Chapter 1
How Serious Is Child Abuse in the United States?

How Widespread is Child Abuse?
The National Survey of Family Violence
Neglect
Physical Abuse
Emotional Abuse—is it Serious?

When security expert Gavin de Becker was a child, he lived in Los Angeles with his physically abusive mother. One night, de Becker feared for his sister's safety. He tried to stop his mother from beating her. As he intervened, his sister ran out the door into the street. De Becker followed. He writes:

We stopped at an all-night market and decided to make an anonymous call to the police (“There are two kids loitering around here”). If we didn't give our names to the police, we concluded, they wouldn't be able to take us back home. And it worked just like that. Our ride from the LAPD showed up within a few minutes and took us to jail. They could hardly put a twelve-year-old boy and a fourteen-year-old girl in with hardened criminals (though we might have felt at home), so they put us in our own cell. In the morning, we called our grandfather, who picked us up and took us home. Two kids found bruised and red-eyed and panting at three-thirty in the morning, and nobody asked us a thing. It was as if the police saw these dramas every day, and I know now that they do.³

How Widespread is Child Abuse?

When he grew up, de Becker found out how common child abuse is. Now he works with organizations and families to prevent child abuse. As children, however, he and his sister thought

their home life was normal. Many abuse survivors feel the same way, until they have a chance to observe friends whose homes are quite different. Until then, they assume all families are like theirs.

It is difficult for experts to determine how many cases of child abuse occur in the United States every year. Also, government statistics on child abuse are always two or three years out of date, because the statistics are carefully reviewed before they are released to the public. In 2005 more than 3 million cases of suspected child abuse or neglect were reported to the authorities. This means that about 3 million times, someone called child welfare authorities to report that children were in danger. The number of children in danger, though, is greater than the number of calls. Usually, each call is connected with one family, which may have more than one child. In 2005 the 3 million calls concerned more than 6 million children. The person making the

call may be a child's relative, friend, or neighbor, or even a concerned stranger. Or it might be a mandated reporter—someone who is required by law to report suspected cases of child abuse. Teachers, doctors, nurses, police officers, and social workers are all mandated reporters. So are members of the clergy.

Not every phone call represents a genuine case of abuse. Of the 3 million initial phone calls reporting abuse in the United States in 2005, child welfare investigators confirmed that acts of abuse or neglect had actually occurred in 899,000 cases. In other words, investigators could substantiate less than one-third of the reports that they received. Some phone calls were false reports. Others concerned acts that did not meet the statutory definition for child abuse or neglect. For example, sometimes child welfare agencies receive calls from teenagers who feel their parents are neglectful, even if their parents do provide food, clothing, and shelter. At other times, a call may be the result of a misunderstanding. For example, a neighbor may phone about children who are home alone and may not realize that an adult is actually on the premises.

Finding the Victims

“They almost looked as though they were sleeping. It almost looked like they were cuddled up together for the night.” —Lt. Michael Fleming, commander of the Nassau, New York, homicide squad, after finding three young children dead in their bed after their mother killed them.

Quoted in Fox News.com, “Police Cite Possible Drowning, Poisoning in Deaths of 3 New York Children,” February 25, 2008. www.foxnews.com/printer_friendly_story/0,3566,332390,00.html.

Although many reported cases of child abuse do not meet the legal definition for abuse, there are also many cases of abuse that would meet the definition but are never reported. Most cases of child abuse are not reported by anyone. For this reason, experts believe that the true number of cases each year probably is in the millions.

The National Survey of Family Violence

Since most cases of child abuse are not reported, it is difficult to compile accurate statistics about how many children are actually abused or neglected. Up until the mid-1970s, statistics on violence in American families were based on reports that were made to child welfare agencies, police reports, and reports made by emergency room staff. But those statistics tended to underreport the actual number of abusive incidents. Most of the time, child abuse does not result in the police being called or in a child being taken to the doctor or to an emergency room. Most child abuse occurs behind closed doors, where concerned neighbors or family members are unlikely to see and report it. Most child abuse does not

cause injuries that would be immediately obvious to teachers or child care workers. And the statistics collected by child welfare agencies only concern those cases where children were in enough danger that the state felt it was necessary to intervene. If researchers collect only data on those cases in which outside institutions such as police, child welfare organizations, or hospitals get involved, they end up with data on only the most severe cases of child abuse. They are left with no data about less severe cases.

In 1975 sociologists Richard Gelles and Murray Straus decided to try studying abuse in a new way. They wanted to have a large, national data sample. So they chose to interview people in every state. In addition, they wanted to find a way to collect data about how much abuse is really happening in American families. They did not think they could get that information just from police reports and child welfare agency statistics. They set up a new method. They went door to door, talking to random parents and caregivers in randomly chosen families nationwide. They asked parents and caregivers how they treated their children. They specifically asked about hitting children and about other acts of abuse. They also asked how adults in the family treated each other, which told them whether or not domestic violence was occurring. (In some states, causing a child to witness domestic violence is also considered an act of child abuse.)

It might seem unlikely that a person who abuses children would willingly tell a door-to-door surveyor about the abuse. But Straus and Gelles found that a surprisingly large number of parents and caregivers did tell interviewers about acts of abuse they had committed. Almost all parents admitted sometimes hitting their children as punishment. (Not everyone agrees with Straus and Gelles that hitting or spanking a child as punishment is a form of abuse. Spanking, also sometimes called corporal punishment, does not meet the legal definition for child abuse in most states, unless it becomes severe and extreme.) The family members interviewed by Straus and Gelles also admitted committing acts of severe abuse at times. Straus and Gelles defined extreme violence as including hitting with an object like a hairbrush or belt, kicking, punching, burning, and attacking with

weapons. These sorts of acts would meet the statutory definition for physical abuse in most states.

According to the data gathered by Straus and Gelles, about 2.8 million children are likely to be seriously assaulted each year in the United States. As of the 2000 census, there were 72.3 million children in the United States. If Straus and Gelles are correct, a little less than 4 percent of American children are physically abused annually.

Neglect

Child abuse can take many different forms. The most common form is neglect. More than half of child abuse cases that are investigated by child protective services involve neglect. Neglect is

defined differently in different states. In most states, it means depriving a child of food, clothing, shelter, medical care, or supervision. In twenty-one states, though, failure to educate a child also meets the legal definition for neglect.

Many neglect cases involve parents leaving their children unsupervised, often because the parents do not have child care available when they are working. Another common form of neglect is to expose children to illegal drugs. When a child's mother is a drug user, she may expose her child to drugs unintentionally by taking drugs while she is pregnant or breast-feeding. In some states, cases of prenatal and perinatal (just after birth) exposure to drugs make up a large percentage of the total reported child abuse for that state. In Illinois, for example, 40 percent of reported child abuse cases are reports of drug-exposed newborns.

However, there are also many neglect cases based on failure to feed and clothe children, failure to provide them with needed medical care, or failure to provide them with adequate shelter. New York social worker Marc Parent wrote about handling one such case. He received the following report:

Mother lives alone with her five children—aged 2 yrs to 7 yrs. There is no furniture in the home. Children sleep on the floor and are frequently seen “running wild” in the hallways. The building is very run-down and there are drug dealers on every floor. The children are often seen naked and unsupervised. Unknown if there is food in the home now. Mother just had a baby and the infant appears to be thin and weak.⁴

In a case like this, child protection workers visit the home. They try to determine whether or not there is food in the house, whether or not the children have been fed regularly, whether they have been provided with clothing, and whether they are supervised. They must assess whether the parent is willing and able to care for the children in question. In many cases, parents and caregivers are trying their best to provide for their children. Sometimes they are overwhelmed by financial problems or the stress of caring for several children at once. In these cases, child

What Constitutes Child Abuse?

Different people have different ideas about what constitutes child abuse. Some people consider any corporal punishment of children to be abusive. Others only consider an action abusive if it is particularly harmful or injurious. For the state to intervene in family life, however, an act of abuse must meet the standards that are defined by law. Each state has its own laws defining what constitutes child abuse. In most states, any nonaccidental physical injury to a child is considered to be physical abuse. In fourteen states the law provides an exception for cases of corporal punishment if it is “reasonable” and does not cause an injury.

Neglect is usually defined as deprivation of food, clothing, shelter, medical care, or supervision. Eleven states, though, make exceptions for parents who are financially unable to provide for their children.

Almost all states include emotional abuse in their child abuse statutes. (Only Georgia and Washington do not.) Emotional abuse is usually defined as a psychological or emotional injury that results in anxiety, depression, withdrawal, or aggressive behavior.

Although different states have different laws, each state's laws must meet standards that are set by the federal government. These standards are defined by the Child Abuse Prevention and Treatment Act (CAPTA).

protection workers may be able to direct the family to community resources that can help. For example, they could help a single mother to apply for aid from the Women, Infants, and Children (WIC) program. WIC is a federal program that gives money to states. The money is used to provide food for children under the age of five and their mothers.

In some cases, neglect is caused by mental illness. While working in New York City, Parent also received this report:

Mother believes she and her children are under a hex. Mother is not feeding children because she is afraid of the food. The children are hungry now. Mother is behaving strangely. She is not answering the phone and will not open the door for anyone. Last week Mother reported seeing “strange men” outside of her apartment window.

Mother lives on the 16th floor. There are bizarre sounds coming from the apartment and it is believed that the children are at risk.⁵

When he visited this apartment, Parent and his partner found a single mother who genuinely loved and cared for her children but who was mentally ill. As the social workers talked with her, they discovered that she believed a hex would cause any food she brought into the house to become infested with shards of glass if it was not eaten right away. She was afraid to feed her children because she thought shards of glass were in the food. In that case, child protection workers took

temporary custody of the children, hoping that the children could be reunited with their mother after her mental illness was treated.

Physical Abuse

Neglect can take a physical toll on children. It may leave them malnourished, for example, and can cause developmental delays. But in cases of neglect, parents or caregivers may not actually intend to harm the children. They may simply fail to care for the children. They may not have enough money to buy food or clothes. They may be mentally ill. They might be addicted to alcohol or drugs. Or they may not understand how to care for a very young child.

Reacting to News of Abuse

“My sister's not crazy. She's not ballistic. This is a shock to all of us.” —Robert McCord, reacting to news that his sister, Leatrice Brewer, had killed her three children.

Quoted in Fox News.com, “Police Cite Possible Drowning, Poisoning in Deaths of 3 New York Children,” February 25, 2008. www.foxnews.com/printer_friendly_story/0,3566,332390,00.html.

Nearly a third of child abuse cases, however, involve harm that was done to a child deliberately. In most states, a deliberate, nonaccidental injury to a child is considered physical abuse. Sexual acts forced on a child are always considered abusive, as well, even if they do not result in a visible injury. Thirty-six states also include threats of harm in their definitions for physical abuse. In addition, these states include, as part of their physical abuse definition, taking actions that risk harming a child, even if the child was not actually harmed. For example, forcing a child to sit on the windowsill of a twenty-story building is child abuse, even if the child does not fall and is not physically harmed. (Some states classify this kind of act as child endangerment.)

Physical abuse is less common than neglect, but it is easier for mandated child abuse reporters, such as doctors and nurses, to spot. Doctors and nurses become concerned about physical abuse when they see a child who has a pattern of injuries that have occurred regularly over a period of time. For example, they may see bruises or burns in different parts of the body, all in different stages of healing. When several injuries are all in different stages of healing, a doctor can surmise that the injuries occurred on several different occasions, not all at once.

Doctors can also recognize certain kinds of injuries as more likely than others to be the result of physical abuse. Children often injure themselves in the course of everyday life. But an injury caused by a fall, or by playing sports, will usually be located in a part of the body that is frequently exposed and not well protected. For example, typical childhood injuries might be located on the shins, knees, hands, elbows, nose, or forehead. Doctors are more suspicious if they see bruises on

False Accusations

Not all allegations of child abuse turn out to be true. In 2006 child welfare agencies received more than 3 million calls reporting possible cases of child abuse or neglect. Of those 3 million calls, nearly a million were in regard to behavior that is legal and not considered abuse. Of the original 3 million calls, only about 18 percent were found to concern verifiable cases of child abuse.

Every year, there are a few cases that are verified at first but are later discovered not to be true. In April 2003, Steve Smith was accusing of shaking his eleven-month-old, causing brain damage. His wife, Corinne, was shocked. She refused to believe that her husband could have abused their child. She insisted on further testing. The testing revealed that everyone in the family had von Willebrand disease, a disease that reduces blood clotting. People who have this disease can have major bruising and blood loss even from a minor fall. All the charges against Steve Smith were dropped.

the buttocks, thighs, torso, ears, or neck. They suspect child abuse if they see bruises shaped like a hand, belt buckle, electrical cord loop, or other object. Doctors also become suspicious if they find bruises on babies who have not yet learned to walk or to pull up and cruise. Babies that young are unlikely to hurt themselves accidentally.

One type of physical abuse that doctors have become expert at recognizing is shaken baby syndrome. Shaken baby syndrome is damage to a baby that is caused by shaking the baby. Babies who have been shaken tend to appear in the emergency room with bleeding inside their brains and eyes. They often have broken ribs as well. Babies with shaken baby syndrome are usually too young to walk or crawl. They are unlikely to have broken their own ribs or to have shaken their own heads hard enough to have caused internal bleeding. So emergency room workers can quickly figure out what must have happened.

For example, in 2008 doctors in a Summit County, Ohio, emergency room determined that three-month-old Camryn Jakeb Wilson was suffering from shaken baby syndrome. In Camryn's case, his mother, Crystal Wilson, had gone to an Alcoholics Anonymous meeting after arguing with her husband, Craig. Craig stayed home with Camryn. When Crystal arrived home, she found Camryn gasping for air in his baby swing. She rushed him to the emergency room, where he died. Doctors knew Camryn had likely been shaken because he had retinal hemorrhaging (bleeding in his eyes) and hemorrhaging in his brain. He also had broken ribs, some of which were new injuries and some of which were old. The old injuries established a pattern of abuse—someone in Camryn's family had been abusing him regularly.

Emotional Abuse—is it Serious?

When people think about child abuse, they usually think about cases such as Camryn's—shaken baby syndrome, or other forms of physical abuse or neglect. But most states also include emotional abuse in their child abuse laws. Emotional abuse

means failing to meet a child's emotional needs or causing a child to experience psychological damage. All forms of child abuse cause emotional and psychological damage. But some children are abused emotionally without having ever been injured physically.

What is emotional abuse? According to Patricia Leiby, a child abuse prevention coordinator in Frederick County, Maryland, “The child who constantly hears how dumb he is, or that

he can't do it, is emotionally abused.”⁶ Most child abuse experts would probably agree with Leiby's definition. However, for emotional abuse to reach a point that would warrant intervention by state authorities, it must fall within the definition included in the laws of the state. State laws define emotional abuse much more narrowly. Most define it as psychological or emotional damage that leads to the development of a mental disorder such as anxiety or depression.

According to legal scholar J. Robert Shull, psychological abuse can consist of any “imaginative cruelty”⁷ that does not involve physical injury or sexual abuse. Imaginative cruelty does not necessarily mean thinking of more creative but hurtful things to say to a child. It could also involve noninjurious physical acts such as confining a child by locking him or her in a closet or binding the child with ropes or chains. For example, in Lancaster, Pennsylvania, Elsa Speller locked her thirteen-year-old daughter naked in a closet for seventeen hours. She provided a bucket for a toilet but gave the girl no food or water. Patricia Muncy of La Grande, Oregon, chained her thirteen-year-old daughter to a tree for two days.

Psychological injury can also be caused by a pattern of verbally belittling or denigrating a child. (Parents may occasionally, or even regularly, criticize their children without it being considered child abuse, however.) It can mean damaging a child's personal possessions or humiliating the child in front of friends. Or it could involve threatening a child's pet or deliberately hurting or killing a pet while forcing the child to watch. In families that are experiencing domestic violence or spousal abuse, a child might be emotionally injured by being forced to watch his or her mother being hurt or threatened.

Is emotional abuse as serious as physical abuse and neglect? Most child abuse experts consider emotional abuse to be far more damaging—and far more common—than physical abuse. Psychologists James Garbarino, Edna Guttman, and Janis Wilson Seeley write: “Children are resilient, and they can handle parents' normal emotional ebb and flow; what most children typically cannot handle is a pervasive pattern of destructive

emotions or extreme outbursts that threaten their world. Isolated trauma is not nearly so threatening as repeated emotional assault.”⁸

In other words, it is easier for children to recover from the physical damage of an assault that occurs on rare occasions than it is for them to live with constant belittling, name-calling, and intimidation. Unfortunately, many abused children must recover from both.