Child Maltreatment: Theory, Policies, Strategies – A Critical Review
By: Meghan Arnold, Advisor – Gary Apperson
Abstract
In this paper, a brief history of child maltreatment is addressed, as well as statistics showing the need for action against child maltreatment. Several theories account for child maltreatment, including but not limited to, social learning theory and attachment theory. This paper will address review on the effects of child maltreatment, both physical and emotional. Cases of child maltreatment require the collaboration between agencies, especially the public health system and the criminal justice system. The public health system practices a systematic way on handling cases of child-maltreatment. An investigator must follow crucial protocols when interviewing abused children in order to earn the child’s trust and cooperation.
Keywords: child assault, physical abuse, emotional abuse, sexual abuse, child neglect.
I. Introduction
Despite a wide range of prevention efforts, child maltreatment cases continue to produce high victimization rates, and as such, warrant further review. This paper will begin by defining specific terms that are germane to the topic of child maltreatment. The next section will provide a brief history of child maltreatment and how the criminal justice system has evolved to protect children. This will be followed by a scope of the problem section that details the enormity of the problem. The following section will offer a theory framework to account for child maltreatment causation. Next, a literature review will explain effects of child maltreatment. A discussion section that will examine research studies on the difficulties investigating child maltreatment follows, and then, offers recommendations based on current published research. Finally, a conclusion will recap this paper’s most important points.
The significance of this paper is that it contributes to the criminal justice system by critically reviewing child maltreatment policies as they relate to their mission of reducing child abuse. This paper is written for colleagues and clerisy who have a professional or academic interest in reducing child maltreatment through more precise strategies and policies.
II. Terms Defined
In this paper, maltreatment will utilize the Center for Disease Control (2014) definition as any act or series of acts of commission or omission by a parent or other caregiver that result in harm, potential for harm, or threat of harm to a child. Neglect as defined by Hess and Orthmann (2010) is the failure to meet a child’s basic needs, including housing, food, clothing, education, and access to medical care. Physical abuse refers to beating, whipping, burning, or otherwise inflicting physical harm upon a child (Hess and Orthmann, 2010). Furthermore, emotional abuse as defined by Hess and Orthmann (2010) is causing fear or feelings of unworthiness in children by such means as locking them in closets, ignoring them, or constantly belittling them. Finally, sexual abuse includes sexual molestation, performing sexual acts, statutory rape, and seduction of a child (Hess and Orthmann, 2010).
III. Brief History
The abuse of children is not a new problem, and there have been reports of child maltreatment dating prior to 1875. The New York Society for the Prevention of Cruelty to Children was established in 1875 as the world’s first organization devoted entirely to child protection services (Myers, 2009). Prior to 1875, many children who were mistreated went without protection of the law and the government. Interventions to protect children were sporadic, but did occur (Myers, 2009). During these times, adults were aware of child maltreatment, but children were still generally unprotected. It was not until 1935 when Congress passed the Social Security Act that created aid to dependent children that brought focus to the protection of child maltreatment. In this provision, the Children’s Bureaus were authorized to cooperate with state public welfare agencies in establishing, extending, and strengthening the protection and care of homeless, dependent, and neglected children, and children in danger of becoming delinquent (Myers, 2009). The 1960s witnessed a huge interest in child abuse, mainly due to physicians playing a key role. Congress placed new emphasis on child protection with the amendments to the Social Security Act, requiring states to pledge that child welfare programs would be available statewide. Significant progress has been made since the amendment of the Social Security Act, although practitioners have better identified continuing child maltreatment issues that need to be addressed. Child protection services were available across the country, the growth of these services helped thousands of children, and there were rapid deployment of laws that require professionals to report suspected abuse and neglect (Myers, 2009).
IV. Scope of the Problem
According to the Children’s Bureau of the U.S. Department of Health and Human Services, in 2011 there were approximately 742,000 instances of confirmed child maltreatment. The overall national child victim rate was 9.9 child victims per 1,000 children in the population. State child victims’ rates varied dramatically, ranging from 1.2 child victims per 1,000 children to 24.0 child victims per 1,000 children. The national child victim rate decreased from 10.3 child victims per 1,000 children in the population in 2008 to 9.9 in 2011. It is estimated that worldwide 150 million girls and 73 million boys, less than 18 years of age, are abused every year (Molyneux, Kennedy, Dano, and Mulambia, 2013). Hess and Orthmann (2010) report that currently, professionals initiate more than half of all reports of alleged child abuse or neglect. The three most common report sources were teachers, lawyers or police officers, and social services staff (Hess and Orthmann, 2010).
According to Crum, Joyner, Ellis, and Saul (2013), the total lifetime financial costs associated with just one year of confirmed cases of child maltreatment totals $124 billion. The average lifetime cost per victim of nonfatal child maltreatment was $210,012, which included costs for childhood and adult medical care, productivity losses, child welfare, criminal justice, and special education services (Crum et al., 2013). Moreover, Crum et al. (2013) further reports the estimated average lifetime cost per death was $1,272,900, which includes medical costs and productivity losses. The costs of child maltreatment are comparable to the societal costs of other major public health problems, such as Type 2 Diabetes.
V. Theory Framework to Account for Child Maltreatment
The theoretical assumptions informing child maltreatment interventions are shifting. Originally, child maltreatment was believed to be a consequence of individual psychopathology (Garrett, 1997). Researchers are beginning to recognize that it is also a family and social problem. There are a number of theories that guide research strategies for child maltreatment, two of which are the social learning theory and attachment theory.
According to social learning theory as originally posited by theorist Bandura, behavior is learned through two methods in which learning occurs by being rewarded for one’s actions or by observation and imitation of the behavior of others (Bandura, 1971; Garrett, 1997). According to this theory, abused children learn to be abusive through modeling the observed behavior and continuing this behavior into their adulthood. This pattern of aggression is commonly referred to as the cycle of violence. The cycle of violence suggests that a childhood history of physical abuse predisposes the survivor to violence in later years (Samuels, 2001). There have been several key findings associated with the cycle of violence. A child that had been abused or neglected as a child increased the likelihood of arrest as a juvenile by 59 percent, maltreated children were arrested more frequently, and physically abused and neglected children were most likely to be arrested later for a violent crime (Samuels, 2001).
Attachment theorists believe humans develop a repertoire of behaviors that promote interaction between themselves and their caregivers (Garrett, 1997). Children learn these behaviors as a result of how they were nurtured by their caregivers. The type of bond that develops between child and caregiver affects the child’s later relationships (Garrett, 1997). According to the Garrett, children who are neglected or abused may be more distrustful, have limited self-esteem, and seek out more maladaptive relationships later in life. Attachment theorists believe not only does the abuse and neglect impact the children during their juvenile years, but these patterns may even continue into adulthood. The type of care giving the child received is the type of care giving the child will provide later in life as a parent.
VI. Literature Review
Child abuse and neglect can result in serious and permanent physical, mental and emotional damage, as well as in future criminal behavior (Hess and Orthmann, 2010). Research has shown a link between adverse childhood experiences and adult chronic disease and negative health behaviors (Crum et al., 2013). Physical damage can involve bruising, damage to any organs including the brain, and damage to ears, eyes, or limbs. Severe physical damage may result in mental retardation, loss of limbs, restricted language ability, or even death (Hess and Orthmann, 2010).
In addition to immediate consequences such as physical injuries, maltreatment can impact a child’s brain development and lead to life-long health problems (Crum et al., 2013). These life-long health problems may include heart, lung and liver disease, cancer, depression, obesity, substance abuse, and eating disorders. Emotional damage may result in a child’s impaired self-concept and self-worthiness. Emotional damage can also lead to aggressive behavior and anxiety. Children who suffer emotional abuse may act out in social settings, such as school. Destructive behavior could have negative implications on the child’s health and safety (Hess and Orthmann, 2010). Research on brain development has shown that abuse and neglect can lead to sustained stress responses in children (Crum et al., 2013). According to Crum et al. (2013), this stress response results in sustained high levels of hormones, and this can negatively impact brain architecture.
Child dysfunctional behaviors are frequently classified as either externalizing (e.g. hostility, aggression, delinquency, conduct disorder, attention problems) or internalizing (e.g. anxiety, depression, withdrawal, somatic complaints) (Binder, McFarlane, Nava, Gilroy, and Maddoux, 2013). According to Binder et al. (2013), children exposed to abuse of their mothers demonstrate high rates of externalizing and internalizing behaviors. Boys and girls tend to respond differently. Boys tend to respond to abuse in a more externalizing behavior, whereas, girls tend to respond to abuse in a more internalizing behavior. As girls grow older, some studies have reported girls demonstrating more violent aggressive behaviors than boys (Binder et al., 2013).
Another effect of child abuse is that as an adult, the former victim frequently becomes a perpetrator of child abuse (Hess and Orthmann, 2010). According to Child Welfare (2012), research suggests about one-third of all individuals who were abused or neglected as children will subject their own children to maltreatment. This cycle of abuse can occur when children who either experienced maltreatment or witnessed violence between their parents or caregivers, learn to use physical punishment as means of parenting their own children (Child Welfare, 2012).
VII. Discussion
Challenges in investigating crimes against children may include protecting the child from further harm, the need to collaborate with other agencies, and the difficulties that come with interviewing the child. The primary responsibility for an investigator assigned to a child abuse case, is the safety of the child (Hess and Orthmann, 2010). If the officer feels the child is in immediate danger, the officer may opt to take the child into temporary custody. Under child protection legislation Wisconsin State Statute 48.19 (d), the officer does not need a warrant to remove a child from an environment if the officer believes the child is subject to further abuse or is in immediate danger. Another challenge for investigators is the need to collaborate with other agencies, such as social services, child welfare, and health agencies (Hess and Orthmann, 2010). Child maltreatment is a complex problem that requires multiple systems working together to bring about necessary change; not only in individual behavior and family functioning, but also to community and social contexts that affect individual families (Crum et al., 2013). The lack of coordination between agencies can lead to cases falling through the cracks and even have dangerous and devastating results (Hess and Orthmann, 2010). No one agency or organization can accomplish the problem of child maltreatment alone, as current research indicates a team approach produces the best outcomes.
Lastly, it may be extremely difficult for an investigator to interview a child. Studies by Hess and Orthmann (2010) report that when children are young, they have limited vocabulary, and could possibly be afraid to talk to anyone due to threats from the abuser. Abused children may not complain directly of what has happened to them. This may be due to being threatened by the perpetrator, the child is ashamed, embarrassed or do not think that they will be believed (Molyneux et al., 2013). Furthermore, Molyneux et al. (2013), reports most disclosures are accidental and prompted after a change in behavior is recognized, rather than being spontaneous or initiated by the victim of abuse.
VIII. Recommendations
Adequate responses to the needs of survivors of abuse require the services of several different agencies, which must work together (Molyneux et al., 2013). Coordinated responses between agencies can minimize the likelihood of conflicts between these agencies with different philosophies and mandates on how to handle a child abuse case (Hess and Orthmann, 2010). Communication, cooperation, and teamwork are vital, but are often hampered due to lack of funding (Molyneux et al., 2013). The criminal justice system and the public health system both play vital roles in response to child-maltreatment.
The extreme burden and consequences of child maltreatment, both to individuals and society, makes the issue a public health problem (Crum et al., 2013). The public health system attempts to solve the problems of child maltreatment in a systematic way. According to Crum et al. (2013), the first step is defining and monitoring the problem (i.e., surveillance). Well-carried out surveillance provides an understanding of prevalence and risk, and supports effective planning, implementation, and evaluation of public health programs. Next is to identify risk and protective factors. This step focuses on characteristics that increase or decrease the likelihood someone will be a victim or a perpetrator of child maltreatment (Crum et al., 2013). Next, Crum et al. (2013) continues with the third step of developing and testing prevention strategies. This step builds on the first two steps to create programs and strategies that promote protective factors and reduce risk factors in individuals and communities. The final recommended step is assuring widespread adoption. This involves scaling up evidence-based programs and practices through dissemination and implementation in a range of settings (Crum et al., 2013).