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Child abuse and neglect remains a significant public health and social problem in the United States. Epidemiologic methods provide a systematic approach for surveillance, determination of risk factors, and estimates of service delivery needs on the basis of prevalence and incidence estimates. During the past decade, the information provided by many multidisciplinary studies has increased awareness about child maltreatment, improved the treatment of families and offenders, and promoted stricter law enforcement. This work is at the base of the current trend that shows a decline in child abuse and neglect, with 38,000 less children abused in 2004 compared with the previous year, according to ‘Child Maltreatment 2004,’ a report from the Children's Bureau, U.S. Department of Health and Human Services (2006). This entry reviews the definitions of physical abuse, sexual abuse, and neglect; discusses prevalence (number of victims in a population at any point in time with a maltreatment experience that occurred recently or a long time ago) and incidence data (number of new cases occurring in the population during a given period of time) for child abuse in the United States; and identifies risk factors for child abuse.

Definitions of Child Abuse

In the United States, federal legislation establishes the minimum standards for the definition of child abuse and neglect that states must incorporate as part of their definitions. The Federal Child Abuse Prevention and Treatment Act (CAPTA) (42 U.S.C.A. x5106g) defines child abuse and neglect as

  • a recent act or failure to act on the part of a parent or caretaker which results in death, serious physical or emotional harm, sexual abuse or exploitation; or an act or failure to act which presents an imminent risk of serious harm. (Child Welfare Information Gateway, 2005, p. 1)

Some states define child abuse and neglect as a single concept, while other states include definitions for several categories of abuse and neglect. Physical abuse, sexual abuse, and neglect are included in definitions of child abuse in all states. Physical abuse is generally defined as a nonaccidental physical injury to the child or any action that results in a physical impairment. Sexual abuse includes

  • the employment, use, persuasion, inducement, enticement, or coercion of any child to engage in, or assist any other person to engage in, any sexually explicit conduct or simulation of such conduct for the purpose of producing a visual depiction of such conduct; or the rape, and in cases of caretaker or interfamilial relationships, statutory rape, molestation, prostitution, or other form of sexual exploitation of children, or incest with children. (Child Welfare Information Gateway, 2005, p. 1)

Neglect generally encompasses failure to provide for no apparent financial reason (deprivation of adequate food, clothing, shelter, medical care) and lack of supervision. The majority of states (except Georgia and Washington) include emotional abuse in their definitions, generally defined as damage to the psychological capacity or emotional stability of the child (evidenced by symptoms such as anxiety, depression, aggressive behavior, withdrawal, and other substantial changes in behavior, cognition, or emotional response). Abandonment is included by many states either as part of their definition of neglect (18 states) or as a separate definition (13 states), and it includes

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