abuse means doing something that hurts a child. Neglect means not giving or doing something that a child
Physical abuse includes hitting, kicking, shaking, pinching, and burning. It may
leave bruises, cuts, or other marks and cause pain, broken bones, or internal
Emotional abuse is saying or doing things that make a
child feel unloved, unwanted, unsafe, or worthless. It can range from yelling
and threatening to ignoring the child and not giving love and support. It may
not leave scars you can see, but the damage to a child is just as
Sexual abuse is any sexual contact between an adult and a
child or between an older child and a younger child. Showing pornography to a
child is a type of sexual abuse.
Neglect happens when a child
does not get the shelter, schooling, clothing, medical care, or protection he
or she needs. Child neglect is just as serious as abuse and is more
Abuse or neglect hurts children in many ways. Young children are at special risk. They
may not grow properly. They may have learning problems. They may feel bad
about themselves and not trust other people. They may be scared or angry.
Sometimes they die.
Children often believe that abuse
or neglect is their fault. They may think that they did something wrong and
deserve what happened. It is up to adults who care to protect them.
What can you do if you suspect that a child has been abused or neglected?
Call the police or local child protective
services. You don't have to give your name. If you don't know who to call, a hospital may be able to tell you. Many of them have special programs
to deal with child abuse and neglect.
If a child is in immediate
danger or has been badly hurt, don't wait. Call
911 or other emergency services right
If it is your own child, get him or her to a safe place and
stay there. This may be the home of a close friend or family member or a
domestic violence shelter. To find help in your area, call a trusted health professional, a child abuse organization, or the police.
If you are a child or teen who is being abused, don't keep
the secret. Tell someone who can make a difference: a trusted family member,
teacher, counselor, or doctor.
National Child Abuse hotline is open 24 hours a day, 7 days a week to offer
information, advice, and support. Call 1-800-4-A-CHILD (1-800-422-4453).
What can you do if you're afraid someone might harm your child?
If there is someone in your child's life who you think is close to becoming an abuser, you may be able to talk to that person about it and help the person learn more about managing stress and about how children grow and develop.
If you're afraid to talk to the person, make a specific plan for how you will protect your children if you think abuse is about to happen or has happened. Know who you will call and where you and your children will go.
How can you prevent child abuse and neglect?
protect your child from abuse:
Listen to your child. Let him or her know it
is safe to talk about anything with you.
Get to know your child's
friends and their families.
Screen all caregivers, such as
babysitters and day care centers. Find out what they know about child health,
child development, and child care. This may include getting permission for a
police background check.
Teach your child the difference between "good touches"
and "bad touches."
Take a break. Ask a family member
or friend to give you a break when you feel overwhelmed. Learn healthy ways to
manage stress. Look online for information and support, such as
Get help if you have ever been a victim of abuse. Having a history of being abused increases your chances of becoming an abuser. A good place to
start is the Childhelp hotline at 1-800-4-A-CHILD (1-800-422-4453). You can
talk to a counselor for free without giving your name.
To help other children:
Learn to recognize the signs of abuse and
neglect. For example, a child may not grow as expected, may be dirty or
unhealthy, or may seem fearful, anxious, or depressed.
names of your neighbors and their children. Offer to help a new parent. Child
abuse becomes less likely if parents and caregivers feel
Be an advocate for children. Support any group that helps
parents at risk of abusing their children. Donate time, money, or goods to a
local domestic violence shelter.
If you see abuse or neglect
happening, speak up. A child's life may depend on it.
Keep in mind that older children may not talk about the
problem, because they fear or want to protect the offender. Or they don't believe they will be taken seriously.
Certain general symptoms that
may suggest that a child is experiencing some type of abuse or neglect
Slower-than-normal development. The child does not show the abilities and skills normally found in other children the same age, such as starting to talk or socialize with others.
Some children regress, which means they slip backward, losing skills they had before.
Failure to thrive. This is a term that means the
child isn't gaining weight
or height the way he or she should. Although this can be caused by a medical problem, it can also be a sign that the child is not being well cared for.
Unusual interaction with a parent. The
parent may not be interested in the child. Or the child may be constantly trying not to upset the parent. The child may actually be afraid of the parent.
Behaving in a way that isn't appropriate or that causes problems. In a young child, this could mean being unusually fussy, being afraid, or not being interested in activities. Children often act out what they have seen or experienced, such as violence or
sexual activity. Older children may act out in unusual ways, such as having sex, fighting, using drugs, or running away.
Children who are abused or neglected may have long-term emotional and physical problems. Abuse and neglect in children
younger than 7 years of age may lead to permanent behavior and personality
When physical abuse happens repeatedly or for a long time, it can cause permanent damage.
Borderline personality disorder. A person with this mental health condition may have trouble
controlling his or her anger and impulses. He or she may have a low sense of self-worth and may have extreme worries about being abandoned.
Emotional detachment. A person may
have problems making friends. This can lead to feeling isolated and alone. Children may not learn how to feel sympathy for others.
Impulsiveness. The person acts without thinking about the consequences. They may take risks, such as driving
Sexual problems. Abused or neglected children,
especially those who are sexually abused, often have problems developing
healthy feelings about sex as they reach adolescence and adulthood. Some may be overly active sexually. Others may be too afraid to be intimate with anyone.
Children who are abused or neglected are more likely to abuse other children and siblings and, later in life, their own
children or elderly parents. They are also more likely to become involved in crime.
What Increases the Risk
A risk factor is anything that makes you more likely to have a certain problem or disease.
Risk factors for parents and caregivers
People are more likely to abuse or neglect children if they:
Are living in poverty or near poverty. This is a major risk factor for child abuse and neglect.
Have a history of:
including domestic violence.
Drug or alcohol abuse.
Abusing children, or having been abused themselves.
health problems, such as depression.
Have little knowledge about how children grow and what to expect from them.
Have a high stress level that is not managed well. This often includes being a single or teen parent or
having several young children close in age.
Don't have good support. A parent or caregiver who doesn't have financial, emotional, and other types of support may have to deal with a variety of
Risk factors for children
The risk of abuse and
neglect increases when a child has a disability or other health issue, such
Being a premature baby. Babies born early often add
emotional and financial stress to a family because they need longer and more
expensive hospital care. They may also need to be watched closely once they are home.
A physical disability, such as blindness or being
confined to a wheelchair.
Another risk factor for children is not having a close bond with parents. Not having a close bond may be caused by:
Parents not wanting the child.
The birth of twins or
A long hospitalization of the newborn and separation
from parents because of premature birth or health
Challenges related to fostering or adopting a
Mental health problems in a caregiver. For example, a parent
who is severely depressed may unintentionally neglect his or her
A child with a major health problem or disability, such as
blindness, deafness, or
autism. These types of problems can make it hard
for a parent to communicate with the child or for the child to give and receive
When to Seek Help
Call 911 or other emergency services immediately if you see a child being abused or believe a child is in immediate danger, or you see that a child:
Is not breathing. The
911 operator can guide you through
CPR until help
Childhelp, a nonprofit agency, provides
telephone numbers and information about how to report suspected or observed
child abuse or neglect. The national Child Abuse hotline number is
1-800-4-A-CHILD (1-800-422-4453). The U.S. Administration of Children and
Families, under the Department of Health and Human Services, has established a
Children's Bureau that supports the states in the delivery of child welfare
services designed to protect children and strengthen families.
Exams and Tests
An abused or neglected child who is taken to a doctor will first
have a general physical exam. The doctor will review the child's medical history and ask parents or caregivers questions about the child's
A child who is able to talk will be separated from the caregiver
during the interview.
The law requires doctors to consider the possibility of abuse or neglect. Along with
seeing signs of
physical abuse or
neglect, a doctor may become suspicious when:
The injury is unusual or is not likely to be an
accident, especially for the child's age.
The parents or caregivers don't have a good explanation, or the explanation changes.
The parents or caregivers say no one saw the injury happen.
Medical records show that
similar injuries or patterns of neglect have occurred in the past.
The parents or
caregivers put off taking the child to the doctor without a good reason.
Information about a child's injuries is carefully recorded. A detailed
account of the injuries goes into the child's permanent health record.
This record usually
includes photographs and drawings of the injuries.
Measurements such as weight,
height, and head circumference are also taken and recorded to help establish a
child's baseline growth pattern. Recording these measurements on growth charts
can help identify
failure to thrive that sometimes is related to
Early treatment gives an abused or neglected child the best chance for recovery.
Treatment for the child
The first step is to provide a safe
environment to prevent further harm. The sooner this happens, the better the child's chance for physical and emotional recovery. This includes separating the child,
as well as any other children in the household, from the person suspected of abuse.
Any physical injuries will be treated, either in a hospital or at a doctor's office, depending on how serious they are.
always recommended for abused or neglected children. It usually focuses on:
How they feel about
Their past experiences.
Fears and concerns
they may have about the present and future.
young children, counseling may involve
Treatment for parents or caregivers
caregivers who have abused or neglected a child also need treatment. The type
of treatment depends on the specific abuse that occurred.
Some people need to learn more
about how to raise and care for children. Others may need treatment for
other serious problems, such as:
Parents who have lost custody of their children can sometimes
regain it. It depends on how bad the abuse or neglect
was and how far they have come in realizing what their problems are and how to prevent them.
cases, the parent can see the child only when someone else is present. Sometimes
a judge permanently ends the parent-child relationship.
Everyone can help prevent child abuse and neglect by showing concern for children and their well-being.
Learn healthy ways to resolve conflicts and
manage stress. For more information, see the topic
Ask for help when you
need it. Call a family member or friend to give you a break if you feel
overwhelmed. Find out about community resources that can help you
with child care or other services. Call a doctor or local hospital
Remove firearms and other
dangerous weapons from your home.
Learn more about how children grow at different stages in their lives. For example, lack of knowledge about why babies cry can make the crying a trigger for shaken
baby syndrome. For more information, see:
Get to know the children in your neighborhood. Learn their names, and show you care simply by waving to them or
asking about how they're doing at home and school.
Give parents a break. Relieve a
friend, neighbor, or relative who is feeling overwhelmed with child care and
Learn the signs of child abuse and
Encourage your community to offer services to help families who are at risk for abuse or neglect.
Volunteer in child abuse programs.
How Child Abuse Is Reported
Laws about reporting abuse
The law requires certain
people, such as doctors, social workers, and teachers, to report suspected
child abuse and neglect. Usually the report is made to the police or to
child welfare or child protection agencies. In some areas the law requires all citizens to report suspected abuse or neglect.
Police and child welfare workers investigate the report. If the government believes a crime has been committed, the suspected abuser is tried and, if found guilty, sentenced.
Investigators sometimes can't find enough evidence to charge someone with a crime. In this case, parents or caregivers may be referred to social
services to lower the child's risk of being hurt.
Knowing when to call police
When you suspect a child is, or is
at risk of, being abused or neglected, it is important to take action. Most
abused children are not able to help themselves.
Many people don't know what to do about suspected
abuse, because they:
Are not sure what is considered abuse and
Are afraid they'll cause the child more
Are worried that they will falsely accuse a parent or caregiver.
Are afraid the abuser will hurt or harass them.
Are worried about being sued.
Keep in mind that by reporting your suspicions,
you may prevent a child from being seriously hurt or even killed and from having lifelong
emotional problems. You can make reports anonymously. If you
give your name, it is kept confidential.
Also, you can't be sued successfully if you make a report in good
Other Places To Get Help
Kempe Foundation for the Prevention and Treatment of Child
Abuse and Neglect
13123 East 16th Avenue, B390
Aurora, CO 80045
The Kempe Foundation is a world leader in programs that
treat abused children. The foundation focuses on the causes, effects, and
prevention of child abuse and has information for parents and
American Academy of Pediatrics
141 Northwest Point Boulevard
Elk Grove Village, IL 60007-1098
The American Academy of Pediatrics (AAP) offers a
variety of educational materials about parenting,
general growth and development, immunizations, safety, disease prevention, and more. AAP guidelines for various conditions and links to other
organizations are also available.
Child Welfare Information Gateway
1250 Maryland Avenue SW, Eighth Floor
Washington, DC 20024
1-800-394-3366 (703) 385-7565
The Child Welfare Information Gateway is a national
resource for people seeking information about how to prevent, identify, and
treat child abuse and neglect. The Web site has information about family
support services, fostering and adopting a child, and child welfare issues.
There are also links for many toll-free crisis hotline numbers.
Childhelp is a nonprofit agency that provides parenting
advice, child abuse prevention, and basic information about the normal growth
and development of children. Also, Childhelp provides telephone numbers
and information about how to report suspected or observed child abuse or
neglect. Hotline counselors and referrals are available. The agency also
supports abused children through abuse prevention programs, preschool programs
(including Head Start), and community outreach. Other services include
referrals to residential treatment facilities, child advocacy
centers, group homes, and foster care.
Prevent Child Abuse America
228 South Wabash Avenue, 10th Floor
Chicago, IL 60604
1-800-CHILDREN (1-800-244-5373) (312) 663-3520
This organization provides information on topics
related to child abuse and neglect. It offers various programs on child abuse
prevention, and it also directs efforts toward increasing public awareness of
child abuse and neglect. You can find out whether your state has a local
chapter by going to the website.
American Academy of Pediatrics (2007, reaffirmed 2011). Maltreatment of children with disabilities. Pediatrics, 119(5): 1018–1025. Also available online: http://pediatrics.aappublications.org/content/119/5/1018.full.
American Academy of Pediatrics (2007, reaffirmed 2012). Evaluation of suspected child physical abuse. Pediatrics, 119(6): 1232–1241. Also available online: http://pediatrics.aappublications.org/content/119/6/1232.full.
Chiesa A, Sirotnak AP (2012). Child abuse and neglect. In WW Hay et al., eds., Current Diagnosis and Treatment: Pediatrics, 21st ed., pp. 223–230. New York: McGraw-Hill.
Dubowitz H, Lane WG (2011). Abused and neglected children. In RM Kliegman et al., eds., Nelson Textbook of Pediatrics, 19th ed., pp. 135–142. Philadelphia: Saunders.
Dubowitz H, Lane WG (2011). Sexual abuse. In RM Kliegman et al., eds., Nelson Textbook of Pediatrics, 19th ed., pp. 142–146. Philadelphia: Saunders.
Leventhal JM, Asnes AG (2011). Child maltreatment: Neglect to abuse. In CD Rudolph et al., eds., Rudolph's Pediatrics, 22nd ed., pp. 137–143. New York: McGraw-Hill.
Ludwig S, Rostain A (2009). Family function and dysfunction. In WB Carey et al., eds., Developmental-Behavioral Pediatrics, 4th ed., pp. 103–117. Philadelphia: Saunders Elsevier.
How this information was developed to help you make better health decisions.