Abusive kids

It is hard to imagine an adult would ever purposely hurt a child. Parents want to protect their children. Adults want to keep children safe. Sadly, that does not always happen.

Almost 3 million cases of child abuse are reported each year in the United States. It is likely that even more cases of abuse are not reported.

The American Academy of Pediatrics lists five types of child abuse:

Physical abuse
Physical neglect
Verbal abuse
Emotional abuse
Sexual abuse
A study just published in the medical journal Pediatrics focuses on physical abuse. Researchers studied data from the 2006 Kids' Inpatient Database. This includes information from about 4,000 hospitals in almost 40 states.

The authors confirmed many cases of physical abuse in children in the United States. In 2006, about 4,500 children were hospitalized due to physical abuse. Three hundred of these children (7%) died from their injuries.

Which children were more likely to have a hospital stay for serious physical abuse?

Boys more than girls
White children, followed by African-American children
Children who were poor -- About 3 out of 4 abused children had Medicaid.
Children less than 1 year of age died most often from physical abuse. School-aged children had the lowest rates of death.

Children who were abused had longer hospital stays (about 7.5 days) than children in the hospital for other reasons (about 4 days). They also had higher hospital costs (roughly twice as much for each hospital stay).

This new information can allow experts to study trends in physical abuse in children over time. It also can show how well programs created to prevent child abuse are working.

What Changes Can I Make Now?

Abuse often happens right in the child's home. The child may even know his abuser. It can be a parent, relative, babysitter or neighbor. This makes it very hard for children to tell someone that they are being hurt.

Abuse may cause a major lifelong problem for its victims. Parents, pediatricians and all adults must be on guard. We must all watch out for signs of child abuse. We all must know what abuse is and when and how to respond to it.

Look for these types of injuries:

Black eyes
Bite marks
Burns in the shape of cigarette butts or of having been put in scalding hot water
Repeated injuries (especially if the child cannot explain how she got them)
Injuries that the parent does not want to talk about
Watch out for these kinds of behavior in a child:

Cries a lot (more than usual)
Is very aggressive and disruptive
Seems afraid of a parent or caretaker
Is unusually tired or tired too often
Tries to run away from home
Has sudden changes in how she feels about herself (self-esteem)
Has too many fears
Has too many nightmares
Is failing in school
If you ever think that a child is being abused, you must say something! Contact your local child protective services agency, police, hospital or emergency hotline. If necessary, you can do so anonymously (without giving your name).

In many states, teachers, doctors, dentists and other professionals are required (by law) to report suspected cases of abuse.

Keep your children safe from physical abuse outside the home. Teach them to:

Say "no" when someone asks them to do something they do not want to do
Always tell an adult if someone hurts them or makes them feel bad
Stay away from places they don't know or don't usually go by themselves
Keep their distance from people they do not know
What Can I Expect Looking to the Future?

We must continue to do what we can to help all children feel safe and loved, especially in their homes. Abuse is a major public health problem. I hope that we can decrease the number of children who are abused each year.