Child Abuse

Objectives: Upon completion of this course, the student will know the forms of child abuse, 
how to recognize abuse, reporting requirements and current statistics on child abuse in the United States.

 

INTRODUCTION

Child abuse describes a variety of abnormal behaviors directed against children. It can take many forms. Child abuse in general is a psychological problem or perversion of the abuser. The abuser is referred to as the perpetrator of abuse.

Child abuse includes the following conditions:

 

  • Child sexual abuse

     

  • Pedophilia

     

  • Physical abuse

     

  • Child neglect

     

  • Emotional neglect

     

  • Failure to thrive

     

  • Munchausen by proxy syndrome

     

The following descriptions of child abuse are intended for people who have questions about abuse and how it may present itself. Although some cases of child abuse are obvious, many are not. These descriptions may help you identify abuse in its various forms. You will also find information about what you can do if you observe child abuse or if you are a parent. If you think you are a child abuser, you will want to seek help.

FORMS OF CHILD ABUSE

  • Child sexual abuse includes any activity that uses a child to create sexual gratification either in you or in others. Although the touching of children as a sign of affection and for hygiene is considered normal and necessary, there is a way to distinguish normal touching from child sexual abuse. The key is the intention by the perpetrator to be sexually aroused by the activity or the intention to create sexual arousal in others. The intent to use children in any way to create sexual arousal is illegal. This is criminal behavior that is aggressively prosecuted and severely punished by our legal system.

     

    • Child sexual abuse can include a wide variety of activities, any of which can be evaluated to determine if they are designed to create sexual gratification.

       

      • Activities can include any conventional adult sexual activity with a child. Also included are acts such as touching the child's genitals or fondling with the intention of arousing sexual feelings.

         

      • Prolonged kissing, cuddling, "French" kissing, excessive touching, looking at children either with or without clothes with the intent to be sexually aroused can also be included.

         

      • Photographing, videotaping, or filming of children with the intent to create sexual stimulation is a form of child abuse as well.

         

      • Other forms of child sexual abuse include exposure of a child to erotic material in the form of either live behavior (excessive nudity), photographs, film, or video. The collection of any photographs or images of children taken by others in suggestive poses is illegal. The collection of any excessive number of photographs of naked children in any pose may draw the attention of law enforcement.

         

      • Any efforts to seduce a minor into a sexual relationship, whether the act is accomplished or not, will likewise be considered a form of child sexual abuse and will result in severe legal consequences. Inappropriate intimacy with children will also be regarded as child sexual abuse. Any of these situations should be reported to the authorities immediately.

         

      • Most child sexual abuse will ultimately be discovered. Once discovered, the perpetrator will be prosecuted to the full extent of the law. Broad and flexible laws are aimed at preventing child sexual abuse. These laws give law enforcement personnel and prosecutors great latitude to classify and prosecute as child sexual abuse behavior that they believe is intended to produce sexual gratification .

       

    • Take care around children at all times to prevent activities that might be construed as "sexual" abuse. If reasonable care is taken, displays of affection or inadvertent incidents that result in exposure of a child to a sexual act or sexual material (for example, a child walking into a closed bedroom while the parents are having sex or finding an adult magazine) will not be considered criminal.

       

    • To identify the physical signs of child sexual abuse, parents should know the normal appearance of the genitalia of their child so that they can identify if any changes occur. If a child complains about problems with his or her genitals, take the child to the family doctor for examination. Children in day care, children cared for by others, or children who spend time alone with other people are at risk of sexual abuse.

       

    • Changes in behavior, including discipline problems, loss of bowel habits by soiling or bed wetting, insomnia, nightmares, depression, or other changes in the way a child normally acts can be signs of sexual abuse. Parents should discuss the possible reasons for such changes in behaviors with professionals who are in a position to do proper evaluations of the behavioral changes and explore the possibility of child sexual abuse.

       

    • Parents, however, should not question the child about possible abuse. Special techniques and formal interviews are the best forum for discovering and documenting allegations of sexual abuse. Contacting your family physician or local child protection services will usually result in adequate initial investigation of any concerns.

     

  • Pedophilia, a form of child sexual abuse, is an abnormal interest in children that is based on the intention by the perpetrator to be sexually aroused by children

     

    • Someone with an erotic interest in children may collect material that demonstrates a child in sexual poses. The person may seek interaction with children with the intention of satisfying an erotic or sexual desire or actively seek a sexual relationship with a child. Adults who seek sexual relations with children are the most extreme and deviant of the pedophiles.

       

    • Using children to create erotic materials or for erotic acts with other adults is another form of child sexual abuse. In this form, the intention is not to arouse the abuser, but to arouse others. The law does not distinguish one from the other. Both are severely prosecuted.

       

    • Pedophilia, although a mental disorder, if not resisted, repressed, and treated will result in the most severe legal consequences. The law will not tolerate pedophilia. It is imperative that any person who feels sexually attracted to children immediately seek help from a qualified therapist. People who use children to create sexual arousal for others are already involved in serious criminal activity. Report any suspicions to police immediately.

     

  • Physical abuse of children is defined as excessive intentional physical injury to a child or corporal punishment of a child. Torture, beatings, and assault of children are obvious forms of physical abuse.

     

    • Corporal punishment by parents, on the other hand, is subject to evaluation and interpretation. In general, spanking with a hand and other forms of mild physical punishment that do not leave any marks are considered within the realm of parental discretion.

       

    • Punishment that leads to marks that last for more than a few minutes can be interpreted as abuse, regardless of intention. The use of any objects to strike a child (other than with your open hand) is wrong. That includes belts, paddles, sticks, or any other object. A family tradition of beatings will not be an acceptable excuse for severe injury to a child.

       

    • Excessive physical discipline is harmful and dangerous to children. Small children can be killed by relatively minor acts of physical violence (for example, shaking, dropping, or throwing the child against hard surfaces). Any severe beatings with an object, forceful shaking, submersion in hot water, intentional burning, and other forms of intentional infliction of pain are inappropriate and criminal behaviors.

       

    • Any person who has been reared in an environment of violence may be more likely to inflict violence on others. People who recognize their tendencies to get angry, out of control, or violent should seek help. They can learn anger management, child rearing techniques, and try to suppress their violent tendencies at all times.

       

    • Seeing others inflict physical abuse on children should prompt immediate action by the observer. People who are physically violent generally demonstrate violence again—at higher levels. Early intervention is the best strategy to avoid lifelong consequences.

     

  • Child neglect in any form when it concerns a child’s welfare is generally considered to be criminal behavior. Child neglect will be considered as a possible diagnosis for children that are poorly cared for, not fed properly, improperly clothed, denied basic necessities, denied proper medical care, or treated with indifference to a degree that appears to cause damage or suffering.

     

    • Parents, caregivers, and guardians of children must seek help from medical and social services in situations in which children have less-than-adequate care. Children can develop long-term medical and developmental problems from such neglect.

       

    • Failure to continue to get help for a child who is not doing well or who is improperly cared for may be interpreted as another form of neglect. This can result in criminal action or action by child protective services that may result in children being removed from the home and placed in foster care.

     

  • Emotional neglect is a condition in which children do not get adequate attention from their parents or guardians.

     

    • With mild forms of emotional neglect, children can develop rebellious behaviors or become alienated from their parents.

       

    • In more severe cases of emotional neglect, especially with babies or very young children, neglect can result in very abnormal behaviors, such as these:

       

      • Listlessness

         

      • Profound detachment from the parents

         

      • Poor bonding with other people

         

      • Poor interactive skills with other children or at times inappropriate attachment to anyone who will pay attention to them

       

    • These behaviors in young children continue as they get older and can transform into other personality or mental disorders that can be difficult, if not impossible to treat.

       

    • Parents who feel their relationship to their children is causing problems, is stressful, or not working well should consider the following questions:

       

      • Are you spending time with your children in recreational or learning activities in which they are the focus of your attention?

         

      • Do you show your children love and affection?

         

      • Do you feel out of control of your children or detached from them and their activities?

         

      • Do you have excessive behavioral problems with your children?

         

      • Are you supervising their time during which you are caring for them or letting them be on their own and unsupervised?

         

      • Is there excessive yelling, anger, or punishment?

         

      • Do you yourself exhibit bad behaviors in front of your children that disregard the children such as drug use, profanity, physical violence, bigotry, or ignoring the child's feelings and concerns?

       

    • Parents who recognize any of these problems can avoid the consequences of emotional neglect through parental training courses, reading, and effort. Seeking a little help can achieve big results. Children are very responsive to any positive effort put forth by a parent to improve the parent-child relationship, especially when children are young.

     

  • Failure to thrive is a condition in which children fail physically to develop normally to their full genetic potential. It is caused, most commonly, by medical conditions that can result in children not growing as expected. At times, though, it can be caused by intentional or unintentional behavior on the part of the parent.

     

    • The diagnosis is made when a doctor compares the growth of a child on standard growth charts and looks for changes in the rate of growth of a child. These measurements are usually taken during well-child visits to the family doctor.

       

    • Any decrease in the rate of growth of a child with respect to weight, height, or head size will raise concern and force the doctor to consider the diagnosis of failure to thrive. The doctor will begin to seek a reason for the decrease in the rate of growth and try to make sure that there is no intentional behavior by the parents responsible for the child's slow growth.

       

    • Medical conditions that affect growth will generally be tested. But if there is no other explanation for the abnormal growth, parents will be suspected of intentional abuse. This could include these behaviors:

       

      • Denying the child food

         

      • Feeding the child the wrong foods

         

      • Emotional neglect

         

      • Allowing a child to remain ill (not seeking medical care)

       

    • Once failure to thrive is considered, parents must comply with their doctor’s recommendations regarding testing and any other investigation into the child’s failure to thrive. If not, the doctor's suspicion may increase that the parent is contributing to or causing the condition.

       

    • Although some children are destined to be small, they generally grow at a predictable rate. If a child is eating adequately and consuming an adequate number of calories and generally appears happy and healthy, regardless of size, there is little reason to worry.

     

  • Munchausen by proxy syndrome is a serious psychiatric disorder of parents or guardians of children. Perpetrators manufacture, intentionally or unintentionally, signs and symptoms of disease in their child. They do this, not for the good of the child, but generally to satisfy their own abnormal need. By literally making the child sick, the caregiver has excessive contact with doctors and hospitals. Children undergo unnecessary testing and treatment for diseases that they do not have.

     

    • This condition is difficult for doctors to identify. Other family members or friends can usually sense an excessive amount of medical activity surrounding an apparently healthy child. If you suspect this is happening, you should inform the parent and the family physician of any such concerns.

       

    • Parents can ask themselves these questions with respect to seeking medical attention for their children:

       

      • Are you overly concerned about the health of your children?

         

      • Do you remain concerned about minor problems that you have been told not to worry about?

         

      • Do you find yourself obsessing over possible medical problems that might affect your children?

         

      • Have you ever done an intentional act to make a child appear ill?

         

      • Do you have any motivation or will you derive any benefit if you make your child appear ill?

       

    • Parents who see this behavior in themselves should stop the medical attention-seeking behavior and seek psychiatric help as soon as possible.

    BASIC PARENTING SKILLS

  • General parenting guidelines

    Raising children can be a successful and satisfying experience. Without basic parenting skills, the task is difficult and frustrating.

    Children seek love and discipline. Discipline takes the form of structured environment, rules, and boundaries, not just physical punishment and obedience. Love is the complementary behavior to discipline. Both are necessary if you are to be a successful parent. Both are needed to create the correct balance of concern and caring required in raising well-adjusted and happy children. When love and discipline are blended correctly, your child will be mentally healthy, self-assured, responsible, self-controlled, and prepared for their own parenting experience.

    Problem teenagers can be more difficult to manage, but social organizations, friends, parents, and other family members along with counseling and patience can help. Parents should be wary that bad behavior caused by poor parenting skills can sometimes be diagnosed as a mental disorder, hyperactivity, or attention deficit disorder.

    Efforts to alter behavior through the thoughtful use of love and discipline should be tried before resorting to medication and other medical treatment, which can have a lasting effect on children and on their self-image. When problems with children are severe, children need to be evaluated by professionals to determine if they have true psychiatric problems.

     

  • The limited role of corporal punishment

    It is important for parents to understand the limited role of spanking and corporal punishment. Many parents have successfully raised children with no corporal punishment at all.

    If punishment is to be used, it must be done carefully.

     

    • Light spanking or hand slapping with an open hand can be used to discourage dangerous behaviors such as reminding a 1-year-old trying to play with an electric socket.

       

    • Other situations where light spanking can be employed are with children between the ages of 1-3 years who choose to ignore verbal direction in dangerous situations. Reserve this for situations such as being told "no" for very unacceptable behaviors such as leaning out windows or pulling at glasses of hot liquid.

       

    • Any physical punishment should be given with words that demonstrate love and concern for the child. Make it clear to the child that any and all punishment is done because you love the child.

       

    • Use words of discouragement in place of spanking as the child's language skills and level of maturity improve.

       

    • After the age of 3 years, there should be very little need or use of any physical punishment of a child. If behavioral and control problems continue through this age, seek counseling and work out detailed plans on how to deal with bad behavior.

     

  • Alternatives to physical violence

    There is ample evidence that the following forms of punishment are workable solutions that eliminate the need for any physical forms of punishment:

     

    • Timeouts

       

    • Sending children to their rooms

       

    • Taking away privileges of various types

       

    • Denying children enjoyable activities

    REPORTING ABUSE

    You may have questions about possible abuse in your own behavior or, more often, about the behavior of others. State law mandates that certain people, called mandated reporters, report any suspected child abuse to authorities. These are teachers, police, and doctors.

    Nonmandated reporters, however, which includes almost everyone else, frequently are the first people to notice possible abuse. Ironically, nonmandated reporters are actually the people most likely to be able to identify potential abusers. They are the people who see abuse early enough to play an active role in preventing it and saving the abuser from the terrible consequences that are associated with child abuse.

    The first observer of abuse or abusive tendencies is in a position to intervene with the potential abuser before any substantial abuse has taken place.

    Although we would like to think that abusers are receptive to having these tendencies pointed out, generally they are not. Unfortunately, abusive tendencies frequently turn into abusive behaviors, which are usually difficult, if not impossible, to stop. This forces the typical observer of abuse into the unenviable, but necessary, position of having to report the abuser to the proper authorities.

    Reporting is the only effective step to control the abuser and stop the abuse. If reporting a pattern of abuse is delayed, the abuse situation usually gets worse until the abuser and his or her behaviors are discovered by others. At this point, law enforcement usually becomes aware of the situation.

 

Statutes-at-a-Glance
2001

Mandatory Reporters of Child Abuse and Neglect

Each State designates individuals, typically by professional group, who are mandated by law to report child maltreatment. Any person, however, may report incidents of abuse or neglect.

Individuals Typically Mandated to Report

Individuals typically designated as mandatory reporters have frequent contact with children. Such individuals include:

  • Health care workers

  • School personnel

  • Day-care providers

  • Social workers

  • Law enforcement officers

  • Mental health professionals

Some States also mandate animal control officers, veterinarians, commercial film or photograph processors, substance abuse counselors, and firefighters to report abuse or neglect. Four States--Alaska, Arkansas, Connecticut, and South Dakota--include domestic violence workers on the list of mandated reporters. Approximately1 eighteen States require all citizens to report suspected abuse or neglect regardless of profession.

Standard for Making a Report

Typically a report must be made when the reporter suspects or has reasons to suspect that a child has been abused or neglected.

Categories

Approximately twenty-six States specify when a communication is privileged. Privileged communications are exempt from mandatory reporting laws. The privilege most widely recognized by the States is that of attorney-client. The privilege pertaining to clergy-penitent also is frequently recognized. For example, when a priest becomes aware of child abuse through confessions or in the capacity of spiritual advisor, he is not required to report. Very few States recognize the physician-patient and mental health professional-patient privileges as exempt from mandatory reporting laws.

This summary is a product of the State Statutes Project, a partnership between the National Clearinghouse on Child Abuse and Neglect Information and the National Center for Prosecution of Child Abuse. The Clearinghouse is supported by the Children's Bureau, Administration for Children and Families, U.S. Department of Health and Human Services. The National Center for Prosecution of Child Abuse is a program of the American Prosecutors Research Institute (APRI), the non-profit affiliate of the National District Attorneys Association.

Statutes-at-a-Glance: Mandatory Reporters of Child Abuse and Neglect highlights one topic from the Child Abuse and Neglect State Statutes Elements. The Elements are a compilation of State laws on 39 different topics related to child maltreatment reporting laws, central registries, investigations, child witnesses, crimes and permanency planning. For more information on child maltreatment statutes or related publications, contact the Clearinghouse at 1-800-FYI-3366.

The word approximately is used to stress the fact that statutes are constantly being revised and updated.

(Current through December 31, 2000)
STATE PROFESSIONS THAT 
MUST REPORT		 OTHERS WHO 
MUST REPORT		 STANDARD FOR REPORTING PRIVILEGED COMMUNICATIONS
Health Care Mental Health Social Work Education/ Child Care Law Enforcement All Persons Other
ALABAMA
§§26-14-3(a)
26-14-10		 X X X X X   · Any other person called upon to give aid or assistance to any child · Known or suspected · Attorney/client
ALASKA
§§47.17.020(a)
47.17.023
47.17.060		 X X X X X   · Paid employees of domestic violence and sexual assault programs and drug and alcohol treatment facilities
· Members of a child fatality review team or multidisciplinary child protection team
· Commercial or private film or photograph processors		 · Have reasonable cause to suspect  
ARIZONA
§§13-3620(A)
8-805(B)-(C)		 X X X X X   · Parents
· Anyone responsible for care or treatment of children
· Clergy		 · Have reasonable grounds to believe · Clergy/penitent
· Attorney/client
ARKANSAS
§12-12-507(b)-(c)		 X X X X X   · Prosecutors
· Judges
· Div. of Youth Services employees
· Domestic violence shelter employees and volunteers		 · Have reasonable cause to suspect
· Have observed conditions which would reasonably result		  
CALIFORNIA
Penal Code
§§11166(a), (c)
11165.7(a)		 X X X X X   · Firefighters
· Animal control officers
· Commercial film and photographic print processors
· Clergy		 · Have knowledge of or observe
· Know or reasonably suspect		 · Clergy/penitent
COLORADO
§§19-3-304(1), (2), (2.5)
19-3-311		 X X X X X   · Christian Science practitioners
· Veterinarians
· Firefighters
· Victim advocates
· Commercial film and photographic print processors		 · Have reasonable cause to know or suspect
· Have observed conditions which would reasonably result		  
CONNECTICUT
§§17a-101(b)
17a-103(a)		 X X X X X   · Substance abuse counselors
· Sexual assault counselors
· Battered women's counselors
· Clergy		 · Have reasonable cause to suspect or believe  
DELAWARE
tit. 16, § 903
tit. 16, § 909		 X X X X   X   · Know or in good faith suspect · Attorney/client
· Clergy/penitent
DISTRICT OF COLUMBIA
§§2-1352(a), (b), (d)
2-1355		 X X X X X     · Know or have reasonable cause to suspect  
FLORIDA
§§39.201(1)
39.204		 X X X X X X · Judges
· Religious healers		 · Know or have reasonable cause to suspect · Attorney/client
GEORGIA
§§19-7-5(c)(1), (g)
16-12-100(c)		 X X X X X   · Persons who produce visual or printed matter · Have reasonable cause to believe  
HAWAII
§§350-1.1(a)
350-5		 X X X X X   · Employees of recreational or sports activities · Have reason to believe  
IDAHO
§§16-1619(a), (c)
16-1620		 X   X X X X   · Have reason to believe
· Have observed conditions which would reasonably result		 · Clergy/penitent
· Attorney/client
ILLINOIS
325 ILCS 5/4
720 ILCS 5/11-20.2		 X X X X X   · Homemakers, substance abuse treatment personnel
· Christian Science practitioners
· Funeral home directors
· Commercial film and photographic print processors		 · Have reasonable cause to believe  
INDIANA
§§31-33-5-1
31-33-5-2
31-32-11-1		 X X X X X X · Staff member of any public or private institution, school, facility, or agency · Have reason to believe  
IOWA
§§232.69(1)(a)-(b)
728.14(1)
232.74		 X X X X X   · Commercial film and photographic print processors
· Employees of sub-stance abuse programs		 · Reasonably believe  
KANSAS
§38-1522(a), (b)		 X X X X X   · Firefighters
· Juvenile intake and assessment workers		 · Have reason to suspect  
KENTUCKY
§§620.030(1), (2)
620.050(2)		 X X X X X X   · Know or have reasonable cause to believe · Attorney/client
· Clergy/penitent
LOUISIANA
Ch. Code art. 603(13)
Ch. Code art. 609(A)(1)
Ch. Code art. 610(F)		 X X X X X   · Commercial film or photographic print processors
· Mediators		 · Have cause to believe · Clergy/penitent
· Christian Science practitioner
MAINE
tit. 22, § 4011(1)
tit. 22, §4015		 X X X X X   · Guardians ad litem and CASAs
· Fire inspectors
· Commercial film processors
· Homemakers		 · Know or have reasonable cause to suspect · Clergy/penitent
MARYLAND
Family Law
§§5-704(a)
5-705(a)		 X   X X X X   · Have reason to believe · Attorney/client
· Clergy/penitent
MASSACHUSETTS
ch. 119, § 51A
ch. 119, § 51B		 X X X X X   · Drug and alcoholism counselors
· Probation and parole officers
· Clerks/magistrates of district courts
· Firefighters		 · Have reasonable cause to believe  
MICHIGAN
§722.623 (1), (8)
722.631		 X X X X X     · Have reasonable cause to suspect · Attorney/client
MINNESOTA
§§626.556 Subd. 3(a), 8		 X X X X X     · Know or have reason to believe · Clergy/penitent
MISSISSIPPI
§43-21-353(1)		 X X X X X X · Attorneys
· Ministers		 · Have reasonable cause to suspect  
MISSOURI
§§210.115(1)
568.110
210.140		 X X X X X   · Persons with responsibility for care of children
· Christian Science practitioners
· Probation/parole officers
· Commercial film processors		 · Have reasonable cause to suspect
· Have observed conditions which would reasonably result		 · Attorney/client
MONTANA
§41-3-201(1)-(2), (4)		 X X X X X   · Guardians ad litem
· Clergy
· Religious healers
· Christian Science practitioners		 · Know or have reasonable cause to suspect · Clergy/penitent
NEBRASKA
§§28-711(1)
28-714		 X   X X   X   · Have reasonable cause to believe
· Have observed conditions which would reasonably result		  
NEVADA
§§432B.220(3), (5)
432B.250		 X X X X X   · Clergy
· Religious healers
· Alcohol/drug abuse counselors
· Christian Science practitioners
· Probation officers
· Attorneys		 · Know or have reason to believe · Clergy/penitent
· Attorney/client
NEW HAMPSHIRE
§§169-C:29
169-C:32		 X X X X X X · Christian Science practitioners
· Clergy		 · Have reason to suspect · Attorney/client
NEW JERSEY
§9:6-8.10		           X   · Have reasonable cause to believe  
NEW MEXICO
§§32A-4-3(A)
32A-4-5(A)		 X   X X X X · Judges · Know or have reasonable suspicion  
NEW YORK
Soc. Serv. Law
§413(1)		 X X X X X   · Alcoholism/substance abuse counselors
· District Attorneys
· Christian Science practitioners		 · Have reasonable cause to suspect  
NORTH CAROLINA
§§7B-301
7B-310		           X · Any institution · Have cause to suspect · Attorney/client
NORTH DAKOTA
§§50-25.1-03
50-25.1-10		 X X X X X   · Clergy
· Religious healers
· Addiction counselors		 · Have knowledge of or reasonable cause to suspect · Clergy/penitent
· Attorney/client
OHIO
§2151.421(A)(1), (A)(2), (G)(1)(b)		 X X X X     · Attorneys
· Religious healers		 · Know or suspect · Attorney/client
· Physician/patient
OKLAHOMA
tit. 10, § 7103(A)(1)
tit. 10, §7104
tit. 10, §7113
tit. 21, §1021.4		 X     X   X · Commercial film and photographic print processors · Have reason to believe  
OREGON
§§419B.005(3)
419B.010(1)		 X X X X X   · Attorneys
· Clergy
· Firefighters
· CASAs		 · Have reasonable cause to believe · Mental health/ patient
· Clergy/penitent
· Attorney/client
PENNSYLVANIA
§23-6311(a),(b)		 X X X X X   · Funeral directors
· Christian Science practitioners
· Clergy		 · Have reasonable cause to suspect · Clergy/penitent
RHODE ISLAND
§§40-11-3(a)
40-11-6(a)
40-11-11		 X         X   · Have reasonable cause to know or suspect · Attorney/client
SOUTH CAROLINA
§§20-7-510(A)
20-7-550		 X X X X X   · Judges
· Funeral home directors and employees
· Christian Science practitioners
· Film processors
· Religious healers
· Substance abuse treatment staff		 · Have reason to believe · Attorney/client
· Priest/penitent
SOUTH DAKOTA
§§26-8A-3
26-8A-15		 X X X X X   · Chemical dependency counselors
· Religious healers
· Parole or court services officers
· Employees of domestic abuse shelters		 · Have reasonable cause to suspect  
TENNESSEE
§§37-1-403(a)
37-1-605(a)
37-1-411		 X X X X X X · Judges
· Neighbors
· Relatives
· Friends
· Religious healers		 · Knowledge of/reasonably know
· Have reasonable cause to suspect		  
TEXAS
Family Code
§§261.101(a)-(c)
261.102		 X     X   X · Juvenile probation or detention officers
· Employees or clinics that provide reproductive services		 · Have cause to believe  
UTAH
§§62A-4a-403(1)-(3)
62A-4a-412(5)		 X         X   · Have reason to believe
· Have observed conditions which would reasonably result		 · Clergy/penitent
VERMONT
tit. 33, §4913(a)		 X X X X X   · Camp administrators and counselors
· Probation officers		 · Have reasonable cause to believe  
VIRGINIA
§63.1-248.3(A)
63.1-248.11		 X X X X X   · Mediators
· Christian Science practitioners
· Probation officers
· CASAs		 · Have reason to suspect  
WASHINGTON
§§26.44.030 (1), (2)
26.44.060(3)		 X X X X X   · Any adult with whom a child resides
· Responsible living skills program staff		 · Have reasonable cause to believe  
WEST VIRGINIA
§§49-6A-2
49-6A-7		 X X X X X   · Clergy
· Religious healers
· Judges, family law masters or magistrates
· Christian Science practitioners		 · Reasonable cause to suspect
· When believe
· Have observed		 · Attorney/client
WISCONSIN
§48.981(2), (2m)(c), (2m)(d)		 X X X X X   · Alcohol or drug abuse counselors
· Mediators
· Financial and employment planners
· CASAs		 · Have reasonable cause to suspect
· Have reason to believe		  
WYOMING
§§14-3-205(a)
14-3-210		           X   · Know or have reasonable cause to believe or suspect
· Have observed conditions which would reasonably result		 · Attorney/client
· Physician/patient
· Clergy/penitent
TOTALS, ALL STATES 48 40 44 46 41 18 N/A N/A 26

Readers should not rely on this summary for legal advice.

Statutes-at-a-Glance
2001

Reporting Penalties

Many cases of child abuse or neglect are neither reported nor investigated even when suspected by professionals. Therefore, almost every State imposes penalties, in the form of a fine or imprisonment, on those who knowingly and/or willfully fail to report. Also, in order to prevent malicious or intentional reporting of cases that are not founded, several States impose additional penalties for false reports of child abuse or neglect.

Penalties for Failure to Report

Approximately  forty-four States and the District of Columbia have enacted statutes specifying the penalties for failure to report child abuse or neglect. Of these jurisdictions, approximately thirty-three States and the District of Columbia use a "knowingly," "knows or should have known," and/or "willfully" standard. Other standards include "intentionally" and "purposely." A few States impose penalties without providing a standard. Failure to report is classified as a misdemeanor in approximately thirty-four States.

Penalties for False Reports

Approximately twenty-nine States have statutes specifying penalties for false reports of child abuse or neglect. The most common standards are "knowingly" and/ or "willfully." The penalties imposed are similar to those for failure to report. The majority of States classify false reporting as a misdemeanor. In nine States, however, a false report may be classified as a felony.

The chart presented on the following pages summarizes reporting penalties for each State and the District of Columbia.

1 The word approximately is used to stress the fact that statutes are constantly being revised and updated.

 

This summary is a product of the State Statutes Project, a partnership between the National Clearinghouse on Child Abuse and Neglect Information and the National Center for Prosecution of Child Abuse. The Clearinghouse is supported by the Children's Bureau, Administration for Children and Families, U.S. Department of Health and Human Services. The National Center for Prosecution of Child Abuse is a program of the American Prosecutors Research Institute (APRI), the non-profit affiliate of the National District Attorneys Association.

Statutes-at-a-Glance: Reporting Penalties highlights one topic from the Child Abuse and Neglect State Statutes Elements. The Elements are a compilation of State laws on 39 different topics related to child maltreatment reporting laws, central registries, investigations, child witnesses, crimes and permanency planning. For more information on child maltreatment statutes or related publications, contact the Clearinghouse at 1-800-FYI-3366.

(Current through December 31, 2000)

  FAILURE TO REPORT FALSE REPORTING
STATE/STATUTE Standard Penalty Standard Penalty
ALABAMA
§§26-14-13
13A-10-9		 Knowingly Misdemeanor:
•imprisonment not exceeding 6 months; or
•a fine not exceeding $500		 Knowingly Class A misdemeanor
ALASKA
§47.17.068		 Knew or should have known Class B misdemeanor * *
ARIZONA
§§13-3620(K)
13-3620.01(A)-(B)		 Not specified Class 1 misdemeanor Knowingly and intentionally; with malice Class 1 misdemeanor
ARKANSAS
§12-12-504(a), (b), (d)		 Willfully;
Negligently		 Class C misdemeanor

Civilly liable for damages proximately caused		 Willfully Class A misdemeanor

Class D felony, when there is a prior conviction
CALIFORNIA
Penal §§11166(b)
11172(a)		 Knows or reasonably suspects Misdemeanor:
•confinement in county jail not exceeding 6 months; and/or
•a fine not exceeding $1,000		 Reckless disregard of truth; knowingly Liable for damages proximately caused
COLORADO
§19-3-304(3.5),(4)		 Willfully Class 3 misdemeanor

Liable for damages		 Knowingly Class 3 misdemeanor

Liable for damages
CONNECTICUT
§§17a-101a
17a-101e(c)		 Not specified A fine not exceeding $500 Knowingly A fine not exceeding $2,000 and/or

Imprisonment for not more than one year
DELAWARE
Tit. 16, § 914		 Knowingly or willfully A fine not exceeding $1000; and/or

Imprisonment not exceeding 15 days		 Knowingly and willfully A fine not exceeding $1000; and/or

Imprisonment not exceeding 15 days
DISTRICT OF COLUMBIA
§2-1357		 Willfully

 

 A fine not exceeding $100; and/or

Imprisonment not exceeding 30 days		 * *
FLORIDA
§§39.205(1)-(2), (6)
39.206(1)		 Knowingly or willfully Misdemeanor of first degree Knowingly and willfully Felony of third degree

Possible fine not exceeding $10,000
GEORGIA
§19-7-5(h)		 Knowingly or willfully Misdemeanor * *
HAWAII
§350-1.2		 Knowingly Petty misdemeanor * *
IDAHO
§§16-1619(d)
16-1620A		 Not specified Misdemeanor Knowingly; in bad faith or with malice Liable for damages sustained or statutory damages of $500, whichever is greater, plus attorney's fees and costs
ILLINOIS
ch. 325, para. 5/4
ch. 325, para. 5/4.02		 Knowingly and willfully

Willfully		 Class A misdemeanor

Physician: referred to Illinois State Medical Disciplinary Board2		 Knowingly Class 4 felony
INDIANA
§§31-33-22-1
31-33-22-3(a)-(b)		 Knowingly

Knowingly		 Class B misdemeanor

Staff member of a medical or other institution, school, facility, or agency: Class B misdemeanor penalty imposed in addition to above		 Intentionally Class A misdemeanor

Liable for actual damages and possibly punitive damages

Class D felony, if there is a prior conviction
IOWA
§232.75		 Knowingly and willfully

Knowingly		 Simple misdemeanor

Civilly liable for damages proximately caused		 Knowingly Simple misdemeanor
KANSAS
§38-1522(f),(g)		 Knowingly and willfully Class B misdemeanor * *
KENTUCKY
§§ 620.990(1)
620.050(1)		 Intentionally Class B misdemeanor Knowingly, with malice Class A misdemeanor
LOUISIANA
La. Children's Code Ann. art. 609(A)(2),(C)		 Not specified Subject to criminal prosecution Knowingly Subject to criminal prosecution
MAINE
Tit. 22, § 4014(1)		 * * Knowingly Subject to criminal or civil action
MASSACHUSETTS
ch. 119, § 51A		 Not specified A fine not exceeding $1,000 Knowingly A fine not exceeding $1,000
MICHIGAN
§722.633(1),(2),(5)		 Knowingly Misdemeanor

Imprisonment not exceeding 93 days and/or fine not exceeding $100

Civilly liable for damages proximately caused		 Knowingly,
Intentionally		 Misdemeanor, punishable by imprisonment of not more than 93 days for a fine of not more than $100, if the abuse reported would be a misdemeanor if true.

Felony, if the abuse reported would be a felony if true, punishable by imprisonment of not more than 4 years and/or a fine of not more than $2,000
MINNESOTA
§626.556 Subd. 5, 6		 Knows or has reason to believe

Knows or reasonably should know		 Mandatory reporter:
•misdemeanor

Parent, guardian, or caretaker:
•gross misdemeanor if child's health is in serious danger and child suffers great bodily harm due to lack of medical care;
•felony if child dies

Imprisonment not exceeding 2 years and/or fine not exceeding $4,000

 Knowingly or recklessly Civilly liable for actual and punitive damages

Responsible for costs and reasonable attorney fees
MISSISSIPPI
§43-21-353(7)		 Willfully Imprisonment not exceeding 1 year and/or a fine not exceeding $5,000 * *
MISSOURI
§210.165(1)-(3)		 Not specified Class A misdemeanor Intentionally Class A misdemeanor

Class D felony if previously convicted
MONTANA
§§41-3-207
41-3-203(1)		 Purposely or knowingly Misdemeanor

 

Civilly liable for damages proximately caused

 Knowingly Civilly liable for damages
NEBRASKA
§28-717		 Willfully Class 3 misdemeanor * *
NEVADA
§432B.240		 Knowingly or willfully Misdemeanor * *
NEW HAMPSHIRE
§169-C:39		 Knowingly Misdemeanor * *
NEW JERSEY
§9:6-8.14		 Knowingly Imprisonment not exceeding 6 months * *
NEW MEXICO
§32A-4-3(F)		 Not specified Misdemeanor * *
NEW YORK
Soc. Serv. § 420
Penal § 240.55(3)		 Willfully

Knowingly and willfully		 Class A misdemeanor

Civilly liable for damages proximately caused		 Knowingly Class A misdemeanor
NORTH CAROLINA * * * *
NORTH DAKOTA
§50-25.1-13		 Willfully Class B misdemeanor Willfully Class B misdemeanor

If made to a law enforcement official: Class A misdemeanor

Civilly liable for damages
OHIO
§§2151.421(A),(G),(H)
2921.14		 Knowledge or suspicion None specified Knowingly Misdemeanor of first degree
OKLAHOMA
tit. 10, § 7103(C),(D)		 Knowingly or willfully Misdemeanor Knowingly and willfully Misdemeanor

A fine not to exceed $5,000 if made during a child custody proceeding.
OREGON
§419B.010(2)		 Not specified Class A violation * *
PENNSYLVANIA
23 PCSA § 6319		 Willfully Summary offense for first violation

Misdemeanor of third degree for second or subsequent violation		 * *
RHODE ISLAND
§§40-11-6.1
40-11-3.2		 Knowingly Misdemeanor:
•a fine not exceeding $500; and/or
•imprisonment not exceeding 1 year

Civilly liable for damages proximately caused		 Knowingly and willingly Misdemeanor:
•A fine not exceeding $1000; and/or
•Imprisonment not exceeding one year.
SOUTH CAROLINA
§§20-7-560
20-7-567		 Knowingly Misdemeanor:
•a fine not exceeding $500; and/or
•imprisonment not exceeding 6 months		 Knowingly Misdemeanor:
•A fine not exceeding $5000; and/or
•Imprisonment not exceeding 90 days
SOUTH DAKOTA
§§26-8A-3
26-8A-6
26-8A-7		 Intentionally

Knowingly and intentionally		 Class 1 misdemeanor

If child dies: Class 1 misdemeanor		 * *
TENNESSEE
§§37-1-412(a)
37-1-413		 Knowingly Class A misdemeanor Knowingly and maliciously Class E felony (only applies to sexual abuse reporting)
TEXAS
Fam. §§261.107(a)-(b)
261.109		 Knowingly Class B misdemeanor Knowingly or intentionally Class A misdemeanor

State jail felony, if there is a prior conviction
UTAH
§62A-4a-411		 Willfully Class B misdemeanor * *
VERMONT
tit. 33, § 4913(e)		 Not specified A fine not exceeding $500 * *
VIRGINIA
§§63.1-248.3(B)
63.1-248.5:1.01(A)		 Not specified A fine not exceeding $500 for first violation

A fine of no less than $100 nor exceeding $1,000 for subsequent violations		 Knowingly Class 1 misdemeanor

Class 6 felony, if there is a prior conviction
WASHINGTON
§§26.44.080
26.44.060(4) 		Knowingly Gross misdemeanor Intentionally and in bad faith or maliciously; knowingly Misdemeanor
WEST VIRGINIA
§49-6A-8 		Knowingly Misdemeanor:
•imprisonment in county jail not exceeding 10 days; and/or
•a fine not exceeding $100		 * *
WISCONSIN
§48.981(6) 		Intentionally A fine not exceeding $1,000; and/or imprisonment not exceeding 6 months * *
WYOMING * * * *

2 Dentist or dental hygienist: Referred to Department of Professional Regulation.
* Not Addressed in statutes reviewed.

Readers should not rely on this summary for legal advice.

 

ABUSE AND THE LAW

Take care in interpreting certain behaviors in adults and children that suggest the possibility of abuse. Parents and all reporters of abuse must realize that accusations of abuse are taken very seriously by law enforcement, child abuse professionals, and prosecutors. While the reporter of abuse (mandated or nonmandated) is granted immunity from any liability when they make reports about possible abuse, such reports should be done in good faith only. This is not always the case.

Some people are willing to use allegations of abuse to achieve their own goals at the expense of an accused person. Once allegations of abuse are made, the general belief by the authorities is that accusations are true until proven otherwise. False accusations can rarely be taken back without very significant damage to families and the lives of the accused person.

 

  • False allegations can arise from family members, enemies, or from unhappy or disturbed children. Children can be manipulated by adults to make false accusations. The younger the child, the more susceptible the child is to manipulation.

     

  • False allegations of abuse occur in a small number (3-5%) of all abuse reports. But under certain circumstances, the percentage can increase. In divorce and custody disputes, in which allegations of abuse are raised, the percentage of false allegations has been reported to be as high as 22%.

     

  • Misinterpretation of medical findings or behaviors (especially sexual abuse behaviors) by overly protective authorities (at school, day care, and in medical facilities) have been responsible for many false allegations of abuse, even when all parties (including the children) deny that abuse has occurred.

Although the vast majority of allegations of abuse are true (more than 95%), the number of false accusations that occur make it necessary to at least consider the truth of each accusation as part of a complete evaluation. It is a crime to make false statements about abuse.

DIFFERING CULTURAL NORMS FOR CHILD REARING

Various cultures have different cultural norms with respect to appropriate behavior toward children.

 

  • Some cultures are more "touchy" than others.

     

  • Some believe in physical discipline to an extreme.

     

  • There are cultures in which certain things that are done to children out of caring create the appearance of child abuse.

     

  • In some cultures, rituals are performed. These same rituals may be unacceptable in the country in which you live.

In general, the laws of the country in which you live are the laws that must be obeyed.

PREVENTION OF CHILD ABUSE

Child abuse is prevented, first, through awareness, then early detection and intervention. Protecting children from abuse is the first and foremost concern of police and child protection authorities.

 

  • In an ideal world, psychiatric help would be available to treat those who abuse children. But that is rarely the case. Most abusers, once they have acted out and committed acts of abuse, are arrested, charged, tried, convicted, sent to prison, and marked for life as sexual offenders.

     

  • To prevent abuse by changing the behavior of the abuser (whether they are a loved one or a friend), tendencies to be abusive must be identified before any actual abuse takes place. Once a tendency is identified, the best hope for treating this serious mental disorder is behavioral counseling.

    THE COSTS OF CHILD MALTREATMENT

    Child abuse and neglect cost our society dearly, not only in terms of the trauma caused to the maltreated individuals but also in economic terms. Economic costs include the funds spent each year on child welfare services for abused and neglected children as well as the large sums dedicated to addressing the short- and long-term consequences of abuse and neglect. Effective prevention programs that promote the safety and well-being of children and families hold potential for lessening the suffering and trauma experienced by children and greatly reducing these economic costs.

    To date, few in-depth and rigorous financial analyses have been conducted to give us a solid understanding of the total costs of maltreatment (i.e., the costs of not preventing child abuse and neglect) as compared with the economic savings associated with prevention. Nevertheless, several prevention advocates, researchers, and evaluators have begun to grapple with these issues. The purpose of this paper is to promote greater understanding of what is known about the financial costs of maltreatment and to encourage continued examination and comparison of these costs with the benefits of prevention. The paper begins with a discussion of the cost elements that make up the total cost of child maltreatment. The second section highlights findings from selected studies that have conducted cost-benefit and cost-of-failure analyses.

    THE COSTS OF CHILD MALTREATMENT

    Child abuse and neglect have known detrimental effects on the physical, psychological, cognitive, and behavioral development of children (National Research Council, 1993). These consequences range from minor to severe and include physical injuries, brain damage, chronic low self-esteem, problems with bonding and forming relationships, developmental delays, learning disorders, and aggressive behavior. Clinical conditions associated with abuse and neglect include depression, post-traumatic stress disorder, and conduct disorders. Beyond the trauma inflicted on individual children, child maltreatment also has been linked with long-term, negative societal consequences. For example, studies associate child maltreatment with increased risk of low academic achievement, drug use, teen pregnancy, juvenile delinquency, and adult criminality (Widom, 1992; Kelly, Thornberry, and Smith, 1997). Further, these consequences cost society by expanding the need for mental health and substance abuse treatment programs, police and court interventions, correctional facilities, and public assistance programs, and by causing losses in productivity. Calculation of the total financial cost of child maltreatment must account for both the direct costs as well as the indirect costs of its long-term consequences.

    Direct Costs

    Direct costs reflect expenditures incurred by the child welfare system as well as the judicial, law enforcement, health, and mental health systems in responding to abused and neglected children and their families. Direct costs include expenses associated with hospitalization and medical services provided to treat injuries resulting from abuse, child protective services (CPS) and/or police investigations; foster care and other out-of-home placement services for maltreated children; and family preservation, rehabilitation, and treatment programs.

    Government expenditures for child welfare programs provide a benchmark for estimating a portion of the annual direct costs of child abuse and neglect. For fiscal year 1998, Federal expenditures to States for major child welfare programs will exceed $4.5 billion. This figure includes child welfare services, foster care, adoption assistance, and family preservation and support, but excludes Medicaid dollars, an important source of treatment funding for children and families. Based on a survey of State child welfare agencies (CWLA, 1997), Federal funding accounts for less than half (42%) of State child welfare expenditures with the remainder supported by State (49%) and local (9%) funding.

    A recent study by the Missouri Children's Trust Fund (1997) provides a different lens through which to view direct costs of maltreatment. The study analyzed the direct economic costs of one type of child maltreatment-Shaken Baby Syndrome (SBS)-in Missouri over a 10-year period. The study found that the State spent at least $6.9 million, or approximately $32,500 on each of the 214 identified SBS victims. These costs included $4 million in Medicaid expenses, $1.9 million for Division of Family Services expenditures, and nearly $1 million for Department of Mental Health services.

    Indirect Costs

    Indirect costs reflect the long-term economic consequences of child maltreatment in such areas as special education, mental health, substance abuse, teen pregnancy, welfare dependency, domestic violence, homelessness, juvenile delinquency, and adult criminality. Indirect costs are more difficult to assess than direct costs, and frequently calculations are based on assumptions or they are extrapolated from research. For example, Deborah Daro (1988) estimated a national indirect juvenile delinquency cost of $14.9 million based on the following: an estimated 177,300 adolescent maltreatment victims nationwide in 1983; research indicating a 20 percent delinquency rate among adolescent victims; and average costs ($21,000 per year) for 2 years of correctional institutionalization for these abused and delinquent youth. The same analysis estimated that if 1 percent of severely abused children were to suffer permanent disabilities, the annual cost of community services for treating children with developmental disabilities would increase by $1.1 million.

    Indirect costs also may include inferred costs of lost productivity associated with injury, incarceration, long-term unemployment, or death. For example, Daro's cost analysis (1988) projected that the national cost in future lost productivity of severely abused or neglected children is between $658 million and $1.3 billion each year, assuming that their impairments reduce their future earnings by as little as 5 percent to 10 percent. A Michigan study (Caldwell, 1992) used rates of per capita income and average lifetime participation in the labor force to generate average lifetime earnings of, and calculate lost tax revenue from, those children who died as a result of child abuse or preventable infant mortality. The study concluded that, in addition to the devastating personal losses experienced by the families of the infants and children who died, the State lost an estimated $46 million in tax revenue. (Although this figure represents the loss of tax revenue over a lifetime, it can also be interpreted as the per year loss to the State if the rates of tax, abuse, and mortality remain relatively stable.)

    As the above examples show, the total financial costs of child abuse and neglect can be quite high. Conversely, the potential benefits or savings from prevention also are high. These costs and potential savings form the basis of cost-benefit analyses.

     

    PREVENTION COST-BENEFIT ANALYSES

    Few in-depth economic analyses have been conducted to assess the cost-effectiveness of child abuse prevention. Four key studies, presented below, compare the costs of preventive family support services with the savings generated from the positive outcomes of prevention programs and/or the direct and indirect costs of not preventing child maltreatment. Many prevention programs, including those referenced in the studies below, address not only prevention of child abuse and neglect, but also prevention of other threats to child and family well-being. Examples of such threats include preventable health conditions (e.g., low birthweight, infant mortality, newborn addictions), lack of economic self-sufficiency, social isolation, lack of parenting skills or knowledge, and inappropriate child rearing behaviors. Several of these other threats also represent precursors or risk factors associated with abuse and neglect. As such, the benefits generated by addressing these risk factors are included in this broad view of the costs related to child maltreatment.

    Elmira, New York

    A 1990 report by David Olds and colleagues presents an economic analysis within a rigorous evaluation based on a randomized trial of a nurse home visitation program serving 400 pregnant women in Elmira, New York (Olds et al, 1993). The evaluation indicated that frequent home visits by nurses during pregnancy and the first 2 years of the child's life improved a wide range of maternal and child health outcomes among adolescent, unmarried, and low-income first-time mothers (Olds & Kitzman, 1993). The study found that in contrast to women assigned to the comparison group, nurse-visited women experienced: (1) improved health related behaviors (e.g., reduced cigarette use and improved diets) and use of prenatal services during pregnancy; (2) fewer emergency-room visits for children during the second year of life; (3) greater workforce participation; and (4) fewer subsequent pregnancies for low-income and unmarried women. In addition, among poor, unmarried teenage women, the study observed a 75 percent reduction in State-verified cases of child abuse and neglect during the first 2 years of a child's life.

    The economic analysis for the Elmira home visitation program concluded that government savings could offset the program costs for low-income participants within 4 years (Olds et al, 1993). The analysis estimated an average cost of $3,133 per family (1980 dollars) for providing home visitation services to low-income participants, based on expenditures for nurses' salaries, benefits, supplies, and transportation. These costs were compared with reduced expenditures in other government programs affected by the positive outcomes of home visitation. The economic impact of improved maternal and child functioning was evaluated from a standpoint of four government programs-Aid to Families with Dependent Children, Medicaid, Food Stamps, and CPS-as well as increased tax revenues generated by subsequent employment. Within low-income families, for the 4-year period following the child's birth, the estimated per family government savings was $3,498 (Olds et al, 1993). The majority of estimated government savings (based on comparison group expenditures) was derived from reductions in AFDC and Food Stamp payments, which were associated with increased employment and reduced subsequent pregnancies among program clients.

    Michigan

    A 1992 study for the Michigan Children's Trust Fund (Caldwell, 1992) concluded that providing either comprehensive parent education or home visitation service for every Michigan family expecting its first child would amount to only 5 percent of the estimated total State cost of maltreatment. Based on an estimated per-family cost of $712, statewide prevention services were projected at approximately $43 million. In comparison, analysts figured that child maltreatment and inadequate prenatal care cost the State approximately $823 million. Michigan's total estimated annual cost of child maltreatment and inadequate prenatal care included direct and indirect costs associated with the following:

    • Protective services ($38 million)
    • Foster care ($74 million)
    • Health costs of low birth weight babies ($256 million)
    • Medical treatment of injuries due to abuse ($5 million)
    • Special education costs ($6 million)
    • Psychological care for child maltreatment victims ($16 million)
    • Juvenile justice system and correction services ($207 million)
    • Adult criminality ($175 million)
    • Projected tax revenue lost from infant deaths ($46 million).

     

    In making these estimates, a series of extrapolations were used to account for the proportion of total spending that can be linked to maltreatment. For example, prior research (Loeber & Stouthamer-Loeber, 1987), suggests that approximately 20 percent of children from abusive homes commit delinquent acts as juveniles and 25 percent of these go on to commit crimes as adults. Based on these findings, the Michigan researchers predicted that of the 39,452 children identified as abused that year, 1,996 would become involved in the adult criminal justice system. With an average annual State adult prison cost of $25,000, and an average prison sentence of 3.5 years, total adult criminality associated with child abuse and neglect was estimated to cost $175 million (1,996 x $25,000 x 3.5).

    Colorado

    A similar 1995 analysis, commissioned by the Colorado Children's Trust Fund, examined the costs incurred in the State of Colorado by failing to prevent child abuse and neglect, and then compared these costs with the savings that would accrue from an investment in effective prevention services (Gould & O'Brien, 1995). The State estimated $190 million in annual direct costs for child maltreatment, including the costs of CPS investigations, child welfare services to children in their own homes, and out-of-home placements. In addition, annual indirect costs were calculated based on an assumption that $212 million (approximately 20 percent of the $1 billion total expenditure) in State social programs were associated with the long-term consequences to individuals maltreated as children (e.g., special education, AFDC assistance payments, job training programs, youth institutional and community programs, mental health programs for children and adults, substance and drug abuse programs, victim services, criminal justice programs, domestic violence shelters, and prisons). Indirect costs ($212 million) and direct costs ($190 million) combined for an estimated total of $402 million in annual expenditures related to abuse and neglect.

    The State costs of maltreatment were compared to the potential savings associated with an intensive home visitor prevention program targeted toward those families most at risk of abuse and neglect. Based on an estimated $2,000 per-family cost of a State-wide home visitation program for high risk families with children from birth to 3 years old, the Colorado analysis projected total costs of $32 million. At the time of the study, $8 million was being spent in the State on home visitation and family support, thus suggesting a need for $24 million in new money. The Colorado analysis concluded that if the program were able to reduce child maltreatment expenditure by only 6 percent (.06 x $402 million annual expenditure), the cost of the prevention investment would be offset.

    Allegheny County, Pennsylvania

    In a recent study, Bruner (1996) used statistical modeling to estimate benefits or savings as the potential returns on investment from family centers for high-risk neighborhoods in Allegheny County, Pennsylvania. This study approaches the cost-of-failure by contrasting the level of spending on remediation, maintenance, and CPS for residents living in the highest-risk, distressed neighborhoods of the county with the level of spending in lower risk neighborhoods in the same county. This approach captures real-world comparisons for estimates of "what could be." (Bruner, 1996).

    The study first determined the potential "savings" obtainable by transforming the high-risk neighborhoods into neighborhoods similar to the rest of Allegheny County. This potential savings, or cost-of-failure, included expenditures across a number of public spending areas most associated with preventable maltreatment and health problems in childhood-AFDC and Medicaid, food stamps, children and youth social services, juvenile justice, jail and prison, and lost economic activity and tax revenue. The analysis concluded that the county would save approximately $565 million annually in public spending, or $416.3 million, if these costs were discounted over a 20-year timeframe.

    Costs were calculated for establishing family centers to serve populations within the high-risk neighborhoods. This analysis was grounded in the existing body of research on the various elements needed for children to succeed, the principles of effective frontline practice, and the potential long-term effects of such strategies upon child outcomes. The study projected that to serve 45 percent to 60 percent of all families with very young children in Allegheny County high-risk neighborhoods would require an expansion of funding of $11.9 million, from $6.6 million (for existing centers with a capacity for 2,640 families) to $18.5 million (to serve up to 8,400 families).

    From a return-on-investment perspective, the $18.5 million expenditure can be compared with the $416.3 million estimated long-term preventable expenditures. An $18.5 million investment would have to contribute to reducing such preventable financial costs by only 5 percent for it to be considered cost-effective.

     

    CONCLUSION

    In each of the above studies, the analysts concluded that the positive outcomes of prevention programs, with even relatively small reductions in the rate of child maltreatment, demonstrate that prevention can be cost effective. Although much remains to be learned about the optimal levels of investment in prevention, these studies present a starting point for continued analysis and discussion.

    To estimate the financial costs of the long-term consequences of child maltreatment on adolescent and adult development and behavior, cost-benefit analyses must take a holistic and long-term perspective. Most of the investments in prevention, particularly as they apply to investments in families with young children, are likely to have "payback curves" that extend over a long period of time, with much of the savings occurring when the child reaches a healthy, productive, and non-violent adulthood (Bruner and Scott, 1994). While additional investment, research, careful documentation, and well-designed analysis is needed within the prevention field-both to assess the effectiveness of prevention programs as well as its cost-effectiveness-current findings suggest that over the long-term, prevention pays.

    Highlights from Child Maltreatment 1999
    April 2001

    This fact sheet presents highlights from the Federal publication Child Maltreatment 1999 . The highlights are based on responses from the States to the 1999 National Child Abuse and Neglect Reporting System (NCANDS). Data were collected in aggregate through the Summary Data Component Survey or at the case level through the Detailed Case Data Component of NCANDS.

    REFERRALS AND REPORTS
    As referrals of possible child maltreatment come to the attention of child protective services (CPS), they either are winnowed from consideration or transmitted further for investigation or assessment ("screened in" or "screened out") For those reports screened in, a further determination is made about whether to investigate. The role of the CPS agency includes deciding whether to take further protective actions on behalf of a child.

    • Of the estimated 2,974,000 referrals received, approximately three-fifths (60.4%) were transferred for investigation or assessment and two-fifths (39.6%) were screened out.
    • More than half of child abuse and neglect reports (54.7) were received from professionals. The remaining 45.3 percent of reports were submitted by nonprofessionals, including family and community members.
    • Most States have established time standards for initiating the investigation of reports. The average response time to initiate investigating reports was 63.8 hours.*
    • Slightly fewer than one-third of investigations (29.2%) resulted in a disposition of either substantiated or indicated child maltreatment. More than half (54.7%) resulted in a finding that child maltreatment was not substantiated.*
    • The average annual workload of CPS investigation and assessment workers was 72 investigations.*

    CHILD MALTREATMENT VICTIMS
    Victims of maltreatment are defined as children who are found to have experienced substantiated or indicated maltreatment or are found to be at risk of experiencing maltreatment.

    • There were an estimated 826,000 victims of maltreatment nationwide. The 1999 rate of victimization, 11.8 per 1,000 children, decreased from the 1998 rate of 12.6.*
    • Almost three-fifths of all victims (58.4%) suffered neglect, while one-fifth (21.3%) suffered physical abuse; 11.3 percent were sexually abused. More than one-third (35.9%) of all victims were reported to be victims of other or additional types of maltreatment.
    • The highest victimization rates were for the 0-3 age group (13.9 maltreatments per 1,000 children of this age in the population), and rates declined as age increased.
    • Rates of many types of maltreatment were similar for male and female children, but the sexual abuse rate for female children (1.6 female children for every 1,000 female children in the population) was higher than the sexual abuse rate for male children (0.4 male children per 1,000).
    • Victimization rates by race/ethnicity ranged from a low of 4.4 Asian/Pacific Islander victims per 1,000 children of the same race in the population to 25.2 African-American victims per 1,000 children of the same race in the population.
    • Children who had been victimized prior to 1999 were almost three times more likely to experience recurrence during the 6 months following their first victimization in 1999 than children without a prior history of victimization.

    PERPETRATORS
    A perpetrator of child abuse and/or neglect is a person who has maltreated a child while in a caretaking relationship to that child.

    • Three-fifths (61.8%) of perpetrators were female. Female perpetrators were typically younger than their male counterparts-41.5 percent of female perpetrators were younger than 30 compared with 31.2 percent of male perpetrators who were younger than 30.
    • Almost nine-tenths (87.3%) of all victims were maltreated by at least one parent. The most common pattern of maltreatment was a child victimized by a female parent acting alone (44.7%).
    • Female parents were identified as the perpetrators of neglect and physical abuse for the highest percentage of child victims. In contrast, male parents were identified as the perpetrators of sexual abuse for the highest percentage of victims.

    FATALITIES
    Child fatality estimates are based on data recorded by CPS agencies and/or other agencies.

    • An estimated 1,100 children died of abuse and neglect, a rate of approximately 1.62 deaths per 100,000 children in the general population.*
    • Slightly more than 2 percent (2.1%) of all fatalities occurred while the victim was in foster care.*
    • Children younger than a year old accounted for 42.6 percent of the fatalities, and 86.1 percent were younger than 6 years of age.
    • Maltreatment deaths were more often associated with neglect (38.2%) than with any other type of abuse.
    • Slightly more than one-tenth (12.5%) of the families of child fatalities had received family preservation services in the 5 years prior to the deaths, while only 2.7 percent of the child fatality victims had been returned to the care of their families prior to their deaths.*

    SERVICES PROVIDED
    CPS agencies provide services to prevent future instances of child abuse and neglect and to remedy harm that has occurred as a result of child maltreatment. Preventive services are provided to parents whose children are at risk of abuse or neglect. Remedial or post-investigative services are offered to families that have experienced a child maltreatment episode.

    • Nationwide, an estimated 1,563,000 children (22.3 out of every 1,000 children in the population) received preventive services.*
    • The average time from the start of investigation to provision of service was 47.4 days.*
    • Nationally, 55.8 percent of child victims (an estimated 461,000) received post-investigative services, and an additional 14.2 percent of children with unsubstantiated reports (an estimated 217,000) also received services.*
    • Nationally, an estimated 171,000 child victims were placed in foster care. An estimated additional 49,000 children who were not victims (i.e., children with unsubstantiated reports) were placed in foster care.*
    • About one-fifth (21.2%) of victims had received family preservation services within the previous 5 years, while more than 5 percent (5.1% of victims) had been reunited with their families in the previous five years.*
    • Court actions were initiated for an estimated 26.1 percent of maltreatment victims. Four-fifths of these victims (79.3%) were provided with court-appointed representatives.*

    *Findings required by the Child Abuse Prevention and Treatment Act, as amended in 1996, to be included in all annual State data reports to the Secretary of Health and Human Services. Because this is only the third year that many of these data have been required, not all States were able to provide data on every item.

    Source: U.S. Department of Health and Human Services. Child Maltreatment 1999: Reports from the States to the National Child Abuse and Neglect Data System. (Washington, DC: U.S. Government Printing Office, 2001).

     

     

    REFERENCES

    • Berkowitz CD: Pediatric abuse. New patterns of injury. Emerg Med Clin North Am 1995 May; 13(2): 321-41[Medline].
    • Chadwick DL: Color Atlas of Sexual Abuse. Chicago, IL: Mosby; 1989.
    • Heger AH, Emans SJ: Evaluation of the Sexually Abused Child: A Medical Textbook and Photographic Atlas. NY: Oxford University Press; 1992.
    • McCann J, Wells R, Simon M, et al: Genital findings in prepubertal girls selected for nonabuse: a descriptive study. Pediatrics 1990 Sep; 86(3): 428-39[Medline]
    • McCann J, Voris J, Simon M, et al: Perianal findings in prepubertal children selected for nonabuse: a descriptive study. Child Abuse Negl 1989; 13(2): 179-93[Medline].
    • Quinn K: The credibility of children's allegations of sexual abuse. In: Behavioral Sciences and the Law. Vol 6 1988: 181-199.
    • Reece RM: Child abuse: Medical Diagnosis and Management. Philadelphia: Lea & Febiger; 1994.
    • Tintinalli JE, Kelen GD, Stapczynski JS: Emergency Medicine: a Comprehensive Study Guide. NY: McGraw-Hill; 2000.

     

Child Abuse Reporting Statistics By state 1997-1999

State 1997 Child Population Data 1997 Children Subject of An Investigation (estimated at 42.0) 1997 Rate of Children Subject of An Investigation/1,000 1998 Child Population Data 1998 Children Subject of An Investigation (estimated at 42.1) 1998 Rate of Children Subject of An Investigation/1,000 1999 Child Population Data 1999 Children Subject of An Investigation (estimated at 41.0) 1999 Rate of Children Subject of An Investigation/1,000
Alabama                 1,071,708                     37,873                         35.3                 1,084,135                     35,912                         33.1                 1,066,177                     36,276                         34.0
Alaska                    188,329                     11,616                         61.7                    192,261                     11,326                         58.9                    196,825                     10,705                         54.4
Arizona                 1,278,063                     80,622                         63.1                 1,263,404                     60,610                         48.0                 1,334,564                     52,611                         39.4
Arkansas                    662,692                     36,340                         54.8                    653,721                     29,572                         45.2                    660,224                     23,970                         36.3
California                 8,951,653                    480,443                         53.7                 8,911,372                    413,372                         46.4                 8,923,423                    452,887                         50.8
Colorado                 1,015,529                     18,893                         18.6                 1,040,580                     39,141                         37.6                 1,065,510                     34,110                         32.0
Connecticut                    792,161                     34,152                         43.1                    790,715                     40,905                         51.7                    828,260                     40,714                         49.2
Delaware                    177,411                       9,657                         54.4                    179,071                       9,693                         54.1                    182,450                       8,330                         45.7
District of Columbia                    107,204                     11,518                       107.4                    102,959                       9,862                         95.8                     95,290                       5,062                         53.1
Florida                 3,471,316                    186,726                         53.8                 3,539,932                    186,967                         52.8                 3,569,878                    160,686                         45.0
Georgia                 1,987,811                     79,848                         40.2                 2,022,351                     74,180                         36.7                 2,056,885                     78,734                         38.3
Hawaii                    302,592                       4,221                         13.9                    298,327                       3,568                         12.0                    289,340                       4,646                         16.1
Idaho                    351,352                     32,522                         92.6                    351,158                     26,682                         76.0                    350,464                     11,161                         31.8
Illinois                 3,174,223                    115,344                         36.3                 3,187,332                    110,658                         34.7                 3,181,338                    104,418                         32.8
Indiana                 1,497,455                     47,170                         31.5                 1,517,366                    102,155                         67.3                 1,528,991                     91,625                         59.9
Iowa                    725,325                     30,464                         42.0                    722,139                     28,072                         38.9                    719,685                     26,812                         37.3
Kansas                    687,931                     45,459                         66.1                    697,452                     26,751                         38.4                    698,637                     28,694                         41.1
Kentucky                    961,202                     45,001                         46.8                    988,293                     63,439                         64.2                    965,528                     63,384                         65.6
Louisiana                 1,190,878                     46,287                         38.9                 1,191,412                     45,318                         38.0                 1,190,001                     46,230                         38.8
Maine                    297,266                     10,041                         33.8                    291,585                       9,030                         31.0                    290,439                       9,877                         34.0
Maryland                 1,268,552                     48,528                         38.3                 1,287,190                     55,964                         43.5                 1,309,432                     53,687                         41.0
Massachusetts                 1,451,374                     64,008                         44.1                 1,457,703                     52,899                         36.3                 1,468,554                     56,620                         38.6
Michigan                 2,504,757                    147,628                         58.9                 2,551,615                    156,425                         61.3                 2,561,139                    166,160                         64.9
Minnesota                 1,250,685                     26,252                         21.0                 1,259,447                     24,844                         19.7                 1,271,850                     24,855                         19.5
Mississippi                    752,998                     31,626                         42.0                    756,875                     32,404                         42.8                    752,866                     29,422                         39.1
Missouri                 1,406,425                     80,185                         57.0                 1,406,616                     75,178                         53.4                 1,399,492                     71,488                         51.1
Montana                    229,530                     21,568                         94.0                    224,403                     19,004                         84.7                    223,819                     20,315                         90.8
Nebraska                    444,681                     16,654                         37.5                    445,642                     14,641                         32.9                    443,800                     13,582                         30.6
Nevada                    442,856                     18,600                         42.0                    467,107                     23,229                         49.7                    491,476                     27,682                         56.3
New Hampshire                    296,090                       9,015                         30.4                    298,610                       8,974                         30.1                    304,436                       8,833                         29.0
New Jersey                 1,987,124                     70,024                         35.2                 1,990,439                     75,988                         38.2                 2,003,204                     74,585                         37.2
New Mexico                    499,322                     23,454                         47.0                    504,210                     13,403                         26.6                    495,612                     12,084                         24.4
New York                 4,560,031                    234,205                         51.4                 4,502,611                    240,655                         53.4                 4,440,924                    186,002                         41.9
North Carolina                 1,873,403                    104,950                         56.0                 1,919,774                    125,862                         65.6                 1,940,947                    127,522                         65.7
North Dakota                    165,208                       6,870                         41.6                    162,611                       7,098                         43.7                    160,092                       6,926                         43.3
Ohio                 2,838,641                    119,223                         42.0                 2,844,005                    135,628                         47.7                 2,844,071                    129,306                         45.5
Oklahoma                    878,305                     51,001                         58.1                    879,367                     60,340                         68.6                    882,062                     60,955                         69.1
Oregon                    810,699                     27,499                         33.9                    825,170                     27,680                         33.5                    827,501                     24,627                         29.8
Pennsylvania                 2,864,082                     22,688                          7.9                 2,859,828                     22,589                          7.9                 2,852,520                     22,437                          7.9
Rhode Island                    233,654                     10,182                         43.6                    237,917                       9,863                         41.5                    241,180                       9,424                         39.1
South Carolina                    955,641                     39,333                         41.2                    959,296                     38,238                         39.9                    955,930                     39,902                         41.7
South Dakota                    197,338                       4,874                         24.7                    200,937                       5,313                         26.4                    198,037                       4,709                         23.8
Tennessee                 1,324,789                     32,383                         24.4                 1,331,402                     32,286                         24.2                 1,340,930                     33,629                         25.1
Texas                 5,577,135                    162,974                         29.2                 5,629,200                    172,718                         30.7                 5,719,234                    170,834                         29.9
Utah                    688,077                     27,219

                        39.6

                    701,300                     27,222                         38.8                    707,366                     26,847                         38.0
Vermont                    145,519                       2,309                         15.9                    141,347                       1,973                         14.0                    139,346                       2,470                         17.7
Virginia                 1,644,386                     51,227                         31.2                 1,644,678                     49,026                         29.8                 1,664,810                     53,837                         32.3
Washington                 1,454,654                     38,200                         26.3                 1,472,490                     47,281                         32.1                 1,486,340                     53,060                         35.7
West Virginia                    411,746                     17,293                         42.0                    404,254                     33,601                         83.1                    403,481                     36,142                         89.6
Wisconsin                 1,346,376                     43,406                         32.2                 1,351,044                     22,232                         16.5                 1,348,268                     34,311                         25.4
Wyoming                    131,765                       5,534                         42.0                    129,406                       2,209                         17.1                    126,807                       3,331                         26.3
UNITED STATES               69,527,944                 2,923,109                         42.0               69,872,059                 2,941,980                         42.1               70,199,435                 2,876,516                         41.0

MEDCEU Continuing Education Courses CEU for Nurses and Healthcare Professional

 Home Page