The World Health Organization has estimated that 40 million children are the victims of abuse and neglect worldwide. Accurate statistics concerning abuse and neglect of children are difficult to find for various reasons, including differing cultural definitions of child abuse, failures to report abuse for a variety of social reasons, and inadequate studies and record-keeping. St. Kitts and Nevis statistics concerning reported abuse and neglect of children are maintained by Probation and Child Protection Services and represent only the tip of the iceberg relative to actual incidents of child maltreatment. Let's look at what child abuse is and how it affects our children and future.

PHYSICAL ABUSE AND NEGLECT: Physical abuse is physical aggression directed at a child by an adult, usually in the context of discipline or caretaking. This can be inflicted by a parent, guardian, teacher, coach, or any adult. At its most extreme, it can result in the death of a child. Physical abuse can involve striking, beating, burning, choking, drowning, or any violent attacks on the body of a child. The immediate bodily damage can be seen in broken bones, bruises, welts, lacerations, burns, and damage to external and internal organs. Shaking infants and young children results in brain damage and even death.

Whereas physical abuse is often an intentional act on the part of an adult to inflict pain and injury on the child, whether as a form of discipline or due to vexation, neglect is maltreatment of the child by omission. Child neglect is defined as failure on the part of the parent or caretaker to provide for the child's basic needs such as food, shelter, clothing, safety, essential medical care, education, or failure to provide adequate supervision. Neglect too can result in immediate and life-threatening medical conditions, as well as disruption of normal intellectual and emotional development. A particularly devastating child psychiatric disorder known as Attachment Disorder can result from infants and very young children not receiving enough attention, nurturance, love, and holding by a parent. Additionally, children raised in neglectful homes are at high risk for sexual exploitation by adults outside of the family.

Beyond the immediate and apparent injuries and damage resulting from abuse and neglect, there are long-term emotional and psycho-social consequences. Physically abused and neglected children learn that the world is not safe, secure, or predictable. They frequently model themselves after their perpetrators, having learned that physical force and violence are reasonable solutions to interpersonal disputes and differences with others.

EMOTIONAL ABUSE: Of all variants of child abuse, emotional abuse is the most difficult to identify. This is not to suggest that it can be any less damaging then other forms. Emotional abuse involves a pattern of belittling, shaming, and humiliating a child. Examples include name calling; negative comparisons to others; telling a child he/she is worthless or "a mistake"; frequent yelling, threatening, or bullying the child or other parent; and emotionally ignoring or rejecting a child as a form of punishment. A parent's misusing alcohol or drugs can also be emotionally abusive to children. Although less dramatic than physical abuse, the consequences of emotional abuse can be even more devastating to the emotional development of children. Children who have grown up in emotionally and/or physically abusive families frequently suffer long-term consequences involving poor self-esteem, self-blaming thoughts, passivity, problems with independent functioning, and a variety of psychiatric disorders such as depression, acting out, and use of alcohol and drugs.

SEXUAL ABUSE: Sexual abuse is a form of child abuse in which an adult or older adolescent abuses a child for the purpose of the perpetrator's sexual gratification. If the abuse occurs in the context of the family it is known as incest. Although previously limited to any type of sexual behavior between blood-related individuals, incest now includes sexual behavior between a child and any adult in a parental or caretaking role residing in the home. Children are also abused sexually by pedophiles, who prey exclusively on pre-pubescent children, and by adult males in the community who manipulate and exploit emotionally-needy children with the use of money, power, and adult authority. Adult sexual activity with a minor (under 16) is sexual abuse, legally and morally.

Teenaged pregnancy, transmission of HIV-AIDS and other sexually transmitted diseases are common immediate consequences of sexual abuse. On a long-term basis, sexually abused children have an increased risk for sexual acting-out and prostitution. Sexually abused boys can become perpetrators of sexual abuse. Victims of child sexual abuse are more likely to develop emotional problems, such as depression, substance abuse, personality disorders, and suicidality. They often have relationship problems and sometimes engage in criminal behavior.

In matters of how we care for our children, we indeed reap what we sow. In order to become healthy, productive, and caring adults, children need unconditional love, security, nurturance, healthy limits/boundaries, and predictability in their lives. They need and are entitled to these things until such time as they can manage on their own. Abused and neglected children are cheated of these basic necessities and have increased problems functioning in the world. They are vastly over-represented in our prisons, psychiatric wards, and counseling centers, as well as among the poorly educated, homeless, and under-socialized youth who prey upon us with violence. Child abuse is described by the World Health Organization as a "silent emergency." The costs of continued silence and apathy about this social problem are enormous. In addition, the law requires that if we know of child abuse, we must report it to Child Protection Services at 467-1308.

By George Stouter, MSW, LCSW (Licensed Clinical Social Worker),
U.S. Peace Corps Volunteer working in the Ministry of Health