Child Abuse and Role of the Family - Essay Example

Running Head: Child Abuse and Role of the Family Child Abuse and Role of the Family of the of the Child Abuse and Role of the Family Table of Content Child Abuse and Role of the Family Introduction Throughout the world, literally hundreds of millions of children are victims of abuse, neglect, and exploitation. Restricting our focus to the US, over 3 million children are reported to official agencies for severe maltreatment in any given year. While approximately 15 percent of children have been reported to agencies for maltreatment, surveys indicate that this figure grossly underestimates the true extent of the problem, as over a third of adults in the US report having experienced physical, sexual, emotional abuse and/or neglect as a child (Child Trauma Academy, 2003). How child abuse is defined has enormous implications for the safety and well-being of children and reflects existing cultural, political, and structural inequalities. Narrowly defining child maltreatment, as we do in the US, as only the extremes of abuse with demonstrable injuries, not only results in artificially low estimates of child maltreatment, but also limits the government's ability to intervene on behalf of children, affords abusing parents the greatest protection, and places children in the greatest danger. This paper discusses child abuse and role of the family in a concise and comprehensive way. Child Abuse and Sexual Abuse: A Brief Reflection As summarized by the World Health Organization (2002, online), "Child abuse or maltreatment constitutes all forms of physical and/or emotional ill-treatment, sexual abuse, neglect or negligent treatment or commercial or other exploitation, resulting in actual or potential harm to the child's health, survival, development, or dignity in the context of a relationship of responsibility, trust, or power." Child physical abuse involves a parent or caretaker intentionally inflicting physical pain on the child and can range, for example, from shaking, dragging, or spanking a child to the extremes of kicking, punching, or beating. Child sexual abuse involves a caretaker using a child for sexual gratification and can range from non-contact abuse (proposition, exhibition) to the extremes of actual penetration, to commercial sexual exploitation. Child emotional abuse involves inflicting psychological pain on the child (Child Trauma Academy, 2003). This includes, for example, yelling at, ridiculing, degrading, or humiliating a child; communicating that the child is flawed or unlovable; threatening a child or a child's loved one; exposure to domestic violence. Child neglect involves a caretaker's failure to provide for the child's basic needs. This includes physical neglect (adequate shelter, food, clothing), medical neglect (adequate health care), cognitive or educational neglect (intellectual stimulation, involvement in child's schooling), supervision neglect (monitoring the child's whereabouts, involvement in child's activities), and emotional neglect (providing emotional responsiveness, support, and affection). Prenatal neglect and abuse (failure to obtain proper care and/or substance abuse during pregnancy) constitutes yet another category of maltreatment (McLoyd, 1998). The consequences of child maltreatment are considerable, not only for the child, but also for society. Some consequences for the child are greater for one type of maltreatment than another. For example, child neglect is most strongly associated with the child having a lower IQ and lower educational achievement; child physical abuse with the child engaging in violence as a teen and adult; and, child emotional abuse with subsequent psychopathology. However, all forms of maltreatment are associated with adverse effects for children and the adults they become (Small, Luster, 1994). Child physical and emotional abuse and neglect all increase the likelihood that the child will subsequently: * - Be cognitively impaired (e.g., lower IQ and cognitive development; lower grades and educational achievement). * - Have impaired moral reasoning (e.g., less empathy, less compliance, and less developed conscience). * - Engage in violence and crime (e.g., more likely to engage in juvenile delinquency, nonviolent crime, and violent criminal behavior as a teenager and adult). * - Be violent in relationships (e.g., more likely to assault their siblings and other children, and later to abuse their spouse, child, and elderly parents). In addition, all types of child maltreatment, physical and emotional abuse and neglect, and sexual abuse increase the likelihood that the child will subsequently: * - Have mental health problems as a child, teenager, and adult (e.g., higher rates of depression, anxiety, anger, anti-social personality disorder, eating disorder, etc.). * - Become a substance abuser of both legal and illegal substances as a teenager and adult. * - Become pregnant as a teenager and engage in risky sexual behavior (e.g., engage in earlier first intercourse, higher rates of STDs, more partners, and teenage pregnancy). * - Have poor health when older (e.g., higher rates of cancer, heart disease, chronic lung disease, irritable bowel syndrome, liver diseases, etc.). Aside from the obvious, reasons why the effects of child abuse and neglect are so profound and long-lasting include the neurological changes in the child's brain that result from maltreatment; the modeling effects of seriously inadequate parenting; the adoption of a belief system about self, others, and the world as malevolent; and the defense mechanisms that maltreated children must develop to cope with their terror, despair, and hopelessness (World Health Organization, 2002). Child Abuse: A Familial Perspective Many of the parents who abuse and neglect their children were themselves maltreated as children. In addition, having been maltreated as a child also increases the likelihood that one will suffer other outcomes such as lower IQ and educational attainment, more mental health problems, substance abuse, and teen pregnancy - each of which, in turn, independently increases the risk of maltreating one's child. In other words, many of the consequences of having been abused and neglected as a child are also the causes of growing up to maltreat one's own child, laying the foundation for a cycle of abuse and neglect across generations (Nichols, Schwartz, 2004). For example, parents who abuse or neglect their children are more likely to: * - Have been maltreated as a child. * - Have mental health problems, including parent depression. * - Have a violent marriage. * - Be a substance abuser. * - Be a teenage mother. * - Have lower levels of education and to be chronically poor. In addition to the above, parents who abuse or neglect their children are also more likely to: * - Have serious parenting deficits (e.g., have unrealistic expectations for their children). * - Use harsh and aggressive parenting with their children (i.e., high levels of emotional abuse). * - Have low levels of parental involvement and supervision; give their children low levels of attention and affection (i.e., high levels of physical and emotional neglect). * - Frequently use corporal punishment on their children (i.e., high levels of physical abuse). * - Have less play materials or any cognitively stimulating materials in the home for their children (i.e., high levels of neglect). The first set of factors points to the cycle of child abuse and neglect (Nichols, Schwartz, 2004). The second set of factors indicates that engaging in low or "culturally acceptable" (Dong et al, 2004, pp. 771-84) levels of harsh parenting, corporal punishment, and neglect significantly increases the likelihood that parents will proceed to more severely abuse and/or neglect their children. Moreover, at least in the area of physical violence, more frequent corporal punishment has the same adverse consequences as physical abuse, from lower IQ to more violent behavior, mental health problems and risky sexual behavior, except to lesser degrees (Belsky, 2001). Child maltreatment is associated with substantial costs to society. The World Health Organization (2002: 70) estimated that the total financial cost of child maltreatment in the US was $12.4 billion, which includes, for example, the costs of services to families of maltreated children, the loss of the contributions of victims, and related costs of the criminal justice and health care system (Belsky, 2001). In addition, it is important to acknowledge the ways in which the larger community and society fail children, neglecting them (e.g., high levels of child poverty, poor-quality schools, lack of neighborhood monitoring of children) and abusing them (exposure to high levels of violence and crime, legal support for children as property). * - Intervention and prevention must address the larger context of child abuse, including for example: * - The degree to which the government and corporations support policies that benefit children (e.g., providing quality childcare for every child). * - The degree to which children are economically provided for by encouraging gender equality in the labor force, enforcing fathers' child support payments, and having a strong social welfare system which provides for all children (Booth, Kelly, 2002). * - The provision of sex education, on-site availability of contraceptives, and parenting classes in high school designed to help teens, and ultimately all parents, postpone childbearing until they are mentally and financially able to raise a child without maltreatment. * - The level of help provided to maltreated children and survivors (Booth, Kelly, 2002). * - The extent of protection for children provided by the law, agencies, and the criminal justice system. * - The degree to which children are viewed as the property of parents as opposed to the responsibility of the entire community. * - The level of support for extending human rights to children. In these and other ways, a society can move toward protecting rather than forsaking its children. Situations of risk in which one or more children in the same family may be maltreated, leading, for example, to the presentation of child abuse, are a difficult problem to assess and resolve. Social workers, doctors and the courts are, however, often confronted with such situations (Brauner et al, 2004), though the symptoms take different forms: straightforward neglect leading to the child being deprived in physical or psychological ways; various forms of bodily injury which may end in the child's death; sexual abuse; or psychological maltreatment, which may oscillate between attitudes of pure and simple rejection and subtle forms of alienation through one or other of the parents bringing a child or adolescent 'under their influence' (Adams and East, 1999, pp. 133-8). Families in which abuse occurs are, naturally, very diverse and the prognosis will vary depending upon whether the parents acknowledge their responsibility in the situation. Masson (1981) distinguishes two major subgroups: first, families in which the abuse is a sign of a temporary crisis, the family having shown, in other respects, that it can function more harmoniously; and, secondly, chronically and transgenerationally disturbed families, with repeated poor levels of care and aggressive behavior, among which Masson distinguishes two sub-categories: * 1 Chaotic families with transgenerational repetition of relational breakdowns and, sometimes, of abuse. The parents themselves suffer from a past in which they were placed in care or experienced deprivations of various kinds and expect relief and reparation of their distress from their children, who can only disappoint them in this impossible task. Hence the aggressive reactions which ensue (Fabes, Hanish, Martin, 2003). * 2 Families whose structure remains intact but which is characterized by the persistence of alliances with privileged figures in the previous generation fixed in a sort of perverse triangle between the grandparents and the young parents. This makes it impossible for the latter to form a conjugal and parental alliance of the kind that is indispensable for the protection of the children. These young parents are often children chronically farentified in their families of origin, which, from time to time, suck them back into old alliances (Fabes, Hanish, Martin, 2003). Systemic intervention may be of great help in such situations and this is the case at two levels of intervention. First, it may facilitate the analysis of the functioning - often incoherent and contradictory - of the many professionals already involved in the situation (courts, pediatricians, home helps, psychiatrists, social workers, teachers etc.) who often see the situation in different - if not indeed opposed - ways, and either become involved in conflicts about how it can be resolved or remain totally ignorant of one another. As stressed by Myers et al (2002, pp. 67-79) , medical personnel, traingulated by the different members of the family, are placed in coalitions with sub-systems and tend to take over and play out between themselves a conflictual scenario which has as its model the unresolved family conflict (Fabes, Hanish, Martin, 2003). In a second phase, systemic intervention may be a resource in dealing with and treating the problem. As an indispensable preliminary to this, a precise evaluation of the risks run by the victim(s) must be made and a decision taken as to whether the children need to be temporarily or permanently placed in residential care or foster homes. For this purpose, a 'functional intervention team' (Adams and East, 1999, pp. 133-8) must be set in place, comprising multiple professionals who are able to work as a team when the case is being taken up. This is always a serious and difficult matter and it therefore requires a high level of training on the part of the team members and 'relationships in which they mutually value and recognize each other's skills' (English, 1998, pp. 39-53). It is possible to begin family therapy in such cases where there is a hope of creating new modes of transaction within the family. This may apply even where the child is temporarily placed in care. Such hope may be based on several criteria: interest shown by the parents in the child placed in care; the gradual establishment of a bond with one of the professionals involved and regularity of attendance at the meetings arranged with them (even if they openly criticize the function of such meetings or even the actions of the courts in their case); the appearance of a phase of cooperation after an initial phase of opposition; the identification of affective resources which may yet be mobilized; the possibility of a change in transgenerational relations (Center for the Child Care Workforce, 2004). Children often find it difficult to disclose their abusive experiences. In a study of 116 cases where child sexual abuse was confirmed by a perpetrator's subsequent guilty plea or conviction, or by highly consistent medical evidence, 72% of the victims denied the abuse when they were first questioned about it. The literature suggests that the strongest inhibitors of disclosure are fear of the consequences (Center for the Child Care Workforce, 2004), self-blame, lack of awareness, and difficulty in talking about the abuse. Children's fear of the consequences of disclosure may be the strongest inhibitor of disclosure. In Center for the Child Care Workforce (2004) study, several latency-age girls expressed fears of retribution from male offenders or angry responses from their non-offending mothers. For some children, the fear extends beyond their own safety to a fear of betraying or harming their families (e.g., the fear of police involvement that might lead to the offender being jailed). Evidence suggests that a child's relationship with the perpetrator and the latter's skill in manipulation are much more influential in whether the child discloses than is the child's exposure to educational prevention programs. Victims may assume blame for the abuse, despite the perpetrator's superior age and status. For example, S recalled asking herself what she was doing wrong when her father masturbated in front of her daily until she was 10 years old. A male survivor, abused from early childhood, spoke with shame about initiating sex with his abuser to be loved. A female survivor who made an educational videotape felt guilty about the responses of her body to her father's advances (Center for the Child Care Workforce, 2004). Children may not recognize that they are being abused because they lack knowledge of social norms, and their awareness may be blocked by self-protective defense mechanisms. Perpetrators of sexual abuse often use a deceptive process of grooming, pressure for secrecy, and distortion of reality and morality, leaving the child confused about what happened. Many children use defense mechanisms to deal with the emotional pain and cognitive dissonance that might otherwise overwhelm them. Common defenses are denial and repression to keep the abusive experience below the level of the child's consciousness. Repression is sometimes partial, blocking out the most disturbing aspects of the abuse. S was aware of being molested as a small child by a man in uniform, but realized only in adulthood that the man was her father (Hildyard, Wolfe, 2002). Polonko and Karen (2007) point out that the process of investigation and clarifying family goals can be beneficial to more than a few families. Under "dual track systems" (Dong et al, 2004, pp. 771-84) that refer families involved with physical or sexual abuse to conventional investigations and other families to family assessment services, there appears to be still greater satisfaction with the services received (Hildyard, Wolfe, 2002). If the logic of dual track systems is to make referrals less punitive, then they must provide additional reassurance that referral to child welfare services will not necessarily result in punishment. Conclusion How child abuse is defined has enormous implications for the safety and well-being of children and reflects existing cultural, political, and structural inequalities. Narrowly defining child maltreatment, as we do in the US, as only the extremes of abuse with demonstrable injuries, not only results in artificially low estimates of child maltreatment, but also limits the government's ability to intervene on behalf of children, affords abusing parents the greatest protection, and places children in the greatest danger. In short, the responsibility to protect and nurture the safety and developmental capacity of children is the primary goal of public policymakers, according to recent local laws that have shifted the balance toward child safety as the super-ordinate goal. Agreeing on such a "safety of the child first" (Dong et al, 2004, pp. 771-84) principle does not necessitate that the rights of parents be denied - only that services always weigh the right and need to assess the situation of a child with a presumptive risk higher than the rights of a parent not to be disturbed by a child welfare service intervention. References Adams, J. A. & East, P. L. (1999) Past Physical Abuse is Significantly Correlated with Pregnancy as an Adolescent. Journal of Pediatric and Adolescent Gynecology (12): pp. 133 8. Child Trauma Academy (2003) Child Trauma Academy version of chapter first published in Osofsky, J. (Ed.) (1997) Children, Youth and Violence: The Search for Solutions. Guilford Press, New York, pp. 124 48. Dong, M., Anda, R., Felitti, V., Dube, S., Williamson, D., Thompson, T., Loo, C., & Giles, W. (2004) The Interrelatedness of Multiple Forms of Childhood Abuse, Neglect and Household Dysfunction. Child Abuse and Neglect (28): pp. 771-84. English, D. J. (1998) The Extent and Consequences of Child Maltreatment. The Future of Children (8) (1): pp. 39-53. Hildyard, K. L. & Wolfe, D. A. (2002) Child Neglect: Developmental Issues and Outcomes. Child Abuse and Neglect (26): pp. 679-95. McLoyd, V. C. (1998) Socioeconomic Disadvantage and Child Development. American Psychologist (53) (2): pp. 185-204. Myers, J., Berliner, L., Briere, J., Hendrix, C. T., Jenny, C., & Reid, T. A. (Eds.) (2002) The APSAC Handbook on Child Maltreatment, 2nd ed. Sage, Thousand Oaks, CA, pp. 67-79. Small, S. & Luster, T. (1994) Adolescent Sexual Activity: An Ecological, Risk-Factor Approach. Journal of Marriage and the Family (56) (1): pp. 181-92. World Health Organization (2002) World Report on Health and Violence. WHO, Geneva. Online. www.who.int/violence_injury__prevention/violence/world_report/en/full_en.pdf. Polonko, Karen, 2007, "Child Abuse." Blackwell Encyclopedia of Sociology, Blackwell Publishing, pp. 123-131. Nichols, M. P. & Schwartz, R. C. (2004) Family Therapy: Concepts and Methods, 6th edn. Pearson, Boston, pp. 89-96. Belsky, J. (2001). Developmental risks (still) associated with early child care. Journal of Child Psychology and Psychiatry, (42), pp. 845-859. Booth, C. L., & Kelly, J. F. (2002). Child care effects on the development of toddlers with special needs. Early Childhood Research Quarterly, (17) (2), pp. 171 196. Brauner, J., Gordic, B., & Zigler, E. (2004). Putting the child back into child care. Social Policy Report, (XVIII) (III), pp. 5-19 Center for the Child Care Workforce. (2004). Current data on the salaries and benefits of the US early childhood education workforce, 2004. Washington, DC, pp. 45-53. Fabes, R. A., Hanish, L. D., & Martin, C. L. (2003). Children at play: The role of peers in understanding the effects of child care. Child Development, (74), pp. 1039-1043. Read More