2.4 Abuse and Neglect
Open Resources for Nursing (Open RN)
Child Neglect and Abuse
All 50 states and the District of Columbia have child abuse and neglect reporting laws that mandate certain professionals and institutions refer suspected maltreatment to a Child Protective Services (CPS) agency. Each state has its own definitions of child abuse and neglect that are based on standards set by federal law. Federal legislation defines child abuse and neglect as, “Any recent act or failure to act on the part of a parent or caretaker which results in death, serious physical or emotional harm, sexual abuse or exploitation, or an act or failure to act, which presents an imminent risk of serious harm.”[1] In 2019 there were 656,000 victims of child abuse and neglect, with a victim rate calculated as 9 victims per 1,000 children across the United States. In addition, 74.9 percent of victims were neglected, 17.5 percent were physically abused, and 9.3 percent were sexually abused. Child fatalities are the most tragic consequence of maltreatment. In 2019 it was estimated that 1,840 children died from abuse and neglect in the United States. The youngest children are the most vulnerable to maltreatment, with 45.4 percent of child fatalities younger than 1 year old. A perpetrator is the person who is responsible for the abuse or neglect of a child. Furthermore, 77.5% of perpetrators are a parent of the victim.[2]
An organization called A Safe Haven for Newborns is dedicated to preventing infant abuse and abandonment through education, prevention, and direct assistance (see Figure 15.4[3]).
Call the Safe Haven Helpline at 1-877-440-2229 or visit the A Safe Haven for Newborns website to find local resources.
Signs of Neglect and Abuse
Neglect
Neglect is a situation in which a parent or caretaker fails, refuses, or is unable, for reasons other than poverty, to provide the necessary care, food, clothing, or medical or dental care, which seriously endangers the physical, mental, or emotional health of the child. Signs of child neglect include the following[4]:
- Exhibits poor hygiene or body odor
- Is inappropriately dressed for weather
- Demonstrates needed medical or dental care
- Is left alone unsupervised for long periods of time
- Appears malnourished
- Is constantly hungry or begs for or steals food
- Demonstrates exhibits extreme willingness to please
- Is frequently absent from school
- Arrives early and stays late at school, play areas, or other people’s home
Physical Abuse
Physical abuse is defined as injury inflicted on a child by other than accidental means. Physical injury includes, but is not limited to, lacerations, fractured bones, burns, internal injuries, severe or frequent bruising, or great bodily harm. Signs of physical abuse in children are as follows[5]:
- Bruises and/or welts on face, neck, chest, back, or soft muscle areas less prone to bruising by natural play or accidents (e.g., abdomen, breasts, under arm, inner thigh)
- Injuries in the sh