Overview of child maltreatment


  • Child maltreatment is behavior toward a child that is outside the norms of conduct and entails substantial risk of causing physical or emotional harm. Four types of maltreatment are generally recognized: physical abuse, sexual abuse, emotional abuse (psychologic abuse), and neglect. The causes of child maltreatment are varied and not well understood. Abuse and neglect are often associated with physical injuries, delayed growth and development, and mental problems. Diagnosis is based on history, physical examination, and sometimes laboratory tests and diagnostic imaging. Management includes documentation and treatment of any injuries and urgent physical and mental conditions, mandatory reporting to appropriate state agencies, and sometimes hospitalization and/or foster care to keep the child safe.
    In 2015, 4.4 million reports of alleged child maltreatment were made to Child Protective Services (CPS) in the US involving 7.2 million children. About 2.1 million of these reports were investigated in detail and about 683,000 maltreated children were identified. Both sexes are affected equally; the younger the child, the higher the rate of victimization.
    About three fifths of all reports to Child Protective Services were made by professionals who are mandated to report maltreatment (eg, educators, law enforcement personnel, social services personnel, legal professionals, day care providers, medical or mental health personnel, foster care providers).
    Of substantiated cases in the US in 2015, 75.3% involved neglect (including medical neglect), 17.2% involved physical abuse, 8.4% involved sexual abuse, and 6.9% involved other forms of abuse including psychologic maltreatment. Many children were victims of multiple types of maltreatment.
    About 1670 children died in the US from maltreatment in 2015, about three quarters of whom were lt; 3 yr. Over 70% of these children were victims of neglect and 44% were victims of physical abuse with or without other forms of maltreatment. More than three quarters of perpetrators were parents acting alone or with other individuals, and about 25% of child abuse fatalities were perpetrated by the mother acting alone (1).


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