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CHILD ABUSE.
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Discusses growing problem, causes & effects, role of justice and school systems & social workers. Cites reports & studies.... More...
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Paper Abstract:
Discusses growing problem, causes & effects, role of justice and school systems & social workers. Cites reports & studies.
Paper Introduction:
Introduction to the Study
Child abuse is a serious social, political, and emotional problem in the United States. This has become, in recent years, the focus of numerous quantitative and qualitative studies designed to identify both the causes of this problem and its effects, as well as research designed to develop prevention and intervention efforts to ameliorate and reduce the problem. Murry, Baker and Lewin (2000) note that each year in the United States, the abuse and neglect of children results in over 1,200 preventable deaths and thousands of reported and unreported injuries. Hyden (1999) further indicates that in 1995, approximately 3 million abused or neglected children were reported in the United States, with many more cases unreported. Of these, 1.6 million cases involved neglect, 800,000 children were
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Beginning with a diagnostic orientation focused on physicalinjuries, subsequent research expanded to include definitions of childabuse, incidence reports, causal research, and treatment modalities. Washington, D.C.: APA. Screening familieswith young children for child maltreatment potential.Pediatric Nursing, 26 (1), 47 - 54. Elmer, E., Evans, S., and Reinhart, J.B. T. Friedman, S.B. (198 ). Introduction to the Study Child abuse is a serious social, political, and emotional problem inthe United States. Martin, H.P., and Rodeheffer, M. It is estimated that nationally between 1 , and 2 , children are abused to some degree each year; only a relativelysmall portion of that number are identified by such groups as schools,doctors, other health care providers, social service agencies, and lawenforcement officials (Tower, 1993; Hyden, 1999; Murry, et al, 2 ). Helfer (Eds.), Helping the BatteredChild and His Family. Developmental characteristics of abusedchildren. The juvenile justice system became, to adegree, the point of congruence between the related but still disparateissues of child abuse and juvenile delinquency (Sears, 1961). (1993). Diagnosticand Statistical Manual of Mental Disorders. Martin (Ed.), The Abused Child: A MultidisciplinaryApproach to Developmental Issues and Treatment. Fiesta, J. Society has for many decades perceived a relationship betweenchildhood abuse or victimization and delinquency. Child Welfare, 73 (1), 15 - 27. The need for intensive follow-up ofabused children. It has been found to be a major component in psychologicalfunctioning. (2 ). There is a tendency for the former abuse victimto become abusive to spouses, significant others, and children (Alfaro,1978). Earlytreatment literature focused on parental involvement and only graduallyshifted to a focus on the child or victim. Rotter (1966)introduced this theory in the mid-196 s, and it has since been studiedextensively. It has been theorized that expectation can develop gradually duringchildhood, in the general context of relationships with parents or otherprimary caretakers. It is, absent clear-cut medical evidence of sustained orchronic abuse that results in permanent damage to the child, extremelydifficult for the courts to obtain convictions against parents inparticular. According to Janine Fiesta (1992), inmost states four types of child abuse are recognized: 1) physical abuse; 2)mental abuse; 3) neglect; and 4) sexual abuse and sexual exploitation.Under the statutes of all states, physicians and nurses are required by lawto report suspected child abuse of any type, and some states also imposethis requirement on other health care workers, clergy, social workers, andteachers. In New York state AssemblyCommittee on Child Abuse. Eventually, the child may learn that his response or lack thereof hasno contingency or bearing upon the ways in which he is treated or hisparents' response to his behavior. Batter, B.S. Other studies focus onidentifying social work and other therapeutic interventions that have beenemployed in assisting both the victim and the perpetrator of this abuse. Cambridge:Harvard University Press. These categories are useful to social workers and otherhealth care professionals as a means of determining the primary locus ofthe problem and developing appropriate interventions and treatmentstrategies. Understanding Child Abuse and Neglect. Furthermore, no single model or theory of whychild abuse occurs has been regarded by mental health professionals asadequate to explain a phenomena that cuts across racial, ethnic, economic,social, cultural, familial, and other lines and appears in virtually allsocial units. Crenshaw, Bartell, and Lichten-berg (1994) have argued thatmandatory reporting laws, now established in most of the 5 states, havecomplicated the task of social workers. (1988). Theconstruction, in smaller communities, of "health awareness teams" thatoffer prevention programs as well as direct services to victims and theirfamilies has also been somewhat successful (Kroll, 199 ). (1996). (1999). PsychologicalMonographs, 8 (1), 16 -25. CHAT: The Community Health Awareness Team. The non-accidental emotional and physical injury to children underthe age of 18 by a caretaker is regarded, in general, as constituting theact of abuse; as early as 1875, the Society for the Prevention of Crueltyto Children was working to create awareness of this problem and to providerelief to its victims. (1976). (1998).Rush to judgement? HealthCare Supervisor, 8(3), 27 -31.. Pediatrics, 4 , 596-6 2. Caffey, J. The research on these topics is as yet in the preliminary stages.However, what is available tends to provide limited support to theassertion that abused children either disproportionately become problemsfor society or continue to require supportive services as a result of aninability to overcome childhood traumas or deficiencies (Alfaro, 1978). For many years, it was simply assumed that some type of mental illnessmust be responsible for the abuse of children by adults (Tower, 1993).Research, however, now strongly indicates that while some abusive adultswho focus their anger and rage upon children may be mentally ill, manyothers are not mentally ill but are reacting to other, perhaps externalstressors or events that cause a breakdown in self-control and behavior.The problem has gained national attention in recent years, largely becauseof the willingness of several well-known individuals to publicly confessthat they were victims of such abuse and of increased media attention.Employers have become involved in the treatment and identification of thisproblem, with several corporations such as Honeywell, Inc., working withstate-funded and operated abuse prevention and intervention programs toprovide services to employees (Droste, 1988). Given these theories, it is possible to hypothesize that the earlylearning experiences of the abused child may well have a long-term impactupon expectations as well as behaviors. Coleman (199 )has pointed out that there is a substantial body of literature thatsuggests a profound linkage between childhood or adolescent victimizationand the various types of "acting out" and/or overtly criminal behaviorsthat encompass juvenile delinquency. Chance events, dysfunctional familyrelationships and behaviors, or poor understanding of the role of a childwithin society and the family may be in operation. Throughout history,children have been victims of abuse by parents, caretakers, otherrelatives, and total strangers; in virtually all cultures and societies,child abuse is a cause for concern (Tower, 1993). These laws have been created to address the issue, and it isgenerally recognized in the nations of the West, at any rate, thatexcessive, brutal, or dangerous physical punishment directed againstchildren constitutes nothing less than a crime (Tower, 1993). The Abused Child; A MultidisciplinaryApproach to Developmental Issues and Treatment. Violence Against Children. (1992).The littlest victims. Alfaro (1978) has pointed out that contemporary psychologists andother researchers are becoming aware of the long-term physical andpsychological effects of abuse, as well as its behavioral outcomes. Abused children are typically described or characterized as bothwithdrawn and depressed. Employers force family abuse out of closet.Hospitals, 62(19), 54 -55. Most social workers tend to agree that abused children must beremoved, at least on a temporary basis, from the environment in which theyare being abused (Terling, 1998; Tower, 1993. Efficiency in behavior-changing programs. Battered children cannot anticipateparental responses and their lives lack behavioral consistency; the childmay not be able to develop any rational understanding of why he is abusedat specific times, ignored at others, and rewarded at others. Journal of Orthopsychiatry, 68 1, 1 1 - 1 7. Even after becoming engaged in treatment, many adultsdo not follow through; therapy can be frustrating and painful, as well asexpensive if families do not meet eligibility criteria for free or reducedcost services. In-home child abuse prevention and treatment programs which providein-home counseling to parents and children by means of behaviormodification approaches have also been successful in reducing oreliminating the problems of abuse (Johnson & Clancy, 1991). (1946). Emily Friedman(1992) has reported that many states do not aggressively address thisissue; specifically, some states focus intervention efforts on measuresthat maintain family unity, often leaving children in or returning them toabusive homes. Multiple fractures in the long bones of infantssuffering from chronic subdural hematoma. Cambridge:Ballinger. Levine, M., Doueck, H.J., Freeman, J., and Compaan, C. The use of corporal orphysical punishment to discipline children has, however, in recent years,begun to be regarded as inappropriate in most cases and unnecessary inmany. Studies also show that many delinquents havebeen abused by caretakers, that abused children tend to have an externallocus of control. Child abuse prevention programs offer a great opportunity to educatechildren as to their rights and parents as to their responsibilities in non-critical, non-threatening settings and situations. Human Sexuality. New York:Harcourt Brace Jovanovich.----------------------- 18 Gil, D.G. The roles and interventions of social workers will beanalyzed, as well as those of the school system and justice system. Child abuse is a problem that cuts across all sociocultural andsocioeconomic grounds and boundaries (Coleman, 199 ). Tower (1993) has suggested that child abuse isa consequence of dysfunctional family constellations and inadequate adultdevelopment of appropriate parenting skills, anger management strategies,and emotional/developmental maturation. FragileFamilies, Troubled Children. For example, children who have learned that theirbehavior elicits response from their parents are considered to be"inoculated" against helplessness. The efficacy of family reunification practices.Child Abuse & Neglect, 23 (12), 1359 - 137 . Chicago: Illinois Department of Children and Family Services. Hyden (1999) comments that this early work soimpressed members of the medical, social work, educational, and legalcommunities that efforts were set in motion to learn more about thephenomenon in hopes of leading to adequate prevention and interventionstrategies. (1975). Administration in Social Work, 15(1,2),1 5 -118. Houses ofrefuge, as institutions serving this population were initially called, didnot distinguish between these two groups of young service needers and,under statutory authority, provided services to both groups of young peoplein a single residential care setting. (1978). Conversely, children not so "inoculated" againsthelplessness during development are those who learned that theenvironmental outcome is not contingent upon their response. Tower, C.C. As Hyden (1999) comments, the incidence of childabuses continues to rise, but this may be a result in part of increasedrecognition of the problem and increased willingness to disclose abuse asan existing problem. (1998). Studies by Dr. Henry Kempe revealed the existence of a "batteredchild syndrome" in 1962. This has become, in recent years, the focus of numerousquantitative and qualitative studies designed to identify both the causesof this problem and its effects, as well as research designed to developprevention and intervention efforts to ameliorate and reduce the problem.Murry, Baker and Lewin (2 ) note that each year in the United States, theabuse and neglect of children results in over 1,2 preventable deaths andthousands of reported and unreported injuries. Healthcare Forum,35(6), 1 -14. Pittsburgh: University ofPittsburgh Press. This is not to suggest that other cultures do not recognize theproblem of child abuse. Boston:Allyn and Bacon, 1989. Life skillstraining, is an excellent means of preventing future child abuse episodesand helping already abusive adults learn to redirect their energies andcope with external problems that may foster an abusive or violent attitude. Thereport will demonstrate that despite heightened attention to the problem ofchild abuse, interventions remain difficult to implement. Protecting children. Tower (1993) hasreported that in-school programs geared to children of all ages areparticularly useful, as are parenting classes for young adults, newparents, and families identified as at-risk for this problem. Top Emergency Medicine, 21(2), 58 - 69. It was a member of the medical community who, in 1946, published aseries of studies detailing the prevalence of physiological child abuse inAmerican society. Kroll, M. This institutional linkage betweenchild abuse and delinquency remains relatively unchanged today; forexample, the runaway child of abusive parents or guardians is often placedin a detention center or other institution serving adolescents adjudicateddelinquent. Freeman. Fiesta (1992) has made note of the fact that thesetwo characteristics are typical of the population, pointing out that abusedchildren are more lacking in confidence than non-abused children. Moreover, even ifhe does respond, and the response succeeds in producing some reward, he hasdifficulty learning, perceiving, and believing that his response worked orinfluenced the treatment he received. Evanston, Il.:Scott, Foresman. Today, many studies of theproblem address the role of the family in child and other abusivesituations as well as the problem as it relates to older children ratherthan primarily to children age birth to five years. Theliterature is beginning to demonstrate that among the consequences of childabuse are such disparate but related phenomena as a variety of adolescentadjustment problems (i.e., delinquency, deviance, school difficulties, andrunning away from home and an abusive situation). As noted briefly above, social workers are often directly involvedwith the psychological, emotional, physical and behavioral consequences ofabuse of children, adolescents, and adults. Wade and Cirese (1991), forexample, have pointed out that a substantial number of individuals whobecome clients of social workers and/or other mental health professionalsreport some type of physical, psychological or sexual abuse as having takenplace during adolescence. (1992). Schools are, like social workers, physicians, an hospitals and othersin positions of social authority, often legally mandated to reportsuspected child abuse to law enforcement authorities (Children's TaskForce, 1998; Howing, et al, 1992; Levine, Doucek, Freeman, & Compaan,1998). Report on the RelationshipBetween Child Abuse and Neglect and Later SociallyDeviant Behavior. (1992). American Journalof Roentgenology, 56, 163 -173. One of the more perplexing treatment or service populationsconsists of adolescent male delinquents who have a history of significantbehavior problems. Tower (1993) notes that the theories of child abuse causation areabundant and overlapping. Of these, 1.6 million cases involved neglect, 8 , childrenwere physically abused, 3 , were sexually abused, and almost 1 , were emotionally abused. A Manual for MandatedReporters. (1991). While the social service system has developed adequate methods ofrecognizing, validating, and initially intervening in child abuse orneglect situations, treatment methods are still, in many cases, in thedevelopment stages (Tower, 1993). Investigators have -consistently found locus of control to bea factor distinguishing abused children from non-abused children (Batter,198 ). Crenshaw, W.B., Bartell, P.A., and Lichtenberg, J.W. Lippincott, 79-92. Attempts to understand delinquency and youth are receiving increasedattention from professionals caring for this population and the generalpublic as well. The purpose of this report is to examine the problem of child abusewithin the context of the American social welfare system. Hyden (1999) furtherindicates that in 1995, approximately 3 million abused or neglectedchildren were reported in the United States, with many more casesunreported. Abnormal Psychology. Further,assailants in child abuse cases often go free even when evidence of abusedoes exist. Coleman (199 ) has argued that thisrelationship is an ideal locus for further research on the causes andetiology of juvenile delinquency. The interfactional categorysuggests that child abuse occurs because of specific interactions or flawsin the relationship between parent and child (or adult and child when theabusive person is not a parent). Learning and intelligence.H.P. It is interesting that research indicates that as economic conditionsworsen, child abuse increases (Fiesta, 1992). Compared to non-abusedchildren, physically abused children have been reported to demonstrate(typically) a higher incidence of behavioral abnormalities in general,hyperactivity, physical handicaps, and mental retardation. Howing and Wodarski (1992) state that while there is nouniversal agreement no which constitutes child abuse or neglect, the 1974Child Abuse Prevention and Treatment Act established broad parameters fordefining child abuse while permitting each state to develop its owndefinitions within those parameters.Causes and Effects of Child Abuse A number of theories as to the cause of child abuse have beenadvanced. San Francisco: W.H. Further, abused children are viewed as having increased potential ofbecoming abusive adults and parents. Given that child abuse represents a form a deviance andantisocial, violent, aggressive behavior, anomie theory may be of value inidentifying a sociological lens for studying this phenomenon. The logistics of such services aredifficult to work out. Flood, makes it clear that the liability forfailure to report child abuse when suspected is a greater risk exposurethan the reporting of suspected child abuse that, when investigated, provesto be in error (Fiesta, 1992). Most states grant persons who report suspected child abuseimmunity from civil and criminal liability; when a physician suspects bydoes not report child abuse, that physician's failure is viewed asproximate cause of judicial failure to remove the child to a safe place. Seligman, M.E.P. Some successful intervention/treatment methodsinclude that of Anchorage, Alaska, where two treatment and preventionprograms were consolidated into a single entity focused on this topicalone. Clinical reports portray the home environment of abused children ashaving certain factors, which according to Seligman's (1975) theory, wouldproduce learned helplessness. Life skills training focuses on such topics as coping with stress andcrisis, making decisions, learning socialization, building a positive self-image, and preparing for parenthood. Murry, S.K., Baker, A.W., and Lewin, L. Legal requisites and socialworkers in child abuse and neglect situations. This suggests that as adultsencounter difficulties in meeting economic demands and requirements, self-control becomes more difficult to maintain and chance events or children'sbehaviors can exacerbate already tense situations. Since that time, numerous private and public sectorprograms and efforts to resolve this problem have been undertaken(Children's Justice Task Force, 1998; Howing & Wodarshi, 1992; Hyden, 1999). Friedman, E. (1994). Fundamental tothe success of any treatment program, however, is the willingness anddetermination of the abusive adult to participate in treatment and make areal commitment to changing inappropriate and damaging behaviors (Tower,1993). The sociological lens or theory through which child abuse isto be discussed herein positions child abuse as a direct violation of thebasic human rights of a child by an adult parent, guardian, caretaker orother individual or group. American Psychiatric Association. However, as asubsequent section of this study will demonstrate, most causation theoriestend to be psychological or psychosocial in orientation.Definitions of Child Abuse The physical abuse of children is a phenomenon that can only beunderstood in terms of the social and cultural context in which it takesplace, with emphasis on some specific factors. They can facilitate the safeplacement of the child as needed. There are numerousvariables, which may interact to produce an abusive home environment, andnumerous effects of these interactions. Friedman has pointed out that many children are eitherinarticulate when called upon to testify in such cases or too traumatizedby their experiences to sit in a witness box and confront the abusiveadult. Interestingly, in themiddle 182 s and until fairly recently, children categorized as neglectedor abused were often housed and treated alongside children and adolescentscategorized as delinquent. Terling (1999) believes that there maybe some relationship between any number of variables (age, income, familydemographics, race/ethnicity, etc.) and child abuse, but that there isenormous and perhaps insurmountable difficulty in generalizing suchrelationships. Community resources are often limited, and many smallercommunities lack the financial resources to provide direct, meaningfulservices to families in which abuse takes place (Tower, 1993). They would expect an outcome tobe uncontrollable, and would have marked difficulty in understanding thattheir response would make a difference in controlling outcome (Seligman,1975). Child abuse. Johnson, W., and Clancy, T. Albany: New York State Assembly. Since 1946 and the release ofCaffey's (1946) findings, the literature on child abuse has increased andbroadened. Many abusive adults were, themselves, victims of child abuseand approach childcare and discipline with the same set of attitudes thattheir own parents held; according to Tower (1993), such adults are highlyresistant to therapy. Droste. Cambridge:Ballinger. Nursing Management,23(7), 14 -17. The child's voluntary responses quicklydiminish because he has experienced trauma, which he cannot control and hismotivation to respond in the face of later trauma wanes. Thesecharacteristics are inferred to be a result of certain features of thecaretaking styles of abusive parents, beyond the effects of physicalassault itself. Still othercultures regard children as virtually the property of parents and do notinterfere in this relationship even when abuse is a factor. Lacking this, only removal of the child permanently will ensurefuture safety and security. Arecent court case, Landeros v. (1991). Elmer, E. By working with both the abuse victim andthe abusive adult, social workers can assist the family in coming to termswith the problem, its causes and its effects. A sociologicallens through which the problem is to be considered will be presented, alongwith an analysis of the definitions, causes, and consequences of thissocial problem. (1966). (Ed.). (1977). Studies focused on child abuse have incorporated examination ofthe influence of demographic variables such as age, sex, ethnicity andsocial class (Gil, 197 ). While these are relativelyrecent innovations in the field, a number of other treatment approacheshave been evaluated as having a successful effect on the problem. It is also difficult for the courts to remove children fromparental custody and control lacking such clear-cut evidence. However, a survey of childprotective agencies and services (CPS) undertaken by Crenshaw, et al(1994), suggests that most social workers support mandatory reportingdespite these potential complications.Role of Social Workers Tower (1993) has pointed out that one of the difficulties inherent inidentifying, preventing or treating this problem is that many abusiveadults and their victims resist efforts to force them to come to terms withthe problem. When confronting future frustratingtasks these children will expect the outcome to be controllable and willpersist in responding. The consequences cancontinue into adulthood. (199 ). Martin, H.P. (199 ). Rotter, J. Locus of control, persistence, and use of contingency information in physically abused children.Dissertation Abstracts International, 49, (2-B) 681. Child abuse is defined as the nonaccidental injury of children; a keyelement in this definition is the voluntary nature of child abuse, while asecond implication of the definition is that real, measurable andobservable harm or damage has taken place (Tower, 1993). (1999). (1976). One anomaly linked in theliterature to child abuse is juvenile delinquency, which may in some casesbe the result or artifact of or earlier or ongoing abuse. Wade, C., and Cirese, S. In futurefrustrating tasks, the old learning would presumably interfere with newlearning about response-outcome dependence. Generalized expectancies for internalversus external control of reinforcement. (1972). In C. Once the safety and thesecurity of the child is assured, treatment of individual adult abusers andthe family as a whole can begin. The environmental-social-cultural category contains those theories that regard stresses from theimmediate environment, society, or culture as the primary contributingfactors to abuse. Purposedrevisions to mandatory reporting laws: An exploratory survey of ChildProtection Service agencies. Professional ethics,confidentiality, and the best interests of the client often are in conflictwith legal obligations to report child abuse. Philadelphia: J.B. The type ordegree of abuse may not have any direct relationship to the child'sbehavior, and the child may perceive himself to be at the literal andfigurative mercy of the abusive adult caretaker. Many non-Western cultures are far more permissivewith respect to children's behavior than Western societies, and allow youngchildren in particular enormous freedom of behavior and attitude thatWestern cultures would regard as inappropriate (Tower, 1993). Caffey (1946) published radiologic studies of subduralhematomas and fractures of the long bones which often occur together ininfants, strongly suggesting accidental or willful trauma to the infantinflicted by a parent or other caretaker. Helplessness: On Depression,Development,andDeath. One factor, which has received attention recently with respect toboth abuse victims and juvenile delinquents, though not in a studyincorporating both groups of subjects, is locus of control. Repeated uncontrollabilityprocedures, therefore, an interference with response-outcome dependencewhich may be chronic (Seligman, 1975).Role of the Justice and School Systems The legal penalties associated with child abuse are significant, butdo not appear to be effective as deterrents of this problem. In the UnitedStates, however, the problem has become the center of debate andcontroversy as more sophisticated reporting and identification techniquesand methods are created. Social Work,37 (4), 33 - 335. Tower (1993) has proposed three "categories" of causalexplanations. References Alfaro, J. Behavior modification, stress management,making use of hotline and other support networks when a situation threatensto become abusive, group therapy with other victims and abusers, individualand family therapy - each of these treatment modalities can be and has beensuccessful in eliminating abusive behavior from daily life. There is, however, noevidence which suggests that poor people are more likely than economicallysecure or wealthy people to abuse their children (Tower, 1989).Summary and Conclusions As the foregoing discussion of child abuse demonstrates, this is aproblem that cuts across many (and many real as well as artificial) socialboundaries. Howing, P.T., and Wodarski, J.S. Terling, T. Children's Justice Task Force. The psychopathological category encompasses models that seethe primary cause of abuse as residing within the parent; all that isneeded for abuse to take place is a stimulus. (197 ). Hyden, P.W. Coleman (1986) has pointed out that delinquency isessentially a legal construct in American society; the term "juveniledelinquent" is generally applied to young persons under the age of 18 whoexhibit behavior which is punishable by laws, many of which do not apply toindividuals older than 18 years. Other studies have looked at intellectual anddevelopmental data such as intelligence scores, head circumference, heightand weight (Elmer, Evans, & Reinhart, 1977). Laws limited the authority of parents and school officials in thisarea. Kemp and R. Certainly these types of abuse have long beenrecognized to have long-lasting and highly damaging consequence and effectsupon individual development, stability, maturation and "normalcy (Wade &Cirese, 1991." These, then are the barriers to intervention, which must beaddressed by the social worker. (1967). Coleman, J.C. Child abuse can beeither physiological or psychological, but most reported cases appear toinclude some type of physical harm.
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