Most people would agree that physical or sexual abuse of children is abhorrent; the outcry over the abuse of children by people in power has been consistent over time – but can verbal and emotional abuse be an equal threat to a child’s long-term mental health?
Dr. Roberta Hibbard, and her colleagues from the Committee on Child Abuse and Neglect, and the American Association of Child and Adolescent Psychiatry’s Child Maltreatment and Violence Committee, believe that not only sticks and stones, but words and non-action may be an an equal threat to a child’s well-being.
Emotional Abuse: Identifying Psychological Maltreatment of Children
While no standard definition of psychological maltreatment exists, Hibbard et al. looked to earlier research in the field and identified six types of psychological maltreatment of children: spurning, terrorizing, isolating, exploiting/corrupting, denying emotional responsiveness, and the neglect of a child’s mental health/medical or educational needs. Specific actions cited included “[s]ingling out or humiliating in public” and “[m]odeling, permitting, or encouraging antisocial or developmentally inappropriate behavior.” Co-author Dr. Harriet MacMillan, in an exclusive interview with Decoded Science, noted that work on an assessment tool is underway, but still needs to be refined.
In their article, published today in the American Academy of Pediatrics journal, authors cited research that found “8% to 9% of women and 4% of men reported exposure to severe psychological abuse during childhood.” Now, more attention is being paid to the behavior of caregivers instead of focusing only on the acting-out of the child.
Combating Child Abuse
As pediatricians, the authors foresee physicians as key players in the identification of psychological maltreatment. With the absence of an assessment tool, MacMillan told Decoded Science that the goal would be not to assess every patient, but to “develop appropriate interviewing skills that include asking about relationships with caregivers and possible adverse experiences.”
While acknowledging the burdens already placed on child-protective agencies, MacMillan states that, “psychological maltreatment is associated with similar types of impairment as other types of maltreatment. In other words, we need to separate out what is potentially harmful for children and then determine the resources needed to address such adversities.” Specifically, the authors suggest that programs that have been effective at lowering the rates of general maltreatment, such as the Nurse-Family Partnership, which targets first-time mothers, may provide a model for the education of caregivers at high risk for abusive behavior.
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