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child abuse Actions by parents and other care-
givers that endanger a child’s physical and emo-
tional well-being. Child abuse affects about 1
million children in the United States each year,
1,200 of whom die as a result of the abuse they
experience. In many countries child abuse is both a
health concern and a legal matter. In the United
States federal law establishes basic legal criteria that
define child abuse; each state further describes the
actions that meet such criteria and may extend the
criteria to include additional circumstances of
abuse. There are four basic types of child abuse:

• Neglect occurs when the parent or caregiver
  fails to provide for the child’s basic needs such
  as appropriate nutrition, clothing, shelter, med-
  ical care, and physical and emotional attention.
  Examples of neglect include grossly unsanitary
  living conditions, persistently depriving a child
  of meals, locking a child in a room or out of the
  house, and leaving a child alone and unat-
  tended for extended periods of time.


• Physical abuse occurs when a child receives
  injuries, regardless of whether the parent or
  caregiver intended to cause harm. Examples of
  physical abuse include harsh physical disci-
  pline, hitting, shaking, kicking, and choking.


• Sexual abuse occurs when there is inappropri-
  ate physical contact of a sexual nature between
  a parent or caregiver and the child. Examples of
  child sexual abuse include fondling, indecent
  exposure, incest, and rape.


• Emotional abuse occurs when the words or
  actions of the parent or caregiver impair the
  child’s sense of self and value. Examples of
  emotional abuse include persistent threatening,
  yelling, criticizing, and ostracizing.

Typically an abused child experiences more

than one type of abuse; emotional abuse is nearly

always a component of any other type of abuse.

Child abuse may also occur when parents or care-

givers fail to take action to prevent harm or injury

to the child, including intervening to stop the abu-

sive actions of another parent or caregiver.

Signs of Child Abuse

Indications of child abuse may be physical or

behavioral. Signs that suggest neglect and child

abuse include

• unexplained bruises, BURNS, fractures, or other
  physical injuries


• weight and size significantly less than appropri-
  ate for age


• steals food or has an extremely unhygienic
  appearance


• flinching, ducking, and other fearful behavior
  in response to sudden movements from adults


• nightmares and unusual fears


• inappropriate sexual knowledge or behavior


• symptoms of SEXUALLY TRANSMITTED DISEASES
  (STDS)

A sudden, unexplainable change in a child’s

behavior is a warning sign that bears investigation

because it can indicate any number of serious

issues, from abuse to physical illness to ILLICIT DRUG

USE. A child often will not acknowledge that a par-

ent or caregiver is abusive. Children depend on

their caregivers and may fear retribution from the

abuser or may not recognize that the behavior or

situation constitutes abuse. As well, secrecy is

often a key component of abuse, with the abuser

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