Child Abuse Prevention

Parenting can be challenging, and sometimes children's behavior can provoke parental responses such as anger, frustration, disappointment, and even rage. When you find that you are losing control, give yourself a time out, go to another room, take a deep breath, and gather your thoughts and emotions.

If your child seems to continually provoke this reaction in you, speak to your child's pediatrician. Referral to a psychologist who may have behavior management advice can make a world of difference. Most parents are trying their best to raise their children to be good world citizens, but along the way, you may need advice and wisdom from a professional to avoid your own meltdowns. Here's some advice from my colleagues, Drs. Hank Bernstein Leann Lesperance.

April is National Child-Abuse Prevention Month and, sadly, child abuse is an enormous problem, affecting all socioeconomic, cultural, racial, and religious groups. In the United States alone, there are almost 3 million reports of suspected child abuse each year, with one third of these being confirmed cases. There may well be many more cases that are not even reported.

What is child abuse?
Child abuse refers to the mistreatment of a child by another person. Legal definitions vary from state to state, but generally include:

• Physical abuse: Deliberate physical contact that causes significant pain, ends up in injury, or jeopardizes a child's safety. It includes hitting, kicking, biting, shoving, shaking, and burning.
• Sexual abuse: Involvement of a child in any act meant to satisfy an adult's sexual needs. It includes both sexual assault (with physical contact) and sexual exploitation (using a child to help satisfy another adult's sexual needs).
• Child neglect: When a caretaker does not provide for a child's basic emotional or physical needs, such as food, shelter, clothing, health care, and education. It includes poor supervision, not taking a child for medical care, not giving the right kind of affection, and abandonment.
• Emotional abuse: Generally refers to behaviors that interfere with a child's emotional health or social development. Emotional abuse can occur with or without other forms of abuse, and includes verbal abuse, inattention, rejection, and terrorization.

Where does child abuse happen?
Child abuse usually happens in the child's home. Usually, the abuser is someone the child knows, such as a parent, neighbor, or relative. Children who are the greatest risk of abuse have caregivers who feel isolated or inadequate, who are teenagers, or who have problems with depression, alcohol, or drugs. Other things that may put a child at an increased risk for child abuse include children less than 1 year of age, children born prematurely or with low birth weight, those with medical problems, those living in poorer communities, boys, twins, and stepchildren.

Detecting abuse can be difficult because it is often hard to know when normal parenting ends and abuse begins. Caring for children of all ages can be stressful, and caregivers may lose their temper from time to time. However, parenting "styles" that include physical or emotional punishment, such as hitting or not recognizing the good things a child has done, deserve evaluation.

What can you do?
You can help to prevent child abuse, in your own home and your community.

In your home:

• Nurture your child. Spend time talking with your child every day and let the child know that you love him or her.
• Take care of yourself. Get enough sleep, eat right, and exercise regularly.
• Take some time for yourself if you need it. Hire a sitter, exchange babysitting with another parent, or ask a trusted relative or friend to baby-sit occasionally so you can take a break from your child.
• Be prepared for stress and find ways to manage it. Know that parenting can be frustrating, and you will feel angry with your child at times. If you start to feel overwhelmed, do not take it out on your child. Put your child in a safe place and go into another room to cool down: Play relaxing music, take a warm shower, or just sit quietly for a few minutes. Many people find exercise or their favorite hobby to be very helpful in managing their own stress.
• Talk it through. It can be helpful to talk about parenting stresses with friends and relatives who also are parents, or join a local parenting support group.
• Teach your child. Encourage your child to share any concerns and problems with you. Explain to your child that his or her body belongs only to him or her, and that the child has the right to say no to anyone who might try to touch him or her.

In your community:

• Help a parent. Offer to baby-sit, even for an hour or two, so the parents can rest or spend a little time together.
• Support local prevention efforts. Promote school, neighborhood, and community programs that teach prevention to parents and children. Help to develop parenting resources at your local library. Volunteer at a local child-abuse prevention program.
• Support social services. Community programs that improve housing, education, transportation, and safety often help to increase self-esteem and reduce isolation and substance abuse within families.
• Report suspected abuse. If you suspect that a child you know is being abused in any way, do something about it. Contact your local child protective-services agency, emergency hotline, or police department.

Do you have any experience handling situations with child abuse? Tell me about them.

Dr. Victoria McEvoy graduated from Harvard Medical School in 1975 and is currently an Assistant Professor of Pediatrics at HMS. She is the Medical Director and Chief of Pediatrics at Mass General West Medical Group. She has practiced pediatrics for almost thirty years. She has been married to Earl for thirty six years and raised four children. She currently enjoys writing, traveling, reading, almost all sports, and spending time with her two grandsons.

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