What is Physical Abuse
How wide spread is the problem?
Identification and Reporting
Impact of Physical Abuse
What is Physical Abuse
As a general rule, physical abuse refers to
the infliction of physical harm on a child by a parent or caregiver. It is
not necessary for the harm to be intentionally inflicted, and in the
majority of situations physical abuse is the unintentional end result of
harsh disciplinary methods or corporal punishment that have escalated to
point of physical injury or the risk of physical injury. Physical abuse
often occurs simultaneously with other forms of child maltreatment. An
unfortunate but common example of this is when a child is hit with close
fists or an object while also being belittled and verbally insulted. In
this case, the child would be considered to have experienced both physical
and emotional abuse.
Child abuse could include bruises,
abrasions, cuts, burns, fractures, bites, or any of a number of other
injuries. Also, physical assault by a parent or caregiver that presents a
substantial risk of physical injury is considered abuse. Hitting a child
with a hard instrument or with closed fists, burning, scalding, poisoning,
suffocating, drowning, kicking, shaking, choking, and stabbing are amongst
behaviors that are considered to be abusive. Although these actions may
not result in observable injuries such as bruises or cuts, they are still
How wide spread
is the problem?
Physical abuse is a widespread problem all over the world. The phenomenon
of physical abuse is not limited to any specific subset of the population.
Families from all racial and ethnic and socioeconomic backgrounds engage
in physical abuse, and children can be subjected to physical abuse
regardless of their sex or age. However, certain social and demographic
factors are correlated with higher levels of reported physical abuse such
as single parenting and low income.
Single parents often find themselves
socially isolated from sources of support that could help decrease the
burdens of parenting, and they can also lack adequate models to help them
make disciplinary choices that are less likely to lead to physical abuse.
Low income normally accumulate finical stress which may lead the parents
to engage in discipline methods that are likely to become physically
Overall, studies examining risk for physical
abuse shows that any conditions that increase distress for the family,
parent or disrupt interaction between parent and child will increase the
risk for physical abuse. Such conditions include: children with complex
medical problems or developmental delays, children who are unwanted,
“difficult" children who are hyperactive, children whose caregivers are
under significant life stresses or have unrealistic developmental
expectations of the children.
It is important to remember that Child Abuse thrives and empowers in the
shadows of privacy and secrecy; it lives by inattention. The first step in
preventing and treating physical abuse is identification. Children may
disclose physical abuse to teachers, physicians, family friends, or their
own friends. Disclosures may be indirect, such as a child saying, “I have
a friend whose father hits them and hurts them.” Many children find it
difficult to openly discuss the abuse that is occurring. They might also
be frightened, since many abusers threaten the child in order to make him
or her remain silent and not to discuss family matters outside of the
Physical abuse is the most visible form of
Child Abuse or maltreatment because physical indicators are the first to
be noticed. The first step to eliminating child physical abuse is to
acknowledge that it occurs. The next step is to learn to recognize the
signs and symptoms in order to determine if a child is being abused. There
are several factors to be considered in raising the question of possible
physical abuse. First, the location, nature, and the extent or severity of
the injury are important to consider.
Does the injury fit with the explanation
given? Is the child's age or developmental stage is consistent with the
type of injury? For example, burns that are in the shape of an iron,
grill, or cigarette, or immersion burns that children could not have
inflicted upon themselves. Other indicators may include human bite marks,
fingernail scratches that leave parallel linear marks, or other
lacerations or abrasions that may indicate an instrument used. Some
children may have missing, loose, or broken teeth, bald spots on their
head, or bruises/welts in various stages of healing all over the body.
Depending on the child’s age, level of functioning, and developmental
stage, behavior can be an indication that something is wrong. The
following are some of the behavioral indicators which may suggest possible
physical abuse on the child:
Unusual wary of physical contact with
adults or is overly friendly to adults, in
other words, is not aware of social boundaries.
Has a low frustration level, becomes upset
very easily or is far too tolerant or patient.
Seems frightened of parents or other adults
Afraid to go home, or is overly compliant
Wet the bed and exhibit regressed behavior.
Shy, withdrawn, and uncommunicative or
hyperactive, aggressive, and disruptive.
Do not show emotion when hurt.
Offer implausible explanations of injuries.
Habitually absent from school or late
without an explanation from the parents.
Thinks he or she is bad and deserves
Wear inappropriate long-sleeved or high
collared clothing on hot days to hide injuries.
Accident prone or moves or walks awkwardly.
It is important to pay attention to these
indicators and not dismiss them as insignificant, especially when several
of these occur together. Older children may exhibit different behavioral
signs than younger children. For example, they may be engaging in acting
out behavior such as running away, getting involved in criminal
activities, or engaging in self-destructive behaviors such as abuse of
drugs and alcohol.
Physical Abuse on Children
Child physical abuse damages children physically, emotionally and
socially. The most obvious and immediate result is physical.
An abused child may experience one of more of the following: hitting,
shaking, choking, biting, kicking, punching, burning, poisoning,
suffocating, or being held underwater. Physical abuse may lead to bruises,
cuts, welts, burns, fractures, internal injuries, or in the most extreme
Initial impact on children will be the immediate pain and suffering and
medical problems caused by the physical injury. However, the pain will
last long after the bruises and wounds have healed. The longer physical
abuse of a child occurs, the more serious the impact. Chronic physical
abuse can result in long term physical disabilities, including brain
damage, hearing loss, or eye damage.
The age at which the abuse takes place influences the impact of the
damage. For example, infants who are physically abused are more likely to
experience long-term physical effects and neurological alterations such as
irritability, lethargy, tremors, and vomiting. In more serious cases where
the abuse was more forceful or longer in duration, the infant may
experience seizures, permanent blindness or deafness, mental and
developmental delays or retardation, coma, paralysis, and in many cases
death. This has recently been called the “Shaken Baby Syndrome” since it
most often occurs as a result of violent shaking or shaking of the head.
Beyond the physical problems experienced by children, there are other
consequences of physical abuse. Studies of physically abused children and
their families indicate that a significant number of psychological
problems are associated with child physical abuse. Abused children
compared with non-abused children may have more difficulty with academic
performance, self- control, self-image and social relationships. A recent
US study comparing physically abused and non-abused children provided
considerable evidence of the negative and lasting consequences of physical
abuse. The physically abused children in the study experienced far greater
problems at home, at school, amongst peers and in the community.
Children who are physically abused have a predisposition to a host of
emotional disturbances. They may experience feelings of low self-esteem
and depression or may be hyperactive and overly anxious. Many of these
children may exhibit behavioral problems such as aggression towards other
children or siblings. Other emotional problems include anger, hostility,
fear, humiliation, and an inability to express feelings. The long-term
emotional consequences can be devastating. For example, children who are
abused are at risk of experiencing low self-esteem, depression, drug or
alcohol dependence, and increased potential for child abuse as a parent.
The social impact on children who have been physically abused is perhaps
less obvious, yet still substantial. Immediate social consequences can
include an inability to form friendships with peers, poor social skills,
poor cognitive and language skills, distrust of others, over-compliance
with authority figures, and a tendency to solve interpersonal problems
with aggression. In their adult life, the long-term consequences can
impact both their family and their community. There are financial costs to
the community and society in general, e.g., funding social welfare
programs and services and the foster care system. Studies have shown that
physically abused children are at a greater risk for mental illness,
homelessness, crime, and unemployment. All of these affect the community
and society in general and are the social costs of physical abuse.
Every family that experiences physical abuse is different. Therefore,
effective interventions must target the problems and deficits specific to
each family that increase the risk of physical abuse. An inability to
appropriately control and express anger is an example of a risk factor
that is frequently associated with parents whom engage in physical abuse.
For those parents, anger management would be a useful intervention. Goals
of anger management include the lessening of heightened arousal levels
during challenging parenting situations, the improvement of abusive
parents’ coping skills, and the reduction of the probability that parents
will have uncontrolled emotional reactions that end in physical abuse.
Techniques that can be used to attain these goals including training
parents in the use of positive imagery and relaxation methods, helping
them identify when they are angry before their emotions get out of
control, and teaching them how to come up with thoughts that help them
Another risk factor associated with physical abuse is social isolation, a
concern that can be addressed through the use of education and support
groups. Parents also engage in physically abusive behaviors because they
are unaware of effective parenting techniques. Educating these parents
about such useful skills such as:
Nonviolent means of discipline.
Setting meaningful rewards.
Consequences for specific behaviors.
Having the education and awareness on the above points can go a long way
towards reducing the risk for the recurrence of physical abuse.
Interventions focusing on skills training should give parents plenty of
opportunities to observe others model parenting techniques and should also
provide parents with role-playing and real-life exercises that allow them
to practice what they’ve learned in a safe, non-threatening environment.
These interventions can also allow parents to receive honest feedback
about their parenting behaviors from experienced professionals.
Finally, other conditions that go beyond simple deficits in knowledge or
difficulty managing anger can interfere with the ability of parents to
appropriately discipline their children. These include external pressures
such as financial problems, interpersonal difficulties like marital strife
or domestic violence, and serious mental health conditions such as
schizophrenia, major depression, and substance abuse problems. When these
circumstances are linked to physical abuse, wide-ranging solutions must be
sought, whether this means connecting parents with appropriate social
services or locating referrals for marital counseling, psychotherapy or
Intervening when physical abuse is identified not only involves working
with the perpetrators of the abuse but also includes treating the
wide-ranging emotional and behavioral consequences that physical abuse can
have for children. For example, it is common for children to experience
symptoms of post-traumatic stress in the aftermath of physical abuse.
Providing these children with anxiety management techniques and psycho
education about family violence can be a useful intervention for these
Play therapy can also be helpful in providing children with an opportunity
to express and work through the painful emotions that may be contributing
to anxiety, depression, or behavioral difficulties. Often, those whom have
been physically abused need help expressing their anger in appropriate
ways. For these children, interventions include teaching them relaxation
techniques, engaging them in role-playing exercises, providing them with
supervised group interactions and feedback, and helping them identify the
signs of anger early in order to prevent inappropriate outbursts.
Children whom exhibit difficulties in their relationships with peers and
adults as a result of their abuse can benefit from social skills training
that teaches them how to have positive interactions with other children
and come up with solutions to problems and ways of handling negative
social situations. Another useful intervention with children who have poor
peer relationship skills pairs them with children who have been identified
as having strong social skills. These children then engage in positive
play activities together with the expectation that the less socially-adept
children will begin to behave in more appropriate ways towards their
peers. While mental health professionals deliver the majority of these
interventions, school personnel can also be brought in to help with both
the academic deficits and behavioral problems that can result from a
history of abuse.
Prevention and intervention techniques need to be designed to help
decrease the scope and frequency of child physical abuse. Knowledge is the
first step to prevention of child abuse.
Early detection of physical abuse starts with teachers, day care center,
hospitals, and other agencies that serve children and families. Beyond
educating those who might detect abuse, prevention efforts need to be
focused on both the population in general as well as population subgroups
that have been identified to have a higher risk of engaging in abusive
behaviors. They can include such indirect means as using media campaigns
designed to spread information on child development or parenting skills.
Other prevention efforts that will be helpful will involve establishing
peer help lines to provide support for parents experiencing crises that
could increase their likelihood of abusing their children. Another
approach is to develop ways to get parents who would otherwise be isolated
from their child-rearing peers linked to social support networks.
An example of a more direct prevention program would be one that provides
in-home family support for parents who are considered to be at risk:
families with lower socioeconomic status, single parents, inexperienced or
isolated parents, or those with alcohol or drug problems. Health services
professionals often offer such preventative measures to parents at
stressful transition points in their lives when the risk of physical abuse
is judged to increase.
Because abuse is transferred from one generation to the next, it is
important to understand that children who are abused are at higher risk
for being abusers. It is understandable that children who have not
received the needed nurturance and support from their parents may find it
difficult to provide this for their children. Prevention efforts must
acknowledge the intergenerational patterns of violence and work with
children who are abused to prevent them from becoming abusers themselves.