Child abuse is under-recognised

Child abuse is under-recognised because it is under-reported according to experts writing in The Lancet.

Ruth Gilbert of the Institute of Child Health at University College London and Cathy Spatz Widom of City University of New York suggest that about 1 in 10 children in the developed world is abused each year but that according to official statistics, less than a tenth of those abused are investigated.

Child protection services are failing to recognise abuse in part because doctors, schools and community health workers underreport it, Gilbert and Widom say.

Tackling the problem is critical as there is clear evidence that effects from abuse last well into adulthood, making it more likely these children will be violent and engage in risky sexual behaviour as adults, they added.

'Child maltreatment is common, and for many it is a chronic condition, with repeated and ongoing maltreatment merging into adverse outcomes throughout childhood and into adulthood,' they wrote. 'The burden on the children themselves and on society is substantial.'

The definition of abuse used was wide-ranging and included punching, hitting, beating, burning, rape, exposure to pornography as well as neglect and emotional abuse such as making a child feel worthless or unwanted.

Parents account for most types of maltreatment except for sexual abuse, which is usually committed by other family members or an acquaintance, the researchers said. They said that 'it is estimated' that at least 15% of girls and 5% of boys have been exposed to sexual abuse of some kind by the age of 18, and that 5-10% of girls and 1-5% of boys are exposed to penetrative sexual abuse.

'How frequently this abuse occurs is underestimated by official reports because recording of more than one type of maltreatment is often discouraged by child-protection agencies and official reports often do not capture the chronology of exposure over time,' Gilbert and Widom said.

Better cooperation among doctors, schools and child service agencies could address this, they said. Telephone helplines and confidential counselling could also reach more children at risk.