Child Abuse

CHILD ABUSE
What is child abuse? It is the physical or emotional abuse of a child by a parent, guardian, or other person. Reports of child abuse, including sexual abuse, beating, and murder, have climbed in the United States and some authorities believe that the number of cases is largely under reported. Child neglect is sometimes included in legal definitions of child abuse to cover instances of malnutrition, desertion, and inadequate care of a child’s safety. When reported, child abuse cases are complicated by inadequate foster care services and a legal system that has trouble accommodating the suggestible nature of children, who are often developmentally unable to distinguish fact from make-believe (Hay, 1996).
In 1993, the United States Advisory Board on Child Abuse and Neglect declared a child protection emergency. Between 1985 and 1993, there was a 50 percent increase in reported cases of child abuse. Three million cases of child abuse are reported in the United States each year. Treatment of the abuser has had only limited success and child protection agencies are overwhelmed (Lewitt, 1997).
Recently, efforts have begun to focus on the primary prevention of child abuse. Primary prevention of child abuse must be implemented on many levels before it can be successful. Prevention plans on the social level include increasing the economic self-sufficiency of families, discouraging corporal punishment and other forms of violence, making health care more accessible and affordable, expanding and improving coordination of social services, improving the identification and treatment of psychological problems, and alcohol and drug abuse, providing more affordable child care and preventing the birth of unwanted children. Prevention plans on the family level include helping parents meet their basic needs, identifying problems of substance abuse and spouse abuse, and educating parents about child behavior, discipline, safety and development. Primary prevention is both the prevention of disease before it occurs, and the reduction of its incidence. In the case of child abuse, primary prevention is defined as any intervention designed for the purpose of preventing child abuse before it occurs (Hay, 1996).

Between 1985 and 1993, the number of cases of child abuse in the United States increased by 50 percent. In 1993, three million children in the United States were reported to have been abused. Thirty-five percent of these cases of child abuse were confirmed. Data from various reporting sources, indicates that improved reporting could lead to a significant increase in the number of cases of child abuse verified by child protection agencies. The lack of verification does not indicate that abuse did not occur, only that it could not be verified. The facts are that each year 160,000 children suffer severe or life-threatening injury and 1,000 to 2,000 children die as a result of abuse. Of these deaths, 80 percent involve children younger than five years of age, and 40 percent involve children younger than one year of age. One out of every 20 murder victims is a child. Murder is the fourth leading cause of death in children from one to four years of age and the third leading cause of death in children from five to fourteen years of age. Neonaticide, which is the murder of a baby during the first 24 hours of life, accounts for 45 percent of children killed during the first year of life (Lewitt, 1997).

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As I stated above, deaths from abuse are under reported and some deaths classified as the result of accident and sudden infant death syndrome might be reclassified as the result of child abuse if comprehensive investigations were more routinely done. Most child abuse takes place in the home and is started by persons are know to and trusted by the child. Even though it has been widely publicized, abuse in day-care and foster-care settings accounts for only a small number of confirmed cases of child abuse. In 1996, only two percent of all confirmed cases of child abuse occurred in these settings. Child abuse if fifteen times more likely to occur in families where spousal abuse occurs. Children are three times more likely to be abused by their fathers than by their mothers. No differences have been found in the incidence of child abuse in rural versus urban areas. Following are the types of abuse and the percentages of the different types.


Neglect – 54%
Physical abuse – 25%
Sexual abuse – 11%
Emotional abuse – 3%
Other – 7%
(Davis, 1998).


Not only do children suffer from the physical and mental cruelty of child abuse, they endure many long-term consequences, including delays in reaching developmental milestones, refusal to attend school and separation anxiety disorders. Other consequences include an increased likelihood of future substance abuse, aggressive behaviors, high-risk health behaviors, criminal activity, depressive and affective disorders, personality disorders, post-traumatic stress disorder, panic attacks, schizophrenia and abuse of their own children and spouse. Research has shown that a loving, caring and stimulating environment during the first three years of a child’s life is important for proper brain development (Davis, 1998).
There have been some recent changes in regards to the causes of child abuse. The results of research initiated by the National Research Council’s Panel on Research on Child Abuse and Neglect showed the first important step away from the simple cause and effect patterns. The panel stated that the simple cause and effect patterns have certain limitations, mostly related to their narrow focus on the parents. These patterns are limited by asking only about the isolated set of personal characteristics that might cause parents to abuse their children. These patterns failed to account for the occurrence of different forms of abuse in one child. These patterns had very little explanatory power in weighing the value of various risk factors involved in child abuse. As a result, they were not very accurate in predicting future cases of child abuse. To replace the old static pattern, the panel has substituted what it calls an ecologic model. This model considers the origin of all forms of child abuse to be a complex interactive process. This ecologic model views child abuse within a system of risk and protective factors interacting across four levels: (1) the individual, (2) the family, (3) the community and (4) the society. Some factors are more closely linked with some forms of abuse than others. The following are factors thought to contribute to the development of physical and emotional abuse and neglect of children:
Community/societyParent-related
High crime ratePersonal history of physical or sexual abuse
Lack of or few social services Teenage parents
High poverty rateLack of parenting skills
High unemployment rateUnwanted pregnancy
Emotional immaturity
Child-relatedPoor coping skills
PrematurityLow self-esteem
Low birth weightPersonal history of substance abuse
HandicapKnown history of child abuse
Domestic violence
Lack of preparation for extreme stress of having a new infant
(Understanding Child Abuse and Neglect,1996).


Many people would argue that our society does not really value its children. This argument is highlighted by the fact that one in four children in the United States lives in poverty, and many children do not have any form of health insurance. The presence of high levels of violence in our society is also thought to contribute to child abuse. Deadly violence is more common in the United States than in seventeen other developed countries. Seventy-five percent of violence occurring in this country is domestic violence. The United States leads developed countries in homicide rates for females older than 14 years and for children from five to fourteen years of age. Other factors that may contribute to high rates of violence include exposure to television violence and reliance on corporal punishment (McKay, 1997).
Poverty is the most frequently and persistently noted risk factor for child abuse. Physical abuse and neglect are more common among the people who are the poorest. Whether this is brought on by the stress of poverty-related conditions or results from greater scrutiny by public agencies, resulting in over reporting, is debated. Other factors include inaccessible and unaffordable health care, fragmented social services and lack of support from extended families and communities (Besharov, 1990).

Parents who were abused as children are more likely than other parents to abuse their own children. Lack of parenting skills, unrealistic expectations about a child’s capabilities, ignorance of ways to manage a child’s behavior and of normal child development may further contribute to child abuse. It is estimated that forty percent of confirmed cases of child abuse are related to substance abuse. It is also estimated that eleven percent of pregnant women are substance abusers, and that 300,000 infants are born each year to mothers who abuse crack cocaine. Domestic violence also increases the risk of child abuse (Helfer, 1998).

Other factors that increase the risk of child abuse include emotional immaturity of the parents, which is often highly correlated to actual age, as in the case of teenage parents, poor coping skills, often related to age but also occurring in older parents, poor self-esteem and other psychologic problems experienced by either one or both parents, single parenthood and the many burdens and hardships of parenting that must be borne without the help of a partner, social isolation of the parent or parents from family and friends and the resulting lack of support that their absence implies, any situation involving a handicapped child or one that is born prematurely or at a low birth weight, any situation where a sibling younger than 18 months of age is already present in the home, any situation in which the child is the result of an unwanted pregnancy or a pregnancy that the mother denies, any situation where one sibling has been reported to the child protective services for suspected abuse, and finally, the general inherent stress of parenting which, when combined with the pressure of anyone or a combination of the factors previously mentioned, may exacerbate any difficult situation (Besharov, 1990).
The United States Advisory Board on Child Abuse and Neglect has stated that only a universal system of early intervention, grounded in the creation of caring communities, could provide an effective foundation for confronting the child abuse crisis. It is believed that successful strategies for preventing child abuse require intervention at all levels of society. No agreement has been formed concerning which programs or services should be offered to prevent child abuse. This is because research on the prevention of child abuse is limited by the complexity of the problem, the difficulty in measuring and interpreting the outcomes, and the lack of attention to the interaction among variables in determining risk status for subsequent abuse. A broad range of programs has been developed and implemented by public and private agencies at many levels, little evidence supports the effectiveness of these programs (Rushton, 1997).
As 1994 look back on a review of 1,526 studies on the primary prevention of child abuse found that only thirty studies were methodologically sound. Of the eleven studies dealing primarily with physical abuse and neglect, only two showed a decrease in child abuse as measured by a reduction in hospital admissions, emergency department visits or reports to child protective services. Although there is a need for better designed research to evaluate the effectiveness of prevention strategies, recommendations for preventive interventions are based on what we currently know about causes of child abuse (Hay, 1996).
Primary prevention strategies based on risk factors that have a low predictive value are not as likely to be effective as more broadly based social programs. In addition, programs focused on a society level rather than on the individual level prevent the stigmatization of a group or an individual. Society strategies for preventing child abuse that are proposed but unproven include increasing the value society places on children, increasing the economic self-sufficiency of families, enhancing communities and their resources, discouraging excessive use of corporal punishment and other forms of violence, making health care more accessible and affordable, expanding and improving treatment for alcohol and drug abuse, improving the identification and treatment of mental health problems, increasing the availability of affordable child care and preventing the births of unwanted children through sex education, family planning, abortion, anonymous delivery and adoption (Rushton, 1997).
Common Features of Successful Child Abuse Prevention Programs
Strengthen family and community connections and support.

Treat parents as vital contributors to their children’s growth and development.

Create opportunities for parents to feel empowered to act on their own behalf.

Respect the integrity of the family.

Enhance parents’ capability to foster the optimal development of their children and themselves.

Establish links with community support systems.

Provide settings where parents and children can gather, interact, support, learn from each other.

Enhance coordination and integration of services needed by families.

Enhance community awareness of the importance of healthy parenting practices.

Provide emergency support for parents 24 hours a day. (Rushton, 1997).


Plans aimed at helping the individual can also be considered strategies for helping the family. In the list of features of successful child abuse prevention programs listed above, the idea is to support parents in their role of parenting. Until parents’ basic needs are met, they may find it difficult to meet the needs of their children. The first thing parents need is assistance in meeting their basic requirements for food, shelter, clothing, safety and medical care. Only when these needs are met can higher needs be addressed (Rushton, 1997).
The next step should be to identify and treat parents who abuse alcohol or drugs, and identify and counsel parents who suffer from spousal abuse. Identifying and treating parents with psychologic problems is also important. Other issues that need attention include financial concerns, and employment and legal problems. Providing an empathetic ear and being a source of referral for help with these issues may take physicians a long way toward nurturing needy parents. The next higher level of need includes education about time management and budgeting skills, stress management, coping and parenting skills such as appropriate discipline, knowledge of child development, nutrition and feeding problems, and safety issues (Rushton, 1997).
In the United States, some of the specific methods of delivering services to families include long-term home visitation, short-term home visitation, early and extended postpartum mother/child contact, rooming in, intensive physician contact, drop-in centers, child classroom education, parent training and free access to health care.

Of all these methods, only long-term home visitation, up to two years, has been found to be effective in reducing the incidence of child abuse as measured by hospital admissions, emergency department visits and reports to child protective services. Man organizations are now embracing the concept of home visitation as a method of preventing child abuse by identifying family needs and providing the appropriate services. Results of one study on home visitation showed benefits or improvements in several areas: parents’ attitudes toward their children, interactions between parents and children, and reduction in the incidence of child abuse. Without a basic framework of support services such as health care, social services and child care, home visitors will be unable to deliver needed services (Rushton, 1997).
Strategies for Preventing Child Abuse
Diagnose pregnancy in unmarried mothers and explore its impact with them.

Assess the number of stressors on new parents, including:
Social support
Financial situation
Martial status
Level of education
Number of children
Identify families with problems of:
Substance abuse
Domestic violence
Mental health
Offer new parents:
Services of a social worker
Long-term home visitation
Parenting classes
Educate new parents regarding:
Developmental tasks of childhood
Age-appropriate anticipatory guidance
Nutrition and feeding problems
Safety
Discipline
Discourage corporal punishment
Survey parents to identify health issues that are of interest to them
Support universal health care for children
Advocate for quality, affordable and universally available child care
Advocate for community respite care for parents
Advocate for community alcohol and drug treatment, mental health, and spouse and child abuse centers
(Rushton, 1997).

Many of the causes of child abuse center on the needs and problems of the parents. In order to prevent child abuse, we must first help and support the parents. Parents with multiple emotional, medical, financial and social needs find it difficult to meet the needs of their children. It is imperative that physicians develop a supportive attitude toward parents to ultimately help the children.
Effective prevention of child abuse and neglect can best be achieved using strategies designed to help parents protect and nurture their children. These strategies including giving parents the necessary support, resources and skills. The physician should obtain help from social workers, home health agencies, financial counselors, psychologist, local mental health facilities, alcohol and drug treatment centers and parenting centers, as appropriate. The National Committee to Prevent Child Abuse has a nationwide network of fifty-two chapters that provide leadership in prevention of child abuse (Understanding Child Abuse and Neglect, 1996).

One source I read suggested setting up group parenting classes to discuss issues such as: safety issues, nutrition and feeding concerns, discipline and normal child development. Classes should be divided into two groups: one for the parents of infants and one for the parents of toddlers, since these two groups will require a different focus. Providing child care during these classes may be necessary to ensure attendance.
Other suggestions are for a physician to help to try prevent child abuse. Spending less time examining an obviously well child and more time discussing psycho social issues with that child’s parent is one suggestion. The following is a list of questions a physician can ask parents that might help assess the risk of child abuse.


What is it like for you taking care of this baby?
Who helps you with your children?
Do you get time to yourself?
What do you do when the child’s behavior drives you crazy?
Do you have trouble with your child at mealtime or bedtime?
Are your children in day care?
How are things between you and your partner?
(Rushton, 1998).

If psycho social problems are uncovered, the physician might schedule more frequent visits to allow for further discussions. Other strategies include inviting fathers for an office visit and encouraging the parents to rely on the support of families and friends. It is important to address issues that are of concern to the parents. It is also important to try to give very specific and concrete suggestions to parents instead of talking in broad generalities. Physicians could suggest that parents use an egg timer to help children anticipate and be more compliant with bedtime or use time-out as an alternative to spanking a child for bad behavior. Parents should be reminded of and taught to distinguish between childish behavior and willful disobedience, and to discipline only those actions that are in the child’s control according to his or her stage of development (Rushton, 1997).
Many things need to happen at international, national, state and community levels to prevent child abuse. Studies have shown that countries with the most generous social services have the lowest rate of child homicide. People should lobby for greater availability of drug and alcohol treatment programs, more shelters for the homeless, more accessible mental health care and more shelters for abused women and children. These programs and those that provide parenting skills, support groups and respite care for parents and care givers should be available in every community.
Child abuse is a complex problem with many causes, it is important that people not take a defeatist attitude toward its prevention. Despite the absence of strong evidence to guide preventive efforts, society can do things to try to prevent abuse. Showing increased concern for the parents or care givers and increasing attempts to enhance their skills as parents or care givers may help save the most vulnerable people, our children, from the nightmare of abuse and neglect.

BIBLIOGRAPHY
Bass, Ellen. The Courage to Heal: A Guide for Women Survivors of Child Abuse. New York: Harper & Row, 1997.


Besharov, Douglas J. Recognizing Child Abuse. New York: Simon & Schuster, 1990
Davis, Laura. Stop Domestic Violence. New York: Macmillan, 1998.


Hay, T. “Social Interventions to Prevent Child Abuse and Neglect.” Child Welfare 5 February 1996: 379-403.


Helfer, Mary Edna. The Battered Child. Chicago: University of Chicago Press, 1998.


Lewitt, E. M.. “Reported Child Abuse and Neglect.” Future Child April 1997: 233-242.


McKay, Michael. “The Link Between Domestic Violence and Child Abuse.” New York: Macmillan, 1997.


Panel on Research on Child Abuse and Neglect. Understanding Child Abuse and Neglect: 1996.


Rushton, Frank. “The Role of Health Care in Child Abuse and Neglect Prevention.” Pediatrics March 1997: 133-136.

Child Abuse

Child abuse is the intentional omission of care by a parent or guardian that can cause a
child to be hurt, maimed, or even killed. Child abuse can be either physical, mental,
emotional or sexual. Because of child abuse, Caprice Ried will never do the things that a
normal four-year old does. She will never play on a playground, or go to a sleepover, and
never go to school. All of this was taken away from her at such a young age, when she
died of child abuse. The foster parents, Patricia Coker, and her mother Betty Coker have
been charged with second degree murder for Caprices death. Caprice went without food
for days. She was also tied to a chair and beaten with a stick until she couldnt walk.
Several days later, she was found dead.
As horrible as this story seems, this scene happens way to often. In 1996,
approximately 3,126,000 children were reported for child abuse. Currently, about 47 out
of every 1,000 children are reported as victims of child abuse and maltreatment.
Overall, child abuse reporting levels have increased 45% between 1987 and 1996.
In 1996, an estimated 1,046 child abuse and neglect related fatalities were
confirmed by Child Protective Services, (CPS) agencies. Since 1985, the rate of child
abuse fatalities has increased by 20%. Based on these numbers, more than three children
die each day as a result of child abuse or neglect.
In 1996, some states reported that almost 77% of these children that died were
less than five years old at the time of their death, while 45% were under 1 year of age.
The causes of death were 45% neglect, 52% physical abuse, 3% from a combination of
neglect and physical abuse. Studies of the general population show that anywhere from
6% to 63% of women were sexually abused as children. A 1985 L.A. Times national
survey found that 27% of women and 16% of men reported being sexually abused prior
to age 18. The true extent of sexual abuse in unknown.
The relationship between parental alcohol or other drug problems and child
maltreatment is becoming increasingly evident. And the risk to the child increases in a
single parent household where there is no supporting adult to diffuse parental stress and
protect the child from the effects of the parents problem.
Both alcohol and drug problems are widespread in this country. Almost 14
million adult Americans abuse alcohol. The number of illicit drug users exceeds 12
million. Illicit drugs include marijuana, cocaine, inhalants, hallucinogens, heroin, and
non-medical use of psychotherapeutics. With more than 6.6 million children under the
age of 18 living in alcoholic households, and an additional number of children living in
households where parents have problems with illicit drugs, a significant number of
children in this country are being raised by addicted parents.
Child maltreatment has become a national epidemic. More than one million
children are confirmed each year as victims of child abuse and neglect by state child
protective service agencies. Every day at least three children die as a result of abuse or
neglect. State child welfare records indicate that substance abuse is one of the top two
problems exhibited by families in 81% of the reported cases.
Recent research on the connection between alcohol or drug problems and child
maltreatment clearly indicates a connection between the two problems. Among
confirmed cases of child maltreatment, 40% involve the use of alcohol or other drugs.
This suggests that of the 1.2 million confirmed victims of child maltreatment, and
estimated 480,000 children are mistreated each year by a caretaker with alcohol or other
drug problems. Additionally, research suggests that alcohol and other drug problems are
factors in a majority of cases of emotional abuse and neglect. In fact, neglect is the
major reason that children are removed from a home in which parents have alcohol or
other drug problems. Children in these homes suffer from a variety of physical, mental,
and emotional health problems at a greater rate than children in the general population.
Children of alcoholics suffer more injuries and poisonings than children in the general
population. Alcohol and other substances may act as disinhibitors, lessening impulse
control and allowing parents to behave abusively. Children in this environment often
demonstrate behavioral problems and are diagnosed as having conduct disorders. This
may result in provocative behavior. Increased stress resulting from preoccupation with
drugs on the part of the parent combined with behavioral problems exhibited by the child
adds to the likelihood of maltreatment.
Histories of parents with alcohol and drug problems or parents involved in child
maltreatment reveal that typically both were reared with a lack of parental nurturing and
appropriate modeling and often grew up in disruptive homes. Family life in these
households also have similarities. The children often lack guidance, positive role
modeling, and live in isolation. Frequently, they suffer from depression, anxiety, and low
self-esteem. They live in an atmosphere of stress and family conflict. Children raised in
both kinds of households are more likely to have problems with alcohol and other drugs
themselves.

Pregnant women who use alcohol may bear children suffering from fetal alcohol
syndrome (FAS). FAS is the leading known environmental cause of mental retardation
in the western world. Each year 4,000 to 12,000 babies are born with the physical signs
and intellectual disabilities associated with FAS, and thousands more experience the
somewhat lesser disabilities of the fetal alcohol effects.

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Children of alcoholics are more likely than children in the general population to
suffer a variety of physical, emotional, and mental health problems. Similar to
maltreatment victims who believe that the abuse is their fault, children of alcoholics feel
guilty and responsible for their parents drinking problem. Both groups of children often
have feelings of low self-esteem and failure and suffer from depression and anxiety. It is
thought that exposure to violence in both alcohol abusing and child maltreating
households increases the likelihood that the children will commit and be recipients of
acts of violence. Additionally, the effects of child maltreatment and parental alcohol
abuse dont end when the children reach adulthood. Both groups of children are likely to
have difficulty with coping and establishing healthy relationships as adults. In addition
to suffering from all the effects of living in a household where alcohol or child
maltreatment are illegal. While research is in its infancy, clinical evidence shows that
children of parents who have problem with illicit drug use may suffer from an inability to
trust legitimate authority because of fear of discovery of a parents illegal habits.
Some individuals can and do break the cycle of abuse. These resilient children
share some characteristics that lead to their successful coping skills such as ability to
obtain positive attention from other people, adequate communication skills, average
intelligence, a caring attitude, a desire to achieve, a belief in self-help. Additionally, the
involvement of a caring adult can help children develop resiliency and break the cycle of
abuse. However, a significant number of individuals fall victim to the same patterns
exhibited by their parents. Those who have been severely physically abused often have
symptoms of post-traumatic disorder and dissociation. Individuals suffering from mental
health disorders may use alcohol and illicit drugs to decrease or mitigate their
psychological distress. Research suggests that adults who were abused as children may
be more likely to abuse their own children than adults who were not abused as children.
One explanation for the continuing cycle is the secrecy, denial, and stigma
involved in both problems. Many child maltreatment cases do not get reported and many
children of alcoholics go unidentified. Within both populations, victims often are afraid
to speak up because they do not think anyone will believe them. Often they do not
realize that what seems to be normal behavior is indeed maltreatment, and learn to repeat
these behaviors unconsciously. The lack of positive parental role modeling and lack of
development of coping skills increases the difficulty of establishing healthy relationships
as an adult. It may not be until they seek help disturbed adults that they are made
cognizant of the root of their emotional problems.
Research has shown that when families exhibit both of these behaviors
(alcohol/drugs and child maltreatment), the problems must be treated simultaneously in
order to insure a childs safety. Although ending the drug dependency does not
automatically end child maltreatment, very little can be done to improve parenting skills
until this step is taken. It should be noted that the withdrawal experienced by parents
who cease using alcohol or other drugs presents specific risks. The effects of withdrawal
often cause a parent to experience intense emotions, which may increase the likelihood
of child maltreatment. During this time, lasting as long as two years, it is especially
important that resources be available to the family.

In 1995, an estimated 1,2115 child maltreatment deaths were confirmed
by child protective services (CPS) agencies. This figure undercounts the actual number
of maltreatment fatalities, however, as some number of accidental deaths, child
homicides, SIDS (Sudden Infant Death Syndrome) cases and deaths attributed to
underestimated causes should be labeled child maltreatment fatalities. According to a
1993 study, and estimated 85% of deaths due to parental maltreatment were coded as due
to some other cause on the childs death certificate.
Over three children dies each day last year as a result of parental maltreatment. A
national survey conducted by the National Committee to Prevent Child Abuse (NCPCA)
early in 1995 suggests that the number of confirmed child abuse fatalities increased 39%
over the last 10 years. This trend is not surprising given the increase in poverty,
substance abuse, and violence experienced by many communities.

Based on the data collected from 37 states and the District of Columbia, a little
over 3 million children were reported for child abuse in 1995, approximately 2% more
than had been reported in 1994. Overall, child abuse reporting rates have risen by an
average of 4% each year between 1990 and 1995. The total number of reports has
increased nationwide by 49% since 1986.
Young children are at the highest risk of dying from maltreatment. Research
indicates that between 1993 and 1995, 85% of fatalities occurred to children under the
age of five, when 45% of children under the age of one. Other studies have found that
child abuse ranks as the second leading cause of death, after accidents, for children
between the ages of one and five years old.
It is difficult to pinpoint one main cause for all fatalities attributed to child
maltreatment. Between 1993 and 1995, 37% of all fatalities were the result of neglect,
48% from abuse, and 15% as a result of both forms of maltreatment. As a result, a few
factors related to these fatalities seem to present themselves year after year. According to
a 1995 report by NCPCA, states reported that substance abuse, by the abuser, was
involved in anywhere from 4% to 65% of all substantiated cases. Additionally, 46% of
children who died between 1993 and 1995 had prior or recent contact with CPS agencies.
This may signify that these are the only deaths that are investigated by many states. As a
result, we can expect that a high percentage of reported deaths involve such children.
Also, however, there is much difficulty in providing sufficient services to all victims
which may also contribute to child maltreatment fatalities.

Improving the ability of child protective services agencies to assist their clients by
reducing caseloads, expanding training of caseworkers, and funding more treatment
services for victims will help reduce fatalities. Child protective services, however,
cannot prevent all fatalities single-handedly. Other formal institutions such as schools
and hospitals as well as informal, personal networks should play an active role in
identifying and assembling families at risk of abusive or neglectful behavior. Finally,
alcohol and drug treatment services need to be expanded and made more accessible to
pregnant and parenting women.

One of the most promising prevention strategies for reducing early childhood
injuries is the provision of comprehensive home health visitors to all expectant and new
mothers, or at the very least, to mothers in high risk neighborhoods. In 1991, NCPCA
introduced Healthy Families America, a comprehensive home visiting initiative. Such
services offer instruction and support regarding prenatal care, parenting skills, household
management, and coping with environmental dangers. As a 1996 report on Hawaiis
Healthy Start home visitation program concluded, home visiting produces measurable
benefits for participants in the areas of parental attitudes toward children, parent-child
interaction patterns, and type and quantity of child maltreatment. Evaluations of other
home visitation programs also are underway, specifically evaluations of Healthy Families
America sites. Its form of primary prevention demonstrates not only a social
commitment to a childs well being from the point of birth, but also a strong commitment
to the welfare of society.
The NCPCA is committed to preventing child abuse before it occurs. Since child
maltreatment is a complex problem with a multitude of causes, an approach to
prevention must respond to a range of needs. Therefore, NCPCA has designed a
comprehensive strategy comprised of a variety of community-based programs to prevent
child abuse. Reflective of the phases of the family life cycle, this approach provides
parents and children with the education and support necessary for healthy family
functioning. Based on what is known or believed to enhance an individuals ability to
function within the family unit, several program areas offer a continuum of educational,
supportive and therapeutic services for parents and children enduring throughout the
school years. Although a community may not choose to offer services in all program
areas, as a group they respond to the needs of all family members.
In conclusion, I usually feel that there are pros and cons about everything. But I
cannot find one pro in child abuse. I feel that child abuse is one of the worst crimes in
the world today. Child abuse hurts and kills so many helpless children. Many adults take
their frustrations out on them and when they realize what they are doing is wrong, their
children have either been seriously hurt, have turn against them, or could have even been
killed. Child abuse is a chain that rarely broken. When children are abused, they learn to
do the same to their children. When a child does actually break the chain, they can still
have emotional problems as adults.


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California: Sage Publications.
12) Ogintz, E. The Littlest Victim. Chicago Tribune, Thursday, October 6, 1988
13) Sedlak, A. (1996) Early Findings from the Third National Incidence Study of Child
Abuse and Neglect:1988. Rockville, MD: Westat, Inc
14) Woodside, M. (1988) Research on Children of Alcoholics: Past and Future. British
Journal of Addiction, 83: 785-792
15) Practical Approaches to Successful Healing Sexual Abuse; Helping Adult and Child
Survivors. Presented by: Adena Bank Lees
16) Our Lady of Mercy Medical Centers : Response To Family Violence: A Teaching
Forum
17) Child Abuse Identification. The New York State Course. Prepared by St. Agnes
Hospital white Plains, New York.


18) Child Abuse and Maltreatment. A guide for Mandated Reporters.

Child Abuse

Child Abuse Child Abuse Child Abuse is behavior by and adult that harms a childs physical, mental, or emotional health and development. Some types of child abuse are neglect, and physical abuse. An example of neglect would be medical neglect. This is where the child does not get the proper medical attention needed. Some examples of physical abuse would be sexual and physiological.

The American Humane Society estimates that nearly 34 out of every 1,000 American children are abused in some way. Most children are too afraid to admit they have been abused; in fact, less than 20 percent of the cases reported were reported by the child being abused. The number one cause of child abuse is stress. The maltreatment or abuse of children can lead to death. Last year, estimated 1,196 child fatalities from maltreatment occurred.

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That would mean 3 children would die every day in the United States from abuse and neglect. Conflicts One of the most frequent and common conflicts is neglect. This conflict is most frequent in divorce cases and single parents. The cause of this conflict is because of the single parent is always at work or busy with their dating/social life. Another conflict is the maltreatment due to substance-abusing parents. A study in 1999 found that children of substance-abusing parents were almost 3 times likelier to be abused and more than 4 times likelier to be neglected than children of parents who are not substance abusers.

Steps to Resolution: 1. Calm down, stop arguing, and take time to cool-off. 2. Describe the problem, be specific, get both sides of the story, and separate feelings from the facts. 3.

Think of solutions. Write down every solution that you can think of. 4. Weigh every solution, think about possible results, and ask yourself: ~What will happen if we do this? ~Will we both get what we need? ~Who else might be affected by this choice? 5. Chose one solution and carry it out.

Then ask if it has been working. Resolutions In a situation where a single parent has just come home from a long, stressful day at work. The child ask for some dinner, and starts to whine when the parent exclaims he doesnt have any. The parent gets agitated and loses it: 1. The parent just needs to calm down and separate himself from the child until he is calmed.

2. The parent can explain to the child that he has had a long day at work and did not have time to pick up dinner on the way home. The child can express his feelings of hunger, and the fact that he needs something to eat for dinner. 3. They can both sit down, discuss/write down solutions to getting some dinner.

Such as, calling for delivery pizza or fixing something quick at home. 4. They can weigh the two solutions, and think of the results and outcomes of each solution. They can ask themselves the three questions. 5.

As they choose the best solution, they can ask themselves, Did I get my dinner?/Did I provide dinner for my child? Resolving conflicts in child abuse can be difficult when someone looses their temper, but other than that they are fairly easy to prevent and resolve. Child Abuse Conflicts Each and every one of us as a moral responsibility and unfortunately, not enough of us take it. Social Issues.

Child Abuse

Conservative Judaism: Inception, History and Way Of Life
“The term “Conservative” had been attached to the moderates by the Reformers because the moderates had branded them as radicals. This name hardly describes the movement aptly. Conservative Judaism, is the American version of the principles of positive historical Judaism. The conservatives accept the findings of modern scholarship that Judaism is the product of a long period of growth and evolution. However, this process did not result in broken or inconsistent lines of development; quite the contrary, the major currents of Judaism run consistently through the extensive literature of the Jewish people, created in successive ages.” (Rudavsky 338)
Conservative Judaism is one of the largest of the various sects of Judaism. Conservative Jews make up about 40-45% of those Jews who affiliate. Conservative Judaism accepts the idea that Jewish law is binding upon Jews. Conservative Jews have an obligation to obey all the teachings and commandments of Judaism., For example, Conservative Jews emphasize the laws of keeping the Sabbath and keeping kosher. Conservative Jews believe that Jewish law is capable of evolution as humans learn more about interpreting the Torah. Therefore, Conservative Jews have changed some of the earlier interpretations. Men and women worship together in Conservative synagogues, people may ride in a car on the Sabbath to attend services, and women can be ordained as rabbis.
“Issac Leeser is generally regarded as the principal forerunner of Conservative Judaism in the United States. A native of Westphalia, Lesser acquired his religious and secular education before coming to American in 1824. He settled in Richmond, Virginia, where he was employed for several years in his uncle’s business. At the same time, he assisted the hazzan in the religious school of the local Sephardic congregation. During this period, he gained prominence by publishing numerous articles in defense of Jews and Judaism in American and foreign journals.”(Dimont 231)
Some Jews who affiliate with the Conservative sect claim that their main reason for belonging is the fact that they don’t want to be Orthodox nor Reformed. “While some individuals describe themselves as Conservative because of their alienation from Orthodox practices, others define themselves from the opposite direction – they point out that they are not reform.” (Sklare 206) For the most part, Conservative Jews feel that if one were to be reformed they would not really be Jewish. The Reformed sect, unlike the conservative do not obey most of the Jewish laws and traditions. Conservative Jew describes Reform as “cold,” “churchlike,” or “going too far,” rather than as being subversive or heretical.” (Sklare 206)
Although Conservative Jews do not associate themselves with the Reform movement, they are still influenced by some of their ideas. “Conservatism has borrowed a number of the innovations instituted by the Reform wing. Orthodoxy, particularly in America has done likewise, though to a lesser degree. Among these changes are the improved decorum, the use of the vernacular and the regular sermon at services, as well as confirmation exercises in various forms. Mixed pews, the organ, and the elimination of the benediction by the priestly caste are among the modifications adopted by the Conservative congregations.”(Gordis 122)
Conservative Judaism says that the laws of the Torah and Talmud are of divine origin, and mandates the following of Jewish Law. At the same time, the Conservative movement recognizes the human element in the Torah and Talmud, and accepts modern scholarship that shows that Jewish writings also show the influence of other cultures, and in general can be treated as historical documents. “The founders of the Conservative movement, the youngest group in modern Judaism, had no wish to create a new alignment in Judaism. They sought, rather, to unite all Jews who had a positive attitude toward Jewish tradition, in spite of variations in detail. Nonetheless, life itself led to the crystallization of Conservative Judaism, which is dedicated to the conservatism and development of traditional Judaism in the modern spirit.”(Gordis 216)
Since the inception of Conservative Judaism in the late 19th century, it is committed to Judaism not only as a faith but also as a system of law, and to the norms of ritual behavior. Conservative Judaism formally involves strict Jewish religious practice of the laws of diet and Sabbath-observance. ” For many Jews in the Gilded Age of the late nineteenth century, Reform was traveling too fast and too far to the left. The Conservative movement long ago ruled that mixed seating was permitted in religious services and so was driving to the synagogue on the Sabbath. Unlike Orthodox, the Conservative allows women rabbis instead of the traditional service lead by men.


“Of the three main Jewish sects in America, Reform Judaism has thus far been the prime force in getting things done, supplying thus far been the prime force in getting things done, supplying most of the ideas, money and leadership. Reform has remained in the vanguard of everything new in secular American Judaism. But it is no longer foremost Jewish religious sect. Nor is it any longer foremost in Jewish scholarship. Here the unaffiliated and Conservative have overtaken it.”(Rudavsky 338)
In order to get a better understanding of how Conservative Jews felt about the sect that they identify themselves with, I asked them the question: “What do you mean when you say that you are Conservative”
My friend Josh Schwartz from Brooklyn said “Well, I obey some laws and I’m not Orthodox, so I guess I’m somewhere in between the two My parents brought me up believing in the Conservative way of life. I go to a Conservative Temple, so I’m Conservative. When I asked the same question to my Jewish friend from Long Island he responded with: ” My parents buy kosher meat and we eat kosher in the house but I often eat non-kosher when I’m out with friends. I think I’m conserving time when I go to a Conservative temple instead of those drawn out services that are conducted in Orthodox temples.” Both of the responses I received revolved around their parents. I think for the most part, Conservative Judaism is placed upon the person instead of deciding which sect you want to belong to on your own.
Growing up in Brooklyn I attended an Orthodox Hebrew school, a Conservative Jewish day camp and belonged to numerous Jewish youth groups. Most of my friends when I was growing up were Jewish. We belonged to the same temple and participated in the same traditions. Brooklyn is made up of a wide range of Jewish sects and groups. In my neighborhood, the most common of all are the conservative Jews.
My grandparents came to this country from Eastern Europe after the end
of World War II. They escaped only with their lives and their belief in the Jewish
Faith. They came to this country to escape the persecution of Nazi Germany. What they found were people who were just like them seeking the teachings of the Conservative sect. Growing up in a conservative Jewish household has had a great impact on my life.

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I was Bar-Mitzvahed in a conservative temple in Brooklyn, which is also the same temple that my parents got married. I attend religious services for the high holidays and obey the laws of Passover, Yom Kippur, Rosh Hashanah and Hanukah. I do not keep the Sabbath and I do not adhere to the kashert laws. Most people that I know who are of the conservative sect obey and disobey the same laws as I.
Youth groups like United Synagogue Youth and the Binai Brith Association are major contributors in keeping the conservative sect alive. USY is a youth group established by the United Synagogue of Conservative Judaism in the hopes but with the intent to foster further continuation in the conservative community. Binai Brith is non denominational and is constantly shifting between reformed and conservative depending on the community in which that chapter is located. Jewish Youth groups throughout the country has had a great impact on the young Jews of America by teaching the religion and providing a entertaining atmosphere at the same time.


In my opinion Orthodox means obeying every Jewish law to the fullest effect. Some of my friends who are Orthodox are curious to what it’s like to go out on Friday nights? Or, What does “real” pizza taste like? But when it comes down to it, they have devoted their lives to G-d and religion and would never disobey the laws. Sometimes when Im driving around the area on a Saturday morning, I see Orthodox Jews walking to their temple which is sometimes miles away from their house.
The reformed on the other hand are the complete opposite of the Orthodox. I’ve been to Jewish Reformed services at my friend’s temple where I would see a woman rabbi playing guitar and singing along at the same time. Sometimes the congregation members aren’t even wearing yamaurlkahs.
Conservative Judaism to me for most Jews in this country is the American way of life. We believe in G-d, belong to temples, engage in religious events and take part in the traditions. We do not dedicate our lives to the religion nor do we say that we are perfect Jews. What we do say is that we are Jewish and affiliate ourselves with other Jews of various sects. Unlike the Hassidim who constantly fight within their own community, Conservative Jews have a common understanding for the religion and one another. Conservatism continues to be the most popular sect of Judaism and continues to be a driving force in America.


Conservative Judaism: Inception, History and Way Of Life
“The term “Conservative” had been attached to the moderates by the Reformers because the moderates had branded them as radicals. This name hardly describes the movement aptly. Conservative Judaism, is the American version of the principles of positive historical Judaism. The conservatives accept the findings of modern scholarship that Judaism is the product of a long period of growth and evolution. However, this process did not result in broken or inconsistent lines of development; quite the contrary, the major currents of Judaism run consistently through the extensive literature of the Jewish people, created in successive ages.” (Rudavsky 338)
Conservative Judaism is one of the largest of the various sects of Judaism. Conservative Jews make up about 40-45% of those Jews who affiliate. Conservative Judaism accepts the idea that Jewish law is binding upon Jews. Conservative Jews have an obligation to obey all the teachings and commandments of Judaism., For example, Conservative Jews emphasize the laws of keeping the Sabbath and keeping kosher. Conservative Jews believe that Jewish law is capable of evolution as humans learn more about interpreting the Torah. Therefore, Conservative Jews have changed some of the earlier interpretations. Men and women worship together in Conservative synagogues, people may ride in a car on the Sabbath to attend services, and women can be ordained as rabbis.
“Issac Leeser is generally regarded as the principal forerunner of Conservative Judaism in the United States. A native of Westphalia, Lesser acquired his religious and secular education before coming to American in 1824. He settled in Richmond, Virginia, where he was employed for several years in his uncle’s business. At the same time, he assisted the hazzan in the religious school of the local Sephardic congregation. During this period, he gained prominence by publishing numerous articles in defense of Jews and Judaism in American and foreign journals.”(Dimont 231)
Some Jews who affiliate with the Conservative sect claim that their main reason for belonging is the fact that they don’t want to be Orthodox nor Reformed. “While some individuals describe themselves as Conservative because of their alienation from Orthodox practices, others define themselves from the opposite direction – they point out that they are not reform.” (Sklare 206) For the most part, Conservative Jews feel that if one were to be reformed they would not really be Jewish. The Reformed sect, unlike the conservative do not obey most of the Jewish laws and traditions. Conservative Jew describes Reform as “cold,” “churchlike,” or “going too far,” rather than as being subversive or heretical.” (Sklare 206)
Although Conservative Jews do not associate themselves with the Reform movement, they are still influenced by some of their ideas. “Conservatism has borrowed a number of the innovations instituted by the Reform wing. Orthodoxy, particularly in America has done likewise, though to a lesser degree. Among these changes are the improved decorum, the use of the vernacular and the regular sermon at services, as well as confirmation exercises in various forms. Mixed pews, the organ, and the elimination of the benediction by the priestly caste are among the modifications adopted by the Conservative congregations.”(Gordis 122)
Conservative Judaism says that the laws of the Torah and Talmud are of divine origin, and mandates the following of Jewish Law. At the same time, the Conservative movement recognizes the human element in the Torah and Talmud, and accepts modern scholarship that shows that Jewish writings also show the influence of other cultures, and in general can be treated as historical documents. “The founders of the Conservative movement, the youngest group in modern Judaism, had no wish to create a new alignment in Judaism. They sought, rather, to unite all Jews who had a positive attitude toward Jewish tradition, in spite of variations in detail. Nonetheless, life itself led to the crystallization of Conservative Judaism, which is dedicated to the conservatism and development of traditional Judaism in the modern spirit.”(Gordis 216)
Since the inception of Conservative Judaism in the late 19th century, it is committed to Judaism not only as a faith but also as a system of law, and to the norms of ritual behavior. Conservative Judaism formally involves strict Jewish religious practice of the laws of diet and Sabbath-observance. ” For many Jews in the Gilded Age of the late nineteenth century, Reform was traveling too fast and too far to the left. The Conservative movement long ago ruled that mixed seating was permitted in religious services and so was driving to the synagogue on the Sabbath. Unlike Orthodox, the Conservative allows women rabbis instead of the traditional service lead by men.


“Of the three main Jewish sects in America, Reform Judaism has thus far been the prime force in getting things done, supplying thus far been the prime force in getting things done, supplying most of the ideas, money and leadership. Reform has remained in the vanguard of everything new in secular American Judaism. But it is no longer foremost Jewish religious sect. Nor is it any longer foremost in Jewish scholarship. Here the unaffiliated and Conservative have overtaken it.”(Rudavsky 338)
In order to get a better understanding of how Conservative Jews felt about the sect that they identify themselves with, I asked them the question: “What do you mean when you say that you are Conservative”
My friend Josh Schwartz from Brooklyn said “Well, I obey some laws and I’m not Orthodox, so I guess I’m somewhere in between the two My parents brought me up believing in the Conservative way of life. I go to a Conservative Temple, so I’m Conservative. When I asked the same question to my Jewish friend from Long Island he responded with: ” My parents buy kosher meat and we eat kosher in the house but I often eat non-kosher when I’m out with friends. I think I’m conserving time when I go to a Conservative temple instead of those drawn out services that are conducted in Orthodox temples.” Both of the responses I received revolved around their parents. I think for the most part, Conservative Judaism is placed upon the person instead of deciding which sect you want to belong to on your own.
Growing up in Brooklyn I attended an Orthodox Hebrew school, a Conservative Jewish day camp and belonged to numerous Jewish youth groups. Most of my friends when I was growing up were Jewish. We belonged to the same temple and participated in the same traditions. Brooklyn is made up of a wide range of Jewish sects and groups. In my neighborhood, the most common of all are the conservative Jews.
My grandparents came to this country from Eastern Europe after the end
of World War II. They escaped only with their lives and their belief in the Jewish
Faith. They came to this country to escape the persecution of Nazi Germany. What they found were people who were just like them seeking the teachings of the Conservative sect. Growing up in a conservative Jewish household has had a great impact on my life.


I was Bar-Mitzvahed in a conservative temple in Brooklyn, which is also the same temple that my parents got married. I attend religious services for the high holidays and obey the laws of Passover, Yom Kippur, Rosh Hashanah and Hanukah. I do not keep the Sabbath and I do not adhere to the kashert laws. Most people that I know who are of the conservative sect obey and disobey the same laws as I.
Youth groups like United Synagogue Youth and the Binai Brith Association are major contributors in keeping the conservative sect alive. USY is a youth group established by the United Synagogue of Conservative Judaism in the hopes but with the intent to foster further continuation in the conservative community. Binai Brith is non denominational and is constantly shifting between reformed and conservative depending on the community in which that chapter is located. Jewish Youth groups throughout the country has had a great impact on the young Jews of America by teaching the religion and providing a entertaining atmosphere at the same time.


In my opinion Orthodox means obeying every Jewish law to the fullest effect. Some of my friends who are Orthodox are curious to what it’s like to go out on Friday nights? Or, What does “real” pizza taste like? But when it comes down to it, they have devoted their lives to G-d and religion and would never disobey the laws. Sometimes when Im driving around the area on a Saturday morning, I see Orthodox Jews walking to their temple which is sometimes miles away from their house.
The reformed on the other hand are the complete opposite of the Orthodox. I’ve been to Jewish Reformed services at my friend’s temple where I would see a woman rabbi playing guitar and singing along at the same time. Sometimes the congregation members aren’t even wearing yamaurlkahs.
Conservative Judaism to me for most Jews in this country is the American way of life. We believe in G-d, belong to temples, engage in religious events and take part in the traditions. We do not dedicate our lives to the religion nor do we say that we are perfect Jews. What we do say is that we are Jewish and affiliate ourselves with other Jews of various sects. Unlike the Hassidim who constantly fight within their own community, Conservative Jews have a common understanding for the religion and one another. Conservatism continues to be the most popular sect of Judaism and continues to be a driving force in America.

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