The Power of Neglect

https://www.childwelfare.gov/pubs/usermanuals/neglect/chapterthree.cfm

http://www.minddisorders.com/Kau-Nu/Neglect.html

http://www.acrf.org/Self-StudyCourses/neglectcourse/n2brain.htm

http://www.acf.hhs.gov/programs/cb/resource/can-faq7

http://www.healthcareasia.org/2012/emotionally-neglected-children-may-have-higher-stroke-risk-in-adulthood/

The Impact of Neglect

Raven H.~

How does neglect effect children, neglect has a powerful impact on a child, it may not show when they are very young unless it is a extreme case. However, the effects of neglect are hurtful and can be long-lasting foe the children and can become sever as a child grows older. According to Child Maltreatment 2010 they estimated 695,000 children were found to be victims of child maltreatment in the federal fiscal year (FFY) 2010. More than one-half of states (29) reported a decreased number of victims when it was compared to 2009. An estimated 78% from the 695,000 are from child neglect, 2% were medically neglected and an estimated 10 percent of victim (10.3) experienced "other" types of maltreatment such as "abandonment," "threats of harm to the child," and "congenital drug addiction."

Neglect can affect a child’s…

·         Health and physical development

·         Intellectual development

·         Emotional and psychological development

·         Social and behavioral development

Although there are four categories of neglect's effects on an individual, they often are related. For example, if a child experiences neglect that leads to a delayed development of the brain, this may lead to cognitive delays or psychological problems, which may manifest as social and behavioral problems.

·         The impact of neglect can vary based on:

·         The child's age;

·         The presence and strength of protective factors;

·         The frequency, duration, and severity of the neglect;

·         The relationship between the child and caregiver.

Research shows that the first few years of children's lives are crucial and sensitive periods for development. During these years, neural synapses are formed at a very high rate. After the age of 3, synapses start to be "pruned," and certain pathways that are not used may be discarded. Studies supporting the idea of a sensitive developmental period show that maltreated infants suffer from greater developmental disabilities than those children who were maltreated later in childhood. One example of this is the ability to form attachments with one's primary caregiver. If this process is disrupted early in children's lives, they may have difficulty forming healthy relationships throughout their lives. Although learning can happen throughout life, it often is more difficult for children who were deprived of certain types of early stimulation.

Health and Physical Development

Studies show that neglected children can be at risk for many physical problems, including failure to thrive, severe diaper rash and other skin infections, recurrent and persistent minor infections, malnourishment, and impaired brain development. Because neglect includes medical neglect, other health problems can arise from the failure of the parents to obtain necessary medical care for their children. If children do not receive the proper immunizations, prescribed medications, necessary surgeries, or other interventions, there can be serious consequences, such as impaired brain development or poor physical health. For example, a child who does not receive proper dental care might be all right in the short term, but suffer from tooth decay and gum disease later in life. Children with diabetes may be fine without treatment for a short while, but an extended delay in treatment could have serious consequences and possibly result in death.

A new research suggests children who are emotionally neglected may have a higher risk of stroke in adulthood.

Emotional neglect is defined as failing to provide for a child’s needs emotionally.

“Studies have shown that children who were neglected emotionally in childhood are at an increased risk of a slew of psychiatric disorders, however, our study is one of few that look at an association between emotional neglect and stroke,” said study author Robert S. Wilson, PhD, with Rush University Medical Center in Chicago.

For the study, 1,040 participants who were 55 years of age or older took a survey measuring physical and emotional abuse before the age of 18. Questions focused on whether the participant felt loved by their caregiver, were made to feel afraid or intimidated and whether they were punished with a belt or other object.

Questions about divorce and financial need were also included. 

Over a period of three and a half years, 257 people in the study died, of which 192 had a brain autopsy to look for signs of stroke. Forty of the participants had evidence of a stroke based on their medical history or an examination. A total of 89 people had signs of a stroke based on the autopsy results.

The study found that the risk of stroke was nearly three times higher in those who reported a moderately high level of childhood emotional neglect than those who reported a moderately low level. The results stayed the same after considering factors such as diabetes, physical activity, smoking, anxiety and heart problems.

“The results add to a growing body of evidence suggesting that traumatic childhood experiences and physical illness in adulthood may be linked,” said Kevin Barrett, MD, MSc, with the Mayo Clinic in Jacksonville, Fla., and a member of the American Academy of Neurology, who wrote an editorial on the research.

Wilson noted that a limitation of the study is that neglect was reported from memory many years after occurrence, so participants may not have remembered events accurately.

The study has been published in the latest online issue of Neurology, the medical journal of the American Academy of Neurology.

Impaired Brain Development

Child neglect has been associated with a failure of the brain to form properly, which can lead to impaired physical, mental, and emotional development. The brain of a child who has been maltreated may develop in such a way that it is adaptive for the child's negative environment, but is maladaptive for functional or positive environments. A maltreated child's brain may adapt for day-to-day survival, but may not allow the child to develop fully healthy cognitive and social skills. Children who are neglected early in life may remain in a state of "hyper-arousal" in which they are constantly anticipating threats, or they may experience dissociation with a decreased ability to benefit from social, emotional, and cognitive experiences. To be able to learn, a child's brain needs to be in a state of "attentive calm," which is rare for maltreated children. If a child is unable to learn new information, this may cause some areas of the brain to remain inactive, possibly resulting in delayed or stunted brain growth. It also can impair functioning later in life and may lead to the child being anxious, acting overly aggressive, or being withdrawn.

How does Neglect Impact the Brain?

Pregnancy and the first three years of life are the most active periods of brain development in our lives. The following paragraphs are taken from the work of Dr. Bruce Perry, a pioneer in the work of brain development in children and the impact of maltreatment and trauma.

Huge portions of the human brain are devoted to social functions and communication including establishing and maintaining eye contact, reading faces, judgments and more. When a baby is born, his brain houses over one hundred billion neurons that will chart paths and make connections based on the social experiences they encounter. By the age of two and a half, approximately 85 percent of the baby's neurological growth is complete, meaning the foundation of their brain's capacity is in place. By age three, the child's brain is 90 percent of its completed adult size.

In a remarkable cycle of stimulus and response, the budding brain builds itself using chemical signals generated by vision, smell, touch, hearing and taste to activate and organize the neural cells that make up its tissue and determine the brain's capacity to process, retain and respond to information.

Think of it in terms of nutrition. If a baby is not fed consistent, predictable messages of love and communication, then those areas of the brain shut down and the child's capacity to function later in life is compromised.

- Dr. Bruce Perry

How Does Neglect and Trauma Impact the Brain?

Dr. Bruce Perry has researched how the brain develops in response to trauma. To understand his results, let's review how a healthy brain develops.

Think of the brain as a upside down pyramid. At the bottom and developing first is the BRAINSTEM which monitors basic responses such as breathing and heartbeat. The next to develop is the MIDBRAIN which focuses on survival functions such as safety and responses to threats. Farther up this upside down pyramid is the LIMBIC system which controls feelings and emotions. The largest and the part of the brain last to develop are the CORTICAL functions which include our frontal lobes and parts of the brain that control executive functions such as reasoning, planning, anticipating, and predicting. The executive functions develop most rapidly during adolescences and early adulthood. Below is what a healthy, well-balanced brain should look like from bottom to top.

How Does Neglect and Trauma Impact the Brain?

Dr. Bruce Perry has researched how the brain develops in response to trauma. To understand his results, let's review how a healthy brain develops.

Think of the brain as a upside down pyramid. At the bottom and developing first is the BRAINSTEM which monitors basic responses such as breathing and heartbeat. The next to develop is the MIDBRAIN which focuses on survival functions such as safety and responses to threats. Farther up this upside down pyramid is the LIMBIC system which controls feelings and emotions. The largest and the part of the brain last to develop are the CORTICAL functions which include our frontal lobes and parts of the brain that control executive functions such as reasoning, planning, anticipating, and predicting. The executive functions develop most rapidly during adolescences and early adulthood. Below is what a healthy, well-balanced brain should look like from bottom to top.

Normal development results in a healthy brain that is proportioned about 2 to 1. That means the combined Cortical and Limbic systems should be about twice as big as the combined Midbrain and Brainstem systems. This proportion of brain development allows the Limbic and Cortical functions (higher reasoning skills) to modulate and control and balance the Brainstem and Midbrain functions (reactive and reflexive functions). When we try to teach children think before you act, we are asking them to use one part of their brain to help them assess and control what another part of the brain wants to do out of instinct.

What Dr. Perry found in his research is that when young children experience severe trauma, the Brainstem/Midbrain portion of the brain seems to overdevelop, meaning children will have overdeveloped safety and stress responses and act more impulsively, even though the Thinking/Feeling part of the brain (the Cortical/Limbic systems) may be normally sized.

When children experienced neglect, they often did not develop the Thinking/Feeling parts of the brain resulting in an underdevelopment of the higher reasoning parts of the brain. The worst combination of maltreatment was when children experienced both neglect and trauma. That resulted in overdevelopment of the Brainstem/Midbrain functions ( resulting in anxiety, impulsivity, poor affect regulation, motor hyperactivity) and underdevelopment of Limbic/Cortical functions (which affected empathy and problem solving skills). The result looks like this.

Neglect during infancy, including nutritional deficits during pregnancy, can impact a child’s development of brain capacity and size. When neglect is combined with trauma, a child’s brain develops in a survival style to help him stay safe. This may result in a child being initially “wired” for survival—being impulsive, anxious, acting from instinct instead of reason, and not able to understand or identify his feelings easily.

Poor Physical Health

The physical problems associated with neglect may start even before an infant is born, such as when the mother has had little or no prenatal care or smoked during pregnancy. These children may be born prematurely and have complications at birth.

 Neglected children also can have severe physical injuries, possibly due to the inattention of their parents, such as central nervous system and craniofacial injuries, fractures, and severe burns. They also may be dirty and unhygienic, leading to even more health problems, such as lice or infections. Children also may be exposed to toxins that could cause anemia, cancer, heart disease, poor immune functioning, and asthma.

For example, exposure to indoor and outdoor air pollutants, such as ozone, particulate matter, and sulphur dioxide, can cause the development of asthma or increase the frequency or severity of asthma attacks. Additionally, children may have health problems due to a lack of medical attention for injury or illness, including chronic health problems. Neglected children may suffer from dehydration or diarrhea that can lead to more severe problems if unattended.

A medical condition associated with child neglect is "failure to thrive," which can be defined as "children whose growth deviates significantly from the norms for their age and gender." This condition typically occurs in infants and toddlers under the age of 2 years. Failure to thrive can be manifested as significant growth delays, as well as:

·         Poor muscle tone;

·         Unhappy or minimal facial expressions;

·         Decreased vocalizations;

·         General unresponsiveness.

Failure to thrive can be caused by organic or nonorganic factors, but some doctors may not make such a sharp distinction because physical and behavioral causes often appear together. With organic failure to thrive, the child's delayed growth can be attributed to a physical cause, usually a condition that inhibits the child's ability to take in, digest, or process food. When failure to thrive is a result of the parent's neglectful behavior, it is considered nonorganic.

Treatment for failure to thrive depends on the cause of the delayed growth and development, as well as the child's age, overall health, and medical history. For example, delayed growth due to nutritional factors can be addressed by educating the parents on an appropriate and well-balanced diet for the child. Additionally, parental attitudes and behavior may contribute to a child's problems and need to be examined. In many cases, the child may need to be hospitalized initially to focus on implementation of a comprehensive medical, behavioral, and psychosocial treatment plan. Even with treatment, failure to thrive may have significant long-term consequences for children, such as growth retardation, diminished cognitive ability, mental retardation, socio-emotional deficits, and poor impulse control.

Neglect in itself occurs when a parent or other caretaker chooses not to take care for, provide for, or adequately supervise and monitor the activities of their child. Taking care of a child includes the physical, emotional, and educational well-being of the child. Neglect can also happen when the parent or caretaker does not seek adequate medical or dental care for the child. Another definition of neglect is when the parental figure does not provide sufficient food, clothing, or shelter.

The guardian of the child is expected to provide for the emotional needs of the child, neglect can occur when the parents abandon the child, or simply have no time to spend or take care of the child thus neglecting the child and having him/her take care of themselves. If the child is left without supervision, it is considered neglect.

Effects of Neglect

The consequences of neglect often negatively affect the child’s development. For example, poor nutrition has negative consequences on the child’s physical and mental development. If not properly taken care of and if the proper nutrients are not available to the child the development of the child will not be on the normal pattern. That can include stunned growth, chronic medical problems, inadequate bone and muscle growth, and a lack of brain development will negatively affect the brain functioning and information processing. Processing problems may often make it difficult for children to understand directions, may negatively impact the child's ability to understand social relationships, or may make completion of some academic tasks impossible without assistance from others. A lack of or no medical care may result in long-term health problems or impairments such as hearing loss from untreated ear infections. Long-term mental health effects of neglect are inconsistent. Effects of neglect can range from chronic depression to difficulty with relationships; however, not all adults neglected as children will suffer from these results. Some individuals are more resilient than others and are able to move beyond the emotional neglect they may have experienced. Characteristics of resilient individuals include an optimistic or hopeful outlook on life, and feeling challenged rather than defeated by problems.

Experience

This may not be as long or as detailed as the rest of this but most if not all of this is true(above not this, this is real). If it was not for my grandparents I would more than likly be dead from neglect because of my mother. When I was a baby I would be given old milk that had been out for hours and get sick, she would not change my dipers, and I would be left on the floor crying.

The one's that would help me would be my grandparents, I had gotten no love from my mother, when I was older but not in school, in order to save money for herself she would take us to a place that made me sick from the smell, almost all the time I would be throwing up and not eat while she did. She would not take me to the docters when I was sick(which was a lot), not untill my grandparents yelled at her for hours would she take me, same with the dentist,(I have a small problem with my teeth because of it)

It is hard for me to interact with other people, I hold up walls and be rude to new people because I always think they want to hurt me too. I am sometimes overly paranoid and jumpy too. I dont understand things that others know without having to be told what it feels like, I just dont understand. I just know hurt, and pain by heart, I have to learn the others by hand but I would not know what it is when I feel it. I dont know what it means to like like someone or what it means to love someone. Hell I dont even know how I am to react to some of the things that my friends say or do, I wait untill someone reacts so that I know what to do or how to act. I am better at it now but it is still hard for me to do things and understand them.

Neglect, it is not something that should be taken lightly, it can kill, be it a life or a life style.

Child Abuse - by Graham Laws

                                                                  There’s no positive affect with Child Abuse.

Many situations can affect children throughout their lives being from a positive to a negative experience; every experience a child goes through affects them in some way being good or bad. There are many ways to discipline a child but physically or mentally striking a child damages their own abilities to promote a healthy life structure. During a Child's year of growing they are susceptible to almost everything around them bad or good. The affects of abuse whether it be physical, mental, or sexually have negative outlooks on the young ones future life. The consequences of abuse to a child range from physical health, psychological, behavior, and societal problems. There’s a combination of factors that individually combine to create the problem such as, the age the child is abused, the type of abuse, the severity of abuse, and the relationship between the victim and his or her abuser. The resilience of a child brings characteristics such as optimism, self-esteem, intelligence, creativity, humor, and independence, as well as the acceptance of peers and positive individual influences such as teachers, mentors, and role models.  

The immediate physical effects of abuse or neglect can be relatively minor, such as bruises/cuts or severe ranging from broken bones to death. In some cases the physical effects are not long term but the pain and suffering they caused the child. According to the National Survey of Child and Adolescent Well-Being (NSCAW), more than one-quarter of children who had been in foster care for longer than 12 months had some lasting or recurring health problem. Shaking a baby is a common form of child abuse. The injuries caused by shaking a baby may not be immediately noticeable and may include bleeding in the eye or brain, damage to the spinal cord and neck, and rib or bone fractures. NSCAW found more than three-quarters of foster children between 1 and 2 years of age to be at medium to high risk for problems with brain development, as opposed to less than half of children in a stable environment. Several studies have shown a relationship between various forms of household dysfunction, including childhood abuse and poor health; 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. The immediate emotional effects of abuse and neglect/isolation, fear, and an inability to trust can translate into lifelong consequences, including low self-esteem, depression, and relationship difficulties. Depression and withdrawal symptoms were common among children as young as 3 who experienced emotional, physical, or environmental neglect. In one long-term study as many as 80 percent of young adults who had been abused met the diagnostic criteria for at least one psychiatric disorder at age 21. 

These young adults exhibited many problems, including depression, anxiety, eating disorders, and suicide attempts. Other psychological and emotional conditions associated with abuse and neglect includes panic disorder, dissociative disorders, attention-deficit/hyperactivity disorder, depression, anger, post-traumatic stress disorder, and reactive attachment disorder. NSCAW found that children placed in out-of-home care due to abuse or neglect tended to score lower than the general population on measures of cognitive capacity, language development, and academic achievement. A 1999 LONGSCAN study also found a relationship between substantiated child maltreatment and poor academic performance and classroom functioning for school-age children. Children who experience rejection or neglect are more likely to develop antisocial traits as they grow up. Parental neglect is also associated with borderline personality disorders and violent behavior. Not all victims of child abuse and neglect will experience behavioral consequences. However, behavioral problems appear to be more likely among this group, even at a young age. An NSCAW survey of children ages 3 to 5 in foster care found these children displayed clinical or borderline levels of behavioral problems at a rate of more than twice that of the general population. Studies have found abused and neglected children to be at least 25 percent more likely to experience problems such as delinquency, teen pregnancy, low academic achievement, drug use, and mental health problems. Other studies suggest that abused or neglected children are more likely to engage in sexual risk-taking as they reach adolescence, thereby increasing their chances of contracting a sexually transmitted disease. Abused and neglected children were 11 times more likely to be arrested for criminal behavior as a juvenile, 2.7 times more likely to be arrested for violent and criminal behavior as an adult, and 3.1 times more likely to be arrested for one of many forms of violent crime. Research consistently reflects an increased likelihood that abused and neglected children will smoke cigarettes, abuse alcohol, or take illicit drugs during their lifetime. According to a report from the National Institute on Drug Abuse, as many as two-thirds of people in drug treatment programs reported being abused as children.  Abusive parents often have experienced abuse during their own childhoods. It is estimated approximately one-third of abused and neglected children will eventually victimize their own children.

While child abuse and neglect almost always occur within the family, the impact does not end there. Society as a whole pays a price for child abuse and neglect, in terms of both direct and indirect costs. Direct costs include those associated with maintaining a child welfare system to investigate and respond to allegations of child abuse and neglect, as well as expenditures by the judicial, law enforcement, health, and mental health systems. Prevent Child Abuse America estimates these costs at $24 billion per year. Indirect costs represent the long-term economic consequences of child abuse and neglect. These include costs associated with juvenile and adult criminal activity, mental illness, substance abuse, and domestic violence. They can also include loss of productivity due to unemployment and underemployment, the cost of special education services, and increased use of the health care system. Prevent Child Abuse America estimated these costs at more than $69 billion per year. The effects vary depending on the circumstances of the abuse or neglect, personal characteristics of the child, and the child's environment. 
Consequences may be mild or severe; disappear after a short period or last a lifetime; and affect the child physically, psychologically, behaviorally, or in some combination of all three ways. Child abuse is more than bruises or broken bones. While physical abuse is shocking due to the scars it leaves, not all child abuse is as obvious. Ignoring children’s needs, putting them in unsupervised, dangerous situations, or making a child feel worthless or stupid are also child abuse. Regardless of the type of child abuse, the result is serious emotional harm. All types of child abuse and neglect leave lasting scars. Some of these scars might be physical, but emotional scarring has long lasting effects throughout life, damaging a child’s sense of self, ability to have healthy relationships, and ability to function at home, at work and at school. . If you can’t trust your parents, who can you trust? Abuse by a primary caregiver damages the most fundamental relationship as a child—that you will safely, reliably get your physical and emotional needs met by the person who is responsible for your care. 

  If you’ve been told over and over again as a child that you are stupid or no good, it is very difficult to overcome these core feelings. You may experience them as reality. Adults may not strive for more education, or settle for a job that may not pay enough, because they don’t believe they can do it or are worth more. Sexual abuse survivors, with the stigma and shame surrounding the abuse, often especially struggle with a feeling of being damaged. Abused children cannot express emotions safely. As a result, the emotions get stuffed down, coming out in unexpected ways. Adult survivors of child abuse can struggle with unexplained anxiety, depression, or anger. They may turn to alcohol or drugs to numb out the painful feelings. Sticks and stones may break my bones but words will never hurt me? Contrary to this old saying, emotional abuse can severely damage a child’s mental health or social development, leaving lifelong psychological scars. Child neglect—a very common type of child abuse—is a pattern of failing to provide for a child's basic needs, whether it be adequate food, clothing, hygiene, or supervision. Child neglect is not always easy to spot. Sometimes, a parent might become physically or mentally unable to care for a child, such as with a serious injury, untreated depression, or anxiety. Other times, alcohol or drug abuse may seriously impair judgment and the ability to keep a child safe. Older children might not show outward signs of neglect, becoming used to presenting a competent face to the outside world, and even taking on the role of the parent. But at the end of the day, neglected children are not getting their physical and emotional needs met. Physical abuse involves physical harm or injury to the child. It may be the result of a deliberate attempt to hurt the child, but not always. It can also result from severe discipline, such as using a belt on a child, or physical punishment that is inappropriate to the child’s age or physical condition. Many physically abusive parents and caregivers insist that their actions are simply forms of discipline—ways to make children learn to behave. But there is a big difference between using physical punishment to discipline and physical abuse. The point of disciplining children is to teach them right from wrong, not to make them live in fear.Without this base, it is very difficult to learn to trust people or know who is trustworthy. This can lead to difficulty maintaining relationships due to fear of being controlled or abused. It can also lead to unhealthy relationships. 

Physical abuse vs. Discipline

In physical abuse, unlike physical forms of discipline, the following elements are present:

• Unpredictability. The child never knows what is going to set the parent off. There are no clear boundaries or rules. The child is constantly walking on eggshells, never sure what behavior will trigger a physical assault.
• Lashing out in anger. Physically abusive parents act out of anger and the desire to assert control, not the motivation to lovingly teach the child. The angrier the parent, the more intense the abuse.
• Using fear to control behavior. Parents who are physically abusive may believe that their children need to fear them in order to behave, so they use physical abuse to “keep their child in line.” However, what children are really learning is how to avoid being hit, not how to behave or grow as individuals.

Warning signs of emotional abuse in children

• Excessively withdrawn, fearful, or anxious about doing something wrong.
• Shows extremes in behavior (extremely compliant or extremely demanding; extremely passive or extremely aggressive).
• Doesn’t seem to be attached to the parent or caregiver.
• Acts either inappropriately adult (taking care of other children) or inappropriately infantile (rocking, thumb-sucking, throwing tantrums).

Warning signs of physical abuse in children

• Frequent injuries or unexplained bruises, welts, or cuts.
• Is always watchful and “on alert,” as if waiting for something bad to happen.
• Injuries appear to have a pattern such as marks from a hand or belt.
• Shies away from touch, flinches at sudden movements, or seems afraid to go home.
• Wears inappropriate clothing to cover up injuries, such as long-sleeved shirts on hot days.

Warning signs of neglect in children

• Clothes are ill-fitting, filthy, or inappropriate for the weather.
• Hygiene is consistently bad (unbathed, matted and unwashed hair, noticeable body odor).
• Untreated illnesses and physical injuries.
• Is frequently unsupervised or left alone or allowed to play in unsafe situations and environments.
• Is frequently late or missing from school.

Warning signs of sexual abuse in children

• Trouble walking or sitting.
• Displays knowledge or interest in sexual acts inappropriate to his or her age, or even seductive behavior.
• Makes strong efforts to avoid a specific person, without an obvious reason.
• Doesn’t want to change clothes in front of others or participate in physical activities.
• An STD or pregnancy, especially under the age of 14.
• Runs away from home.

Risk factors for child abuse and neglect

• Domestic violence. Witnessing domestic violence is terrifying to children and emotionally abusive. Even if the mother does her best to protect her children and keeps them from being physically abused, the situation is still extremely damaging. If you or a loved one is in an abusive relationships, getting out is the best thing for protecting the children.
• Alcohol and drug abuse. Living with an alcoholic or addict is very difficult for children and can easily lead to abuse and neglect. Parents who are drunk or high are unable to care for their children, make good parenting decisions, and control often-dangerous impulses. Substance abuse also commonly leads to physical abuse.
• Untreated mental illness. Parents who suffering from depression, an anxiety disorder, bipolar disorder, or another mental illness have trouble taking care of themselves, much less their children. A mentally ill or traumatized parent may be distant and withdrawn from his or her children, or quick to anger without understanding why. Treatment for the caregiver means better care for the children.
• Lack of parenting skills. Some caregivers never learned the skills necessary for good parenting. Teen parents, for example, might have unrealistic expectations about how much care babies and small children need. Or parents who were themselves victims of child abuse may only know how to raise their children the way they were raised. In such cases, parenting classes, therapy, and caregiver support groups are great resources for learning better parenting skills.
• Stress and lack of support. Parenting can be a very time-intensive, difficult job, especially if you’re raising children without support from family, friends, or the community or you’re dealing with relationship problems or financial difficulties. Caring for a child with a disability, special needs, or difficult behaviors is also a challenge. It’s important to get the support you need, so you are emotionally and physically able to support your child.

How do you know when you’ve crossed the line?

• You can’t stop the anger. What starts as a swat on the backside may turn into multiple hits getting harder and harder. You may shake your child harder and harder and finally throw him or her down. You find yourself screaming louder and louder and can’t stop yourself.
• You feel emotionally disconnected from your child. You may feel so overwhelmed that you don’t want anything to do with your child. Day after day, you just want to be left alone and for your child to be quiet.
• Meeting the daily needs of your child seems impossible. While everyone struggles with balancing dressing, feeding, and getting kids to school or other activities, if you continually can’t manage to do it, it’s a sign that something might be wrong.
• Other people have expressed concern. It may be easy to bristle at other people expressing concern. However, consider carefully what they have to say. Are the words coming from someone you normally respect and trust? Denial is not an uncommon reaction.  

www.preventchildabuse.org 
http://kidshealth.org/parent/positive/talk/child_abuse.html
http://www.childhelp.org/pages/statistics
https://www.childwelfare.gov/can/
http://www.childabuse.com/