What if CPS abuses my child

Child abuse at a glance

Abuse of a child is behavior towards a child that is out of the norm and poses a significant risk of physical or emotional harm to the child. There are 4 types of child abuse: physical abuse, sexual abuse, emotional abuse, and neglect. The causes of child abuse vary and have not yet been clarified. Abuse and neglect often come with physical injury, growth and development retardation, and mental disorders. The diagnosis is made based on medical history, physical exam findings, and sometimes laboratory tests and diagnostic imaging. The care includes the documentation and treatment of every injury and the physical and mental condition, as well as a mandatory report to the appropriate authorities and sometimes hospitalization and / or placement in a nursing home to keep the child safe.

In 2015, the Child Protective Services (CPS) in the United States received 4.4 million reports of alleged child abuse affecting 7.2 million children. Approximately 2.1 million of these reports were examined in detail and approximately 683,000 abused children were identified. Both sexes are equally affected, and the younger the child, the greater the likelihood of being a victim.

About three fifths of all reports received by Child Protective Services came from people who are professionally obliged to report abuse (e.g. educators, police officers, social workers, lawyers, child minders, medical staff, health care workers, caregivers).

Of the justified cases in the US in 2015, 75.3% were neglect (including medical neglect), 17.2% physical abuse, 8.4% sexual abuse, and 6.9% other forms of abuse including psychological abuse. Many children have been victims of all kinds of abuse.

Approximately 1,670 children died of abuse in the United States in 2015. About three quarters of the children were <3 years old. Over 70% of these children were victims of neglect and 44% were victims of physical abuse with or without other forms of abuse. More than three quarters of perpetrators were parents acting alone or with other people, and about 25% of deaths from child abuse were committed by the mother acting alone (1).

General remark

  • 1. Administration for Children and Families of the US Department of Health for Children, Adolescents and Families: Child Abuse 2015. Available from the Children's Office web site.

classification

The various forms of abuse coexist and overlap considerably.

Physical abuse

Physical abuse is the infliction of physical harm or involvement by a caregiver in activities that have a high risk of injury. Assault by someone who is not a caregiver or in a position of responsibility for the child (e.g. a shooter in a mass shooting at school) is not special child abuse. Special forms are shaking, dropping, hitting, biting and causing burns (e.g. scalding or touching with a cigarette). Abuse of power is the leading cause of serious head injuries in infants. Abdominal injuries are also common in young children.

Infants and young children are particularly vulnerable because the stages of development they go through (e.g., colic, inconsistent sleep patterns, tantrums, toilet training) can frustrate caregivers. This age group is also at increased risk because they cannot report their abuse. The risk decreases in the first years of school.

Sexual abuse

Any act with a child that takes place as a sexual reward for an adult or a significantly older child is sexual abuse ({blank} pedophile disorder). There are the following types of sexual abuse: sexual intercourse with oral, anal or vaginal penetration; Harassment through touching the sexual organs without sexual intercourse as well as forms that do not involve physical contact by the perpetrator, such as B. Exhibition of the perpetrator's genitals, showing material with sexually explicit content and directing a child to engage in sexual activity with another child or to produce material (photos, films, etc.) of sexual content.

Sexual abuse has nothing to do with the child's sexual curiosity, in which the children of the appropriate age look at each other or touch the other's genital area without violence or coercion. The guidelines that differentiate sexual abuse from game to game vary from state to state, but in general, sexual contact between people with an age difference of> 4 years (chronologically, or in mental or physical development) is considered inappropriate.

Mental abuse

Psychological abuse is the infliction of emotional harm through words and actions. Special forms are scaring a child by yelling and screaming, rejecting it by reducing the child's abilities and achievements, intimidating and terrorizing with threats, and exploiting or corrupting the child by encouraging deviant and criminal behavior. Psychological abuse can also be present if linguistic or physical affection is neglected or withheld, i.e. if there is essentially emotional neglect (e.g. ignoring or rejecting the child or preventing him from interacting with other children or adults).

Abuse in a medical setting

Child abuse in a medical setting (formerly referred to as Munchausen Syndrome, now referred to as an Artificial Disease Caused by Another in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition [DSM-5]) occurs when caregivers are intentionally physical or produce or falsify psychological symptoms or signs in a child. Caregivers may harm the child with drugs or other means, or add blood or bacterial contamination to urine samples to simulate illness. Many children receive unnecessary and harmful or potentially harmful tests and treatments.

neglect

Neglect is the failure to provide for the basic physical, emotional, educational, and medical needs of a child. Neglect differs from abuse in that it is usually not deliberately harming.

Various types of neglect can be defined as follows

  • Physical neglect includes failure to provide adequate food, clothing, shelter, supervision, and protection from possible harm.

  • Emotional neglect is the failure to provide affection, love, or other forms of emotional support to the child.

  • Educational neglect is the inability to enroll a child in school, attend school, or provide home education

  • Medical neglect is the failure to ensure that a child is adequately cared for or treated in the event of injury or physical or mental impairment.

However, failure to take preventive measures (e.g. vaccinations, routine dental exams) is usually not considered neglect.

Cultural factors

Severe corporal punishments (e.g. flogging, burns, scalds) are clearly physical abuse. However, depending on the cultural background, certain punishments move within or outside the boundaries of socially acceptable behavior and abuse. Likewise, certain cultural practices (e.g. female genital mutilation) are so extreme that they constitute abuse. Also, certain traditional medical rituals of folk medicine (e.g. embossing, patechies, cupping, envelopes) often cause lesions (e.g. bruises, slight burns), so that the line between acceptable cultural practice and abuse can be blurred.

Members of certain religious and cultural groups have sometimes failed to receive life-saving treatment (such as diabetic ketoacidosis or meningitis), resulting in the death of a child. Such failure is usually viewed as neglect, regardless of the intent of the parents or caregivers. In addition, in the US certain people and cultural groups have increasing reservations about vaccinating their children, citing safety concerns ({blank} anti-vaccination movement). It is not clear whether this rejection of vaccination is a real medical neglect. However, if the children are sick, refusal of scientifically and medically recognized treatment is a reason to investigate, if necessary, followed by legal consequences.

etiology

abuse

In general, abuse results from a loss of self-control in a parent or carer. Various factors contribute to this.

Parents' character and personality can play a role. There may have been a lack of affection and warmth in the parents' childhood. Parents may not have been nurtured in their development of self-esteem or emotional maturity and, in many cases, suffered other forms of abuse themselves. Abusive parents see their children as a source of unlimited and unconditional affection and support that they themselves have never received. As a result, they sometimes have unrealistic expectations of how the child should support them; they are easily frustrated and have poor impulse control; and they may be unable to give what they have never experienced for themselves. Drug or alcohol abuse can provoke impulsive and uncontrolled behavior towards your children. Parental mental disorders also increase the risk of abuse.

Irritable, demanding, or hyperactive children can provoke angry outbursts in parents; the same applies to mentally or physically handicapped children who need more care than a normally developed child. Sometimes strong emotional bonds do not develop between parents and children. This lack of attachment is more common in premature babies or sick infants who were separated from their parents in early childhood, or between parents and non-biologically related children (e.g., stepchildren). This can increase the risk of abuse.

Situational stress can precede abuse, especially if there is a lack of emotional support from relatives, friends, neighbors, and peers.

Physical abuse, emotional abuse, and neglect are often associated with poverty and low social status. All forms of ill-treatment, including sexual abuse, occur in all social classes. The risk of sexual abuse increases in children who have different caregivers or caregivers with multiple sexual partners.

neglect

Neglect usually results from a combination of factors such as poor parenting, poor stress management strategies, uncooperative family systems, and stressful living conditions. Neglect often occurs in impoverished families where the parents also have a mental disorder (typically depression, bipolar disorder, or schizophrenia), drug or alcohol abuse, or decreased mental health. Single parent children may be at risk of neglect due to lower income and resources.

Symptoms and ailments