Research regarding the causes of child abuse has recently undergone a paradigm shift. The results of research initiated by the National Research Council's Panel on Research on Child Abuse and Neglect8 signal the first important step away from simple cause-and-effect models. As was recognized by researchers for the National Research Council's panel, the simple cause-and-effect models have certain limitations, mainly related to their narrow focus on the parents. These models limit themselves by asking only about the isolated set of personal characteristics that might cause parents to abuse or neglect their children. Moreover, these models also fail to account for the occurrence of different forms of abuse in one child. At the same time, these models had very little explanatory power in weighing the value of various risk factors involved in child abuse. As a result, they were not very accurate in predicting future cases of child abuse.
To replace the old static model, the panel has substituted what it calls an "ecologic" model. This model considers the origin of all forms of child abuse to be a complex interactive process. This ecologic model views child abuse within a system of risk and protective factors interacting across four levels: (1) the individual, (2) the family, (3) the community and (4) the society. However, some factors are more closely linked with some forms of abuse than others. The factors thought to contribute to the development of physical and emotional abuse and neglect of children are listed in Table 2 and are discussed below.
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Societal Factors
Many would argue that our society does not really value its children. This assertion is highlighted by the fact that one in four children in the United States lives in poverty, and many children do not have any form of health insurance. The presence of high levels of violence in our society is also thought to contribute to child abuse. Deadly violence is more common in the United States than in 17 other developed countries. Seventy-five percent of violence occurring in this country is domestic violence. The United States leads developed countries in homicide rates for females older than 14 years and for children from five to 14 years of age. Other factors that may contribute to high rates of violence include exposure to television violence and reliance on corporal punishment.
Poverty is the most frequently and persistently noted risk factor for child abuse. Physical abuse and neglect are more common among the people who are the poorest. Whether this association is precipated by the stress of poverty-related conditions or results from greater scrutiny by public agencies, resulting in over-reporting, is debated. Nevertheless, this association is well documented. Other societal factors that have been cited include inaccessible and unaffordable health care, fragmented social services and lack of support from extended families and communities.
Personal Factors
Lack of parenting skills, unrealistic expectations about a child's capabilities, ignorance of ways to manage a child's behavior and of normal child development may further contribute to child abuse.Parents who were abused as children are more likely than other parents to abuse their own children. However, the retrospective methodology of research in this area has been criticized. It is estimated that 40 percent of confirmed cases of child abuse are related to substance abuse. It is also estimated that 11 percent of pregnant women are substance abusers, and that 300,000 infants are born each year to mothers who abuse crack cocaine. Domestic violence also increases the risk of child abuse.
social isolation of the parent or parents from family and friends and the resulting lack of support that their absence implies, Other factors that increase the risk of child abuse include emotional immaturity of the parents, which is often highly correlated to actual age (as in the case of teenage parents), poor coping skills, often related to age but also occurring in older parents, poor self-esteem and other psychologic problems experienced by either one or both parents, single parenthood and the many burdens and hardships of parenting that must be borne without the help of a partner, any situation involving a handicapped child or one that is born prematurely or at a low birth weight, any situation where a sibling younger than 18 months of age is already present in the home, any situation in which the child is the result of an unwanted pregnancy or a pregnancy that the mother denies, any situation where one sibling has been reported to child protective services for suspected abuse and, finally, the general inherent stress of parenting which, when combined with the pressure of any one or a combination of the factors previously mentioned, may exacerbate any difficult situtation (Figure 1).
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