Child abuse and neglect has been associated with increased risk of adverse outcomes. Not all abused and neglected children suffer immediate or lasting consequences beyond their immediate injuries. Nevertheless, abused and neglected children are at increased risk for a range of physical, mental/emotional, and social/behavioral difficulties. The pathways to these outcomes are currently unclear, but involve a combination of compromised brain development and long-term psychological and emotional sequelae associated with their abuse and neglect. Abused and neglected children are at increased risk of school-related difficulties resulting from cognitive and learning difficulties or from emotional adjustment problems. Abused and neglected children are at increased risk of relationship problems stemming from low-self esteem or aggressive tendencies. Abused children are also at increased risk of juvenile delinquency. Girls who have been sexually abused are at increased risk for violence in dating relationships, teen pregnancy, spousal violence, and abuse of their own children. Abused chidren, particularly sexually abused children, may exhibit symptoms of Posttraumatic Stress Disorder. Abuse in childhood has also been associated with a range of risky health behaviors and suicidal behavior. Cross-culturally, children who are treated with rejection rather than with warmth and acceptance by their parents and care-givers display negative psychological outcomes (Rohner, 1986).
While child abuse and neglect confers increased risk of a variety of problems, much less is known about those factors that promote a healthy or positive development despite the occurrence of abuse. Adults who experienced abuse as children may prefer the term "survivor" over "victim," particularly those who were sexually abused. The term survivor connotes a more active process of healing than does the term victim which is thought to convey helplessness.
Different nations have taken different approaches to child maltreatment. In some countries, the emphasis has been one of enhanced social services and resources for families experiencing difficulties. In others, child maltreatment is handled primarily through the health care system, such as the "confidential doctor" in the Netherlands. In the United States, all 50 states have mandatory reporting legislation that requires professionals working with children to report all cases of suspected abuse or neglect. The categories of professionals required to report varies across states. Child abuse and neglect is reported to child protection agencies who investigate. Depending on the judgment of the child protection agency, cases may or may not proceed to legal intervention and possible removal of the child to foster care. Treatment is not necessarily provided to children or to families through child protection service agencies. When treatment is provided, a variety of modalities have been employed.
In the United States and other Western nations, prevention programs have shown some success in reducing the occurrence of child abuse and neglect. Prevention programs have focused on providing support to new and at-risk parents, particularly through home visitation.
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