Child Abuse
Basics
Description
- Types of abuse: neglect (most common and highest mortality), physical abuse, emotional/psychological abuse, sexual abuse, and sexual exploitation
- Neglect includes physical (e.g., failure to provide necessary food or shelter or lack of appropriate supervision), medical (e.g., failure to provide necessary medical or mental health treatment), educational (e.g., failure to educate a child or attend to special education needs), and emotional (e.g., inattention to a child’s emotional needs, failure to provide psychological care, or permitting the child to use alcohol or other drugs).
- System(s) affected: gastrointestinal (GI), endocrine/metabolic, musculoskeletal, nervous, renal, reproductive, skin/exocrine, pulmonary, cardiac, immune, and psychiatric
- Synonym(s): nonaccidental trauma; child maltreatment; inflicted injury
Epidemiology
Prevalence
Children’s Bureau report for federal fiscal year (FFY) 2021 (1):
- Child Protective Services agencies received an estimated 3.9 million referrals alleging maltreatment, with a national screened-in referral rate of 27.6 referrals per 1,000 children.
- Approximately 3 million children received either an investigation or alternative response. Of those investigated, 588,229 children (8.1 per 1,000) were found to be victims of abuse or neglect.
- Neglect is the most common type of reported maltreatment at 76%, followed by physical abuse at 16% and sexual abuse at 10.1%.
- The overall rate of child fatalities was 2.46 deaths per 100,000 children in the national population. The rate of child fatalities is slightly higher in boys compared to girls.
- The majority of perpetrators are the parents of their victims (76.8%).
Risk Factors
- American Indian or Alaska Native children had the highest rates of victimization.
- Children from birth to 1 year of age had the highest rate of victimization with 25.3 per 1,000 infants and had the highest rate of mortality.
- Females have a slightly higher rate of victimization versus males.
- Military families are at risk, especially with deployment.
- Child risk factors: chronic illness, physical/congenital disability, developmental delay, preterm, unintended pregnancy
- Caregiver risk factors: poverty, substance misuse, lower educational status, parental history of abuse, parental mental health issues, young and/or unmarried mother, poor support network, and domestic violence
General Prevention
- Screen for risk factors at prenatal, postnatal, and pediatric visits.
- Physicians can educate parents on a range of normal behaviors to expect in infants and children: for example, anticipatory guidance on ways to handle crying infants; methods of discipline for toddlers
Commonly Associated Conditions
Failure to thrive, prematurity, developmental delays, poor school performance, poor social skills, low self-esteem, anxiety or depression
There's more to see -- the rest of this topic is available only to subscribers.
Citation
Domino, Frank J., et al., editors. "Child Abuse." 5-Minute Clinical Consult, 33rd ed., Wolters Kluwer, 2025. Medicine Central, im.unboundmedicine.com/medicine/view/5-Minute-Clinical-Consult/116123/all/Child_Abuse.
Child Abuse. In: Domino FJF, Baldor RAR, Golding JJ, et al, eds. 5-Minute Clinical Consult. Wolters Kluwer; 2025. https://im.unboundmedicine.com/medicine/view/5-Minute-Clinical-Consult/116123/all/Child_Abuse. Accessed December 7, 2024.
Child Abuse. (2025). In Domino, F. J., Baldor, R. A., Golding, J., & Stephens, M. B. (Eds.), 5-Minute Clinical Consult (33rd ed.). Wolters Kluwer. https://im.unboundmedicine.com/medicine/view/5-Minute-Clinical-Consult/116123/all/Child_Abuse
Child Abuse [Internet]. In: Domino FJF, Baldor RAR, Golding JJ, Stephens MBM, editors. 5-Minute Clinical Consult. Wolters Kluwer; 2025. [cited 2024 December 07]. Available from: https://im.unboundmedicine.com/medicine/view/5-Minute-Clinical-Consult/116123/all/Child_Abuse.
* Article titles in AMA citation format should be in sentence-case
TY - ELEC
T1 - Child Abuse
ID - 116123
ED - Domino,Frank J,
ED - Baldor,Robert A,
ED - Golding,Jeremy,
ED - Stephens,Mark B,
BT - 5-Minute Clinical Consult, Updating
UR - https://im.unboundmedicine.com/medicine/view/5-Minute-Clinical-Consult/116123/all/Child_Abuse
PB - Wolters Kluwer
ET - 33
DB - Medicine Central
DP - Unbound Medicine
ER -