Overview

Child maltreatment is an act or failure to act by a parent, caretaker, or other person as defined under state law that results in physical abuse, neglect including medical neglect, sexual abuse, emotional abuse, or an imminent risk of serious harm to a child (ACF 2000).

The Child Abuse Prevention and Treatment Act (CAPTA) identifies four major types of maltreatment: physical abuse, child neglect, sexual abuse, and emotional abuse. Although state definitions may vary, operational definitions include the following:
Physical abuse is infliction of physical injury as the result of punching, beating, kicking, biting, burning, shaking, or otherwise harming a child.

Neglect is failure to provide for a child's basic needs. Neglect can be physical, educational, or emotional. It includes withholding medical treatment.

Sexual abuse is fondling a child's genitals, intercourse, rape, sodomy, exhibitionism, and commercial exploitation through prostitution or the production of pornographic materials.

Emotional abuse (psychological/verbal abuse, mental injury) involves acts or failures to act by parents or other caregivers that have caused or could cause serious behavioral, cognitive, emotional, or mental disorders.

Occurrence and Consequences

According to data about child abuse and neglect cases known to child protective services (CPS) agencies in the United States during 2001:
903,000 children in the U.S. experienced or were at risk for child abuse and/or neglect (ACF 2003).

59% of child maltreatment victims suffered neglect (including medical neglect); 19% were physically abused; 10% were sexually abused; and 7% were emotionally or psychologically abused.

1,300 children died from maltreatment; 35% of these deaths were from neglect and 26% from physical abuse (ACF 2003).

Child maltreatment through blunt trauma to the head or violent shaking is a leading cause of head injury among infants and young children (Committee on Child Abuse and Neglect 2001).

Infants are at greatest risk of homicide during the first week of infancy, with the risk being highest on the first day of life (Paulozzi 2002).

Shaken-baby syndrome, a leading cause of brain injury to infants, has been documented among children up to five years old (Committee on Child Abuse and Neglect 2001). An estimated 20% to 25% of infant victims with shaken-baby syndrome die from their injuries. Nonfatal consequences of shaken-baby syndrome include blindness, cerebral palsy and cognitive impairment (U.S. Advisory Board on Child Abuse and Neglect 1995).

Children who experience maltreatment are at increased risk for experiencing adverse health effects and behaviors as adults, including smoking, alcoholism, drug abuse, physical inactivity, severe obesity, depression, suicide, sexual promiscuity, and certain chronic diseases (Felitti 1998).

Victims of child maltreatment are also at increased risk of violence as adults. A national survey found that victims who were physically assaulted by caregivers were twice as likely to be physically assaulted as adults (Tjaden 2000).
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References

Department of Health and Human Services (US), Administration on Children, Youth, and Families.
National Child Abuse and Neglect Data System (NCANDS) Glossary. Washington (DC): U.S. Government Printing Office; 2000. [cited 2003 Dec 15]. Available from: URL: www.acf.hhs.gov/programs/cb/dis/ncands98/glossary/glossary.htm

Department of Health and Human Services (US), Administration on Children, Youth, and Families. Child Maltreatment 2001. Washington (DC): Government Printing Office; 2003. [cited 2003 Dec 15]. Available from: URL: http://www.acf.hhs.gov/programs/cb/publications/cm01/index.htm

Child Abuse Prevention and Treatment Act, Pub. L. 93-247, title I, Sec. 111, formerly Sec. 14, as added Pub. L. 100-294, title I, Sec. 101, 102 Stat. 116 (Apr.25, 1988); renumbered title I, Sec. 113, and amended Pub. L. 101-126, Sec.3 (a)(1),(2),(b)(7), 103 Stat. 764, 765 (Oct. 24, 1989); renumbered Sec. 111 and amended Pub. L. No. 104-235, title I, Sec. 110, 113(a)(1)(B), 110 Stat.3078, 3079 (Oct.3, 1996). [cited 2002 Jul 1]. Available from: URL:
http://uscode.house.gov/usc.htm

Committee on Child Abuse and Neglect. Shaken-baby syndrome: rotational cranial injuries technical report. Pediatrics 2001;108:206-10.

Felitti V, Anda R, Nordenberg D, Williamson D, Spitz A, Edwards V, et al. Relationship of childhood abuse and household dysfunction to many of the leading causes of death in adults. Am J Prev Med 1998;14(4):245-58.

Paulozzi LJ. CDC. Variation in homicide risk during infancy-United States, 1989-1998. MMWR 2002;51(9):187-9.

Tjaden P, Thoennes N. Full report of the prevalence, incidence, and consequences of violence against women: findings from the National Violence Against Women Survey. Washington (DC): National Institute of Justice; 2000 Nov. Report No.: NCJ 183721.

Advisory Board on Child Abuse and Neglect (US). A Nation's Shame: fatal child abuse and neglect in the United States. Washington (DC): Department of Health and Human Services (US); 1995. Report No.: 5.