Fatal child abuse or neglect is the fatal physical injury or negligent treatment of a child by a person who is responsible for the child’s welfare. It is reported that more than 1,700 children in the U.S. die of child abuse and neglect each year, and the actual number of abuse and neglect deaths is estimated to be much higher than that reported by vital statistics data.
Young children are the most vulnerable victims. National statistics show that children under four years of age account for 81.6% of all maltreatment deaths and infants account for over half of those. Fifty-nine percent of the child fatalities in 2011 were boys. One or both parents were perpetrators in 78.3% of all maltreatment deaths. Fatal abuse is interrelated with poverty, domestic violence and substance abuse.
One serious type of physical abuse is abusive head trauma, injuries that occur when a child’s head is slammed against a surface or severely struck, or when a child is violently shaken. AHT occurs most frequently in infants, particularly in the first two months of life. There have been major improvements in the ability to diagnose abusive head trauma and in investigators’ abilities to recognize when a caregiver’s explanation for injuries do not match the severity of the injuries. For example, it is now widely accepted that falls from short heights or a child being accidentally dropped rarely cause extensive and severe head injuries.
Another frequent cause of physical abuse deaths is punches or kicks to the abdomen, leading to internal bleeding. Other forms of fatal physical abuse include immersion into hot water, drowning and smothering. Many children who die from physical abuse have been abused over time, but a one-time event can also cause death. The most common reason given by caretakers who fatally injure their children is that they lost patience when the child would not stop crying. Other common reasons given by the abusers include bedwetting, fussy eating and disobedient behavior.
Fatalities from neglect result from any of a number of different ways that caregivers fail to adequately provide for or supervise their children. Caregivers may fail to provide food and nurturing to their child, leading to malnutrition, failure to thrive, starvation or dehydration. Caregivers may fail to seek medical care when their child is ill, leading to more serious illness and death. Neglect cases can also result from intentional or grossly negligent failure to adequately supervise a child, resulting in bathtub drowning, suffocations, poisonings and other types of fatal incidents.
Some children who die from maltreatment are unknown to Child Protective Services at the time of their death. Child Maltreatment 2011, federal government statistics estimates about state-reported child maltreatment, estimates that 1,570 children died from abuse and neglect in 2011 and states that only 863 of those children were from families that had received Child Protective Services within the five years prior to the death.
Major Risk Factors
- Younger children, especially under the age of four
- Special needs that may increase caregiver burden
- Parent’s young age, low education and income, single parenting
- Low income, single-parent families experiencing major stresses
- Non-biologic caregivers in the home
- Children with emotional and health problems
- Intimate partner violence
- Lack of suitable childcare
- Substance abuse and/or or mental health issues among caregivers
- Parent history as child maltreatment victim
- Parents and caregivers who do not understand children’s needs and development or how to parent
GAO Report on Child Maltreatment
- July 2011 GAO Report to the Chairman, Committee on Ways and Means, House of Representatives: CHILD MALTREATMENT: Strengthening National Data on Child Fatalities Could Aid in Prevention
Experts in prevention of child maltreatment are active on many fronts to prevent child abuse. Their activities are summarized in the CDC document cited below. There are many programs that have been developed to prevent child abuse. A team looking for a program to recommend can check the California Evidence-Based Clearinghouse for Child Welfare, cited below, for programs that have been scientifically proven to be effective.
- California Evidence-Based Clearinghouse for Child Welfare
- CDC Preventing Child Maltreatment: Program Activities Guide
- Preventing Child Abuse & Neglect, Child Welfare Information Gateway, Administration for Children & Families; DHHS
- California Evidence-Based Clearinghouse for Child Welfare, a searchable database of evidence-based programs that can be utilized by professionals that serve children and families involved with the child welfare system
- Children’s Bureau Express
- Children’s Bureau Training and Technical Assistance Network
- Alliance for Children and Families
- American Professional Society on the Abuse of Children
- AVANCE Family Support and Education Program
- Faith Trust Institute
- Mayerson Center for Safe and Healthy Children at Cincinnati Children’s Hospital Medical Center and Children’s Advocacy Centerli>
- Child Trauma Academy
- Child Welfare Information Gateway
- Child Welfare League of America
- Childhelp USA
- Children’s Defense Fund
- Circle of Parents
- Family Support America
- First Star
- The FRIENDS National Resource Center for Community-Based Family Resources and Support Programs
- Healthy Families America
- International Society for the Prevention of Child Abuse and Neglect
- Is It Injury or Neglect? HRSA webinar
- Kempe Children’s Center
- National Alliance of Children’s Trust and Prevention Funds
- National Center on Domestic Violence, Trauma & Mental Health: Representing Domestic Violence Survivors Who Are Experiencing Trauma and Other Mental Health Challenges: A Handbook for Attorneys
- The National Center on Shaken Baby Syndrome
- The National Committee to Prevent Child Abuse
- Office for Victims of Crime video Through Our Eyes: Children, Violence, and Trauma
- National Council on Child Abuse and Family Violence
- National Exchange Club Foundation for the Prevention of Child Abuse
- National Indian Child Welfare Association
- National Safe Haven Alliance
- Parents Anonymous Inc.
- Prevent Child Abuse America
- Understanding Child Maltreatment, CDC Fact Sheet 2013