MEDICAL SURFARI: NEGLECT IS MOST COMMON FORM OF CHILD ABUSE

Parental care and all that it implies is part of mammalian biology. This, in part, is what distinguishes mammals from the rest of the animal kingdom. The converse of care is abuse and neglect. I cannot help but wonder what brings about this type of behavior among our species. Abuse and neglect is not common among the rest of the animal kingdom but, when neglect occurs, it is usually the result of illness and/or stress that is more that the animal can manage. Sadly, deliberate abuse and neglect of offspring seems to occur only among our species.

As the father of four children that I love and cherish, it is very difficult for me to imagine how this can occur. Nevertheless, the sore fact is that maltreatment occurs as physical and emotional abuse, child neglect, and/or sexual abuse. Neglect is by far the most common form of maltreatment. More than 1 million children annually are victims of substantiated child abuse and neglect. Among children confirmed as victims by children protective service agencies, more than half were 7 years old or younger and about one quarter were younger than 4 years old. Fifty-two percent suffered neglect, 25 percent physical abuse, 13 percent sexual abuse, 5 percent emotional maltreatment, 3 percent medical neglect, and 14 percent suffered other forms of maltreatment. Maltreatment occurs almost equally among boys and girls. Nearly 1,000 children annually die as a direct result of abuse or neglect, and most of these children are 3 years of age or younger.

Who abuses and neglects children? The majority of these children are maltreated by birth parents and a relatively small proportion are maltreated by non-birth parents or parent substitutes. Nearly 87 percent of children neglected were neglected by a female. Sixty-seven percent of abused children were abused by males. Nearly half of all sexual abuse occurs by someone other than a parent or parent figure and approximately one-fourth of the children who are sexually abused are abused by a parent and one-fourth are abused by a non-birth parent or parent substitute.

Children of families in all income levels suffer maltreatment. However, children from poverty-level households are more than 25 times more likely to have been harmed or endangered by abuse or neglect. Children from households where alcohol abuse occurs are nearly four times more likely to be maltreated overall, almost five times more likely to be physically neglected, and 10 times more likely to be emotionally neglected than children raised in non-alcohol abusing households. It is estimated that 50-80 percent of all substantiated child abuse cases involve some degree of substance abuse.

April is Child Abuse Prevention Month. This is an effort to encourage parents to use non-violent forms of discipline, promote parent education programs and increase public awareness of how and where to report suspected child abuse and neglect. Public awareness of the magnitude of this problem is an important part of an overall approach to teaching parents, prospective parents, children and community members, especially professionals, who are critical to the identification and reporting of child abuse and neglect.

As I conclude this column, I just looked over and noticed my 7-month old daughter's empty tennis shoes and it caused me to try to imagine the pain and emptiness left in the wake of a family who has lost a child to abuse and neglect -- my imagination could not stretch that far.

Suspected or confirmed child abuse and neglect may be reported in Missouri by dialing (800) 392-3738.

World Wide Web Resources

Child Quest International

http://www.childquest.org/

Child Quest International is a non-profit corporation devoted to the protection and recovery of missing, abused and exploited children. It includes safety tips for parents on protecting your children from abductions, abuse, and exploitation.

HOME PAGE: The Administration For Children and Families (ACF)

http://www.acf.dhhs.gov/

From the Department of Health and Human Services, the ACF promotes the economic and social well-being of families, children, individuals and communities.

Child Abuse and Neglect Clearinghouse

http://www.calib.com/nccanch/

This site helps to define what child maltreatment is, gives statistics on child abuse and neglect, and answers FAQs about child abuse and neglect. It also provides invaluable information on the prevention of child abuse and neglect including public awareness activities, parent education programs, and skills-based curricula to teach children safety and protection skills.

Parents Anonymous (P.A.) National Home Page

http://www.parentsanonymous-natl.org/home.html

This site is helpful in identifying resources available to provide support to overwhelmed families and other families struggling with everyday stresses and strains.

Selected Child Abuse Information and Resources Directory

http://www.childabuse.org/resource.html

This site provides general information on reporting suspected child abuse, hotline numbers, self-help groups and materials on child abuse and parenting. It has selected resources to educate you on children's rights and advocacy, adoption, missing children, medical resources, law enforcement and legal resources.

Dr. Scott Gibbs is a neurosurgeon and editor-in-chief of Mosby's Medical Surfari. You may e-mail questions to him at drgibbs@semissourian.com or write in care of the Southeast Missourian, P.O. Box 699, Cape Girardedau, Mo., 63701.