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Child Abuse 


The following Healthy Kids column originally appeared in the April 14, 2003 edition of the St. Louis Post-Dispatch.

Being a parent is one of the most fulfilling roles a person can undertake. Despite its rewards, however, parenting can also be frustrating, challenging and sometimes downright maddening.

Nearly every parent has been pushed to what they consider a “breaking point” by their children, but most manage to control their emotional reaction. Sadly, many parents fail to manage their anger appropriately and the child can suffer physical or psychological abuse.

Three children die every day in this country from instances of child abuse and neglect in the home, according to the U.S. Department of Health and Human Services. On average, child abuse is reported every 10 seconds.

“Clearly this is a national tragedy, and it can lead not only to physical injury but to poor self esteem, poor school performance, behavior problems, and later in life, difficulty in forming intimate relationships,” says Dr. Tim Kutz, a pediatrician and child abuse expert at SSM Cardinal Glennon Children’s Hospital, and assistant professor of Pediatrics at St. Louis University. “The most heartbreaking thing about child abuse is that it can be prevented but too often isn’t.”

Kutz recommends that parents:

  • Remain calm when angered by a child’s behavior. Parenting classes can help provide strategies for coping with a child’s tantrums or misbehavior.
  • Explain to their child how to describe what the child is feeling. Communication is key to helping avoid abuse.
  • Start at home by making children feel secure and loved. This means making time for children and showing them that they are loved in deeds and in words, and praising their accomplishments.
  • Seek immediate help if they have trouble handling family tension or anger. Parents can talk to their doctor or their child’s doctor, a community leader or clergy member, or a friend. Don’t be afraid to ask for help. People understand, especially if you seek help early before any harm has been done.

Child abuse can take many forms, among them physical, psychological and sexual, and neglect. According to figures released by the Children’s Bureau of the U.S. Department of Health and Human Services, approximately 3 million reports of possible maltreatment are made to child protective service agencies each year. It is estimated that the actual incidence of child abuse and neglect is three times greater than that figure.

Psychological Abuse

Not all abuse leaves physical scars. Psychological abuse can take the form of degrading or ridiculing a child, making him or her feel unsafe through threatening words or actions, exploiting or corrupting a child, failing to express affection and caring, or neglecting medical and educational needs.

The American Academy of Pediatrics advises that these parental behaviors can lead to emotional troubles, antisocial behavior, low academic achievement and impaired physical health.

Sexual Abuse

Sexual abuse can happen even to very young children, and sometimes occurs at the hands of other children or teens. One of every seven victims of sexual assault reported to law enforcement authorities is under age six, according to Childhelp USA, one of the largest and oldest non-profit organizations dedicated to the treatment and prevention of child abuse.

Childhelp recommends that parents follow some simple rules to safeguard their children from sexual abuse. Among them:

  • Participate in your child’s activities and get to know your child’s friends.
  • Never leave your child unattended, especially in the car.
  • Teach your child the difference between “good touches,” “bad touches,” and “confusing touches.”
  • When your child tells you he or she doesn’t want to be with someone, this could be a red flag. Listen to them and believe what they say.
  • Be aware of changes in your child’s behavior or attitude, and inquire into it.
  • Teach your child what to do if you and your child become separated while away from home.
  • Teach your child the correct name of his or her private body parts.
  • Be alert for any talk that reveals premature sexual understanding.
  • Pay attention when someone shows greater than normal interest in your child.
  • Make certain your child’s school or day care center will release him or her only to you or someone you officially designate.

Unintended Injury

About 50 years ago, pediatricians began to recognize what has come to be known as “shaken baby syndrome,” the damage that can be done to very young children by violent shaking.

Infants have large heads and weak neck muscles, and any whiplash motion can cause blood vessels to tear, creating intercranial bleeding and brain damage. These injuries can result in death, brain damage, muscle weakness, seizures, blindness, deafness, mental retardation, poor coordination or learning disabilities.

In some cases, even good parents can injure their young children by playfully tossing them in the air and catching them, playing “airplane” by holding the child’s wrist and ankle and swinging them around, or violently shaking a child who has stopped breathing.

So what’s a parent to do? The main thing is to relax and enjoy your child, and recognize that every moment with him or her is a gift. Before losing control, seek help so you and your child can enjoy that gift for a lifetime. 

Dr. Bob Wilmott is Chief of Pediatrics at SSM Cardinal Glennon Children’s Hospital and is a Professor of Pediatric Medicine at St. Louis University School of Medicine. If you have a child health question for Dr. Wilmott, go to the “Ask Dr. Bob” section of the Cardinal Glennon Web site at



Episodes of abuse often happen over and over again, and they tend to become more severe. If you suspect that a child is the subject of abuse, contact one of the following:

Childhelp USA National Child Abuse Hotline 800-4-A-CHILD. The hotline is available 24 hours a day, seven days a week.
For Missouri call 800-392-3738; For Illinois call 800-252-2873

Other Resources:

SSM Cardinal Glennon Children’s Hospital
Child Protection Division

National Child Welfare Resource Center for Family-Centered Practice

National Resource Center for the Community Based Family Resource and Support Programs (FRIENDS)

Missouri Division of Family Services

Illinois Division of Family Services

St. Louis Crisis Nursery

National Center on Shaken Baby Syndrome

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