30 - Physical abuse and neglect

Summary

Definition and epidemiology

The term physical abuse is used to describe non-accidental physical injury to a child or adolesent caused by a parent or other care-giver. The term child neglect describes inadequate care and attention given to a child.

In the literature, numerous related terms are used (Briere et al., 1996; Lutzker, 1998). The most common terms are: child abuse, child neglect, non-accidental trauma (NAT). The term battered child syndrome has also been used (Kempe and Helfer, 1972), emphasizing the phenomenon of child abuse in a broader social context than just the abusing individual. Recently, the term child abuse has focused on the family, because unfortunately this is the context in which child abuse occurs most commonly.

Emotional abuse by parents usually ensues from an adverse attitude towards the child who is rejected because of gender, physical appearance, or psychological abnormalities (Stutte, 1971). Forms of emotional child abuse comprise rejection (chronic denigration), social isolation, terrorizing by the threat of abandonment, chronic deprivation of attention, corruption by exposure to deviant child care practices and ‘adultification’, which involves making ageinappropriate demands upon the child (Finkelhor and Korbin, 1988). Emotional child abuse may reach sadistic proportions and can result in severe mental disturbance.

Child abuse is a criminal offence in most countries. About 4% of children under the age of 12 are brought to the attention of professionals or child protection agencies (Skuse and Bentovim, 1994). The number of unknown cases is presumed to be very high. About 10% of children who present for treatment of physical injury are thought to have suffered child abuse.