Child maltreatment has occurred throughout history and across cultures. Anthropology’s cross-cultural approach has contributed to efforts to define and explain aggressive or inadequate treatment of children.
Child maltreatment was brought to public and professional attention when it was identified in the medical and social work literature in the United States and Europe during the 1960s and 1970s. The landmark publication by pediatrician C. Henry Kempe and his colleagues coined the term the battered child syndrome and is frequently viewed as initiating the field. The International Society for Prevention and Treatment of Child Abuse and Neglect was founded in the late 1970s, seeking to bring worldwide attention to the problem.
Many nations had similar experiences of first denying the existence of child maltreatment within their boundaries, only to later “discover” its existence. This stimulated interest in the broader cross-cultural record. Anthropology’s cross-cultural perspective has contributed to understandings of definitions and etiology of and a literature on culturally competent responses to child maltreatment.
Defining Child Abuse and Neglect
Criteria for defining and identifying child abuse and neglect were developed in European and North American societies by professionals working primarily in clinical settings. Early definitions of child maltreatment centered on physical harm resulting from acts of omission or commission by parents and other caretakers. Over the next 40 years, definitions expanded in both the national and international literatures to encompass a broad range of harms to children. The four basic categories of child maltreatment are physical abuse, physical neglect, emotional maltreatment, and child sexual abuse. Neglect may also include medical neglect or educational neglect. Munchausen’s Syndrome by Proxy, an illness fabricated by a parent that can cause harm to a child, is also generally included in the spectrum of child maltreatment. Fatal maltreatment, in which a child dies from a repetitive pattern of abuse and/or neglect, is often a separate category in the professional literature.
As international work in child abuse expanded, additional definitional categories were added. Even though these problems exist in Euro-American nations, the international literature brought them more to the fore-front. These include child labor that extends beyond family-based subsistence and is exploitative, and child prostitution. In addition, selective neglect, or underinvestment, has been identified in international demo-graphic data through patterns of differential mortality in which some categories of children are less likely to thrive or survive due to medical, nutritional, and other forms of inattention and neglect.
Establishing culturally valid definitions of child maltreatment has been complex. Identification of child maltreatment relies on a complex interaction of (a) harm to the child, (b) caretaker behaviors that produced or contributed to that harm, and (c) societal or cultural assignment of responsibility or culpability. Just as there is no absolute standard for optimal child rearing that would be considered valid cross-culturally, there has been difficulty in establishing a universal definition of abusive or neglectful behavior. Three definitional levels have been suggested for culturally informed definitions of child maltreatment. First, cultural practices vary, and what one group considers abusive, another group may consider well within the normative range of behavior. Differences in definitions of child maltreatment that can be ascribed to differences in normative cultural beliefs and practices are not, strictly speaking, abuse, since they are not proscribed, at least by the group in question. This does not preclude discussions and evaluations of the relative harm and benefit of different culturally accepted practices but puts different practices in context. Second, idiosyncratic departure from cultural standards and norms affords an intracultural view that highlights those individuals who violate the continuum of acceptable behavior. And third, societal-level maltreatment of children is sometimes confused with culturally acceptable behaviors. Societal neglect refers to the level of harm or deprivation, such as poverty or war, that a larger political body (nation) tolerates or inflicts on its children. Because child maltreatment has not always been labeled as such in other cultures, some anthropological works have examined physical punishment or emotional climate, as maltreatment requires that behaviors meet three criteria. First, the behavior must be proscribed by the culture in question. Second, it must be proximate to the child and caretaker and not be harm that results from broader conditions beyond parental or caretaker control, such as warfare or famine. And third, it must be potentially preventable.
Incidence and Demographics
In the United States, between 800,000 and 1 million children are identified as abused or neglected each year as a result of reports to child protection agencies. Between three and five children die from fatal maltreatment each day, and homicide by parents is a leading cause of trauma-related death for children under 4 years of age. Between one half and two thirds of child maltreatment cases are neglect. Children under 3 years of age have the highest rates of victimization. Victimization rates are similar for males and females, with the exception of child sexual abuse, in which approximately three to four times more girls than boys are involved.
There is limited data on incidence and prevalence of child maltreatment cross-culturally. While the available evidence suggests that child maltreatment occurs, or has the potential to occur, in all societies, the differential distribution is difficult to estimate. Definitional issues discussed above increase the difficulties in making valid cross-cultural or cross-national comparisons. Despite increasing international awareness, child abuse and neglect are often difficult to recognize or make sense of in the small populations often studied by anthropologists. Because child maltreatment is a low base-rate behavior, it may be rare in a small population during a single year of fieldwork. Rare cases that seem at odds with more general cultural patterns, then, may not find their way into the literature. In addition, it often is difficult to estimate the incidence or prevalence of child maltreatment in societies with high infant and child mortality rates due to disease or malnutrition.
In the United States, there is controversy about whether there are differential rates of child maltreatment across ethnically diverse populations. Questions remain as to whether a higher proportion of reports in poor ethnic minority populations is due to stresses associated with poverty leading to maltreatment or due to increased scrutiny by public welfare agencies leading to higher reports.
The etiology of child abuse and neglect is poorly understood, even within those nations that have the longest history of research and policy attention to the problem. More sophisticated etiological models stress the importance of an ecological framework, with risk and protective factors transacting across the ecological levels of individual factors, family factors, community factors, and factors in the larger sociocultural environment. These complex theoretical models, however, have rarely been adequately subjected to empirical testing and research.
A cross-cultural perspective has the potential to enhance understanding of the complex interaction of risk and protective factors that contribute to or prevent the occurrence of child maltreatment. It is not currently known whether common or divergent pathways lead to child maltreatment across diverse populations. For example, does the interaction of poverty and an individual history of child maltreatment have different consequences in different community contexts? Etiological factors should have explanatory power both within and between cultures.
The cross-cultural record sheds some light on categories of children at risk for maltreatment. Even in cultures in which children are highly valued and rarely punished, some children may receive a lesser standard of care than other children. These categories of children may be identifiable through demographic analyses that suggest differential survival by factors such as gender or birth order. Identification of categories of children at risk also requires knowledge of cultural values on specific child behaviors or traits.
Circumstances in which children have diminished social supports or in which social networks are lacking or deficient have also been suggested as increasing the risk of maltreatment. Social networks can act either to prevent child maltreatment or to exacerbate the risk of its occurrence. Social networks, on the one hand, provide the context for assistance with child care, for redistribution of children who may be at risk for maltreatment, and for the establishment, scrutiny, and enforcement of standards of child care and treatment. These functions of social networks should diminish the likelihood of child abuse and neglect. On the other hand, some abusive or neglectful families may be embedded in closely knit but maladaptive networks. Abusive parents may engage with others whose child-rearing attitudes and behaviors are similar to their own. Networks in which attitudes and behaviors toward children tend toward the aggressive or neglectful may provide precisely the kind of role models that facilitate abuse. Network members may be hesitant to intervene or to report maltreatment because their own behavior is similar. They may be fearful that if they report others, they risk reporting themselves. In addition, network members may be isolated from community facilities and supports and therefore may not know how to access supports or services for themselves or for an abusive parent in their midst. Inequality of power between parents has also been implicated in the etiology of child abuse cross-culturally.
Consequences of Child Abuse and Neglect
Child abuse and neglect has been associated with increased risk of adverse outcomes. Not all abused and neglected children suffer immediate or lasting consequences beyond their immediate injuries. Nevertheless, abused and neglected children are at increased risk for a range of physical, mental/emotional, and social/behavioral difficulties. The pathways to these outcomes are complex. Cross-culturally, children who are treated with rejection rather than with warmth and acceptance by their parents and care-givers display negative psychological outcomes.
Cultural Competence in Child Maltreatment
Child abuse and neglect was originally identified in European and Western nations, and many of the formulations about its definitions, causes, and consequences stem from these origins. Anthropology has offered broader understandings of the issues by applying the cross-cultural record both internationally and for diverse populations within multicultural nations. This is a field with many possibilities for future research.
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