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Child Physical Abuse

Chapter 3

Introduction

Case History: Kevin Fell Off His Razor

Miller-Perrin, Violence and Maltreatment in Intimate Relationships. © SAGE Publications, 2018.

Scope of the Problem

Defining child physical abuse is no easy task.

One way to define physical child abuse is to focus on observable harm.

A child who is injured is abused.

Miller-Perrin, Violence and Maltreatment in Intimate Relationships. © SAGE Publications, 2018.

Scope of the Problem (Part 2)

Beginning in 1988, the National Center on Child Abuse and Neglect began to include an endangerment standard in addition to a harm standard.

Miller-Perrin, Violence and Maltreatment in Intimate Relationships. © SAGE Publications, 2018.

Scope of the Problem (Part 3)

While the harm standard recognizes children as CPA victims if they have observable injuries that last at least 48 hours, children without observable injuries may also be recognized as abuse victims if they are deemed substantially at risk for injury or endangerment.

Miller-Perrin, Violence and Maltreatment in Intimate Relationships. © SAGE Publications, 2018.

Definition

Child physical abuse is the intentional use of physical force against a child that results in or has the potential to result in physical injury.

Miller-Perrin, Violence and Maltreatment in Intimate Relationships. © SAGE Publications, 2018.

Examples of Physical Abuse

Behaviors include:

Hitting a child with one’s fist or an object such as a belt

Kicking, biting, choking, shaking, or burning a child

Throwing or knocking down a child

Threatening a child with a weapon

Miller-Perrin, Violence and Maltreatment in Intimate Relationships. © SAGE Publications, 2018.

Examples of Physical Abuse (Part 2)

Shaken baby syndrome or abusive head trauma are additional examples of child physical abuse.

The leading cause of death among physically abused children is death associated with some type of injury to the head, referred to in the medical community as abusive head trauma.

Miller-Perrin, Violence and Maltreatment in Intimate Relationships. © SAGE Publications, 2018.

Shaken Baby Syndrome

Shaken baby syndrome results when a caregiver violently shakes a child, causing the child’s brain to move within the skull.

Miller-Perrin, Violence and Maltreatment in Intimate Relationships. © SAGE Publications, 2018.

Table 3.1: Characteristics of Children Who Are Physically Abused and the Adults Who Abuse Them

Miller-Perrin, Violence and Maltreatment in Intimate Relationships. © SAGE Publications, 2018.

Table 3.1: Characteristics of Children Who Are Physically Abused and the Adults Who Abuse Them (Part 2)

Miller-Perrin, Violence and Maltreatment in Intimate Relationships. © SAGE Publications, 2018.

Table 3.1: Characteristics of Children Who Are Physically Abused and the Adults Who Abuse Them (Part 3)

Miller-Perrin, Violence and Maltreatment in Intimate Relationships. © SAGE Publications, 2018.

Sources: A representative but not exhaustive list of sources for the information displayed in this table includes the following: Berkout & Kolko, 2016; Caselles & Milner, 2000; Chaffin et al., 2004; Crouch, Milner, & Thomsen, 2001; Éthier, Couture, & Lacharite, 2004; S. Graham, Weiner, Cobb & Henderson, 2001; Hartley, 2012b; T. Herrenkohl, Sousa, Tajima, Herrenkohl, & Moylan, 2008; Jouriles, McDonald, Smith Slep, Heyman, & Garrido, 2008; Kelleher et. al., 2008; Mammen, Kolko, & Pilkonis, 2003; Milner, 2003; Sedlak et al., 2010; Timmer, Borrego, & Urquiza, 2002; U.S. Department of Health and Human Services (DHHS), 2016.

Corporal Punishment

There is considerable debate about whether it should be defined as abusive, or at least unacceptable.

Miller-Perrin, Violence and Maltreatment in Intimate Relationships. © SAGE Publications, 2018.

Legal Perspectives

Federal law defines physical abuse as actions that result in “serious physical or emotional harm.”

Child physical abuse is illegal in all 50 states, districts, and U.S. territories, but individual states are left to define the specifics of these guidelines.

Miller-Perrin, Violence and Maltreatment in Intimate Relationships. © SAGE Publications, 2018.

Data

According to the most recent figures available from the National Child Abuse and Neglect Data System (NCANDS), approximately 3.2 million children were reported for abuse to CPS in 2014.

Miller-Perrin, Violence and Maltreatment in Intimate Relationships. © SAGE Publications, 2018.

Risk and Protective Factors

Child physical abuse victims do not respond to being abused in consistent or predictable ways.

Not surprisingly, the more severe the abuse, the longer it continues, the more frequent, and the greater the number of subtypes of maltreatment experienced.

Miller-Perrin, Violence and Maltreatment in Intimate Relationships. © SAGE Publications, 2018.

Table 3.2: Possible Effects Associated With Physical Child Abuse for Children and Adolescents and Adults

Miller-Perrin, Violence and Maltreatment in Intimate Relationships. © SAGE Publications, 2018.

Table 3.2: Possible Effects Associated With Physical Child Abuse for Children and Adolescents and Adults (Part 2)

Miller-Perrin, Violence and Maltreatment in Intimate Relationships. © SAGE Publications, 2018.

Sources: A representative but not exhaustive list of sources for information displayed in this table includes the following: Alvarez-Alonso et al., 2016; Baer & Martinez, 2006; R. Berger & Bell, 2014; Currie & Tekin, 2012; Fuller-Thomson & Lewis, 2015; Gilbert, Widom, Browne, Fergusson, Webb, & Janson, 2009; Gold, Sullivan, & Lewis, 2011; Greger, Myhre, Lydersen, & Jozefiak, 2015; Keene & Epps, 2016; Kleinman, 2015; Klika, Herrenkohl, & Lee, 2012; Lee, Herrenkohl, Jung, Skinner, & Klika, 2015; Lind et al., 2016; Miller-Perrin, Perrin, & Kocur, 2009; Nance & Cooper, 2009; Ouyang, Fang, Mercy, Perou, & Grosse, 2008; Reece, 2011; Rouse & Fantuzzo, 2009; Runyon, Deblinger, & Schroeder, 2009; Runyon, Deblinger, & Steer, 2010; Sachs- Ericsson et al., 2010; R. Schneider, Baumrind, & Kimerling, 2007; Thomas, Hyponnen, & Power, 2008.

Intervention and Prevention

Many strategies have been developed over the years, which focus on the following:

Children (victims)

Parents

Communities

Miller-Perrin, Violence and Maltreatment in Intimate Relationships. © SAGE Publications, 2018.

Programs

Parent training and support efforts:

One such program is Incredible Years (IY), which targets children with behavior problems and aims to reduce coercive parent-child interactions by providing parents with information about child development.

Miller-Perrin, Violence and Maltreatment in Intimate Relationships. © SAGE Publications, 2018.

Programs (Part 2)

Alternatives for Families Cognitive Behavioral Therapy (AF-CBT) is another approach that has been empirically evaluated that targets both physically abusive parents and their children.

Miller-Perrin, Violence and Maltreatment in Intimate Relationships. © SAGE Publications, 2018.

Programs (Part 3)

Parent-child interaction therapy (PCIT):

This form of therapy involves behavioral parent training whereby the parent is coached in parenting skills during live parent-child interactions.

Programs (Part 4)

Primary prevention efforts are designed to prevent child maltreatment from occurring in the first place and are often offered at the community level.

Programs (Part 5)

These prevention strategies are typically designed to improve the larger community environment of children either through wide-scale training, information dissemination, or changes in public policy.

Programs (Part 6)

One of the most widely researched community prevention strategies is the Triple P (Positive Parenting Program).

The primary aim of Triple P is to promote family harmony and reduce parent-child conflict by helping parents develop a safe, nurturing environment.

Programs (Part 7)

One promising school-based program is the Chicago Child-Parent Center program, which provides preschool education and a variety of family support services for low-income children aged 3–9 years.

Programs (Part 8)

The Durham Family Initiative (DFI), attempt to expand universal assessments designed to identify families at risk for child maltreatment and then connect them to appropriate community-based services.

Programs (Part 9)

Public Awareness Campaigns:

Another approach to the prevention of child physical abuse, and child maltreatment more generally, is that of educating the public about the problem through mass media campaigns.

Example

The ACT (Adults and Children Together) Against Violence Campaign is an example of a violence prevention media campaign.

Law and Policy

Another strategy in efforts to reduce or eliminate child physical abuse involves criminal justice system responses that target child physical abuse offenders.

Law and Policy (Part 2)

Since the late 1980s, significant improvements have been made in both the processes of criminal investigation of child physical abuse.

Summary

The physical abuse of children is a complex problem that is not well understood, despite nearly six decades of research.

Proposed solutions to the child physical abuse problem include both intervention and prevention efforts.