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Child Abuse

Child Abuse
Contents

 1 Meaning Of Child Abuse

 2 Types
o 2.1 Physical abuse
o 2.2 Sexual abuse
o 2.3 Psychological abuse
o 2.4 Neglect
 3 Effects
o 3.1 Emotional
o 3.2 Physical
 3.2.1 Adverse Childhood Experiences Study
o 3.3 Psychological
 4 Causes
o 4.1 Worldwide
 5 Disclosure and diagnosis
 6 Assessment
 7 Prevention
 8 Treatment
 9 Prevalence
o 9.1 United States
 10 Examples
o 10.1 History
o 10.2 Child labor
o 10.3 Child trafficking
o 10.4 Forced adoption
o 10.5 Gender based violence against girls
 10.5.1 Infanticide
 10.5.2 Female genital mutilation
 10.5.3 Violence against girl students
o 10.6 Child marriage
o 10.7 Violence against children with superstitious accusations

Child abuse or child maltreatment is physical, sexual, or psychological maltreatment or neglect of a

child or children, especially by a parent or other caregiver. Child abuse may include any act or failure to act
by a parent or other caregiver that results in actual or potential harm to a child, and can occur in a child's
home, or in the organizations, schools or communities the child interacts with.
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The terms child abuse and child maltreatment are often used interchangeably, although some
researchers make a distinction between them, treating child maltreatment as an umbrella term to cover
neglect, exploitation, and trafficking.

Different jurisdictions have developed their own definitions of what constitutes child abuse for the
purposes of removing children from their families or prosecuting a criminal charge.

Introduction

Children are the most beautiful and innocent creation of Allah Almighty and childhood is a wonderful
phase of everyone’s life. Children are supposed to enjoy this period before growing up to face actual
challenges of life. But, unfortunately, children of today are facing numerous issues ranging from child labour
to child abuse and so on.  Like many other countries, in Pakistan too children are deprived of their basic rights
as provided by the law of the land and a plethora of international covenants. They are being denied their
fundamental right to education and to good nourishment. They are employed as labour in factories and
workshops while many of them fall prey to the menace of child trafficking. The protections and remedies
provided by country’s law seem effective on paper only because their implementation is hardly cared about.
The situation has now reached at an alarming stage.

Laws about Child Rights

Let’s start with Article 25A of the Constitution of Pakistan, 1973, which gives a clear message with
guaranteed basic right to education. It states, “The State shall provide free and compulsory education to all
children of the age of five to sixteen years in such manner as may be determined by law.”

According to UNICEF Pakistan and UNESCO Institute for Statistic (UIS) report 2013, so far 6.5
million children are not even getting primary education, while 2.7 million of them are away from lower
secondary school.

According to Alif Ailaan Report, the number of Out-Of-School Children (OOSC) is 25.02 million,
second largest in the world.

Meaning Of Child Abuse

Definitions of what constitutes child abuse vary among professionals, and between social and cultural
groups, as well as across time. [1][2] The terms abuse and maltreatment are often used interchangeably in the
literature.[3]:11 Child maltreatment can also be an umbrella term covering all forms of child abuse and child
neglect.[4] Defining child maltreatment depends on prevailing cultural values as they relate to children, child
development, and parenting.[5] Definitions of child maltreatment can vary across the sectors of society which
deal with the issue,[5] such as child protection agencies, legal and medical communities, public health
officials, researchers, practitioners, and child advocates. Since members of these various fields tend to use
their own definitions, communication across disciplines can be limited, hampering efforts to identify, assess,
track, treat, and prevent child maltreatment. [3]:3[6]
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In general, abuse refers to (usually deliberate) acts of commission while neglect refers to acts of
omission.[4][7] Child maltreatment includes both acts of commission and acts of omission on the part of parents
or caregivers that cause actual or threatened harm to a child. [4] Some health professionals and authors consider
neglect as part of the definition of abuse, while others do not; this is because the harm may have been
unintentional, or because the caregivers did not understand the severity of the problem, which may have been
the result of cultural beliefs about how to raise a child. [8][9] Delayed effects of child abuse and neglect,
especially emotional neglect, and the diversity of acts that qualify as child abuse, are also factors. [9]

The World Health Organization (WHO) defines child abuse and child maltreatment as "all forms of
physical and/or emotional ill-treatment, sexual abuse, neglect or negligent treatment or commercial or other
exploitation, resulting in actual or potential harm to the child's health, survival, development or dignity in the
context of a relationship of responsibility, trust or power." [10] In the United States, the Centers for Disease
Control and Prevention (CDC) uses the term child maltreatment to refer to both acts of commission (abuse),
which include "words or overt actions that cause harm, potential harm, or threat of harm to a child", and acts
of omission (neglect), meaning "the failure to provide for a child's basic physical, emotional, or educational
needs or to protect a child from harm or potential harm". [3]:11 The United States federal Child Abuse
Prevention and Treatment Act defines child abuse and neglect as, at minimum, "any recent act or failure to
act on the part of a parent or caretaker which results in death, serious physical or emotional harm, sexual
abuse or exploitation" or "an act or failure to act which presents an imminent risk of serious harm". [11][12]

Child abuse is an international phenomenon. Poverty and substance abuse are common social
problems worldwide, and no matter the location, show a similar trend in the correlation to child abuse. [citation
needed]
Although these factors can likely contribute to child maltreatment, differences in cultural perspectives
play a significant role in the treatment of children. Laws may influence the population's views on what is
acceptable - for example whether child corporal punishment is legal or not.

A study conducted by members from several Baltic and Eastern European countries, together with
specialists from the United States, examined the causes of child abuse in the countries of Latvia, Lithuania,
Macedonia and Moldova. In these countries, respectively, 33%, 42%, 18% and 43% of children reported at
least one type of child abuse. [130] According to their findings, there was a series of correlations between the
potential risk factors of parental employment status, alcohol abuse, and family size within the abuse ratings.
[131]
In three of the four countries, parental substance abuse was considerably correlated with the presence of
child abuse, and although it was a lower percentage, still showed a relationship in the fourth country
(Moldova).[131] Each country also showed a connection between the father not working outside of the home
and either emotional or physical child abuse. [131] After the fall of the communism regime, some positive
changes have followed with regard to tackling child abuse. While there is a new openness and acceptance
regarding parenting styles and close relationships with children, child abuse still remains a serious concern.
Although it is now more publicly recognized, it has certainly not ceased to exist. While controlling parenting
may be less of a concern, financial difficulty, unemployment, and substance abuse still remain to be
dominating factors in child abuse throughout Eastern Europe.[131]

These cultural differences can be studied from many perspectives. Most importantly, overall parental
behavior is genuinely different in various countries. Each culture has their own "range of acceptability," and
what one may view as offensive, others may seem as tolerable. Behaviors that are normal to some may be
viewed as abusive to others, all depending on the societal norms of that particular country.[131]
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Asian parenting perspectives, specifically, hold different ideals from American culture. Many have
described their traditions as including physical and emotional closeness that ensures a lifelong bond between
parent and child, as well as establishing parental authority and child obedience through harsh discipline.[132]
Balancing disciplinary responsibilities within parenting is common in many Asian cultures, including China,
Japan, Singapore, Vietnam and Korea.[132] To some cultures, forceful parenting may be seen as abuse, but in
other societies such as these, the use of force is looked at as a reflection of parental devotion. [132]

The differences in these cultural beliefs demonstrate the importance of examining all cross-cultural
perspectives when studying the concept of child abuse.

As of 2006, between 25,000 and 50,000 children in Kinshasa, Democratic Republic of the Congo, had
been accused of witchcraft and abandoned.[133] In Malawi it is also common practice to accuse children of
witchcraft and many children have been abandoned, abused and even killed as a result. [134] In the Nigeria,
Akwa Ibom State and Cross River State about 15,000 children were branded as witches.[135]

In April 2015, public broadcasting showed that rate of child abuse in South Korea had increased to
13% compared with the previous year, and 75% of attackers were the children's own parents. [136]

Kinds of Child Abuse

In the recent months, the examination season for school- and college-going children has been in full
swing. An annual examination was conducted by all educational boards across Pakistan. During the exam, the
government imposed Section 144 CrPC restricting thereby the assembly of unauthorized persons in a group
near examination centres within a radius of 400 metres and also banning photocopy facility in the area. But,
we witnessed its flagrant violations. “Naqal Mafia” won the battle and, through their actions, mocked the
claims made by the federal and provincial governments.

Students were openly provided with guide books, notes and each and every material that could help
them in solving the paper, and, above all, even solved papers. But, by involving in such corrupt practices, the
exam-takers were actually destroying their future with their own hands. Although a few raids by government
officers were seen yet no solid gains were seen in terms of curbing the cheating and discouraging such rogue
elements.

Alas, this didn’t happen for the first time. This might continue to happen if we don’t try to nab such
elements who are spoiling the future of children by teaching them the tricks to inoculate germs of cheating in
them.

On the contrary, many students, who worked really hard to pass the examination with flying colours,
felt utterly discouraged when they saw their fellow students likely to get high marks by employing unfair
means.

There are numerous diseases from which our education system is suffering. Few of them are: parents’
reluctance to send their children to school especially girls in rural areas, poor infrastructure of government
schools, lack of teachers as well as schools in remote areas, corporal punishment and high tuition fees charged
by private institutions.
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And when young children cannot avail themselves of educational opportunities, they join the
menacingly burgeoning child labour. On 12th June 2016, “World Day Against Child Labour” under the theme
“End Child Labour in Supply Chain” was observed with seminars, walks, workshops for spreading awareness
against child labour. But, what is perplexing is that despite all this, the number of ill-fated children in Pakistan
is still more than 10 million despite the fact that our country’s constitution states that “No child below the age
of fourteen years shall be engaged in any factory or mine or any other hazardous employment.” (Article
11(3)).

According to International Labour Organization (ILO) Survey 2012, there are 12.5 million children
working as labour in Pakistan. Reportedly, Pakistan has the 3rd largest child labour workforce in the world;
after Mauritania and Haiti. This shows the apathy of government toward this issue.

The menace of child labour shatters the dreams of country’s future generations. This is an unfortunate
fact that some parents compel their kids to work and earn money for them while some are made to send their
children for work as they couldn’t pay their debts to landlords or lenders especially in rural areas. In both
situations, minors and their future suffer.

Another issue which leaves devastating bruises on children’s physical and mental health is their
exposure to child abuse or child molestation. According to one recent study conducted by an NGO named
‘Sahil’, which works exclusively on child exploitation and sexual abuse, the incidences of child abuse
increased by 4.3% in the first six months of 2015 as compared to first half of 2014. Sahil claims that more
than 3,500 cases of child molestation were reported in 2014.

In August 2015, a major child pornography scandal that emerged from Punjab’s Kasur district
astounded the nation. Reportedly some 380 children, including girls, were molested and sodomised. Victims
were later blackmailed by a gang who had videotaped this repulsive act. Many such incidents go unreported
because people consider this will hurt their family’s prestige and reputation.

This scandal, though belatedly, opened the eyes of the government and the Senate passed a bill that
criminalised child molestation, trafficking and pornography. As per this piece of legislation, sexual assault
against minors and child pornography will be punishable by 7 years and penalty of Rs 0.7 million. This is a
welcome step and needs urgent implementation.

Malnutrition is another most common and dangerous risk factor for the children living in Pakistan.
With low social protection and economic potential, as many as 45% of all child deaths occur due to
malnutrition or due to deficiency of vitamins and minerals required for growth. More than 200 children died
in Thar district of Sindh in the first quarter of 2016 due to malnutrition. Incumbent government needs to take
urgent steps to resolve the health issues for the protection of their own children.

Child marriage is yet another issue which needs urgent attention of our legislators as well as civil
society as about 3% of girls are married before they attain the age of 15 years and 21% are married before
reaching 18 years.

The future of 1.2-1.5 million street children is also at risk. Street children are often found on urban
streets living without any shelter, economic support and parental guidance. Street children are most
vulnerable to become drug addicts, criminals and victims of child prostitution.
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Bright future of children having low economic or social profile isn’t the responsibility of solely
government and NGOs but everyone will have to play his/her role to protect the country’s future generation.
If we can’t do anything, then there is no need to come out on roads and chant slogan in favour of children to
mark “World Day Against Child Labour”. We have to shun hypocrisy and take real steps to save children
from falling prey to ills that ruin their future.

Child labor

Child labor refers to the employment of children in any work that deprives children of their
childhood, interferes with their ability to attend regular school, or is mentally, physically, socially or morally
dangerous and harmful.[172] The International Labour Organization considers such labor to be a form of
exploitation and abuse of children. [173][174] Child labor refers to those occupations which infringe the
development of children (due to the nature of the job or lack of appropriate regulation) and does not include
age appropriate and properly supervised jobs in which minors may participate. According to ILO, globally,
around 215 million children work, many full-time. Many of these children do not go to school, do not receive
proper nutrition or care, and have little or no time to play. More than half of them are exposed to the worst
forms of child labor, such as child prostitution, drug trafficking, armed conflicts and other hazardous
environments.[175] There exist several international instruments protecting children from child labor, including
the Minimum Age Convention, 1973 and the Worst Forms of Child Labour Convention.

More girls under 16 work as domestic workers than any other category of child labor, often sent to
cities by parents living in rural poverty[176] such as in restaveks in Haiti.

Child trafficking

Child trafficking is the recruitment, transportation, transfer, harbouring or receipt of children for the
purpose of exploitation.[177] Children are trafficked for purposes such as of commercial sexual exploitation,
bonded labour, camel jockeying, child domestic labour, drug couriering, child soldiering, illegal adoptions,
begging.[178][179][180] It is difficult to obtain reliable estimates concerning the number of children trafficked each
year, primarily due to the covert and criminal nature of the practice. [181][182] The International Labour
Organization estimates that 1.2 million children are trafficked each year. [183]

In Switzerland, between the 1850s and the mid-20th century, hundreds of thousands of children were
forcefully removed from their parents by the authorities, and sent to work on farms, living with new families.
These children usually came from poor or single parents, and were used as free labor by farmers, and were
known as contract children or Verdingkinder.[184][185][186][187]

Other policies of organized child abduction and selling of children in the 20th century include the
Lost children of Francoism (in Spain) and the disappearance of the children of Mothers of the Plaza de Mayo
(in Argentina).

Forced adoption

Throughout the 20th century, until the 1970s, in some Western countries, children from ethnic
minority origin were forcefully removed from their families and communities, by state and church authorities,
and forced to "assimilate". Such policies include the Stolen Generations (in Australia for Australian
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Aboriginal and Torres Strait Islander children) and the Canadian Indian residential school system (in Canada
for First Nations, Métis and Inuit), with such children often suffering severe abuse. [188][189][190][191][192][193][194]

Gender based violence against girls

Infanticide

Under natural conditions, mortality rates for girls under five are slightly lower than boys for
biological reasons. However, after birth, neglect and diverting resources to male children kills an approximate
230,000 girls under five in India each year. [195] While sex-selective abortion is more common among the
higher income population, who can access medical technology, abuse after birth, such as infanticide and
abandonment, is more common among the lower income population. Female infanticide in Pakistan is a
common practice.[196] Methods proposed to deal with the issue are baby hatches to drop off unwanted babies
and safe-haven laws, which decriminalize abandoning babies unharmed.

Female genital mutilation

Female genital mutilation (FGM) is defined by the World Health Organization (WHO) as "all
procedures that involve partial or total removal of the external female genitalia, or other injury to the female
genital organs for non-medical reasons."[198] It is practiced mainly in 28 countries in Africa, and in parts of
Asia and the Middle East.[199][200] FGM is mostly found in a geographical area ranging across Africa, from east
to west – from Somalia to Senegal, and from north to south – from Egypt to Tanzania. [201] FGM is most often
carried out on young girls aged between infancy and 15 years. [198] FGM is classified into four types, of which
type 3 – infibulation – is the most extreme form. [198] The consequences of FGM include physical, emotional
and sexual problems, and include serious risks during childbirth.[202][203] In Western countries this practice is
illegal and considered a form of child abuse. [203][204] The countries which choose to ratify the Istanbul
Convention, the first legally binding instrument in Europe in the field of violence against women and
domestic violence,[205] are bound by its provisions to ensure that FGM is criminalized. [206] In Australia, all
states and territories have outlawed FGM.[207] In the United States, performing FGM on anyone under the age
of 18 became illegal in 1996 with the Federal Prohibition of Female Genital Mutilation Act.[208]

Violence against girl students

In some parts of the world, girls are strongly discouraged from attending school, which some argue is
because they fear losing power to women.[209] They are sometimes attacked by members of the community if
they do so.[210][211][212][213] In parts of South Asia, girls schools are set on fire by vigilante groups. [214][215] Such
attacks are common in Afghanistan and Pakistan. Notable examples include the kidnapping of hundreds of
female students in Chibok in 2014 and Dapchi in 2018.

Child marriage

A child marriage is a marriage between two minors, or between an adult and a minor, often before the
minor has reached puberty. Child marriages are common in many parts of the world, especially in parts of
Asia and Africa. Since children under the age of 18 are not capable of giving "free and full consent" to
marriage, child marriages are considered a type of forced marriage. Such marriages have significant potential
to constitute a form of child abuse. [216] In many countries such practices are lawful, and even where laws
prohibit child marriage, they are often unenforced. [217]
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Sacred prostitution often involves girls being pledged to priests or those of higher castes, such as the
practice of Devadasi in South Asia or fetish slaves in West Africa. Bride kidnapping, also known as marriage
by abduction or marriage by capture, is a practice in which a male abducts the female he wants to marry. In
most countries, bride kidnapping is considered a criminal offense rather than a valid form of marriage.[218] In
many cases, the groom also rapes his kidnapped bride, in order to prevent her from returning to her family
due to shame. [219] Bride kidnapping has been practiced around the world and throughout history. It is still
practiced in parts of Central Asia, the Caucasus region, and some African countries such as Ethiopia. In
Ethiopia, marriage by abduction is widespread, and many young girls are kidnapped for marriage. [220]

India has more child brides than any nation in the world with 40% of the world total happening here.
[221]
The countries with the highest rates of child marriage are: Niger (75%), Central African Republic and
Chad (68%), and Bangladesh (66%).[222]

Violence against children with superstitious accusations

Customary beliefs in witchcraft are common in many parts of the world, even among the educated.
Anthropologists have argued that the disabled are often viewed as bad omens as raising a child with a
disability in such communities are an insurmountable hurdle. [223] This is found in Africa[224] and in
communities in the Amazon. Children who are specifically at risk include orphans, street-children, albinos,
disabled children, children who are unusually gifted, children who were born prematurely or in unusual
positions, twins[225], children of single mothers and children who express gender identity issues. [223]
Consequently, those accused of being a witch are ostracized and subjected to punishment, torture and even
murdered,[226][227] often by being buried alive or left to starve. [223] For example, in southern Ethiopia, children
with physical abnormalities are considered to be ritually impure or mingi, the latter are believed to exert an
evil influence upon others, so disabled infants have traditionally been disposed of without a proper burial. [228]
Reports by UNICEF, UNHCR, Save The Children and Human Rights Watch have highlighted the violence
and abuse towards children accused of witchcraft in Africa. [229][230][231][232] A 2010 UNICEF report describes
children as young as eight being burned, beaten and even killed as punishment for suspected witchcraft. The
report notes that accusations against children are a recent phenomenon; women and the elderly were formerly
more likely to be accused. UNICEF attributes the rise in vulnerable children being abused in this way to
increased urbanization and social disruption caused by war. [233]

Types

The World Health Organization distinguishes four types of child maltreatment: physical abuse; sexual
abuse; emotional and psychological abuse; and neglect.[13]

Physical abuse

Among professionals and the general public, people often do not agree on what behaviors constitute
physical abuse of a child.[14] Physical abuse often does not occur in isolation, but as part of a constellation of
behaviors including authoritarian control, anxiety-provoking behavior, and a lack of parental warmth. [15] The
WHO defines physical abuse as:

Intentional use of physical force against the child that results in – or has a high likelihood of resulting
in – harm for the child's health, survival, development or dignity. This includes hitting, beating, kicking,
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shaking, biting, strangling, scalding, burning, poisoning and suffocating. Much physical violence against
children in the home is inflicted with the object of punishing. [13]

Joan Durrant and Ron Ensom write that most physical abuse is physical punishment "in intent, form,
and effect".[16] Overlapping definitions of physical abuse and physical punishment of children highlight a
subtle or non-existent distinction between abuse and punishment. [17] For instance, Paulo Sergio Pinheiro
writes in the UN Secretary-General's Study on Violence Against Children:

Corporal punishment involves hitting ('smacking', 'slapping', 'spanking') children, with the hand or
with an implement – whip, stick, belt, shoe, wooden spoon, etc. But it can also involve, for example, kicking,
shaking or throwing children, scratching, pinching, biting, pulling hair or boxing ears, forcing children to stay
in uncomfortable positions, burning, scalding or forced ingestion (for example, washing children's mouths out
with soap or forcing them to swallow hot spices). [18]

Most nations with child abuse laws deem the deliberate infliction of serious injuries, or actions that
place the child at obvious risk of serious injury or death, to be illegal. [citation needed] Bruises, scratches, burns,
broken bones, lacerations - as well as repeated "mishaps," and rough treatment that could cause physical
injury - can be physical abuse.[19] Multiple injuries or fractures at different stages of healing can raise
suspicion of abuse.

The psychologist Alice Miller, noted for her books on child abuse, took the view that humiliations,
spankings and beatings, slaps in the face, etc. are all forms of abuse, because they injure the integrity and
dignity of a child, even if their consequences are not visible right away. [20]

Often, physical abuse as a child can lead to physical and mental difficulties in the future, including re-
victimization, personality disorders, post-traumatic stress disorder, dissociative disorders, depression, anxiety,
suicidal ideation, eating disorders, substance abuse, and aggression. Physical abuse in childhood has also been
linked to homelessness in adulthood.[21]

Sexual abuse

Child sexual abuse (CSA) is a form of child abuse in which an adult or older adolescent abuses a
child for sexual stimulation.[22] Sexual abuse refers to the participation of a child in a sexual act aimed toward
the physical gratification or the financial profit of the person committing the act. [19][23] Forms of CSA include
asking or pressuring a child to engage in sexual activities (regardless of the outcome), indecent exposure of
the genitals to a child, displaying pornography to a child, actual sexual contact with a child, physical contact
with the child's genitals, viewing of the child's genitalia without physical contact, or using a child to produce
child pornography.[22][24][25] Selling the sexual services of children may be viewed and treated as child abuse
rather than simple incarceration.[26]

Effects of child sexual abuse on the victim(s) include guilt and self-blame, flashbacks, nightmares,
insomnia, fear of things associated with the abuse (including objects, smells, places, doctor's visits, etc.), self-
esteem difficulties, sexual dysfunction, chronic pain, addiction, self-injury, suicidal ideation, somatic
complaints, depression,[27] post-traumatic stress disorder,[28] anxiety,[29] other mental illnesses including
borderline personality disorder[30] and dissociative identity disorder,[30] propensity to re-victimization in
adulthood,[31] bulimia nervosa,[32] and physical injury to the child, among other problems. [33] Children who are
the victims are also at an increased risk of sexually transmitted infections due to their immature immune
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systems and a high potential for mucosal tears during forced sexual contact. [34] Sexual victimization at a
young age has been correlated with several risk factors for contracting HIV including decreased knowledge of
sexual topics, increased prevalence of HIV, engagement in risky sexual practices, condom avoidance, lower
knowledge of safe sex practices, frequent changing of sexual partners, and more years of sexual activity. [34]

In the United States, approximately 15% to 25% of women and 5% to 15% of men were sexually
abused when they were children. [35][36][37] Most sexual abuse offenders are acquainted with their victims;
approximately 30% are relatives of the child, most often brothers, sisters, fathers, mothers, uncles or cousins;
around 60% are other acquaintances such as friends of the family, babysitters, or neighbours; strangers are the
offenders in approximately 10% of child sexual abuse cases. [35] In over one-third of cases, the perpetrator is
also a minor.[38]

In 1999 the BBC reported on the RAHI Foundation's survey of sexual abuse in India, in which 76%
of respondents said they had been abused as children, 40% of those stating the perpetrator was a family
member.[39]

Psychological abuse

There are multiple definitions of child psychological abuse:

 In 2013, the American Psychiatric Association (APA) added Child Psychological Abuse to the DSM-
5, describing it as "nonaccidental verbal or symbolic acts by a child's parent or caregiver that result,
or have reasonable potential to result, in significant psychological harm to the child." [40]
 In 1995, APSAC defined it as: spurning, terrorizing, isolating, exploiting, corrupting, denying
emotional responsiveness, or neglect" or "A repeated pattern of caregiver behavior or extreme
incident(s) that convey to children that they are worthless, flawed, unloved, unwanted, endangered, or
only of value in meeting another's needs"[41]
 In the United States, states laws vary, but most have laws against "mental injury" [42]
 Some have defined it as the production of psychological and social defects in the growth of a child as
a result of behavior such as loud yelling, coarse and rude attitude, inattention, harsh criticism, and
denigration of the child's personality.[19] Other examples include name-calling, ridicule, degradation,
destruction of personal belongings, torture or killing of a pet, excessive criticism, inappropriate or
excessive demands, withholding communication, and routine labeling or humiliation.[43]

In 2014, the APA stated that:[44]

 "Childhood psychological abuse [is] as harmful as sexual or physical abuse."

 "Nearly 3 million U.S. children experience some form of [psychological] maltreatment annually."
 Psychological maltreatment is "the most challenging and prevalent form of child abuse and neglect."
 "Given the prevalence of childhood psychological abuse and the severity of harm to young victims, it
should be at the forefront of mental health and social service training"

In 2015, additional research confirmed these 2014 statements of the APA. [45][46]

Victims of emotional abuse may react by distancing themselves from the abuser, internalizing the
abusive words, or fighting back by insulting the abuser. Emotional abuse can result in abnormal or disrupted
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attachment development, a tendency for victims to blame themselves (self-blame) for the abuse, learned
helplessness, and overly passive behavior.[43]

Neglect

Child neglect is the failure of a parent or other person with responsibility for the child, to provide
needed food, clothing, shelter, medical care, or supervision to the degree that the child's health, safety or well-
being may be threatened with harm. Neglect is also a lack of attention from the people surrounding a child,
and the non-provision of the relevant and adequate necessities for the child's survival, which would be a
lacking in attention, love, and nurture.[19]

Some observable signs of child neglect include: the child is frequently absent from school, begs or
steals food or money, lacks needed medical and dental care, is consistently dirty, or lacks sufficient clothing
for the weather.[47] The 2010 Child Maltreatment Report (NCANDS), a yearly United States federal
government report based on data supplied by state Child Protective Services (CPS) Agencies in the U.S.,
states, "as in prior years, neglect was the most common form of maltreatment". [48]

Neglectful acts can be divided into six sub-categories: [7]

 Supervisory neglect: characterized by the absence of a parent or guardian which can lead to physical
harm, sexual abuse or criminal behavior;
 Physical neglect: characterized by the failure to provide the basic physical necessities, such as a safe
and clean home;
 Medical neglect: characterized by the lack of providing medical care;
 Emotional neglect: characterized by a lack of nurturance, encouragement and support;
 Educational neglect: characterized by the caregivers lack to provide an education and additional
resources to actively participate in the school system; and
 Abandonment: when the parent or guardian leaves a child alone for a long period of time without a
babysitter.

Neglected children may experience delays in physical and psychosocial development, possibly
resulting in psychopathology and impaired neuropsychological functions including executive function,
attention, processing speed, language, memory and social skills.[49] Researchers investigating maltreated
children have repeatedly found that neglected children in foster and adoptive populations manifest different
emotional and behavioral reactions to regain lost or secure relationships and are frequently reported to have
disorganized attachments and a need to control their environment. Such children are not likely to view
caregivers as being a source of safety, and instead typically show an increase in aggressive and hyperactive
behaviors which may disrupt healthy or secure attachment with their adopted parents. These children have
apparently learned to adapt to an abusive and inconsistent caregiver by becoming cautiously self-reliant, and
are often described as glib, manipulative and disingenuous in their interactions with others as they move
through childhood.[50] Children who are victims of neglect have a more difficult time forming and maintaining
relationships, such as romantic or friendship, later in life due to the lack of attachment they had in their earlier
stages of life.
 12
Child Abuse
Effects

Child abuse can result in immediate adverse physical effects but it is also strongly associated with
developmental problems[51] and with many chronic physical and psychological effects, including subsequent
ill-health, including higher rates of chronic conditions, high-risk health behaviors and shortened lifespan. [52][53]

Maltreated children may grow up to be maltreating adults. [54][55][56] A 1991 source reported that studies
indicate that 90 percent of maltreating adults were maltreated as children. [57] Almost 7 million American
infants receive child care services, such as day care, and much of that care is poor. [51]

Emotional

Child abuse can cause a range of emotional effects. Children who are constantly ignored, shamed,
terrorized or humiliated suffer at least as much, if not more, than if they are physically assaulted. [58] According
to the Joyful Heart Foundation, brain development of the child is greatly influenced and responds to the
experiences with families, caregivers, and the community. [59] Abused children can grow up experiencing
insecurities, low self-esteem, and lack of development. Many abused children experience ongoing difficulties
with trust, social withdrawal, trouble in school, and forming relationships. [58]

Babies and young children can be affected differently by abuse than their older counterparts. Babies
and pre-school children who are being emotionally abused or neglected may be overly affectionate towards
strangers or people they haven't known for very long. [60] They can lack confidence or become anxious, appear
to not have a close relationship with their parent, exhibit aggressive behavior or act nasty towards other
children and animals.[60] Older children may use foul language or act in a markedly different way to other
children at the same age, struggle to control strong emotions, seem isolated from their parents, lack social
skills or have few, if any, friends.[60]

Children can also experience reactive attachment disorder (RAD). RAD is defined as markedly
disturbed and developmentally inappropriate social relatedness, that usually begins before the age of 5 years.
[61]
RAD can present as a persistent failure to start or respond in a developmentally appropriate fashion to
most social situations. The long-term impact of emotional abuse has not been studied widely, but recent
studies have begun to document its long-term consequences. Emotional abuse has been linked to increased
depression, anxiety, and difficulties in interpersonal relationships (Spertus, Wong, Halligan, & Seremetis,
2003).[61] Victims of child abuse and neglect are more likely to commit crimes as juveniles and adults. [62]

Domestic violence also takes its toll on children; although the child is not the one being abused, the
child witnessing the domestic violence is greatly influential as well. Research studies conducted such as the
"Longitudinal Study on the Effects of Child Abuse and Children's Exposure to Domestic Violence", show that
36.8% of children engage in felony assault compared to the 47.5% of abused/assaulted children. Research has
shown that children exposed to domestic violence increases the chances of experienced behavioral and
emotional problems (depression, irritability, anxiety, academic problems, and problems in language
development).[63]

Overall, emotional effects caused by child abuse and even witnessing abuse can result in long-term
and short-term effects that ultimately affect a child's upbringing and development.
 13
Child Abuse
Physical

The immediate physical effects of abuse or neglect can be relatively minor (bruises or cuts) or severe
(broken bones, hemorrhage, or even death). In some cases the physical effects are temporary; however, the
pain and suffering they cause a child should not be discounted. Rib fractures may be seen with physical abuse,
and if present may increase suspicion of abuse, but are found in a small minority of children with
maltreatment-related injuries.[64][65]

The long-term impact of child abuse and neglect on physical health and development can be:

 Shaken baby syndrome. Shaking a baby is a common form of child abuse that often results in
permanent neurological damage (80% of cases) or death (30% of cases). [66] Damage results from
intracranial hypertension (increased pressure in the skull) after bleeding in the brain, damage to the
spinal cord and neck, and rib or bone fractures. [67]
 Impaired brain development. Child abuse and neglect have been shown, in some cases, to cause
important regions of the brain to fail to form or grow properly, resulting in impaired development. [68]
[69]
These alterations in brain maturation have long-term consequences for cognitive, language, and
academic abilities.[70]
 Poor physical health. In addition to possible immediate adverse physical effects, household
dysfunction and childhood maltreatment are strongly associated with many chronic physical and
psychological effects, including subsequent ill-health in childhood, [71] adolescence[72] and adulthood,
with higher rates of chronic conditions, high-risk health behaviors and shortened lifespan. [52][53] Adults
who experienced abuse or neglect during childhood are more likely to suffer from physical ailments
such as allergies, arthritis, asthma, bronchitis, high blood pressure, and ulcers. [53][73][74][75] There may be
a higher risk of developing cancer later in life, [76] as well as possible immune dysfunction.[77]
 Exposure to violence during childhood is associated with shortened telomeres and with reduced
telomerase activity.[78] The increased rate of telomere length reduction correlates to a reduction in
lifespan of 7 to 15 years.[77]
 Data from a recent study supports previous findings that specific neurobiochemical changes are
linked to exposure to violence and abuse, several biological pathways can possibly lead to the
development of illness, and certain physiological mechanisms can moderate how severe illnesses
become in patients with past experience with violence or abuse. [79]
 Recent studies give evidence of a link between stress occurring early in life and epigenetic
modifications that last into adulthood.[69][80]

Adverse Childhood Experiences Study

Possible ways for adverse childhood experiences such as abuse and neglect to influence health and
well-being throughout the lifespan, according to the Centers for Disease Control and Prevention.[81]

The Adverse Childhood Experiences Study is a long-running investigation into the relationship
between childhood adversity, including various forms of abuse and neglect, and health problems in later life.
The initial phase of the study was conducted in San Diego, California from 1995 to 1997.[81] The World
Health Organization summarizes the study's findings as follows:

The Adverse Childhood Experiences (ACE) study, in which some 17,300 middle-aged, middle-class
and mostly employed residents of the state of California participated, suggests that childhood maltreatment
 14
Child Abuse
and household dysfunction contribute to the development – decades later – of the chronic diseases that are the
most common causes of death and disability in the United States. The study examined the long-term effects of
maltreatment and household dysfunction during childhood, including: psychological, physical and sexual
abuse; violence against the mother; and living with household members who were either substance abusers,
mentally ill or suicidal, or else had been in prison. A strong relationship was seen between the number of
adverse experiences (including physical and sexual abuse in childhood) and self-reports of cigarette smoking,
obesity, physical inactivity, alcoholism, drug abuse, depression, attempted suicide, sexual promiscuity and
sexually transmitted diseases in later life. Furthermore, people who reported higher numbers of negative
experiences in childhood were much more likely to exhibit multiple health-risk behaviours, which the study
suggested were adopted as coping devices. Similarly, the more adverse childhood experiences reported, the
more likely the person was to have heart disease, cancer, stroke, diabetes, skeletal fractures, liver disease and
poor health as an adult. Maltreatment and other adverse childhood experiences may thus be among the basic
factors that underlie health risks, illness and death, and could be identified by routine screening of all patients.
Although the ACE study and its findings relate to a specific population within the United States, it is
reasonable to assume that similar trends might be found in countries with different levels of economic and
social development.[13]

A long-term study of adults retrospectively reporting adverse childhood experiences including verbal,
physical and sexual abuse, as well as other forms of childhood trauma found 25.9% of adults reported verbal
abuse as children, 14.8% reported physical abuse, and 12.2% reported sexual abuse. Data from the Centers for
Disease Control and Prevention (CDC) and Behavioral Risk Factor Surveillance System corroborate these
high rates.[82] There is a high correlation between the number of different adverse childhood experiences
(A.C.E.s) and risk for poor health outcomes in adults including cancer, heart attack, mental illness, reduced
longevity drug and alcohol abuse. [83] An anonymous self-reporting survey of Washington State students finds
6–7% of 8th, 10th and 12th grade students actually attempt suicide. Rates of depression are twice as high.
Other risk behaviors are even higher. [84] There is a relationship between child physical and sexual abuse and
suicide.[85] For legal and cultural reasons as well as fears by children of being taken away from their parents
most childhood abuse goes unreported and unsubstantiated.

It has been discovered that childhood abuse can lead to the addiction of drugs and alcohol in
adolescence and adult life. Studies show that any type of abuse experienced in childhood can cause
neurological changes making an individual more prone to addictive tendencies. A significant study examined
900 court cases of children who had experienced sexual and physical abuse along with neglect. The study
found that a large sum of the children who were abused are now currently addicted to alcohol. This case study
outlines how addiction is a significant effect of childhood abuse. [86]

Psychological

Children who have a history of neglect or physical abuse are at risk of developing psychiatric
problems,[87][88] or a disorganized attachment style.[89][90][91] In addition, children who experience child abuse or
neglect are 59% more likely to be arrested as juveniles, 28% more likely to be arrested as adults, and 30%
more likely to commit violent crime. [92] Disorganized attachment is associated with a number of
developmental problems, including dissociative symptoms,[93] as well as anxiety, depressive, and acting out
symptoms.[94][95] A study by Dante Cicchetti found that 80% of abused and maltreated infants exhibited
symptoms of disorganized attachment.[96][97] When some of these children become parents, especially if they
suffer from posttraumatic stress disorder (PTSD), dissociative symptoms, and other sequelae of child abuse,
they may encounter difficulty when faced with their infant and young children's needs and normative distress,
 15
Child Abuse
which may in turn lead to adverse consequences for their child's social-emotional development. [98][99]
Additionally, children may find it difficult to feel empathy towards themselves or others, which may cause
them to feel alone and unable to make friends. [63] Despite these potential difficulties, psychosocial
intervention can be effective, at least in some cases, in changing the ways maltreated parents think about their
young children.[100]

Victims of childhood abuse also suffer from different types of physical health problems later in life.
Some reportedly suffer from some type of chronic head, abdominal, pelvic, or muscular pain with no
identifiable reason.[101] Even though the majority of childhood abuse victims know or believe that their abuse
is, or can be, the cause of different health problems in their adult life, for the great majority their abuse was
not directly associated with those problems, indicating that sufferers were most likely diagnosed with other
possible causes for their health problems, instead of their childhood abuse. [101] One long-term study found that
up to 80% of abused people had at least one psychiatric disorder at age 21, with problems including
depression, anxiety, eating disorders, and suicide attempts. [102] One Canadian hospital found that between 36%
and 76% of women mental health outpatients had been sexually abused, as had 58% of women and 23% of
men schizophrenic inpatients. [103] A recent study has discovered that a crucial structure in the brain's reward
circuits is compromised by childhood abuse and neglect, and predicts Depressive Symptoms later in life. [104]

In the case of 23 of the 27 illnesses listed in the questionnaire of a French INSEE survey, some
statistically significant correlations were found between repeated illness and family traumas encountered by
the child before the age of 18 years. According to Georges Menahem, the French sociologist who found out
these correlations by studying health inequalities, these relationships show that inequalities in illness and
suffering are not only social. Health inequality also has its origins in the family, where it is associated with
the degrees of lasting affective problems (lack of affection, parental discord, the prolonged absence of a
parent, or a serious illness affecting either the mother or father) that individuals report having experienced in
childhood.[105]

Many children who have been abused in any form develop some sort of psychological problem. These
problems may include: anxiety, depression, eating disorders, OCD, co-dependency, or even a lack of human
connections. There is also a slight tendency for children who have been abused to become child abusers
themselves. In the U.S. in 2013, of the 294,000 reported child abuse cases only 81,124 received any sort of
counseling or therapy. Treatment is greatly important for abused children. [106]

On the other hand, there are some children who are raised in child abuse, but who manage to do unexpectedly
well later in life regarding the preconditions. Such children have been termed dandelion children, as inspired
from the way that dandelions seem to prosper irrespective of soil, sun, drought, or rain. [107] Such children (or
currently grown-ups) are of high interest in finding factors that mitigate the effects of child abuse.

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 16
Child Abuse
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Key facts:

 Violence against children includes all forms of violence against people under 18 years old, whether
perpetrated by parents or other caregivers, peers, romantic partners, or strangers.
 Globally, it is estimated that up to 1 billion children aged 2–17 years, have experienced physical,
sexual, or emotional violence or neglect in the past year (1).
 Experiencing violence in childhood impacts lifelong health and well-being.
 Target 16.2 of the 2030 Agenda for Sustainable Development is to “end abuse, exploitation,
trafficking and all forms of violence against, and torture of, children”.
 Evidence from around the world shows that violence against children can be prevented.

Types of violence against children

Most violence against children involves at least one of six main types of interpersonal violence that tend to
occur at different stages in a child’s development.

 Maltreatment (including violent punishment) involves physical, sexual and psychological/emotional

violence; and neglect of infants, children and adolescents by parents, caregivers and other authority
figures, most often in the home but also in settings such as schools and orphanages.
 Bullying (including cyber-bullying) is unwanted aggressive behaviour by another child or group of
children who are neither siblings nor in a romantic relationship with the victim. It involves repeated
physical, psychological or social harm, and often takes place in schools and other settings where
children gather, and online.
 Youth violence is concentrated among children and young adults aged 10–29 years, occurs most often
in community settings between acquaintances and strangers, includes bullying and physical assault
with or without weapons (such as guns and knives), and may involve gang violence.
 Intimate partner violence (or domestic violence) involves physical, sexual and emotional violence by
an intimate partner or ex-partner. Although males can also be victims, intimate partner violence
disproportionately affects females. It commonly occurs against girls within child marriages and
early/forced marriages. Among romantically involved but unmarried adolescents it is sometimes
called “dating violence”.
 Sexual violence includes non-consensual completed or attempted sexual contact and acts of a sexual
nature not involving contact (such as voyeurism or sexual harassment); acts of sexual trafficking
committed against someone who is unable to consent or refuse; and online exploitation.
 Emotional or psychological violence includes restricting a child’s movements, denigration, ridicule,
threats and intimidation, discrimination, rejection and other non-physical forms of hostile treatment.

When directed against girls or boys because of their biological sex or gender identity, any of these types of
violence can also constitute gender-based violence.
 17
Child Abuse
Impact of violence

Violence against children has lifelong impacts on health and well-being of children, families,
communities, and nations. Violence against children can:

 Result in death. Homicide, which often involves weapons such as knives and firearms, is among the
top three causes of death in adolescents, with boys comprising over 80% of victims and perpetrators.
 Lead to severe injuries. For every homicide, there are hundreds of predominantly male victims of
youth violence who sustain injuries because of physical fighting and assault.
 Impair brain and nervous system development. Exposure to violence at an early age can impair
brain development and damage other parts of the nervous system, as well as the endocrine,
circulatory, musculoskeletal, reproductive, respiratory and immune systems, with lifelong
consequences. As such, violence against children can negatively affect cognitive development and
results in educational and vocational under-achievement.
 Result in negative coping and health risk behaviours. Children exposed to violence and other
adversities are substantially more likely to smoke, misuse alcohol and drugs, and engage in high-risk
sexual behaviour. They also have higher rates of anxiety, depression, other mental health problems
and suicide.
 Lead to unintended pregnancies, induced abortions, gynaecological problems, and sexually
transmitted infections, including HIV.
 Contribute to a wide range of non-communicable diseases as children grow older. The increased
risk for cardiovascular disease, cancer, diabetes, and other health conditions is largely due to the
negative coping and health risk behaviours associated with violence.
 Impact opportunities and future generations. Children exposed to violence and other adversities
are more likely to drop out of school, have difficulty finding and keeping a job, and are at heightened
risk for later victimization and/or perpetration of interpersonal and self-directed violence, by which
violence against children can affect the next generation.

Causes of Child Abuses

Child Abuse is a heinous crime which is increasing daily, if not hourly.Keeping historical facts in
mind, Kasur alone has witnessed 12 cases of child abuse in last 12 months.The ratio of this crime has
increased more than 2%-3% in the previous year in Pakistan.

Setting aside all emotions,feelings and sentiments, we have to find the root causes of these acts. There
is a need to discuss practical steps that can help in the eradication of child abuse from our society.Here are
some reasons behind abuse in Pakistan:

1) Lack of awareness and care by parents:

In rural parts of the country we often hear of poverty stricken families with large number of children
and as a result of which the parents often fails to give adequate care to each and every children and the
children eventually becomes victim of various crimes... Sometimes the parents also sell of their own children
in the hands of criminal minded people owing to poverty
 18
Child Abuse
2) Poverty:

Poverty also forces many people to choose the path of crimes and children forms bulk of their preys
because these people thinks that they can get away by committing crimes against children

3) Corrupt government officials:

Well there are many laws, facilities and other incentives that are announced and offered by the
government for the protection of childeren but the bitter reality is that a vast majority of these incentives fails
to reach their target i.e. children of the nation, courtesy the evil minded corrupt officials who are responsible
for bringing these incentives to the children

4)Society:

The society is equally responsible for the increase in crime rates against children... People who
indulge kids in heinous crimes, people who overlook the crimes taking place etc are all responsible the current
scenario.. A dramatic increase in rape incidents against children is another area of concern

5)Internet:

A lot of inappropriate stuff are just a click away in internet and more care and stricter measures must
be taken so that these stuff do not reach the non desirable audiences

6)Television

The crime shows that are aired in a lot of entertainment channels have both pros and cons... In one
hand it creates awareness among people to stay safe while on the other hand it provides criminal minded
people with new ideas to prey on the kids..

The vulgar scenes portrayed in movies are enough to corrupt young minds. Everyone idealizes the
lifestyle of film heroes and tries to be like them. These movies may include content that could demoralize our
society, for instance, extra marital relationships.

Other Reasons

1) No rule of law

In this era, the law is dead. Nobody has fear of law enforcement agencies in this country as everyone
is corrupt. People do not report cases because they believe that the police will bring more troubles for their
family. The culprits are bailed and released due to insufficient evidence and poor investigation by police.
There should be exemplary punishment for culprits. The state must take immediate actions to restore the
confidence of people, especially in our law enforcement agencies.

2) Late marriages 
 19
Child Abuse
Everyone has created the wrong concept of enjoying life. We have made marriage too difficult to
perform. We have set high ideals that create barriers in getting married in time. But man cannot control his
sexual desires; hence the only outlet is to resort to illegal activities and crimes.

3) Lack of sex education 

Sex education is still a taboo in our country. We believe that this is a matter to discuss in person by
only the parents or guardians of children. If we educate our children about dos and don’ts, then it would be
easy for them to avoid such elements. This will ensure that children receive the necessary education,
regardless of their parents teaching them.

4) Pornography

It has destroyed the lives of young individuals. Pornographic content is very common over the
internet. If you are looking for some stuff to complete your college assignment, it is not uncommon to see
pornographic content appear in the form of ads or window pop-ups. The government should ban this sort of
stuff in every possible way.

We have forgotten our ethical values and teachings of Islam. I have pointed out some causes of child
abuse and I believe that you are logical enough to make the right choices.

Causes

Child abuse is a complex phenomenon with multiple causes. [108] No single factor can be identified as
to why some adults behave violently toward children. The World Health Organization (WHO) and the
International Society for Prevention of Child Abuse and Neglect (ISPCAN) identify multiple factors at the
level of the individual, their relationships, their local community, and their society at large, that combine to
influence the occurrence of child maltreatment. At the individual level, such factors include age, sex, and
personal history, while at the level of society, factors contributing to child maltreatment include cultural
norms encouraging harsh physical punishment of children, economic inequality, and the lack of social safety
nets.[13] WHO and ISPCAN state that understanding the complex interplay of various risk factors is vital for
dealing with the problem of child maltreatment.[13]

The American psychoanalyst Elisabeth Young-Bruehl maintains that harm to children is justified and
made acceptable by widely held beliefs in children's inherent subservience to adults, resulting in a largely
unacknowledged prejudice against children she terms childism. She contends that such prejudice, while not
the immediate cause of child maltreatment, must be investigated in order to understand the motivations
behind a given act of abuse, as well as to shed light on societal failures to support children's needs and
development in general.[109]:4–6 Founding editor of the International Journal of Children's Rights, Michael
Freeman, also argues that the ultimate causes of child abuse lie in prejudice against children, especially the
view that human rights do not apply equally to adults and children. He writes, "the roots of child abuse lie not
in parental psycho-pathology or in socio-environmental stress (though their influences cannot be discounted)
but in a sick culture which denigrates and depersonalizes, which reduces children to property, to sexual
objects so that they become the legitimate victims of both adult violence and lust". [110]
 20
Child Abuse
Parents who physically abuse their spouses are more likely than others to physically abuse their
children.[111] However, it is impossible to know whether marital strife is a cause of child abuse, or if both the
marital strife and the abuse are caused by tendencies in the abuser. [111] Sometimes, parents set expectations for
their child that are clearly beyond the child's capability. When parents' expectations are far beyond what is
appropriate to the child (e.g., preschool children who are expected to be totally responsible for self-care or
provision of nurturance to parents) the resulting frustration caused by the child's non-compliance is believed
to function as a contributory if not necessary cause of child abuse. [112]

Most acts of physical violence against children are undertaken with the intent to punish.[113] In the
United States, interviews with parents reveal that as many as two thirds of documented instances of physical
abuse begin as acts of corporal punishment meant to correct a child's behavior, while a large-scale Canadian
study found that three quarters of substantiated cases of physical abuse of children have occurred within the
context of physical punishment.[114] Other studies have shown that children and infants who are spanked by
parents are several times more likely to be severely assaulted by their parents or suffer an injury requiring
medical attention. Studies indicate that such abusive treatment often involves parents attributing conflict to
their child's willfulness or rejection, as well as "coercive family dynamics and conditioned emotional
responses".[16] Factors involved in the escalation of ordinary physical punishment by parents into confirmed
child abuse may be the punishing parent's inability to control their anger or judge their own strength, and the
parent being unaware of the child's physical vulnerabilities. [15]

Some professionals argue that cultural norms that sanction physical punishment are one of the causes
of child abuse, and have undertaken campaigns to redefine such norms. [115][116][117]

Children resulting from unintended pregnancies are more likely to be abused or neglected. [118][119] In
addition, unintended pregnancies are more likely than intended pregnancies to be associated with abusive
relationships,[120] and there is an increased risk of physical violence during pregnancy. [121] They also result in
poorer maternal mental health,[121] and lower mother-child relationship quality.[121]

There is some limited evidence that children with moderate or severe disabilities are more likely to be
victims of abuse than non-disabled children. [122] A study on child abuse sought to determine: the forms of
child abuse perpetrated on children with disabilities; the extent of child abuse; and the causes of child abuse
of children with disabilities. A questionnaire on child abuse was adapted and used to collect data in this study.
Participants comprised a sample of 31 pupils with disabilities (15 children with vision impairment and 16
children with hearing impairment) selected from special schools in Botswana. The study found that the
majority of participants were involved in doing domestic chores. They were also sexually, physically and
emotionally abused by their teachers. This study showed that children with disabilities were vulnerable to
child abuse in their schools.[123]

Substance abuse can be a major contributing factor to child abuse. One U.S. study found that parents
with documented substance abuse, most commonly alcohol, cocaine, and heroin, were much more likely to
mistreat their children, and were also much more likely to reject court-ordered services and treatments. [124]
Another study found that over two-thirds of cases of child maltreatment involved parents with substance
abuse problems. This study specifically found relationships between alcohol and physical abuse, and between
cocaine and sexual abuse.[125] Also parental stress caused by substance increases the likelihood of the minor
exhibiting internalizing and externalizing behaviors. [126] Although the abuse victim does not always realize the
abuse is wrong, the internal confusion can lead to chaos. Inner anger turns to outer frustration. Once aged
 21
Child Abuse
17/18, drink and drugs are used to numb the hurt feelings, nightmares and daytime flashbacks. Acquisitive
crimes to pay for the chemicals are inevitable if the victim is unable to find employment. [127]

Unemployment and financial difficulties are associated with increased rates of child abuse. [128] In
2009 CBS News reported that child abuse in the United States had increased during the economic recession. It
gave the example of a father who had never been the primary care-taker of the children. Now that the father
was in that role, the children began to come in with injuries. [129]

Steps taken for Elimination of Children abuse In Pakistan

The abduction, rape and murder of little Zainab has not only robbed one family of a child but has also
ravaged this country. She was not the first child we failed to protect.

Child abuse, particularly sexual violence, is one of the most pressing social issues facing our nation.
Such crimes are tragic reminders of the failure of the state, and call for a complete overhaul of our intent
towards child protection.

The majority of the child abuse cases in Pakistan are registered under the Zina Ordinance, 1979,
which prohibits all forms of illegal sexual intercourse including rape. The Punjab Suppression of Prostitution
Ordinance, 1961, the Sindh Children Act, 1955, and the Punjab Children Ordinance, 1983, all cover some
forms of child abuse.

In 1990, Pakistan ratified the UN Convention on the Rights of the Child (UNCRC), committing itself
to implement the convention’s provisions through harmonised policies, legislation and plans of action, and to
report progress to the UN Committee on the Rights of the Child every five years.

After revelations of a child pornography ring in Kasur in 2015, 20 people were arrested in connection
with the criminal scandal. At the time, only rape and sodomy were punishable under the law. As a result,
several new provisions were added to our legislature to strengthen our child protection framework.

Let little Zainab be the last child we fail as a state.

The first amendment to the Pakistan Penal Code in relation to child abuse in 2016 criminalised sexual
assault against minors, child pornography and trafficking. Sexual assault is now punishable by up to seven
years in prison (previously, only rape was criminalised), and child pornography (previously not included in
the law) is punishable by seven years in prison and a fine of Rs700,000.

Prosecution for rape has also benefited from recent amendments. Sections 164(A) and 164(B),
inserted into the Code of Criminal Procedure in 2016, enable authorities to obtain and use DNA evidence.
Section 161(A) also guarantees a rape victim the right to legal representation.

Despite a complex framework, the legislative tools we have at our disposal have not been utilised
effectively, and have thus far failed to deter perpetrators of violence against children. While further
specialised legislation is needed, as the situation stands, our biggest failure in protecting our children is not
lack of legislation but lack of its enforcement.
 22
Child Abuse
The depravity that leads to such crimes occurring, especially considering the circumstances of
Zainab’s case, calls for further action. The preamble to the Anti-Terrorism Act, 1997, introduces the act “to
provide for the prevention of terrorism, sectarian violence and for speedy trial of heinous offences”. Based on
these goals, it is high time that rape and sexual violence against children were added to Section 6 of the ATA
so that it may be prosecuted with the same vigilance given to perpetrators of acts of terror.

The DNA profile of all citizens should be included in the Nadra database.

It is also necessary to properly train judicial officials and law-enforcement agencies. According to
Human Rights Watch, “Even a well-drafted law is unlikely to achieve its objectives in the absence of a
trained and accountable police force, adequately staffed probation departments, judges that are familiar with
the applicable domestic law and international standards, and facilities that are designed for the guidance and
care of juvenile offenders.”

The juvenile justice system also requires attention.

The age defining a child should be brought up in accordance to what is prescribed internationally.
Secondly, there should be equal treatment for children regardless of gender — as for zina crimes, female
victims should no longer be punished for an abuse inflicted upon them. Thirdly, there should be stricter
punishment against perpetrators of sexual violence against children. And, as per Article 39 of the UNCRC,
the government should take all necessary measures to promote the psychological and physical recovery of
child victims. Currently, rehabilitative measures are underdeveloped, if not non-existent. There is an urgent
need to establish such facilities throughout the country.

There must be an overhaul of the system at every level so that the authorities are not only successful
in recovering children, but also in catching and punishing culprits. The crimes against Zainab reflect the
absolute failure of the police, expose the lack of foresight in our legislature, and have resulted in the public
losing all faith in this government.

If we wait much longer to effect concrete change, we will also lose faith in ourselves. The fate of
young Zainab, loving daughter, thoughtful sister, cherished granddaughter, passionate student — human
being — should be etched in our collective conscience. Let her be the last child we fail as a state.

Recommendations

A particular challenge arises where child protection professionals are assessing families where
neglect is occurring. Professionals conducting assessments of families where neglect is taking place are said
to sometimes make the following errors:[139]

 Failure to ask the right types of question, including

o Whether neglect is occurring;
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Child Abuse
o Why neglect is occurring;
o What the situation is like for the child;
o Whether improvements in the family are likely to be sustained;
o What needs to be done to ensure the long-term safety of the child?

Prevention

A support-group structure is needed to reinforce parenting skills and closely monitor the child's well-
being. Visiting home nurse or social-worker visits are also required to observe and evaluate the progress of
the child and the caretaking situation.

The support-group structure and visiting home nurse or social-worker visits are not mutually
exclusive. Many studies have demonstrated that the two measures must be coupled together for the best
possible outcome.[140]

Children's school programs regarding "good touch … bad touch" can provide children with a forum
in which to role-play and learn to avoid potentially harmful scenarios. Pediatricians can help identify children
at risk of maltreatment and intervene with the aid of a social worker or provide access to treatment that
addresses potential risk factors such as maternal depression. [141] Videoconferencing has also been used to
diagnose child abuse in remote emergency departments and clinics. [142] Unintended conception increases the
risk of subsequent child abuse, and large family size increases the risk of child neglect. [119] Thus, a
comprehensive study for the National Academy of Sciences concluded that affordable contraceptive services
should form the basis for child abuse prevention. [119][143] "The starting point for effective child abuse
programming is pregnancy planning," according to an analysis for US Surgeon General C. Everett Koop.[119]
[144]

Child sexual abuse prevention programmes were developed in the United States of America during
the 1970s and originally delivered to children. Programmes delivered to parents were developed in the 1980s
and took the form of one-off meetings, two to three hours long [145][146][147][148][149][150]. In the last 15 years, web-
based programmes have been developed.

April has been designated Child Abuse Prevention Month in the United States since 1983. [151] U.S.
President Barack Obama continued that tradition by declaring April 2009 Child Abuse Prevention Month. [152]
One way the Federal government of the United States provides funding for child-abuse prevention is through
Community-Based Grants for the Prevention of Child Abuse and Neglect (CBCAP). [153]

Resources for child-protection services are sometimes limited. According to Hosin (2007), "a
considerable number of traumatized abused children do not gain access to protective child-protection
strategies."[154] Briere (1992) argues that only when "lower-level violence" of children [clarification needed] ceases to
be culturally tolerated will there be changes in the victimization and police protection of children.[155]

Findings from recent research support the importance of family relationships in the trajectory of a
child’s life: family-targeted interventions are important for improving long-term health, particularly in
communities that are socioeconomically disadvantaged. [156]
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Child Abuse
Prevention and response

Violence against children can be prevented. Preventing and responding to violence against children
requires that efforts systematically address risk and protective factors at all four interrelated levels of risk
(individual, relationship, community, society).

Under the leadership of WHO, a group of 10 international agencies have developed and endorsed an
evidence-based technical package called INSPIRE: Seven strategies for ending violence against children. The
package aims to help countries and communities achieve SDG Target 16.2 on ending violence against
children. Each letter of the word INSPIRE stands for one of the strategies, and most have been shown to have
preventive effects across several different types of violence, as well as benefits in areas such as mental health,
education and crime reduction.

 INSPIRE: Seven strategies for ending violence against children

The seven strategies are:

 Implementation and enforcement of laws (for example, banning violent discipline and restricting
access to alcohol and firearms);
 Norms and values change (for example, altering norms that condone the sexual abuse of girls or
aggressive behaviour among boys);
 Safe environments (such as identifying neighbourhood “hot spots” for violence and then addressing
the local causes through problem-oriented policing and other interventions);
 Parental and caregiver support (for example, providing parent training to young, first time parents);
 Income and economic strengthening (such as microfinance and gender equity training);
 Response services provision (for example, ensuring that children who are exposed to violence can
access effective emergency care and receive appropriate psychosocial support); and
 Education and life skills (such as ensuring that children attend school, and providing life and social
skills training).

WHO response

A May 2016 World Health Assembly resolution endorsed the first ever WHO Global plan of action
on strengthening the role of the health system within a national multisectoral response to address
interpersonal violence, in particular against women and girls, and against children.

According to this plan, WHO in collaboration with Member States and other partners, is committed to:

 Monitoring the global magnitude and characteristics of violence against children and supporting
country efforts to document and measure such violence.
 Maintaining an electronic information system that summarizes the scientific data on the burden, risk
factors and consequences of violence against children, and the evidence for its preventability.
 Developing and disseminating evidence-based technical guidance documents, norms and standards
for preventing and responding to violence against children.
 Regularly publishing global status reports on country efforts to address violence against children
through national policies and action plans, laws, prevention programmes and response services.
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Child Abuse
 Supporting countries and partners in implementing evidence-based prevention and response
strategies, such as those included in INSPIRE: Seven strategies for ending violence against children.
 Collaborating with international agencies and organizations to reduce and eliminate violence against
children globally, through initiatives such as the Global Partnership to End Violence against Children,
Together for Girls and the Violence Prevention Alliance.

Prevention and Elimination of Child Sexual Abuse

Prevention measures against child sexual abuse must be improved an increased in number. The most
important is the development in the criminal justice system regarding the child sexual abuse. The state cannot
punish citizens without specific laws warning them that particular conduct will be dealt with by way of
punishment in a particular manner. The criminal law is the strongest arm of all the normative systems of the
society by which it punishes, controls, curbs and prevents crime in the society. The evil has lived with the
mankind from its beginning and the society has to make continuous efforts to keep it at bay and the criminal
law keeps undergoing change so as to meet the new challenges. The basic purpose of the ciminal justice is to
save the society from evil, to free it of crime. The criminal law has to be interpreted, applied and enforced in a
manner so as to acheive these objectives.

We need a comprehensive criminal justice system in order to eliminate child sexual abuse from our
society, and this object should only be acheived by awarding punishment to deter people from committing
this crime. Child molestation should be included as an offence in the Anti-Terrorism Act, 1997.

Judges are particularly accountable to their conscious and more than this to Almighty Allah. A crime
free society can only be set up if every citizen irrespective of his colour, creed, religion and status is provided
justice and in this respect court can play a vital major role.

Campaigns should be launched to aware society about the child sexual abuse and exploitation.

Media and NGO’s should play their effective rols in these campaigns.