The Medical Minute: Protecting the children -- the problem of child abuse

April 13, 2005

By John Messmer
Penn State Family & Community Medicine
Penn State Milton S. Hershey Medical Center
Penn State College of Medicine

Most, if not all, parents have faced it -- anger or frustration at a child's behavior that is so intense they want to strike the child. Not corporal punishment -- a swat on the behind, for example, in response to some infraction, but serious mistreatment or neglect. It's hard to imagine that anyone would intentionally mistreat their child physically or emotionally, but each year around a million cases of child mistreatment are sufficiently substantiated to be handled by state agencies.

Most child abuse is not beating. About 60 percent of cases involve neglect that can include failure to provide food, clothing, medication or regular medical care or evaluation of illness, emotional mistreatment or lack of emotional support. Child abuse includes sexual abuse. Although parents are responsible for most child abuse, other family members and foster parents or non-family members can be responsible. About three quarters of incidents involve substance abuse by the perpetrator.

Abuse and neglect cause pain and emotional trauma for the victims, but the harm doesn't stop when the abuse stops. Scars, physical and emotional, last a lifetime. Abused and neglected children have a 53 percent higher risk of arrest as juveniles and a 38 percent higher risk of criminal behavior and violent crimes as adults. Sexually abused females are 28 times more likely to engage in prostitution.

The typical abusing parents are not evil people. Often they were victims of abuse themselves. When we become parents, we often follow the same child-rearing behaviors we learned from our parents, so unless people make a deliberate effort, they will commonly act as their parents did. That is a part of why abuse victims become abusers.

In addition to lack of proper parenting skills, many abusing parents are immature and have unrealistic expectations of what a young child is capable of learning or what is a normal child's behavior. Social isolation and financial or other social crises contribute to the incidence of abuse.

April is national child-abuse prevention month. Although there has been a statistical decrease in reported cases of abuse, some authorities think the improvement is due to a change in the way reporting is recorded or abuse is defined or understood. Nonetheless, there are things people as a community can do to improve protection of society's children.

Understanding the problem is the first step. As hard as it may be, people must not react with anger or treat the abusing parent as a criminal. Most of the time, these parents simply lack the knowledge or ability to be proper parents and probably were abused themselves. Poverty, divorce, isolation and alcohol or drugs take away a person's ability to cope with parenting stresses.

Report suspected abuse and neglect. In Pennsylvania, the toll free hotline is (800) 932-0313, but a similar reporting mechanism is available throughout the United States. The police or a child welfare agency is a reasonable alternative for reporting.

If possible, look for volunteer opportunities for community programs such as day care for low-income parents, Big Brothers and Big Sisters, or other civic or church-sponsored activities. Such support for at-risk parents and children can make a big difference in whether or not a parent can cope and learn the skills necessary to break the cycle of violence and neglect.

Recognize problems in development. No one likes to have their child-handling criticized, but an offer of assistance to a parent struggling to cope with a child having a tantrum or who is mistreating his or her child can defuse the situation. If a child is alone in a public place, keep an eye on him or her until the parent returns. Become educated about community support activities.

Individuals who find themselves yelling or hitting, withdrawing or wishing they never had children or that they would go away should seek help. They should discuss the situation with their doctor or other health professional. They can contact a local or state child- protection agency for information on parenting classes, day care and so on. In Pennsylvania, visit for more information. Other good sources include Parents Anonymous at online, Circle of Parents at and Prevent Child Abuse America at online.

Parenting is a tough job and it doesn't come naturally. Frustrations and anxieties, fears and our people's own pasts can interfere with their being good parents. It really does take a community to raise a child and the community is there for children and their parents.

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Last Updated March 19, 2009