Alternative Terms: Battered Child, Child Maltreatment, Family Violence
Physical child abuse refers to harm to the child inflicted by the caregiver. Every year, nearly 1,400 cases of fatal child abuse are reported. Recent information from investigators of child fatality records suggests that the actual number of children killed by their caregivers may be much, much larger. Child Death Review Teams are now being formed in many states to investigate child fatalities that may come from physical abuse. Legal definitions of child abuse vary from state to state, but injuries requiring medical attention are typically regarded as abusive. Nonetheless, the difficulties associated with making these kinds of distinctions are well known, and are often characterized by saying that "one person's 'abuse' is another person's 'discipline'." Many states explicitly note that spanking "when administered in a reasonable manner" does not constitute abuse. Thus, how severely parents can inflict physical punishment upon their children without it being considered abusive remains subject to interpretation.
Child abuse is costly to society in a number of ways. Medical costs for direct care to children injured by their parents exceed $20 million each year; the bulk of this amount is paid by taxpayers through Medicaid. Special education services for abused children cost $7 million per year. The direct costs are small in comparison to the $460 million annual costs of foster care for children removed from their home due to parental maltreatment. None of these costs reflect the dysfunction and misery that are seen later in the lives of some abused children.
Physical abuse differs from emotional abuse, in which the child may be ridiculed, blamed or terrorized; sexual abuse, in which the child is subject to sexual behaviors ranging from exposure to intercourse; and child neglect, in which the parents fail to provide the necessities of life or fail to protect the child from harm. However, the factors that place the child at risk for emotional abuse, sexual abuse, and neglect are similar to the factors that lead to physical child abuse. These factors include personality and social class of the parent and the temperament of the child. Understanding why these factors increase the risk of child abuse may ultimately help intervention efforts. This entry will consider the impact of physical child abuse across several developmental levels, explore the risk factors for child abuse, and look at methods of treatment and prevention.
The U.S. Department of Health and Human Services collects data on the incidence of child abuse in the United States. The accompanying table on page 140 provides information on the distribution by age.