Physical and sexual abuse of children has gone down over the past 20 years, but reports of neglect have gone up, a panel of experts reports on Thursday. And the biggest threats to any child are the parents.
It’s not clear why either trend is happening, the panel at the Institute of Medicine says -- although it’s very welcome news to see sexual and other physical abuse on the decline.
“It may be because of increased awareness in the population, that it’s something that has a profound impact on children and should be reported,” says Dr. Angela Diaz, professor of pediatrics at the Mount Sinai School of Medicine in New York and one of the panel members.
Dr. Lolita McDavid, medical director of child advocacy and protection at University Hospitals Case Medical Center in Cleveland, says she believes awareness explains a lot. “I think we are much more aware now that there is physical and sexual abuse and I think we do a much better job of making families and children understand that,” McDavid told NBC News.
“We are empowering children.”
But the experts say it’s vital to look into the reasons that physical abuse may be going down, yet neglect and emotional abuse are staying at the same levels. They call for sustained federal research into what’s going on and a new database to track child abuse statistics.
Even if numbers are going down, overall, many children are abused and neglected in the United States, the panel of experts reports.
“Each year more than 3 million referrals for child abuse and neglect are received that involve around 6 million children, although most of these reports are not substantiated,” the report reads.
“In fiscal year 2011, the latest year for which data are available, state child protective services agencies encountered 676,569 children, or about 9.1 of every 1,000 children, who were found to be victims of child abuse and neglect, including physical abuse, sexual abuse, psychological abuse, and medical and other types of neglect.”
More than 1,500 of the children, most under age 4, died because of the abuse or neglect.
The report, which is mean to inform and advise federal policymakers and Congress, quotes data from the National Child Abuse and Neglect Data. It shows that about three-quarters of reported cases in 2011 were classified as neglect, about 15 percent as physical abuse, and about 10 percent as sexual abuse.
“About 80 percent of perpetrators are parents, 87 percent of whom are biological parents. More than half of perpetrators are female,” the Institute, an independent, non-government organization, says in a statement.
Rates of child maltreatment fell from 12.3 per 1,000 children in 2002 to 9.1 in 2011. But rates of neglect stayed the same, at 7.2 per 1,000. Rates of physical abuse fell from 2.3 per 1.000 children to 1.6, and rates of sexual abuse fell from 1.2 to 0.8.
“Sexual abuse has shown the largest decline in reported rates,” the report adds. One study shows sexual abuse down 62 percent since 1992.
“The sharpest declines occurred during the late 1990s but the downward trajectory has continued, with a 3 percent decline being reported between 2009 and 2010,” the report reads.
But the report says these numbers are likely to be underestimates. “For example, the most recent National Incidence Study of Child Abuse and Neglect from 2005 to 2006 estimated that the rate of child abuse and neglect was 17.2 of every 1,000 children, totaling more than 1.25 million children, and many more were determined to be at risk,” the Institute says.
Police, teachers, neighbors and relatives are all likely to be reluctant to report abuse and neglect, the panel of experts says. And this costs both children and society.
“The thing that surprises some people sometimes is that neglect has pernicious effects across all domains of development, as does abuse,” says Mary Dozier, chair of child development at the University of Delaware and a panel member.
“We see this all the way from growth to illness to things like diabetes and all kinds of other illnesses, the frequency with which children miss school and so forth,” Dozier said in a telephone interview.
There are some known mechanisms -- stress can affect the glands that secrete hormones, in turn affecting growth and the immune system. And there’s also a growing body of evidence that childhood stress can affect the genes.
McDavid says it reaches across generations. She sees it when she sees her patients in the pediatrics clinic and counsels them about protecting themselves from abuse. “I have had mothers who get tearful because they were molested as children, and because they didn’t tell, or nobody believed them when they told,” she says.
“Pediatricians are much more proactive in helping families that may be under stress. We now talk about such things. There was a time when we didn’t talk about it.”
First published September 12 2013, 12:21 PM