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Child Abuse and Prevention

Child abuse is the physical, sexual or emotional mistreatment or neglect of a child.   Child abuse has been defined as any act or series of acts of commission or omission by a parent or other caregiver that results in harm, potential for harm, or threat of harm to a child. Child maltreatment can occur in a child's home, or in the organizations, schools or communities the child interacts with. There are four major categories of child abuse: physical abuse, psychological or emotional abuse, sexual abuse and neglect.  
Physical Abuse involves physical aggression directed at a child by an adult. In most states with child-abuse laws, physical aggression towards a child or putting a child at risk for serious injury or death is illegal.  Physical abuse is the intentional or non-accidental act which causes physical injury. Bruises, scratches, burns, broken bones, lacerations, as well as repeated “mishaps,” and rough treatment that could cause physical injury, are often seen as the result of physical abuse. Beyond this, there is considerable variation. The distinction between child discipline and abuse is often poorly defined; cultural norms about what constitutes abuse vary widely. 

Child Sexual Abuse (CSA) is a form of child abuse in which an adult or older adolescent abuses a child for sexual stimulation. 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. 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.  Child sexual abuse is also illegal. 

The effects of child sexual abuse 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 issues, sexual dysfunction, chronic pain, addiction, self-injury, suicidal ideation, somatic complaints, depression, post-traumatic stress disorder,  anxiety, other mental illnesses including borderline personality disorder and dissociative identity disorder, propensity to re-victimization in adulthood, and bulimia nervosa, among other problems.

Studies indicate that in the United States, approximately 15% to 25% of women and 5% to 15% of men were sexually abused when they were children. Most sexual abuse offenders are acquainted with their victims; approximately 30% are relatives of the child, most often brothers, fathers, mothers, uncles or cousins; around 60% are other acquaintances such as friends of the family, babysitters, or neighbors; strangers are the offenders in approximately 10% of child sexual abuse cases.  In over one-third of cases, the perpetrator is also a minor.

Sexual abuse does not discriminate by ethnicity, socio-economic status, or religion.  It can happen to any child from any community.

Emotional Abuse results in the impairment of the psychological and social growth of a child as a result of behavior that includes 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 criticism, inappropriate or excessive demands, withholding communication, and routine labeling or humiliation.

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, depression, anxiety and overly passive behavior.

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, and well-being are 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 lacking in attention, love, and nurture. Some of the observable signs in a neglected child 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 sufficient clothing for the weather.

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. Researchers investigating maltreated children have repeatedly found that neglected children in foster and adoptive populations present with 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.  Children who are victims of neglect have a more difficult time forming and maintaining relationships, (romantic or friendship), later in life due to the lack of attachment they had in their earlier stages of life.

WHY DO PEOPLE ABUSE THEIR CHILDREN?
The answer to this is complicated and diverse.  In general, studies indicate that parents who abuse may present with the following liabilities including but not limited to:  spousal abuse; substance abuse; having been abused themselves; the child is a product of an unwanted pregnancy; unemployment and financial difficulties.  

The effects of child abuse are serious and long term.  Physical effects include but are not limited to:  higher rates of cancer, overall health problems, impaired brain development, neurological damage, and higher rates of juvenile delinquency and violent crime.  Psychological effects include but are not limited to: difficulties in attachment; cognitive, academic and social dysfunction; anxiety; depression; dissociation; Post traumatic stress disorder; and chronic pain for no apparent reason.

The treatment of child abuse may include trauma focused cognitive behavior therapy; abuse focused cognitive behavior therapy; parent/child therapy; individual psychotherapy; play therapy; group therapy or art therapy.

MANDATED REPORTING
Mandated reporters are professionals who, in the ordinary course of their work and because they have regular contact with children, are required to report (or cause a report to be made) whenever physical, sexual or other types of abuse have been observed or are suspected, or when there is evidence of neglect. These professionals can be held liable by both the civil and criminal legal systems for intentionally failing to make a report, but their name can also be withheld. 

Mandated reporters include but are not limited to mental health professionals, nurses, all types of therapists (physical occupational, art, music etc.), dentists, clergy, pharmacists, medical doctors, teachers, principals or any person who has assumed full or intermittent responsibility for the care or custody of a child, whether or not they are compensated for their services. Reports can also be made by family members, friends, neighbors or concerned citizens.  

Mandated reporting usually begins by calling the State Central Registry of the state where the child resides and answering a series of questions.  The phone number for the New York State Central Registry is 1-800-342-3720.   The phone call is always followed up by a written report.  If the report indicates the necessity for an investigation, an investigation is done by someone from the State Office of Children and Family Services in a timely manner.

If you suspect child abuse--even if you are not a mandated reporter--make the phone call.  The life of a precious child could be saved.

At OHEL, we are here to help.  Our licensed professionals provide individual and family psychotherapy as well as medication consultation.  Our child therapists can teach your child or adolescent skills that will help them cope with the traumatic effects of abuse and help them face the fears, anxieties and worries in a safe and supportive environment. Our goal is to help children and adolescents return to a normal, healthy life.  

Remember, at OHEL, we are only a phone call or a click away from your road to recovery.

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