Features
Protect children and prevent abuse

Both my parents abused me as a child,” says the elegantly dressed, white-haired woman. “They got married only because my mother got pregnant with me, and they took out their rage and resentment on me.”

“How awful,” says her lunch companion, unable to think of anything else to say.

“It happened before I started first grade, and I didn’t remember it until I was grown,” the woman continued. “When memories of it started coming up, I went to a therapist. It took many years of therapy for me to piece it together and come to terms with it.”

“But you had a long teaching career and raised a family of your own. You managed somehow.”

“Yes, but I’m still dealing with the trauma and trying to heal. And I’m 81 years old!”

Child abuse can have lifelong consequences. The woman in the above example was able to rise above her dreadful past experiences, but other victims don’t fare so well. They can be left with learning disabilities, turn to substance abuse for relief, incur problems in school and at work, lag in developing social skills, and develop emotional disorders such as depression and anxiety.

As caregivers and teachers, we are well positioned to recognize and report child abuse. We have an opportunity to help protect children and prevent abuse from happening.

A public health problem
Child abuse is a complex issue—it can be difficult to detect, hard to substantiate, bewildering to pinpoint a cause, and challenging to treat. Nonetheless, research clearly indicates a public health problem—one that must be described carefully and approached appropriately.

Caution is critical for several reasons. First, child generally refers to any child younger than 18. Thus, the statement by the Centers for Disease Control and Prevention (2019) that “At least 1 in 7 children have experienced child abuse and/or neglect in the past year, and this is likely an understatement” encompasses a wide range of ages—infants, preschoolers, school-agers, and teenagers. As a result, early childhood educators cannot assume that, for instance, 1 of 7 children in the 3-year-old room, has been abused.

Second, abuse is defined in different ways. Most sources categorize abuse into four types: physical abuse, neglect, sexual abuse, and emotional abuse, although the term abuse and neglect often refers to all four. Moreover, while the federal government gives guidance to states in defining abuse, each state may write its own definition. For example, some states include abandonment of a child as part of the neglect category. As another example, some states include a mother’s use of illegal drugs during pregnancy as abuse (Child Welfare Information Gateway, 2019).

Third, statistics can be challenging to sift through and select, especially from the Internet. Mitchell Kapor, a founder of the nonprofit Electronic Frontier Foundation, has been quoted as saying, “Getting information off the Internet is like taking a drink from a firehose.”

Apart from the quantity of information, it’s important to look at the source. What are the source’s credentials? Who’s paying for the research or website? Does the source value only recent surveys and ignore the historical perspective? Do commonly held notions hold up under scrutiny? For example, a common theory is that abusive parents were themselves abused as children. But the journal Science (Widom, et al., 2015) has reported research that suggests abuse is not necessarily a cycle, transferred from one generation to the next. Rather, findings may differ depending on the information source and detection bias.

Experience at Texas Child Care Quarterly has found that the most reliable sources are government (such as the Centers for Disease Control and Prevention), universities (such as Texas A&M AgriLife Extension), and independent, nonprofit, non-policy-making organizations (such as the Pew Charitable Trust). Naturally, programs in Texas are required to comply with the rules set by Texas Health and Human Services, Child Care Licensing.

Major types of abuse
The four most generally recognized types of abuse appear below, along with the signs that one can use in recognizing possible abuse in children (Child Welfare Information Gateway, 2019). It’s important to note that in some cases, two or more forms of abuse may occur at the same time.

Physical abuse—an intentional physical injury that can include beating, kicking, biting, shaking, throwing, choking, hitting with a hand or an object, or burning. Injuries can range from minor bruises to severe fractures and death. Forcefully shaking a baby—Shaken Baby Syndrome—is the most common way that a young child becomes seriously brain injured or dies as a result of abuse (The Whole Child, 2018).

Signs can include unexplained injuries and injury that don’t match the explanation given.

In families, physical abuse can happen when discipline gets out of hand. Many parents believe corporal punishment—that is, spanking or hitting a child for bad behavior—is necessary (PubMed, 2017). Child care facilities, on the other hand, generally prohibit corporal punishment. In public schools, the practice is still allowed in 19 states, mostly in the South (Johnson, 2019; Caron, 2018). The American Academy of Pediatrics strongly opposes it based on recent evidence that spanking can lead to more aggressive behavior and an increased risk of mental health disorders and cognitive problems (Sege, 2018).

Neglect—the failure to provide for a child’s basic needs, including food, shelter, supervision, medical or mental health treatment, education, and care. Note: Living in poverty is not considered neglect. Also some states may allow an exemption for lack of medical care in a family whose religion prohibits it.

Signs can include a child’s poor growth, weight gain or being overweight; poor hygiene; lack of needed clothing; hiding food for later or taking food without permission; and poor medical care.

Sexual abuse—forcing a child to engage in any sexually explicit conduct, including molestation, rape, prostitution, and production of pornographic materials.

Signs can include itching, bleeding, or bruises in the genital area; sexual behavior or knowledge premature for the child’s age; inappropriate sexual contact with other children; and reverting to younger behaviors such as soiling their pants.

Emotional abuse—a pattern of behavior that impairs a child’s emotional development or self-worth, including constant criticism, threats, rejection, and withholding love.

Signs can include delayed or inappropriate emotional development, desperate seeking of affection, depression, and social withdrawal and loss of interest or enthusiasm for play and learning.

Who’s most at risk of abusing and being abused?
“In many cases, child abuse is done by someone the child knows and trusts—often a parent or other relative,” according to the Mayo Clinic. A parent’s demeanor or behavior may be a red flag. Signs include showing little concern for a child, inability to recognize a child’s physical or emotional distress, blaming the child for problems, expecting a child to provide the parent with attention and care, and offering conflicting or unconvincing explanations for a child’s injuries (Mayo Clinic staff, n.d.).

Familial stress factors related to poverty—under employment, inconsistent work schedules, poor support systems, and resource scarcity—can put children at risk. According to the CDC (2019), “Rates of child abuse and neglect are 5 times higher for children in families with low socioeconomic status compared to children in families with higher socioeconomic status.”

While low income may indicate risk, it does not apply to all poor families, and it’s well documented that child abuse occurs in all types of families, no matter the income, education, family size, race, religion, or any other trait.

Risk factors for parental abuse include the parents’ lack of understanding of children’s needs, substance abuse or mental health issues in the family as well as young age, low education, single parenthood, and many dependent children (CDC 2019). Stress, depression, and feeling isolated as well as alcohol or drug abuse and violence in the home may cause parents to hurt their children (The Whole Child, 2018).

Children facing the highest risk of abuse are those younger than 4 as well as children with disabilities (CDC, 2019). That means that infant and toddler caregivers, preschool teachers, and anyone who works with children with impairments are well placed to recognize it and do something about it.

Protect children: Report abuse
Any concerned person may report suspicion of child abuse. Remember that reporting is not an accusation but rather a request to determine if help is needed.

Some professionals, including caregivers and teachers, are required by state law to report suspicion of child abuse. For information about where and how to file a report, contact your local child protective services agency or law enforcement office.

You can call Childhelp’s National Child Abuse Hotline (800-4-A-CHILD) and check its website (www.childhelp.org/hotline) to gain additional information and assistance. The Texas Child Abuse Hotline is 1-800-252-5400.

You may be reluctant to report suspected abuse for several reasons. You may think the signs are not clear enough, you don’t want to get anyone in trouble, or you’re afraid the parents may turn against you. Be assured that abuse reports are made in confidence, and you will remain anonymous. Moreover, even if an investigation does not substantiate the abuse, it’s safer to report than not.

Understand protective factors
Of course, everyone would prefer preventing child abuse rather than reporting it after it happens. Unfortunately, prevention by its nature is typically a solitary, unseen strategy, much like a person’s preventing obesity through improved diet and exercise. Prevention doesn’t show immediate or dramatic results.

But over the long term, child abuse is less likely to happen if certain protective factors (CDC 2019) are in place:
a supportive family environment and social networks,
concrete support for basic needs,
nurturing parenting skills,
stable family relationships,
household rules and child monitoring,
parental employment,
parental education,
adequate housing,
access to health care and social services, and
caring adults outside the family who can serve as role models or mentors.

Prevent abuse: Help families
Caregivers and teachers have many opportunities to prevent abuse by helping families, many of which may already be established practices in your program:
set—and help individual children reach—goals that foster positive physical, social, emotional, and cognitive abilities,
serve as role models on how to nurture children,
refer parents to parenting education classes,
discuss protective factors at open houses and parent meetings,
refer first-time parents to programs such as Nurse-Family Partnership, in which a nurse makes regular home visits,
refer parents to health care providers who can help with family planning,
offer classes on child development and effective guidance on behavioral issues,
release children from your care to only those whom parents have approved,
set up a food pantry, clothes closet, toy lending library, and baby equipment depot to ease family economic burdens,
provide a list of resources in the community that offer family counseling, disability services, and GED and adult education, and
partner with other child care programs and professional educational organizations to raise community awareness. For example, you might host educational events during National Child Abuse Prevention Month in April 2020.

Protect and prevent—Yes you can
Learning to recognize and report abuse takes intelligence and courage, but it can reduce injury to children and even save lives.

Taking preventive steps requires creativity and the belief that everyone can make a difference. One may doubt that individual efforts are effective or enough. But over time, the results will become apparent. Even the smallest efforts can make an impact.

Reducing or eliminating child abuse doesn’t happen overnight. It requires individuals working together with the whole community to improve the lives of parents and families.

References
Caron, Christie. (Dec. 13, 2018). In 19 states, it’s still legal to spank children in public schools. The New York Times. Retrieved from www.nytimes.com/2018/12/13/us/corporal-punishment-school-tennessee.html.
Centers for Disease Control & Prevention-a. (Feb. 26, 2019). Preventing child abuse & neglect. Retrieved from www.cdc.gov/violenceprevention/childabuseandneglect/fastfact.html.
Centers for Disease Control & Prevention-b. (Feb. 26, 2019.) Risk and protective factors. Retrieved from www.cdc.gov/violenceprevention/childabuseandneglect.
Child Welfare Information Gateway-a. (2019). Definitions of child abuse and neglect. Washington, DC: U.S. Department of Health & Human Services, Children’s Bureau. Retrieved from www.childwelfare.gov/topics/can/defining/federal/.
Child Welfare Information Gateway-b. (2019). What is child abuse and neglect? Recognizing the signs and symptoms. Washington, DC: U.S. Department of Health and Human Services, Children’s Bureau. Retrieved from www.childwelfare.gov/pubPDFs/whatiscan.pdf#page=4&view=Recognizing%20signs%20of%20abuse%20and%20neglect%20and%20when%20to%20report.
Johnson, Derrick. (June 11, 2019). The striking outlier: The persistent, painful, and problematic practice of corporal punishment in schools. Montgomery, AL: Southern Poverty Law Center. Retrieved from www.splcenter.org/20190611/striking-outlier-persistent-painful-and-problematic-practice-corporal-punishment-schools.
Kapor, Mitchell, www.brainyquote.com/quotes/mitch_kapor_16358.
Mayo Clinic staff. (n.d.). Child abuse. Mayo Clinic. Retrieved from www.mayoclinic.org/diseases-conditions/child-abuse/symptoms-causes/syc-20370864.
PubMed. (2017). American parents’ attitudes and belief about corporal punishment: An integrative literature review. Washington, DC: U.S. National Library of Medicine, National Institutes of Health. Retrieved from www.ncbi.nlm.nih.gov/pubmed/28202205.
Sege, Robert D. (Nov. 5, 2018). AAP policy opposes corporal punishment, draws on recent evidence. American Academy of Pediatrics. Retrieved from www.aappublications.org/news/2018/11/05/discipline110518.
The Whole Child. (November 24, 2018). How to identify child abuse ages 0-5. Whittier, CA. Retrieved from www.thewholechild.org/parent-resources/age-0-5/how-to-identify-child-abuse-ages-0-5/.
Widom, Cathy Spatz, Sally J. Czaja, & Kimberly A. Dumont. (March 27, 2015). Intergenerational transmission of child abuse and neglect: Real or detection bias? Science, Vol. 34, 6229, 1480-1485. Retrieved from https://science.sciencemag.org/content/347/6229/1480.