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FAQ Frequently Asked Questions About Child Abuse

What is child abuse?

Child abuse can include any behavior, action or omission by an adult that causes or allows harm to come to a child. That can include physical abuse, emotional abuse, sexual abuse, and/or neglect. Individual states and other government agencies have specific legal definitions that are used to substantiate reports of alleged maltreatment.

How many children are reported and investigated for abuse or neglect?

In North Carolina, 128,005 children were referred to local Department of Social Service (DSS) agencies for possible abuse and neglect in state fiscal year (SFY) 2013-2014. 31,899 of these children were confirmed as victims or found in need of service in NC. 28 children died at the hand of a parent or caregiver in North Carolina in 2012 (the latest data available). Each year more than 3,000,000 children in the United States are reported abused or neglected and approximately 1,000,000 of those cases are confirmed/substantiated.

North Carolina uses the Multiple Response System (MRS) to respond to suspected child abuse and neglect. Every referral is investigated through a strengths-based, family-centered assessment conducted by either local law enforcement or the local DSS. These professionals recognize that parents want what is best for their children, and that many families face issues that make parenting more challenging. When you refer a family to DSS, you are actually referring them for services that will strengthen the family as a whole.

North Carolina law requires that any adult who suspects that abuse is occurring must make a report. Click here for information on how to make a referral in the state of North Carolina.

What is the Impact of Child Abuse and Neglect

New scientific research confirms what we have long suspected — that child abuse has a long-term impact on a child's life. This new research also shows us that the effects of child abuse impact the entire community, harming both quality of life and economic prosperity.

  • Toxic Stress

    Children who experience abuse develop toxic levels of stress. Some stress - called positive stress - is good and helps a child grow. For example, moving to a new school is stressful but teaches a child how to make new friends and adapt to new situations. Consistent, high levels of stress become toxic to a child and actually damage the developing architecture of a child's brain. Exposure to toxic stress changes the way a child's brain is built. The area that controls the fight-or-flight survival mechanism overdevelops, while areas that control emotion, cognitive thinking and an understanding of risk and consequence are stunted. The changes to a child's brain caused by exposure to toxic stress can lead to significant behavioral changes: The overdeveloped fight-or-flight center seeks calm and pleasure through things like food, drugs and sex. The cognitive center is less prepared for academic success. The part that controls risk or consequence is not prepared to make appropriate decisions.

  • The ACE Study

    In 2005, the Centers for Disease Control and Prevention and insurer Kaiser Permanente released the most comprehensive research to date on the impact of child abuse and neglect. This study, called the Adverse Childhood Experiences Study or ACE Study, surveyed 17,000 adults about their childhood experiences and compared them with their health histories. The research found that children who suffered severe adversity in childhood - violence, abject poverty, substance abuse in the home, child abuse and neglect - were far more likely to suffer long-term intellectual, behavioral, and physical and mental health problems. Problems now concretely linked to child abuse and neglect include behavioral and achievement problems in school; heart, lung and liver disease; obesity and diabetes; depression, anxiety disorders, and increased suicide attempts; increased criminal behaviors, illicit drug use and alcohol abuse; increased risky sexual behavior and unintended pregnancies; and other problems. The ACE Study shows that the long-term impact of child abuse and neglect is not simply an impact on the individual victim. Problems linked to child abuse and neglect tax healthcare, education and criminal justice systems. Child abuse affects a community's quality of life and economic prosperity.

What does it mean to substantiate an allegation of abuse?

The term "substantiated" means that an allegation of maltreatment was confirmed according to the level of evidence required by the state law or state policy. The term "indicated" is sometimes used by investigators when there is insufficient evidence to substantiate a case under state law or policy, but there is reason to suspect that maltreatment occurred or that there is risk of future maltreatment.

Is the number of abused or neglected children increasing?

The number of substantiated victims has fluctuated by approximately 0.9% since 2002. The numbers cited here are from the 2011 Child Maltreatment Report published by the U.S. Department of Health and Human Services. Increases may be related to actual increase of incidents, better reporting by states, or greater recognition and reporting of child abuse within communities, while decreases may indicate reduction in incidents, poor reporting by states, or changes in definitions regarding substantiated cases. Statistics continue to show that a child abuse victim is at high risk of suffering repeated abuse or neglect. Through the Child and Family Services Review, the Children's Bureau has established the current national standard for recurrence as 94.6%. It is challenging to acquire comprehensive statistics regarding the true incidence of child abuse. Currently, the Department of Health and Human Services is conducting a study aimed at collecting statistics from various agency sources to develop a more accurate picture of the incidence of child abuse and neglect across the country. These new sources include law enforcement agencies, tribal jurisdictions, and other social service agencies that are not included now.

What are the most common types of maltreatment?

The majority (59%) of victims suffered from neglect. Child Protective Services investigations determine that 10.8 % of victims suffered from physical abuse, 7.6% suffered from sexual abuse,4.2% suffered from emotional maltreatment, less than 1% experienced medical neglect, and 13.1% suffered multiple forms of maltreatment. In addition, 4.1 percent of victims experienced such "other" types of maltreatment as "abandonment," "threats of harm to the child," or "congenital drug addiction." States may consider any condition that does not fall into one of the main categories - e.g. physical abuse, neglect, or emotional maltreatment - as "other." These maltreatment type percentages total more than 100 percent because children who were victims of more than one type of maltreatment were counted for each incident. Although the percentage of emotional maltreatment appears low, this statistic may be misleading. The Child Welfare Information Gateway states, "Emotional abuse is often difficult to prove and, therefore, CPS may not be able to intervene without evidence of harm to the child. Emotional abuse is almost always present when other forms [of abuse] are identified".

Who abuses and neglects children?

In 2011, exactly 81.2 percent of perpetrators of child maltreatment were parents, and another 12.8% were relatives or caregivers of the child. Caregivers includes foster parents, child daycare providers, and legal guardians. Mothers comprised a larger percentage of perpetrators, 36.8% compared to fathers, 19%, however 18.9% of cases indicated both parents were involved. Nearly one-half of all victims were White (43.9%), 21.5% were African-American, and 22.1% were Hispanic. Child maltreatment occurs across socio-economic, religious, cultural, racial, and ethnic groups.

What makes people abuse children?

It is difficult to imagine that any person would intentionally inflict harm on a child. Many times, physical abuse can result when the physical punishment is inappropriate for the child's age, and parents have an unrealistic expectation of their child's behavior. A parent feeling undue stress may also react inappropriately. Most parents want to be good parents but sometimes lose control. Child abuse can be a symptom that parents are having difficulty coping with other situations, such as those involving finances, work, or housing. A significant factor in many situations relates to a parent's inexperience with or lack of understanding of typical child development. Many childhood behaviors can be frustrating but are normal. Lack of understanding about normal behaviors may lead a parent to react in a punitive manner. Parents with their own negative childhood experiences may not have healthy role models to follow. Other stress factors in the home may increase the risk of abuse or neglect, also. These can include drug or alcohol abuse, family crises, marital difficulties, domestic violence, depression or mental illness.

Are victims of child abuse more likely to engage in criminality later in life?

Victims of child abuse are likely to experience a wide variety of negative outcomes throughout their lives. Involvement in criminal activity is one. For children, the National Survey of Child and Adolescent Well-Being found that children placed in out-of-home care due to abuse or neglect tended to score lower than the general population on measures of cognitive capacity, language development, and academic achievement (U.S. Department of Health and Human Services, 2003).

Other studies have found abuse and neglected children to be at least 25% more likely to experience problems such as delinquency, teen pregnancy, low academic achievement, drug use, and mental health problems.

In one long-term study of young adults who had been abused, as many as 80% met the diagnostic criteria for at least one psychiatric disorder at age 21. These young adults exhibited many problems, including depression, anxiety, eating disorders, and suicide attempts (Silverman, Reinherz, & Giaconia, 1996). Other psychological and emotional conditions associated with abuse and neglect include panic disorder, dissociative disorders, attention-deficit/hyperactivity disorder, posttraumatic stress disorder, and reactive attachment disorder (Teicher, 2000).

The challenges that victims experience continue as they move into adulthood. The U.S. Department of Justice, Bureau of Justice Statistics reports the following adult statistics for 2002:

  • 31% of jail inmates had grown up with a parent or guardian who abused alcohol or drugs.
  • About 12% had lived in a foster home or institution.
  • 46% had a family member who had been incarcerated.
  • More than 50% of the women in jail said they had been physically or sexually abused in the past, and more than 10% of the men.

The National Institute on Drug Abuse reports that nearly two-thirds of all adults entering treatment for drug abuse report being victims of child abuse or neglect.

Is there any evidence linking alcohol or other drug use to child maltreatment?

There is significant research that demonstrates this connection. Research has shown that among confirmed cases of child abuse and neglect, 40% involved the use of alcohol or other drugs (Journal of American Medical Association, and Children of Alcoholics). Substance abuse does not cause child abuse and neglect, but it is a distinct factor in its occurrence.

Can we prevent child abuse and neglect?

Yes, we can make a difference. There are many types of prevention programs across the country. Research has shown that effective programs share similar elements, such as working with families early and on a long-term, intensive basis. Effective programs offer assistance with family problems, refer families to outside supports when needed, and have a structured framework for staff in working with families. These elements are found in the National Exchange Club Foundation's Parent Aide home visitation program model. The Parent Aide Program is the signature program of NECF and is offered at all of the Exchange Club Child Abuse Prevention Centers across the country. You can make a difference as you support NECF's Child Abuse Prevention Centers and the Parent Aide Program.

Where can I find more information?

Child Welfare Information Gateway

2011 Child Maltreatment Report

CDC Child Maltreatment Prevention

Bureau of Justice Statistics

Children's Bureau

Friends National Resource Center


The Parenting PATH
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