The consequences of child abuse and neglect differ by the age of the child. During childhood some of the major consequences of maltreatment include problematic school performance and lowered attention to social cues. Researchers have found that children whose parents are "psychologically unavailable" function poorly across a wide range of psychological, cognitive and developmental areas (Egeland and Sroufe, 1981). Physical aggression, antisocial behavior and juvenile delinquency are among the most consistently documented consequences of abuse in adolescence and adulthood (Aber et al., 1990). Evidence is more suggestive that maltreatment increases the risk of alcohol and drug problems (National Research Council, 1993). Ystgaard, Hestetun, Loeb and Mehlum (2004) report that physical and sexual abuse are significantly and independently associated with repeated suicide attempts. In other words, physical and sexual abuse increase the risk of suicide attempts, even when controlling for other adverse events and situations children experience.

Research on the consequences of sexual abuse finds that inappropriate sexual behavior, such as frequent and overt sexual stimulation and inappropriate sexual overtures to other children, are commonly found among victims of sexual abuse (Kendall-Tackett et al., 1993). Roberts and his colleagues (Roberts, O'Connor, Dunn, Golding et. al., 2004) conducted a longitudinal study of 8,292 families and found that sexual abuse experienced before age 13 was associated with poorer psychological well-being, teenage pregnancy and adjustment problems in the victim's own children. Widom (1995) has found that people who were sexually abused during childhood are at higher risk of arrest for committing crimes as adults, including sex crimes, compared to people who did not suffer sexual abuse. However, this risk is no greater than the risk of arrest for victims of other childhood maltreatment, with one exception: Victims of sexual abuse are more likely to be arrested for prostitution than other victims of maltreatment.

Child neglect is by far the most common form of maltreatment. While the more dramatic forms of maltreatment--physical abuse and sexual abuse--receive considerable attention in terms of the impact on children, there is far less research, and even concern, for the impact of the chronic form of maltreatment: child neglect. Hildyard and Wolfe (2002) reviewed the research on the impact of child neglect and find considerable support for the conclusion that child neglect produces significant developmental problems for child victims. Neglect has a deleterious effect on children's cognitive, socioemotional and behavioral development. The earlier in life a child is neglected, the more comprised the child's development. The impact of neglect is somewhat unique, producing more severe cognitive and academic deficits, social withdrawal and limited peer interactions. Victims of neglect tend to internalize the impact of that neglect as opposed to externalizing through aggressive and violent behavior (Hildyard and Wolfe, 2002).

As severe and significant as the consequences of child abuse and neglect are, it is also important to point out that the majority of children who are abused and neglected do not show signs of extreme disturbance. Despite having been physically, psychologically or sexually abused, many children have effective coping abilities and thus are able to deal with their problems better than other maltreated children. There are a number of protective factors that insulate children from the effects of maltreatment. These include: high intelligence and good scholastic attainment; temperament; cognitive appraisal of events--how the child views the maltreatment; having a healthy relationship with a significant person; and the type of interventions, including placement outside of the home (National Research Council, 1993).

Children who witness domestic violence are a unique population warranting research and clinical attention. Witnessing is at the intersection of child abuse and neglect and domestic violence. Researchers and clinicians report that children who witness acts of domestic violence experience negative behavioral and developmental outcomes, independent of any direct abuse or neglect that they may also experience from their caretakers. Estimates from the two National Family Violence Surveys are that between 1.5 million and 3.3 million children three to 17 years of age are exposed to domestic violence each year (Gelles and Straus, 1988; Straus, Gelles and Steinmetz, 1980).

References:

1)         Aber, J. L., J. P. Alien, V. Carlson, and D. Cicchetti. "The effects of maltreatment on development during early childhood: Recent studies and their theoretical, clinical, and policy implications." In D. Cicchetti and V. Carlson, eds. Child Maltreatment: Theory and Research on Causes and Consequences. New York: Cambridge University Press, 1990, pp. 579-619.

2)         Egeland, B., and L. A. Sroufe. "Attachment and early child maltreatment." Child Development 52 (1981): 44-52.

3)         Gelles, R. J., and M. A. Straus. Intimate Violence. New York: Simon and Schuster, 1988.

4)         Hildyard, K. L., and P. A. Wolfe. "Child Neglect: Developmental Issues and Outcomes." Mental Child Abuse and Neglect 26 (2002): 679-695.

5)         Kendall-Tackett, K. A., L. Williams, and D. Finkelhor. "The impact of sexual abuse on children: A review and synthesis of recent empirical literature." Psychological Bulletin 113 (1993): 164-180.

6)         National Research Council. Understanding Child Abuse and Neglect. Washington, D.C.: National Academy Press, 1993.

7)         Roberts, R., T. O'Connor, J. Dunn, J. Golding et. al. "The effects of child sexual abuse in later family life: Mental health, parenting and adjustment of offspring." Child Abuse & Neglect 28 (2004): 525-545.

8)         Straus, M. A., R. J. Gelles, and S. K. Steinmetz. Behind Closed Doors: Violence in the American Family. New York: Doubleday/Anchor, 1980.

9)         Widom, C. S. Victims of Childhood Sexual Abuse--Later Criminal Consequences. National Institute of Justice research in brief. Washington, D.C.: U.S. Department of Justice Office of Justice Programs, 1995.

10)       Ystgaard, M., Hestetun, I., Loeb, M., and Mehlum, L. "Is there a specific relationship between childhood sexual and physical abuse and repeated suicide behavior?" Child Abuse & Neglect 28 (2004): 863-875.

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