What is Child abuse? There are many formal and unacceptable definitions of child abuse. Any acceptable definition has some emotional and social consequences to our modern families. I intent to offer some guideline information on child abuse and neglect as witnessed in families and society. Child abuse consists of any act of commission or omission that engenders or impairs a child’s physical or emotional health and development.

Child abuse includes any damage done to a child which cannot be reasonably explained. The damage is often represented by an injury or series of injuries appearing to be non accidental in human nature. The damage is considered as child’s physical, psychological or sexual assault resulting in an injury and emotional trauma. Child abuse is any injury or pattern of injuries that do not result from an accident. Scholars and healthcare practitioners suspect an abuse if the child’s injuries cannot be logically explained or if a parent or guardian gives an inconsistent or suspicious account of how the injuries occurred. When caring for a child who may have been abused, a therapist’s priority is to care for the child’s illness or injuries. A child who is abused may be frightened, hysterical or withdrawn. The child may be unwilling to talk to anyone about the incident, in an attempt to protect the abuser especially if the mother or father is involved. Family is advised to explain their concern to law enforcement authorities if they suspect abuse or violence. Families can also explain their concerns to emergency medical services (EMS) if there is suspicion of abuse. There need to be physical indicator that abuse has occurred namely, unexplained bruises and welts on the face, lips or mouth; unexplained burns, fractures to skull, nose, facial structures, dislocations inconsistent with history; unexplained laceration and abrasions. With respect to a child, research shows that abuse includes the following acts or omissions by a person:

• a. causing or permitting a child to be in a situation in which the child sustains a mental or emotional injury that results in an observable and material impairment in the child’s growth, development or psychological functioning.

• b. Physical injury that results in substantial harm

• c. Threatening physical injury.

• d. Sexual conduct harmful to a child’s mental, emotional, or physical welfare

• e. Compelling or encouraging a child to engage in sexual conduct.

• f. Causing, permitting, encouraging, engaging in, or allowing the photographing, filming or pornographic. This includes any situation in which the person knew or should have known that the resulting photograph, film or depiction of the child would be obscene or pornographic.

• g. The use of a controlled substance, health and safety code, in a manner or to the extent that the use results in physical, mental or emotional injury to a child.

• h. Causing, expressly permitting, or encouraging a child to use a controlled substance.

• i. Placing a child in or failing to remove the child from a situation in which the child would be exposed to a substantial risk of sexual conduct harmful to the child.Physical abuse in children may include beating, squeezing, burning, lacerating, suffocating, binding, poisoning, exposing to excessive heat or cold, sensory overload and prevention of sleep. Extreme violation may result in a complex maladaptive interactions and/or lack of essential caretaking behaviors that are influenced by parental skill or knowledge deficits and other stress factors (Hansen et al, 1990; Hansen, Warner-Rogers & Hecht, 1999; Kelly, 1983).

Abuse of children is a complicated societal problem that weakens parental emotions in families. It is a moral problem that has weakens the psyche of the victim. Abuse and violence have continued to weaken family’s parental bond because the act itself have been committed through human history (Zigler & Hall, 1989), with a widespread concern as significant social problems since the 60s. After the 60s, there was no clear distinction between acceptable definitions of this social issue or family concern. Again, distinction was not clear because research was limited on the issue. If there was extensive research going on, I believe modern families would have profited much on how this social issue impact family and society. Abuse/violence against children has been difficult to study in the 80s and 90s because of problems associated in specifying what is excessive discipline or inappropriate human violation. Human physical violation occurs in low frequency episode an). All these according to Wolfe, (1988) pose great consequences on the child. Violence and any social challenge against children is a public health issue, and there is abundant research that illuminates its harmful this affects families (Office of the Surgeon General, 2001). The U.S department of justice (2000) reports that about 22.3m million children; and approximately 1.8 million have been victims of serious sexual assaults, and 3.9 million have witnessed serious incidents of abuse and violence. On many occasion children are murdered while many die from gunshot wounds. Many are wounded either by family members or by strangers. Many have been reported abused as many have been reported neglected (Children’s Defense Fund, 1997).

The questions in mind are: Why are children experiencing these acts of violence? Why is society not committed to solving violent acts against children? Most children who experience abuse or violence are from families with history of neglect or aggressive behavior. Many come from families with frequent or loose disciplinary infractions. Others come from families with long standing history of abuse, neglect or incarcerations. Some children experience violence because parents are socially withdrawn with poor parental relationship or history of depression. The influence of alcohol or substance abuse by parents can challenge children’s social relationship with peers, family and environment. Children who experience violent acts are more likely to come from families who have chosen to defy society rules or family Meta rules.Others who experience abuse/violence and who are victims of neglect can suffer psychological trauma, including PTSD (NASW, 2003-2006) These Children can display array of emotional and behavioral disturbances, including low self-esteem; withdrawal, nightmares, self-blame and aggression against peers, family members and property (Peled, Jaffee & Edelson, 1995). Exposure to violence/abuse can adversely affect them and their ability to learn (Barton, Coley & Wenglinsky, 1998). It can affect any family mentally, psychologically and emotionally.

Early conceptualizations indicate that abuse and violence against children result from severe parental psychopathology. The work of (Ammerman 1990, and Kelly, 1983) congealed my spirit and it confirmed that abusive parents are diagnosed with a psychiatric condition who exhibit significant psychopathology. These studies contradict that primitive family mode of disciple where parents spank (abuse) their children when they fail to comply with rules or break family Meta rules. Belsky (1980) however sampled four ecological models that could warrant parents to violate children. These four levels are based on: genetic (personal characteristics), micro system (family characteristics), and ecosystem (community and social forces), and macro system (cultural determinants). I make bold to reason that community and social forces as well as cultural determination have the strongest hold in determining why parents abuse children. In both medical and psychiatric settings however, child abuse and neglect can be categorized into classes. Class one abuse: means any act or failure to act recklessly, or intentionally, including incitement to act which caused or could have caused major physical injury to a child.

A major physical injury may be defined as any injury determined to be serious by an individual to a child. Examples of major physical injury include, but not limited to, the following: fracture; dislocation of any joint; internal injury, non-superficial confusion; concussion; first, second, or third degree burn; or laceration requiring sutures. With regard to injury, any sexual activity between an adult and a child will be considered as class one abuse. Class two abuses means any act or failure done knowingly, recklessly, or intentionally, including incitement to act, which caused minor physical injury to a child and exploitation. A minor physical injury may be defined as any injury determined not to be serious by appropriate medical personnel to examine the child. Examples of minor physical injury include, but not limited to the following superficial laceration, confusion, or abrasion. In the medical or psychiatric setting, class two abuse means any use of verbal or other communication to curse, vilify, or degrade a child, or threaten a patient with physical or emotional harm, or any act which vilifies, degrades, or threatens a child with physical or emotional harm.

MAJOR FORMS OF CHILD ABUSE: Physical Abuse: This is any non-accidental injury to a child. This includes hitting, kicking, slapping, and shaking, burning, pinching, hair pulling, biting, choking, throwing, shoving, whipping and paddling.

Sexual Abuse: This is any sexual act between an adult and child. This includes fondling, penetration, intercourse, exploitation, exhibitionism, child prostitution, group sex, oral sex, or forced observation of sexual act.Neglect: This is a failure to provide for a child’s physical needs. Neglect includes lack of supervision, inappropriate housing or shelter, inadequate provision of food, inappropriate clothing for season or weather, abandonment, denial of medical care, and inadequate hygiene.Emotional Abuse: According to studies, emotional abuse is any attitude or behavior which interferes with a child’s mental health, family interaction social development. This includes but not limited to yelling, screaming, name-calling, and shaming, negative comparisms, telling them they are “bad, not good,” “worthless or a mistake.” It also includes the failure to provide the affection and support necessary for the development of a child’s emotional, social, physical and intellectual well-being. This includes ignoring, lack of appropriate physical and intellectual well-being. It includes ignoring, lack of appropriate physical affection (hugs), not saying “I love you”, withdrawal of affection, lack of praise and lack of positive reinforcement (Child help USA, 2009)

PROBLEMS RELATED TO ABUSE AND NEGLECT IN FAMILY AND SOCIETY: The problem of abuse and neglect are socially and psychologically inter-related. Neglect so to speak, means the negligence of an adult (parents), affiliates or agents which causes or may have caused any physical, social or emotional injury to a child. Examples of child neglect include, but not limited to, failure to carry out as prescribed individual program plan or treatment plan; failure to provide adequate nutrition, clothing, or health care; or failure to provide a safe environment. This category may include both adult who were abused as children and adolescents who have been abused or those from whom there is high potential for abuse in the future. Types of abuse may include physical, emotional, and sexual. Sexual and financial exploitation should be considered here too. Children who have been chronically neglected, not supervised adequately should be considered too. Adolescents with behavioral problems, with chronic runaway history, with parents who have a history of violence and or mental problems could be considered high risk for abuse. Below are problems related to abuse and neglect.

a. Psychological consequences include nightmares, anxiety, high levels of anger and aggression, phobias, psychosomatic complaints, facial soiling, bedwetting, depression and social isolation.

b.Physical consequences can include: smaller body size, permanent neurological damage, gastrointestinal problems, aches, pains, rashes and overall poor health.

c. Behavioral consequences can include: developmental delays, clinging behavior and extreme shyness, trouble socializing, poor school adjustment and disruptive school behavior, running away, delinquency and, eating disorder, suicide attempts and suicide contemplation or completion.

d. Academic consequences can include: Lower school performance, grade repetition, working and learning below average.

e. Sexual consequences can include: premature sexual knowledge, promiscuity, stimulated sexual acts with siblings and friends.

f. Interpersonal consequences can include: loss of close friends, very low levels of self-esteem, difficulty trusting others, overwhelming sense of guilty.g. Subsequent violence can include: maltreatment of their own children, children, becoming a victim or an assaultive partner, date violence in adolescence.

CHILD MALTREATMENT: In psychopathology, child maltreatment is the mistreatment of a child or a disregard for the developmental needs of a child by a parent, guardian or caregiver resulting in injury, emotional/psychological harm or the potential for such harm. For simplicity of terms, the consequences of physical, sexual and emotional abuse, neglect and signs of witnessing family violence will be explored in our subsequent discussion as a single entity. But before we delve into that, it is cogent to elaborate on the forms of abuse/violence and how it devastates children and families.

FORMS OF CHILD MALTREATMENT:

(A). Physical Abuse: This refers to the beating or battering of a child that includes: poisoning, burning, hitting, kicking, shaking, throwing, chocking or any other harmful force or restraint. Physical abusive behavior is often justified in the name of disciplining a child. Psychiatrists and Healthcare professionals believe that it is not an effective method of positively influencing a child’s behavior. In behavioral science, the use of physical force as a means of child discipline has the potential to escalate into much violent behavior.

(B). Sexual Abuse: This refers to the use of a child for sexual gratification of an older adolescent or adult that involves the exposure of a child to a sexual contact, activity or behavior. Sexual abuse may include invitation to sexual touching, intercourse or other forms of exploitation such as child prostitution. The key to defining an act of abuse is the difference in age and power between the victim and the offender.

(C). Neglect: This is describes as failure to provide the physical and/or psychological necessities of life to a child. It is difficult to define and detect. Examples of neglect include: not providing appropriate food, clothing and/or shelter, consistently ignoring his/her concerns and needs, or not providing developmentally appropriate levels of supervision. Neglect may have more devastating effects on children than other forms of maltreatment because it often remains undetected and is an ongoing pattern of parenting.

(d). Emotional abuse: This is difficult to define and detect. Emotional abuse does not occur in a single episode action rather in a form of repeated and sustained “mental violence”. Such behaviors as rejecting, degrading, terrorizing, isolating, corrupting/exploiting and withholding positive emotional responses are considered major forms of emotional abuse.

(e).Witnessing family violence: To witness is to be present, to observe, to be part of an event or incident. When we speak of witnessing here, we are committing to memory experiences that involve exposing children directly or indirectly to violence in the family (cat and dog fight of parents). Children sometimes may be physically present and observe the violence or they may be in another room and still hear the violence. Sometimes, children may not hear anything but witness the aftermath, such as smashed furniture or bruises on the victim. Statistics of children who have witnessed family violence are proportional to the number who has observed the assaults of a sibling or another family member. Here, there is a tendency for families to view the aftermath as less serious if the impact happens to be temporary and disappears in the course of child’s development. There are strong arguments against this proposition:Adult traumas such as rape are not assessed ultimately in terms of whether or not they will have an impact on old age. They are acknowledged as painful and alarming events whether their impact lasts for one year or ten. Similarly, childhood trauma should not be dismissed simply because no long-term effects can be demonstrated. Abuse need to be reorganized as a serious problem of childhood that results in immediate pain, confusion and upset.Research on child developmental psychology reveal that child maltreatment is not however, a short-term crisis in a child’s life. Although children are removed from violent homes or leave home in order to live on their own, the effects of experiencing abuse, grows and follow them through life. On a serious note, child maltreatment can affect all aspect of a child’s life including the following:

PSYCHOLOGICAL CONSEQUENCES: Child maltreatment may permanently alter the psychological well-being of a child. Several other problems may result such as:-extreme and repetitive nightmares-Anxiety-unusually high levels of anger and aggression-Feelings of guilt and shame for sexually abused victims; this can be quite severe especially if the Victim experienced some degree of pleasure during a portion of the abuse.-Sudden phobia such as fear of the darkness or water-Psychosomatic complaints such as stomach aches, headaches-hypochondriasis, facial soiling, bedwetting and excessive blinking-general fearfulness and a specific fear of others of the same gender as the abuser-depressive symptoms include long bouts of sadness and social withdrawal, social isolation and feelings of stigmatization. After continued or prolonged maltreatment, children may develop further pronounced complications such as:-a significant increase in psychiatric disorders-dissociation, intrusive thoughts, suicidal ideation and more acute phobias-more serious levels of anxiety, fear, depression, loneliness, anger hostility and guilty-distorted cognition, such as chronic perceptions of danger and confusion,-Illogical thinking, inaccurate perceptions of the world, shattered assumptions about the world and difficulty determining what is and is not real.-Decreased effectiveness in comprehending interpersonal relationship roles and finally difficulty in thinking through and/or resolving social problems.

PHYSICAL CONSEQUENCES: According to some mental health literature, maltreatment is always related to various physical complications in children:-children who have suffered serious neglect are more likely to be smaller and lighter whichaffects long-term health.-children who are physically abused (or shaken) may suffer permanent neurological damage that dramatically affects their future development.-weight problems often emerge as eating disorders.- Serious sleep disturbances and bouts of laziness may develop.-Other stress-related symptoms, such as gastrointestinal problems, migraine headaches, difficulty breathing, HTN, aches, pains, and rashes which defy diagnosis and/or treatment and finally-poor overall health status will result.

BEHAVIORAL CONSEQUENCES: -Developmental delays.-Clinging behavior, extreme shyness and fear of strangers.-Troubled socialization skills with peers-constant fighting and/or socially.-undesirable behaviors such as self-mutilation or burning-truancy and running away behavior-delinquency and prostitution-early use of drugs/alcohol and substance abuse/dependence-eating disorders, such as anorexia, bulimia or obesity-primarily among female victims-Suicide attempt suicide contemplation and suicide complétion.Behavioral studies always attempt to demonstrate that these problems will continue into adulthood and become a common behavior pattern. In order to deal with trauma of abuse and neglect, children and youth must develop such behaviors as coping strategies. Most often coping behavioral strategies children adopt early is very difficult to abandon. However, additional behavior difficulties in children may continue into adulthood such as: increased aggression and violence, homelessness, criminal offending-crimes which are sexual in nature and are often associated with sexual abuse while violent crimes are more often linked to physical abuse.

ACADEMIC CONSEQUENCES: One major consequences of child maltreatment is the detrimental effect on a child’s school performance. Over and over again, research has indicated that maltreated children demonstrate reduced intellectual functioning and perform very poorly in school. Maltreated children sometime elope from school. Eloping from school or having poor school performance can have a long term consequences. Again academic failure is associated with antisocial behavior and quitting school. These behaviors increases the risk of long term decreased productivity, long term economic dependence and generally lower levels of satisfaction with life as adult. Outcome of research observation indicate that maltreated children may displace the following:-lower overall school performance test scores and lower language, reading and math scores-grade repetitions, disciplinary referrals and a high number of suspensions-Working and learning at below average levels as reported by teachers and school counselors.-Weaker orientation to future vocational, educational and career goals compared to non maltreated children

SEXUAL CONSEQUENCES: Maltreatment of children in the family affects their concept of sexuality. It reduces children’s ability to set appropriate boundaries for themselves. It confronts them to develop dyad with parents and siblings of the opposite sex. The consequences are developing negative perception of sex and sexuality. While the majority of sexual consequences are the result of emotional and sexual abuse, other forms of maltreatment can also be sexually destructive. A child who has suffered sexual abuse can as well have difficulty distinguishing between a sexual and non sexual relationship and therefore introduce a sexual element into every relationship. Studies show that a neglected child may seek sexual intimacy, very early in life to fulfill an unmet need for parental intimacy. This situation creates a risk for teen pregnancy or come by those killer diseases such as gonorrhea, Herpes, STD’S or HIV/AIDS. Studies have identified the followings as major sexual consequences of maltreated children.-engaging in open or excessive masturbation, excessive sexual curiosity and frequent exposure of the genitals-Simulated sexual acts with siblings and friends, inappropriate sexual behavior such as breast or genital grabbing.-premature sexual knowledge, sexualized kissing in friendships and with parents.-In adolescence, there is common experience of orgasmic disorders and painful intercourse-promiscuity, dissatisfaction with sex and negative attitudes about sex results too often

INTERPERSONAL CONSEQUENCES:This is negative experience that affects the child, parents, peer groups and others in his/her environment. Negative experience of this nature interferes with a child’s ability to develop meaningful and appropriate relationships from childhood to adulthood. Studies have shown that abused and neglected children are consistently rated by their peers as demonstrating socially undesirable behavior. Major psychiatric evaluations indicate that children who are maltreated by their parents display multiple psychological and behavioral problems as they try to develop and maintaining healthy relationships in adulthood. The reason is because social victimization reduces children’s social competence and limits empathic ability, both of which are necessary to establish satisfying relationships with others. Other significant interpersonal relationship that the child may display includes:-Insecure attachments to parents, siblings and care-givers-a loss of close friends, relatives and school mates-difficulty trusting others in the family and at school-relationship problems such as overly sexualized or overly conflicted relationships-chronic dissatisfaction with adult relationships and a fear of intimacy

SELF-PERCEPTUAL CONSEQUENCES:Our perceptions add to the new body of research in psychiatry and psychopathology. Perception is a psychological faculty of human being. When this faculty is altered the individual becomes worthless and losses his individuality. Parental abuse undoubtedly affects the self-worth of a child. A lack of interest in a child or a violent attack on a child will most likely lead to the child to develop a sense of social worthlessness. Current studies have associated maltreatment with negative self-image starting in childhood and continuing into adulthood. Without doubt in my mind, maltreated children typically view themselves as bad, worthless or unlovable and may develop the following perceptual issues:-extremely low levels of self-esteem-feelings of being “out of control”-inaccurate body images which often lead to eating disorders-overwhelming sense of guilt or self-blame for the abuse-impairment of a cohesive sense of identity SPIRITUAL

CONSEQUENCES: Human body is made of body and spirit. This is the more reason while the French rationalist, Rene Descartes conceived human body as made of matter and mind (body and spirit) and these two are distinctly different and separate substances, each ultimately real in its own way. The mind/body (spirit/soul) problem has been one of the oldest and most perennial problems in the study of philosophical Anthropology. However, Leibniz tried to resolve the mind-body controversies on the basis of the theory of “psychophysical parallelism” or the “doctrine of pre-established harmony”- the monads of mind and the monads of body, and each will be acting according to their prescribed nature, and function in unison to give the outward appearance interception. Abuse and neglect affects the monads of the body and the monads that constitute the spiritual wellbeing of children. Abuse corrupts the monads of the mind and causes children to detach from their mind and lack the ultimate sense of normalcy. Most often adults who have been abused and neglected report having lost their ethical sense of right or wrong. They report they have lost their belief and conviction in their moral being, and in faith in themselves; or other people and the world around them. On one hand, it is common for abused children to experience what trauma counselors would call a shattered soul or “soul pain”. Children who experience maltreatment display less interest and participation in moral or ethical activities. The consequence destroys the child’s enthusiasm for life and things concerning ethics and public conduct. Shattered soul may prove to be extremely significant long-term consequences of child maltreatment. While this is the case, there are other consequences of maltreatment of children. Victims of child maltreatment often become further victimized as adolescents and adults. Most often they become violent themselves towards their own children and other intimate relationships. Studies on intergenerational transmission of child maltreatment, reveal that one-third of victims grow up to continue a pattern of seriously ineptness or neglectfulness.

SUMMARY:There is need for dispositional optimism in mediating distress among children and adolescents who have experienced traumatic events like PTSD, IPV, Child physical abuse, Emotional abuse, and Sexual abuse (Brodhagen et al, 2008). This need is based on psychopathological optimism. Disproportional optimism on the other hand, has been found to partially mediate distress among individuals who had experienced child physical abuse and child emotional trauma. Studies show that participants with higher level of optimism show lower levels of distress (Kelly, 1982). The above approach requires supplemental intervention in psychiatric care. The reason is because primary prevention, early intervention and urgent response and crises intervention are optimal intervention best suited for children who experience child abuse, violence and traumatic confrontations. Social skill training, peer support groups, family mediation programs, anger management, mentoring programs and parent/family education and parental management training classes are common intervention skills essential for children who are victims of abuse and violence. These forms of support are capable of stimulating effective parenting and disciplinary practices as well as provide referrals to community resources for additional or more intensive help for the family (NASW, 2003-2006). Children who have experienced violence need individual behavioral therapy that would focus on skill building in problem solving; empathy training; and nonaggressive, more effective methods of dealing with their feelings. Parent management training that focuses on treating kids with empathy and effective use of encouragement, discipline, and problem solving skills are options imperative for healthcare professionals. They are options for modern families. Society I believe, will profit from these therapeutic options.

References:

1. Ammerman, RT, Cassisi, JE, Hersen, M & Van Hasselt, VB (1990) Consequences of physical abuse and neglect in children, Clinical psychological review, 6, 291-310

2. Barton,PE , Coley, R & Wenglinsky, H (1998) Order in the classroom; Violence, discipline and student achievement (Online) available

3. Belsky, J (1980) Child maltreatment: An ecological integration, American psychologist, 35, 320-335

4. Brodenhagen, A & Wise, D (2008) Optimism as a mediator between the experience of child abuse, other traumatic events and distress, Journal of family violence, Springer, Netherland

5. Children’s defense fund (1997) Everybody in America, Children’s defense reports 18(2), 15

6. Child helps USA (2009) Information on child abuse and neglect, retrieved October 4, 2009 @ http://www.childhelp.org

7. Hansel DJ, Macmillan, VM (1990) Warner-Rogers & Hecht (1999) Behavioral assessment of child abuse and neglectful families,

8. Recent development and current issues, Behavior modification, 14, 255-278

9. National Association of Social Worker s policy statements (2003-2006) Social Work Speaks, Sixth Edition; NASW Press, Washington, DC

10. Office of the Surgeon General, (2001) Youth Violence: A report of the Surgeon General (Online) available @ www. Surgeon general, gov/liberal/youth violence

11. Kelly, JA (1982) Social Skills Training: A practical guide for intervention: New York: Springer

12. Kelly, JA (1983) Treating child abuse families: Intervention based on skill training principles: New York, Plenum press

13. Peled, E; Jaffee, PJ & Edelson, JL (1995) Ending the circle of violence: Community responses to children of battered women, thousand oak, CA: Sage publications

14. U.S Department of Justice (2000) Family violence statistics: Including Statistics on Strangers and acquaintance; Office of Justice program, Bureau of Justice Statistics, BJS home page

15. Wolfe, J (1988) Single parent statistics, Average single parent statistical

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Gerald Ogbuja

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