?

Emotional abuse is any attitude, behavior, or failure to act on the part of the caregiver that interferes with a child's mental health or social development.

Other names for emotional abuse are:

• verbal abuse
• mental abuse
• psychological maltreatment or abuse

Emotional abuse can range from a simple verbal insult to an extreme form of punishment. The following are examples of emotional abuse:

• ignoring, withdrawal of attention, or rejection
• lack of physical affection such as hugs
• lack of praise, positive reinforcement, or saying "I love you"
• yelling or screaming
• threatening or frightening
• negative comparisons to others
• belittling; telling the child he or she is "no good," "worthless," "bad," or "a mistake"
• using derogatory terms to describe the child, name-calling
• shaming or humiliating
• habitual scapegoating or blaming
• using extreme or bizarre forms of punishment, such as confinement to a closet or dark room, tying to a chair for long periods of time, or terrorizing a child
• parental child abduction

Emotional abuse is almost always present when another form of abuse is found. Some overlap exists between the definitions of emotional abuse and emotional neglect; regardless, they are both child abuse.

Emotional abuse of children can come from adults or from other children:

• parents or caregivers
• teachers or athletic coaches
• siblings
• bullies at school
• middle- and high-school girls in social cliques

What is neglect?

Neglect is a failure to provide for the child's basic needs. The types of neglect are:

• physical
• educational
• emotional

Physical neglect

Physical neglect is not providing for a child's physical needs, including:

• inadequate provision of food, housing, or clothing appropriate for season or weather
• lack of supervision
• expulsion from the home or refusal to allow a runaway to return home
• abandonment
• denial or delay of medical care
• inadequate hygiene

Educational neglect

Educational neglect is the failure to enroll a child of mandatory school age in school or to provide necessary special education. This includes allowing excessive truancies from school.

Emotional (psychological) neglect

Emotional neglect is a lack of emotional support and love, such as:

• not attending to the child's needs, including need for affection
• failure to provide necessary psychological care
• domestic violence in the child's presence, such as spousal or partner abuse
• drug and alcohol abuse in the presence of the child, or allowing the child to participate in drug and alcohol use

When authorities examine emotional neglect, they take into consideration cultural values and standards of care, as well as the level of family income, which may interfere with proper care.

Some overlap exists between the definitions of emotional abuse and emotional neglect; regardless, they are both child abuse.

What are the signs and symptoms of child abuse?

If you suspect child abuse, but aren't sure, look for clusters of the following physical and behavioral signs.

Some signs of physical abuse

• Unexplained burns, cuts, bruises, or welts in the shape of an object
• Bite marks
• Anti-social behavior
• Problems in school
• Fear of adults
• Drug or alcohol abuse
• Self-destructive or suicidal behavior
• Depression or poor self-image

Some signs of emotional abuse

• Apathy
• Depression
• Hostility
• Lack of concentration
• Eating disorders

Some signs of sexual abuse

• Inappropriate interest in or knowledge of sexual acts
• Seductiveness
• Avoidance of things related to sexuality, or rejection of own genitals or bodies
• Nightmares and bedwetting
• Drastic changes in appetite
• Overcompliance or excessive aggression
• Fear of a particular person or family member
• Withdrawal, secretiveness, or depression
• Suicidal behavior
• Eating disorders
• Self-injury

Sometimes there are no obvious physical signs of sexual abuse, and a physician must examine the child to confirm the abuse.

Some signs of neglect

• Unsuitable clothing for weather
• Being dirty or unbathed
• Extreme hunger
• Apparent lack of supervision

What are the causes of child abuse?

Why would someone abuse a child? What kind of person abuses a child? Not all abuse is deliberate or intended. Several factors in a person's life may combine to move them toward abusing a child:

• general stress
• the stress of having children in the family, when one didn't have children before
• dealing with a handicapped or behaviorally difficult child
• the stress of caring for someone besides oneself
• a personal history of being abused (childhood trauma)
• alcohol or drug use
• marital conflict
• unemployment

No one has been able to predict which of these factors will cause someone to abuse a child. A significant factor is that abuse tends to be intergenerational - those who were abused as children are more likely to repeat the act when they become parents or caretakers.

In addition, many forms of abuse arise from ignorance, isolation, or benign neglect. Sometimes a cultural tradition leads to abuse, for example, such beliefs as:

• children are property
• parents (especially males) have the right to control their children in any way they wish
• children need to be toughened up to face the hardships of life
• girls need to be genitally mutilated to assure virginity and later marriage.

What are the results of child abuse?

Child abuse can have the following dire consequences:

• Your child may become someone who lies, resents, fears, and retaliates, rather than loves, trusts, and listens.
• Your child may become reclusive, and alienated from you and from the rest of your family.
• Your child will have low self-esteem, and is likely to engage in self-destructive behaviors.
• Your child's psychological development and social behavior will be impaired.
• As an adult, your child will probably abuse his or her own children, who are your grandchildren.
• As an adult, your child may exclude you, including from celebrations and family gatherings. You may not be permitted to spend time with your grandchildren.

The results of being abused as a child vary according to the severity of the abuse and the surrounding environment of the child. If the social environment of the family or school is nurturing and supportive, the child will probably have a better outcome.

Results of physical abuse

Physical abuse may result in:

• difficulty establishing intimate personal relationships
• difficulty in adulthood with physical closeness, touching, intimacy, or trust
• high levels of anxiety, depression, substance abuse, medical illness, or problems at school or work
• becoming an abusive parent or caregiver

Results of emotional abuse

Emotional abuse can result in serious behavioral, cognitive, emotional, or mental disorders.

Results of sexual abuse

Some results of prolonged sexual abuse are:

• low self-esteem
• a feeling of worthlessness
• an abnormal or distorted view of sex
• personality disorders
• difficulty relating to others except on sexual terms
• tendency to become child abusers or prostitutes
• other serious problems in adulthood