11 Child Maltreatment
WARNING: This chapter contains information about child abuse, which may be triggering for some readers.
Learning Objectives
By the end of this chapter, you should be able to:
- Define the four types of child maltreatment (physical abuse, emotional abuse, sexual abuse, and neglect).
- Identify risk factors for child maltreatment.
- Discuss protective factors and prevention strategies.
- List signs of each type of maltreatment.
- Explain what mandated reporting is and who it applies to.
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LICENSING REGULATIONS WAC and RCW Regulations that relate to this chapter include:
WAC 110-06-0040 BACKGROUND CLEARANCE REQUIREMENTS
RCW 43.216.270 FINGERPRINT CRIMINAL HISTORY RECORD CHECKS
Mandated Reporter Laws Child care providers are included in the professions that are required to report suspected child maltreatment by the Wash. Rev. Code § 26.44.030. |
Introduction
One more responsibility early childhood educators have to protect children’s safety is to understand what child maltreatment is, risk factors for child maltreatment, signs of different forms of child maltreatment, and what they should do to support children and families and what they must legally do if they suspect child maltreatment.
Looking at the Data
In 2017, there were 674,000 substantiated victims of child abuse and neglect across the U.S. The youngest children are the most vulnerable to maltreatment. Nationally, states report that more than one-quarter (28.5%) of victims are younger than 3 years old. The victimization rate is highest for children younger than 1-year-old at 25.3 per 1,000 children.
The percentages of child victims are similar for both boys (47.2%) and girls (52.5%). Eighty-nine percent of victims are maltreated by a mother acting alone (37.4%), a father acting alone (24.5%), or both parents (19.2%). More than 15.0 percent (15.8%) of victims are maltreated by a perpetrator who was not the child’s parent. The largest categories in the nonparent group are relative (5.8%), unmarried partner of parent (3.7%), and “other” (3.4%).
The effects of child abuse and neglect are serious, and a child fatality is the most tragic consequence. In 2022, a national estimate of 1,990 children died from abuse and neglect at a rate of 2.73 per 100,000 children in the population.[1]
Definitions
Child maltreatment includes all types of abuse and neglect of a child under the age of 18 by a parent, caregiver, or another person in a custodial role (such as clergy, a coach, a teacher) that results in harm, potential for harm, or threat of harm to a child. There are four common types of abuse and neglect: physical abuse, sexual abuse, emotional abuse, and neglect.[2]
Physical Abuse
Physical abuse is a nonaccidental physical injury to a child caused by a parent, caregiver, or other person responsible for a child and can include punching, beating, kicking, biting, shaking, throwing, stabbing, choking, hitting (with a hand, stick, strap, or other object), burning, or otherwise causing physical harm. Physical discipline, such as spanking or paddling, is not considered abuse as long as it is reasonable and causes no bodily injury to the child. Injuries from physical abuse could range from minor bruises to severe fractures or death.
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ABUSIVE HEAD TRAUMA Abusive head trauma (AHT), which includes shaken baby syndrome, is a preventable and severe form of physical child abuse that results in an injury to the brain of a child. AHT is most common in children under age five, with children under one year of age at most risk. It is caused by violent shaking and/or with blunt impact. The resulting injury can cause bleeding around the brain or on the inside back layer of the eyes. Nearly all victims of AHT suffer serious, long-term health consequences such as vision problems, developmental delays, physical disabilities, and hearing loss. At least one of every four babies who experience AHT dies from this form of child abuse. AHT often happens when a parent or caregiver becomes angry or frustrated because of a child’s crying. The caregiver then shakes the child and/or hits or slams the child’s head into something in an effort to stop the crying. Crying, including long bouts of inconsolable crying, is normal behavior in infants. Shaking, throwing, hitting, or hurting a baby is never the right response to crying. How Can Abusive Head Trauma Be Prevented? Anyone can play a role in preventing AHT by understanding the dangers of violently shaking or hitting a baby’s head into something, knowing the risk factors and the triggers for abuse, and finding ways to support families and caregivers in their community.[3] The Bottom Line Shaking a baby can cause death or permanent brain damage. It can result in life-long disability. Healthy strategies for dealing with a crying baby include:
All babies cry. Caregivers often feel overwhelmed by a crying baby. Calling a friend, relative, or neighbor for support or assistance lets the caregiver take a break from the situation. If immediate support is not available, the caregiver could place the baby in a crib (making sure the baby is safe), close the door, and check on the baby every five minutes.[4] If an early childhood educator is growing frustrated with a child’s crying or other behaviors, it’s important that they follow the same advice they would give a parent/caregiver or find a co-worker to relieve them while they calm down. |
Sexual Abuse
Child sexual abuse is a significant but preventable adverse childhood experience and public health problem. Sexual abuse includes activities by a parent or other caregiver such as fondling a child’s genitals, penetration, incest, rape, sodomy, indecent exposure, and exploitation through prostitution or the production of pornographic materials. Sexual abuse is defined by the Federal Child Abuse Prevention and Treatment Act as “the employment, use, persuasion, inducement, enticement, or coercion of any child to engage in, or assist any other person to engage in, any sexually explicit conduct or simulation of such conduct for the purpose of producing a visual depiction of such conduct; or the rape, and in cases of caretaker or interfamilial relationships, statutory rape, molestation, prostitution, or other form of sexual exploitation of children, or incest with children”[5]
About 1 in 4 girls and 1 in 20 boys experience child sexual abuse at some point in childhood. And 90% of child sexual abuse is perpetrated by someone the child or child’s family knows.[6]
Emotional Abuse
Emotional abuse (or psychological abuse) is a pattern of behavior that impairs a child’s emotional development or sense of self-worth. This may include constant criticism, threats, or rejection as well as withholding love, support, or guidance. Emotional abuse is often difficult to prove, and, therefore, child protective services may not be able to intervene without evidence of harm or mental injury to the child (Prevent Child Abuse America, 2016).[7]
Neglect
Neglect is the failure of a parent or other caregiver to provide for a child’s basic needs. Neglect generally includes the following categories:
- Physical (e.g., failure to provide necessary food or shelter, lack of appropriate supervision)
- Medical (e.g., failure to provide necessary medical or mental health treatment, withholding medically indicated treatment from children with life-threatening conditions)
- Educational (e.g., failure to educate a child or attend to special education needs)
- Emotional (e.g., inattention to a child’s emotional needs, failure to provide psychological care, permitting a child to use alcohol or other drugs)
Sometimes cultural values, the standards of care in the community, and poverty may contribute to what is perceived as maltreatment, indicating the family may need information or assistance. It is important to note that living in poverty is not considered child abuse or neglect. However, a family’s failure to use available information and resources to care for their child may put the child’s health or safety at risk, and child welfare intervention could be required. In addition, many states provide an exception to the definition of neglect for parents/caregivers who choose not to seek medical care for their children due to religious beliefs.
Abandonment is considered in many states as a form of neglect. In general, a child is considered to be abandoned when the parent’s identity or whereabouts are unknown, the child has been left alone in circumstances where the child suffers serious harm, the child has been deserted with no regard for his or her health or safety, or the parent has failed to maintain contact with the child or provide reasonable support for a specified period of time. Some states have enacted laws—often called safe haven laws—that provide safe places for parents to relinquish newborn infants.
In Washington State, the Safety of Newborn Children Law allows parents to anonymously leave their baby with a staff person at any hospital, staffed fire station, or rural health clinic without fear of prosecution.[8]
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REFLECTIVE PRACTICE
Come up with a situation that would be an example of each type of abuse and each type of neglect. Keep these in mind to revisit in another Reflective Practice feature later in the chapter. |
Risk Factors
Risk factors are those characteristics linked with child abuse and neglect—they may or may not be direct causes. A combination of individual, relational, community, and societal factors contribute to the risk of child abuse and neglect. Although children are not responsible for the harm inflicted upon them, certain characteristics have been found to increase their risk of being abused and or neglected.
Individual Risk Factors for Victimization
- Children younger than 4 years of age
- Special needs that may increase caregiver burden (e.g., disabilities, mental health issues, and chronic physical illnesses)
Risk Factors for Perpetration
There are different levels of risk factors for the perpetrators of child maltreatment
Individual Risk Factors
- Families’ lack of understanding of children’s needs, child development and parenting skills
- Parental history of child abuse and or neglect
- Substance abuse and/or mental health issues including depression in the family
- Parental characteristics such as young age, low education, single parenthood, a large number of dependent children, and low income
- Nonbiological, transient caregivers in the home (e.g., mother’s male partner)
- Parental thoughts and emotions that tend to support or justify maltreatment behaviors
Family Risk Factors
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Social isolation
- Family disorganization, dissolution, and violence, including intimate partner violence
- Parenting stress, poor parent-child relationships, and negative interactions
Community Risk Factors
Community violence
Concentrated neighborhood disadvantage (e.g., high poverty and residential instability, high unemployment rates, and high density of alcohol outlets), and poor social connections.[9]
Protective Factors
Protective factors may lessen the likelihood of children being abused or neglected. Protective factors have not been studied as extensively or rigorously as risk factors. Identifying and understanding protective factors are equally as important as researching risk factors.
Family Protective Factors
- Supportive family environment and social networks
- Concrete support for basic needs
- Nurturing parenting skills
- Stable family relationships
- Household rules and child monitoring
- Parental employment
- Parental education
- Adequate housing
- Access to health care and social services
- Caring adults outside the family who can serve as role models or mentors
Community Protective Factors
- Communities that support families and take responsibility for preventing abuse[10]
Preventative Strategies
Child abuse and neglect are serious problems that can have lasting harmful effects on its victims. The goal of preventing child abuse and neglect is to stop this violence from happening in the first place.
Child abuse and neglect are complex problems rooted in unhealthy relationships and environments. Preventing child abuse and neglect requires addressing factors at all levels of the social ecology–the individual, relational, community, and societal levels.[11] As you can see in Figure 11.5, early care and education has a direct role to play in one of the National Center for Injury Prevention and Control, Division of Violence Prevention’s strategies and can support families in some of the others. Families who have access to quality childcare, which increases the likelihood that children will experience safe, stable, nurturing relationships and environments. Access to affordable childcare also reduces parental stress and maternal depression, which are risk factors for child abuse and neglect.[12]
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DOMESTIC VIOLENCE
Given the magnitude of the problem of children’s exposure to violence, including the co-occurrence of domestic violence and child maltreatment, early care and education programs are serving children and families impacted by violence. Here are some key facts about domestic violence and intimate partner violence:
Children may very well experience the violence themselves; however, even when they are not directly injured, exposure to traumatic events can cause social, emotional, and behavioral difficulties. Children exposed to domestic violence have often been found to develop a wide range of problems, including externalizing behavior problems, interpersonal skill deficits, and psychological and emotional problems such as depression and post-traumatic stress disorder (PTSD). In addition, a Michigan study of preschool-aged children found that those exposed to domestic violence at home are more likely to have health problems, including allergies, asthma, frequent headaches and stomach-aches, and generalized lethargy.
What Early Care and Education Programs Should Do to Help It is critical that early childhood educators be prepared to work with and guide these children and families to needed services. Teachers and administrators can support the child and family during times of stress by making hotline and other domestic violence information available to families.
The early childhood workforce is currently comprised of about 1 million center-based teachers and caregivers, 1 million home-based teachers and caregivers, and an additional 2.7 million unpaid home-based teachers and caregivers. This workforce consists largely of women, and women are disproportionately affected by domestic violence. Therefore, information about appropriate services and programs should be made available for both staff and families.[13] |
Signs of Child Maltreatment
It is important to recognize high-risk situations and the signs and symptoms of maltreatment. If you suspect a child is being harmed or the child directly discloses that they have experienced abuse or neglect, reporting suspicions may protect him or her and help the family receive assistance. Any concerned person can report suspicions of child abuse or neglect. Reporting your concerns is not making an accusation; rather, it is a request for an investigation and assessment to determine if help is needed.
Table 11.1 – Signs of General Maltreatment[14]
| Child |
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| Parent/Caregiver |
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| Parent/Caregiver and Child |
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It is important to pay attention to other behaviors that may seem unusual or concerning. Additionally, the presence of these signs does not necessarily mean that a child is being maltreated; there may be other causes. They are, however, indicators that others should be concerned about the child’s welfare, particularly when multiple signs are present or they occur repeatedly.
Signs of Specific Forms of Child Maltreatment
Table 11.2 – Signs of Physical Abuse[15]
| Scenario | Characteristics |
| A child who exhibits the following signs may be a victim of physical abuse |
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| Consider the possibility of physical abuse when a parent or other adult caregiver exhibits the following |
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Table 11.3 – Signs of Sexual Abuse[16]
| Scenario | Characteristics |
| A child who exhibits the following signs may be a victim of sexual abuse |
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| Consider the possibility of sexual abuse when a parent or other adult caregiver exhibits the following |
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Table 11.4 – Signs of Emotional Abuse[17]
| Scenario | Characteristics |
| A child who exhibits the following signs may be a victim of emotional abuse |
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| Consider the possibility of emotional abuse when a parent or other adult caregiver exhibits the following |
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Table 11.5 – Signs of Neglect[18]
| Scenario | Characteristics |
| A child who exhibits the following signs may be a victim of neglect |
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| Consider the possibility of neglect when a parent or other adult caregiver exhibits the following |
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Mandated Reporting of Child Maltreatment in Washington
A list of persons whose profession qualifies them as “mandated reporters” of child abuse or neglect is found in Washington Rev. Code § 26.44.030. The list is extensive and continues to grow. It includes all school/district employees, administrators, and athletic coaches. All persons hired into positions included on the list of mandated reporters are required, upon employment, to be provided with a statement, informing them that they are a mandated reporter and their obligations to report suspected cases of abuse and neglect pursuant to Washington Rev. Code § 26.44.030(23).
All persons who are mandated reporters are required, by law, to report all known or suspected cases of child abuse or neglect. It is not the job of the mandated reporter to determine whether the allegations are valid. If child abuse or neglect is reasonably suspected or if the child shares information with a mandated reporter leading him/her to believe abuse or neglect has taken place, the report must be made. No supervisor or administrator can impede or inhibit a report or subject the reporting person to any sanction.
To make a report, an employee must contact appropriate local law enforcement or county child welfare agency, listed below. This legal obligation is not satisfied by making a report of the incident to a supervisor or to the school. An appropriate law enforcement agency can be found using the link below:
- Find your local intake number to report abuse or neglect (https://apps-ca-ext.dcyf.wa.gov/CAOfficesPub/offices/general/OfficePick.asp)
The report should be made immediately over the telephone and should be followed up in writing. The law enforcement agency has special forms for this purpose that they will ask you to complete. If a report cannot be made immediately over the telephone, then an initial report may be made via e-mail or fax.
Rights to Confidentiality and Immunity
Mandated reporters are required to give their names when making a report. However, the reporter’s identity is kept confidential. Reports of suspected child abuse are also confidential. Mandated reporters have immunity from state criminal or civil liability for reporting as required. This is true even if the mandated reporter acquired the knowledge, or suspicion of abuse or neglect, outside his/her professional capacity or scope of employment.
Consequences of Failing to Report
Persons who report in good faith have immunity from liability, while those who fail to report or make a bad faith report may be charged with a gross misdemeanor under RCW 26.44.
After the Report is Made
The local law enforcement agency is required to investigate all reports. Cases may also be investigated by Child Welfare Services when allegations involve abuse or neglect within families.
Child Protective Services
Child Protective Services (CPS) is the major organization to intervene in child abuse and neglect cases in Washington. Existing law provides services to abused and neglected children and their families. More information can be found at Child Protective Services.[19]
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THE IMPACT OF TRAUMA ON WELL-BEING
Child abuse and neglect can have lifelong implications for victims, including on their wellbeing. While the physical wounds may heal, there are many long-term consequences of experiencing the trauma of abuse or neglect. A child or youth’s ability to cope and thrive after trauma is called “resilience.” With help, many of these children can work through and overcome their past experiences.
Children who are maltreated may be at risk of experiencing cognitive delays and emotional difficulties, among other issues, which can affect many aspects of their lives, including their academic outcomes and social skills development (Bick & Nelson, 2016). Experiencing childhood maltreatment also is a risk factor for depression, anxiety, and other psychiatric disorders (FullerThomson, Baird, Dhrodia, & Brennenstuhl, 2016).[20]
We will look more closely at this when we examine mental health, social and emotional well-being, adverse childhood events, and trauma informed care in the next chapters. |
Working with Children that Have Been Abused
Children who have experienced abuse or neglect need support from caring adults who understand the impact of trauma and how to help. Early childhood educators should consider the following suggestions:
- Help children feel safe. Support them in expressing and managing intense emotions. Help children understand their trauma history and current experiences (for example, by helping them understand that what happened was not their fault, or helping them see how their current emotions might be related to past trauma).
- Assess the impact of trauma on the child, and address any trauma-related challenges in the child’s behavior, development, and relationships.
- Support and promote safe and stable relationships in the child’s life, including supporting the child’s family and caregivers if appropriate. Often parents and caregivers have also experienced trauma.
- Manage your own stress. Providers who have histories of trauma themselves may be at particular risk of experiencing secondary trauma symptoms.
- Refer the child to trauma-informed services, which may be more effective than generic services that do not address trauma.[21]
Summary
Child maltreatment results from the interaction of a number of individual, family, societal, and environmental factors. Child abuse and neglect are not inevitable—safe, stable, and nurturing relationships and environments are key for prevention. Preventing child abuse and neglect can also prevent other forms of violence, as various types of violence are interrelated and share many risk and protective factors, consequences, and effective prevention tactics.[22] When there is suspicion that maltreatment has occurred, it’s critical that early childhood educators report that. And being educated on trauma-informed care can help you support children who have been the victims of child maltreatment.
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RESOURCES FOR FURTHER EXPLORATION
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- Child Maltreatment 2022 by the Administration for Children and Families is in the public domain. ↵
- About Child Abuse and Neglect | Child Abuse and Neglect Prevention by CDC is in the public domain. ↵
- About Abusive Head Trauma | Child Abuse and Neglect Prevention by CDC is in the public domain. ↵
- About Abusive Head Trauma | Child Abuse and Neglect Prevention by CDC is in the public domain. ↵
- What is Child Abuse and Neglect? Recognizing the Signs and Symptoms by the Children’s Bureau is in the public domain. ↵
- About Child Sexual Abuse | Child Abuse and Neglect Prevention by the CDC is in the public domain. ↵
- What is Child Abuse and Neglect? Recognizing the Signs and Symptoms by the Children’s Bureau is in the public domain. ↵
- Safety of Newborn Children Law by Washington State Department of Children, Youth, and Families is in the public domain. ↵
- Risk and Protective Factors by the CDC is in the public domain. ↵
- Risk and Protective Factors by the CDC is in the public domain. ↵
- Preventing Child Abuse and Neglect by the CDC is in the public domain. ↵
- About Adverse Childhood Experiences - Prevention by the CDC is in the public domain. ↵
- Helping Children and Families Experiencing Domestic/Intimate Partner Violence ACF-IM-HS-14-06 by the Office of Head Start is in the public domain. ↵
- What is Child Abuse and Neglect? Recognizing the Signs and Symptoms by the Children’s Bureau is in the public domain. ↵
- What is Child Abuse and Neglect? Recognizing the Signs and Symptoms by the Children’s Bureau is in the public domain. ↵
- What is Child Abuse and Neglect? Recognizing the Signs and Symptoms by the Children’s Bureau is in the public domain. ↵
- What is Child Abuse and Neglect? Recognizing the Signs and Symptoms by the Children’s Bureau is in the public domain. ↵
- What is Child Abuse and Neglect? Recognizing the Signs and Symptoms by the Children’s Bureau is in the public domain. ↵
- Child Protective Services by the Washington State Department of Children, Youth, and Families is in the public domain. ↵
- What is Child Abuse and Neglect? Recognizing the Signs and Symptoms by the Children’s Bureau is in the public domain. ↵
- 2018 Prevention Resource Guide by the Administration for Children and Families is in the public domain. ↵
- About Child Abuse and Neglect by the CDC is in the public domain. ↵