Unfortunately, punishment sometimes leads to the abuse of infants and children (Cicchetti, 2013; Cicchetti & Toth, 2015). In 2009, approximately 702,000 U.S. children were found to be victims of child abuse at least once during that year (U.S. Department of Health and Human Services, 2010). Eighty-one percent of these children were abused by a parent or parents. Laws in many states now require physicians and teachers to report suspected cases of child abuse, yet many cases go unreported, especially those involving battered infants.
Whereas the public and many professionals use the term child abuse to refer to both abuse and neglect, developmentalists increasingly use the term child maltreatment (Cicchetti, 2013; Cicchetti & Toth, 2015; Jackson & Deye, 2015). This term does not have quite the emotional impact of the term abuse and acknowledges that maltreatment includes diverse conditions.
Child maltreatment involves grossly inadequate and destructive aspects of parenting.
Types of Child Maltreatment The four main types of child maltreatment are physical abuse, child neglect, sexual abuse, and emotional abuse (Jackson, Kissoon, & Greene, 2015; National Clearinghouse on Child Abuse and Neglect, 2013):
-Physical abuse is characterized by the infliction of physical injury as a result of punching, beating, kicking, biting, burning, shaking, or otherwise harming a child. The parent or other person may not have intended to hurt the child; the injury may have resulted from excessive physical punishment (Flaherty & others, 2014; Villodas & others, 2015).
-Child neglect is characterized by failure to provide for the child's basic needs (O'Hara & others, 2015; Ross & Juarez, 2014). Neglect can be physical (abandonment, for example), educational (allowing chronic truancy, for example), or emotional (marked inattention to the child's needs, for example) (Horner, 2014). Child neglect is by far the most common form of child maltreatment. In every country where relevant data have been collected, neglect occurs up to three times as often as abuse (Potthast, Neuner, & Catani, 2014).
-Sexual abuse includes fondling a child's genitals, intercourse, incest, rape, sodomy, exhibitionism, and commercial exploitation through prostitution or the production of pornographic materials (Collin-Vezina & others, 2015; Williams & others, 2014). Unlike physical abuse, many cases of sexual abuse produce no outward physical signs that abuse has taken place.
-Emotional abuse (psychological/verbal abuse/mental injury) includes acts or omissions by parents or other caregivers that have caused, or could cause, serious behavioral, cognitive, or emotional problems (Shin & others, 2015; Sorbo & others, 2013).
No single factor causes child maltreatment (Cicchetti, 2013). A combination of factors, including the culture, neighborhood, family, and development, likely contribute to child maltreatment.
The extensive violence that takes place in American culture is reflected in the occurrence of violence in the family (Leppakoski, Flinck, & Paavilainen, 2015). A regular diet of violence appears on television screens, and parents often resort to power assertion as a disciplinary technique. In China, where physical punishment is rarely used to discipline children, the incidence of child abuse is reportedly very low.
The family itself is obviously a key part of the context of abuse (Diderich & others, 2014). Among the family and family-associated characteristics that may contribute to child maltreatment are parenting stress, substance abuse, social isolation, single parenting, and socioeconomic difficulties (especially poverty) (Cicchetti & Toth, 2015). The interactions of all family members should be considered, regardless of who performs the violent acts against the child (Kim & Cicchetti, 2004). For example, even though the father may be the one who physically abuses the child, contributions by the mother, the child, and siblings also should be evaluated.
Were parents who abuse children abused by their own parents? A 30-year longitudinal study found that offspring of parents who had engaged in child maltreatment and neglect are at risk for engaging in child neglect and sexual maltreatment themselves (Widom, Cazja, & Dumont, 2015). It is estimated that about one-third of parents who were abused when they were young abuse their own children (Cicchetti & Toth, 2015). Thus, some, but not a majority, of parents are locked into an intergenerational transmission of abuse (Dixon, Browne, & Hamilton-Giachritsis, 2005).
Developmental Consequences of Abuse Among the consequences of child maltreatment are poor emotion regulation, attachment problems, problems in peer relations, difficulty in adapting to school, and other psychological problems such as depression and delinquency during childhood and adolescence (Cicchetti & Banny, 2014; Cicchetti & Toth, 2015). As shown in Figure 9, maltreated young children in foster care were more likely to show abnormal stress hormone levels than middle-SES young children living with their birth family (Gunnar & Fisher, 2006). In this study, the abnormal stress hormone levels were mainly present in the foster children who experienced neglect, best described as "institutional neglect" (Fisher, 2005). Adolescents who experienced abuse or neglect as children are more likely than adolescents who were not maltreated as children to engage in violent romantic relationships, suicide attempts, delinquency, sexual risk taking, and substance abuse (Miller & others, 2013). Further, a recent study revealed that young adults who experienced child maltreatment, especially physical abuse, at any age were more likely to be depressed and engage in suicide ideation as adults (Dunn & others, 2013). In this study, child maltreatment at 3 to 5 years of age was associated more strongly with depression in early adulthood than other childhood age periods. And a recent study revealed that a significant increase in suicide attempts before age 18 occurred with repeated child maltreatment (Jonson-Reid, Kohl, & Drake, 2012).
Later, during the adult years, individuals who were maltreated as children are more likely to experience physical, emotional, and sexual problems (Lacelle & others, 2012). A 30-year longitudinal study found that middle-aged adults who had experienced child maltreatment had increased risk for diabetes, lung disease, malnutrition, and vision problems (Widom & others, 2012). Another study revealed that young adults who had experienced child maltreatment, especially physical abuse, at any age were more likely to be depressed and to engage in suicidal ideation as adults (Dunn & others, 2013). Further, adults who were maltreated as children often have difficulty establishing and maintaining healthy intimate relationships (Dozier, Stovall-McClough, & Albus, 2009). As adults, maltreated children are also at higher risk for violent behavior toward other adults—especially dating partners and marital partners—as well as for substance abuse, anxiety, and depression (Miller-Perrin, Perrin, & Kocur, 2009). One study also revealed that adults who had experienced child maltreatment were at increased risk for financial and employment-related difficulties (Zielinski, 2009).
An important research agenda is to discover how to prevent child maltreatment or intervene in children's lives when they have been maltreated (Petersen, Joseph, & Feit, 2014). In one study of maltreating mothers and their 1-year-olds, two treatments were effective in reducing child maltreatment: (1) home visitation that emphasized improved parenting, coping with stress, and increasing support for the mother; and (2) parent-infant psychotherapy that focused on improving maternal-infant attachment (Cicchetti, Toth, & Rogosch, 2005).