The phrase ''child abuse'' often immediately brings to mind the image of a child beaten black and blue by an angry parent or caregiver. This is merely one scenario and perhaps the easiest to contrive because one can see what has been done to the child. It sparks people's emotions and a desire to take action against the offending adult. In reality there are many faces of child abuse and many more acts that leave scars ''invisible'' to the naked eye. There is a tendency to ignore children who display no physical or outward signs of abuse. A large number of these children go unrecognized, living in environments that hinder their potential and their development as secure, healthy individuals.
''Child maltreatment'' is a term designed to draw attention away from the purely abuse-related acts or injuries that children suffer. It is an all-inclusive term to describe, in essence, when a caregiver does something or fails to do something that has harmed or threatens to harm a child in his or her care. Child abuse refers to acts of commission, which are done to a child and cause harm (or the threat of harm), whereas child neglect refers to acts of omission, acts that are not done to or for a child, which result in harm (or the threat of harm). In using the separate categories of child abuse and child neglect there are further distinctions that can be made. Abuse is often categorized into physical, sexual, psychological, and emotional abuse. Neglect is often categorized into physical, emotional, medical, and educational neglect. The most commonly reported statistics are those for physical abuse, sexual abuse, and overall child neglect.
How are child abuse and neglect manifested? Physical abuse involves harming the physical body with such acts as kicking, punching, stabbing, or beating a child with an object; whereas physical neglect involves not taking care of the needs of the physical body with food or shelter. A child's exposure to a harmful environment (such as one in which drug use is occurring) could also be construed as physical neglect because of the threat of harm to the child (i.e., if the child were capable of getting to the drugs himself, or if the drugs impaired the ability of the caretaker to adequately supervise the child). Similarly, emotional abuse might involve harming a child emotionally by yelling, threatening the child, or calling the child demeaning names, such as ''stupid.'' Emotional neglect would be failing to provide emotional support for a child such as happens when a caretaker abandons a child or lacks any affection for a child. For many children, different forms of maltreatment occur at the same time.
While these definitions seem self-explanatory, there is much debate about what constitutes abuse and neglect in the United States. In other words, the practical application of these terms is not always easy. At the broad ends of the spectrum, there is usually little argument about whether abuse or neglect has occurred. If a parent takes an iron and intentionally burns his two-year-old child just because the child wet the bed at night, few would argue that this was child abuse. Yet, if a single parent working two jobs to support the family has no time at the end of the day to interact with his children, is this neglect? The larger issue is that having such definitions implies that there are certain standards for parenting or caring for children. With such a diverse and multicultural population, clear differences in parenting styles and standards exist. The task of deciding where abuse and neglect fall in that spectrum is challenging.
Another issue of debate in defining child maltreatment involves the societal response to child maltreatment. Social workers, medical professionals, and law enforcement personnel are most often involved in cases of child maltreatment. Each profession has its own criteria for identifying abuse and neglect. Law enforcement, for example, is concerned with proof of abuse or neglect and assigning culpability; in other words, who is to blame? The law requires respondents to look for and present ''evidence'' of maltreatment, when evidence may not be readily apparent. In many sexual abuse cases, for example, a child has made statements that indicate abuse, but the physical exam of the child is normal. Despite what the child has disclosed, it is rare for these cases to be brought to trial without physical evidence of abuse being present.
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