Consequences of Child Abuse and Neglect

A new report from the Children’s Bureau says an estimated 906,000 children were victims of child abuse or neglect in 2003.

I don’t have numbers to back it up but my gut feeling is that this estimate is very low. The report is about the consequences of abuse and neglect and not about the reasons for its occurrence. It would be interesting to know how many of these children’s parents are involved in bad marriages.

Below you can read a summary of the report or go to the Child Welfare Information Gateway to read the complete report.

Long-term Consequences of Child Abuse and Neglect (summary)

While physical injuries may or may not be immediately visible, abuse and neglect can have consequences for children, families, and society that last lifetimes, if not generations.

The impact of child abuse and neglect is often discussed in terms of physical, psychological, behavioral, and societal consequences.

In reality, however, it is impossible to separate them completely.

Physical consequences (such as damage to a child’s growing brain) can have psychological implications (cognitive delays or emotional difficulties, for example).

Psychological problems often manifest as high-risk behaviors.

Depression and anxiety, for example, may make a person more likely to smoke, abuse alcohol or illicit drugs, or overeat.

High-risk behaviors, in turn, can lead to long-term physical health problems such as sexually transmitted diseases, cancer, and obesity.

This fact sheet provides an overview of some of the most common physical, psychological, behavioral, and societal consequences of child abuse and neglect, while acknowledging that much crossover among categories exists.

Not all abused and neglected children will experience long-term consequences.

The type of abuse (physical abuse, neglect, sexual abuse, etc.)

Relationship between the victim and his or her abuser (Chalk, Gibbons, & Scarupa, 2002).

Researchers also have begun to explore why, given similar conditions, some children experience long-term consequences of abuse and neglect while others emerge relatively unscathed.

The ability to cope, and even thrive, following a negative experience is sometimes referred to as “resilience.”

A number of protective factors may contribute to an abused or neglected child’s resilience.

These include individual characteristics, such as optimism, self-esteem, intelligence, creativity, humor, and independence.

Protective factors can also include the family or social environment, such as a child’s access to social support; in particular, a caring adult in the child’s life.

Community well-being, including neighborhood stability and access to health care, is also a protective factor (Thomlison, 1997).

The immediate physical effects of abuse or neglect can be relatively minor (bruises or cuts) or severe (broken bones, hemorrhage, or even death).

In some cases the physical effects are temporary; however, the pain and suffering they cause a child should not be discounted.

Meanwhile, the long-term impact of child abuse and neglect on physical health is just beginning to be explored.

The immediate effects of shaking a baby (a common form of child abuse in infants) can include vomiting, concussion, respiratory distress, seizures, and death.

Long-term consequences can include blindness, learning disabilities, mental retardation, cerebral palsy, or paralysis (Conway, 1998).

Child abuse and neglect have been shown, in some cases, to cause important regions of the brain to fail to form properly, resulting in impaired physical, mental, and emotional development (Perry, 2002; Shore, 1997).

In other cases, the stress of chronic abuse causes a “hyperarousal” response by certain areas of the brain, which may result in hyperactivity, sleep disturbances, and anxiety, as well as increased vulnerability to post-traumatic stress disorder, attention deficit/hyperactivity disorder, conduct disorder, and learning and memory difficulties (Perry, 2001; Dallam, 2001).

A study of 700 children who had been in foster care for 1 year found more than one-quarter of the children had some kind of recurring physical or mental health problem (National Survey of Child and Adolescent Well-Being).

A study of 9,500 HMO participants showed a relationship between various forms of household dysfunction (including childhood abuse) and long-term health problems such as sexually transmitted diseases, heart disease, cancer, chronic lung disease, skeletal fractures, and liver disease (Hillis, Anda, Felitti, Nordenberg, & Marchbanks, 2000; Felitti, Anda, Nordenberg, Williamson, Spitz, Edwards, Koss, & Marks, 1998).

The immediate emotional effects of abuse and neglect—isolation, fear, and an inability to trust—can translate into lifelong consequences including low self-esteem, depression, and relationship difficulties.

In one long-term study, as many as 80 percent of young adults who had been abused met the diagnostic criteria for at least one psychiatric disorder at age 21.

These young adults exhibited many problems, including depression, anxiety, eating disorders, and suicide attempts (Silverman, Reinherz, & Giaconia, 1996).

Other psychological and emotional conditions associated with abuse and neglect include panic disorder, dissociative disorders, attention-deficit/hyperactivity disorder, post-traumatic stress disorder, and reactive attachment disorder (Teicher, 2000).

The National Survey of Child and Adolescent Well-Being recently found children placed in out-of-home care due to abuse or neglect tended to score lower than the general population on measures of cognitive capacity, language development, and academic achievement (2003).

Children who are abused and neglected by caretakers often do not form secure attachments to them.

According to the National Institute on Drug Abuse, as many as two-thirds of people in drug treatment programs reported being abused as children (2000).

Society as a whole pays a price for child abuse and neglect, in terms of both direct and indirect costs.

Direct costs include those associated with maintaining a child welfare system to investigate allegations of child abuse and neglect, as well as expenditures by the judicial, law enforcement, health, and mental health systems to respond to and treat abused children and their families.

These include juvenile and adult criminal activity, mental illness, substance abuse, and domestic violence.

Prevent Child Abuse America recently estimated these costs at more than $69 billion per year (2001).

Consequences may be mild or severe; disappear after a short period or last a lifetime; and affect the child physically, psychologically, behaviorally, or in some combination of all three ways.

Ultimately, due to related costs to public entities such as the health care, human services, and educational systems, abuse and neglect impact not just the child and family, but society as a whole.

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