What is abuse and neglect?

Federal law defines child abuse and neglect as “Any recent act or failure to act on the part of a parent or caretaker which results in death, serious physical or emotional harm, sexual abuse or exploitation; or an act or failure to act which presents an imminent risk of serious harm.”

Child Abuse/Neglect (CA/N) is a widespread problem that occurs across geographic, racial, ethnic and socioeconomic lines. Abuse can be physical, emotional, or sexual in nature, and can also include providing illegal substances to a child. Actions are considered “neglect” if they result in failing to meet the physical, emotional, educational or medical needs of a child. Abandonment is also considered abuse/neglect in many states.

Certain behaviors of children and their caregivers indicate the possibility of abuse or neglect. An excellent description of these can be found at https://www.childwelfare.gov/pubs/factsheets/whatiscan.cfm.

Each state government operates a division to address child welfare issues. In Missouri, the Department of Social Services, Children’s Division is responsible for investigating cases of abuse and neglect, and for some foster care and adoptive care work. The State also contracts with private agencies to provide foster care case management, adoption services, residential treatment, and specialized support services for older youth. As of July 14, 2014the Children’s division managed 46 percent of foster cases in St. Louis County and 38 percent of cases in St. Louis City. Source: Program and Evaluation Unit, Missouri Children’s Division. 

In Illinois the Division of Children and Family Services is responsible for child welfare issues. Illinois also shares responsibility for case management and other functions through contracts with private agencies.

The impact of abuse/neglect on children and youth

The impact of child abuse and neglect is often discussed in terms of physical, psychological, behavioral, and societal consequences. In reality, however, it is impossible to separate the types of impacts. Physical consequences, such as damage to a child’s growing brain, can have psychological implications, such as cognitive delays or emotional difficulties. Psychological problems often manifest as high-risk behaviors. Depression and anxiety, for example, may make a person more likely to smoke, abuse alcohol or drugs, or overeat. High-risk behaviors, in turn, can lead to long-term physical health problems, such as sexually transmitted diseases, cancer, and obesity. Not all children who have been abused or neglected will experience long- term consequences, but they may have an increased susceptibility.

Physical health consequences directly linked to abuse/neglect include abusive head trauma, impaired brain development, and poor physical health. Direct psychological consequences can include difficulty of infants in attaching to adults, poor mental and emotional health, cognitive and social difficulties.Behavioral consequences in adolescence include grade repetition, truancy, pregnancy and engaging in risky sexual behavior that results in sexually transmitted diseases, juvenile delinquency, adult crime, substance abuse, abusive behaviors, and difficulty in maintaining employment.

The societal impact of abuse/neglect

While child abuse and neglect usually occur within the family, the impact does not end there. Society as a whole pays a price for child abuse and neglect, in terms of both direct and indirect costs.

The direct lifetime cost of child maltreatment and related fatalities in 1 year totals $124 billion, according to a study funded by the Centers for Disease Control. Child maltreatment is more costly on an annual basis than the two leading health concerns, stroke and type 2 diabetes (Xiangming, Brown, Florence, & Mercy, 2012).

Indirect costs represent the long-term economic consequences to society as the result of child abuse and neglect. These include costs associated with increased use of our health-care system, juvenile and adult criminal activity, mental illness, substance abuse, and domestic violence. The indirect costs also include lost wages and inability to retain jobs.

For a more complete overview of the impact of the long term consequences of abuse go to https://www.childwelfare.gov/pubs/factsheets/long_term_consequences.cfm.

Both nationally and in states, focus has increased on responding to the trauma of children who have been abused and neglected, and the trauma experienced by adults who work or live with them. In 2012 the Children’sDivision and partners from the Department of Mental Health, Office of State Court Administrators and the provider community developed a plan to shift the culture of the Children’s Division and the child welfare system to consider and better respond to the impact of trauma on every person served, every employee and every community partner.

The goal is to move the culture from trauma aware (seeking information) to trauma sensitive (infusing best practice concepts) to trauma responsive (responding differently in all aspects from the moment the agency makes first contact) to a trauma informed system. Information about recognizing and treating trauma and other efforts to improve the child welfare system can be found in the Department of Social Services’ Annual Report at http://dss.mo.gov/re/pdf/2012-dss-annual-report.pdf.

Child abuse and neglect in the St. Louis metropolitan area

In FY2013 (beginning July 1, 2012 and ending June 30, 2013) in the 3 Missouri metropolitan counties of St. Charles, St. Louis and St. Louis City,  reports of suspected abuse/neglect were made involving 18,992 children. This number was down slightly from 2012, but was 21 percent higher than 5 years ago.

Sources: Child Abuse/Neglect Annual Report, 2013.  Downloaded October 2, 2014Annual Statistical Report 2012. http://www.state.il.us/dcfs/docs/DCFS_Annual_Statistical_Report_FY2012.pdf. Downloaded on October 2, 2014.

The 3 county area accounts for 12 percent of reports made on children, and 14 percent of the substantiated cases of abuse/neglect in Missouri statewide.

The Illinois counties of Madison and St. Clair account for 6 percent of child abuse/neglect reports made statewide. County breakdowns were not available for substantiated cases of abuse/neglect.

Who reports child abuse and neglect?

Calls alleging the abuse or neglect of a child may be made by legally mandated reporters (including, but not limited to teachers, child care providers, medical personnel, and law enforcement) or by non-mandated individuals who may be a relative, neighbor or acquaintance of the child. The following shows the breakdown of those most likely to report abuse/neglect.

13.7%36.7%41.3%Non-mandated reporters
11.8%17.2%16.6%School personnel (teachers, principals)
11.9%12.5%11.1%Social Worker
38.3%13.2%16.7%Law Enforcement or Juvenile Officers
19.4%12.6%13.2%Health and Mental Health professionals

Sources: Child Abuse/Neglect Annual Report, 2013. Downloaded October 2, 2014. Child Maltreatment 2012.
http://www.acf.hhs.gov/sites/default/files/cb/cm2012.pdf. Downloaded on October 2, 2014. Annual Statistical Report 2012. http://www.state.il.us/dcfs/docs/DCFS_Annual_Statistical_Report_FY2012.pdf. Downloaded on October 2, 2014.

Types of Abuse

Substantiated incident of abuse in Missouri and in Illinois were most likely to be incidents of physical neglect, physical abuse or sexual abuse. Percent totals are greater than 100 because some incidents include multiple types of maltreatment. In both states, the incidence of emotional abuse is lower than the national average. Sexual abuse is significantly higher in both Illinois and Missouri. Only 3 other states have a higher percent of sexual abuse victims than Missouri.

Type of AbuseIllinoisMissouriNational
Physical Neglect70.4%60.4%78.3%
Physical Abuse25.3%29.8%18.3%
Emotional Abuse0.2%4.5%8.5%
Sexual Abuse18.1%24.3%9.3%
Maltreatment per 1000 victims116.3122.6127.5

Sources: Child Abuse/Neglect Annual Report, 2013.  Downloaded October 2, 2014. Child Maltreatment 2012. http://www.acf.hhs.gov/sites/default/files/cb/cm2012.pdf.  Downloaded on October 2, 2014.

Preventing Child Abuse and Neglect

Prevention programs have long focused on reducing particular risk factors, or conditions that research shows are associated with child abuse and neglect. Increasingly, prevention services are also recognizing the importance of promoting protective factors, circumstances in families and communities that increase the health and well-being of children and families. These factors help parents who might otherwise be at risk of abusing or neglecting their children to find resources, supports, or coping strategies that allow them to parent effectively, even under stress.

Protective factors that have been shown to reduce the risk of child abuse/neglect include: a warm and nurturing relationship between parents and their children; parents’ knowledge of parenting skills and child development; parents who are emotionally resilient; emotional support for parents; support to meet the concrete needs of families; and social/emotional competence of children. These protective factors are the basis of the Strengthening Families approach, an evidence based program that is used nationally. Locally, the St. Louis Family and Community Partnership provides training in Strengthening Families to child-serving individuals and organizations. For more information about the St. Louis Family and Community Partnership, go to Partnering Agencies on the Vision for Children at Risk web site.

Public/private collaborations such as the St. Louis Family and Community Partnership and the Council on Child Abuse and Neglect offer community events, educational programs and trainings that focus on the prevention and treatment of child abuse and neglect.

Prevention programs are more effective when they involve parents as partners in all aspects of program planning, implementation, and evaluation. Parents are more likely to make lasting changes when they are empowered to identify solutions that make sense for them. Common activities of prevention programs include:

  • Public awareness campaigns, such as PSAs, posters, and brochures that promote healthy parenting, child safety, and how to report suspected maltreatment
  • Skills-based curricula that teach children safety and protection skills, such as programs that focus on preventing sexual abuse
  • Parent education programs to help parents develop positive parenting skills and decrease behaviors associated with child abuse and neglect
  • Home visiting programs that provide support and assistance to expecting and new mothers in their homes
  • Parent mentor or leadership programs that provide role models and support to families in crisis
  • Parent support groups, where parents work together to strengthen their families and build social networks
  • Respite and crisis care programs, which offer temporary relief to caregivers in stressful situations by providing short-term care for their children
  • Family resource centers, which work with community members to develop a variety of services to meet the specific needs of the people who live in surrounding neighborhoods

More information on prevention and other aspects of child abuse/neglect are available online at https://www.childwelfare.gov/pubs/factsheets/preventingcan.cfm. and at https://www.childwelfare.gov.