Child abuse is common. Sexual abuse includes inappropriate touching of a child’s breasts or genitalia, as well as someone’s exposing their genitalia to a child. Physical abuse involves injuring a child’s body by burning them, beating them or breaking their bones. Because a bruise indicates that body tissue has been damaged and blood vessels have broken, any discipline method that leaves bruises is not appropriate.
Child neglect can include physical neglect (withholding food, clothing, shelter or other physical necessities), emotional neglect (withholding love, comfort or affection) or medical neglect (withholding needed medical care).
Recognizing Child Abuse and Neglect
It’s not always easy to recognize when a child has been abused. Children who have been mistreated are often afraid to tell anyone because they think they will be blamed or that no one will believe them. Parents also tend to overlook symptoms because they don’t want to face the truth. This is a serious mistake. A child who has been abused needs special support and treatment as early as possible. The longer he continues to be abused or is left to deal with the situation on his own, the less likely he is to make a full recovery.
The best way to check for signs of abuse is to be alert to any unexplainable changes in your child’s body or behavior. Don’t conduct a formal “examination” unless you have reason for suspicion, as this may make the child fearful, but do look further if you notice any of the following:
Signs of Physical Abuse
Any injury (bruise, burn, fracture, abdominal or head injury) that cannot be explained
Signs of Sexual Abuse
- Fearful behavior (nightmares, depression, unusual fears, attempts to run away)
- Abdominal pain, bedwetting, urinary tract infection, genital pain or bleeding, sexually transmitted disease
- Extreme sexual behavior that seems inappropriate for the child’s age
Signs of Emotional Abuse
- Sudden change in self-confidence
- Headaches or stomachaches with no medical cause
- Abnormal fears, increased nightmares
- Attempts to run away
Signs of Emotional Neglect
- Failure to gain weight (especially in infants)
- Desperately affectionate behavior
- Voracious appetite and stealing of food
Long-Term Consequences of Abuse and Neglect
In most cases, children who are abused or neglected suffer greater emotional than physical damage. A child who is severely mistreated may become depressed or develop suicidal, withdrawn or violent behavior. As he gets older, he may use drugs or alcohol, try to run away, refuse discipline or abuse others. As an adult, he may develop marital and sexual difficulties, depression or suicidal behavior.
Not all abuse victims have severe reactions. Usually, the younger the child, the longer the abuse continues, and the closer the child’s relationship with the abuser, the more serious the emotional damage will be.
When to Call the Pediatrician
If you suspect your child has been abused, get help immediately through your pediatrician or a local child protective agency.
Physicians are legally obligated to report all suspected cases of abuse or neglect to authorities. Your pediatrician also will detect and treat any medical injuries or ailments, recommend a therapist and provide necessary information to investigators. The doctor also may testify in court if necessary to obtain legal protection for the child or criminal prosecution of a sexual abuse suspect. Criminal prosecution is rarely sought in mild physical abuse cases but is likely in those involving sexual abuse.
Your child will benefit from the services of a qualified mental health professional if he has been abused. You and other members of the family may be advised to seek counseling so that you’ll be able to provide the support and comfort your child needs. If someone in your family is responsible for the abuse, a mental health professional may be able to successfully treat that person as well.
If your child has been abused, you may be the only person who can help him. There is no good reason to delay reporting your suspicions of abuse. Denying the problem will only make the situation worse, allowing the abuse to continue unchecked and decreasing your child’s chance for a full recovery.
Excerpted from Caring for Baby and Young Child: Birth to Age 5, Bantam 1999
© Copyright 2000 American Academy of Pediatrics
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