Child Abuse (cont.)

Medical Author:

David Perlstein, MD, MBA, FAAP

David Perlstein, MD, MBA, FAAP

Dr. Perlstein received his Medical Degree from the University of Cincinnati and then completed his internship and residency in pediatrics at The New York Hospital, Cornell medical Center in New York City. After serving an additional year as Chief Pediatric Resident, he worked as a private practitioner and then was appointed Director of Ambulatory Pediatrics at St. Barnabas Hospital in the Bronx.

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Medical Editor:

Roxanne Dryden-Edwards, MD

Roxanne Dryden-Edwards, MD

Dr. Roxanne Dryden-Edwards is an adult, child, and adolescent psychiatrist. She is a former Chair of the Committee on Developmental Disabilities for the American Psychiatric Association, Assistant Professor of Psychiatry at Johns Hopkins Hospital in Baltimore, Maryland, and Medical Director of the National Center for Children and Families in Bethesda, Maryland.

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Take care in interpreting certain behaviors in adults and children that suggest the possibility of abuse. Parents and all reporters of abuse must realize that accusations of abuse are taken very seriously by law enforcement, child abuse professionals, and prosecutors. While the reporter of abuse (mandated or nonmandated) is granted immunity from any liability when they make reports about possible abuse, such reports should be done in good faith only.

Some people are willing to use allegations of abuse to achieve their own goals at the expense of an accused person. Once allegations of abuse are made, the general belief by the authorities is that accusations are true until proven otherwise. False accusations can rarely be taken back without very significant damage to families and the lives of the accused person.

• If you, as a parent, are concerned about abuse, take that concern to a professional. Avoid any interrogation of your child, which may produce unintended consequences that would interfere with the legal process that follows allegations of abuse. Excessive questioning will often produce unintended consequences that can interfere with the prosecution of abuse. Special techniques and formal interviews are the best forum for discovering and documenting allegations of sexual abuse. Contacting a family doctor or local child protection services usually results in adequate initial investigation of any concerns.
• Parents and other adults should be aware that they have extraordinary powers to influence both a child's words and memory. Parents can, by exerting psychological pressure, either intentional or unintentionally elicit statements from children that are not true but could later be regarded as true.
• False allegations can arise from family members, enemies, or from unhappy or disturbed children. Children can be manipulated by adults to make false accusations. The younger the child, the more susceptible the child is to manipulation.
• False allegations of abuse occur in a small number (3%-5%) of all abuse reports. However, under certain circumstances, the percentage can increase. In divorce and custody disputes, in which allegations of abuse are raised, the percentage of false allegations has been reported to be as high as 35%. Stepchild-stepfather false accusations have also increased in frequency as well over the last 20 years as children use their knowledge of the legal system against parental figures who are putting legitimate boundaries on them as they enter adolescence.
• Misinterpretation of medical findings or the observation of abnormal behaviors by overly protective authorities at school, daycare, and in medical facilities, have been responsible for many false allegations of abuse, even when all parties (including the children) deny that abuse has occurred. Sexualized behaviors, depression, or poor school performance to name a few, can be interpreted or misinterpreted, at times, as being the result of child abuse.

According to the 2010 Child Maltreatment report, there were 2.98 million children in the United States who were evaluated for suspected abuse or neglect. Of those, 20% met the "legal requirements" for abuse. The rest could not be substantiated. This means that almost 600,000 cases of child abuse are substantiated annually, which justifies the continued process for identifying potential cases of abuse.

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