International perspectives on child abuse

This paper reviews an extensive sampling of the international literature on child abuse. The paper focuses on: (1) where the international research on child abuse is being conducted; (2) similarities and differences in definitions of abuse and violence; (3) the types of research methods and theoretical models used to study abuse; and (4) what we currently know about child abuse in other countries. The paper concludes with a discussion of how we can advance our understanding of child abuse by pursuing cross-cultural research. Awareness of child abuse, internationally, varies a great deal, often depending on the political, social, economic, and cultural milieu of the country. Also, despite noticeable trends within countries, the research techniques and theoretical models used to guide scientific investigations vary considerably from one country to the next. For these reasons, one must draw conclusions about the patterns, causes, and extent of child abuse around the world very tentatively. There is much variation as to the likelihood of children being abused, although western, industrialized nations report the highest rates of abuse. Explanations for the variation of child abuse from one country to the next emphasize cultural differences in attitudes towards, and values placed on children, and the cultural appropriateness of using violence as a means of social control.     

Child sexual abuse in sub-Saharan Africa: a literature review

OBJECTIVE: This article reviews the English-language literature on child sexual abuse in sub-Saharan Africa (SSA). The focus is on the sexual abuse of children in the home/community, as opposed to the commercial sexual exploitation of children. METHODS: English language, peer-reviewed papers cited in the Social Sciences Citation Index (SSCI) are examined. Reports from international and local NGOs and UN agencies are also examined. RESULTS: Few published studies on the sexual abuse of children have been conducted in the region, with the exception of South Africa. Samples are predominantly clinical or University based. A number of studies report that approximately 5% of the sample reported penetrative sexual abuse during their childhood. No national survey of the general population has been conducted. The most frequent explanations for the sexual abuse of children in SSA include rapid social change, AIDS/HIV avoidance strategies and the patriarchal nature of society. Child sexual abuse is most frequently perpetrated by family members, relatives, neighbors or others known to the child. CONCLUSIONS: There is nothing to support the widely held view that child sexual abuse is very rare in SSA-prevalence levels are comparable with studies reported from other regions. The high prevalence levels of AIDS/HIV in the region expose sexually abused children to high risks of infection. It is estimated that, approximately.6-1.8% of all children in high HIV-incidence countries in Southern Africa will experience penetrative sexual abuse by an AIDS/HIV infected perpetrator before 18 years of age.     

The assessment of risk in child abuse and neglect case investigations

Estimates vary, but statistics indicate that anywhere between one and six million children will be abused and/or neglected this year in the United States. In the process of investigating reports of abuse and neglect, child protective service workers are called upon to make numerous case decisions. Critical to much of this decision making is the assessment by the worker of the potential risk of harm that exists to the child regarding further abuse or neglect. This paper, based on two separate research studies, identifies the criteria child protective service workers use to assess this potential risk of harm to the child. The research also shows that the criteria are not used as individual factors that indicate the presence or absence of risk. Instead the criteria form a constellation of factors that function for the worker in assessing the degree of potential risk to the child. The article concludes with a discussion of the implications of research findings for child welfare practice.     

The Los Angeles County response to child abuse and deafness: a social movement theory analysis

There is increasingly strong evidence that children with disabilities are at higher risk for maltreatment when compared to children without disabilities. There is also concern about the adequacy of child welfare services for children and parents with disabilities, particularly those disabilities that result in a communication impairment. This article describes a successful community practice effort in Los Angeles County that resulted in the establishment of a comprehensive array of linguistically and culturally competent child abuse prevention and treatment services for the maltreated deaf child and for the deaf parent at risk for child abuse perpetration. Social movement theory is used to analyze a change effort that was developed and implemented by a broad coalition of members of the Deaf and hearing communities. Elements of the problem, social movement theory, the coalition, the change strategy, and the results are described.     

Parents’ spontaneous evaluations of children and symbolic harmful behaviors toward their child

Parents’ evaluations of children are believed to be a cognitive contributor to their subsequent child-directed harsh or physically abusive behaviors. The current research examined whether parents’ (N = 100) evaluations of children were moderated by either (a) the child behavior on which the evaluation was based and (b) parents’ measured risk for child physical abuse. The study also explored whether parents’ evaluations of children were related to their tendencies to symbolically harm their child. The current study also used a novel method to indirectly assess parents’ evaluations of children: A modified Affect Misattribution Procedure. Contrary to a priori expectations, negative evaluations of children were stronger for parents who were at low risk, relative to high risk, for child physical abuse. Nonetheless, we observed that high-risk parents were more likely than low-risk parents to inflict symbolic harm onto their child. In an exploratory analysis we observed that parents who formed more overall negative evaluations of children engaged in more symbolic harm to their child. Although high-risk parents were more likely to symbolically harm their child than low-risk parents, this effect does not seem to be due to high-risk parents’ negative child evaluations from negative child behaviors.     

The services provided during a child abuse and/or neglect case investigation and the barriers that exist to service provision

More than one million cases of child abuse and neglect come to attention of child protection agencies each year. During the course of investigating these cases, social workers are charged with protecting the child while assessing whether or not abuse or neglect has actually occurred. Child welfare philosophy also dictates that at the same time the investigation is being conducted, the social worker strives to maintain the family intact, if at all possible. One way to address this dual responsibility of protecting the child while working towards family stability is through the provision of services during the investigation. The purpose of this paper is to identify the services that are provided during the course of a child abuse and/or neglect case investigation. The paper also identifies the barriers that exist both within an agency and within the external community that discourage the provision of services to children and families. The findings of this research show that in the majority of cases services are not provided during the investigation. In those case investigations where services are provided, a much broader range of services are considered for provision than are actually delivered. The research also found that placement is the most frequently provided service; however, only one-third of those children in placement receive any clinical services while in placement. Finally, this study found that the greatest barrier to service provision is a lack of evidence necessary to intervene in the home situation.     

Intervention de la police en France,dans le milieu familial,en cas de mauvais traitements à enfants

Intervention of Police Forces in France in the Family Setting When Child Abuse and Neglect Are Noticed. French police forces, in charge of safety of persons and effects, are accustomed to intervening in family circles when child abuse occurs, and, also, each time a child's security and health are seriously threatened. They can intervene on their own, or respond to orders from an attorney or judge for children (Procureur de la République, Juge d'Instruction, Juge des Enfants). Their investigation is more easily accomplished when child abuse and neglect have just been discovered and traces of violence are still noticeable (Flagrant délit). They establish judicial procedures concerning offences committed against children, especially child abuse and neglect. But they also conduct inquiries of a social nature in order to inform a magistrate of a dangerous situation or behavior of young people under 18. This enables the judge for children to prescribe educative assistance measures. Doctors and social workers are still reluctant to notify policemen and judges, although they do not have to respect professional secrecy in any cases of injuries against children. In order to improve prevention and protection of victims of child abuse and neglect, it is truly necessary to coordinate activities of all those who intervene in pathologic family behavior: doctors, social workers, judges and policemen.     

Discourses of education,protection, and child labor: case studies of Benin,Namibia and Swaziland

This article analyses discontinuities between local, national and international discourse in the fields of education, protection of children, and child labor, using Benin, Namibia and Swaziland as case studies. In Benin, child abuse and child labor are related to poverty, whereas in Namibia and Swaziland they are also interrelated with HIV/AIDS. In these countries, the notion of childhood is seen as continuous with adulthood, and the change from education to work is not abrupt and age-determined, but a smooth transition. The international discourse defines children in binary terms (child or adult), and promotes free and compulsory education for children, without recognizing the direct and indirect costs of education. Projects based on an international discourse may have little relevance in a poverty context where it is natural to make children work to ensure food safety. Local communities consider children from a logic of community survival; the external aid agencies consider them from a logic of individual children's rights. There is a need to find a bridge between these two interpretations of childhood.     

Major findings from the Canadian incidence study of reported child abuse and neglect

OBJECTIVE: To present key findings from the Canadian Incidence Study of Reported Child Maltreatment (CIS) in sufficient detail to provide a basis for international comparisons in terms of forms and severity of maltreatment and the age and sex of victims. METHOD: A survey conducted in a random sample of 51 child welfare service areas across Canada tracked child maltreatment investigations conducted during the months of October to December 1998, produced a national sample of 7672 child maltreatment investigations. Information was collected directly from investigating workers on child and family background, perpetrator characteristics, severity and types of maltreatment and service and court outcomes of investigations. RESULTS: Forty-five percent of investigations were substantiated and in a further 22% of investigations maltreatment remained suspected. Primary reasons for investigation were physical abuse (31%), sexual abuse (11%), neglect (40%), and emotional maltreatment (19%). A larger proportion of physical abuse cases are isolated incidents involving older children and are more likely to lead to injuries. Sexual abuse, neglect and emotional maltreatment involve more chronic situations with children showing signs of emotional harm. Rates of investigated and substantiated maltreatment are lower in Canada compared to the United States, but are higher than rates reported in Australia. CONCLUSIONS: The CIS provides much needed information for developing a better understanding of the profile and needs of children and families investigated by child welfare authorities in Canada. The study also serves as a point from which international comparisons can be made.     

Child sexual abuse in Tanzania and Kenya

OBJECTIVE: Most research on child abuse in Tanzania and Kenya is unpublished in the international literature. The purpose of this paper is to examine the various commentaries and reports extant, toward an overview of the nature and frequency of child sexual abuse in Tanzania and Kenya. METHODS: Contacts were made with academics, government departments, NGOs, and UN agencies. This was followed by a field trip in the summer of 2001 where all available reports were examined and a wide range of interviews conducted. RESULTS: Little empirical data exist on child sexual abuse in Tanzania. It is widely perceived that it may be increasing as a result of AIDS sufferers' attempts to "cleanse" themselves. The breakdown of traditional childcare systems, foreign influences, poverty, and the lowly position of girls in society are also implicated. More research has been conducted in Kenya. It is clear that first coitus occurs at a young age for many Kenyan children and adolescents. Also, a degree of force, trickery, or material exchange is not uncommon in adolescent sexual relations. CONCLUSIONS: Child sexual abuse is under-researched in Tanzania and Kenya. Studies by UN agencies such as United Nations Children's Fund (UNICEF) and the International Labour Organisation (ILO) have focused on the commercial sexual exploitation of children, to the neglect of more pervasive abuse in children's own communities by family, relatives, and neighbors. Nationwide surveys of the general population are required for an empirical understanding of this topic. Given the high incidence of AIDS/HIV in both countries, it is important to know if the epidemic is increasing the risk of rape or incest for children.     

Sexual abuse: A sociological perspective

How have contemporary social changes affected the problem of child sexual abuse? The rapid rise of this problem to public attention in the United States is in part due to the mobilization around the problem by the women's movement and the child welfare movement there. But factors shown by research to be associated with the problem—social isolation and patriarchal authority—are so widespread as to suggest that this is a problem of international proportions, as well. The rising divorce rate in the U.S. and worldwide, would appear to put more children at risk at the same time that it has also made it easier for children and their mothers to escape from the most oppressive and intolerable family situations. The sexual revolution and the erosion of external controls on sexual behavior have also in all likelihood aggravated the problem, too. Sexual abuse needs to be seen as a problem distinct from physical child abuse—characterized by the preponderance of offenders who are males. This suggests searching for the sources of the problem in male sexual socialization rather than in problems of inadequate and disaffected parenting.     

The international epidemiology of child sexual abuse: A continuation of Finkelhor (1994)

ObjectiveThe purpose of this paper was to compare the prevalence rates of child sexual abuse reported by [Finkelhor, D. (1994). The international epidemiology of child sexual abuse. Child Abuse & Neglect, 18 (5), 409–417] with those found in recent publications in order to confirm the widespread prevalence of child sexual abuse.MethodsRelevant articles about prevalence of child sexual abuse were identified through searches of computerized databases and a handsearch of Child Abuse & Neglect and the Journal of Child Sexual Abuse.ResultsThirty-eight independent articles were identified, corresponding to 39 prevalence studies; these articles report the prevalence of childhood sexual abuse in 21 different countries, ranging from 0 to 53% for women and 0 to 60% for men.ConclusionsComparison of the present study with that of [Finkelhor, D. (1994). The international epidemiology of child sexual abuse. Child Abuse & Neglect, 18 (5), 409–417] shows a similarity between prevalence distributions; there appears to be a general pattern that remains more or less constant over the years, especially in women.Practice implicationsTwelve years after the first revision study about the international prevalence of child sexual abuse, there is still a need for new data about this topic. The present study shows child sexual abuse is still a widespread problem in the society. In this research, carried out on 38 independent studies, there is new data for 21 countries over the world, being especially relevant the results obtained from other countries different from those pertaining to North America or Europe. It is important to point out the high prevalence found in most of the countries, so this information could be a new warning to make society and governments aware of this problem and undertake actions to prevent sexual abuse in childhood.     

The ecological model and the study of child abuse in Nigeria

Physical abuse and exploitative child labor are two common forms of child abuse in Nigeria. Exploitative child labor exists in both the formal and informal sectors where children work as hairdressers, beggars' assistants, hawkers, and as factory and agricultural workers under conditions characterized by long hours, hazardous environment, and meager remuneration. Research on the incidence of physical abuse in Nigeria is less systematic, and few empirical studies are available. Physical abuse is primarily the result of corporal punishment which has become excessive. Poverty and the existence of a dependent capitalist economy are often proffered as the primary causes of child abuse. While both explanations have some validity, their unidimensional nature limits their explanatory capacity. These explanations also lead to the belief that very little can be done to improve the quality of children's lives until the social order is restructured. The ecological model proposes that child abuse can best be understood if it is analyzed multidimensionally with emphasis on the individual, family, social environment, and cultural milieau, as well as the dynamic interaction between these levels. This model appears appropriate for the study of child abuse in Nigeria, and its application is advocated as a vehicle for improving the quality of child abuse research.     

Child maltreatment: social representation of the general population and the professionals working with children in the Caribbean area of Colombia

OBJECTIVE: The main objective was to know social representations about child maltreatment (severity, etiology, and intervention strategies) of the general population and the professionals working with children in the Caribbean area of Colombia. METHOD: Sample was composed for 402 participants. From this pool of participants, 111 of them were working in child protection, 95 worked with children but not in the child protection system and 196 pertained to the general population. All participants answered to a questionnaire composed by 86 items. The questionnaire was developed to assess (1) the perceived severity of different typologies of child abuse, (2) opinions about risk factors for child maltreatment and sexual abuse, and (3) opinions about the most adequate ways of intervention with perpetrator of child abuse. RESULTS: Sexual abuse is considered as the most severe typology of child maltreatment and emotional abuse is considered as more severe than physical abuse. No differences between groups were found in perceived severity of typologies of child maltreatment. Differences in the social representation about the etiology of child maltreatment were found. Professionals working in the child protection system give more value to characteristics of parents and to the socio-economic and familiar environment in the etiology of child maltreatment than participants from the general population. Prevention and treatment programs for abusers were considered as the more relevant strategies against child maltreatment. DISCUSSION: Findings of present study suggest that social representations about child maltreatment of general population and professionals from the Caribbean area of Colombia are similar than social representation observed in other regions and countries. It is important to take into account that child labor and child poverty were considered as non-severe typologies of child maltreatment. Moreover, findings suggest that people from general population in the Caribbean area of Colombia have a relevant knowledge about agencies working for child protection.     

Child abuse and neglect in Denmark: Medicolegal aspects

On the basis of material selected at the Institute of Forensic Medicine. Aarhus, from 1959 to 1980. we estimated the frequency of mortality from child abuse in Denmark to be 0.5 child deaths per million inhabitants per year. This figure is equal to that in Sweden and Norway but lower than most other countries. The study population included 53 abused children: 33 living children (18 boys and 15 girls) and 20 fatalities (11 boys and 9 girls). The social background of the children and abusers (32 men and 15 women) is described in connection with the juridical and social outcome of the cases. Cases with repetitive lesions were the most important evidence of child abuse. In cases with non-repetitive injuries, it was more difficult to prove that child abuse had taken place, but subdural hematoma and abdominal lesions with rupture of the duodenum or tearing of the mesenterium were very strong evidence. We think that a better handling of cases of child abuse or neglect could be obtained with extended collaboration between the social authorities, the police, the public prosecutor, the pediatrician and the forensic pathologist.     

The impacts of institutional child sexual abuse: A rapid review of the evidence

While awareness of institutional child sexual abuse has grown in recent years, there remains limited understanding of its occurrence and outcomes as a distinct form of abuse. Drawing on research commissioned by the Australian Royal Commission into Institutional Responses to Child Sexual Abuse, this article presents a rapid review of available evidence on the impacts of institutional abuse on victim/survivors. Literature searches identified 75 sources spanning international peer reviewed work and reports to Government that document or quantify the impacts of mostly historical child sexual abuse occurring in religious, educational, sporting and residential or out-of-home care settings. Consistent with child sexual abuse in other contexts, institutional child sexual abuse is found to be associated with numerous, pervasive and connected impacts upon the psychological, physical, social, educative and economic wellbeing of victims/survivors. Further, institutional child sexual abuse is associated with vicarious trauma at the individual, family and community level, and with impacts to the spiritual wellbeing of victims/survivors of abuse that occurs in religious settings. The identified literature suggests the trauma of institutional child sexual abuse may be exacerbated by the interplay of abuse dynamics in institutional settings, which may reduce or impede circumstances supporting disclosure, belief, support and protection from future harm. Acknowledging the limitations of the present study and the available evidence, this narrative synthesis provides insights into the complex impacts of institutional child sexual abuse.     

Getting evidence into action to tackle institutional child abuse

The Australian Royal Commission into Institutional Responses to Child Sexual Abuse is an example of a government response to survivors’ demands to address the harm they suffered. It is also a major response by a national government to improve child safety in the future. Facing up to child abuse is difficult and in other countries similar inquiries have suffered delays and derailing. This commentary uses an evidence-to-action lens to explore why clear evidence of child sexual abuse may be ignored and side-lined. It argues that where evidence challenges the powerful, is surprising and shocking, or undercuts current institutional and policy arrangements, then that evidence is likely to be ignored, undermined or refuted – all factors which are present in the case of historical institutional child sexual abuse.     

Decisions and attitudes concerning child sexual abuse: does the gender of the perpetrator make a difference to child protection professionals?

Objective: An investigation was conducted into whether child protection investigators, specifically social workers and the police, are as likely to take seriously a case of child sexual abuse if it had been perpetrated by a female rather than a male. Also, to examine whether the decisions relating to female-perpetrated abuse were predicted by participants’ sex role perceptions of women and their attitudes concerning women’s sexualized behavior towards children.Method: Participants advocated decisions in response to four hypothetical case of child sexual abuse in which the perpetrator was either male or female. The female perpetrators were then rated on femininity and masculinity characteristics and attitudes concerning women’s sexualized behavior toward children were assessed.Results: Following male—rather than female—perpetrated sexual abuse, case registration and imprisonment of the perpetrator was considered more appropriate by all participant groups; male social workers also considered social services involvement and investigation as more appropriate. A substantial number of decisions concerning female perpetrated abuse were predicted by participants’ attitudes.Conclusion: While child protection professionals considered child sexual abuse perpetrated by females to be a serious issue warranting intervention, a number of advocated decisions suggested that they did not consider female-perpetrated abuse to be as serious as male-perpetrated abuse. The implication is that victims of sexual abuse perpetrated by a woman may be less likely to receive the protection afforded victims of male-perpetrated abuse. Furthermore, professionals’ practices may be inadvertently perpetuating the view that female child sexual abuse is rare or less harmful than abuse carried out by males.Spanish abstract was not available at time of publication.     

From maltreatment report to juvenile incarceration: the role of child welfare services

OBJECTIVE: This study examined whether children who received child welfare services (e.g., in-home or out-of-home placement) were more or less likely to become incarcerated as serious and violent youthful offenders than those children who were investigated as victims of abuse and neglect but received no further child welfare intervention. METHOD: Administrative data on child abuse reporting, foster care, birth records, and juvenile corrections (CYA) were linked to prospectively examine the risk of incarceration as an adolescent following an investigation of abuse or neglect after age 6. The 10 county California sample included 159,549 school-aged children reported for abuse and neglect after 1990. RESULTS: About 8 per 1,000 children in the sample were later incarcerated in CYA. African American and Hispanic children who received in-home or foster care services after the index investigation event had a lower risk of incarceration than those whose cases were closed after the investigation. Among females, the rate of incarceration was highest for those who experienced foster or group care placements. Children initially reported for neglect were more likely to be incarcerated than those reported for physical or sexual abuse. CONCLUSIONS: Public child welfare services have rarely been assessed in terms of future negative child outcomes. This study finds that one serious negative outcome, CYA involvement, can only be understood when a number of factors are considered. The importance of understanding the differences between how different subpopulations respond to services is highlighted. Specifically, our findings suggest that more attention should be focused on children who are now receiving no services after an investigated child abuse and neglect report, on females, and on victims of child neglect.     

The incidence of severe physical child abuse in Wales

OBJECTIVES: The purposes of this study were: (1) to ascertain the incidence and nature of severe physical child abuse in Wales; (2) to ascertain the incidence of all physical abuse in babies under 1 year of age; and (3) to determine whether child protection registers (CPR) accurately reflect the numbers of children who are physically abused. METHODS: This is a population-based incidence study based in Wales, UK, for 2 years from April 1996 through March 1998. Children studied were under the age of 14 with severe physical abuse consistent with the criminal law level of Grievous Bodily Harm. This included seven categories of injury (death; head injury including subdural hemorrhage; internal abdominal injury; physical injury in Munchausen Syndrome by Proxy including suffocation; fracture; burn or scald; adult bite). Cases were ascertained by a pediatrician surveillance reporting system (WPSU). A criterion for inclusion was multidisciplinary agreement that physical abuse had occurred (at case conference, strategy meeting, or Part 8 Review). The incidence of all babies under 1 year of age with physical abuse was also studied. Ascertainment of babies under the age of 1 year was undertaken from CPR as well as the WPSU. RESULTS: Severe abuse is six times more common in babies [54/100,000/year (95% CI +/- 17.2)] than in children from 1 year to 4 years of age [9.2/100,000 (95% CI +/- 3.6)]. It is 120 times more common than in 5- to 13-year-olds [0.47/100,000 (95% CI +/- 0.47)]. This is mainly because two types of serious abuse (brain injury including subdural hemorrhage and fractures) are more common in babies under the age of 1 year than older children. Using data from two sources (the WPSU and CPRs), the incidence of physical abuse in babies is 114/100,000 (CI 114 +/- 11.8) per year. This equates to 1 baby in 880 being abused in the first year of life. The largely rural Health Authority area in Wales had incidence figures for abuse in babies that were 50% of the three other predominantly urban Health Authority areas. Boys throughout the series were more at risk of being severely abused than girls (p < .025). Only 29% of the babies under 1 year of age on the CPR had actually been injured. Thirty percent of abused babies under the age of 1 year and 73% of severely abused children over the age of 1 year had caused previous concern to health professionals regarding abuse or neglect. Conclusions: Physical abuse is a significant problem in babies under the age of 1 year. Very young babies (under 6 months old) have the highest risk of suffering damage or death as a result of physical abuse. Severe abuse, in particular subdural hematoma and fracture, is much more common in babies than in older children. There is evidence of failure of secondary prevention of child abuse by health professionals, with a greater need to act on concerns regarding abuse and neglect. Interagency child protection work in partnership with parents should focus more on protecting babies under age 1 year from further abuse than on maintenance of the infant within an abusive home. The CPR is not intended as an accurate measure of children suffering abuse. It is a record of children requiring a child protection plan and must not be used as a measure of numbers of abused children.