Articles
| Prepared by Dr. Neil Chadwick
James Garbarino and John Eckenrode For children, neglect is probably a greater social threat than active abuse. More than half the reported incidents of maltreatment investigated by Child Protective Service agencies involve neglect (National Center on Child Abuse and Neglect, 1995). A classic study by Downing (1978) looked at thirty children who had died after having been protective service cases but whose death certificates listed natural causes. Downing found that half of these deaths were directly attributable to parental neglect, such as failure to give prescribed medication. Among infants, neglect can mean all kinds of damage and exposure to needless risk because the infant is so totally dependent on the parents for basic care. For older children, neglect can mean physical and psychological impoverishment when the basic necessities of life are denied. In both cases, we must look beyond the parents to the community that permits neglect. Since adolescents are much more capable of handling their own daily living and personal hygiene needs than children, physical neglect per se is much less an issue once adolescence is reached. For teenagers, neglect usually means parental failure to sustain contact or to provide realistic supervision. Failure to care about the whereabouts of a twelve-year-old at midnight is neglectful, as is an indefinite refusal to talk (even to a noncommunicative teenager). Neglect is distinct from abusive forms of maltreatment because it is not identified with inappropriate physical contact between a child and a caretaker and on the surface may appear more passive than active. But many neglected children and adolescents seem to be harmed just as severely as victims of more active sorts of abuse. Indifference, forgotten promises, and withdrawal are all inappropriate parental behaviors, damaging to children and teenagers who may feel they are not worth their parents' concern and care. Neglect of this sort may lead its victims to very self-destructive behavior. Research on depression (Weissman & Paykel, 1973) and suicide (Paykel, 1976) links overall psychological well-being to involvement in enduring supportive social relationships. Disrupting or termination of these relationships is highly stressful (Fox, 1974). Where does privacy fit into this matrix of stress, psychological distress, and, ultimately, child maltreatment? Privacy provides a fertile medium in which all three grow. What is more, privacy works against natural healing forces and makes it more difficult to deliver help as well as to ask for it. As Elder (1974) noted, a condition of ascendancy to the middle class is the relinquishing of ownership and neighborhood bonds in return for the benefits of privacy. Let us be clear in recognizing that traditional kinship and neighborhood relationships exact psychological costs. The sense of obligation, guilt, dependence, and intrusion weighs heavily on many. There is little privacy. As isolation increases, so does the possibility of child maltreatment. Involvement of families in extensive kin networks (Stack, 1974), natural-helping networks (Collins & Pancoast, 1976), or strong neighborhoods with positive values, organized to implement them (Fellin & Litwak, 1968), can inhibit child maltreatment (Farbarion, Stocking, & Associates, 1980). Such involvement provides both child-care resources and the right to call upon those resources. Both the time and expertise necessary for effective involvement are often lacking in high-risk homes (Gil, 1970). Social connectedness provides access to social and economic resources that can aid the family in times of stress (Garbarino, 1981) and provides personalized observation of the family. It combats family climates that induce depression, anger, helplessness, loss of control, and violence. Without privacy it is unlikely that a pattern of maltreatment can be established and maintained. Abuse or neglect generally will be inhibited or at least identified at an early stage when families are involved in an active exchange network with pro-social friends, neighbors, and relatives. "Securely attached" infants show distress when separated from their mothers briefly but are readily comforted and soothed by the mother upon her return. Overall, Crockenberg found that mothers who had good social support from adults in their lives were more sensitive to their babies than mothers with poor social support. Mothers' level of social support was also the best predictor of secure infant attachment. Moreover, social support was especially important for mothers with irritable babies. Without good social support, mothers of irritable infants were less responsive to their babies; however, mothers of irritable infants who had good social support were able to cope with their difficult infants and respond sensitively to their needs. Parents who mistreat their children have been described as individuals who have trouble prioritizing and weighing their needs against those of the child's and receive little support in making appropriate choices (Justice & Justice, 1976). Often these parents present an odd picture of both selfishness and impoverished self-image. What are a child's rightful claims on a parent or other caregiver? As always, we must employ a mixture of culture and science, community standards and professional expertise, in answering this question. Briefly, we think we can establish that a child has a rightful claim to a parent (1) who recognizes and responds positively to socially desirable accomplishments; and (2) who does not inflict on the child his or her own needs at the expense of the child's. Thus an emotionally abusive parent may reject the infant's smiling, the toddler's exploration, the schoolchild's efforts to make friends, and the adolescent's autonomy. An emotionally abusive parent demands that the infant gratify the parent's needs ahead of the child's, that the child take care of the parent, and that the adolescent subjugate himself or herself to the parent's wishes in all matters (including perhaps sexual relations). Principle Two: Discouraging caregiver-infant attachment is psychological maltreatment.
Caregiver-infant attachment has emerged as one of the central issues in child development.
Disruptions in early attachment has been linked to physical abuse, failure to thrive, and a
variety of deficits in competence. Researchers who have examined the impact of insecure
attachment in infancy on the development of preschoolers have noted two major signs of
emotional damage: (1) an over-concern with dependence/security issues and (2) an under-
concern with competence/effectance issues (Aber, Allen, Carlson, & Cichetti, 1989).
Systematic efforts to discourage early attachment therefore pose a direct threat to adequate
development and are grounds for diagnosing emotional abuse.
Principle Three: Punishing self-esteem is psychological maltreatment. Self-esteem is
the positive valuing of one's characteristics, a positive identity. Self-esteem rises and falls
in response to the behaviors of others, and it is linked to a variety of pro-social
characteristics. To discourage self-esteem is to attack a fundamental component of
competent development. It is emotionally abusive.
Principle Four: Punishing the interpersonal skills necessary for adequate performance
in nonfamilial contexts, such as schools and peer groups, is psychological maltreatment.
Burgess and Conger (1978) observed that families involved in child maltreatment do not
provide positive reinforcement for important interpersonal behaviors.
Understanding Abusive Families An Ecological Approach to Theory and Practice James Garbarino and John Eckenrode Jossey-Bass Publishers, San Francisco, Copyright 1997 ABOUT CHILD ABUSE & NEGLECT WHAT IS CHILD ABUSE? The National Committee for Prevention of Child Abuse defines child abuse as a non-accidental injury or pattern of injuries to a child, including physical abuse, neglect, sexual abuse, and emotional abuse. Examples of physical abuse include hitting, biting, shaking, choking, kicking, burning, or throwing objects. Neglect includes willfully failing to provide for a child's basic necessities of life, such as food, clothing, shelter or medical care, and/or failing to provide guidance and supervision. Sexual abuse includes sexual contact with a child, including incest, rape and inappropriate touching; exposure not involving contact; obscene language; or using a child for sexual photographs, films or prostitution. Emotional abuse is a pattern of behavior that attacks a child's emotional development and self-worth. Examples include verbally attacking, threatening, belittling, humiliating or rejecting a child and/or failing to provide love and affection. Keep in mind that the following signs do not necessarily indicate child abuse. Child abuse is not usually a single event, but rather a pattern of behavior. WHAT ARE THE PHYSICAL SIGNS OF CHILD ABUSE? The physical signs of physical abuse include bald spots, human bite marks, and/or unexplained bruises and welts on the face, lips, mouth, chest, back, buttocks or thighs. They may be in various stages of healing; form regular patterns; and/or resemble the shape of the article used to inflict harm. Unexplained burns may include cigar or cigarette burns, especially on the hands, feet, back or buttocks; rope burns on arms, legs, neck or chest; or patterned burns resembling the shape of an electric burner or iron. There may be broken bones or unexplained fractures to the skull, nose, or face. Such fractures may be multiple and in various stages of healing. Cuts and bruises may be evident around the mouth, lips, gums, eyes and genitals. School teachers may notice that these signs regularly appear after school absence, weekends or vacations. Neglect may be evident from poor growth; failure to thrive; consistent hunger; low weight; distended stomach; poor hygiene; lice; inappropriate dress; consistent lack of supervision, especially for prolonged periods or in dangerous activities; unattended physical or medical problems; or abandonment. Sexual abuse may be exhibited through difficulty in walking or sitting; torn, stained or bloody undergarments; bruises, bleeding, pain, itching or sensitivity around genitals or anal areas; painful urination; frequent urinary or yeast infections; frequent unexplained sore throats; stomachaches; sleep disturbances and nightmares; bedwetting; or sexually transmitted diseases. Children who are emotionally abused may experience speech disorders, lags in physical development, failure to thrive (especially in infants), asthma, severe allergies, ulcers, substance abuse, or hyperactive/disruptive behavior. WHAT ARE THE BEHAVIORAL SIGNS OF CHILD ABUSE? Children who are physically abused may be accident prone; unable to tolerate physical contact or touch; show fear of adult contact; feel apprehensive when other children cry; exhibit aggressiveness, withdrawal or extreme compliance; feel afraid to go home; complain of soreness; move awkwardly; exhibit destructive behavior to self or others; arrive early to school or stay late, as if afraid to go home; wear clothing that covers the body when not appropriate; or run away from home. The behavioral signs of neglected children include stealing or begging for food; persistent fatigue, listlessness or falling asleep; frequent school absence or tardiness; destructive behavior; dropping out of school; and/or substance abuse. Children who are sexually abused may feel depressed or isolated; be reluctant to participate in certain physical activities; perform more less well than usual in school; have difficulty concentrating; withdraw, fantasize or exhibit infantile behavior; appear to cry for no reason; develop eating disorders or substance abuse; develop poor peer relationships; possess an unusually high level of sexual knowledge; act sexually provocative; show fear of or seductiveness toward the opposite sex; engage in prostitution; report sexual assault by an authority figure; become pregnant; run away from home; or attempt suicide. Emotional abuse may show itself through habit disorders, such as sucking, biting or rocking; conduct disorders, such as antisocial or destructive behavior; neurotic traits, such as sleep disorders or inhibited play; behavioral extremes, such as extreme compliance, passivity or aggression; overly adaptive behavior, such as acting inappropriately adult or inappropriately infantile; developmental lags; delinquent behavior; or attempted suicide. Children who are abused may talk of being abused. Listen closely, and take them seriously. These signs don't always indicate abuse, but it's best to find out. Note: Children who are sexually abused may keep the abuse a secret for various reasons: they may think no one will believe them; they may have been threatened that something bad will happen to them or their loved ones if they tell; they may feel embarrassed or ashamed; or they may be too young to have the verbal skills to talk about the abuse. WHO ABUSES CHILDREN? People who abuse children come from all socioeconomic, ethnic and social groups. Most are ordinary people; very few are mentally ill. Often the child's abuser is someone very familiar, such as a parent, another relative or close family friend; it is less common for children to be abused by strangers. Abusers usually suffer from low self-esteem, have poor control over their emotions, and often have been abused themselves earlier in life. An adult who is abusing a child may harshly punish the child in public; refer to the child as "difficult," "different" or "bad"; seem unconcerned about the child; give conflicting stories about the child's injuries; or become defensive when asked about the child's health. WHY ARE CHILDREN ABUSED? Stress is often found to be a major factor leading to child abuse. Sources of stress can include financial difficulties, loss of a job, social isolation, marital problems, inadequate parenting skills, serious illness, death, or substance abuse. Sometimes there is a crisis or a series of crises that trigger the incident. In addition, some children are at higher risk for abuse, including children under the age of 6, children with physical or emotional handicaps, adopted children, and hyperactive or emotionally disturbed children. Some children may even provoke abuse in an attempt to get attention. WHERE CAN CHILDREN WHO ARE ABUSED RECEIVE HELP AND TREATMENT? Children who are abused and need medical attention should be transported to the emergency room. Once treated, the child's non-offending parent or guardian will receive referral for other needed services. WHAT WILL HAPPEN IN THE EMERGENCY ROOM? Victims are examined and treated by Emergency Services staff and referred for appropriate and necessary services. Emergency Services staff also network with local agencies to arrange other necessities for victims, such as shelter, crisis intervention, social services, mental health counseling, spiritual assistance, self-help/support groups, and legal assistance. Physicians and other healthcare professionals treating victims of child abuse are required to report incidents of abuse to the Division of Children, Youth and Families. WHO DO I CONTACT FOR FURTHER INFORMATION? The National Child Abuse Hotline may be reached at 1-800-422-4453. Child Neglect Child neglect is responsible for more deaths every year than is abuse. Medical and supervisional neglect leave a large number of children permanently damaged. Neglect occurs when a child's basic needs, food, clothing, a home, education, love, protection, and health care - are not adequately met. Child Neglect Leads to Juvenile Crime This is sobering. Apparently, child NEGLECT is a big factor in juvenile crime more so than illiteracy or even drug use. The NSW Bureau of Crime Statistics has done a review of all the national and international research into the area of juvenile delinquency. Their findings are that neglectful parents don't instill a respect of other people or property in their kids. As a result the kids turn into delinquents. Doctor Don Weatherburn, the Director of the Crime Statistics Unit, had this to say: "Kids are not born good. The willingness to curtail your impulse to take what you want is ACQUIRED not inborn. Concern for others concern for other's property is acquired not inherited. If you don't have a strong connection to your parents and if your parents don't closely supervise you you don't acquire that respect." Mental/Emotional Maltreatment Just as physical injuries can scar and incapacitate a child, emotional maltreatment can similarly cripple a child emotionally, behaviorally, and intellectually. Varying degrees of emotional and behavioral problems are common among children who have been emotionally abused. Emotional maltreatment can include patterns of: humor that is sarcastic or detrimental to the child's self-image
teasing, taunting, belittling, or ridiculing
name calling
ignoring and indifference
deliberately setting up a competitive situation in which the child is sure to
lose
overpowering a child, so that you cause them to feel helpless or captive (eg.
tickling until breathless)
constant family conflict
Emotional abuse can be seen as a self-fulfilling prophecy. If a child is degraded enough, the child will begin to live up to the image communicated by the abusing parent or caretaker. EDUCATIONAL NEGLECT Educational neglect includes allowing your school aged child to commit the act of chronic truancy, failure to enroll a child of mandatory school age, every child has the right to education and should be in school according to your state's guidelines. Inattention to a special educational need, such as knowing your child is in need of special education classes and doing nothing about it.
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