While child abuse and neglect by caretakers is not the only threat to children’s well-being, it certainly cannot be excluded from this discussion.
Unfortunately, far too many children worldwide experience child maltreatment. An estimated 86% of children between the ages of 2 and 14 years experiences physical or psychological aggression from their family; two-thirds experience physical aggression (UNICEF, 2009). Article 19 of the CRC provides that the state will ensure that all children are protected from child maltreatment. However, even within a culture, there are different definitions of what is “maltreatment.” For example, within the United States, there is no single clear-cut definition of child physical abuse; some would include corporal punishment, while others would not. It has been a concern of many of those working in the area of culture and child maltreatment that a balance be found between respecting a person’s culture and not allowing maltreatment to occur. This is similar to the discussion on human rights and cultural relativism in Chapter 2. In an attempt to create a cross-cultural definition of child maltreatment, Finkelhor and Korbin (1988, p. 4) define it as “the portion of harm to children that results from human action that is proscribed, proximate, and preventable.”
This definition allows for cultural variation in childrearing but is inclusive of child maltreatment as well. Some behaviors might meet a cultural norm but be considered maltreatment by other cultures. For example, some cultures are appalled that Americans have infants sleep in separate rooms from their parents, considering this practice to be detrimental to the child’s development (Small, 1998). Other cultures may accept a behavior that is considered abusive by most other cultures, such as Female Genital Cutting (see Chapter 7). It is important to differentiate between what are cultural differences and what is maltreatment. Despite some differences in definition about what constitutes maltreatment, there is general agreement that certain acts are definitely maltreatment. Globally, sexual abuse is the type of abuse most commonly considered to be maltreatment, followed by abandonment and physical abuse by a parent (Bross, Miyoshi, Miyoshi, & Krugman, 2000).
Maltreatment has long-lasting consequences. In the short term, death and injury may be the immediate most visible results. In the long term, it can result in an increased likelihood of mental health diagnoses, especially depression, substance abuse, and low self-esteem. It has also been linked to physical health conditions, including cancer, chronic lung disease, and liver disease (Pinheiro, 2006). Women who have experienced child sexual abuse are more likely to be victims of intimate partner violence in their adulthood (Speizer, Goodwin, Whittle, Clyde, & Rogers, 2008). Child maltreatment can also permanently alter the developing brain structure in a child, causing the child to be hypervigilant to threats and be less able to react positively to others and engage in complex thought (Pinheiro, 2006; US Department of Health and Human Services, 2009).
Programs to prevent child maltreatment have been concentrated in countries in the Global North, and there have been relatively few in the Global South and these have tended to focus on sexual abuse. As this is the most universally recognized form of abuse, this is logical. Educating children about sexual abuse can be an effective primary prevention tool. In Thailand, a child abuse prevention project teaches the children the mantra “Why, no, go, tell” to help children protect themselves from sexual abuse by teaching them they have the right to refuse a person seeking to abuse them and to tell another person about what happened (“Mantra may help,” 2005).
However, many parents consider it to be inappropriate to discuss topics of a sexual nature with their children. For example, in Afghanistan, many parents consider any discussion of sex with their children to be indecent, even though 40% of child sexual abuse occurs within the home. Rates of child sexual abuse have been rising in that nation in the post-Taliban era, but few children will speak of it due to the associated disgrace and stigma (“War, poverty and ignorance,” 2007). A survey of parents in China found that although almost half of respondents were concerned that education about child sexual abuse might cause their children to know too much about sex, 95% thought such programs should be offered in elementary school and were willing to have their children attend (Chen, Dunne, & Han, 2007).