Child abuse is doing something or failing to do something that results in harm to a child or puts a child at risk of harm. Child abuse can be physical, sexual or emotional. Neglect, or not providing for a child's needs, is also a form of abuse.

Most abused children suffer greater emotional than physical damage. An abused child may become depressed. He or she may withdraw, think of suicide or become violent. An older child may use drugs or alcohol, try to run away or abuse others.

Child abuse is a serious problem. If you suspect a child is being abused or neglected, call the police or your local child welfare agency.

Preventing Child Abuse & Neglect

What are child abuse and neglect?

Child abuse and neglect are serious public health problems and adverse childhood experiences (ACEs) that can have long-term impact on health, opportunity, and wellbeing. This issue includes all types of abuse and neglect against a child under the age of 18 by a parent, caregiver, or another person in a custodial role (such as a religious leader, a coach, a teacher) that results in harm, the potential for harm, or threat of harm to a child. There are four common types of abuse and neglect:

• Physical abuse is the intentional use of physical force that can result in physical injury. Examples include hitting, kicking, shaking, burning, or other shows of force against a child.
• Sexual abuse involves pressuring or forcing a child to engage in sexual acts. It includes behaviors such as fondling, penetration, and exposing a child to other sexual activities.
• Emotional abuse refers to behaviors that harm a child’s self-worth or emotional well-being. Examples include name-calling, shaming, rejection, withholding love, and threatening.
• Neglect is the failure to meet a child’s basic physical and emotional needs. These needs include housing, food, clothing, education, and access to medical care.

How big is the problem?

Child abuse and neglect are common. At least 1 in 7 children have experienced child abuse and/or neglect in the past year, and this is likely an underestimate. In 2019, 1,840 children died of abuse and neglect in the United States.

Children living in poverty experience more abuse and neglect. Experiencing poverty can place a lot of stress on families, which may increase the risk for child abuse and neglect. Rates of child abuse and neglect are 5 times higher for children in families with low socioeconomic status compared to children in families with higher socioeconomic status.

Child maltreatment is costly. In the United States, the total lifetime economic burden associated with child abuse and neglect was approximately $428 billion in 2015. This economic burden rivals the cost of other high-profile public health problems, such as stroke and type 2 diabetes.

What are the consequences?

Children who are abused and neglected may suffer immediate physical injuries such as cuts, bruises, or broken bones, as well as emotional and psychological problems, such as impaired social-emotional skills or anxiety.

Child abuse and neglect and other ACEs can also have a tremendous impact on lifelong health, opportunity, and wellbeing if left untreated. For example, exposure to violence in childhood increases the risks of injury, future violence victimization and perpetration, substance abuse, sexually transmitted infections, delayed brain development, lower educational attainment, and limited employment opportunities.

Chronic abuse may result in toxic stress, which can change brain development and increase the risk for problems like post-traumatic stress disorder and learning, attention, and memory difficulties.

How can we prevent child abuse and neglect?

Child abuse and neglect are preventable. There are a number of factors that may increase or decrease the risk for perpetrating and/or experiencing child abuse and neglect. To prevent child abuse and neglect violence, we must understand and address the factors that put people at risk for or protect them from violence. Everyone benefits when children have safe, stable, nurturing relationships and environments.

Different types of violence are connected and often share root causes. Child abuse and neglect are linked to other forms of violence through shared risk and protective factors. Addressing and preventing one form of violence may have an impact on preventing other forms of violence.

Protective factors may lessen the likelihood of children being abused or neglected. Identifying and understanding protective factors are equally as important as researching risk factors.

Individual Protective Factors

• Caregivers who create safe, positive relationships with children
• Caregivers who practice nurturing parenting skills and provide emotional support
• Caregivers who can meet basic needs of food, shelter, education, and health services
• Caregivers who have a college degree or higher and have steady employment

Family Protective Factors

• Families with strong social support networks and stable, positive relationships with the people around them
• Families where caregivers are present and interested in the child
• Families where caregivers enforce household rules and engage in child monitoring
• Families with caring adults outside the family who can serve as role models or mentors

Community Protective Factors

• Communities with access to safe, stable housing
• Communities where families have access to high-quality preschool
• Communities where families have access to nurturing and safe childcare
• Communities where families have access to safe, engaging after school programs and activities
• Communities where families have access to medical care and mental health services
• Communities where families have access to economic and financial help
• Communities where adults have work opportunities with family-friendly policies

Risk factors are characteristics that may increase the likelihood of experiencing or perpetrating child abuse and neglect, but they may or may not be direct causes. A combination of individual, relational, community, and societal factors contribute to the risk of child abuse and neglect. Although children are not responsible for the harm inflicted upon them, certain factors have been found to increase their risk of being abused and or neglected.

Risk Factors for Victimization

Individual Risk Factors

• Children younger than 4 years of age
• Children with special needs that may increase caregiver burden (e.g., disabilities, mental health issues, and chronic physical illnesses)

Individual Risk Factors

• Caregivers with drug or alcohol issues
• Caregivers with mental health issues, including depression
• Caregivers who don’t understand children’s needs or development
• Caregivers who were abused or neglected as children
• Caregivers who are young or single parents or parents with many children
• Caregivers with low education or income
• Caregivers experiencing high levels of parenting stress and economic stress
• Caregivers who use spanking and other forms of corporal punishment for discipline
• Caregivers in the home who are not a biological parent
• Caregivers with attitudes accepting of or justifying violence or aggression

Family Risk Factors

• Families that have family members in jail or prison
• Families that are isolated from and not connected to other people (extended family, friends, neighbors)
• Family violence, including relationship violence
• Families with high conflict and negative communication styles

Community Risk Factors

• Communities with high rates of violence and crime
• Communities with high rates of poverty and limited educational and economic opportunities
• Communities with high unemployment rates
• Communities with easy access to drugs and alcohol
• Communities where neighbors don’t know or look out for each other and there is low community involvement among residents
• Communities with few community activities for young people
• Communities with unstable housing and where residents move frequently
• Communities where families frequently experience food insecurity

What is Abusive Head Trauma?

Abusive head trauma (AHT), which includes shaken baby syndrome, is a preventable and severe form of physical child abuse that results in an injury to the brain of a child. AHT often happens when a parent or caregiver becomes angry or frustrated because of a child’s crying. It is caused by violent shaking and/or with blunt impact. The resulting injury can cause bleeding around the brain or on the inside back layer of the eyes. Data show:

• AHT is a leading cause of physical child abuse deaths in children under 5 in the United States.
• Babies less than one-year-old are at the greatest risk of injury from AHT.
• AHT accounts for about one-third of all child maltreatment deaths.

Crying, including long periods of inconsolable crying, is a normal behavior in infants. Shaking, throwing, or hitting a baby is never the right response to crying.

What are the consequences?

Nearly all victims of AHT suffer serious, long-term health consequences. Examples include:

• vision problems
• developmental delays
• physical disabilities
• hearing loss

At least one of every four babies who experience AHT dies from this form of child abuse.

How can we prevent Abusive Head Trauma?

Anyone can play a role in preventing AHT. Understanding the dangers of shaking or hitting a baby’s head against something, knowing the risk factors and the triggers for abuse, and finding ways to support parents and caregivers in their community are all ways to prevent AHT.

If you are a parent or caregiver
Parenting is hard work! We know that every child and every parent is unique. You may face many different situations and challenges every day. It’s ok to ask for help.

• Understand that infant crying is worse in the first few months of life, but it will get better as the child grows.
• Try calming a crying baby by rocking gently, swaddling in a blanket, offering a pacifier, holding your baby against your bare skin, singing or talking softly, taking a walk with a stroller, or going for a drive in the car.
• If the baby won’t stop crying, check for signs of illness and call the doctor if you think the child is sick.
• If you are getting upset, focus on calming yourself down. Put the baby in a safe place and walk away to calm down, checking on the baby every 5 to 10 minutes.
• Call a friend, relative, neighbor, parent help, or your child’s healthcare provider for support.
• Never leave your baby alone with a person who is easily irritated, has a temper, or a history of violence.

If you are a friend or family member of a parent or caregiver or live in their community

• Be aware of new parents in your family and community who may need help or support.
• Offer to give a parent or caregiver a break when needed.
• Let the parent know that dealing with a crying baby can be very frustrating, but infant crying is normal and it will get better.
• Encourage parents and caregivers to take a calming break if needed while the baby is safe in the crib.
• Be sensitive and supportive in situations when parents are dealing with a crying baby.
• Be supportive of work policies (e.g., paid family leave) that make it easier for working parents to stay with their infants during the period of increased infant crying (i.e., between 4-20 weeks of age).

Child abuse and neglect (CAN) are serious problems that can have lasting harmful effects on its victims. CDC’s goal is to stop child abuse and neglect from happening in the first place.

Child abuse and neglect are complex problems rooted in unhealthy relationships and environments. Preventing child abuse and neglect requires addressing risk and protective factors at the individual, relational, community, and societal levels.