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Child Abuse and Neglect

Editor(s): International Committee of Paediatricians. 62 / 1

International Perspectives on the Epidemiology of Child Neglect and Abuse A Primer on the Diagnosis of Child Abuse and Neglect The Treatment of Child Abuse and Violence The Prevention of Child Abuse and Neglect This publication is not available online yet. You can buy it on the Karger website

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Content

Author(s): International Committee of Paediatricians

International Perspectives on the Epidemiology of Child Neglect and Abuse A Primer on the Diagnosis of Child Abuse and Neglect The Treatment of Child Abuse and Violence The Prevention of Child Abuse and Neglect This publication is not available online yet. You can buy it on the Karger website

Editorial

Author(s): International Committee of Paediatricians

International Perspectives on the Epidemiology of Child Neglect and Abuse A Primer on the Diagnosis of Child Abuse and Neglect The Treatment of Child Abuse and Violence The Prevention of Child Abuse and Neglect This publication is not available online yet. You can buy it on the Karger website

International Perspectives on the Epidemiology

Author(s): D.K. Runyan, J. Eckenrode

The abuse and neglect of children have been described in every country of the world where there has been an investigation of the issue [1-5].It has been estimated that, each year, 40 million children under age 15 years around the world suffer from abuse or neglect that requires health and social care [5]. The  recognition of child abuse as a global public health problem is recent [6, 7]. Investigations, in both developed and lesser-developed countries, have demonstrated significant initial and long-term harm [8-10].However, professionals in many countries continue to be blind to the problem. Clinical skills in the recognition of child abuse, even among medical professionals in countries with a history of awareness, are far from ideal. There are fewhours devoted to child abuse in medical curricula even in the United States (US), a country that has one of the largest clinical literatures on the problem [11]. Physicians and other child workers in developing, as well as industrialized countries, must increase their skills and awareness of the problem.

A Primer on the Diagnosis of Child Abuse

Author(s): C.W. Christian, M. Cox

Child abuse and neglect is an international public health problem affecting all races, religions and socioeconomic groups. The World Health Organization (WHO) has defined child abuse as “all forms of physical and/or emotional ill-treatment, sexual abuse, neglect or negligent treatment or commercial or other exploitation resulting in actual or potential harm to the child’s health, survival, development or dignity in the context of a relationship of responsibility, trust,or power” [1]. Identifying abused children is challenging because abuse can take many forms and does not necessarily include physical injury. Child abuse affects children of all ages. Some physical abuse stems from child punishment for misbehaviours, which may take many forms and is influenced strongly by culture, societal views and tolerance of different forms of punishment [2]. The corporal punishment of children is tolerated in many countries and ranges from minor forms (slap on the buttocks) to more severe forms (e.g. caning and other injurious beatings).The purpose of this article is to provide some general structure to the identification and medical evaluation of suspected child abuse.

The Treatment of Child Abuse and Violence

Author(s): S. Ludwig

Child abuse and violence against children is a complex human behaviour with varied aetiologies [1, 2]. Why would parents or persons acting in loco parentis do something to injure or kill a child?  After working on the problem of child abuse for more than 30 years, it is a question that I both understand because I have witnessed so many examples and yet I still do not understand.My lack of comprehension comes because of the complexity of human motivation.  In some cases abuse is an act of ignorance, in some it is an act born of stress and frustration, in other cases it is just one small element in an entire lifestyle of anger, violence and antisocial behaviour. All of these causes for abuse exist with many others and many mixtures of differing aetiologies. Figure 1 shows the many influences on a family and the factors that have been identified as leading to abuse [3].  For the most part, parents start out to want and love their children and somewhere in time they may deviate from those initial goals to do something that will hurt rather than protect their offspring. It is only the minority of situations that I have encountered wherein the parent was without remorse or not express the desire to control their violent behaviour. Many of the cases of the most brutal abuse comes at the hands of adults who do not have a true biological connection to thechild and are placed in a parenting situation while being unprepared and not wanting to accept the challenging task of child rearing.  It is because there are many different dynamics to abusive or violent acts that there must be many different treatment modalities employed to help parents and families make thechanges needed to control their abuse [4]. This paper will explore some of those modalities of treatment and will describe what some have done to stop the abuse and the cycle of abuse into future generations...

The Prevention of Child Abuse and Neglect

Author(s): J. Eckenrode, D.K. Runyan

It's a problem that reaches well beyond the victims and perpetrators directly affected by these behaviours. It affects the lives of professionals who are charged to care for the health and wellbeing of families and children, as well the government officials and private citizens who are concerned with the quality of life in their communities.Child maltreatment erodes social capital and the social cohesion that binds communities.  An effective approach to the prevention of child abuse and neglect must reflect the complexity of the causes of the problem and the diverse interests and needs represented by all persons who are affected by it. In a report from the United States’ National Research Council, the goals of prevention efforts in the field of child maltreatment are viewed as efforts “to reduce risk factors associated with child abuse and neglect, to improve the outcomes of individuals or families exposed to such risk factors, and to enhance compensatory or protective factors that could mitigate or buffer the child from the effects of victimization” [1].Alongside efforts to improve systems for detecting and treating maltreated children and maltreating families, prevention must be viewed as part of a comprehensive approach to the total problem of child maltreatment in countries and communities. Ideally, efforts at detection and child protection should share the same philosophical approach with prevention efforts in terms of optimizing child and family well-being.But an over-emphasis on detection and secondary prevention has at times diverted attention away from primary prevention strategies that are focused on providing support and assistance to families who are distressed or not functioningeffectively [2].