Signs of parental neglect

Child abuse - Symptoms and causes

Overview

Mayo Clinic Center for Safe and Healthy Children and Adolescents

Any intentional harm or mistreatment to a child under 18 years old is considered child abuse. Child abuse takes many forms, which often occur at the same time.

Physical abuse. Physical child abuse occurs when a child is purposely physically injured or put at risk of harm by another person.
Sexual abuse. Child sexual abuse is any sexual activity with a child. This can involve sexual contact, such as intentional sexual touching, oral-genital contact or intercourse. This can also involve noncontact sexual abuse of a child, such as exposing a child to sexual activity or pornography; observing or filming a child in a sexual manner; sexual harassment of a child; or prostitution of a child, including sex trafficking.
Emotional abuse. Emotional child abuse means injuring a child's self-esteem or emotional well-being. It includes verbal and emotional assault — such as continually belittling or berating a child — as well as isolating, ignoring or rejecting a child.
Medical abuse. Medical child abuse occurs when someone gives false information about illness in a child that requires medical attention, putting the child at risk of injury and unnecessary medical care.
Neglect. Child neglect is failure to provide adequate food, clothing, shelter, clean living conditions, affection, supervision, education, or dental or medical care.

In many cases, child abuse is done by someone the child knows and trusts — often a parent or other relative. If you suspect child abuse, report the abuse to the proper authorities.

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Symptoms

A child who's being abused may feel guilty, ashamed or confused. The child may be afraid to tell anyone about the abuse, especially if the abuser is a parent, other relative or family friend. That's why it's vital to watch for red flags, such as:

Withdrawal from friends or usual activities
Changes in behavior — such as aggression, anger, hostility or hyperactivity — or changes in school performance
Depression, anxiety or unusual fears, or a sudden loss of self-confidence
Sleep problems and nightmares
An apparent lack of supervision
Frequent absences from school
Rebellious or defiant behavior
Self-harm or attempts at suicide

Specific signs and symptoms depend on the type of abuse and can vary. Keep in mind that warning signs are just that — warning signs. The presence of warning signs doesn't necessarily mean that a child is being abused.

Physical abuse signs and symptoms

Unexplained injuries, such as bruises, broken bones (fractures) or burns
Injuries that don't match the given explanation
Injuries that aren't compatible with the child's developmental ability

Sexual abuse signs and symptoms

Sexual behavior or knowledge that's inappropriate for the child's age
Pregnancy or a sexually transmitted infection
Genital or anal pain, bleeding, or injury
Statements by the child that he or she was sexually abused
Inappropriate sexual behavior with other children

Emotional abuse signs and symptoms

Delayed or inappropriate emotional development
Loss of self-confidence or self-esteem
Social withdrawal or a loss of interest or enthusiasm
Depression
Avoidance of certain situations, such as refusing to go to school or ride the bus
Appears to desperately seek affection
A decrease in school performance or loss of interest in school
Loss of previously acquired developmental skills

Neglect signs and symptoms

Poor growth
Excessive weight with medical complications that are not being adequately addressed
Poor personal cleanliness
Lack of clothing or supplies to meet physical needs
Hoarding or stealing food
Poor record of school attendance
Lack of appropriate attention for medical, dental or psychological problems or lack of necessary follow-up care

Parental behavior

Sometimes a parent's demeanor or behavior sends red flags about child abuse. Warning signs include a parent who:

Shows little concern for the child
Appears unable to recognize physical or emotional distress in the child
Blames the child for the problems
Consistently belittles or berates the child, and describes the child with negative terms, such as "worthless" or "evil"
Expects the child to provide attention and care to the parent and seems jealous of other family members getting attention from the child
Uses harsh physical discipline
Demands an inappropriate level of physical or academic performance
Severely limits the child's contact with others
Offers conflicting or unconvincing explanations for a child's injuries or no explanation at all
Repeatedly brings the child for medical evaluations or requests medical tests, such as X-rays and lab tests, for concerns not seen during the health care provider's examination

Physical punishment

Child health experts condemn the use of violence in any form, but some people still use physical punishment, such as spanking, to discipline their children. While parents and caregivers often use physical punishment with the intention of helping their children or making their behavior better, research shows that spanking is linked with worse, not better, behavior. It's also linked to mental health problems, difficult relationships with parents, lower self-esteem and lower academic performance.

Any physical punishment may leave emotional scars. Parental behaviors that cause pain, physical injury or emotional trauma — even when done in the name of discipline — could be child abuse.

When to see a doctor

If you're concerned that your child or another child has been abused, seek help immediately. Depending on the situation, contact the child's health care provider, a local child welfare agency, the police department or a 24-hour hotline for advice. In the United States, you can get information and assistance by calling or texting the Childhelp National Child Abuse Hotline at 1-800-422-4453.

If the child needs immediate medical attention, call 911 or your local emergency number.

In the United States, keep in mind that health care professionals and many other people, such as teachers and social workers, are legally required to report all suspected cases of child abuse to the appropriate local child welfare agency.

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Risk factors

Factors that may increase a person's risk of becoming abusive include:

A history of being abused or neglected as a child
Physical or mental illness, such as depression or post-traumatic stress disorder (PTSD)
Family crisis or stress, including domestic violence and other marital conflicts, or single parenting
A child in the family who is developmentally or physically disabled
Financial stress, unemployment or poverty
Social or extended family isolation
Poor understanding of child development and parenting skills
Alcohol, drugs or other substance abuse

Complications

Some children overcome the physical and psychological effects of child abuse, particularly those with strong social support and resiliency skills who can adapt and cope with bad experiences. For many others, however, child abuse may result in physical, behavioral, emotional or mental health issues — even years later.

Here are some examples.

Physical issues

Premature death
Physical disabilities
Learning disabilities
Substance abuse
Health problems, such as heart disease, diabetes, chronic lung disease and cancer

Behavioral issues

Illegal or violent behavior
Abuse of others
Withdrawal
Suicide attempts or self-injury
High-risk sexual behaviors or teen pregnancy
Problems in school or not finishing high school
Limited social and relationship skills
Problems with work or staying employed

Emotional issues

Low self-esteem
Difficulty establishing or maintaining relationships
Challenges with intimacy and trust
An unhealthy view of parenthood
Inability to cope with stress and frustrations
An acceptance that violence is a normal part of relationships

Mental health disorders

Eating disorders
Personality disorders
Behavior disorders
Depression
Anxiety disorders
Post-traumatic stress disorder (PTSD)
Trouble sleeping (insomnia) and nightmares
Attachment disorders

Prevention

You can take important steps to protect your child from exploitation and child abuse, as well as prevent child abuse in your neighborhood or community. The goal is to provide safe, stable, nurturing relationships for children.

Here's how you can help keep children safe:

Offer your child love and attention. Nurture and listen to your child and be involved in your child's life to develop trust and good communication. Encourage your child to tell you if there's a problem. A supportive family environment and social networks can help improve your child's feelings of self-esteem and self-worth.
Don't respond in anger. If you feel overwhelmed or out of control, take a break. Don't take out your anger on your child. Talk with your health care provider or a therapist about ways you can learn to cope with stress and better interact with your child.
Think supervision. Don't leave a young child home alone. In public, keep a close eye on your child. Volunteer at school and for activities to get to know the adults who spend time with your child. When old enough to go out without supervision, encourage your child to stay away from strangers and to hang out with friends rather than be alone. Make it a rule that your child tells you where he or she is at all times. Find out who's supervising your child — for example, at a sleepover.
Know your child's caregivers. Check references for babysitters and other caregivers. Make irregular, but frequent, unannounced visits to observe what's happening. Don't allow substitutes for your usual child care provider if you don't know the substitute.
Emphasize when to say no. Make sure your child understands that he or she doesn't have to do anything that seems scary or uncomfortable. Encourage your child to leave a threatening or frightening situation immediately and seek help from a trusted adult. If something happens, encourage your child to talk to you or another trusted adult about what happened. Assure your child that it's OK to talk and that he or she won't get in trouble.
Teach your child how to stay safe online. Put the computer in a common area of your home, not the child's bedroom. Use the parental controls to restrict the types of websites your child can visit. Check your child's privacy settings on social networking sites. Consider it a red flag if your child is secretive about online activities.

Cover online ground rules, such as not sharing personal information; not responding to inappropriate, hurtful or frightening messages; and not arranging to meet an online contact in person without your permission. Tell your child to let you know if an unknown person makes contact through a social networking site. Report online harassment or inappropriate senders to your service provider and local authorities, if necessary.
Reach out. Meet the families in your neighborhood, including parents and children. Develop a network of supportive family and friends. If a friend or neighbor seems to be struggling, offer to babysit or help in another way. Consider joining a parent support group so that you have an appropriate place to vent your frustrations.

If you worry that you might abuse your child

If you're concerned that you might abuse your child, seek help immediately. In the United States, you can get information and assistance by calling or texting the Childhelp National Child Abuse Hotline: 1-800-4-A-CHILD (1-800-422-4453).

Or you can start by talking with your family health care provider. Your provider may offer a referral to a parent education class, counseling or a support group for parents to help you learn appropriate ways to deal with your anger. If you're misusing alcohol or drugs, ask your health care provider about treatment options.

If you were abused as a child, get counseling to ensure you don't continue the abuse cycle or teach those destructive behaviors to your child.

Remember, child abuse is preventable — and often a symptom of a problem that may be treatable. Ask for help today.

By Mayo Clinic Staff

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Warning signs of child abuse and neglect

Learn about the warning signs of child abuse and neglect.

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Signs of physical abuse

Bruising, welts or burns that cannot be sufficiently explained, particularly bruises on the face, lips and mouth of infants or on several surface planes at the same time
Unusual bruising patterns that reflect the shape of the instrument used to cause injury (e.g., belt, wire hanger, hairbrush, hand, human bite marks)
Clusters of bruises, welts or burns, indicating repeated contact with a hand or instrument
Injuries on the body where children usually do not get hurt (e.g., the torso, back, buttocks, thighs, neck)
Burns that are insufficiently explained, e.g., cigarette burns
- Immersion burns including marks indicating dunking in a hot liquid, including “stocking” and “glove” burns on feet and hands, or “doughnut” shaped burns on buttocks and genitalia
- Rope or restraint burns on the arms, hands, neck or legs
- Dry burns caused by forced contact with a hot surface (e. g., a clothes iron, hair curler, heater or stove)
Lacerations and abrasions of the lip, eye, or to any part of a child’s face
Tears in the tissue of the gums, possibly as a result of force-feeding
Laceration or abrasion to external genitalia
Absence of hair or hemorrhaging beneath the scalp due to vigorous hair pulling
Withdrawn, fearful or extreme behavior

Signs of possible neglect

Child or youth

Shows sudden changes in behavior or school performance
Is frequently absent from school or child care
Has not received help for physical or medical problems brought to parent or caregiver’s attention
Has learning problems (or difficulty concentrating) that cannot be attributed to specific physical or psychological causes
Is always watchful, as though preparing for something bad to happen
Begs or steals food or money
Lacks adult supervision
Is consistently dirty and has severe body odor
Lacks sufficient clothing for the weather

Parent or caregiver

Denies the existence of, or blames the child for, problems in school
Shows little concern for the child
Is abusing alcohol or drugs
Seems apathetic or depressed

Signs of possible sexual abuse

Perceptible Signs of Sexual Abuse

Difficulty walking or sitting
Pain or itching in the genital area
Torn, stained or bloody underclothing
Bruises or bleeding in external genitalia
Frequent complaints of stomachaches or headaches
Venereal disease
Frequent urinary or yeast infections
Pregnancy

Behavioral Signs of Sexual Abuse

Withdrawal or chronic depression
Inappropriate sex play or premature understanding of sex
Feeling threatened by physical contact, closeness
Promiscuity
Running away from home
Child is “parentified” or overly concerned for siblings
Poor self-esteem, lack of confidence
Peer problems, lack of involvement with friends
Extreme weight change
Suicide attempts or threats; especially with adolescents
Hysteria, lack of emotional control
Sudden school difficulties
Unprovoked cruelty to animals

Signs of possible sexual exploitation or human trafficking

Instability in life functioning: Youth lacks access to basic needs, including stable shelter, and is unable to engage in activities expected of her/his age
Relationships: Youth’s relationships are concerning, placing him/her at risk or in danger
Finances and belongings: Youth has money or material goods that are incongruent with her/his life circumstances
Use of technology: Youth’s use of internet, cell phone or social media involves social or sexual behavior that is atypical for his/her age
Physical health: Youth has significant health problems related to sexual activity and lack of access to basic needs
Risky behaviors: Youth engages in dangerous or risky behaviors, e. g., spending time with abusive partners or in locations where exploitation is known to occur, running away or staying away overnight, using substances)
Trauma exposure/signs: Youth has been exposed to traumatic circumstances and/or exhibits signs and emotional symptoms of trauma exposure
Coercion and grooming: Youth exhibits behaviors or otherwise indicates he/she is being controlled or coerced by another person
Exploitation: Youth has been exposed to sexual exploitation or victimization

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Signs of parental burnout and how to help yourself - Uchi.ru Magazine

We talk about the causes of burnout, ways to prevent it and how to support yourself if you are tired of being a parent

Anastasia Demchikova

Knows everything about how to support parents

April 27, 2022

What is burnout
How it arises
4 stage burnout
What is dangerous
How to help yourself
Prophylaxis

Parental burnout has been talked about for the last 15 years. According to a recent study of more than 17,000 parents from 42 countries, 7% of parents in Russia experience symptoms of physical and mental exhaustion from parenthood. Parents of younger students are at risk due to increased attention to the child's education. With experts, we figured out the causes of burnout, prevention options, as well as what to do if you are tired of the parental role.

The material was prepared with the help of experts: candidate of psychological sciences and practicing psychotherapist Vera Yakupova and psychologist, writer and mother of 11 children Ekaterina Burmistrova.

What is burnout

Vera Yakupova

Candidate of Psychological Sciences and practicing psychotherapist

Burnout is a great fatigue from parental functions, a feeling of emotional devastation when there is no more strength to continue. This is probably familiar to many - when being a parent is so hard that the thought “you need to do homework” gives up.

Parental burnout is not yet recognized as a separate disease (unlike professional burnout, which is included in the ICD). Burnout is often considered as a pre-depressive state associated with prolonged chronic stress in an important area of life for a person, however, psychologists distinguish parental burnout from depression. With parental burnout, severe physical and mental exhaustion is associated precisely with the parental role.

Burnout is often thought of as a pre-depressive condition. Photo: Lena Ivanova/shutterstock.com

Characteristic signs of burnout:

emotional distance from the child;
inability to enjoy parenthood;
disappointment in oneself as a parent;
"I've had enough" feeling.

How it arises

Vera Yakupova notes that in psychotherapeutic practice, parental burnout is now a frequent request. This is due to external factors and cultural characteristics. The requirements for parents are much higher than they used to be. In European countries, children grow up in nuclear families (parents and children), without the constant support of other relatives. All duties and responsibilities are shared between the parents, most often with a bias towards the woman.

Sociologists single out the concept of "intensive parenting", when parents invest a lot of resources in the comprehensive development of the child. Parenthood is turning into a science, the development of which seems vital in order to prevent serious mistakes.

According to psychologist Ekaterina Burmistrova, one of the main risk factors for schoolchildren's parents is the hyperattentive and hypermotivated attitude of parents to their child's studies.

Ekaterina Burmistrova

Psychologist, writer and mother of 11 children

Experts and educational psychologists themselves have been forming such an attitude for a long time. The educational system has changed and developed over the past 20 years. Today, the child does not always have the opportunity to learn according to his abilities. The concept of intensified stimulated learning - "educational race" - takes into account not the individual profile of the child, but the reactions, projections, ambitions of parents.

One of the main risk factors for schoolchildren's parents is hyper-attentive and hyper-motivated attitude to their child's studies. Photo: Alexander_Safonov/shutterstock.com

Parental over-attention to learning includes:

ignoring the neurology, health characteristics and psychological typology of the child;
early start of school: children are still sent to the first grade at less than seven years of age, when the will and emotions have not yet matured;
schedule overload: in addition to school, children have a huge amount of extra classes, there is no time for breaks, development, sports and walks;
parent's tense, anxious attitude to learning;
experience because of assessments, perception of current assessments not as a process, but as a result;
feeling of guilt: "I'm a bad mother, I don't give enough to my child, more can be done. "

All this does not mean that parental burnout is inevitable for you if your child goes to school early, attends clubs every day and you really care about his education. We will understand how parental burnout develops and what to do to prevent it.

Four stages of burnout

The authors of the first Russian-language book on parental burnout, Mom at Zero, identify four stages of parental burnout.

The first stage - mobilization

Each new stage of parenthood first causes joyful excitement and inspiration. For example, preparing a child for first grade and the first months of school are exciting but enjoyable chores. Parents want to foresee and control everything, choose the best school and a good teacher, organize a comfortable place for their child to study, buy everything they need in advance - from pencils and pens to sportswear. This requires the mobilization of forces, and on an emotional upsurge everything works out.

The second stage is holding on.

Gradually, the feeling of novelty passes, the routine begins. Younger students need attention and support, they need help with their homework. When there are breakdowns in the routine - due to telecommuting, illness, inconsistency between parents, lack of additional help - any problem can annoy the parent.

At this stage, fatigue from a constant sense of responsibility appears, but while there is strength to cope with stress and relax in moments when everything is fine. For many adults, scheduling routines and rest planning is enough to save energy and recover from unforeseen tasks.

Third stage - incontinence

If the load is not reduced and rest does not occur, prolonged stress leads to nervous exhaustion. The feeling of fatigue has been haunting since the morning, irritation and anger in response to the child's request for help become a common reaction. Uncleaned toys or an unlearned verse cause anger or despair, which does not correspond to the severity of the problem.

Irritation and anger in response to a child's request for help become a common reaction. Photo: Lapina/shutterstock.com

Increasingly, one has to act out of self-saving reasons, and not out of love and care for the child. As a result, there is a feeling of guilt, a feeling of "I'm not appreciated" and "I'm not doing well." If both parents are in such a state and there are no close people who help the child cope with current problems, the child becomes anxious, insecure, his performance decreases, his health deteriorates.

All this snowballs and leads to more stress. If nothing is done, physical exhaustion joins the parent's nervous exhaustion: chronic diseases worsen, SARS and injuries occur more often. Your body needs to take a break.

Fourth stage - deformity

Many parents who have been through the deformity stage remember shouting at their children. The desire to escape and the impossibility of its realization leads to bitterness: the ability to sympathy and empathy decreases. It seems that children deliberately create problems and are to blame for everything. Sarcasm, aggression, control come to replace the warm relationship with the child.

At this stage, the parents no longer feel pain. Along with the pain, the joy of communicating with the child, interest in his development, and inspiration for joint activities also go away.

What is dangerous

Parental burnout harms the human psyche. Because of the unbearable reality, parents may be saved by destructive thoughts or addictions. If you ignore the signs of emotional exhaustion, the system of hormonal response to stress is disrupted in the body. There are somatic manifestations of parental burnout, sleep disturbances and eating disorders, as well as parental aggression and neglect. All this can not only lead the parent to depression, but also affects the parent-child relationship and ultimately the child.

How to help yourself

Verya Yakupova says that often an adult is prevented from asking for help by the mindset “I myself”. On the one hand, it is important for a person to understand "I can do it myself, I can cope with life." On the other hand, if there is a feeling that help is needed, it is better to seek it in the early stages. Then the therapy will be short-lived, because the parent himself can still rebuild his situation according to new guidelines. It is more difficult and longer to get out of severe burnout; long-term rehabilitation is required.

Severe burnout requires longer rehabilitation. Photo: fizkes/shutterstock.com

In addition to psychological help, delegating those responsibilities that now take away strength will help to cope with parental burnout:

doing homework;
delivery to circles and additional classes;
daily walks.

It is not necessary to use expensive paid services - you can agree with other parents and accompany the children to classes and walks in turns, and a familiar student or high school student can help with their studies.

Another point to consider if you want to help yourself is the influence of the information environment. To reduce it, you can unsubscribe from resources and blogs of psychologists, as well as successful mothers, which increase feelings of anxiety and guilt.

Prophylaxis

If you find yourself at risk, Ekaterina Burmistrova offers four steps to prevent parental burnout:

Recognizing a problem is always the first step towards solving it. In the case of intensive parenting, the problem may not be so much in learning, but in the perception of the situation.
Understand the roots of the problem: perhaps you are trying to actively add something that you yourself did not receive in childhood - attention, education. In this case, it is better to first analyze your childhood stories with a specialist - this greatly levels the situation, this is a long process.
Create a supportive environment that conveys a relaxed attitude towards learning. Perhaps there will be people a little older who understand that the problems of elementary school are the moment that the child outgrows.
Say to yourself, "I'm a good enough parent for my child", "I'm trying hard enough". Move the internal accent from minus to plus.

Equal participation of both parents in the upbringing of the child and professional psychological assistance mitigate the problem. Photo: LightField Studios/shutterstock.com

Vera Yakupova

PhD in Psychology and a practicing psychotherapist

Parents are living, normal and imperfect people. We have few children in our families, they are very valuable, and parenthood is an important activity, it receives a lot of attention and many questions. On the one hand, this is good, children get a good education, parents take care of their physical and emotional development. At the same time, there is a side effect in the form of burnout, because they try to do everything right, but no one really knows how to do it right.

Vera Yakupova believes that the equal participation of both parents in the upbringing of the child and professional psychological assistance mitigate the problem, but parental burnout will occur more often in the near future.

If you feel tired and parenthood is hard for you, know that you are not alone. In the initial stages, burnout can be managed on your own, but do not neglect help. Think about what kind of support is available to you now: is there anyone to share the care of children with, do you need psychological counseling, talking with friends, or time for yourself. All this serves as a prevention of severe nervous exhaustion.

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© A photo

\n

Scale of the problem

\n

\nChild maltreatment is a global problem with serious lifelong consequences. Although studies have recently been carried out in some low- and middle-income countries, much data is still lacking.

\n

\nChild maltreatment is a complex and difficult issue to study. Available estimates vary widely depending on the country and the research method used. Scores depend on:

\n
- definitions of child abuse used;\t
- type of child abuse being studied;
- statistical coverage and quality of official statistics;
- coverage and quality of surveys that require reports from victims themselves, parents or caregivers.
\n

\nHowever, international studies show that one quarter of all adults were physically abused as children, and that 1 in 5 women and 1 in 13 men were sexually abused as children. In addition, many children are victims of emotional (psychological) abuse and neglect.

\n

\nAn estimated 41,000 murders of children under the age of 15 occur each year. This figure underestimates the true extent of the problem, as a significant proportion of child abuse deaths are incorrectly attributed to falls, burns, drowning, and other causes.

\n

\nIn armed conflict and refugee camps, girls are particularly vulnerable to sexual violence, exploitation and abuse by the military, security forces, other members of their communities, humanitarian workers and others.

\n

Consequences of child abuse

\n

\n Child abuse causes suffering to children and families and can have long-term consequences. Abuse leads to stress, which is associated with impaired early brain development. Extreme stress can disrupt the development of the nervous and immune systems. As a result, in adulthood, people who were abused as children are at increased risk of behavioral and physical and mental health problems, such as:

\n
- committing or being a victim of violence;\t
- depression;
- smoking;
- obesity;\n
- high-risk sexual behavior;
- unplanned pregnancy;
- Harmful use of alcohol and drugs.
\n

\nAs a result of these behavioral and mental health consequences, abuse can lead to heart disease, cancer, suicide, and sexually transmitted infections.

\n

\nIn addition to its health and societal impacts, child abuse also has economic impacts, including hospitalization costs, mental health care, child care, and long-term health costs.

\n

Risk factors

\n

\nIdentified risk factors for child abuse. These risk factors are not present in all social and cultural settings, but they give a general idea when trying to understand the causes of child abuse.

\n

Child

\n

\nIt is important to emphasize that children are victims and should never be blamed for abuse. Some individual characteristics of a child may increase the likelihood of abuse:

\n
- a child under 4 years of age or a teenager;\n
- a child who is unwanted or does not live up to parental expectations;
- a child who has special needs, who cries constantly, or who has an abnormal physical condition.
\n

Parents or caregivers

\n

\nSome characteristics of parents or caregivers may increase the risk of child abuse. Among them are the following:

\n
- difficulties associated with the newborn;\n
- leaving the child unattended;
- childhood abuse;
- lack of knowledge about child development or unrealistic expectations;
- harmful use of alcohol or drugs, including during pregnancy;
- involvement in criminal activity;
- experiencing financial difficulties. \n
\n

Relationships

\n

\nA number of factors in relationships within families or between sexual partners, friends, and peers can increase the risk of child abuse, such as :

\n
- problems in the field of physical or mental health or development of any family member;\n
- discord in the family or violence between other family members;
- isolation in the community or lack of a supportive circle;
- lack of support in raising a child from other family members.
\n

Community and social factors

\n

\nA number of characteristics of individual communities and communities can increase the risk of child abuse. They include:

\n
- gender and social inequality;
- lack of adequate housing or family support services and institutions;
- high levels of unemployment and poverty;
- easy access to alcohol and drugs;
- inappropriate policies and programs to prevent child abuse, child pornography, child prostitution, and child labor;\n
- social and cultural norms that support or glorify violence against others, favor the use of corporal punishment, require strong gender roles or belittling the status of the child in the relationship between parents and children;
- social, economic, health, and educational policies that lead to poor living standards or socioeconomic inequality or instability.
\n

Prevention

\n

\nPrevention of child abuse requires a multisectoral approach. Effective programs are those that support parents and instill positive parenting skills. They include:

\n
- Nursing home visits to parents and children for support, education, and information;\n
- Parent education, usually in groups, to improve child-rearing skills, increase knowledge of child development, and encourage positive child-care strategies ; and
- multi-component activities, typically including parent support and education, early childhood education, and child care.
\n

\nOther prevention programs are also promising in some respects.

\n
- Abuse Head Injury Prevention Programs (also called Shaken Baby Syndrome and Inflicted Traumatic Brain Injury). These are usually hospital-level programs targeting young parents prior to their discharge, educating them about the dangers of shaken baby syndrome and recommending interventions for inconsolably crying babies.
- Child sexual abuse prevention programs. They are usually held in schools and teach children about the following areas:
\n

\nSuch programs are effective in increasing protective factors against child sexual abuse (such as knowledge about sexual abuse and protective behaviors), but data on whether such programs reduce others types of violence are absent.

\n

\nThe earlier in a child's life such interventions are carried out, the more beneficial they are for the child (eg, cognitive development, behavioral and social competence, educational training) and for society (eg, reduced delinquency and crime).

\n

\nIn addition, early recognition of cases, combined with continued care for child victims of abuse and their families, can help reduce re-abuse and its consequences.

\n

\nFor maximum impact, prevention and care interventions are recommended by WHO as part of a four-pronged public health approach:

\n
- identifying the problem;\n
- identifying causes and risk factors;
- development and testing of measures aimed at minimizing risk factors;
- disseminate information on the effectiveness of interventions and scale up proven effective interventions.\n
\n

WHO activities

\n

\nWHO in collaboration with a number of partners in the following areas:

\ n
- provides technical and regulatory guidance for evidence-based child abuse prevention;\n
- calls for greater international support for and investment in evidence-based child abuse prevention;
- provides technical support for evidence-based child abuse prevention programs in select low- and middle-income countries.
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Key Facts
- One in 5 women and 1 in 13 men report being sexually abused as children.
- The effects of child maltreatment include lifelong physical and mental health damage, and its social and professional effects can ultimately slow down the economic and social development of a country.
- Child maltreatment is preventable—a multisectoral approach is needed.
- Effective prevention programs can support parents and teach them positive parenting skills.
- Continued care for children and families can help reduce the risk of re-abuse and minimize its consequences.
Child abuse is the mistreatment and neglect of children under the age of 18. It covers all types of physical and/or emotional abuse, sexual abuse, neglect, neglect and commercial or other exploitation that results in actual or potential harm to the health, survival, development or dignity of the child in the context of a relationship of responsibility, trust or power. . Intimate partner violence is also sometimes considered a form of child abuse.

Magnitude of the problem

Child abuse is a global problem with serious lifelong consequences. Although studies have recently been carried out in some low- and middle-income countries, much data is still lacking.

Child abuse is a complex and difficult issue to study. Available estimates vary widely depending on the country and the research method used. Grades depend on the following aspects:
- applicable definitions of child abuse;
- type of child abuse being studied;
- coverage and quality of official statistics;
- coverage and quality of surveys that require reports from victims themselves, parents or caregivers.
However, international studies show that one quarter of all adults were physically abused as children, and that 1 in 5 women and 1 in 13 men were sexually abused as children. In addition, many children are victims of emotional (psychological) abuse and neglect.

An estimated 41,000 murders of children under the age of 15 occur each year. This figure underestimates the true extent of the problem, as a significant proportion of child abuse deaths are incorrectly attributed to falls, burns, drowning, and other causes.

In armed conflict and refugee camps, girls are particularly vulnerable to sexual violence, exploitation and abuse by the military, security forces, other members of their communities, humanitarian workers and others.

Consequences of abuse

Child abuse causes suffering to children and families and can have long-term consequences. Abuse leads to stress, which is associated with impaired early brain development. Extreme stress can disrupt the development of the nervous and immune systems. As a result, in adulthood, people who were abused as children are at increased risk of behavioral and physical and mental health problems, such as:
- committing violence or becoming a victim of violence;
- depression;
- smoking;
- obesity;
- high risk sexual behavior;
- unplanned pregnancy;
- Harmful use of alcohol and drugs.
As a result of these behavioral and mental health consequences, abuse can lead to heart disease, cancer, suicide, and sexually transmitted infections.

In addition to health and societal impacts, child maltreatment also has economic impacts, including the cost of hospitalization, mental health treatment, child care, and long-term health costs.

Risk factors

Risk factors for child abuse have been identified. These risk factors are not present in all social and cultural settings, but they give a general idea when trying to understand the causes of child abuse.

Child

It is important to emphasize that children are victims and should never be blamed for abuse. Certain individual characteristics of a child may increase the likelihood of abuse:
- child under 4 years of age or adolescent;
- an unwanted child or a child that does not live up to the expectations of the parents;
- a child with special needs, constant crying or abnormal physical features.
Parents or caregivers

Certain characteristics of parents or caregivers may increase the risk of child abuse. Among them are the following:
- difficulties associated with the newborn;
- leaving a child unattended;
- childhood abuse;
- ignorance of child development or unrealistic expectations;
- harmful use of alcohol or drugs, including during pregnancy;
- involvement in criminal activity;
- experiencing financial difficulties.
Relationships

A number of factors in family relationships or between sexual partners, friends and peers can increase the risk of child abuse, for example:
- a family member's physical or mental health or developmental problems;
- discord in the family or violence between other family members;
- isolation in the community or absence of a support circle;
- lack of support in raising a child from other family members.
Community and social factors

A number of characteristics of individual communities and communities can increase the risk of child abuse. They include:
- gender and social inequality;
- Lack of adequate housing or family support services and institutions;
- high levels of unemployment and poverty;
- easy access to alcohol and drugs;
- inadequate policies and programs to prevent child abuse, child pornography, child prostitution and child labor;
- social and cultural norms that support or glorify violence against others, favor the use of corporal punishment, require rigid gender roles, or degrade the status of the child in parent-child relationships;
- social, economic, health and educational policies that lead to poor living standards or socioeconomic inequality or instability.
Prophylaxis

A multisectoral approach is needed to prevent child maltreatment. Effective programs are those that support parents and instill positive parenting skills. These include:
- Nursing home visits to parents and children for support, education and information;
- Parent education, usually in groups, to improve child-rearing skills, increase knowledge of child development, and encourage positive child-care strategies; and
- multi-component activities, usually including parent support and education, early childhood education and childcare.
Other prevention programs are also promising in some respects.
- Abuse Head Injury Prevention Programs (also called Shaken Baby Syndrome and Inflicted Traumatic Brain Injury). These are usually hospital-level programs targeting young parents prior to their discharge, educating them about the dangers of shaken baby syndrome and recommending interventions for inconsolably crying babies.
- Child sexual abuse prevention programs. They are usually held in schools and educate children in the following areas:
Such programs are effective in increasing protective factors against child sexual abuse (eg, knowledge about sexual abuse and protective behaviours), but there is no data on whether such programs reduce other types of violence.

The earlier in a child's life such interventions are, the more beneficial they are for the child (eg cognitive development, behavioral and social competence, educational training) and society (eg reduction in delinquency and crime).

In addition, early recognition of cases, combined with continued care for child victims of violence and families, can help reduce re-abuse and its consequences.
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