Child abuse and neglect, which are sometimes collectively referred to as child maltreatment, are hard for many people to define.
In general, North Carolina law defines an abused child as one whose "parent, guardian, custodian, or caretaker" inflicts or allows serious injury, or the substantial risk of serious injury, or serious emotional damage, or exploitation. "Custodians" include people or agencies that have been awarded legal custody of a child. "Caretakers" include anyone else who has responsibility for the child's health and welfare in a residential setting -- for example, stepparents, foster parents, other adults in the household, relatives who care for the child, and employees of group homes (North Carolina General Statutes 7B-101).
Child abuse is typically divided into three types: physical, sexual, and emotional. Most forms of child physical and emotional abuse, along with child neglect, are addressed in the state Juvenile Code. Most forms of sexual abuse are addressed in parts of the Criminal Code, especially Article 7A which deals with sexual offenses; Article 10A which deals with human trafficking; and Article 26 which concerns offenses against public morality and decency.
Physical Abuse includes beating, harmful restraint, the use or threatened use of a weapon or of an object that could be used as a weapon, or other actions that might result in physical injury. These injuries may include bruises, cuts, burns, fractures, and head injuries. As with all forms of child abuse, physical abuse can include serious psychological damage that may persist long after the child's physical injuries have healed.
Physical abuse is typically identified through an adult's observation of the abuse, a child's disclosure of it, or a careful examination of the child's injuries. A trained examiner can generally distinguish between accidental injuries and those which have been intentionally inflicted.
Sexual Abuse includes any type of sexual contact with a child. The act may be perpetrated by an adult or by another child or adolescent who forces, persuades, or manipulates the victim. Most children who are referred to TEDI BEAR and other children's advocacy centers are alleged victims of sexual abuse.
Sexual abuse differs legally and behaviorally from other forms of child abuse. From a legal standpoint, virtually any adult or adolescent who sexually abuses a child may be prosecuted for sexual abuse, regardless of whether the abuser is a parent or other caregiver. Approximately 70% of child sexual abuse is committed by people outside the victim's family. About 40% of child sexual abuse is committed by adolescents or, less frequently, by younger children who may be older or stronger than their victims.
From a behavioral standpoint, child sexual abuse is often preceded and accompanied by "grooming." The abuser will try to gain the confidence and affection of the child through special attention and gift-giving, with gradual escalation to sexual activity. This mixture of affectionate and abusive behavior can be confusing for the child. It can also make it difficult for the child's family to recognize abuse, since they typically see only the affectionate behavior.
This difficulty is compounded by the fact that most abusers carefully manipulate children to keep the abuse secret. Also, very few children who have experienced contact sexual abuse have obvious physical symptoms.
Only about 10% of child sexual abusers are strangers to their victims. Approximately 60% of abusers are not only known to their victims' families, but are trusted by them.
Sexual abuse can be divided into two sub-types. Contact sexual abuse occurs when a child is penetrated, fondled, subjected to oral-genital contact, or touched in some other sexual way. It is reliably estimated that one in ten children and teens suffer contact sexual abuse. This excludes most consensual sex between adolescents who are close to one another in age.
Non-contact sexual abuse is more common, but is generally less damaging unless it leads to contact abuse. Non-contact abuse includes exhibitionism (exposing one's genitals to a child), voyeurism (viewing a child's exposed genitals), deliberately or carelessly exposing a child to pornography, or approaching a child for sexual purposes either directly or through media such as the telephone or internet.
Child sexual abuse also includes two types of activity that are not shared with other types of abuse: pornography and trafficking. Child pornography is any image that includes nudity or sexual activity involving someone under age 18. Trafficking is also called child prostitution when -- as is typically the case -- it is conducted for sexual purposes. This includes engaging, offering to engage, or facilitating the engagement in sexual activity by someone under age 18 in exchange for anything of value.
Emotional Abuse includes attitudes or behaviors toward a child that create serious emotional or psychological damage. This may include active forms of abuse such as chronically belittling or isolating a child, or passive forms of abuse such as ignoring a child's need for emotional support and nurturing. At the passive end of the spectrum, emotional abuse becomes a type of neglect.
Emotional trauma is a component of most child abuse, and is often among its most serious effects. As shown on the infographic at right, the trauma associated with abuse can affect a child's physical and mental health long after any physical scars have healed. Childhood trauma also contributes to a variety of social problems.
Neglect includes serious disregard for a child's supervision, care, or discipline. This may include malnourishment, poor hygiene, lack of needed medical care, and insufficient supervision. Neglect accounts for about three quarters of reports to child welfare authorities, in part because it can be easier to identify than abuse.
While children may experience any type of maltreatment at any age, younger children are more likely than older ones to experience neglect and some forms of physical abuse, such as shaken baby syndrome. Older children are more likely to experience sexual abuse, with pre-teens and adolescents being at greatest risk for commercial sexual exploitation. Although abuse and neglect can occur in any type of home, the risk is heightened by poverty, and by high levels of violence and substance abuse.
Suspected child abuse or neglect should always be reported to the Department of Social Services in the county where the child lives. Anyone who has a reasonable suspicion of child abuse or neglect is required by law to report (North Carolina General Statutes 7B-301). Failure to report is a Class 1 misdemeanor, and people do get prosecuted for it. It is generally advisable to also report abuse to law enforcement, which works with DSS offices to investigate.
Further information about each state's laws concerning child abuse and other child welfare issues can be found in a searchable online database maintained by the federal Child Welfare Information Gateway.