Neglect tops the list of abuses that children endure, according to a new report that finds cases of abuse and neglect edged up for the third consecutive year during 2015.
The Child Maltreatment 2015 report by the Administration on Children, Youth and Families noted 683,000 victims of child maltreatment or 9.2 victims per 1,000 children. The slight increase from 2014's 9.1 victims per 1,000 is concerning, experts said, because not all maltreatment is reported and in some cases abuse or neglect exists but there's not enough evidence to substantiate it, leading to the suspicion that the count is actually undercounted.
"I think the findings of abuse reports and substantiations here say essentially a child abuse investigator went out and said something's going on here; we need to take a closer look," said Daniel Heimpel, executive director of the nonprofit Fostering Media Connections, which produces three publications for foster and adoptive parents. He also teaches at the University of Southern California School of Social Work.
"The number of kids in foster care also has gone up over this period of time," he said. "Abuse rates have gone up, reports of abuse have gone up and the number of kids entering the system has gone up after a huge decline for many years."
Child Trends senior child welfare research scientist Sharon Vandivere warns people to pay attention to what's harming children but not to take the numbers and small differences too literally because maltreatment must first be reported and then substantiated in order to be counted.
She also noted that while child maltreatment seems to be flat or rising nationally, some states are succeeding in reducing it.
Neither she nor Heimpel was involved in the government report.
As the nation grapples with rising number of adults addicted to opioids, experts are beginning to explore connections to increases in child abuse and neglect. Others point to financial woes that rode into family life during the recession as being related to the rising rates of maltreatment of children.
The Child Abuse Prevention and Treatment Act is used to guide national policy reporting of instances of abuse. It calls out both the things that caregivers and parents do and the things they fail to do that harms kids.
When counting and reporting abuse, most states divide maltreatment into neglect, physical abuse, psychological abuse and sexual abuse. Some children endure a combination. The new report is based on voluntary reporting from the all 50 states, the District of Columbia and Puerto Rico, often referred to as the 52 states.
Among the findings:
• The report estimates 1,670 child deaths in 2015 related to maltreatment. Actual reporting from 49 states documented 1,585 child deaths. The estimate was calculated based on the population in both reporting and non-reporting states; the death is assigned to the year the maltreatment was confirmed, which is not always the year the child died.
• Infants were three times more likely to die from abuse or neglect than a year-old child.
• Fifty-five percent of child victims who die from abuse or neglect are boys.
• At least one parent was involved in 77 percent of the deaths, and alcohol, drug abuse or domestic violence were often factors. Women were more likely than men to be perpetrators, 54 percent vs. 45 percent. In the other cases, gender wasn't known.
• Three-fifths of maltreatment reports to child welfare systems came from professionals, including teachers, lawyers, social workers and police officers.
• Demographically, the biggest category of victims were white at 43.2 percent, compared to Hispanic at 23.6 percent and African-American at 21.4 percent.
The real harm
Neglect is the most common form of child maltreatment and the damage it does is often underestimated compared to forms of abuse, according to Vandivere. "There's some evidence neglect can be more harmful, particularly for younger children, infants and toddlers, as their brains are developing. It can really interfere with the attachment cycle and create long-term learning and emotional problems," she said. "It's potentially a serious problem, along with forms of abuse."
She noted that children who don't hear a lot of language and are not spoken to or interacted with — among the hallmarks of neglect — may suffer permanent deficits in brain development.
Some impacts of child maltreatment may not be seen until children hit adolescence, which has ramifications for families who adopt children who cannot be safely returned to their family of origin.
"Little is known about how children are faring after an adoption is finalized," she said. "There'a bit of research showing it's not so much the age a child is adopted — some think older kids are more challenging — but the problem may appear only when the child hits adolescence. So I worry about little guys who experience severe neglect and are adopted, with things going well until the child hits adolescence and then it gets harder to address."
Opioids and other theories
Some experts, including federal officials, have suggested that a national opioid addiction crisis may be fueling the increase in child abuse and neglect. It makes sense that parents who are addicted might neglect their children, said Vandivere, but she noted it's not a complete explanation.
"If you look at the states with opioid deaths, some of them did show increases (in child maltreatment), like New Mexico and Kentucky and Oklahoma. But other states that had relatively high opioid rates didn't, so that doesn't fully explain what's going on, either. It is something to be aware of in the child maltreatment arena. I can't imagine that it doesn't have impact."
It's hard to quantify causes of child maltreatment or even numbers for a variety of reasons, she said, citing research in 2013 that found reports of child maltreatment seemed to drop in some areas that were hard hit by recessions, but that abuse-related Google searches increased.
The researcher, Harvard economist Seth Stephens-Davidowitz, worried that though the number of substantiated cases of abuse seemed to be declining, it could simply reflect inadequately funded programs to investigate and address abuse and neglect. If there are fewer social workers and investigators, there could be fewer proven cases, without a decline in actual maltreatment, Vandivere said.
Heimpel believes the rising number might indicate a philosophical pendulum swing between child protection and family preservation. Public policy swings between aggressive child protection policing and softer interventions to keep families together.
That the report has captured the more aggressive approach is "historically at least plausible," said Heimpel, who said the report suggests we either decide it documents an acceptable number of mistreated children — "which I don't think people are going to accept" — or take what has been learned about root causes of abuse and try to provide interventions.
"How do we put the kind of voluntary services around the folks that are in the most compromised situations and most likely to abuse their kids? How can we focus those services on people and make that the focal point of how we allocate a broad array of services — not just child welfare services, but welfare, public health, nurse home visitors, all those things?"
He said child maltreatment could serve as the "orienting principle" of how services that benefit kids are allocated. But he expressed skepticism of policy that waits for abuse to trigger services, especially since a great deal is known about preventing child abuse and neglect.