Child abuse#Physical abuse

As late as the 19th century, cruelty to children, perpetrated by employers and teachers, was commonplace and widespread, and corporal punishment was customary in many countries, but in the first half of the 19th century, pathologists studying filicide (the parental killing of children) reported cases of death from paternal rage,Editorial (1848) Triple infanticide – suicide du meurtrier. Annales Médico-psycholiques 11: 108 only. recurrent physical maltreatment,Leuret (1837) Suspicion de folie chez une femme reconnue coupable d'avoir, pendant sa grossesse fait des blessures mortelles a deux de ses enfans: affaire R. Annales d'Hygiène Publique et de Médecine Légale 17: 374–400. starvation,Rothamel (1845) Eine Mutter führt durch allmälige Entziehung der Nahrungsmittel den Tod ihres ehelichen Kindes herbei. Henke's Zeitschrift für der Staatsarzneikunde 50: 139–156. and sexual abuse.Boys-de-Loury, Devergie, Ollivier (1843) Consultation medico-légale sur un cas de mort violente, chez un enfant de deux ans et demi. Annales d'Hygiène Publique et de Médecine Légale 29: 185–203. In an 1860 paper, French forensic medical expert Auguste Ambroise Tardieu gathered together a series of 32 such cases, of which 18 were fatal, the children dying from starvation and/or recurrent physical abuse; it included the case of Adeline Defert, who was returned by her grandparents at the age of 8, and for 9 years tortured by her parents – whipped every day, hung up by her thumbs and beaten with a nailed plank, burnt with hot coals and her wounds bathed in nitric acid, and deflorated with a baton.Tardieu A (1860) Étude médico-légale sur les sévices et mauvais traitements exercés sur des enfants. Annales d'Hygiène 15: 361–398. Tardieu made home visits and observed the effect on the children; he noticed that the sadness and fear on their faces disappeared when they were placed under protection. He commented, "When we consider the tender age of these poor defenceless beings, subjected daily and almost hourly to savage atrocities, unimaginable tortures and harsh privation, their lives one long martyrdom – and when we face the fact that their tormentors are the very mothers who gave them life, we are confronted with one of the most appalling problems that can disturb the soul of a moralist, or the conscience of justice".Brockington I F (1996) Motherhood and Mental Health. Oxford, Oxford University Press, page 396 – translation of a passage in Tardieu (1860). His observations were echoed by Boileau de Castélnau (who introduced the term misopédie – hatred of children),Boileau de Castélnau P (1861) Misopédie ou lesion de l'amour de la progéniture. Annales Médico-psychologiques 3rd series 7: 553–568. and confirmed by AubryAubry P (1891) De l'Homicide Commis par la Femme. Paris, Storck, pp 1–38. and several theses.Delcasse A (1885) Étude medico-légale sur les sévices de l'enfance. Thèse, Paris.Duval P (1892) Des sévices et mauvais traitements. Thèse, Lyon.Dumas E (1892) Du libéricide ou meurtre des enfants mineurs par leurs parents. Thèse, Lyon.

These early French observations failed to cross the language barrier, and other nations remained ignorant of the cause of many traumatic lesions in infants and toddlers; almost one hundred years would pass before humankind began to systematically confront Tardieu's "appalling problem". In the 20th century, evidence began to accumulate from pathology and paediatric radiology, particularly in relation to chronic subdural haematoma and limb fractures: subdural haematoma had a curious bimodal distribution, idiopathic in infants and traumatic in adults,Sherwood D (1930) Chronic subdural haematoma in infants. American Journal of Diseases of Children 39: 980–1021. while unexplained ossifying periostitis of the long bones was similar to that occurring after breech extractions.Snedecor S T, Knapp R E, Wilson H B (1935) Traumatic ossifying periostitis of the newborn. Surgery, Gynecology and Obstetrics 61: 385–387. In 1946, John Caffey, the American founder of paediatric radiology, drew attention to the association of long bone fractures and chronic subdural haematoma,Caffey J (1946) Multiple fractures in long bones of infant suffering from chronic subdural haematoma. American Journal of Roentgenology 56: 163–173. and, in 1955, it was noticed that infants removed from the care of aggressive, immature and emotionally ill parents developed no new lesions.Woolley P V, Evans W A (1955) Significance of skeletal lesions in infants resembling those of traumatic origin. Journal of the American Medical Association 158: 539–543.

As a result, professional inquiry into the topic began again in the 1960s. The July 1962 publication of the paper "The Battered Child-Syndrome" authored principally by pediatrician C. Henry Kempe and published in The Journal of the American Medical Association represents the moment that child maltreatment entered mainstream awareness. Before the article's publication, injuries to children—even repeated bone fractures—were not commonly recognized as the results of intentional trauma. Instead, physicians often looked for undiagnosed bone diseases or accepted parents' accounts of accidental mishaps such as falls or assaults by neighborhood bullies.{{cite book |author=Young-Bruehl, Elisabeth |title=Childish : Confronting Prejudice Against Children |date=2012 |publisher=Yale University Press |isbn=978-0-300-17311-6 |location=New Haven, Connecticut}}{{rp|100–103}}

The study of child abuse emerged as an academic discipline in the early 1970s in the United States. Elisabeth Young-Bruehl maintained that despite the growing numbers of child advocates and interest in protecting children which took place, the grouping of children into "the abused" and the "non-abused" created an artificial distinction that narrowed the concept of children's rights to simply protection from maltreatment, and blocked investigation of how children are discriminated against in society generally. Another effect of the way child abuse and neglect have been studied, according to Young-Bruehl, was to close off consideration of how children themselves perceive maltreatment and the importance they place on adults' attitudes toward them. Young-Bruehl wrote that when the belief in children's inherent inferiority to adults is present in society, all children suffer whether or not their treatment is labeled as "abuse".{{rp|15–16}}

Definitions of what constitutes child abuse vary among professionals, between social and cultural groups, and across time.{{cite book|author1=Coghill, D. |author2=Bonnar, S. |author3=Duke, S. |author4=Graham, J. |author5=Seth, S. |title=Child and Adolescent Psychiatry|publisher=Oxford University Press|isbn=978-0-19-923499-8|year=2009|page=412|access-date=8 March 2016|url=https://books.google.com/books?id=pcUeLW9O0ZgC&pg=PA412|url-status=live|archive-url=https://web.archive.org/web/20170224005130/https://books.google.com/books?id=pcUeLW9O0ZgC&pg=PA412|archive-date=24 February 2017}}{{cite book|author=Wise, Deborah|chapter=Child Abuse Assessment|editor=Hersen, Michel|title=Clinician's Handbook of Child Behavioral Assessment|publisher=Academic Press|isbn=978-0-08-049067-0|year=2011|page=550|access-date=8 March 2016|chapter-url=https://books.google.com/books?id=dyhRU_dOqAoC&pg=PA550|url-status=live|archive-url=https://web.archive.org/web/20170223175700/https://books.google.com/books?id=dyhRU_dOqAoC&pg=PA550|archive-date=23 February 2017}} The terms abuse and maltreatment are often used interchangeably in the literature.{{cite book |url=https://www.cdc.gov/violenceprevention/pdf/cm_surveillance-a.pdf |publisher=Centers for Disease Control and Prevention, National Center for Injury Prevention and Control |location=Atlanta, Georgia |title=Child Maltreatment Surveillance: Uniform Definitions for Public Health and Recommended Data Elements, Version 1.0 |date=January 2008 |author1=Leeb, R.T. |author2=Paulozzi, L.J. |author3=Melanson, C. |author4=Simon, T.R. |author5=Arias, I. |url-status=live |archive-url=https://web.archive.org/web/20170829063410/https://www.cdc.gov/ViolencePrevention/pdf/CM_Surveillance-a.pdf |archive-date=29 August 2017 }}{{rp|11}} Child maltreatment can also be an umbrella term covering all forms of child abuse and child neglect.{{cite book |author1=McCoy, M.L. |author2=Keen, S.M. |chapter=Introduction |title=Child Abuse and Neglect |edition=2 |date=2013 |access-date=4 February 2016 |location=New York |publisher=Psychology Press |isbn=978-1-84872-529-4 |oclc=863824493 |pages=3–22 |chapter-url=https://books.google.com/books?id=ZCkVAgAAQBAJ&pg=PA3 |url-status=live |archive-url=https://web.archive.org/web/20170223162013/https://books.google.com/books?id=ZCkVAgAAQBAJ&pg=PA3 |archive-date=23 February 2017 }} Defining child maltreatment depends on prevailing cultural values as they relate to children, child development, and parenting.{{cite book|author=Conley, Amy|editor1=Midgley, James|editor2=Conley, Amy|chapter=2. Social Development, Social Investment, and Child Welfare|title=Social Work and Social Development: Theories and Skills for Developmental Social Work|publisher=Oxford University Press|isbn=978-0-19-045350-3|year=2010|pages=53–55|access-date=8 March 2016|chapter-url=https://books.google.com/books?id=0n9MCAAAQBAJ&pg=PT53|url-status=live|archive-url=https://web.archive.org/web/20170224005422/https://books.google.com/books?id=0n9MCAAAQBAJ&pg=PT53|archive-date=24 February 2017}} Definitions of child maltreatment can vary across the sectors of society which deal with the issue, such as child protection agencies, legal and medical communities, public health officials, researchers, practitioners, and child advocates. Since members of these various fields tend to use their own definitions, communication across disciplines can be limited, hampering efforts to identify, assess, track, treat, and prevent child maltreatment.{{rp|3}}{{cite book|editor=Bonnie S. Fisher|editor2=Steven P. Lab|title=Encyclopedia of Victimology and Crime Prevention|publisher=SAGE Publications|isbn=978-1-4522-6637-4|year=2010|pages=86–92|access-date=8 March 2016|url=https://books.google.com/books?id=dVJ2AwAAQBAJ&pg=PA86|url-status=live|archive-url=https://web.archive.org/web/20170223195806/https://books.google.com/books?id=dVJ2AwAAQBAJ&pg=PA86|archive-date=23 February 2017}}

In general, abuse refers to (usually deliberate) acts of commission while neglect refers to acts of omission.{{cite web |title=What is Child Abuse and Neglect? |publisher=Australian Institute of Family Studies |url=https://aifs.gov.au/cfca/publications/what-child-abuse-and-neglect |date=September 2015 |url-status=live |archive-url=https://web.archive.org/web/20150915225607/https://aifs.gov.au/cfca/publications/what-child-abuse-and-neglect |archive-date=15 September 2015 }} Child maltreatment includes both acts of commission and acts of omission on the part of parents or caregivers that cause actual or threatened harm to a child. Some health professionals and authors consider neglect as part of the definition of abuse, while others do not; this is because the harm may have been unintentional, or because the caregivers did not understand the severity of the problem, which may have been the result of cultural beliefs about how to raise a child.{{cite book|author=Mehnaz, Aisha|editor=RN Srivastava|editor2=Rajeev Seth|editor3=Joan van Niekerk|chapter=Child Neglect: Wider Dimensions|title=Child Abuse and Neglect: Challenges and Opportunities|publisher=JP Medical Ltd|isbn=978-93-5090-449-7|year=2013|page=101|chapter-url=https://books.google.com/books?id=SgpEpebbhWcC&pg=PA100|quote=Many do not consider neglect a kind of abuse especially in a condition where the parents are involved as it is often considered unintentional and arise from a lack of knowledge or awareness. This may be true in certain circumstances and often it results in insurmountable problem being faced by the parents.|url-status=live|archive-url=https://web.archive.org/web/20170223235503/https://books.google.com/books?id=SgpEpebbhWcC&pg=PA100|archive-date=23 February 2017}}{{cite journal|last1=Friedman|first1=E |last2=Billick |first2=SB|title=Unintentional child neglect: literature review and observational study. |journal=Psychiatric Quarterly |volume=86 | issue = 2 |pages=253–9|date=June 2015 |doi=10.1007/s11126-014-9328-0|pmid=25398462|s2cid=9090210 |quote=[T]he issue of child neglect is still not well understood, partially because child neglect does not have a consistent, universally accepted definition. Some researchers consider child neglect and child abuse to be one in the same {{sic}}, while other researchers consider them to be conceptually different. Factors that make child neglect difficult to define include: (1) Cultural differences; motives must be taken into account because parents may believe they are acting in the child's best interests based on cultural beliefs (2) the fact that the effect of child abuse is not always immediately visible; the effects of emotional neglect specifically may not be apparent until later in the child's development, and (3) the large spectrum of actions that fall under the category of child abuse. | issn = 0033-2720 }} Delayed effects of child abuse and neglect, especially emotional neglect, and the diversity of acts that qualify as child abuse, are also factors.

The World Health Organization (WHO) defines child abuse and child maltreatment as "all forms of physical and/or emotional ill-treatment, sexual abuse, neglect or negligent treatment or commercial or other exploitation, resulting in actual or potential harm to the child's health, survival, development or dignity in the context of a relationship of responsibility, trust or power."{{cite web|title=Child abuse and neglect by parents and other caregivers|page=3|access-date=8 March 2016|work=World Health Organization|url=https://www.who.int/violence_injury_prevention/violence/global_campaign/en/chap3.pdf|url-status=live|archive-url=https://web.archive.org/web/20160304092230/http://www.who.int/violence_injury_prevention/violence/global_campaign/en/chap3.pdf|archive-date=4 March 2016}} The WHO also says, "Violence against children includes all forms of violence against people under 18 years old, whether perpetrated by parents or other caregivers, peers, romantic partners, or strangers."{{Cite web|title=Violence against children|url=https://www.who.int/news-room/fact-sheets/detail/violence-against-children|access-date=2021-03-10|website=www.who.int|language=en}} In the United States, the Centers for Disease Control and Prevention (CDC) uses the term child maltreatment to refer to both acts of commission (abuse), which include "words or overt actions that cause harm, potential harm, or threat of harm to a child", and acts of omission (neglect), meaning "the failure to provide for a child's basic physical, emotional, or educational needs or to protect a child from harm or potential harm".{{rp|11}} The United States federal Child Abuse Prevention and Treatment Act defines child abuse and neglect as, at minimum, "any recent act or failure to act on the part of a parent or caretaker which results in death, serious physical or emotional harm, sexual abuse or exploitation" or "an act or failure to act which presents an imminent risk of serious harm".{{cite journal | author = Herrenkohl RC | title = The definition of child maltreatment: from case study to construct | journal = Child Abuse and Neglect | volume = 29 | issue = 5 | pages = 413–24 | year = 2005 | pmid = 15970317 | doi = 10.1016/j.chiabu.2005.04.002 }}{{cite web |title=Definitions of Child Abuse and Neglect in Federal Law |website=childwelfare.gov |publisher=Children's Bureau, Administration for Children and Families, U.S. Department of Health and Human Services |url=https://www.childwelfare.gov/topics/can/defining/federal/ |access-date=20 February 2016 |url-status=live |archive-url=https://web.archive.org/web/20160516131820/https://www.childwelfare.gov/topics/can/defining/federal/ |archive-date=16 May 2016 }}

{{As of|2006}}, the World Health Organization distinguishes four types of child maltreatment: physical abuse; sexual abuse; emotional (or psychological) abuse; and neglect.

Among professionals and the general public, there is disagreement as to what behaviors constitute physical abuse of a child.Noh Anh, Helen (1994). "Cultural Diversity and the Definition of Child Abuse", in Barth, R.P. et al., Child Welfare Research Review, Columbia University Press, 1994, p. 28. {{ISBN|0-231-08074-3}} Physical abuse often does not occur in isolation but as part of a pattern of behaviors including authoritarian control, anxiety-provoking behavior, and a lack of parental warmth. The WHO defines physical abuse as:

{{Blockquote|Intentional use of physical force against the child that results in{{snd}}or has a high likelihood of resulting in{{snd}}harm for the child's health, survival, development, or dignity. This includes hitting, beating, kicking, shaking, biting, strangling, scalding, burning, poisoning, and suffocating. Much physical violence against children in the home is inflicted with the object of punishing.{{cite book |author=World Health Organization and International Society for Prevention of Child Abuse and Neglect |chapter=1. The nature and consequences of child maltreatment |title=Preventing child maltreatment: a guide to taking action and generating evidence |date=2006 |location=Geneva, Switzerland |isbn=978-92-4-159436-3 |chapter-url=http://whqlibdoc.who.int/publications/2006/9241594365_eng.pdf?ua=1 |chapter-format=PDF}}}}

Overlapping definitions of physical abuse and physical punishment of children highlight a subtle or non-existent distinction between abuse and punishment,{{cite book |author1=Saunders, Bernadette |author2=Goddard, Chris |date=2010 |title=Physical Punishment in Childhood: The Rights of the Child |url=https://archive.org/details/physicalpunishme00saun |url-access=limited |location=Chichester, West Sussex, UK |publisher=John Wiley & Sons |pages=[https://archive.org/details/physicalpunishme00saun/page/n13 2]–3 |isbn=978-0-470-72706-5}} but most physical abuse is physical punishment "in intent, form, and effect". As of 2006, for instance, Paulo Sergio Pinheiro wrote in the UN Secretary-General's Study on Violence Against Children:

{{blockquote |Corporal punishment involves hitting ('smacking', 'slapping', 'spanking') children, with the hand or with an implement – whip, stick, belt, shoe, wooden spoon, etc. But it can also involve, for example, kicking, shaking or throwing children, scratching, pinching, biting, pulling hair or boxing ears, forcing children to stay in uncomfortable positions, burning, scalding, or forced ingestion (for example, washing children's mouths out with soap or forcing them to swallow hot spices).{{cite book |author=Pinheiro, Paulo Sérgio |date=2006 |chapter=Violence against children in the home and family |chapter-url=http://www.unicef.org/violencestudy/3.%20World%20Report%20on%20Violence%20against%20Children.pdf |title=World Report on Violence Against Children |location=Geneva, Switzerland |publisher=United Nations Secretary-General's Study on Violence Against Children |isbn=978-92-95057-51-7 |url=http://www.unviolencestudy.org/ |url-status=live |archive-url=https://web.archive.org/web/20160111110523/http://unviolencestudy.org/ |archive-date=11 January 2016 |df=dmy-all }}}}

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.{{Cite book |vauthors=Coleman D, Dodge L, Campbell KA, Keeton S |title=Where and How to Draw the Line Between Reasonable Corporal Punishment and Abuse|date=2010-04-01|publisher=Duke University School of Law|oclc=854519105}} Bruises, scratches, burns, broken bones, lacerations—as well as repeated "mishaps", and rough treatment that could cause physical injuries—can be physical abuse.{{cite journal |vauthors=Theoklitou D, Kabitsis N, Kabitsi A | title = Physical and emotional abuse of primary school children by teachers | journal = Child Abuse Negl | volume = 36 | issue = 1 | pages = 64–70 | year = 2012 | pmid = 22197151 | doi = 10.1016/j.chiabu.2011.05.007 }} Multiple injuries or fractures at different stages of healing can raise suspicion of abuse.

The psychologist Alice Miller, noted for her books on child abuse, took the view that humiliations, spankings, and beatings, slaps in the face, etc. are all forms of abuse, because they injure the integrity and dignity of a child, even if their consequences are not visible right away.{{cite web|url=http://www.alice-miller.com|title=Alice Miller – Child Abuse and Mistreatment|access-date=5 March 2015|url-status=live|archive-url=https://web.archive.org/web/20160109133036/http://www.alice-miller.com/|archive-date=9 January 2016}}

Physical abuse as a child can lead to physical and mental difficulties in the future, including re-victimization, personality disorders, post-traumatic stress disorder (PTSD), dissociative disorders, depression, anxiety, suicidal ideation, eating disorders, substance use disorders, and aggression. Physical abuse in childhood has also been linked to homelessness in adulthood.{{cite web |url=https://www.havoca.org/effects-child-abuse-neglect-adult-survivors/ |title=Effects of child abuse and neglect for adult survivors |access-date=19 December 2016 |url-status=live |archive-url=https://web.archive.org/web/20161110151813/http://www.havoca.org/effects-child-abuse-neglect-adult-survivors/ |archive-date=10 November 2016 |date=16 June 2014 }}

C. Henry Kempe and his colleagues were the first to describe the battered-child syndrome in 1962.{{Cite book |last1=Hibbard |first1=Roberta A. |url=https://linkinghub.elsevier.com/retrieve/pii/B9780323057240500060 |title=McDonald and Avery Dentistry for the Child and Adolescent |edition=Ninth |chapter=Child Abuse and Neglect |last2=Sanders |first2=Brian J. |date=2011 |publisher=Elsevier |isbn=978-0-323-05724-0 |pages=19–26 |language=en |doi=10.1016/b978-0-323-05724-0.50006-0}} The battered-child syndrome is a term used to describe a collection of injuries that young children sustain as a result of repeated physical abuse or neglect.{{Cite web |title=Battered Child Syndrome: Investigating Physical Abuse and Homicid. Portable Guides to Investigating Child Abuse. |url=https://www.ojp.gov/pdffiles1/ojjdp/161406.pdf |access-date=2023-03-20 |website=Office of Justice Programs |language=en}} These symptoms may include: fractures of bones, multiple soft tissue injuries, subdural hematoma (bleeding in the brain), malnutrition, and poor skin hygiene.{{cite journal | last=Kempe | first=C. Henry | title=The Battered-Child Syndrome | journal=JAMA: The Journal of the American Medical Association | publisher=American Medical Association (AMA) | volume=181 | issue=1 | date=1962-07-07 | pages=17–24 | issn=0098-7484 | doi=10.1001/jama.1962.03050270019004 | pmid=14455086 }}{{cite book | last=Levesque | first=Roger J. R. | title=Encyclopedia of Adolescence | chapter=Battered Child Syndrome | publisher=Springer New York | publication-place=New York, NY | year=2011 | doi=10.1007/978-1-4419-1695-2_511 | page=252| isbn=978-1-4419-1694-5 }}

Children suffering from battered-child syndrome may come to the doctor's attention for a problem unrelated to abuse or after experiencing an acute injury, but when examined, they show signs of long-term abuse. In most cases, the caretakers try to justify the visible injuries by blaming them on minor accidents. When asked, parents may attribute the injuries to a child's behaviour or habits, such as being fussy or clumsy. Despite the abuse, the child may show attachment to the parent.{{Cite book |editor-last=Winn |editor-first=H. Richard |last1=Duhaime |first1=Ann-Christine |last2=Christian |first2=Cindy W. |title=Youmans & Winn Neurological Surgery |date=2023 |publisher=Elsevier |chapter=Inflicted Trauma (Child Abuse) |isbn=978-0-323-66192-8 |edition=Eighth |location=Philadelphia, PA |pages=1895–1896 |oclc=1300711519}}

{{Main|Child sexual abuse|child-on-child sexual abuse}}

Child sexual abuse (CSA) is a form of child abuse in which an adult or older adolescent abuses a child for sexual stimulation.{{cite web|url=https://www.nlm.nih.gov/medlineplus/childsexualabuse.html|title=Child Sexual Abuse|work=Medline Plus|date=2 April 2008|publisher=U.S. National Library of Medicine|url-status=live|archive-url=https://web.archive.org/web/20131205001005/http://www.nlm.nih.gov/medlineplus/childsexualabuse.html|archive-date=5 December 2013}} Sexual abuse refers to the participation of a child in a sexual act aimed toward the physical gratification or the financial profit of the person committing the act.{{cite journal | title = Guidelines for psychological evaluations in child protection matters. Committee on Professional Practice and Standards, APA Board of Professional Affairs | journal = The American Psychologist | volume = 54 | issue = 8 | pages = 586–93 | date = August 1999 | pmid = 10453704 | doi = 10.1037/0003-066X.54.8.586 | quote = Abuse, sexual (child): generally defined as contacts between a child and an adult or other person significantly older or in a position of power or control over the child, where the child is being used for sexual stimulation of the adult or other person. }} Forms of CSA include asking or pressuring a child to engage in sexual activities (regardless of the outcome), indecent 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 without physical contact, or using a child to produce child pornography.{{cite journal |vauthors=Martin J, Anderson J, Romans S, Mullen P, O'Shea M | title = Asking about child sexual abuse: methodological implications of a two stage survey | journal = Child Abuse & Neglect | volume = 17 | issue = 3 | pages = 383–92 | year = 1993 | pmid = 8330225 | doi = 10.1016/0145-2134(93)90061-9 }}{{cite web|url=http://www.nspcc.org.uk/helpandadvice/whatchildabuse/sexualabuse/sexualabuse_wda36370.html|title=Search|author=NSPCC|work=NSPCC|access-date=5 March 2015|archive-url=https://web.archive.org/web/20100213140423/http://www.nspcc.org.uk/helpandadvice/whatchildabuse/sexualabuse/sexualabuse_wda36370.html|archive-date=13 February 2010|df=dmy-all}} Selling the sexual services of children is also a type of child abuse.{{cite news|last=Brown|first=Patricia Leigh|title=In Oakland, Redefining Sex Trade Workers as Abuse Victims|url=https://www.nytimes.com/2011/05/24/us/24oakland.html|access-date=24 May 2011|newspaper=The New York Times|date=23 May 2011|quote=Once viewed as criminals and dispatched to juvenile centers, where treatment was rare, sexually exploited youths are increasingly seen as victims of child abuse, with a new focus on early intervention and counseling.|url-status=live|archive-url=https://web.archive.org/web/20110526135258/http://www.nytimes.com/2011/05/24/us/24oakland.html|archive-date=26 May 2011}}

Effects of child sexual abuse on the victim(s) include guilt and self-blame, flashbacks, nightmares, insomnia, fear of things associated with the abuse (including objects, smells, places, doctor's visits, etc.), self-esteem difficulties, sexual dysfunction, chronic pain, addiction, self-injury, suicidal ideation, somatic complaints, depression,{{cite journal |vauthors=Roosa MW, Reinholtz C, Angelini PJ | title = The relation of child sexual abuse and depression in young women: comparisons across four ethnic groups | journal = Journal of Abnormal Child Psychology | volume = 27 | issue = 1 | pages = 65–76 | year = 1999 | pmid = 10197407 | url = http://findarticles.com/p/articles/mi_m0902/is_1_27/ai_54422556/print | archive-url = https://web.archive.org/web/20041214115501/http://www.findarticles.com/p/articles/mi_m0902/is_1_27/ai_54422556/print | archive-date = 14 December 2004 }} PTSD,{{cite journal | author = Widom CS | title = Post-traumatic stress disorder in abused and neglected children grown up | journal = American Journal of Psychiatry | volume = 156 | issue = 8 | pages = 1223–1229 | year = 1999 | pmid = 10450264 | url = http://ajp.psychiatryonline.org/cgi/content/full/156/8/1223 | doi = 10.1176/ajp.156.8.1223 | s2cid = 7339542 | url-access = subscription }} anxiety,{{cite journal |author1=Levitan R. D. |author2=Rector N. A. |author3=Sheldon T. |author4=Goering P. | year = 2003 | title = Childhood adversities associated with major depression and/or anxiety disorders in a community sample of Ontario: Issues of co-morbidity and specificity | journal = Depression and Anxiety | volume = 17 | issue = 1| pages = 34–42 | doi=10.1002/da.10077 | pmid=12577276|s2cid=26031006 | doi-access=free }} other mental illnesses including borderline personality disorder,{{Cite journal|title= Confirmation of Childhood Abuse in Child and Adolescent Cases of Multiple Personality Disorder and Dissociative Disorder Not Otherwise Specified|volume=182|issue=8|pages=461–4|journal=The Journal of Nervous and Mental Disease|date=August 1994|last1=Coons|first1=Philip M.|s2cid=34417803|doi=10.1097/00005053-199408000-00007|pmid=8040657}} propensity to re-victimization in adulthood,{{Cite journal|doi=10.1177/088626000015005003 |title=Child Sexual Abuse and Revictimization in the Form of Adult Sexual Abuse, Adult Physical Abuse, and Adult Psychological Maltreatment |year=2000 |last1=Messman-Moore |first1=T. L. |last2=Long |first2=P. J. |journal=Journal of Interpersonal Violence |volume=15 |pages=489–502|issue=5|s2cid=145761598 }} bulimia nervosa,{{cite journal |last=Hornor |first=G |title=Child sexual abuse: consequences and implications |journal=Journal of Pediatric Health Care |volume=24 |issue=6 |pages=358–364 |year=2010 |pmid=20971410 |doi=10.1016/j.pedhc.2009.07.003 }} and physical injury to the child, among other problems.{{cite journal | vauthors = Dinwiddie S, Heath AC, Dunne MP, Bucholz KK, Madden PA, Slutske WS, Bierut LJ, Statham DB, Martin NG | s2cid = 15270464 | title = Early sexual abuse and lifetime psychopathology: a co-twin-control study | journal = Psychological Medicine | volume = 30 | issue = 1 | pages = 41–52 | year = 2000 | pmid = 10722174 | doi = 10.1017/S0033291799001373 | df = dmy-all }} 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.{{cite journal|last1=Thornton|first1=Clifton P.|last2=Veenema|first2=Tener Goodwin|title=Children seeking refuge: A review of the escalating humanitarian crisis of child sexual abuse and HIV/AIDS in Latin America|journal=Journal of the Association of Nurses in AIDS Care| date=2015| volume=26| issue=4| pages=432–442| doi=10.1016/j.jana.2015.01.002|pmid=25769757|s2cid=31814720}} Sexual victimization at a young age has been correlated with several risk factors for contracting HIV including decreased knowledge of sexual topics, increased prevalence of HIV, engagement in risky sexual practices, condom avoidance, lower knowledge of safe sex practices, frequent changing of sexual partners, and more years of sexual activity.

{{as of|2016}}, in the United States, about 15% to 25% of women and 5% to 15% of men were sexually abused when they were children.{{cite web|url=http://www.ptsd.va.gov/professional/trauma/other/child_sexual_abuse.asp|title=Child Sexual Abuse|author=Whealin, Julia|publisher=National Center for Post Traumatic Stress Disorder, US Department of Veterans Affairs|date=23 February 2016|url-status=live|archive-url=https://web.archive.org/web/20161208203148/http://www.ptsd.va.gov/professional/trauma/other/child_sexual_abuse.asp|archive-date=8 December 2016}}{{cite journal | author = Finkelhor D | title = Current information on the scope and nature of child sexual abuse | journal = The Future of Children | volume = 4 | issue = 2 | pages = 31–53 | year = 1994 | pmid = 7804768 | doi = 10.2307/1602522 | url = http://www.unh.edu/ccrc/pdf/VS75.pdf | jstor = 1602522 | url-status = live | archive-url = https://web.archive.org/web/20081013192224/http://www.unh.edu/ccrc/pdf/VS75.pdf | archive-date = 13 October 2008 | df = dmy-all }}{{cite journal |vauthors=Gorey KM, Leslie DR | title = The prevalence of child sexual abuse: integrative review adjustment for potential response and measurement biases | journal = Child Abuse & Neglect | volume = 21 | issue = 4 | pages = 391–8 | date = April 1997 | pmid = 9134267 | doi = 10.1016/S0145-2134(96)00180-9 | citeseerx = 10.1.1.465.1057 }} Most sexual abuse offenders are acquainted with their victims; approximately 30% are relatives of the child, most often brothers, sisters, fathers, mothers, uncles or cousins; around 60% are other acquaintances such as friends of the family, babysitters, or neighbours; strangers are the offenders in approximately 10% of child sexual abuse cases. In over one-third of cases, the perpetrator is also a minor.{{cite journal|last=Finkelhor|first=David|author2=Richard Ormrod|author3=Mark Chaffin|title=Juveniles Who Commit Sex Offenses Against Minors|journal=Washington, DC: Office of Juvenile Justice and Delinquency Prevention. Office of Justice Programs, Department of Justice|year=2009|url=http://www.ncjrs.gov/pdffiles1/ojjdp/227763.pdf|access-date=25 February 2012|url-status=live|archive-url=https://web.archive.org/web/20100216030702/http://www.ncjrs.gov/pdffiles1/ojjdp/227763.pdf|archive-date=16 February 2010}}

In 1999 the BBC reported on the RAHI Foundation's survey of sexual abuse in India, in which 76% of respondents said they had been abused as children, 40% of those stating the perpetrator was a family member.{{Cite news |url=http://news.bbc.co.uk/2/hi/south_asia/259959.stm |title=India's hidden incest |date=22 January 1999 |work=BBC News |archive-url=https://web.archive.org/web/20130508105445/http://news.bbc.co.uk/2/hi/south_asia/259959.stm |archive-date=8 May 2013}}

{{Main|Psychological abuse}}

There are multiple definitions of child psychological abuse:

• In 1995, The American Professional Society on the Abuse of Children (APSAC) defined it as: spurning, terrorizing, isolating, exploiting, corrupting, denying emotional responsiveness, or neglect" or "A repeated pattern of caregiver behavior or extreme incident(s) that convey to children that they are worthless, flawed, unloved, unwanted, endangered, or only of value in meeting another's needs"{{cite book|author=John E. B. Myers|title=The APSAC Handbook on Child Maltreatment|publisher=SAGE Publications Inc |pages=[https://books.google.com/books?id=zP3ql9puzvQC&q=%20%22Table%208.1%22%20%22Psychological%20Maltreatment%20Forms%22&pg=PA129 126–130]|isbn=978-1-4129-6681-8|year=2011}}
• In 2013, the American Psychiatric Association (APA) added Child Psychological Abuse to the DSM-5, describing it 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."{{cite book|author=Donald Black|title=DSM-5® Guidebook: The Essential Companion to the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition |url=https://books.google.com/books?id=3JuvBAAAQBAJ&q=%22nonaccidental+verbal+or+symbolic+acts+by+a+child%27s+parent+or+caregiver+that++result,+or+have+reasonable+potential+to+result,+in+significant+psychological++harm+to+the+child.%22&pg=PA423 |page=423|isbn=978-1-58562-465-2|date=1 February 2014 |publisher=American Psychiatric Pub }}
• In the United States, states' laws vary, but most have laws against "mental injury"{{cite web|title=Child Abuse Laws State-by-State|url=http://family.findlaw.com/child-abuse/child-abuse-laws-state-by-state.html|website=findLaw|access-date=25 September 2015|url-status=live|archive-url=https://web.archive.org/web/20151008015855/http://family.findlaw.com/child-abuse/child-abuse-laws-state-by-state.html|archive-date=8 October 2015}} against minors.
• Some have defined it as the production of psychological and social defects in the growth of a minor as a result of behavior such as loud yelling, coarse and rude attitude, inattention, harsh criticism, and denigration of the child's personality. Other examples include name-calling, ridicule, degradation, destruction of personal belongings, torture or killing of a pet, excessive or extreme unconstructive criticism, inappropriate or excessive demands, withholding communication, and routine labeling or humiliation.{{cite web|url=http://ncvc.org/ncvc/main.aspx?dbName=DocumentViewer&DocumentAction=ViewProperties&DocumentID=32313&UrlToReturn=http%3a%2f%2fncvc.org%2fncvc%2fmain.aspx%3fdbName%3dAdvancedSearch&gclid=CJ_1q6m2oZ4CFcx25QodNG2_ow |title=Child Abuse |publisher=The National Center for Victims of Crime |archive-url=https://web.archive.org/web/20110727114517/http://ncvc.org/ncvc/main.aspx?dbName=DocumentViewer&DocumentAction=ViewProperties&DocumentID=32313&UrlToReturn=http%3A%2F%2Fncvc.org%2Fncvc%2Fmain.aspx%3FdbName%3DAdvancedSearch&gclid=CJ_1q6m2oZ4CFcx25QodNG2_ow |archive-date=27 July 2011 }}
• Many psychological abuse that happens to adults are harder to change to improve{{Cite journal |last=Kendall-Tackett |first=Kathleen |date=2002 |title=The health effects of childhood abuse: four pathways by which abuse can influence health |journal=Child Abuse & Neglect |volume=26 |issue=6 |pages=715–729 |doi=10.1016/S0145-2134(02)00343-5|pmid=12201164 }} and turn back due to fixed habits and living style after abuse. Child abuse can create a big toll on psychological behavior that put many risk to unhealthy thoughts. In order to minimize these negative outcomes, many need to seek help to spread awareness to those around them for preventative measures.{{cite journal | url=https://journals.lww.com/co-pediatrics/Fulltext/2001/10000/Child_abuse_prevention.2.aspx | title=Child abuse prevention | journal=Current Opinion in Pediatrics | date=October 2001 | volume=13 | issue=5 | last1=Rubin | first1=David | last2=Lane | first2=Wendy | last3=Ludwig | first3=Stephen | pages=388–401 | doi=10.1097/00008480-200110000-00002 | pmid=11801882 | s2cid=39961725 | url-access=subscription }}

In 2014, the APA found that child psychological abuse is the most prevalent form of childhood abuse in the United States, affecting nearly 3 million children annually. Research has suggested that the consequences of child psychological abuse may be equally as harmful as those of sexual or physical abuse.{{cite web|url=http://www.apa.org/news/press/releases/2014/10/psychological-abuse.aspx|title=Childhood Psychological Abuse as Harmful as Sexual or Physical Abuse|publisher=The American Psychological Association|date=8 October 2014|url-status=live|archive-url=https://web.archive.org/web/20151208144610/http://www.apa.org/news/press/releases/2014/10/psychological-abuse.aspx|archive-date=8 December 2015}}{{cite web|last1=McGill University|title=Different types of child abuse: Similar consequences|url=https://www.sciencedaily.com/releases/2015/10/151014121059.htm|website=Science News|access-date=11 December 2015|url-status=live|archive-url=https://web.archive.org/web/20151218064639/https://www.sciencedaily.com/releases/2015/10/151014121059.htm|archive-date=18 December 2015}}{{cite web|last1=Loudenback|first1=Jeremy|title=Is Emotional Abuse as Harmful as Physical and Sexual Abuse?|url=https://chronicleofsocialchange.org/featured/emotional-abuse-harmful-physical-sexual-abuse/13944|website=Chronicle of Social Change|access-date=11 December 2015|url-status=live|archive-url=https://web.archive.org/web/20151222112008/https://chronicleofsocialchange.org/featured/emotional-abuse-harmful-physical-sexual-abuse/13944|archive-date=22 December 2015|date=25 October 2015}}

Victims of emotional abuse may react by distancing themselves from the abuser, internalizing the abusive words, or fighting back by insulting the abuser. Emotional abuse can result in abnormal or disrupted attachment development, a tendency for victims to blame themselves (self-blame) for the abuse, learned helplessness, and overly passive behavior in order to avoid such a situation again.

{{Main|Child neglect}}

Child neglect is the failure of a parent or other person with responsibility for the child, to provide needed 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, and the non-provision of the relevant and adequate necessities for the child's survival, which would be a lack of attention, love, and nurturing.

Some observable signs of child neglect include: the child is frequently absent from school, begs or steals food or money, lacks needed medical and dental care, is consistently dirty, or lacks appropriate clothing for the weather.{{cite web|title=Chronic Neglect |url=http://www.childwelfare.gov/systemwide/laws_policies/statutes/define.pdf#Page=2&view=Fit |access-date=10 October 2012 |archive-url=https://web.archive.org/web/20071011062659/http://www.childwelfare.gov/systemwide/laws_policies/statutes/define.pdf |archive-date=11 October 2007 }} The 2010 Child Maltreatment Report (NCANDS), a yearly United States federal government report based on data supplied by state Child Protective Services (CPS) Agencies in the U.S., found that neglect/neglectful behavior was the "most common form of child maltreatment".{{cite web|url=https://childwelfare.gov/pubs/factsheets/canstats.pdf|title=Child Maltreatment 2010: Summary of Key Findings|publisher=Children's Bureau, Child Welfare Information Gateway, Protecting Children Strengthening Families|access-date=|url-status=live|archive-url=https://web.archive.org/web/20120916043419/http://www.childwelfare.gov/pubs/factsheets/canstats.pdf|archive-date=16 September 2012}}

Neglectful acts can be divided into six sub-categories:

• Supervisory neglect: characterized by the absence of a parent or guardian which can lead to physical harm, sexual abuse, or criminal behavior;
• Physical neglect: characterized by the failure to provide the basic physical necessities, such as a safe and clean home;
• Medical neglect: characterized by the lack of providing medical care;
• Emotional neglect: characterized by a lack of nurturance, encouragement, and support;
• Educational neglect: characterized by the caregivers lack to provide an education and additional resources to actively participate in the school system; and
• Abandonment: when the parent or guardian leaves a child alone for a long period of time without a babysitter or caretaker.

Neglected children may experience delays in physical and psychosocial development, possibly resulting in psychopathology and impaired neuropsychological functions including executive function, attention, processing speed, language, memory and social skills.{{cite web|url=http://www.apa.org/pi/families/resources/newsletter/2012/07/neurocognitive-impacts.aspx|title=Neurocognitive impacts for children of poverty and neglect|publisher=Apa.org|date=July 2012|access-date=24 December 2012|url-status=live|archive-url=https://web.archive.org/web/20130131122212/http://www.apa.org/pi/families/resources/newsletter/2012/07/neurocognitive-impacts.aspx|archive-date=31 January 2013}} Researchers investigating maltreated children have repeatedly found that neglected children in the foster and adoptive populations manifest different emotional and behavioral reactions to regain lost or secure relationships and are frequently reported to have disorganized attachments and a need to control their environment. Such children 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. These children seem to have learned to adapt to an abusive and inconsistent caregiver by becoming cautiously self-reliant, and are often described as glib, manipulative and disingenuous in their interactions with others as they move through childhood.{{cite journal | author = Golden J.A., Prather W. | s2cid = 45317073 | year = 2009 | title = A behavioral perspective of childhood trauma and attachment issues: toward alternative treatment approaches for children with a history of abuse | journal = International Journal of Behavioral Consultation and Therapy| volume = 5 | issue = 1 | pages = 56–74 | doi = 10.1037/h0100872 }} Children who are victims of neglect can have a more difficult time forming and maintaining relationships, such as romantic or friendship, later in life due to the lack of attachment they had in their earlier stages of life.

{{Anchor|Effects}}

Child abuse can result in immediate adverse physical effects but it is also strongly associated with developmental problems{{cite magazine | author = Cohn Jonathan | year = 2011 | title = "The Two Year Window." (Cover story) | url = https://newrepublic.com/article/economy/magazine/97268/the-two-year-window | magazine = New Republic | volume = 242 | issue = 18 | pages = 10–13 | url-status = live | archive-url = https://web.archive.org/web/20150910032320/http://www.newrepublic.com/article/economy/magazine/97268/the-two-year-window | archive-date = 10 September 2015 | df = dmy-all }} 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.{{cite book |author1=Middlebrooks, J.S. |author2=Audage, N.C. |title=The Effects of Childhood Stress on Health Across the Lifespan |year=2008 |location=Atlanta, Georgia (US) |publisher=Centers for Disease Control and Prevention, National Center for Injury Prevention and Control |url=http://health-equity.pitt.edu/932/1/Childhood_Stress.pdf |archive-url=https://web.archive.org/web/20160205035817/http://health-equity.pitt.edu/932/1/Childhood_Stress.pdf |archive-date=5 February 2016 }}{{cite book|author1=Dolezal, T. |author2=McCollum, D. |author3=Callahan, M. |title=Hidden Costs in Health Care: The Economic Impact of Violence and Abuse|year=2009|publisher=Academy on Violence and Abuse}} Child abuse has also been linked to suicide, according to a May 2019 study, published in the Cambridge University Press.{{Cite journal |last1=Angelakis |first1=Ioannis |last2=Gillespie |first2=Emma Louise |last3=Panagioti |first3=Maria |date=May 2019 |title=Childhood maltreatment and adult suicidality: a comprehensive systematic review with meta-analysis |journal=Psychological Medicine |language=en |volume=49 |issue=7 |pages=1057–1078 |doi=10.1017/S0033291718003823 |pmid=30608046 |pmc=6498789 |issn=0033-2917}}

Maltreated children may be at risk to become maltreating adults.{{cite journal |vauthors=Thornberry TP, Henry KL | title = Intergenerational continuity in maltreatment | journal = J Abnorm Child Psychol | volume = 41 | pages = 555–569 | year = 2013 | pmid = 23192742 | pmc = 3640695 | doi = 10.1007/s10802-012-9697-5 | issue=4}}{{cite journal |vauthors=Ertem IO, Leventhal JM, Dobbs S | title = Intergenerational continuity of child physical abuse: how good is the evidence? | journal = Lancet | volume = 356 | pages = 814–9 | year = 2000 | pmid = 11022929 | doi = 10.1016/S0140-6736(00)02656-8 | issue=9232| s2cid = 30069254 }}{{cite journal |vauthors=Thornberry TP, Knight KE, Lovegrove PJ | title = Does maltreatment beget maltreatment? A systematic review of the intergenerational literature. | journal = Trauma, Violence, & Abuse | volume = 13 | pages = 135–52 | year = 2012 | pmid = 22673145 | doi = 10.1177/1524838012447697 | issue=3 | pmc=4035025}}

Physical and emotional abuse have comparable effects on a child's emotional state and have been linked to childhood depression, low self-compassion, and negative automatic thoughts.{{Cite journal |last1=Zhang |first1=Rui |last2=Xie |first2=Ruibo |last3=Ding |first3=Wan |last4=Wang |first4=Xiaoyue |last5=Song |first5=Shengcheng |last6=Li |first6=Weijian |date=2022-07-01 |title=Why is my world so dark? Effects of child physical and emotional abuse on child depression: The mediating role of self-compassion and negative automatic thoughts |url=https://www.sciencedirect.com/science/article/pii/S0145213422001971 |journal=Child Abuse & Neglect |language=en |volume=129 |page=105677 |doi=10.1016/j.chiabu.2022.105677 |pmid=35640351 |s2cid=249114910 |issn=0145-2134|url-access=subscription }} Some research suggests that high stress levels from child abuse may cause structural and functional changes within the brain, and therefore cause emotional and social disruptions.{{Cite journal |last1=McCrory |first1=Eamon |last2=De Brito |first2=Stephane A |last3=Viding |first3=Essi |date=April 2012 |title=The link between child abuse and psychopathology: A review of neurobiological and genetic research |journal=Journal of the Royal Society of Medicine |language=en |volume=105 |issue=4 |pages=151–156 |doi=10.1258/jrsm.2011.110222 |pmid=22532655 |pmc=3343716 |issn=0141-0768}} Abused children can grow up experiencing insecurities, low self-esteem, and lack of development. Many abused children experience ongoing difficulties with trust, social withdrawal, trouble in school, and forming relationships.{{cite web |title=Emotional Abuse |url=http://www.americanhumane.org/children/stop-child-abuse/fact-sheets/emotional-abuse.html |archive-url=https://web.archive.org/web/20150422054312/http://www.americanhumane.org/children/stop-child-abuse/fact-sheets/emotional-abuse.html |archive-date=22 April 2015 |work=American Humane Association}}

Babies and other young children can be affected differently by abuse than their older counterparts. Babies and pre-school children who are being emotionally abused or neglected may be overly affectionate towards strangers or people they have not known for very long.{{cite web|url=http://www.nspcc.org.uk/preventing-abuse/child-abuse-and-neglect/emotional-abuse/emotional-abuse-signs-symptoms-effects/|title=Emotional abuse: Signs, symptoms and effects|work=NSPCC|url-status=live|archive-url=https://web.archive.org/web/20150426202832/http://www.nspcc.org.uk/preventing-abuse/child-abuse-and-neglect/emotional-abuse/emotional-abuse-signs-symptoms-effects|archive-date=26 April 2015}} They can 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. Older children may 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.

Children can also experience reactive attachment disorder (RAD). RAD is defined as markedly disturbed and developmentally inappropriate social relatedness, that usually begins before the age of 5 years.{{cite web|title=Reactive attachment disorder|url=http://www.medscape.com/viewarticle/775782_3|url-status=live|archive-url=https://web.archive.org/web/20150511231642/http://www.medscape.com/viewarticle/775782_3|archive-date=11 May 2015}}{{subscription required}} RAD can present as a persistent failure to start or respond in a developmentally appropriate fashion to most social situations. The long-term impact of emotional abuse has not been studied widely, but recent studies have begun to document its long-term consequences. Emotional abuse has been linked to increased depression, anxiety, and difficulties in interpersonal relationships (Spertus, Wong, Halligan, & Seremetis, 2003). Victims of child abuse and neglect are more likely to commit crimes as juveniles and adults.{{cite web|title=Impact of child abuse|url=http://www.asca.org.au/About/Resources/Impact-of-child-abuse.aspx|work=Adults Surviving Child Abuse (ASCA)|archive-url=https://web.archive.org/web/20150424063756/http://www.asca.org.au/About/Resources/Impact-of-child-abuse.aspx|archive-date=24 April 2015|access-date=21 April 2015}}

Domestic violence also takes its toll on children; although the child is not the one being abused, the child witnessing the domestic violence is greatly influenced as well. Research studies conducted such as the "Longitudinal Study on the Effects of Child Abuse and Children's Exposure to Domestic Violence", show that 36.8% of children engage in felony assault compared to the 47.5% of abused/assaulted children. Research has shown that children exposed to domestic violence increases the chances of experienced behavioral and emotional problems (depression, irritability, anxiety, academic problems, and problems in language development).{{Cite web|url=https://www.unicef.org/media/files/BehindClosedDoors.pdf|title=Behind Closed Doors: The Impact of Domestic Violence on Children|date=2006|website=UNICEF|access-date=29 January 2018|archive-date=2 June 2021|archive-url=https://web.archive.org/web/20210602043348/https://www.unicef.org/media/files/BehindClosedDoors.pdf}}

File:Fractured ribs.jpgs in an infant secondary to child abuse]]

The immediate physical effects of abuse or neglect can be relatively minor (bruises or cuts) or severe (broken bones, hemorrhage, death). Certain injuries, such as rib fractures or femoral fractures in infants that are not yet walking, may increase suspicion of child physical abuse, although such injuries are only seen in a fraction of children suffering physical abuse.{{cite journal |vauthors=Kemp AM, Dunstan F, Harrison S, Morris S, Mann M, Rolfe K, Datta S, Thomas DP, Sibert JR, Maguire S | title = Patterns of skeletal fractures in child abuse: systematic review | journal = BMJ | volume = 337 | issue = oct02 1 | pages = a1518 | year = 2008 | pmid = 18832412 | pmc = 2563260 | doi = 10.1136/bmj.a1518 }}{{Cite journal|last1=Lee|first1=Joseph Jonathan|last2=Gonzalez-Izquierdo|first2=Arturo|last3=Gilbert|first3=Ruth|date=31 October 2012|title=Risk of Maltreatment-Related Injury: A Cross-Sectional Study of Children under Five Years Old Admitted to Hospital with a Head or Neck Injury or Fracture|journal=PLOS ONE|volume=7|issue=10|pages=e46522|doi=10.1371/journal.pone.0046522|issn=1932-6203|pmc=3485294|pmid=23118853|bibcode=2012PLoSO...746522L|doi-access=free}} Cigarette burns or scald injuries may also prompt evaluation for child physical abuse.{{Cite journal |last=Hobbs |first=C. J. |date=May 13, 1989 |title=ABC of child abuse. Burns and scalds. |journal=The BMJ |volume=298(6683) |issue=6683 |pages=1302–1305|doi=10.1136/bmj.298.6683.1302 |pmid=2500207 |pmc=1836519 }}

The long-term impact of child abuse and neglect on physical health and development can be:

• Shaken baby syndrome. Shaking a baby is a common form of child abuse that often results in permanent neurological damage (80% of cases) or death (30% of cases).{{cite journal |vauthors=Morad Y, Wygnansky-Jaffe T, Levin AV | title = Retinal haemorrhage in abusive head trauma. | journal = Clinical & Experimental Ophthalmology | volume = 38 | pages = 514–520 | year = 2010 | pmid = 20584025 | doi = 10.1111/j.1442-9071.2010.02291.x | issue=5| s2cid = 11422418 | doi-access = free }} Damage results from intracranial hypertension (increased pressure in the skull) after bleeding in the brain, damage to the spinal cord and neck, and rib or bone fractures.{{Cite web |url=http://www.ninds.nih.gov/disorders/shakenbaby/shakenbaby.htm |title=Shaken Baby Syndrome information page |date=14 February 2014 |publisher=National Institute of Neurological Disorders and Stroke |archive-url=https://web.archive.org/web/20140529085726/http://www.ninds.nih.gov/disorders/shakenbaby/shakenbaby.htm |archive-date=29 May 2014 }}
• Impaired brain development. Child abuse and neglect have been shown, in some cases, to cause important regions of the brain to fail to form or grow properly, resulting in impaired development.{{cite journal |vauthors=De Bellis MD, Thomas LA | title = Biologic findings of post-traumatic stress disorder and child maltreatment. | journal = Curr Psychiatry Rep | volume = 5 | issue = 2 | pages = 108–17 | year = 2003 | pmid = 12685990 | doi = 10.1007/s11920-003-0027-z | s2cid = 14941891 }}{{cite journal |vauthors=Raabe FJ, Spengler D | title = Epigenetic risk factors in PTSD and depression | journal = Frontiers in Psychiatry | volume = 4 | issue = 80 | page = 80 | date = 7 August 2013 | pmid = 23966957 | pmc = 3736070 | doi = 10.3389/fpsyt.2013.00080 | doi-access = free }} Structural brain changes as a result of child abuse or neglect include overall smaller brain volume, hippocampal atrophy, prefrontal cortex dysfunction, decreased corpus callosum density, and delays in the myelination of synapses.{{Citation|last=Bremner|first=J. Douglas|chapter=Does Stress Damage the Brain?|pages=118–141|publisher=Cambridge University Press|isbn=978-0-511-50000-8|doi=10.1017/cbo9780511500008.010|title=Understanding Trauma|year=2007|editor1-last=Kirmayer|editor1-first=Laurence J|editor2-last=Lemelson|editor2-first=Robert|editor3-last=Barad|editor3-first=Mark}}{{Cite book|title=Child development: A practitioner's guide (3rd ed.).|last=Davies|first=D|publisher=The Guilford Press|year=2011|location=New York}} These alterations in brain maturation have long-term consequences for cognitive, language, and academic abilities.{{cite journal | last1=Watts-English | first1=Tiffany | last2=Fortson | first2=Beverly L. | last3=Gibler | first3=Nicole | last4=Hooper | first4=Stephen R. | last5=De Bellis | first5=Michael D. | title=The Psychobiology of Maltreatment in Childhood | journal=Journal of Social Issues | publisher=Wiley | volume=62 | issue=4 | year=2006 | issn=0022-4537 | doi=10.1111/j.1540-4560.2006.00484.x | pages=717–736 | url=http://www.ocfcpacourts.us/assets/files/list-758/file-937.pdf | access-date=29 May 2014 | url-status=live | archive-url=https://web.archive.org/web/20121224040135/http://www.ocfcpacourts.us/assets/files/list-758/file-937.pdf | archive-date=24 December 2012 }} In addition, these neurological changes impact the amygdala and hypothalamic-pituitary-adrenal (HPA) axis which are involved in stress response and may cause PTSD symptoms.
• Poor physical health. In addition to possible immediate adverse physical effects, household dysfunction and childhood maltreatment are strongly associated with many chronic physical and psychological effects, including subsequent ill-health in childhood,{{cite journal |author1=Flaherty EG |author2=Thompson R |author3=Litrownik AJ |display-authors=etal | date = Dec 2006 | title = Effect of early childhood adversity on child health | journal = Arch Pediatr Adolesc Med | volume = 160 | issue = 12| pages = 1232–8 | doi = 10.1001/archpedi.160.12.1232 | pmid = 17146020 | doi-access = free }} adolescence{{cite journal |vauthors=Flaherty EG, Thompson R, Dubowitz H | display-authors = etal | date = Jul 2013 | title = Adverse childhood experiences and child health in early adolescence | journal = JAMA Pediatr | volume = 167 | issue = 7| pages = 622–9 | doi = 10.1001/jamapediatrics.2013.22 | pmid = 23645114 | pmc = 3732117 }} and adulthood, with higher rates of chronic conditions, high-risk health behaviors and shortened lifespan. Adults who experienced abuse or neglect during childhood are more likely to have physical ailments such as allergies, arthritis, asthma, bronchitis, high blood pressure, and ulcers.{{cite journal |vauthors=Springer KW, Sheridan J, Kuo D, Carnes M | title = Long-term physical and mental health consequences of childhood physical abuse: results from a large population-based sample of men and women | journal = Child Abuse Negl | volume = 31 | pages = 517–30 | year = 2007 | pmid = 17532465 | doi = 10.1016/j.chiabu.2007.01.003 | issue=5 | pmc=3031095}}Long-Term Consequences of Child Abuse and Neglect. Child Welfare Information Gateway, U.S. Department of Health and Human Services 2013. [http://www.childwelfare.gov/pubs/factsheets/long_term_consequences.cfm#factors Factsheet] {{webarchive|url=https://web.archive.org/web/20101113021526/http://www.childwelfare.gov/pubs/factsheets/long_term_consequences.cfm |date=13 November 2010 }}{{cite journal |vauthors=Felitti VJ, Anda RF, Nordenberg D, Williamson DF, Spitz AM, Edwards V, Koss MP, Marks JS | title = Relationship of childhood abuse and household dysfunction to many of the leading causes of death in adults. The Adverse Childhood Experiences (ACE) Study | volume = 14 | issue = 4 | pages = 245–58 | date = 1998 | pmid = 9635069 | doi = 10.1016/S0749-3797(98)00017-8 | journal = American Journal of Preventive Medicine | s2cid = 26055600 | doi-access = free }} There may be a higher risk of developing cancer later in life,{{cite journal |vauthors=Fuller-Thomson E, Brennenstuhl S | s2cid = 17102800 | title = Making a link between childhood physical abuse and cancer: results from a regional representative survey | journal = Cancer | volume = 115 | issue = 14 | pages = 3341–50 | date = July 2009 | pmid = 19472404 | doi = 10.1002/cncr.24372 | doi-access = free }} as well as possible immune dysfunction.{{Cite journal|last=Kolassa|first=Iris – Tatjana|title=Biological memory of childhood maltreatment – current knowledge and recommendations for future research|volume=1262|issue=1|pages=93–100|url=http://vts.uni-ulm.de/docs/2012/8061/vts_8061_11733.pdf|journal=Ulmer Volltextserver – Institutional Repository der Universität Ulm|access-date=30 March 2014|url-status=live|archive-url=https://web.archive.org/web/20140527212051/http://vts.uni-ulm.de/docs/2012/8061/vts_8061_11733.pdf|archive-date=27 May 2014|bibcode=2012NYASA1262...93S|year=2012|doi=10.1111/j.1749-6632.2012.06617.x|pmid=22823440|s2cid=205937864}}
• Data from a recent study supports previous findings that specific neurobiochemical changes are linked to exposure to violence and abuse, several biological pathways can possibly lead to the development of illness, and certain physiological mechanisms can moderate how severe illnesses become in patients with past experience with violence or abuse.{{cite journal |vauthors=Keeshin BR, Cronholm PF, Strawn JR | year = 2012 | title = Physiologic changes associated with violence and abuse exposure: An examination of related medical conditions | journal = Trauma, Violence, & Abuse | volume = 13 | issue = 1| pages = 41–56 | doi = 10.1177/1524838011426152 | pmid = 22186168 | s2cid = 46028000 }}
• Recent studies give evidence of a link between stress occurring early in life and epigenetic modifications that last into adulthood.{{cite journal |vauthors=Matosin N, Cruceanu C, Binder EB |title=Preclinical and Clinical Evidence of DNA Methylation Changes in Response to Trauma and Chronic Stress |journal=Chronic Stress (Thousand Oaks, Calif.) |volume=1 |page= 247054701771076|date=February 2017 |pmid=29503977 |pmc=5831952 |doi=10.1177/2470547017710764 |type=Review}}

{{Main|Adverse Childhood Experiences}}

File:The ACE Pyramid.gif{{cite web |author=Division of Violence Prevention |title=The Adverse Childhood Experiences (ACE) Study |url=https://www.cdc.gov/violenceprevention/acestudy/ |website=cdc.gov |publisher=Centers for Disease Control and Prevention |access-date=31 January 2016 |url-status=live |archive-url=https://web.archive.org/web/20151231190742/http://www.cdc.gov/violenceprevention/acestudy/ |archive-date=31 December 2015 |date=12 December 2017 }}]]

The Adverse Childhood Experiences Study is a long-running investigation into the relationship between childhood adversity, including various forms of abuse and neglect, and health problems in later life. The initial phase of the study was conducted in San Diego, California from 1995 to 1997. The World Health Organization summarizes the study as:

childhood maltreatment and household dysfunction contribute to the development – decades later – of the chronic diseases that are the most common causes of death and disability in the United States... A strong relationship was seen between the number of adverse experiences (including physical and sexual abuse in childhood) and self-reports of cigarette smoking, obesity, physical inactivity, alcoholism, drug abuse, depression, attempted suicide, sexual promiscuity and sexually transmitted diseases in later life.

It has been discovered that childhood abuse can lead to the addiction of drugs and alcohol in adolescence and adult life. Studies show that any type of abuse experienced in childhood can cause neurological changes making an individual more prone to addictive tendencies. A significant study examined 900 court cases of children who had experienced sexual and physical abuse along with neglect. The study found that a large sum of the children who were abused are now currently addicted to alcohol. This case study outlines how addiction is a significant effect of childhood abuse.{{cite journal|last1=Enoch|first1=Marry-Anne|title=The role of early life stress as a predictor for alcohol and drug dependence|journal=Psychopharmacology|date=2011|pages=17–31|pmid=20596857|doi=10.1007/s00213-010-1916-6|pmc=3005022|volume=214|issue=1}}

{{See also|Adverse childhood experiences}}

Children who have a history of neglect or physical abuse are at risk of developing psychiatric problems,{{cite journal |vauthors=Gauthier L, Stollak G, Messé L, Aronoff J | title = Recall of childhood neglect and physical abuse as differential predictors of current psychological functioning | journal = Child Abuse & Neglect | volume = 20 | issue = 7 | pages = 549–59 | date = July 1996 | pmid = 8832112 | doi = 10.1016/0145-2134(96)00043-9 }}{{cite journal |vauthors=Malinosky-Rummell R, Hansen DJ | title = Long-term consequences of childhood physical abuse | journal = Psychological Bulletin | volume = 114 | issue = 1 | pages = 68–79 | date = July 1993 | pmid = 8346329 | doi = 10.1037/0033-2909.114.1.68 | url = http://digitalcommons.unl.edu/cgi/viewcontent.cgi?article=1098&context=psychfacpub | url-access = subscription }} or a disorganized attachment style.{{cite book|author1=Lyons-Ruth, K. |author2=Jacobvitz, D. |year=1999|chapter=Attachment disorganization: unresolved loss, relational violence and lapses in behavioral and attentional strategies|editor1=Cassidy, J. |editor2=Shaver, P. |title=Handbook of Attachment|pages=520–554|location=New York|publisher=Guilford Press}}{{cite book|editor1=Solomon, J. |editor2=George, C. |year=1999|title=Attachment Disorganization|location=New York|publisher=Guilford Press|isbn=978-1-57230-480-2}}{{Page needed|date=September 2010}}{{cite book|author1=Main, M. |author2=Hesse, E. |year=1990|chapter=Parents' Unresolved Traumatic Experiences are related to infant disorganized attachment status|editor1=Greenberg, M.T. |editor2=Ciccehetti, D |editor3=Cummings, E.M. |title=Attachment in the Preschool Years: Theory, Research, and Intervention|chapter-url=https://archive.org/details/attachmentinpres00thol |chapter-url-access=registration |pages=[https://archive.org/details/attachmentinpres00thol/page/161 161–184]|publisher=University of Chicago Press|isbn=978-0-226-30629-2 }} In addition, 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 crime.{{cite web|url=http://www.childhelp.org/pages/statistics|title=Child Abuse Statistics|work=Childhelp|access-date=5 March 2015|archive-url=https://web.archive.org/web/20141112102655/http://www.childhelp.org/pages/statistics|archive-date=12 November 2014}} Disorganized attachment is associated with a number of developmental problems, including dissociative symptoms,{{cite journal | author = Carlson EA | title = A prospective longitudinal study of attachment disorganization/disorientation | journal = Child Development | volume = 69 | issue = 4 | pages = 1107–28 | date = August 1998 | pmid = 9768489 | doi = 10.1111/j.1467-8624.1998.tb06163.x | jstor = 1132365 | doi-access = free }} as well as anxiety, depressive, and acting out symptoms.{{cite journal | author = Lyons-Ruth K | title = Attachment relationships among children with aggressive behavior problems: the role of disorganized early attachment patterns | journal = Journal of Consulting and Clinical Psychology | volume = 64 | issue = 1 | pages = 64–73 | date = February 1996 | pmid = 8907085 | doi = 10.1037/0022-006X.64.1.64 | citeseerx = 10.1.1.463.4585 }}{{cite journal |vauthors=Lyons-Ruth K, Alpern L, Repacholi B | title = Disorganized infant attachment classification and maternal psychosocial problems as predictors of hostile-aggressive behavior in the preschool classroom | journal = Child Development | volume = 64 | issue = 2 | pages = 572–85 | date = April 1993 | pmid = 8477635 | doi = 10.2307/1131270 | jstor = 1131270 }} When some of these children become parents, especially if they have PTSD, dissociative symptoms, and other sequelae of child abuse, they may encounter difficulty when faced with their infant and young children's needs and normative distress, which may in turn lead to adverse consequences for their child's social-emotional development.{{cite journal |vauthors=Schechter DS, Coates SW, Kaminer T, Coots T, Zeanah CH, Davies M, Schonfeld IS, Marshall RD, Liebowitz MR, Trabka KA, McCaw JE, Myers MM | title = Distorted maternal mental representations and atypical behavior in a clinical sample of violence-exposed mothers and their toddlers | journal = Journal of Trauma & Dissociation | volume = 9 | issue = 2 | pages = 123–149 | year = 2008 | pmid = 18985165 | pmc = 2577290 | doi = 10.1080/15299730802045666 }}{{cite journal |vauthors=Schechter DS, Zygmunt A, Coates SW, Davies M, Trabka K, McCaw J, Kolodji A, Robinson J | title = Caregiver traumatization adversely impacts young children's mental representations of self and others | journal = Attachment & Human Development | volume = 9 | issue = 3 | pages = 187–205 | year = 2007 | pmid = 18007959 | pmc = 2078523 | doi = 10.1080/14616730701453762 }} Additionally, children may find it difficult to feel empathy towards themselves or others, which may cause them to feel alone and unable to make friends. Despite these potential difficulties, psychosocial intervention can be effective, at least in some cases, in changing the ways maltreated parents think about their young children.{{cite journal |vauthors=Schechter DS, Myers MM, Brunelli SA, Coates SW, Zeanah CH, Davies M, Grienenberger JF, Marshall RD, McCaw JE, Trabka KA, Liebowitz MR| title = Traumatized mothers can change their minds about their toddlers: Understanding how a novel use of video feedback supports positive change of maternal attributions | journal = Infant Mental Health Journal | volume = 27 | issue = 5 | pages = 429–448 | year = 2006 | pmid = 18007960 | pmc = 2078524 | doi = 10.1002/imhj.20101 | last5 = Zeanah }}

Victims of childhood abuse also have different types of physical health problems later in life. Some reportedly have some type of chronic head, abdominal, pelvic, or muscular pain with no identifiable reason.Takele Hamnasu, MBA. Impact of Childhood Abuse on Adult Health. Amberton University.{{Page needed|date=September 2010}} Even though the majority of childhood abuse victims know or believe that their abuse is, or can be, the cause of different health problems in their adult life, for the great majority their abuse was not directly associated with those problems, indicating that they were most likely diagnosed with other possible causes for their health problems, instead of their childhood abuse.

On the other hand, there are some children who are raised in child abuse, but who manage to do unexpectedly well later in life regarding the preconditions. Such children have been termed {{visible anchor|resilient children}}, as inspired from the way that dandelions seem to prosper irrespective of soil, sun, drought, or rain.{{cite journal | last1 = Ellis | first1 = Bruce J. | last2 = Boyce | first2 = W. Thomas | s2cid = 16688319 | title = Biological Sensitivity to Context | journal = Current Directions in Psychological Science | volume = 17 | issue = 3 | pages = 183–187 | year = 2008 | doi = 10.1111/j.1467-8721.2008.00571.x }} Such children (or currently grown-ups) are of high interest in finding factors that mitigate the effects of child abuse.

Child abuse is a complex phenomenon with multiple causes.{{cite journal |author=Fontana VJ |title=The maltreatment syndrome of children |journal=Pediatric Annals |volume=13 |issue=10 |pages=736–44 |date=October 1984 |pmid=6504584}} No single factor can be identified as to why some adults behave abusively or neglectfully toward children. The World Health Organization (WHO) and the International Society for Prevention of Child Abuse and Neglect (ISPCAN) identify multiple factors at the level of the individual, their relationships, their local community, and their society at large, that combine to influence the occurrence of child maltreatment. At the individual level, studies have shown that age, mental health, and substance use, and a personal history of abuse may serve as risk factors of child abuse.{{Cite journal |last1=Djeddah |first1=Carol |last2=Facchin |first2=Paola |last3=Ranzato |first3=Cristina |last4=Romer |first4=Claude |date=2000-09-15 |title=Child abuse: current problems and key public health challenges |url=https://www.sciencedirect.com/science/article/pii/S0277953600000708 |journal=Social Science & Medicine |language=en |volume=51 |issue=6 |pages=905–915 |doi=10.1016/S0277-9536(00)00070-8 |pmid=10972434 |issn=0277-9536|url-access=subscription }} At the level of society, factors contributing to child maltreatment include cultural norms that encourage harsh physical punishment of children, economic inequality, and the lack of social safety nets. WHO and ISPCAN state that understanding the complex interplay of various risk factors is vital for dealing with the problem of child maltreatment.

Factors related to relationships include marital strife and tension. Parents who physically abuse their spouses are more likely than others to physically abuse their children.{{cite journal |last1=Ross |first1=S. |year=1996 |title=Risk of physical abuse to children of spouse abusing parents |journal=Child Abuse & Neglect |volume=20 |issue=7 |pages=589–598 |doi=10.1016/0145-2134(96)00046-4 |pmid=8832115}} However, it is impossible to know whether marital strife is a cause of child abuse, or if both the marital strife and the abuse are caused by tendencies in the abuser. Parents may also set expectations for their child that are clearly beyond the child's capability (e.g., preschool children who are expected to be totally responsible for self-care or provision of nurturance to parents), and the resulting frustration caused by the child's non-compliance may function as a contributory factor of the occurrence of child abuse.{{cite journal |vauthors=Twentyman CT, Plotkin RC |year=1982 |title=Unrealistic expectations of parents who maltreat their children: an educational deficit that pertains to child development |journal=J Clin Psychol |volume=38 |issue=3 |pages=497–503 |doi=10.1002/1097-4679(198207)38:3<497::aid-jclp2270380306>3.0.co;2-x |pmid=7107912 |s2cid=25302667}}

File:Girl sufferedwithburnwounds.jpg, India]]

Most acts of physical violence against children are undertaken with the intent to punish.{{cite journal |author=Durrant, Joan |title=Physical Punishment, Culture, and Rights: Current Issues for Professionals |date=March 2008 |journal=Journal of Developmental & Behavioral Pediatrics |volume=29 |issue=1 |pages=55–66 |url=https://www.researchgate.net/publication/5551171 |pmid=18300726 |doi=10.1097/DBP.0b013e318135448a |s2cid=20693162 |url-status=live |archive-url=https://web.archive.org/web/20160205034542/https://www.researchgate.net/publication/5551171_Physical_Punishment_Culture_and_Rights_Current_Issues_for_Professionals |archive-date=5 February 2016 }} In the United States, interviews with parents reveal that as many as two thirds of documented instances of physical abuse begin as acts of corporal punishment meant to correct a child's behavior, while a large-scale Canadian study found that three quarters of substantiated cases of physical abuse of children have occurred within the context of physical punishment.{{cite journal |author=Gershoff, Elizabeth T. |date=Spring 2010 |title=More Harm Than Good: A Summary of Scientific Research on the Intended and Unintended Effects of Corporal Punishment on Children |url=http://scholarship.law.duke.edu/lcp/vol73/iss2/3/ |journal=Law & Contemporary Problems |volume=73 |issue=2 |pages=31–56 |url-status=live |archive-url=https://web.archive.org/web/20170620170605/http://scholarship.law.duke.edu/lcp/vol73/iss2/3/ |archive-date=20 June 2017 }} Other studies have shown that children and infants who are spanked by parents are several times more likely to be severely assaulted by their parents or suffer an injury requiring medical attention. Studies indicate that such abusive treatment often involves parents attributing conflict to their child's willfulness or rejection, as well as "coercive family dynamics and conditioned emotional responses".{{cite journal |last1=Durrant |first1=Joan |last2=Ensom |first2=Ron |date=4 September 2012 |title=Physical punishment of children: lessons from 20 years of research |journal=Canadian Medical Association Journal |volume=184 |issue=12 |pages=1373–1377 |doi=10.1503/cmaj.101314 |pmid=22311946 |pmc=3447048}} Factors involved in the escalation of ordinary physical punishment by parents into confirmed child abuse may be the punishing parent's inability to control their anger or judge their own strength, and the parent being unaware of the child's physical vulnerabilities.[http://www.encyclopedia.com/doc/1G2-3045300461.html "Corporal Punishment"] {{webarchive|url=https://web.archive.org/web/20101031091526/http://www.encyclopedia.com/doc/1G2-3045300461.html |date=31 October 2010 }} International Encyclopedia of the Social Sciences. 2008.

Children resulting from unintended pregnancies are more likely to be abused or neglected.{{cite journal |title=Primary Prevention of Child Abuse |author=Lesa Bethea |year=1999 |journal=American Family Physician |volume=59 |issue=6 |pages=1577–85, 1591–2 |url=http://www.aafp.org/afp/990315ap/1577.html |url-status=live |archive-url=https://web.archive.org/web/20101228042800/http://www.aafp.org/afp/990315ap/1577.html |archive-date=28 December 2010 |pmid=10193598 }}{{cite book |author1=Eisenberg, Leon |author2=Brown, Sarah Hart |title=The Best Intentions: Unintended Pregnancy and the Well-Being of Children and Families |publisher=National Academy Press |location=Washington, D.C. |year=1995 |pages=[https://archive.org/details/bestintentionsun0000unse/page/73 73–74] |isbn=978-0-309-05230-6 |url=https://archive.org/details/bestintentionsun0000unse/page/73 }} In addition, unintended pregnancies are more likely than intended pregnancies to be associated with abusive relationships,{{cite journal |author1=Hathaway J.E. |author2=Mucci L.A. |author3=Silverman J.G. |display-authors=etal | year = 2000 | title = Health status and health care use of Massachusetts women reporting partner abuse | journal = Am J Prev Med | volume = 19 | issue = 4| pages = 302–307 | doi=10.1016/s0749-3797(00)00236-1|pmid=11064235 }} and there is an increased risk of physical violence during pregnancy.{{cite web |title=Family Planning – Healthy People 2020 |url=http://healthypeople.gov/2020/topicsobjectives2020/overview.aspx?topicid=13 |archive-url=https://web.archive.org/web/20101228012908/http://www.healthypeople.gov/2020/topicsobjectives2020/overview.aspx?topicid=13 |archive-date=28 December 2010 |access-date=18 August 2011 }} Which cites:

• {{cite report |author1=Logan, C. |author2=Holcombe, E. |author3=Manlove J. |title=The consequences of unintended childbearing: A white paper |publisher=Child Trends |location=Washington, D.C. |date=May 2007 |url=http://www.childtrends.org/Files/Child_Trends-2007_05_01_FR_Consequences.pdf |display-authors=etal |id={{ERIC|ED510648}} |ref=none |access-date=16 September 2011 |archive-date=2 July 2010 |archive-url=https://web.archive.org/web/20100702204001/http://www.childtrends.org/Files//Child_Trends-2007_05_01_FR_Consequences.pdf }}
• {{cite journal |author1=Cheng D. |author2=Schwarz, E. |author3=Douglas, E. |title=Unintended pregnancy and associated maternal preconception, prenatal and postpartum behaviors |journal=Contraception |date=March 2009 |volume=79 |pages=194–198 |pmid=19185672 |doi=10.1016/j.contraception.2008.09.009 |issue=3 |display-authors=etal |ref=none}}
• {{cite journal |vauthors=Kost K, Landry DJ, Darroch JE|s2cid=29117714 |title=Predicting maternal behaviors during pregnancy: does intention status matter? |journal=Fam Plann Perspect |volume=30 |issue=2 |pages=79–88 |year=1998 |pmid=9561873 |doi=10.2307/2991664 |jstor=2991664 |ref=none}}
• {{cite journal |vauthors=D'Angelo DV, Gilbert BC, Rochat RW, Santelli JS, Herold JM |s2cid=29285899 |title=Differences between mistimed and unwanted pregnancies among women who have live births |journal=Perspectives on Sexual and Reproductive Health |volume=36 |issue=5 |pages=192–7 |year=2004 |pmid=15519961 |doi=10.1363/3619204 |ref=none}} They also result in poorer maternal mental health, and lower mother-child relationship quality.

There is some limited evidence that children with moderate or severe disabilities are more likely to be victims of abuse than non-disabled children.{{cite journal |vauthors=Jones L, Bellis MA, Wood S |title=Prevalence and risk of violence against children with disabilities: a systematic review and meta-analysis of observational studies |journal=The Lancet |date=8 September 2012 |volume=380 |issue=9845 |pages=899–907 |doi=10.1016/S0140-6736(12)60692-8 |display-authors=etal |pmid=22795511|s2cid=21485530 }} A study on child abuse sought to determine: the forms of child abuse perpetrated on children with disabilities; the extent of child abuse; and the causes of child abuse of children with disabilities. A questionnaire on child abuse was adapted and used to collect data in this study. Participants comprised a sample of 31 pupils with disabilities (15 children with vision impairment and 16 children with hearing impairment) selected from special schools in Botswana. The study found that the majority of participants were involved in doing domestic chores. They were also sexually, physically and emotionally abused by their teachers. This study showed that children with disabilities were vulnerable to child abuse in their schools.{{cite journal |author1=Shumba, A. |author2=Abosi, O.C. |year=2011 |title=The Nature, Extent and Causes of Abuse of Children with Disabilities in Schools in Botswana |journal=International Journal of Disability, Development & Education |volume=58 |issue=4 |pages=373–388 |doi=10.1080/1034912X.2011.626664|s2cid=145145228 }}

Substance use disorder can be a major contributing factor to child abuse. One U.S. study found that parents with documented substance use, most commonly alcohol, cocaine, and heroin, were much more likely to mistreat their children, and were also much more likely to reject court-ordered services and treatments.{{cite journal |vauthors=Murphy JM, Jellinek M, Quinn D, Smith G, Poitrast FG, Goshko M|title=Substance abuse and serious child mistreatment: prevalence, risk, and outcome in a court sample |journal=Child Abuse & Neglect |volume=15 |issue=3 |pages=197–211 |year=1991 |pmid=2043972 |doi=10.1016/0145-2134(91)90065-L}} Another study found that over two-thirds of cases of child maltreatment involved parents with substance use disorders. This study specifically found relationships between alcohol and physical abuse, and between cocaine and sexual abuse.{{cite journal |vauthors=Famularo R, Kinscherff R, Fenton T|title=Parental substance abuse and the nature of child maltreatment |journal=Child Abuse & Neglect |volume=16 |issue=4 |pages=475–83 |year=1992 |pmid=1393711 |doi=10.1016/0145-2134(92)90064-X}} Also, parental stress caused by substance increases the likelihood of the minor exhibiting internalizing and externalizing behaviors.{{cite journal |title=Parenting and problem behaviors in children of substance abusing parents |last=Burlew |first=Kathleen |date=4 November 2013 |journal=Child and Adolescent Mental Health |volume=18 |issue=4 |pages=231–239 |doi=10.1111/camh.12001 |pmid=32847306 }} Although the abuse victim does not always realize the abuse is wrong, the internal confusion can lead to chaos. Inner anger turns to outer frustration. Once aged 17/18, drink and drugs are used to numb the hurt feelings, nightmares, and daytime flashbacks. Acquisitive crimes to pay for the chemicals are inevitable if the victim is unable to find employment.{{cite web|url=http://www.insidetime.org/articleview.asp?a=510|title=Does child abuse cause crime?|last=Garsden|first=Peter|work=insidetime |date=June 2009|archive-url=https://web.archive.org/web/20111229234409/http://www.insidetime.org/articleview.asp?a=510|archive-date=29 December 2011}}

Unemployment and financial difficulties are associated with increased rates of child abuse.{{cite web |url=http://www.floridaperforms.com/Indicators.aspx?si=SI_007 |title=Child Abuse |publisher=Florida Performs |url-status=usurped |archive-url=https://web.archive.org/web/20100113070831/http://www.floridaperforms.com/Indicators.aspx?si=SI_007 |archive-date=13 January 2010 }} In 2009 CBS News reported that child abuse in the United States had increased during the economic recession. It gave the example of a father who had never been the primary care-taker of the children. Now that the father was in that role, the children began to come in with injuries.{{cite web|author=Hughes, Sandra|date=20 May 2009|url=https://www.cbsnews.com/news/child-abuse-spikes-during-recession/|title=Child Abuse Spikes During Recession|work=CBS News|url-status=live|archive-url=https://web.archive.org/web/20090919053255/http://www.cbsnews.com/stories/2009/05/20/business/childofrecession/main5029133.shtml|archive-date=19 September 2009}} Parental mental health has also been seen as a factor towards child maltreatment.{{Cite journal|last1=Conron|first1=Kerith J.|last2=Beardslee|first2=William|last3=Koenen|first3=Karestan C.|last4=Buka|first4=Stephen L.|last5=Gortmaker|first5=Steven L.|date=5 October 2009|title=A Longitudinal Study of Maternal Depression and Child Maltreatment in a National Sample of Families Investigated by Child Protective Services|journal=Archives of Pediatrics & Adolescent Medicine|volume=163|issue=10|pages=922–30|doi=10.1001/archpediatrics.2009.176|pmid=19805711|issn=1072-4710|doi-access=free}} According to a recent Children's HealthWatch study, mothers with positive symptoms of depression display a greater rate of food insecurity, poor health care for their children, and greater number of hospitalizations.{{Cite journal|last1=Casey|first1=Patrick|last2=Goolsby|first2=Susan|last3=Berkowitz|first3=Carol|last4=Frank|first4=Deborah|last5=Cook|first5=John|last6=Cutts|first6=Diana|last7=Black|first7=Maureen M.|last8=Zaldivar|first8=Nieves|last9=Levenson|first9=Suzette|s2cid=40550743|date=February 2004|title=Maternal depression, changing public assistance, food security, and child health status|journal=Pediatrics|volume=113|issue=2|pages=298–304|issn=1098-4275|pmid=14754941|doi=10.1542/peds.113.2.298}}

The American psychoanalyst Elisabeth Young-Bruehl maintains that harm to children is justified and made acceptable by widely held beliefs in children's inherent subservience to adults, resulting in a largely unacknowledged prejudice against children she terms childism. She contends that such prejudice, while not the immediate cause of child maltreatment, must be investigated in order to understand the motivations behind a given act of abuse, as well as to shed light on societal failures to support children's needs and development in general.{{rp|4–6}} Founding editor of the International Journal of Children's Rights, Michael Freeman, also argues that 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. He writes, "the roots of child abuse lie not in parental psycho-pathology or in socio-environmental stress (though their influences cannot be discounted) but in a sick culture which denigrates and depersonalizes, which reduces children to property, to sexual objects so that they become the legitimate victims of both adult violence and lust".{{cite book |author=Freeman, Michael |title=The Moral Status of Children: Essays on the Rights of the Child |date=1997 |publisher=Martinus Nijhoff Publishers |isbn=978-90-411-0377-2 |location=Netherlands |page=76 |chapter=Beyond conventions{{mdash}}towards empowerment |chapter-url=https://books.google.com/books?id=BOGZgSgcDRYC |archive-url=https://web.archive.org/web/20160113081307/https://books.google.com/books?id=BOGZgSgcDRYC&printsec=frontcover |archive-date=13 January 2016 |url-status=live}}

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{{Geographical imbalance|United States|date=April 2024}}

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| caption1 = Legality of school{{cite web |title=Corporal Punishment in Schools |url=https://www.aacap.org/aacap/Policy_Statements/1988/Corporal_Punishment_in_Schools.aspx |website=American Academy of Child and Adolescent Psychiatry |access-date=14 June 2022 |language=en}} and general corporal punishment in the United States

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{{legend|#0000ff|Corporal punishment illegal in schools only}} {{legend|#ff0000|Corporal punishment not illegal}}

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| caption2 = Legality of corporal punishment of minors in Europe{{cite web |title=Corporal punishment |url=https://www.coe.int/en/web/children/corporal-punishment |website=Council of Europe |access-date=14 June 2022}}

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{{legend|#09c70d|Corporal punishment illegal in both schools and the home}}

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Child abuse is an international public health crisis. Poverty and substance use disorders are common social problems worldwide, and no matter the location, show a similar trend in the correlation to child abuse.{{Cite journal|last=Zimrin|first=Hanita|date=May 1996|title=Licensing parents: Can we prevent child abuse and neglect?|journal=Child Abuse & Neglect|volume=20|issue=5|pages=468–469|doi=10.1016/s0145-2134(96)90007-1|issn=0145-2134}} Differences in cultural perspectives play a significant role in how children are treated.{{Cite book|vauthors=Zevulun D, Post WJ, Zijlstra AE, Kalverboer ME, Knorth EJ|title=The Best Interests of the Child from different cultural perspectives:Factors influencing judgements of the quality of child-rearing environment and construct validity of the Best Interests of the Child-Questionnaire (BIC-Q) in Kosovo and Albania|date=2018-02-22|oclc=1028551290}} Laws reflect the population's views on what is acceptable – for example whether child corporal punishment is legal or not.

A study conducted by members from several Baltic and Eastern European countries, together with specialists from the United States, examined the causes of child abuse in the countries of Latvia, Lithuania, Macedonia and Moldova. In these countries, respectively, 33%, 42%, 18% and 43% of children reported at least one type of child abuse.{{cite journal |vauthors=Sebre S, Sprugevica I, Novotni A, Bonevski D, Pakalniskiene V, Popescu D, Turchina T, Friedrich W, Lewis O|title=Cross-cultural comparisons of child-reported emotional and physical abuse: Rates, risk factors and psychosocial symptoms |journal=Child Abuse & Neglect |volume=28 |issue=1 |pages=113–127 |year=2004 |pmid=15019442 |doi=10.1016/j.chiabu.2003.06.004|title-link=psychosocial }} According to their findings, there was a series of correlations between the potential risk factors of parental employment status, alcohol abuse, and family size within the abuse ratings.{{cite journal |vauthors=Sebre S, Sprugevica I, Novotni A, Bonevski D, Pakalniskiene V, Popescu D, Turchina T, Friedrich W, Lewis O|title=Cross-cultural comparisons of child-reported emotional and physical abuse: Rates, risk factors and psychosocial symptoms |journal=Child Abuse & Neglect |volume=28 |issue=1 |pages=113–127 |year=2004 |pmid=15019442 |doi=10.1016/j.chiabu.2003.06.004}} In three of the four countries, parental substance use was considerably correlated with the presence of child abuse, and although it was a lower percentage, still showed a relationship in the fourth country (Moldova). Each country also showed a connection between the father not working outside of the home and either emotional or physical child abuse. After the fall of the communism regime, some positive changes have followed with regard to tackling child abuse. While there is a new openness and acceptance regarding parenting styles and close relationships with children, child abuse has certainly not ceased to exist. While controlling parenting may be less of a concern, financial difficulty, unemployment, and substance use remain dominating factors in child abuse throughout Eastern Europe.

There is some evidence that countries in conflict or transitioning out of conflict have increased rates of child abuse. This increasing prevalence may be secondary to displacement and family disruption, as well as trauma.

Asian parenting perspectives hold different ideals from American culture. Many have described their traditions as including physical and emotional closeness that ensures a lifelong bond between parent and child, as well as establishing parental authority and child obedience through harsh discipline.Lau, A. S., Takeuchi, D. T., & Alegría, M. (2006). Parent-to-child aggression among Asian American parents: Culture, context, and vulnerability. Journal of Marriage and Family, 68(5), 1261–1275. Retrieved Balancing disciplinary responsibilities within parenting is common in many Asian cultures, including China, Japan, Singapore, Vietnam and Korea. To some cultures, forceful parenting may be seen as abuse, but in other societies such as these, the use of force is looked at as a reflection of parental devotion.

These cultural differences can be studied from many perspectives. Most importantly, overall parental behavior is genuinely different in various countries. Each culture has their own "range of acceptability", and what one may view as offensive, others may seem as tolerable. Behaviors that are normal to some may be viewed as abusive to others, all depending on the societal norms of that particular country. The differences in these cultural beliefs demonstrate the importance of examining all cross-cultural perspectives when studying the concept of child abuse. Some professionals argue that cultural norms that sanction physical punishment are one of the causes of child abuse, and have undertaken campaigns to redefine such norms.{{cite book |author=Haeuser, A. A. |title=International Congress on Child Abuse and Neglect |year=1990 |location=Hamburg |chapter=Banning parental use of physical punishment: Success in Sweden}}{{cite book |last=Barth |first=Richard |url=https://books.google.com/books?id=OzTq7SHLlIMC&q=child+abuse+cultural+norms+movement+change&pg=PA28 |title=Child Welfare Research Review, Volume 1 |publisher=Columbia University Press |year=1994 |isbn=978-0-231-08075-0 |pages=49–50 |access-date=25 May 2012}}{{cite book |last=Durrant |first=Joan E. |title=From Family Violence Against Children: A Challenge for Society |publisher=Walter de Gruyter & Co. |year=1996 |isbn=978-3-11-014996-8 |editor=Detlev Frehsee |location=New York |pages=19–25 |chapter=The Swedish Ban on Corporal Punishment: Its History and Effects |editor2=Wiebke Horn |editor3=Kai-D. Bussmann |chapter-url=https://books.google.com/books?id=aMebqOjGz28C&q=Family%20Violence%20Against%20Children%3A%20A%20Challenge%20for%20Society&pg=PA19 |archive-url=https://web.archive.org/web/20160113081307/https://books.google.com/books?id=aMebqOjGz28C&lpg=PP1&pg=PA19#v=onepage&q=Family%20Violence%20Against%20Children:%20A%20Challenge%20for%20Society |archive-date=13 January 2016 |url-status=live}}

In April 2015, public broadcasting reported that the rate of child abuse in South Korea had increased to 13% compared with the previous year, and 75% of attackers were the children's own parents.{{Cite news|url=http://www.ytn.co.kr/_ln/0103_201603160622133266|title=지난해 아동학대 17% 증가...가해자 75% 친부모|last=YTN|date=16 March 2016|url-status=live|archive-url=https://web.archive.org/web/20160405202227/http://www.ytn.co.kr/_ln/0103_201603160622133266|archive-date=5 April 2016}}

A large national survey by the Norwegian Centre for Violence and Traumatic Stress Studies found a "substantial overlap between companion animal abuse and child abuse" and that cruelty to animals "most frequently co-occurred with psychological abuse and less severe forms of physical child abuse," which "resonates with conceptualizations of domestic abuse as an ongoing pattern of psychological abuse and coercive control."{{Cite journal|last1 = Muri | first1 =K.|last2=Augusti|first2=E.M.|last3=Bjørnholt|first3=M.|last4=Hafstad|first4=G.S| year = 2022 | title = Childhood experiences of companion animal abuse and its co-occurrence with domestic abuse: Evidence from a national youth survey in Norway | url = | format = | journal = Journal of Interpersonal Violence | volume = 37|issue = 23–24| pages = NP22627–NP22646| doi =10.1177/08862605211072176| pmid =35156447| pmc =9679564| s2cid =246806885}}{{Non-primary source needed|date=January 2025}}

Suspicion for physical abuse is recommended when injuries occur in a child who is not yet able to walk independently. Additionally, having multiple injuries that are in different stages of healing and having injuries in unusual location, such as the torso, ears, face, or neck, may prompt evaluation for child abuse.{{cite journal|last1=Christian|first1=C. W.|title=The Evaluation of Suspected Child Physical Abuse|journal=Pediatrics|date=27 April 2015|volume=135|issue=5|pages=e1337–e1354|doi=10.1542/peds.2015-0356|pmid=25917988|doi-access=free}} Medical professionals may also become suspicious of child abuse when a caregiver is not able to provide an explanation for an injury that is consistent with the type or severity of the injury.{{Cite web |last=Flaherty |first=E.G. |title=From Suspicion of Physical Child Abuse to Reporting: Primary Care Clinician Decision-Making |url=https://publications.aap.org//ExternalLoginResponse.ashx?elpId=3&redirecturlback=http://publications.aap.org/pediatrics/article-abstract/122/3/611/72290/From-Suspicion-of-Physical-Child-Abuse-to?autologincheck=redirected?nfToken=00000000-0000-0000-0000-000000000000 |access-date=2022-09-12 |website=publications.aap.org}}

In many jurisdictions, suspected abuse, even if not necessarily proven, requires reporting to child protection agencies, such as the Child Protection Services in the United States. Recommendations for healthcare workers, such as primary care providers and nurses, who are often suited to encounter suspected abuse are advised to firstly determine the child's immediate need for safety. A private environment away from suspected abusers is desired for interviewing and examining. Leading statements that can distort the story are avoided. As disclosing abuse can be distressing and sometimes even shameful, reassuring the child that he or she has done the right thing by telling and that they are not bad or that the abuse was not their fault helps in disclosing more information. Dolls are sometimes used to help explain what happened. In Mexico, psychologists trial using cartoons to speak to children who may be more likely to disclose information than to an adult stranger.{{Cite news|last=Kenny|first=Richard|date=25 July 2017|title=Cartoon alien helps children in Mexico deal with trauma|work=BBC News|type=Video|url=https://www.bbc.com/news/av/magazine-40708314/cartoon-alien-helps-children-in-mexico-deal-with-trauma|access-date=27 July 2020}} For the suspected abusers, it is also recommended to use a nonjudgmental, nonthreatening attitude towards them and to withhold expressing shock, in order to help disclose information.Wilson, S.F.W, Giddens, J.F.G. (2009) Health Assessment for Nursing Practice. St.Louis: Mosby Elsevier, page 506.

A key part of child abuse work is assessment. A few methods of assessment include Projective tests, clinical interviews, and behavioral observations.{{Cite journal|last1=Brown|first1=Ted|last2=Bourke-Taylor|first2=Helen|date=2014-09-01|title=Children and Youth Instrument Development and Testing Articles Published in the American Journal of Occupational Therapy, 2009–2013: A Content, Methodology, and Instrument Design Review|url=https://ajot.aota.org/article.aspx?articleid=1901066|journal=American Journal of Occupational Therapy|language=en|volume=68|issue=5|pages=e154–e216|doi=10.5014/ajot.2014.012237|pmid=25184476|issn=0272-9490|url-access=subscription}}

• Projective tests allow for the child to express themselves through drawings, stories, or even descriptions in order to get help establish an initial understanding of the abuse that took place
• Clinical interviews are comprehensive interviews performed by professionals to analyze the mental state of the one being interviewed{{Cite web |title=Clinical Interviewing |url=https://www.carepatron.com/guides/clinical-interviewing |access-date=2024-07-05 |website=www.carepatron.com |language=en}}
• Behavioral observation gives an insight into things that trigger a child's memory of the abuse through observation of the child's behavior when interacting with other adults or children

A particular challenge arises where child protection professionals are assessing families where neglect is occurring. Neglect is a complex phenomenon without a universally-accepted definition{{Cite journal |last=Truman |first=P. |title=Problems in identifying cases of child neglect |url=https://www.proquest.com/openview/83e8849af46f285d2dd287221f8f0dee/1?pq-origsite=gscholar&cbl=30130 |access-date=2022-09-12 |journal=Nursing Standard |year=2004 |volume=18 |issue=29 |pages=33–38 |doi=10.7748/ns2004.03.18.29.33.c3579 |pmid=15079965 |language=en|url-access=subscription }} and professionals cite difficulty in knowing which questions to ask to identify neglect.Williams, M. (2015) [https://www.nspcc.org.uk/globalassets/documents/research-reports/evidence-based-decisions-evaluation-report.pdf Evidence based decisions in child neglect: An evaluation of an exploratory approach to assessment using the North Carolina Family Assessment Scale] {{webarchive|url=https://web.archive.org/web/20151122204727/https://www.nspcc.org.uk/globalassets/documents/research-reports/evidence-based-decisions-evaluation-report.pdf |date=22 November 2015 }}, London, NSPCC. Younger children, children living in poverty, and children with more siblings are at increased risk of neglect.{{Cite journal |last=Connell-Carrick |first=Kelli |date=2003-10-01 |title=A Critical Review of the Empirical Literature: Identifying Correlates of Child Neglect |journal=Child and Adolescent Social Work Journal |language=en |volume=20 |issue=5 |pages=389–425 |doi=10.1023/A:1026099913845 |s2cid=142581537 |issn=1573-2797}}

A support-group structure is needed to reinforce parenting skills and closely monitor the child's well-being. Visiting home nurse or social-worker visits are also required to observe and evaluate the progress of the child and the caretaking situation. The support-group structure and visiting home nurse or social-worker visits are not mutually exclusive. Many studies have demonstrated that the two measures must be coupled together for the best possible outcome.{{cite web|url=http://www.medicinenet.com/child_abuse/page8.htm#how_can_child_abuse_be_prevented|title=Child Abuse Symptoms, Causes, Treatment – How can child abuse be prevented? on MedicineNet|publisher=Medicinenet.com|access-date=24 December 2012|archive-url=https://web.archive.org/web/20121221061631/http://www.medicinenet.com/child_abuse/page8.htm#how_can_child_abuse_be_prevented|archive-date=21 December 2012}}

Studies show that if health and medical care personnel in a structured way ask parents about important psychosocial risk factors in connection with visiting pediatric primary care and, if necessary, offering the parent help may help prevent child maltreatment.{{Cite journal|last1=Dubowitz|first1=Howard|last2=Lane|first2=Wendy G.|last3=Semiatin|first3=Joshua N.|last4=Magder|first4=Laurence S.|date=July 2012|title=The SEEK Model of Pediatric Primary Care: Can Child Maltreatment Be Prevented in a Low-Risk Population?|journal=Academic Pediatrics|volume=12|issue=4|pages=259–268|doi=10.1016/j.acap.2012.03.005|pmc=5482714|pmid=22658954}}{{Cite journal|last1=Dubowitz|first1=H.|last2=Lane|first2=W. G.|last3=Semiatin|first3=J. N.|last4=Magder|first4=L. S.|last5=Venepally|first5=M.|last6=Jans|first6=M.|date=2011-04-01|title=The Safe Environment for Every Kid Model: Impact on Pediatric Primary Care Professionals|journal=Pediatrics|volume=127|issue=4|pages=e962–e970|doi=10.1542/peds.2010-1845|issn=0031-4005|pmc=3387892|pmid=21444590}}

Children's school programs regarding "good touch ... bad touch" can provide children with a forum in which to role-play and learn to avoid potentially harmful scenarios. Pediatricians can help identify children at risk of maltreatment and intervene with the aid of a social worker or provide access to treatment that addresses potential risk factors such as maternal depression.{{cite web|publisher=Agency for Healthcare Research and Quality|url=https://innovations.ahrq.gov/profiles/pediatrician-training-and-office-support-significantly-reduce-instances-child-maltreatment|title=Pediatrician Training and In-Office Support Significantly Reduce Instances of Child Maltreatment|date=22 May 2013|access-date=17 October 2013|url-status=live|archive-url=https://web.archive.org/web/20160113081307/https://innovations.ahrq.gov/profiles/pediatrician-training-and-office-support-significantly-reduce-instances-child-maltreatment|archive-date=13 January 2016}} Videoconferencing has also been used to diagnose child abuse in remote emergency departments and clinics.{{cite web |publisher=Agency for Healthcare Research and Quality |url=https://innovations.ahrq.gov/profiles/child-abuse-experts-provide-videoconference-enabled-consultations-providers-remote |title=Child Abuse Experts Provide Videoconference-Enabled Consultations to Providers in Remote Emergency Departments and Clinics, Leading to More Accurate Diagnosis |date=26 March 2014 |access-date=26 March 2014 |url-status=live |archive-url=https://web.archive.org/web/20160113081307/https://innovations.ahrq.gov/profiles/child-abuse-experts-provide-videoconference-enabled-consultations-providers-remote |archive-date=13 January 2016 }} Unintended conception increases the risk of subsequent child abuse, and large family size increases the risk of child neglect. Thus, a comprehensive study for the National Academy of Sciences concluded that affordable contraceptive services should form the basis for child abuse prevention.{{cite report|title=Optimal Caregiving and Child Abuse: Continuities and Discontinuities. National Academy of Sciences Study Panel on Child Abuse and Neglect.|publisher=National Academy Press|year=1993|author=Baumrind|location=Washington, DC}} "The starting point for effective child abuse programming is pregnancy planning," according to an analysis for US Surgeon General C. Everett Koop.{{cite report|title=The Surgeon General's Workshop on Violence and Public Health: Review of the recommendations.|year=1986|volume=101|pages=8–14|author=Cron T|journal=Public Health Rep.}}

Findings from research published in 2016 support the importance of family relationships in the trajectory of a child's life: family-targeted interventions are important for improving long-term health, particularly in communities that are socioeconomically disadvantaged.{{cite journal |vauthors=Wade R Jr, Cronholm PF, Fein JA, Forke CM, Davis MB, Harkins-Schwarz M, Pachter LM, Bair-Merritt MH | year = 2016 | title = Household and community-level Adverse Childhood Experiences and adult health outcomes in a diverse urban population | journal = Child Abuse & Neglect | volume = 52 | pages = 135–45 | doi = 10.1016/j.chiabu.2015.11.021 | pmid = 26726759 | doi-access = free }}

Resources for child-protection services are sometimes limited. According to Hosin (2007), "a considerable number of traumatized abused children do not gain access to protective child-protection strategies."{{where|date=January 2020}}{{cite book|editor=Hosin, A.A.|year=2007|title=Responses to traumatized children|url=https://archive.org/details/responsestotraum00hosi|url-access=limited|publisher=Palgrave Macmillan|location=Basingstoke|page=[https://archive.org/details/responsestotraum00hosi/page/n231 211]|isbn=978-1-4039-9680-0}} Briere (1992) argues that only when "lower-level violence" of children{{clarify|presumably this means "towards children", but the source should be checked whether it's not the potentially more fringe view "by children", which the current wording seems to imply|date=October 2013}} ceases to be culturally tolerated will there be changes in the victimization and police protection of children.{{Cite book|author=Briere, John|year=1992|title=Child abuse trauma|publisher=Sage|page=[https://archive.org/details/childabusetrauma00brie/page/7 7]|isbn=978-0-8039-3713-0|url=https://archive.org/details/childabusetrauma00brie/page/7}}

Child sexual abuse prevention programs were developed in the United States of America during the 1970s and originally delivered to children. Programmes delivered to parents were developed in the 1980s and took the form of one-off meetings, two to three hours long.{{cite journal | last=Babatsikos | first=Georgia | title=Parents' knowledge, attitudes and practices about preventing child sexual abuse: a literature review | journal=Child Abuse Review | volume=19 | issue=2 | year=2010 | issn=0952-9136 | doi=10.1002/car.1102 | pages=107–129}}{{cite journal | last1=Hébert | first1=Martine | last2=Lavoie | first2=Francine | last3=Parent | first3=Nathalie | title=An Assessment of Outcomes Following Parents' Participation in a Child Abuse Prevention Program | journal=Violence and Victims | volume=17 | issue=3 | date=1 June 2002 | issn=0886-6708 | doi=10.1891/vivi.17.3.355.33664 | pmid=12102058 | pages=355–372| s2cid=33445782 }}{{cite journal | last1=Wurtele | first1=Sandy K. | last2=Moreno | first2=Tasha | last3=Kenny | first3=Maureen C. | title=Evaluation of a Sexual Abuse Prevention Workshop for Parents of Young Children | journal=Journal of Child & Adolescent Trauma | volume=1 | issue=4 | year=2008 | issn=1936-1521 | doi=10.1080/19361520802505768 | pages=331–340| s2cid=146651342 }}{{cite journal | last1=Wurtele | first1=Sandy K. | last2=Kenny | first2=Maureen C. | title=Partnering with parents to prevent childhood sexual abuse | journal=Child Abuse Review | volume=19 | issue=2 | year=2010 | issn=0952-9136 | doi=10.1002/car.1112 | pages=130–152}}{{Cite web|url=http://library.nspcc.org.uk/HeritageScripts/Hapi.dll/filetransfer/2018FourStepsToThePreventionOfCSAInTheHome.pdf?CookieCheck=43313.725224213&filename=AA58F75CEDE68892A73FB681FE246B8371684F102152F0AA780A14959D3BCE5767137B3B2A935011CBAEC3068664FF681AA6D2524E357BAB96C006752CCD756759AD77BD1E389823A55CFAAE74B2EE64F46C611AD1724BE1AC500B025490CCB1CD8D9D26B00674E723A731951BB13FBE2976BA14838E6BBB09A4FA52BE735F27D92CBFED7FA6CFFA88BC073F0228EAA69F4D1FE158D846D5D4DD33F8F3466703AC49AD67CE927D87622D067280EF2A231A479B85D0572EF2AABC4480&DataSetName=LIVEDATA|title=Four Steps to the Prevention of Child Sexual Abuse in the Home|last=Williams|first=Mike|date=2018|website=NSPCC}}{{Cite web|url=http://library.nspcc.org.uk/HeritageScripts/Hapi.dll/filetransfer/2018WorkingWithACommunityToPreventCSAInTheHome.pdf?filename=AA58F75CEDE68892A73FB681FE246B8371684F102152F0AA780A14959D3BCE5767137B3B2A935011CBAEC3068664FF681AA6D2524E357BAB96C006752CCD756759AD77BD1E389823A55CFAAE74B2EE64F46C611AD1724BE1AC500B025490CCB1CD8D9D26B00674E723A731951BB13FBE2976BA14838E6BBB09A4EB52B96A653DDB0BA5CD78B3E4F0B5A317270E32E79B9F7322E26DEE69E8F9DA1AD4D57D6203CA56A4641A004820ECE9E3EB4F712C3FED9F46CEBCE377C14C55CB2FBCFD7942&DataSetName=LIVEDATA|title=Working with a community to prevent child sexual abuse in the home|last=Williams|first=Mike|date=2018|website=NSPCC|access-date=1 August 2018}} In the last 15 years, web-based programmes have been developed.

Since 1983, April has been designated Child Abuse Prevention Month in the United States.[http://www.childwelfare.gov/preventing/preventionmonth/history.cfm Child Welfare Information Gateway] {{webarchive|url=https://web.archive.org/web/20100828085844/http://www.childwelfare.gov/preventing/preventionmonth/history.cfm |date=28 August 2010 }}, History of National Child Abuse Prevention Month. 3 April 2009. U.S. President Barack Obama continued that tradition by declaring April 2009 Child Abuse Prevention Month.[https://obamawhitehouse.archives.gov/the_press_office/Presidential-Proclamation-Marking-National-Child-Abuse-Prevention-Month/ Presidential Proclamation Marking National Child Abuse Prevention Month] {{webarchive|url=https://web.archive.org/web/20090831064559/http://www.whitehouse.gov/the_press_office/Presidential-Proclamation-Marking-National-Child-Abuse-Prevention-Month/ |date=31 August 2009 }}. The White House – Press Room, 1 April 2009. One way the Federal government of the United States provides funding for child-abuse prevention is through Community-Based Grants for the Prevention of Child Abuse and Neglect (CBCAP).[http://www.acf.hhs.gov/programs/cb/programs_fund/state_tribal/cbcap.htm U.S. Administration for Children and Families] {{webarchive|url=https://web.archive.org/web/20090830154359/http://www.acf.hhs.gov/programs/cb/programs_fund/state_tribal/cbcap.htm |date=30 August 2009 }}. Department of Health and Human Services. Children's Bureau.

An investigation by The Boston Globe and ProPublica published in 2019{{Cite web|url=https://www.bostonglobe.com/metro/2019/12/13/cry-for-help/prT5xvp27BGZK6AZQWRNVL/story.html|title=The federal government has one main law to prevent child abuse. No state follows all of it – The Boston Globe|website=BostonGlobe.com}} found that the 50 states, the District of Columbia, and Puerto Rico were all out of compliance with the requirements of the Child Abuse Prevention and Treatment Act, and that underfunding of child welfare agencies and substandard procedures in some states caused failures to prevent avoidable child injuries and deaths.

A number of policies and programs have been put in place in the U.S. to try to better understand and to prevent child abuse fatalities, including: safe-haven laws, child fatality review teams, training for investigators, shaken baby syndrome prevention programs, and child abuse death laws which mandate harsher sentencing for taking the life of a child.Douglas, E.M., 2005, Child maltreatment fatalities: What do we know, what have we learned, and where do we go from here?,pp 4.1–4.18, in Child Victimization, edited by K. Kendall-Tackett & S. Giacomoni, published by Civic Research Institute, Kingston, N.J.

A number of treatments are available to victims of child abuse.{{cite journal|author=Cohen, J.A.|author2=Mannarino, A.P. |author3=Murray, L.K. |author4= Igelman, R. |year=2006|title=Psychosocial Interventions for Maltreated and Violence-Exposed Children|journal=Journal of Social Issues|volume=62|issue=4|pages=737–766|doi=10.1111/j.1540-4560.2006.00485.x|citeseerx=10.1.1.578.243 }} However, children who experience childhood trauma do not heal from abuse easily.{{Cite web|title = Children Who Experience Early Childhood Trauma Do Not 'Just Get Over It'|url = http://www.socialworkhelper.com/2014/10/08/children-experience-early-childhood-trauma-just-get/|website = Social Work Helper|access-date = 13 May 2015|first = Jane|last = Evans|url-status = live|archive-url = https://web.archive.org/web/20150518081735/http://www.socialworkhelper.com/2014/10/08/children-experience-early-childhood-trauma-just-get/|archive-date = 18 May 2015|df = dmy-all|date = 8 October 2014}} Trauma-focused cognitive behavioral therapy, first developed to treat sexually abused children, is now used for victims of any kind of trauma. It targets trauma-related symptoms in children including PTSD, clinical depression and anxiety. It also includes a component for non-offending parents. Several studies have found that sexually abused children undergoing TF-CBT improved more than children undergoing certain other therapies. Data on the effects of TF-CBT for children who experienced non-sexual abuse was not available {{as of|2006|lc=y}}. The purpose of dealing with the thoughts and feelings associated with the trauma is to deal with nightmares, flashbacks and other intrusive experiences that might be spontaneously brought on by any number of discriminative stimuli in the environment or in the individual's brain. This would aid the individual in becoming less fearful of specific stimuli that would arouse debilitating fear, anger, sadness or other negative emotion. In other words, the individual would have some control or mastery over those emotions.

Rational Cognitive Emotive Behavior Therapy is another available treatment and is intended to provide abused children and their adoptive parents with positive behavior change, corrective interpersonal skills, and greater control over themselves and their relationships.

Parent–child interaction therapy was designed to improve the child-parent relationship following the experience of domestic violence. It targets trauma-related symptoms in infants, toddlers, and preschoolers, including PTSD, aggression, defiance, and anxiety. It is supported by two studies of one sample.

School-based programs have also been developed to treat children who are survivors of abuse.{{Cite journal|last=Walsh|first=Kerryann|date=April 16, 2015|title=School-based education programmes for the prevention of child sexual abuse|journal=Cochrane Database of Systematic Reviews|volume=2015 |issue=4|pages=CD004380|doi=10.1002/14651858.CD004380.pub3|pmid=25876919|pmc=9805791 }} This approach teaches children, parents, teachers, and other school staff how to identify the signs of child maltreatment as well as skills that can be helpful in preventing child maltreatment.{{Cite web|last=Child Welfare Information Gateway|first=U.S. Department of Health and Human Services|date=2003|title=School-Based Child Maltreatment Programs|url=https://www.childwelfare.gov/pubPDFs/schoolbased.pdf|access-date=24 September 2020|archive-date=22 July 2022|archive-url=https://web.archive.org/web/20220722213206/https://www.childwelfare.gov/pubPDFs/schoolbased.pdf|url-status=dead}}

Other forms of treatment include group therapy, play therapy, and art therapy. Each of these types of treatment can be used to better assist the client, depending on the form of abuse they have experienced. Play therapy and art therapy are ways to get children more comfortable with therapy by working on something that they enjoy (coloring, drawing, painting, etc.). The design of a child's artwork can be a symbolic representation of what they are feeling, relationships with friends or family, and more. Being able to discuss and analyze a child's artwork can allow a professional to get a better insight of the child.{{cite journal |vauthors=Schechter DS, Zygmunt A, Trabka KA, Davies M, Colon E, Kolodji A, McCaw JE | title = Child mental representations of attachment when mothers are traumatized: The relationship of family-drawings to story-stem completion | journal = Journal of Early Childhood and Infant Psychology | volume = 3 | pages = 119–141 | year = 2007 | pmid = 18347736 | pmc = 2268110 }}

Interventions targeting the offending parents are rare. Parenting training can prevent child abuse in the short term, and help children with a range of emotional, conduct and behavioral challenges, but there is insufficient evidence about whether it has impact on parents who already abuse their children.{{cite web |date=19 January 2017 |title=Parent training works for child and adolescent mental health |url=https://www.nationalelfservice.net/populations-and-settings/parenting/parent-training-works-for-child-and-adolescent-mental-health/}} Abuse-focused cognitive behavioral therapy may target offending parents, but most interventions exclusively target victims and non-offending parents.

Child abuse is complex and difficult to study. According to the World Health Organization (WHO), estimates of the rates of child maltreatment vary widely by country, depending on how child maltreatment is defined, the type of maltreatment studied, the scope and quality of data gathered, and the scope and quality of surveys that ask for self-reports from victims, parents, and caregivers. Despite these limitations, international studies show that a quarter of all adults report experiencing physical abuse as children, and that 1 in 5 women and 1 in 13 men report experiencing childhood sexual abuse. Emotional abuse and neglect are also common childhood experiences.{{cite web |title=Child maltreatment: Fact sheet No. 150 |date=December 2014 |publisher=World Health Organization |url=https://www.who.int/mediacentre/factsheets/fs150/en/ |url-status=live |archive-url=https://web.archive.org/web/20150717165627/http://www.who.int/mediacentre/factsheets/fs150/en/ |archive-date=17 July 2015 }}

{{as of|2014}}, an estimated 41,000 children under 15 are victims of homicide each year. The WHO states that this number underestimates the true extent of child homicide; a significant proportion of child deaths caused by maltreatment are incorrectly attributed to unrelated factors such as falls, burns, and drowning. Also, girls are particularly vulnerable to sexual violence, exploitation and abuse in situations of armed conflict and refugee settings, whether by combatants, security forces, community members, aid workers, or others.

The National Research Council wrote in 1993 that "...the available evidence suggests that child abuse and neglect is an important, prevalent problem in the United States [...] Child abuse and neglect are particularly important compared with other critical childhood problems because they are often directly associated with adverse physical and mental health consequences in children and families".{{cite book |author=Panel on Research on Child Abuse and Neglect |chapter=Front matter |title=Understanding Child Abuse and Neglect |date=1993 |location=Washington, D.C. |publisher=National Academy Press |chapter-url=http://www.nap.edu/read/2117/chapter/1 |url-status=live |archive-url=https://web.archive.org/web/20160324085817/http://www.nap.edu/read/2117/chapter/1 |archive-date=24 March 2016 |doi=10.17226/2117 |isbn=978-0-309-04889-7 |url=https://directory.doabooks.org/handle/20.500.12854/140260 }}{{rp|6}}

In 1995, a one-off judicial decision found that parents failing to sufficiently speak the national standard language at home to their children was a form of child abuse by a judge in a child custody matter.{{cite web |url=http://www.deseretnews.com/article/436153/SPEAKING-ONLY-SPANISH-AT-HOME-IS-ABUSE-TEXAS-JUDGE-RULES.html |title=SPEAKING ONLY SPANISH AT HOME IS ABUSE, TEXAS JUDGE RULES. |publisher=deseretnews.com. |date=29 August 1995 |access-date=21 March 2011 |url-status=dead |archive-url=https://web.archive.org/web/20121022202152/http://www.deseretnews.com/article/436153/SPEAKING-ONLY-SPANISH-AT-HOME-IS-ABUSE-TEXAS-JUDGE-RULES.html |archive-date=22 October 2012 }}

In 1998, Douglas Besharov, the first Director of the U.S. Center on Child Abuse and Neglect, stated "the existing laws are often vague and overly broad"{{cite web|url=http://www.philanthropyroundtable.org/topic/excellence_in_philanthropy/fixing_child_protection|title=Fixing Child Protection|author=Besharov, Douglas J.|publisher=Philanthropy Roundtable|date=1 January 1998|pages=1–4|url-status=live|archive-url=https://web.archive.org/web/20130314061514/http://www.philanthropyroundtable.org/topic/excellence_in_philanthropy/fixing_child_protection|archive-date=14 March 2013}} and there was a "lack of consensus among professionals and Child Protective Services (CPS), personnel about what the terms abuse and neglect mean".{{cite web|url=http://cssronline.org/CSSR/Archival/2007/Krason.pdf |title=The Critics of Current Child Abuse Laws and the Child Protective System: A Survey of the Leading |author=Krason, Stephen M. |publisher=The Catholic Social Science Review |pages=307–350 |archive-url=https://web.archive.org/web/20140427025448/http://cssronline.org/CSSR/Archival/2007/Krason.pdf |archive-date=27 April 2014 }}

In 2012, Child Protective Services (CPS) agencies estimated that about 9 out of 1000 children in the United States were victims of child maltreatment. Most (78%) were victims of neglect. Physical abuse, sexual abuse, and other types of maltreatment, were less common, making up 18%, 9%, and 11% of cases, respectively ("other types" included emotional abuse, parental substance use, and inadequate supervision). According to data reported by the Children's Bureau of the US Department of Health and Human Services, more than 3.5 million allegations of child abuse were looked into by child protective services who in turn confirmed 674,000 of those cases in 2017.{{Cite web|date=2020|title=Child Abuse|url=http://link.galegroup.com/apps/doc/PC3010999343/OVIC?sid=OVIC&xid=35ee811a|access-date=2020-06-11|website=Opposing Viewpoints Online Collection|publisher=Gale|location=Farmington Hills, Michigan}} However, CPS reports may underestimate the true scope of child maltreatment. A non-CPS 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).{{cite web |title=Child Maltreatment: Facts at a Glance |location=Atlanta, GA |publisher=Centers for Disease Control and Prevention |date=2014 |url=https://www.cdc.gov/violenceprevention/pdf/childmaltreatment-facts-at-a-glance.pdf |url-status=live |archive-url=https://web.archive.org/web/20170829054942/https://www.cdc.gov/violenceprevention/pdf/childmaltreatment-facts-at-a-glance.pdf |archive-date=29 August 2017 }}

In February 2017, the American Public Health Association published a Washington University study estimating 37% of American children experienced a child protective services investigation by age 18 (or 53% if African American).{{cite journal | title = Lifetime Prevalence of Investigating Child Maltreatment Among US Children | first1 = Hyunil | last1 = Kim | first2 = Christopher | last2 = Wildeman | first3 = Melissa|last3=Jonson-Reid|first4=Brett|last4=Drake|date=1 February 2017|journal=American Journal of Public Health|volume=107|issue=2|pages=274–280|doi=10.2105/ajph.2016.303545|pmid=27997240|pmc=5227926}}

According to David Finkelhor who tracked Child Maltreatment Report (NCANDS) data from 1990 to 2010, sexual abuse had declined 62% from 1992 to 2009 and the long-term trend for physical abuse was also down by 56% since 1992. He stated: "It is unfortunate that information about the trends in child maltreatment are not better publicized and more widely known. The long-term decline in sexual and physical abuse may have important implications for public policy."{{cite web|url=http://www.unh.edu/ccrc/pdf/CV203_Updated%20trends%202010%20FINAL_12-19-11.pdf|title=Updated Trends in Child Maltreatment, 2010|last=Finkelhor|first=David|author2=Lisa Jones|author3=Anne Shuttuch|publisher=University of New Hampshire, Crimes Against Children Research Center|access-date=19 December 2011|url-status=live|archive-url=https://web.archive.org/web/20121010181838/http://www.unh.edu/ccrc/pdf/CV203_Updated%20trends%202010%20FINAL_12-19-11.pdf|archive-date=10 October 2012}}

A child abuse fatality occurs when a child's death is the result of abuse or neglect, or when abuse or neglect are contributing factors to a child's death. In 2008, 1,730 children died in the United States due to factors related to abuse; this is a rate of 2 per 100,000 U.S. children.[http://www.acf.hhs.gov/programs/cb/pubs/cm08/cm08.pdf Child Maltreatment 2008] {{webarchive|url=https://web.archive.org/web/20100705035918/http://www.acf.hhs.gov/programs/cb/pubs/cm08/cm08.pdf |date=5 July 2010 }}, U.S. Department of Health and Human Services, p. 55. Family situations which place children at risk include moving, unemployment, and having non-family members living in the household. A number of policies and programs have been put in place in the U.S. to try to better understand and to prevent child abuse fatalities, including: safe-haven laws, child fatality review teams, training for investigators, shaken baby syndrome prevention programs, and child abuse death laws which mandate harsher sentencing for taking the life of a child.

In a year-long period between 2019 and 2020, approximately 8.4 out of every 1,000 children were abused or neglected, a number equating to 618,000 children. 77.2% of the perpetrators were parents, the majority of which were one parent acting alone. 37.6% of child abuse was perpetrated by mothers acting alone, and 23.6% was perpetrated by fathers acting alone. 20.7% of child abuse was committed by both parents.{{Cite journal |last1=Lee |first1=Joyce Y. |last2=Yoon |first2=Susan |last3=Park |first3=Keunhye |last4=Radney |first4=Angelise |last5=Shipe |first5=Stacey L. |last6=Pace |first6=Garrett T. |date=2023-04-11 |title=Father–Mother Co-Involvement in Child Maltreatment: Associations of Prior Perpetration, Parental Substance Use, Parental Medical Conditions, Inadequate Housing, and Intimate Partner Violence with Different Maltreatment Types |journal=Children |volume=10 |issue=4 |pages=707 |doi=10.3390/children10040707 |doi-access=free |issn=2227-9067 |pmid=37189957|pmc=10136478 }}

{{Main|Child labor}}

{{See also|Child trafficking}}

File:ERP combatants Perquín 1990 35.jpg in El Salvador, 1990]]

Child trafficking is the recruitment, transportation, transfer, harbouring or receipt of children for the purpose of exploitation.{{cite web|url=http://www.unicef.org/protection/57929_58005.html|title=Child trafficking|date=22 March 2011|work=UNICEF|access-date=5 March 2015|url-status=live|archive-url=https://web.archive.org/web/20150301130402/http://www.unicef.org/protection/57929_58005.html|archive-date=1 March 2015}} Children are trafficked for purposes such as of commercial sexual exploitation, bonded labour, camel jockeying, child domestic labour, drug couriering, child soldiering, illegal adoptions, and begging.{{cite web|url=http://www.traffickingproject.org/2011/03/human-trafficking-for-begging-old-game.html|title=The Human Trafficking Project: Human Trafficking for Begging: Old Game, New Name|work=The Human Trafficking Project|access-date=5 March 2015|url-status=live|archive-url=https://web.archive.org/web/20150326021523/http://www.traffickingproject.org/2011/03/human-trafficking-for-begging-old-game.html|archive-date=26 March 2015}}{{cite web|url=http://www.ecpat.org.uk/sites/default/files/begging_organised_crime_briefing.pdf|title=Child trafficking – begging and organised crime|publisher=ECPAT UK|archive-url=https://web.archive.org/web/20131020041323/http://www.ecpat.org.uk/sites/default/files/begging_organised_crime_briefing.pdf|archive-date=20 October 2013}}{{Cite journal|url=http://works.bepress.com/david_smolin/3/|title=Intercountry Adoption as Child Trafficking|journal=Valparaiso Law Review|volume=39|issue=2|author=David M. Smolin|access-date=5 March 2015|url-status=live|archive-url=https://web.archive.org/web/20150402124401/http://works.bepress.com/david_smolin/3/|archive-date=2 April 2015|year=2005}} It is difficult to obtain reliable estimates concerning the number of children trafficked each year, primarily due to the covert and criminal nature of the practice.{{cite web|url=http://www.unicef.org/protection/Textbook_1.pdf|title=Training Manual to Fight Child Trafficking in Children for Labour, Sexual and Other Forms of Exploitation|publisher=Unicef|access-date=4 September 2013|url-status=live|archive-url=https://web.archive.org/web/20130903005514/http://www.unicef.org/protection/Textbook_1.pdf|archive-date=3 September 2013}}{{cite web|url=https://www.ncjrs.gov/pdffiles1/nij/grants/221891.pdf#page=55|title=Victims No Longer: Research on Child Survivors of Trafficking for Sexual and Labor Exploitation in the United States|access-date=4 September 2013|url-status=live|archive-url=https://web.archive.org/web/20150302115944/https://www.ncjrs.gov/pdffiles1/nij/grants/221891.pdf#page=55|archive-date=2 March 2015}} The International Labour Organization estimates that 1.2 million children are trafficked each year.{{cite book | title=Every child counts: new global estimates on child labour | publisher=ILO International Labour Office | year=2002 | isbn=978-92-2-113113-7 | url=https://books.google.com/books?id=EZn4_edQuikC | access-date=2021-11-10 | page=}}

Child labor refers to the employment of children in any work that deprives children of their childhood, interferes with their ability to attend regular school, or is mentally, physically, socially or morally dangerous and harmful.{{cite web|title=What is child labour?|publisher=International Labour Organisation|year=2012|url=http://www.ilo.org/ipec/facts/lang--en/index.htm|url-status=live|archive-url=https://web.archive.org/web/20170714172957/http://www.ilo.org/ipec/facts/lang--en/index.htm|archive-date=14 July 2017}} The International Labour Organization considers such labor to be a form of exploitation and abuse of children.{{cite web|url=https://www.un.org/en/globalissues/briefingpapers/childlabour/ |title=United Nations Resources for Speakers on Global Issues – Child Labour |publisher=United Nations |access-date=4 September 2013 |archive-url=https://web.archive.org/web/20130807175544/http://www.un.org/en/globalissues/briefingpapers/childlabour/ |archive-date=7 August 2013 }}{{cite web|title=International and national legislation – Child Labour|publisher=International Labour Organisation|year=2011|url=http://www.ilo.org/ipec/areas/Childdomesticlabour/iInternationalnationallegislation/lang--en/index.htm|url-status=live|archive-url=https://web.archive.org/web/20120209175548/http://www.ilo.org/ipec/areas/Childdomesticlabour/iInternationalnationallegislation/lang--en/index.htm|archive-date=9 February 2012}} Child labor refers to those occupations which infringe the development of children (due to the nature of the job or lack of appropriate regulation) and does not include age appropriate and properly supervised jobs in which minors may participate. According to ILO, globally, around 215 million children work, many full-time. Many of these children do not go to school, do not receive proper nutrition or care, and have little or no time to play. More than half of them are exposed to the worst forms of child labor, such as child prostitution, drug trafficking, armed conflicts and other hazardous environments.{{cite web|url=http://www.ilo.org/global/topics/child-labour/lang--en/index.htm#a2|title=Child Labour|access-date=5 March 2015|url-status=live|archive-url=https://web.archive.org/web/20150302152656/http://www.ilo.org/global/topics/child-labour/lang--en/index.htm#a2|archive-date=2 March 2015}} There exist several international instruments protecting children from child labor, including the Minimum Age Convention, 1973 and the Worst Forms of Child Labour Convention.

More girls under 16 work as domestic workers than any other category of child labor, often sent to cities by parents living in rural poverty{{Cite news|url=https://www.washingtonpost.com/wp-dyn/content/article/2008/12/25/AR2008122501198.html?wprss=rss_print/asection&sid=ST2008122600004|title=In Togo, a 10-Year-Old's Muted Cry: 'I Couldn't Take Any More'|newspaper=The Washington Post|access-date=27 May 2018|date=26 December 2008|last1=Sullivan|first1=Kevin}} such as in restaveks in Haiti.

{{Main|Forced adoption}}

{{See also|Forced assimilation}}

Children in poverty have been removed from their families with their welfare being used an argument to do so. The European Court of Human Rights ruled that Norway, which disproportionately removes children of immigrant background and argues it gives them a better future, was mistaking poverty for neglect and that there are other ways to help destitute children.{{cite web|url=https://www.courthousenews.com/forced-adoption-case-against-norway-hits-european-rights-court/|title=Forced Adoption Case Against Norway Hits European Rights Court|date=27 January 2021|website=courthousenews}}{{Cite news|url=https://www.bbc.co.uk/news/resources/idt-sh/norways_hidden_scandal|title=Norway's hidden scandal|journal=BBC News|access-date=2 March 2023|date=3 August 2018|last=Whewell|first=Tim}} In Switzerland, between the 1850s and the mid-20th century, hundreds of thousands of children mostly from poor or single parents were forcefully removed from their parents by the authorities, and sent to work on farms, living with new families. They were known as contract children or Verdingkinder.{{cite web|url=http://www.swissinfo.ch/eng/historian-reveals-tragedy-of-swiss-child-trade/3791220|title=Historian reveals tragedy of Swiss child trade|date=29 February 2004|website=Swissinfo.ch|url-status=live|archive-url=https://web.archive.org/web/20151118163629/http://www.swissinfo.ch/eng/historian-reveals-tragedy-of-swiss-child-trade/3791220|archive-date=18 November 2015}}{{Cite news|url=https://www.bbc.com/news/magazine-29765623|title=Switzerland's shame: The children used as cheap farm labour|journal=BBC News|access-date=28 June 2016|date=29 October 2014|last=Puri|first=Kavita|url-status=live|archive-url=https://web.archive.org/web/20160720143159/http://www.bbc.com/news/magazine-29765623|archive-date=20 July 2016}}{{Cite news|url=https://www.boston.com/news/world/europe/articles/2011/11/24/swiss_grapple_with_history_of_forced_child_labor/|title=Swiss grapple with history of forced child labor|author=Jordans, Frank|website=Boston.com|date=24 November 2011|url-status=live|archive-url=https://web.archive.org/web/20151118145003/http://www.boston.com/news/world/europe/articles/2011/11/24/swiss_grapple_with_history_of_forced_child_labor/|archive-date=18 November 2015}}{{Cite news|url=https://www.bbc.com/news/world-europe-16620597|title=Swiss 'contract children' speak out|journal=BBC News|date=19 January 2012|author=Foulkes, Imogen|url-status=live|archive-url=https://web.archive.org/web/20160113081307/http://www.bbc.com/news/world-europe-16620597|archive-date=13 January 2016}}

Removing children of ethnic minorities from their families to be adopted by those of the dominant ethnic group has been used as a method of forced assimilation. The Stolen Generations in Australia involved Australian Aboriginal and Torres Strait Islander children.{{cite web|url=http://www.australianstogether.org.au/stories/detail/the-stolen-generations|title=The Stolen Generations|work=Australians Together|url-status=live|archive-url=https://web.archive.org/web/20151119075600/http://www.australianstogether.org.au/stories/detail/the-stolen-generations|archive-date=19 November 2015}}{{cite web|url=http://news.bbc.co.uk/2/hi/asia-pacific/6937222.stm|title=The agony of Australia's Stolen Generation|date=9 August 2007|work=BBC News|url-status=live|archive-url=https://web.archive.org/web/20071204120919/http://news.bbc.co.uk/2/hi/asia-pacific/6937222.stm|archive-date=4 December 2007}} In Canada, the Canadian Indian residential school system involved First Nations, Métis and Inuit children, who often suffered severe abuse.{{Cite news|url=https://www.bbc.com/news/magazine-33099511|title=The schools that had cemeteries instead of playgrounds|author=Griffiths, Sian|journal=BBC News|date=13 June 2015|url-status=live|archive-url=https://web.archive.org/web/20151019155547/http://www.bbc.com/news/magazine-33099511|archive-date=19 October 2015}}{{cite web|url=https://www.bbc.com/news/world-us-canada-33011821|work=BBC News|title=Survivor of Canada's residential schools talks about abuse|date=5 June 2015|url-status=live|archive-url=https://web.archive.org/web/20151018153926/http://www.bbc.com/news/world-us-canada-33011821|archive-date=18 October 2015}}{{Cite news|url=https://www.theguardian.com/world/2015/jun/06/canada-dark-of-history-residential-schools|title=Canada confronts its dark history of abuse in residential schools|date=6 June 2015|author=Paquin, Mali Ilse|journal=The Guardian|url-status=live|archive-url=https://web.archive.org/web/20170121130552/https://www.theguardian.com/world/2015/jun/06/canada-dark-of-history-residential-schools|archive-date=21 January 2017}}{{Cite news|url=https://www.bbc.com/news/magazine-33001425|title=Survivors of Canada's 'cultural genocide' still healing|author=Luxen, Micah|journal=BBC News|date=4 June 2015|url-status=live|archive-url=https://web.archive.org/web/20160725181119/http://www.bbc.com/news/magazine-33001425|archive-date=25 July 2016}}{{cite web|url=http://news.bbc.co.uk/2/hi/7447811.stm|title=Canada apology for native schools|date=11 June 2008|work=BBC News|url-status=live|archive-url=https://web.archive.org/web/20151118130805/http://news.bbc.co.uk/2/hi/7447811.stm|archive-date=18 November 2015}} As part of the persecution of Uyghurs in China, in 2017 alone at least half a million children were also forcefully separated from their families, and placed in pre-school camps with prison-style surveillance systems and 10,000 volt electric fences.{{Cite news |url=https://www.bbc.com/news/world-asia-china-48825090 |title=China separating Muslim children from families |access-date=5 July 2019 |archive-url=https://web.archive.org/web/20190705043103/https://www.bbc.com/news/world-asia-china-48825090 |archive-date=5 July 2019 |url-status=live |work=BBC News |date=4 July 2019 |last1=Sudworth |first1=John }}

{{Main|Child harvesting}}

It is speculated that, for-profit orphanages are increasing and push for children to join even though demographic data show that even the poorest extended families usually take in children whose parents have died and it would be cheaper to aid close relatives who want to take in the orphans. Experts maintain that separating children from their families often harm children's development.{{Cite news|url=https://www.nytimes.com/2009/12/06/world/africa/06orphans.html|title=Aid Gives Alternative to African Orphanages|first=Celia W.|last=Dugger|newspaper=The New York Times|date=5 December 2009}} Adoption fees result in such orphanages and similar networks such as "baby factories" in Nigeria coercing or abducting and raping women to sell their babies for adoption.{{Cite news |url=https://www.bbc.com/news/world-africa-43905606|title=Nigeria 'baby factory' raided in Lagos|date=26 April 2018|access-date=5 December 2023|work=BBC News}}{{Cite news |url=https://www.bbc.com/news/world-africa-19718084|title=Nigerian's battle to keep her baby|date=26 September 2012|access-date=5 December 2023|work=BBC News}} During the One Child Policy in China, when women were only allowed to have one child, local governments would often allow the woman to give birth and then they would take the baby away. Child traffickers, often paid by the government, would sell the children to orphanages that would arrange international adoptions worth tens of thousands of dollars, turning a profit for the government.{{cite web|url=https://www.youtube.com/watch?v=RdkHA_-xryk| archive-url=https://ghostarchive.org/varchive/youtube/20211029/RdkHA_-xryk| archive-date=2021-10-29|title='One Child Nation' Exposes the Tragic Consequences of Chinese Population Control|work=Reason TV|date=2019-08-16}}{{cbignore}}

{{Main|Infanticide}}

{{see also|Child abandonment|Baby farm}}

Under natural conditions, mortality rates for girls under five are slightly lower than boys for biological reasons. However, after birth, neglect and diverting resources to male children can lead to some countries having a skewed ratio with more boys than girls, with such practices killing an approximate 230,000 girls under five in India each year.{{cite news|url=https://www.theguardian.com/global-development/2018/may/15/discrimination-deaths-girls-under-five-india-lancet-study|title=Discrimination kills 230,000 girls under five in India each year, study shows |date=15 May 2018|access-date=20 August 2018|work=The Guardian}} While sex-selective abortion is more common among the higher income population, who can access medical technology, abuse after birth, such as infanticide and abandonment, is more common among the lower income population.{{cite web|author=Mariya Karimjee |url=http://america.aljazeera.com/articles/2014/1/14/infanticides-on-theriseinpakistan.html |title=Infanticide is on the rise in Pakistan | Al Jazeera America |publisher=America.aljazeera.com |date=14 January 2014 |access-date=18 February 2014}} Baby farming is practice of accepting custody of a child in exchange for payment. As it became profitable, baby 'farmers' would neglect or murder the babies to keep costs down. Illegitimacy and its attendant social stigma were usually the impetus for a mother's decision to give her child to a baby farmer. Methods proposed to deal with the issue are baby hatches to drop off unwanted babies and safe-haven laws, which decriminalize abandoning babies unharmed.{{cite news|url=https://www.theatlantic.com/international/archive/2012/05/trash-bin-babies-indias-female-infanticide-crisis/257672/|title=Trash Bin Babies: India's Female Infanticide Crisis|author=RANJANI IYER MOHANTY|date=25 May 2012|work=The Atlantic|access-date=29 April 2019}}

{{See also|Female genital mutilation|Labia stretching|Breast ironing}}

File:FGM prevalence UNICEF 2016.svg){{cite web |url=http://www.unicef.org/media/files/FGMC_2016_brochure_final_UNICEF_SPREAD.pdf |title=Female Genital Mutilation/Cutting: A Global Concern |location=New York |publisher=United Nations Children's Fund |date=2016 |access-date=2020-12-26 |archive-date=2017-02-10 |archive-url=https://web.archive.org/web/20170210071422/http://www.unicef.org/media/files/FGMC_2016_brochure_final_UNICEF_SPREAD.pdf }}]]

Female genital mutilation (FGM) is defined by the World Health Organization (WHO) as "all procedures that involve partial or total removal of the external female genitalia, or other injury to the female genital organs for non-medical reasons."{{cite web|url=https://www.who.int/mediacentre/factsheets/fs241/en/|title=WHO – Female genital mutilation|publisher=WHO|access-date=28 June 2016|date=February 2016|url-status=live|archive-url=https://web.archive.org/web/20160628070619/http://www.who.int/mediacentre/factsheets/fs241/en/|archive-date=28 June 2016}} It is practiced mainly in 28 countries in Africa, and in parts of Asia and the Middle East.{{cite web|url=http://www.lightfoot-klein.com/|title=Prisoners of Ritual, An Odyssey into Female Genital Mutilation in Africa|publisher=Hanny Lightfoot-Klein|access-date=28 August 2014|url-status=live|archive-url=https://web.archive.org/web/20140821014602/http://www.lightfoot-klein.com/|archive-date=21 August 2014}}[http://whqlibdoc.who.int/hq/2011/WHO_RHR_11.18_eng.pdf "An update on WHO's work on female genital mutilation (FGM)"] {{webarchive|url=https://web.archive.org/web/20130701052551/http://whqlibdoc.who.int/hq/2011/WHO_RHR_11.18_eng.pdf |date=1 July 2013 }}, World Health Organization, 2011, p. 2: "Most women who have experienced FGM live in one of the 28 countries in Africa and the Middle East – nearly half of them in just two countries: Egypt and Ethiopia. Countries in which FGM has been documented include: Benin, Burkina Faso, Cameroon, Central African Republic, Chad, Cote d'Ivoire, Djibouti, Egypt, Eritrea, Ethiopia, Gambia, Ghana, Guinea, Guinea-Bissau, Kenya, Liberia, Mali, Mauritania, Niger, Nigeria, Senegal, Sierra Leone, Somalia, Sudan, Togo, Uganda, United Republic of Tanzania and Yemen. The prevalence of FGM ranges from 0.6% to 98% of the female population."

• Rahman, Anika and Toubia, Nahid. Female Genital Mutilation: A Guide to Laws and Policies Worldwide. Zed Books, 2000 (hereafter Rahman and Toubia 2000), p. 7: "Currently, FC/FGM is practiced in 28 African countries in the sub-Saharan and Northeastern regions."
• Also see [http://whqlibdoc.who.int/publications/2008/9789241596442_eng.pdf "Eliminating Female Genital Mutilation"] {{webarchive|url=https://web.archive.org/web/20130810080948/http://whqlibdoc.who.int/publications/2008/9789241596442_eng.pdf |date=10 August 2013 }}, World Health Organization, 2008, p. 4: "Types I, II and III female genital mutilation have been documented in 28 countries in Africa and in a few countries in Asia and the Middle East." FGM is mostly found in a geographical area ranging across Africa, from east to west – from Somalia to Senegal, and from north to south – from Egypt to Tanzania.{{cite web|archive-url=https://web.archive.org/web/20131014151512/http://www.polisci.ucsd.edu/~gmackie/documents/UNICEF.pdf|url=http://www.polisci.ucsd.edu/~gmackie/documents/UNICEF.pdf|archive-date=14 October 2013|title=Social dynamics of abandonment of harmful practices: a new look at the theory|publisher=UNICEF Innocenti Research Centre|author1=John LeJeune |author2=Gerry Mackie }} FGM is most often carried out on young girls aged between infancy and 15 years. FGM is classified into four types, of which type 3 – infibulation – is the most extreme form. The consequences of FGM include physical, emotional and sexual problems, and include serious risks during childbirth.{{cite web|url=https://www.who.int/mediacentre/news/releases/2006/pr30/en/|title=WHO – New study shows female genital mutilation exposes women and babies to significant risk at childbirth|access-date=5 March 2015|archive-url=https://web.archive.org/web/20150308144033/http://www.who.int/mediacentre/news/releases/2006/pr30/en/|archive-date=8 March 2015}}{{cite web|url=http://www.protectingchildren.org.uk/cp-topics/cultural-themes/female-genital-mutilation/|title=Female genital mutilation|access-date=5 March 2015|archive-url=https://web.archive.org/web/20150402134446/http://www.protectingchildren.org.uk/cp-topics/cultural-themes/female-genital-mutilation/|archive-date=2 April 2015}} The countries which choose to ratify the Istanbul Convention, the first legally binding instrument in Europe in the field of violence against women and domestic violence,{{cite web|title=The Convention of Belém do Pará and the Istanbul Convention: A response to violence against women worldwide|url=https://www.oas.org/es/mesecvi/docs/CSW-SideEvent2014-Flyer-EN.pdf|url-status=live|archive-url=https://web.archive.org/web/20160304093634/https://www.oas.org/es/mesecvi/docs/CSW-SideEvent2014-Flyer-EN.pdf|archive-date=4 March 2016}} are bound by its provisions to ensure that FGM is criminalized.[http://conventions.coe.int/Treaty/EN/Treaties/Html/210.htm See Article 38 – Female genital mutilation] {{webarchive|url=https://web.archive.org/web/20150923210455/http://www.conventions.coe.int/Treaty/EN/Treaties/Html/210.htm |date=23 September 2015 }}, [https://rm.coe.int/CoERMPublicCommonSearchServices/DisplayDCTMContent?documentId=090000168008482e page 11] {{webarchive|url=https://web.archive.org/web/20151226111100/https://rm.coe.int/CoERMPublicCommonSearchServices/DisplayDCTMContent?documentId=090000168008482e |date=26 December 2015 }} Labia stretching is the act of lengthening the labia minora and may be initiated in girls from ages 8 to 14 years.{{cite journal|last1=Pérez|first1=Guillermo Martínez|last2=Tomás Aznar|first2=Concepción|last3=Bagnol|first3=Brigitte|date=14 July 2014|title=Labia Minora Elongation and its Implications on the Health of Women: A Systematic Review|journal=International Journal of Sexual Health|volume=26|issue=3|pages=155–171|doi=10.1080/19317611.2013.851139|s2cid=72132133}}

The practice of using hot stones or other implements to flatten the breast tissue of pubescent girls is widespread in Cameroon{{cite web |work=GENDER EMPOWERMENT AND DEVELOPMENT |author1=Rosaline Ngunshi |title=BREAST IRONING… A HARMFUL PRACTICE THAT HAS BEEN SILENCED FOR TOO LONG |url=https://www2.ohchr.org/english/bodies/cedaw/docs/cedaw_crc_contributions/GenderEmpowermentandDevelopment.pdf |access-date=14 February 2019 |date=August 2011}} and exists elsewhere in West Africa as well. It is believed to have come with that diaspora to Britain,{{cite news |last1=Lazareva |first1=Inna |title=Revealed: 'dozens' of girls subjected to breast-ironing in UK |url=https://www.theguardian.com/global-development/2019/jan/26/revealed-dozens-of-girls-subjected-to-breast-ironing-in-uk |access-date=14 February 2019 |work=The Guardian |date=26 January 2019}} where the government declared it a form of child abuse and said that it could be prosecuted under existing assault laws.{{cite news |last1=Lazareva |first1=Inna |title=Breast-ironing: UK government vows to tackle abusive practice |url=https://www.theguardian.com/society/2019/feb/13/breast-ironing-uk-government-vows-to-tackle-abusive-practice |access-date=14 February 2019 |work=The Guardian |date=13 February 2019}}

{{Main|Sexual cleansing}}

A tradition often performed in some regions in Africa involves a man initiating a girl into womanhood by having sex with her, usually after her first period, in a practice known as "sexual cleansing". The rite can last for three days and there is an increased risk of contracting sexually transmitted infections as the ritual requires condoms not be worn.{{cite news|url=https://www.bbc.com/news/magazine-36843769|title=The man hired to have sex with children|author=Ed Butler|date=21 July 2016|work=BBC News|access-date=22 July 2016}}

File:Students of Sultan Razia Girls School in 2002.jpg are common]]

In some parts of the world, girls are strongly discouraged from attending school.{{Cite journal |last1=N. Bell |first1=Ariana |last2=Juvonen |first2=Jaana |date=2020-07-25 |title=Gender Discrimination, Perceived School Unfairness, Depressive Symptoms, and Sleep Duration Among Middle School Girls |url=http://dx.doi.org/10.1111/cdev.13388 |journal=Child Development |volume=91 |issue=6 |pages=1865–1876 |doi=10.1111/cdev.13388 |pmid=32712961 |s2cid=220797745 |issn=0009-3920|url-access=subscription }} They are sometimes attacked by members of the community if they do so.{{cite web | url=https://edition.cnn.com/2012/08/02/world/meast/cnnheroes-jan-afghan-school/index.html | title=Acid attacks, poison: What Afghan girls risk by going to school| date=2 August 2012}}{{cite web | url=https://edition.cnn.com/2012/05/29/world/asia/afghanistan-girls-poisoned/index.html | title=Official: 160 girls poisoned at Afghan school| date=29 May 2012}}{{cite web | url=https://latitude.blogs.nytimes.com/2013/04/25/the-poisoned-girls-of-afghanistan/ | title=The 'Poisoned' Girls of Afghanistan| date=25 April 2013}}{{Cite news | url=https://www.bbc.com/news/world-asia-34186904 | title=Afghan schoolgirls 'poisoning' probed| journal=BBC News| date=8 September 2015}} In parts of South Asia, girls schools are set on fire by vigilante groups.{{cite news | url=https://timesofindia.indiatimes.com/world/pakistan/two-more-girls-schools-burnt-down-in-pakistan/articleshow/65320936.cms | title=Two more girls' schools burnt down in Pakistan – Times of India| website=The Times of India| date=8 August 2018}}{{cite web | url=http://edition.cnn.com/2010/WORLD/asiapcf/11/09/afghanistan.school.torched/index.html | title=Girls' school burned down in Afghanistan, Qurans destroyed}} Such attacks are common in Afghanistan and Pakistan. Notable examples include the kidnapping of hundreds of female students in Chibok in 2014 and Dapchi in 2018.

{{Main|Child marriage}}

{{See also|Money marriage}}

A child marriage is a marriage in which one or both participants are minors, often before the age of puberty. Child marriages are common in many parts of the world, especially in parts of Asia and Africa. The United Nations considers those below the age of 18 years to be incapable of giving valid consent to marriage and therefore regards such marriages as a form of forced marriage; and that marriages under the age of majority have significant potential to constitute a form of child abuse.{{cite web|url=http://www.endvawnow.org/en/articles/614-definition-of-forced-and-child-marriage.html|title=Definition of forced and child marriage|publisher=United Nations Entity for Gender Equality and the Empowerment of Women|access-date=5 March 2015|url-status=live|archive-url=https://web.archive.org/web/20150315070017/http://endvawnow.org/en/articles/614-definition-of-forced-and-child-marriage.html|archive-date=15 March 2015}} In many countries, such practices are lawful or – even where laws prohibit child marriage – often unenforced.{{cite web|title=Forced and early marriage: a focus on central and eastern Europe and former Soviet Union countries with selected laws from other countries|author=Thomas, Cheryl|date=19 June 2009|publisher=United Nations Division for the Advancement of Women; United Nations Economic Commission for Africa|url=https://www.un.org/womenwatch/daw/egm/vaw_legislation_2009/Expert%20Paper%20EGMGPLHP%20_Cheryl%20Thomas%20revised_.pdf|url-status=live|archive-url=https://web.archive.org/web/20150704111936/http://www.un.org/womenwatch/daw/egm/vaw_legislation_2009/Expert%20Paper%20EGMGPLHP%20_Cheryl%20Thomas%20revised_.pdf|archive-date=4 July 2015}} India has more child brides than any other nation, with 40% of the world total.{{Cite magazine|url=https://world.time.com/2013/10/14/india-criticized-for-not-co-sponsoring-u-n-child-bride-resolution/|author=Bhowmick, Nilanjana|title=India Criticized for Not Co-Sponsoring U.N. Child-Bride Resolution|magazine=Time|date=14 October 2013|url-status=live|archive-url=https://web.archive.org/web/20131129083636/http://world.time.com/2013/10/14/india-criticized-for-not-co-sponsoring-u-n-child-bride-resolution/|archive-date=29 November 2013}} The countries with the highest rates of child marriage are: Niger (75%), Central African Republic and Chad (68%), and Bangladesh (66%).{{cite news|url=https://www.usatoday.com/story/news/world/2013/03/08/child-brides-sold/1972905/|title=Child brides around the world sold off like cattle|work=USA Today|date=8 March 2013|url-status=live|archive-url=https://web.archive.org/web/20171010184412/https://www.usatoday.com/story/news/world/2013/03/08/child-brides-sold/1972905/|archive-date=10 October 2017}}

Image:Central Asia political.png.]]

Bride kidnapping, also known as marriage by abduction or marriage by capture, has been practiced around the world and throughout history, and sometimes involves minors. It is still practiced in parts of Central Asia, the Caucasus region, and some African countries. In Ethiopia, marriage by abduction is widespread, and many young girls are kidnapped this way.{{cite news | url=http://news.bbc.co.uk/2/hi/africa/4763185.stm#sa-link_location=story-body&intlink_from_url=https%3A%2F%2Fwww.bbc.com%2Fnews%2Fworld-africa-13681053&intlink_ts=1535080949722-sa | title=Ethiopian girls fear forced marriage| date=14 May 2006}} In most countries, bride kidnapping is considered a criminal offense rather than a valid form of marriage.{{cite web| url=https://womennewsnetwork.net/2015/01/14/truth-about-bride-kidnapping/| title=The truth about bride kidnapping: An insider interview on Chechnya| date=14 January 2015| access-date=21 August 2018| archive-date=18 June 2022| archive-url=https://web.archive.org/web/20220618004449/http://womennewsnetwork.net/2015/01/14/truth-about-bride-kidnapping}} In many cases, the groom also rapes his kidnapped bride, in order to prevent her from returning to her family due to shame.{{Cite news | url=https://www.reuters.com/article/us-kyrgyzstan-women-bride-kidnapping/one-in-five-girls-and-women-kidnapped-for-marriage-in-kyrgyzstan-study-idUSKBN1AH5GI | title=One in five girls and women kidnapped for marriage in Kyrgyzstan| journal=Reuters| date=August 2017}}

Money marriage refers to a marriage where a girl, usually, is married off to a man to settle debts owed by her parents.{{cite news|url=https://www.aljazeera.com/news/2018/09/nigerias-young-daughters-sold-money-wives-180921153424671.html|title=Nigeria's young daughters are sold as 'money wives'|publisher=Al Jazeera|access-date=12 May 2020|date=21 September 2018}}{{cite news|url=https://www.bbc.com/news/av/world-africa-45514154/money-wives-the-nigerian-girls-sold-to-repay-debts|title=Money wives: The Nigerian girls sold to repay debts|publisher=BBC|access-date=12 May 2020|date=17 September 2018}} The female is referred to as a "money wife".{{cite news|url=https://www.france24.com/en/20190906-focus-nigeria-child-brides-girls-money-wives-marriage-forced-labour-rape-debts|title='Money wives': Nigerian girls sold off to settle debts|publisher=France 24|access-date=12 May 2020|date=9 June 2019}}

Sacred prostitution often involves girls being pledged to priests or those of higher castes, such as fetish slaves in West Africa.

{{See also|Witchcraft accusations against children|Witchcraft accusations against children in Africa|Mingi}}

Customary beliefs in witchcraft are common in many parts of the world, even among the educated. Anthropologists have argued that those with disabilities are often viewed as bad omens as raising a child with a disability in such communities are an insurmountable hurdle.{{cite news|url=https://foreignpolicy.com/2018/04/09/the-right-to-kill-brazil-infanticide/|title=The Right to Kill|date=9 April 2018|access-date=9 June 2018|work=Foreign Policy}} For example, in southern Ethiopia, children with physical abnormalities are considered to be ritually impure or mingi, the latter are believed to exert an evil influence upon others, so disabled infants have traditionally been disposed of without a proper burial.{{cite book|last=Petros|first=Gezahegn|title=The Karo of the lower Omo Valley: subsistence, social organisation and relations with neighbouring groups|year=2000|publisher=Dept. of Sociology, Anthropology and Social Administration, Addis Ababa University|page=57|url=https://books.google.com/books?id=bE0wAQAAIAAJ|url-status=live|archive-url=https://web.archive.org/web/20151017033609/https://books.google.com/books?id=bE0wAQAAIAAJ|archive-date=17 October 2015}} A 2010 UNICEF report notes that accusations against children are a recent phenomenon with women and the elderly usually being accused 10–20 years ago. Greater urbanization and the growing economic burden of raising children is attributed as a factor.[https://www.bbc.co.uk/news/world-africa-10671790 "Rise in African children accused of witchcraft".] {{webarchive|url=https://web.archive.org/web/20130616233238/http://www.bbc.co.uk/news/world-africa-10671790 |date=16 June 2013 }} BBC News, 17 July 2010.{{cite web |url=http://www.unicef.org/infobycountry/nigeria_55301.html |title=Cases of children accused of 'witchcraft' rising in parts of West and Central Africa |date=28 July 2010 |publisher=UNICEF |access-date=5 March 2015 |url-status=live |archive-url=https://web.archive.org/web/20150402162015/http://www.unicef.org/infobycountry/nigeria_55301.html |archive-date=2 April 2015 }} {{as of|2006}}, between 25,000 and 50,000 children in Kinshasa, Democratic Republic of the Congo, had been accused of witchcraft and abandoned.Dowden, Richard (12 February 2006). [https://www.theguardian.com/world/2006/feb/12/theobserver.worldnews11 "Thousands of child 'witches' turned on to the streets to starve"] {{webarchive|url=https://web.archive.org/web/20161115052631/https://www.theguardian.com/world/2006/feb/12/theobserver.worldnews11 |date=15 November 2016 }}. The Observer (London). In Malawi it is common practice to accuse children of witchcraft and many children have been abandoned, abused and even killed as a result.Byrne, Carrie (16 June 2011). [http://www.consultancyafrica.com/index.php?option=com_content&view=article&id=783:hunting-the-vulnerable-witchcraft-and-the-law-in-malawi&catid=91:rights-in-focus&Itemid=296 "Hunting the vulnerable: Witchcraft and the law in Malawi"] {{webarchive|url=https://web.archive.org/web/20120329233740/http://www.consultancyafrica.com/index.php?option=com_content&view=article&id=783:hunting-the-vulnerable-witchcraft-and-the-law-in-malawi&catid=91:rights-in-focus&Itemid=296 |date=29 March 2012 }}. Consultancy Africa Intelligence. In the Nigerian, Akwa Ibom State and Cross River State about 15,000 children were branded as witches.[http://www.cnn.com/2009/WORLD/africa/05/18/nigeria.child.witchcraft/index.html "Abuse of child 'witches' on rise, aid group says"] {{webarchive|url=https://web.archive.org/web/20121106012011/http://www.cnn.com/2009/WORLD/africa/05/18/nigeria.child.witchcraft/index.html |date=6 November 2012 }}. CNN. 18 May 2009. This practice is also found in communities in the Amazon. Children who are specifically at risk include orphans, street-children, albinos, disabled children, children who are unusually gifted, children who were born prematurely or in unusual positions, twins,{{cite web |url=http://www.irinnews.org/report/89858/rights-child-witchcraft-allegations-on-the-rise |title=Child witchcraft allegations on the rise – Angola – Benin – DRC – Central African Republic – Cameroon – Gabon – Nigeria – Chad – Children – Education – Gender Issues – Human Rights – Urban Risk |agency=IRINnews |access-date=5 March 2015 |url-status=live |archive-url=https://web.archive.org/web/20150205090303/http://www.irinnews.org/report/89858/rights-child-witchcraft-allegations-on-the-rise |archive-date=5 February 2015 |date=15 July 2010 }} children of single mothers and children who express gender identity issues and can involve children as young as eight. Consequently, those accused of being a witch are ostracized and subjected to punishment, torture and even murdered,Mbiti, John 1975. Introduction to African Religion (2nd rev. ed.). Oxford: Heinemann: 117–118, 165.Moreau, A. Scott 1990. The World of the Spirits: A Bible Study in the African Context. Nairobi: Evangel, p. 116. often by being buried alive or left to starve. Reports by UNICEF, UNHCR, Save The Children and Human Rights Watch have highlighted the violence and abuse towards children accused of witchcraft in Africa.Bussien, Nathaly et al. 2011. Breaking the spell: Responding to witchcraft accusations against children, in New Issues in refugee Research (197). Geneva, Switzerland: UNHCRCimpric, Aleksandra 2010. Children accused of witchcraft, An anthropological study of contemporary practices in Africa. Dakar, Senegal: UNICEF WCAROMolina, Javier Aguilar 2006. The Invention of Child Witches in the Democratic Republic of Congo, Social cleansing, religious commerce and the difficulties of being a parent in an urban culture. London: Save the ChildrenHuman Rights Watch 2006. Children in the DRC. Human Rights Watch report, 18 (2)

One of the most challenging ethical dilemmas arising from child abuse relates to the parental rights of abusive parents or caretakers with regard to their children, particularly in medical settings.{{cite journal | author = Appel JM | title = Mixed motives, mixed outcomes when accused parents won't agree to withdraw care | journal = Journal of Medical Ethics | volume = 35 | issue = 10 | pages = 635–7 | date = October 2009 | pmid = 19793945 | doi = 10.1136/jme.2009.030510 | s2cid = 36455495 | url = http://jme.bmj.com/content/35/10.toc | access-date = 2 June 2022 | archive-date = 30 December 2013 | archive-url = https://web.archive.org/web/20131230050415/http://jme.bmj.com/content/35/10.toc | url-access = subscription }} In the United States, the 2008 New Hampshire case of Andrew Bedner drew attention to this legal and moral conundrum. Bedner, accused of severely injuring his infant daughter, sued for the right to determine whether or not she remain on life support; keeping her alive, which would have prevented a murder charge, created a motive for Bedner to act that conflicted with the apparent interests of his child."Springfield man denies charges in infant assault", Rutland Herald, New Hampshire, 5 August 2008.[http://www.wcax.com/Global/story.asp?S=9711115 "Springfield Father Charged with Baby's Murder"] {{webarchive|url=https://web.archive.org/web/20120406101346/http://www.wcax.com/Global/story.asp?S=9711115 |date=6 April 2012 }}, WCAX.com, Vermont, 21 January 2009. Bioethicists Jacob M. Appel and Thaddeus Mason Pope recently argued, in separate articles, that such cases justify the replacement of the accused parent with an alternative decision-maker.[http://medicalfutility.blogspot.com/2009/10/withdrawal-okay-when-surrogates-refusal.html "Withdrawal Okay When Surrogate's Refusal to Consent Based on Wrong Reasons"] {{webarchive|url=https://web.archive.org/web/20110708052809/http://medicalfutility.blogspot.com/2009/10/withdrawal-okay-when-surrogates-refusal.html |date=8 July 2011 }}, Medical Futility (blog).

Child abuse also poses ethical concerns related to confidentiality, as victims may be physically or psychologically unable to report abuse to authorities. Accordingly, many jurisdictions and professional bodies have made exceptions to standard requirements for confidentiality and legal privileges in instances of child abuse. Medical professionals, including doctors, therapists, and other mental health workers typically owe a duty of confidentiality to their patients and clients, either by law or the standards of professional ethics, and cannot disclose personal information without the consent of the individual concerned. This duty conflicts with an ethical obligation to protect children from preventable harm. Accordingly, confidentiality is often waived when these professionals have a good faith suspicion that child abuse or neglect has occurred or is likely to occur and make a report to local child protection authorities. This exception allows professionals to breach confidentiality and make a report even when children or their parents or guardians have specifically instructed to the contrary. Child abuse is also a common exception to physician–patient privilege: a medical professional may be called upon to testify in court as to otherwise privileged evidence about suspected child abuse despite the wishes of children or their families.{{cite web|last=National Center for Youth Law |title=Minor Consent, Confidentiality, and Child Abuse Reporting |url=http://www.youthlaw.org/publications/minor_consent/ |access-date=29 December 2010 |archive-url=https://web.archive.org/web/20101215152122/http://www.youthlaw.org/publications/minor_consent |archive-date=15 December 2010 }} Some child abuse policies in Western countries have been criticized both by some conservatives, who claim such policies unduly interfere in the privacy of the family, and by some feminists of the left wing, who claim such policies disproportionally target and punish disadvantaged women who are often themselves in vulnerable positions.{{Cite journal |url=https://www.academia.edu/3555098 |title=Marxist and feminist critiques of child protection: To protect children or to change society? |journal=Children Australia |volume=24 |issue=2 |pages=27–31 |access-date=24 August 2016 |url-status=live |archive-url=https://web.archive.org/web/20171106031622/http://www.academia.edu/3555098/Marxist_and_Feminist_critiques_of_Child_Protection_To_Protect_Children_or_to_Change_Society_By_Philip_Mendes_published_in_Children_Australia_24_2_1999_27-31 |archive-date=6 November 2017 |last1=Mendes |first1=Philip |doi=10.1017/S103507720000910X |year=1999 |s2cid=147579145 }} There has also been concern that ethnic minority families are disproportionally targeted.{{Cite web|url=https://www.wnyc.org/story/role-drugs-child-removal-cases-new-jersey/|title=When Race and Drugs Intersect, Children More Likely to Enter Foster Care | WNYC | New York Public Radio, Podcasts, Live Streaming Radio, News|website=WNYC}}{{cite news|url=https://nationalpost.com/news/canada/a-lost-tribe-child-welfare-system-accused-of-repeating-residential-school-history-sapping-aboriginal-kids-from-their-homes|title='A lost tribe': Child welfare system accused of repeating residential school history|newspaper=Nationalpost|date=15 December 2014}}

Laws and legislation against child abuse are enacted on the provincial and Federal Territories level. Investigations into child abuse are handled by Provincial and Territorial Authorities through government social service departments and enforcement is through local police and courts.{{Cite web|url=https://cwrp.ca/frequently-asked-questions-faqs|title=Frequently Asked Questions (FAQs) | Canadian Child Welfare Research Portal|website=cwrp.ca}}

In Germany, the abuse of vulnerable persons (including children) is punishable according to the German Criminal code § 225 with a from 6 months to 10 years, in aggravated cases at least 1 year (to 15 years pursuant to § 38). If the case is only an attempt, the penalty can be lower (§ 23). However, crimes against children must be prosecuted within 10 years (in aggravated cases 20 years) of the victims reaching 30 years of age (§ 78b and § 78).{{Cite news|url=https://www.reuters.com/article/us-germany-chile-sect-idUSBRE8480MN20120509|title=Insight: German sect victims seek escape from Chilean nightmare past|date=2012-05-09|work=Reuters|access-date=2019-09-06|language=en}}

As of 2020, Germany and the Netherlands are 2 out of all 27 EU countries that do not have any reporting obligations for civilians or professionals. There is no mandatory reporting law, which would grant reporters of child abuse anonymity and immunity.{{Cite web |url=https://www.gesetze-im-internet.de/sgb_8/__8a.html |title=§ 8a SGB 8 – Einzelnorm |date=n.d. |website=www.gesetze-im-internet.de |access-date=2020-04-04}}

In the 1960s, mandatory reporting in the United States was introduced and had been adopted in some form by all 50 states by 1970.{{cite report |title = Australian Institute of Family Studies Submission to the Special Commission of Inquiry into Child Protection Services in NSW|publisher = Australian Institute of Family Studies|last1 = Bromfield|first1 = Leah|last2 = Holzer|first2 = Prue|citeseerx = 10.1.1.385.2444|publication-place=Melbourne, Vic}}{{Cite book |author=Nelson, Barbara J. |title=Making an issue of child abuse: political agenda setting for social problems |date=2000 |publisher=University of Chicago Press |isbn=0-226-57201-3 |oclc=443652284}}{{rp|3}}

In 1974, the Child Abuse Prevention and Treatment Act (CAPTA) was introduced and began an upswing in reported child sexual abuse cases which lasted until the 1990s.{{Cite journal |last=Weatherred |first=Jane Long |date=2015-01-02 |title=Child Sexual Abuse and the Media: A Literature Review |journal=Journal of Child Sexual Abuse |volume=24 |issue=1 |pages=16–34 |doi=10.1080/10538712.2015.976302 |issn=1053-8712 |pmid=25635896|s2cid=38230484 }} The Child Abuse Victims Rights Act of 1986 gave victims of child abuse the ability to file lawsuits against abuse perpetrators and their employers after the statute of limitations had expired. The Victims of Child Abuse Act of 1990 further gave victims of abuse capacity to press charges by permitting the court to assign lawyers to advise, act in the best interest of, and elevate the voices of child victims of abuse.{{Cite journal |last=Raeder |first=Myrna |date=2009 |title=ENHANCING THE LEGAL PROFESSION'S RESPONSE TO VICTIMS OF CHILD ABUSE |url=https://www.improvechildrep.org/Portals/0/PDF/Raeder_24%20Crim.%20Just.%2012.pdf |journal=Crim. Just. |volume=24 |issue=12 |via=US Department of Justice |access-date=12 September 2022 |archive-date=12 September 2022 |archive-url=https://web.archive.org/web/20220912194018/https://www.improvechildrep.org/Portals/0/PDF/Raeder_24%20Crim.%20Just.%2012.pdf }} The Adoption and Safe Families Act (1997) followed, shifting emphasis away from court-sanctioned reunification of families to giving parents or guardians time-bound opportunities for rehabilitation prior to making long term plans for children.{{Cite journal |last1=Zeanah |first1=Charles H. |last2=Humphreys |first2=Kathryn L. |date=2018-09-01 |title=Child Abuse and Neglect |journal=Journal of the American Academy of Child & Adolescent Psychiatry |language=en |volume=57 |issue=9 |pages=637–644 |doi=10.1016/j.jaac.2018.06.007 |pmid=30196867 |pmc=6615750 |issn=0890-8567}} Child Abuse Reform and Enforcement Act was enacted in 2000 to further reduce the incidence of child abuse and neglect.

Shifting legislative focus more heavily towards sexual abuse and exploitation of children, Adam Walsh Child Protection and Safety Act was passed in 2006 to increase penalties and registration for child sexual abuse, exploitation, and transportation crimes. top Exploitation Through Trafficking Act passed in 2013 aimed at preventing the prosecution of sexually exploited youth being sex trafficked, redirecting abused and exploited youth from the criminal justice system to the child welfare system.{{Cite journal |last1=Shields |first1=Ryan T. |last2=Letourneau |first2=Elizabeth J. |date=2015-02-06 |title=Commercial Sexual Exploitation of Children and the Emergence of Safe Harbor Legislation: Implications for Policy and Practice |journal=Current Psychiatry Reports |language=en |volume=17 |issue=3 |page=11 |doi=10.1007/s11920-015-0553-5 |pmid=25652252 |s2cid=40099203 |issn=1535-1645}}{{Cite journal |last1=Barnert |first1=Elizabeth S. |last2=Abrams |first2=Susan |last3=Azzi |first3=Veronica F. |last4=Ryan |first4=Gery |last5=Brook |first5=Robert |last6=Chung |first6=Paul J. |date=2016-01-01 |title=Identifying best practices for "Safe Harbor" legislation to protect child sex trafficking victims: Decriminalization alone is not sufficient |url=https://www.sciencedirect.com/science/article/pii/S0145213415003609 |journal=Child Abuse & Neglect |language=en |volume=51 |pages=249–262 |doi=10.1016/j.chiabu.2015.10.002 |pmid=26520827 |issn=0145-2134|url-access=subscription }} This and other laws redirecting victims of child sex trafficking to the child welfare system are known as "Safe Harbor" laws.

{{as of|2019|April|}}, 18 states had legislation requiring that mandated reporters report based on suspicion of child abuse of neglect.{{Cite web|last=Child Welfare Information Gateway|date=April 2019|title=Mandatory Reporters of Child Abuse and Neglect|url=https://www.childwelfare.gov/pubPDFs/manda.pdf}}

There are organizations at national, state, and county levels in the United States that provide community leadership in preventing child abuse and neglect.

Mary Ellen Wilson, also called Mary Ellen McCormack, was an American whose case of child abuse, the first documented case of child abuse in the United States,{{cite book

|vauthors=Regoli RM, Hewitt JD, DeLisi M

| title = Delinquency in Society

| publisher = Jones & Bartlett Learning

| edition = 9th

| date = 2014

| location = Burlington, MA

| page = 7

| url = https://books.google.com/books?id=63BbYdRJt7YC

| isbn = 978-1-4496-4549-6

| quote = The 1874 case of Mary Ellen Wilson is generally regarded as the first documented child abuse case in the United States.}} led to the creation of the New York Society for the Prevention of Cruelty to Children, which was incorporated in 1875.{{cite news |title=Case Shined First Light on Abuse of Children |url=https://www.nytimes.com/2009/12/15/health/15abus.html |quote=In fact, though, the quotation is from the 1874 case of Mary Ellen McCormack, below, a self-possessed 10-year-old who lived on West 41st Street, in the Hell's Kitchen section of Manhattan. It was Mary Ellen who finally put a human face on child abuse — and prompted a reformers' crusade to prevent it and to protect its victims, an effort that continues to this day. |work=New York Times |date=December 14, 2009 |access-date=2009-12-15 | first1=Howard | last1=Markel}}{{cite web|title=The Response|publisher=New York Society for the Prevention of Cruelty to Children|url=http://www.nyspcc.org/nyspcc/history/the_response/|archive-url=https://web.archive.org/web/20091012024341/http://www.nyspcc.org/nyspcc/history/the_response/|archive-date=2009-10-12}} It was the world's first child protective agency.🖉{{Cite web|url=https://www.prweb.com/releases/the-new-york-society-for-the-prevention-of-cruelty-to-children-elects-shane-foley-lilian-yang-and-mikal-finkelstein-as-new-members-of-its-board-of-directors-870755601.html|title=The New York Society for the Prevention of Cruelty to Children Elects Shane Foley, Lilian Yang and Mikal Finkelstein as New Members of Its Board of Directors}}

Prevent Child Abuse America,{{Cite web |last= |first= |title=Learn about |url=https://preventchildabuse.org/about-us/ |access-date=2022-04-24 |website=Prevent Child Abuse America |language=en-US}} founded in 1976, operates in 46 states to provide child abuse and neglect protection.{{Cite web |last= |first= |title=Where We Work |url=https://preventchildabuse.org/where-we-work/ |access-date=2022-04-24 |website=Prevent Child Abuse America |language=en-US}}

Founded in 1985, the National Children's Advocacy Center, along with National Children's Alliance, coordinates efforts and sets standards and policy for child advocacy centers across the US and abroad.

The Children's Trust Fund Alliance,{{Cite web |title=About {{!}} CTF Alliance |url=https://ctfalliance.org/about/#open-overlay |access-date=2022-04-24 |website=Children's Trust Fund Alliance}} established in 1989, provides funding support to state level child abuse organisations.

Many investigations into child abuse in the US are handled on the local level by 924{{Cite web |title=Our Story |url=https://www.nationalchildrensalliance.org/our-story/ |access-date=2022-04-24 |website=National Children's Alliance |language=en-US}} child advocacy centers, some of which are distributed among 34{{Cite web |title=History – National Children's Advocacy Center |url=https://www.nationalcac.org/history/ |access-date=2022-04-24 |website=www.nationalcac.org}} other countries.

Other organizations focus on specific prevention strategies. The National Center on Shaken Baby Syndrome focuses its efforts on the specific issue of preventing child abuse that is manifested as shaken baby syndrome.{{cite web|url=https://www.dontshake.org/ |access-date=2020-11-22 |title=National Center on Shaken Baby Syndrome|website=dontshake.org}}

NICHD, also known as the National Institute of Child Health & Human Development is an organization that helps victims of child abuse through one of its branches. Through the Child Development and Behavior (CDB) Branch, NICHD raises awareness efforts by supporting research projects to better understand the short- and long-term impacts of child abuse and neglect. They provide programs and observe National Child Abuse Prevention Month every April since 1984.{{Cite web |title=Strengthening Families & Communities: National Child Abuse Prevention Month |url=https://www.nichd.nih.gov/newsroom/resources/spotlight/041310-strengthening-families-communities |access-date=2022-04-24 |website=National Institute of Child Health and Human Development |date=2 April 2010 |language=en}} The United States Children's Bureau, a federal agency tasked to improve child abuse protection leads activities for the Month, including the release of updated statistics about child abuse and neglect, candlelight vigils, and fundraisers to support prevention activities and treatment for victims. The Bureau also sponsors a "Blue Ribbon Campaign", in which people wear blue ribbons in memory of children who have died from abuse, or in honor of individuals and organizations that have taken important steps to prevent child abuse and neglect.

Charitable organizations exist in each province to assist children and families with abuse. Organizations such as the Canadian Red Cross,{{Cite web|url=https://www.redcross.ca/how-we-help/violence-bullying-and-abuse-prevention/parents/child-abuse|title=Child Abuse – Canadian Red Cross|website=Red Cross Canada|access-date=2 April 2020|archive-date=21 April 2021|archive-url=https://web.archive.org/web/20210421070201/https://www.redcross.ca/how-we-help/violence-bullying-and-abuse-prevention/parents/child-abuse|url-status=dead}} Kids Help Phone,{{Cite web |title=About Kids Help Phone |url=https://kidshelpphone.ca/get-involved/about-us/about-kids-help-phone/ |access-date=2022-04-24 |website=Kids Help Phone |language=en-CA}} and Guardians of the Children Canada,{{Cite web |title=Home - Guardiansofthechildrencanada.com |url=http://guardiansofthechildrencanada.com/ |access-date=2022-04-24 |website=Guardians of the children Canada}} are able to direct people to locally available resources.

{{Portal|Law}}

{{div col|colwidth=22em}}

• Abuse
• Abusive power and control
• Adverse Childhood Experiences
• AMBER Alert
• Bullying
• Child abuse in association football
• Child and family services
• Child sexual abuse
• Child murder
• Child protection
• Cinderella effect
• Complex post-traumatic stress disorder
• Corporal punishment in the home
• Dysfunctional family
• Emotional dysregulation
• Foster Care
• Influence of childhood trauma in psychopathy
• Isolation to facilitate abuse
• Karly's Law
• List of global issues
• National Society for the Prevention of Cruelty to Children
• Narcissistic parent
• Outcry witness
• Parental bullying of children
• Parental narcissistic abuse
• Residential Child Care Community
• School corporal punishment
• Songs about child abuse

{{div col end}}

{{Reflist|colwidth=35em}}

• {{cite book|last=Crosson-Tower |first=C.|title=Understanding Child Abuse and Neglect|year=2008|publisher=Pearson Education|location=Boston, MA|isbn=978-0-205-50326-1|oclc=150902303 |ref=none}}
• {{cite book|last=Finkelhor|first=D.|title=Childhood Victimization: Violence, Crime, and Abuse in the Lives of Young People|location=Oxford; New York|publisher=Oxford University Press|isbn=978-0-19-534285-7|oclc=162501989| url=https://books.google.com/books?id=IOOgAFQdRPwC|page=244|date=19 February 2008 |ref=none}}
• {{cite book |last1=Hefler |first1=Ray E. |last2=Kempe |first2=Ruth S. |title=The Battered Child |date=1987 |publisher=University of Chicago Press |location=Chicago |isbn=9780226326313 |edition=4th rev. & expanded}}
• {{cite book|last=Hoyano|first=L.|author2=Keenan C.|title=Child Abuse: Law and Policy Across Boundaries|year=2007|location=Oxford; New York|publisher=Oxford University Press|isbn=978-0-19-829946-2|oclc=79004390 |ref=none}}
• {{cite book|last=Korbin|first=Jill E.|title=Child abuse and neglect: cross-cultural perspectives|year=1983|publisher=University of California Press|location=Berkeley, CA|isbn=978-0-520-05070-9|oclc=144570871|url=https://archive.org/details/childabuseneglec00jill |ref=none}}
• Miller, Alice (1990). "Thou Shalt Not Be Aware": Society's Betrayal of the Child, in series, Meridian Book[s]. Trans. by Heildegarde and Hunter Hannum. New York: Penguin. x, 329 p. Trans. from the German, titled {{Lang|de|Du sollst nicht merken}}. {{ISBN|0-452-00929-4}} pbk
• {{cite book|last=Turton|first=Jackie|title=Child Abuse, Gender, and Society|publisher=Routledge|location=New York|isbn=978-0-415-36505-5|oclc=144570871| url=https://books.google.com/books?id=FDGaTSUXpdsC|page=161|year=2008 |ref=none}}
• {{cite book |author=Young, Leontine |title=Wednesday's children: A study of child neglect and abuse |url=https://archive.org/details/wednesdayschildryou00youn |url-access=registration |location=New York |publisher=McGraw-Hill |date=1964 |oclc=192177 |ref=none}}
• Hanvey, I., Malovic, A. and Ntontis, E. 2022. [https://doi.org/10.1002/casp.2602 Glass children: The lived experiences of siblings of people with a disability or chronic illness.] Journal of Community & Applied Social Psychology. 32 (5), pp. 936–948.

{{EB1911 poster|Children, Law Relating to|Child abuse}}

{{Commons category}}

• [https://www.who.int/news-room/fact-sheets/detail/child-maltreatment WHO fact sheet on child maltreatment]
• [http://www.unviolencestudy.org/ World Report on Violence Against Children] {{Webarchive|url=https://web.archive.org/web/20160111110523/http://unviolencestudy.org/ |date=11 January 2016 }}, Secretary-General of the United Nations
• [https://preventchildabuse.org/ Prevent Child Abuse America]
• [https://web.archive.org/web/20110708195725/http://www.courthousedogs.com/pdf/KellyBaltimoreCAC.pdf "Cold-nosed Comfort"] (using a service dog to aid child abuse victims), Maryland Lawyer

{{Infants and their care}}

{{Abuse}}

{{Parenting}}

{{Authority control}}

Category:Paraphilias

Abuse

Category:Family therapy

Category:Child welfare

Category:Crimes

Category:Adverse childhood experiences