Child abuse


Refers to words or actions that cause or failed to protect children from harm, potential harm, or threat of harm, is associated with negative physical and emotional health outcomes that persist and can lead to serious disorders throughout life.

Child maltreatment is a pervasive public health and costly societal problem.

It is a long-term physical and mental health and well-being consequences for survivors.

Ongoing effects of racism or poverty, experiencing housing or food insecurity can contribute exacerbate the effects of adverse childhood experiences.




The potential societal cost of adverse childhood experiences are estimated to be in hundreds of billions of dollars each year, with a significant portion of these costs occurring in healthcare.


Adverse childhood experiences result in the chronic activation of the stress response system.


Children’s neurological development can be permanently disrupted by  chronic exposure to stressful events:  physical, emotional, or sexual abuse, physical or emotional neglect, witnessing violence in the household, or a parent being incarcerated or suffering from a mental illness. 

Toxic stress results in dysregulation of the limbic-hypothalamus-pituitary-adrenal axis, elevating levels of catecholamine, cortisol and pro inflammatory cytokines leading to effects on the nervous, endocrine  and immune systems.


Toxic stress changes can affect attention, executive functioning,impulsive behavior, brain reward systems, decision making, and response stress throughout the lifespan.

Child maltreatment is physical, sexual, or psychological maltreatment or neglect of a child or children, especially by a parent or other caregiver.

Includes any act or failure to act by a parent or other caregiver that results in actual or potential harm to a child.

Estimates of the rates of child maltreatment vary widely by country, by how it is defined, the scope and quality of data gathered, and the scope and quality of surveys that ask for self-reports from victims, parents, and caregivers.

Can occur in a child’s home, or the organizations, schools or communities the child attends.

Child abuse is an international phenomenon.

Child maltreatment as an umbrella term to cover neglect, exploitation, and trafficking.

Child abuse refers to usually deliberate acts of commission while neglect refers to acts of omission.

Child maltreatment includes both acts of commission and acts of omission on the part of parents or caregivers, causing actual or threatened harm to a child.

Retrospective study of adults reporting adverse childhood experiences including verbal, physical and sexual abuse, as well as other forms of childhood trauma found 26% of adults reported verbal abuse as children, 15% reported physical abuse, and 12.% reported sexual abuse.

For legal and cultural reasons as well as fears by children most childhood abuse goes unreported and unsubstantiated.

Adverse childhood experiences are associated with many negative outcomes, including chronic diseases such as cancer, diabetes, heart disease, suicide, and drug abuse.

In 2012, Child Protective Services agencies estimated that approximately 9 out of 1000 children in the United States were victims of child maltreatment.

Most (78%) cases of child maltreat were victims of neglect.

Adverse childhood experiences and various forms of maltreatment and household dysfunction experienced in childhood  has shown a strong dose–response relationship with numerous health, social, and behavioral problems throughout a person’s lifespan, including substance abuse and addiction.


In a study of 900 court cases involving children who experienced abuse: a vast amount of them went on to suffer from some form of addiction in their adolescence or adult life.

The World Health Organization describes four types of child maltreatment: physical abuse; sexual abuse; emotional and psychological abuse; and neglect.

Psychological child abuse is defined as nonaccidental verbal or symbolic acts by a child’s parent or caregiver that result, or have reasonable potential to result, in significant psychological harm to the child.

Psychological child abuse additionally defined as spurning, terrorizing, isolating, exploiting, corrupting, denying emotional responsiveness, or neglect, conveying to children that they are worthless, flawed, unloved, unwanted, endangered, or only of value in meeting another’s needs.

Physical abuse often does not occur in isolation, but as part of authoritarian control, anxiety-provoking behavior, and a lack of parental warmth.

Physical abuse is defined as the use of physical force against the child that results in, or has a high likelihood of harm for the child’s health, survival, development or dignity.

Physical abuse includes hitting, beating, kicking, shaking, biting, strangling, scalding, burning, poisoning and suffocating.

Much physical violence against children inflicted with the object of punishment.

Suspicion for physical abuse is suggested when an injury occurs in an infant that does not move independently, injuries in unusual areas, more than one injury at different stages of healing, symptoms of possible head trauma, and injuries to more than one body system.

Most nations with child abuse laws deem the deliberate infliction of serious injuries, or actions that place the child at obvious risk of serious injury or death, to be illegal.

Multiple injuries or fractures, bruises, scratches, burns, broken bones, lacerations, repeated mishaps, and rough treatment that could cause physical injuries and should raise suspicion of abuse.

Some view humiliations, spankings and beatings, slaps in the face as forms of abuse, injuring the integrity and dignity of a child.

Physical abuse as a child can is associated with physical and mental difficulties in adult, including re-victimization, personality disorders, post-traumatic stress disorder, dissociative disorders, depression, anxiety, suicidal ideation, eating disorders, substance abuse, and aggression.

Physical abuse during childhood can lead to homelessness in adulthood.

Child sexual abuse is a form of child abuse in which an adult or older adolescent abuses a child for sexual stimulation, and may include: asking or pressuring a child to engage in sexual activities, exposure of the genitals to a child, displaying pornography to a child, actual sexual contact with a child, physical contact with the child’s genitals, viewing of the child’s genitalia, or using a child to produce child pornography.

Child sexual abuse on the victim may result in guilt and self-blame, flashbacks, nightmares, insomnia, diminished self-esteem, sexual dysfunction, chronic pain, addiction, self-injury, suicidal ideation, somatic complaints, depression, post-traumatic stress disorder, anxiety, other mental illnesses including borderline personality disorder and dissociative identity disorder, propensity to re-victimization, bulimia nervosa, physical injury to the child, risk of sexually transmitted infections, due to their immature immune, potential for mucosal tears during forced sexual contact,

Children who are the victims are also at an increased risk of sexually transmitted infections due to their immature immune systems and a high potential for mucosal tears during forced sexual contact, increased prevalence of HIV,

Most sexual abuse offenders are acquainted with their victims.

Approximately 30% of child sexual abusers are relatives of the child: most often brothers, sisters, fathers, mothers, uncles or cousins.

Around 60% of child sexual abusers are other acquaintances such as friends of the family, babysitters, or neighbors.

Strangers are the sexual child abuse offenders in approximately 10% of child sexual abuse cases.

In over one-third of cases of child sexual abuse the perpetrator is also a minor.

Others define child abuse as the induction of psychological and social defects in the growth of a child as a result of behavior such as loud yelling, coarse and rude attitude, inattention, harsh criticism, and denigration of the child’s personality, name-calling, ridicule, degradation, destruction of personal belongings, torture or killing of a pet, excessive criticism, inappropriate or excessive demands, withholding communication, and routine labeling or humiliation.

Childhood psychological abuse is as harmful as sexual or physical abuse,and is the most prevalent form of child abuse and neglect.

Nearly 3 million U.S. children experience some form of psychological maltreatment annually.

Victims of emotional abuse may react by distancing themselves from the abuser, internalizing the abusive words, or fighting back by insulting the abuser, abnormal or disrupted attachment development, a tendency for victims to blame themselves, learned helplessness, and overly passive behavior.

Child neglect refers to the failure of a parent or other person with responsibility for the child to provide: food, clothing, shelter, medical care, or supervision to the degree that the child’s health, safety or well-being may be threatened with harm.

Neglect is also a lack of attention from the people surrounding a child, attention, love, and nurturing.

Neglect is the most common form of maltreatment.

Signs of child neglect include: frequent absence from school, begs or steals food or money, lacks medical and dental care, is consistently dirty, or lacks sufficient clothing.

Neglectful acts can be divided into six sub-categories:

Supervisory neglect:

Physical neglect:

Medical neglect:

Emotional neglect:

Educational neglect:


Neglected children may experience delays in physical and psychosocial development.

Impaired neuropsychological functions including executive function, attention, processing speed, language, memory and social skills may occur as a result of neglect.

Children who are ignored, shamed, or humiliated suffer at least as much, if not more, than if they are physically assaulted.

Abused children can grow up experiencing insecurities, low self-esteem, and lack of development, ongoing difficulties with trust, social withdrawal, trouble in school, and forming relationships.

Neglected children in foster are not likely to view caregivers as being a source of safety, and instead typically show an increase in aggressive and hyperactive behaviors which may disrupt healthy or secure attachment with their adopted parents.

Neglected children learn to adapt to an abusive and inconsistent caregivers by becoming cautiously self-reliant, and are often described as glib, manipulative and disingenuous in their interactions with others.

Neglected children have a more difficult time forming and maintaining relationships, later in life due to the lack of attachment they had in their earlier stages of life.

Child abuse can result in higher rates of chronic conditions, high-risk health behaviors and shortened lifespan.

Brain development of the child responds to the experiences with families, caregivers, and the community.

Child abuse adverse physical effects are strongly associated with developmental problems and with many chronic physical and psychological effects, including subsequent ill-health, including higher rates of chronic conditions, high-risk health behaviors and shortened lifespan.

Childhood maltreated children may grow up to be maltreating adults.

Almost 90 percent of maltreating adults were maltreated as children.

International studies show that a quarter of all adults report experiencing physical abuse as children, and that and 1 in 5 women and 1 in 13 men report experiencing childhood sexual abuse.

Babies and young children respond differently to abuse than their older counterparts, manifesting an overly affectionate attitude towards strangers or people they haven’t known for very long.

Maltreated children may lack confidence or become anxious, appear to not have a close relationship with their parent, exhibit aggressive behavior or act nasty towards other children and animals, use foul language or act in a markedly different way to other children at the same age, struggle to control strong emotions, seem isolated from their parents, lack social skills or have few, if any, friends.

Reactive attachment disorder can occur in child abuse victims.

Reactive attachment disorder is defined as disturbed and developmentally inappropriate social relatedness, that usually begins before the age of 5 years.

Can manifest as a persistent failure to start or respond in an appropriate fashion to most social situations.

Emotional abuse has been linked to increased depression, anxiety, and difficulties in interpersonal relationships.

Child abuse and neglect victims are more likely to commit crimes as juveniles and adults.

Exposure to domestic violence increases risk of child engagement in felony assault, increases chances of experiencing behavioral and emotional problems, depression, irritability, anxiety, academic problems, and problems in language development.

A common form of child abuse is the shaking baby syndrome that results in permanent neurological damage in 80% of cases or death in 30% of cases).

The shaking baby syndrome results from intracranial hypertension after bleeding in the brain, damage to the spinal cord and neck, and rib or bone fractures.

The shaking baby syndrome may impair brain development to cause important regions of the brain to fail to form or grow properly.

Alterations in brain maturation have long-term consequences for cognitive, language, and academic abilities.

Household dysfunction and childhood maltreatment are strongly associated with many higher rates of chronic conditions, high-risk health behaviors, shortened lifespan, adulthood allergies, arthritis, asthma, bronchitis, high blood pressure, and ulcers.

Childhood maltreatment may be associated with a higher risk of developing cancer later in life, as well as possible immune dysfunction.

During childhood the exposure to violence is associated with shortened telomeres and reduced telomerase activity, resulting in an increased rate of telomere length reduction which correlates to a reduction in lifespan of 7 to 15 years.

Strong relationships exist between the number of adverse experiences, including physical and sexual abuse in childhood, and reports of cigarette smoking, obesity, physical inactivity, alcoholism, drug abuse, depression, attempted suicide, sexual promiscuity and sexually transmitted diseases in later life.

There is a dose response relationship between the number of types of adverse childhood experiences and increased risk for a range of outcomes including health risk behaviors, chronic health conditions such as coronary artery disease, cancer, stroke, diabetes, kidney disease, COPD, asthma, obesity and Socioeconomic challenges.

Adults who report adverse childhood experiences of 4 or more types, had a significant increase in likelihood of having coronary heart disease, stroke, cancer, COPD, and depression.

Girls are particularly vulnerable to sexual violence, exploitation and abuse in situations of armed conflict and refugee settings.

There is a significant correlation between the number of different adverse childhood experiences and risk for poor health outcomes in adults including cancer, heart attack, mental illness, reduced longevity drug, alcohol abuse, depression, and suicide.

Children who experience child abuse or neglect are 59% more likely to be arrested as juveniles, 28% more likely to be arrested as adults, and 30% more likely to commit violent crimes.

80% of abused and maltreated infants exhibited symptoms of disorganized attachment, and may encounter difficulty when faced with their infant and young children’s needs and which may in turn lead to adverse consequences for their child’s social-emotional development.

Victims of childhood abuse may suffer from chronic head, abdominal, pelvic, or muscular pain with no identifiable reason.

In one study up to 80% of abused people had at least one psychiatric disorder at age 21, including depression, anxiety, eating disorders, suicide attempts,

Studies have shown that between 36 and 76% of women mental health outpatients have been sexually abused as had 58% of women and 23% of men schizophrenic patients.

A crucial structure in the brain’s reward circuits is compromised by childhood abuse and neglect, and predicts depressive symptoms later in life. OCD, co-dependency, or even a lack of human connections.

Some children who are raised in child abuse settings, do manage to do unexpectedly well later in life.

Some suggest that those who harm children, justify and make it acceptable because of beliefs in children’s inherent subservience to adults, and the ultimate causes of child abuse lie in prejudice against children, especially the view that human rights do not apply equally to adults and children.

Individuals who physically abuse their spouses are more likely than others to physically abuse their children.

Parents set expectations for their child that are clearly beyond the child’s capability, so that the resulting frustration caused by the child’s non-compliance is believed to function as a contributory if not necessary cause of child abuse.

Punishment is the intent of more than 2/3 acts of physical violence against children.

Spanking by parents increases risk of severe assaults on infants and children and such abusive treatment often involves parents attributing conflict to their child’s willfulness or rejection.

Children resulting from unintended pregnancies are more likely to be abused or neglected.

Some evidence exists that children with moderate or severe disabilities are more likely to be victims of abuse than non-disabled children.

Parents with documented substance abuse, most commonly alcohol, cocaine, and heroin, are much more likely to mistreat their children.

Parental unemployment and financial difficulties, and mental health are associated with increased rates of child abuse.

Asian parenting perspectives, specifically, hold different ideals from American culture.

It is necessary to understand differences in cultural beliefs when examining all cross-cultural perspectives of child abuse.

Large family size increases the risk of child neglect.

Children who experience childhood trauma do not heal from abuse easily.

As of 2014, an estimated 41,000 children under 15 are victims of homicide each year.

A significant proportion of child deaths caused by maltreatment are incorrectly attributed to unrelated factors such as falls, burns, and drowning.

A study estimated that one in four children experience some form of maltreatment in their lifetimes, according to the Centers for Disease Control and Prevention (CDC).

A Washington University study estimating 37% of American children experiencing a child protective services investigation by age 18, and is as high as 53% for African Americans.

In the United States, 1,730 children died in 2008 due to factors related to abuse; this is a rate of 2 per 100,000 U.S. children.

Family situations which place children at risk include moving, unemployment, and having non-family members living in the household.

In 2016, more than 676,000 children were reported and substantial as abused or neglected in the US.

In recent years there has been a decline in child physical abuse and child sexual abuse, related to a decline in risk factors.

The above statistic is an underestimation of the scope of the problem, and estimates of the actual rates of abuse maybe 10-40 times higher.

A 2017 report indicated in estimated 37.4% of all US children, and 53% of African-American children, will have been reported to authorities for suspected abuse or neglect by the time they reach 18 years(Kim, H).

A LONGSCAN study suggested children reported to authorities, even without substantiation or confirmation after investigation, have mental health outcomes similar to those with substantiated reported outcomes, and these findings are quite different from those of never reported children.

Factors that increase a child’s risk for maltreatment include race, being born to an adolescent mother, having parents with low education or low income, or having parents who have been subject to abuse or neglect.

Injuries sustained may include brain injuries, blindness, and fractures that can lead to disability or death.

Increased with COVID-19 due to lockdowns and school closings.


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