Types of Maltreatment

There are four commonly recognized forms of child maltreatment: neglect (including medical neglect), physical abusesexual abuse, and psychological maltreatment. These may be found separately or in any combination.  For fiscal year 2010, the breakdown of substantiated maltreatment for child victims is as follows.

  • 78.3 percent neglect
  • 17.6 percent physical abuse
  • 9.2 percent sexual abuse
  • 8.1 percent psychological maltreatment
  • 2.4 percent medical neglect
  • 10.3 percent other, such as abandonment or threats of harm to the child

Note that the sum of these percentages is more than 100 percent because children may have experienced more than one type of maltreatment.

There is no single, universally applied definition of child abuse and neglect.  While legal definitions describing the different forms of child maltreatment, as well as guidelines for reporting suspected maltreatment and criminal prosecutions, are found mainly in state statutes, the guidelines for accepting reports, conducting an investigation, and providing interventions may vary not only from state to state, but county to county.

Despite these differences, there are some commonalities.  The Child Abuse Prevention and Treatment Act (CAPTA) provides minimum federal standards for states to use when defining physical child abuse, child neglect, and sexual abuse if states choose to receive federal funds under the CAPTA state grant program.  Under CAPTA, child abuse and neglect means:

  • Any recent act or failure to act on the part of a parent or caretaker that results in death, serious physical or emotional harm, sexual abuse, or exploitation
  • An act or failure to act that presents an imminent risk of serious harm

This definition refers specifically to parents and other caregivers.  Under this definition, a child generally means someone under the age of 18 or someone who is not an emancipated minor.  In sexual abuse cases, a child is someone who is under 18 or the age specified by the state’s child protection law where he or she lives, whichever is younger.

While CAPTA provides definitions for sexual abuse and special cases related to withholding medical treatment, it does not provide specific definitions for physical abuse, neglect, or psychological maltreatment.  Each state provides the specific definitions for those and may expand upon the CAPTA definitions for sexual abuse and withholding of medical treatment.

Neglect

Child neglect is the most common form of child maltreatment, comprising more than 75 percent of victims.  It is usually defined by omissions in care that may result in significant harm or the risk of significant harm and is characterized by the failure of a parent or caregiver to provide for the child’s basic needs.  Examples of neglect include:

  • Physical, such as the failure to provide necessary food, shelter, or supervision
  • Medical, such as the failure to provide necessary medical or mental health treatment
  • Educational, such as the failure to educate a child or attend to his or her special education needs
  • Emotional, such as inattention to a child’s emotional needs or psychological care or letting the child use alcohol or drugs

Sometimes cultural values, the standards of care in the community, and poverty may be contributing factors in what is considered neglect and how child protective service agencies respond.  State laws often exclude charges of neglect when a parent or caregiver cannot meet a child’s needs because of poverty or an inability to provide.  When a family fails to use information and resources, and the child's health or safety is at risk, child welfare intervention may be required.

The issue of medical neglect can sometimes be complicated.  The Child Abuse Prevention and Treatment Act (CAPTA), in part, defines the withholding of medically indicated treatment as the “failure to respond to the infant's life-threatening conditions by providing treatment…which, in the treating physician's reasonable medical judgment, will be most likely to be effective in ameliorating or correcting all such conditions.”  Many states, as allowed by CAPTA, provide an exception to this definition of neglect for parents who choose not to seek medical care for their children due to religious beliefs that may prohibit medical intervention.

Physical Abuse

Physical abuse is nonaccidental physical injury that is inflicted by a parent, caregiver, or other person who has responsibility for the child.  Such injury is considered abuse regardless of whether or not the caregiver intended to hurt the child and can result from severe discipline or physical punishment that is inappropriate to the child's age or condition.  Physical abuse may occur as the result of a single episode or of repeated episodes and can range in severity from minor marks and bruising to death. 

Sexual Abuse

Child sexual abuse generally refers to sexual acts, sexual exploitation, or sexually motivated behaviors involving children.  It includes both touching offenses, such as fondling or sexual intercourse, and nontouching offenses, such as exposing a child to pornographic materials.  It can also involve varying degrees of violence and emotional trauma. 

The Child Abuse Prevention and Treatment Act (CAPTA) defines sexual abuse as 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” and the “rape, and in cases of caretaker or inter-familial relationships, statutory rape, molestation, prostitution, or other form of sexual exploitation of children, or incest with children.”

Note that the most commonly reported cases of child sexual abuse involve incest, which is sexual abuse occurring among family members.

Psychological Maltreatment

Psychological maltreatment (also called emotional abuse) is a repeated pattern of parental or caregiver behavior that communicates to the child that he or she is worthless, unloved, unwanted, or endangered.  This behavior can impair a child’s emotional development or sense of self-worth.  It may include constant criticism, threats, rejection, or the withholding of love, support, or guidance.

To warrant intervention, psychological maltreatment must be sustained and repetitive.  This type of maltreatment is often difficult to prove.  Therefore, child protective services agencies may not be able to intervene without evidence of harm to the child.  Psychological maltreatment, however, is almost always present when other forms of abuse and neglect are found.