Child Abuse

By Tim Taylor

Sticks and stones

As the childhood rhyme goes, sticks and stones may break my bones but words will never hurt me. Not when it comes to children, however. Physical abuse is one of four common types of maltreatment children may endure during their early years. There’s also sexual abuse, emotional abuse and neglect. According to the National Children’s Alliance, nearly 700,000 children are abused in this country every year. In four out of five cases, the abusers are the victim’s parents. Neglect, which is the failure by a parent or guardian to provide for a child’s basic needs, accounts for 75 percent of these cases. Emotional abuse is a pattern of behavior that hinders a child’s development or sense of self-worth. Constant criticism, threats and rejection are examples of emotional abuse. Because it is difficult to prove, this form of abuse can go on for years without intervention.  Emotional abuse can undermine a child’s sense of self and disrupt their emotional and relational development.

Most vulnerable

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April is National Child Abuse Prevention Month, created to raise awareness about a significant problem in this country. Drawing attention to this issue is all the more important considering that many of its victims can’t speak for themselves. And unfortunately, the youngest victims are also the most vulnerable. More than a quarter of all victims of child abuse are younger than three years old. Of all child abuse fatalities in the U.S. in 2015, nearly 75 percent were under the age of 3. The fatalities could be the result of repeated abuse, such as battered child syndrome, or may involve a single, impulsive incident. Very young children are the most vulnerable for many reasons, including their dependency and inability to defend themselves. Infants are particularly susceptible to injury because of their size. If you are having trouble parenting a young child or know of someone who does, call the National Child Abuse Hotline at 1-800-4-A-CHILD.

May know offender

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Children are taught from a young age to avoid strangers but they are rarely taught to look out for those whose ultimate intention may be sexual abuse. In as many as 93 percent of child sexual abuse cases, the child knows the person that commits the abuse. It could be anyone in the immediate or extended family. It may also be a neighbor, teacher or coach, someone the family has come to trust. Offenders may use a method known as grooming to gain access to a child. In doing this, the offender may assume a caring role, befriend the child or even exploit their position of trust and authority to get close to the child and their family. These individuals intentionally build relationships with the adults around a child or seek out a child who may have fewer adults in his or her life. Signals of grooming relationships between children and adults can include unexplained gifts or money, special treatment or a child wanting to avoid being with a particular adult.

Long-term effects

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Child abuse can have long-term effects on its victims. According to UAMS chief psychologist Teresa Kramer, the emotional damage an abuse victim can suffer may not surface until later in life. Adults who were abused as a child often have trouble establishing lasting and stable personal relationships. They may have trouble with physical closeness, touching, intimacy, and trust as adults. Abuse victims are 1.5 times more likely to use illicit drugs in middle adulthood. They are also at higher risk for anxiety, depression and problems at school or work. Kramer says early identification and treatment is important to minimize the long-term consequences of abuse. Qualified mental health professionals should conduct a comprehensive evaluation and provide treatment shown to be effective for children who have been abused. Through treatment, the abused child can learn he or she was not responsible and regain a sense of self-confidence and trust.

There is hope

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Given the complex nature of child abuse, it’s important to know that there are positive aspects to treating the problem. Trauma-focused cognitive behavioral therapy, or TF-CBT, is an evidence-based treatment designed to help children and their caregivers overcome traumatic events such as abuse. The treatment, based on learning theories, addresses distorted beliefs related to the abuse and provides a supportive environment in which children are encouraged to talk about their traumatic experience. TF-CBT also helps parents who were not abusive to cope effectively with their own emotional distress and develop skills that support their children. Child Parent Psychotherapy or CPP is a relationship-based intervention in which a child is typically seen with his or her primary caregiver. CPP examines how the trauma and the caregiver’s history affect their relationship and the child’s overall developmental so that recovery can occur.

Trusted by thousands of listeners every week, T. Glenn Pait, M.D., began offering expert advice as the host of UAMS’ “Here’s to Your Health” program in 1996. Dr. Pait began working at UAMS in 1994 and has been practicing medicine for over 20 years.