Denise Shellyann Clarke’s latest book, My Protector Was My Molester 978-1-951630-57-7 is an account of the horrifying abuse the author faced at the hands of her father from an early age. The book discusses how the abuse changed Clarke's life and how she managed to rise against all the struggles of her life to become the bold and strong woman she is today. Clarke aims to help other survivors feel less isolated. She wants to give survivors a voice and encourage them to talk about what they have been through. Child abuse can have a severe impact on children, well into adulthood as well. Alicia R. Pekarsky, MD, shares the different types of abuse or maltreatment children can face.
Physical abuse
Physical abuse involves a caregiver inflicting physical harm or engaging in actions that create a high risk of harm. Assault by someone who is not a caregiver or in a position of responsibility to the child (eg, a shooter in a school mass shooting) is not specifically child abuse. Specific forms include shaking, dropping, striking, biting, and burning (eg, by scalding or touching with cigarettes). Abuse is the most common cause of serious head injury in infants. In toddlers, abdominal injury is also common.
Infants and toddlers are the most vulnerable because the developmental stages that they may go through (eg, colic, inconsistent sleep patterns, temper tantrums, toilet training) may frustrate caregivers. This age group is also at increased risk because they cannot report their abuse. The risk declines in the early school years.
Sexual abuse
Any action with a child that is done for the sexual gratification of an adult or significantly older child constitutes sexual abuse (see Pedophilic Disorder). Forms of sexual abuse include intercourse, which is oral, anal, or vaginal penetration; molestation, which is genital contact without intercourse; and forms that do not involve physical contact by the perpetrator, including exposure of the perpetrator's genitals, showing sexually explicit material to a child, and forcing a child to participate in a sex act with another child or to participate in the production of sexual material.
Sexual abuse does not include sexual play, in which children close in age view or touch each other’s genital area without force or coercion. The guidelines that differentiate sexual abuse from play vary from state to state, but in general sexual contact between individuals with a > 4 yr (chronologically, or in mental or physical development) age difference is considered to be inappropriate.
Emotional abuse
Emotional abuse is inflicting emotional harm through the use of words or actions. Specific forms include berating a child by yelling or screaming, spurning by belittling the child’s abilities and achievements, intimidating and terrorizing with threats, and exploiting or corrupting by encouraging deviant or criminal behavior. Emotional abuse can also occur when words or actions are omitted or withheld, in essence becoming emotional neglect (eg, ignoring or rejecting children or isolating them from interaction with other children or adults).
Abuse in a medical setting
Child abuse in a medical setting (previously called Munchausen syndrome by proxy, now called factitious disorder imposed on another in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition [DSM-5]) occurs when caregivers intentionally produce or falsify physical or psychological symptoms or signs in a child. Caregivers may injure the child with drugs or other agents or add blood or bacterial contaminants to urine specimens to simulate disease. Many children receive unnecessary and harmful or potentially harmful tests and treatments.
Neglect
Neglect is the failure to provide for or meet a child’s basic physical, emotional, educational, and medical needs. Neglect differs from abuse in that it usually occurs without intent to harm.
Different types of neglect can be defined as
· Physical neglect includes failure to provide adequate food, clothing, shelter, supervision, and protection from potential harm.
· Emotional neglect is a failure to provide affection or love or other kinds of emotional support.
· Educational neglect is the failure to enroll a child in school, ensure attendance at school, or provide homeschooling
· Medical neglect is the failure to ensure that a child receives appropriate care or needed treatment for injuries or physical or mental disorders.
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