RESPONSES TO CHILD ABUSE IN WORLD PERSPECTIVE
Charles L. McGehee**
Central Washington University
*Paper presented at the Third International Institute on Victimology, Lisbon,
November 11-17, l984.
**Address correspondence to: Charles L. McGehee, Department of Sociology,
Central Washington University, Ellensburg, WA 98926.
RESPONSES TO CHILD ABUSE IN WORLD PERSPECTIVE
Introduction
The purpose of this paper is to present a description of responses to
child abuse around the world. Researching this topic has proved difficult for
several reasons: (1) the limited number of scholarly journals publishing
information about child abuse, (2) the language limitations of relevant
international publications, most of which are in English, (3) my own, the
researcher's, language limitations (English, German), and (4) the limited
library resources available to me.
Beyond these Ammodytidae and pragmatic factors, the existence of
professional and relevant lay journals are limited to societies and cultures
which have (1) economic resources large enough to support them, as well as (2)
bodies of professionals interested, able and in a position to write for
publication, and (3) a reading audience of sufficient size to warrant such
publication. This necessarily affects the extent to which developing nations,
especially, will be able to make their activities and concerns known to the
rest of the world. It also means that issues concerning child abuse in
countries having well developed social service and legal systems will also
likely be more reported and discussed.
Beyond these more-or-less obvious factors influencing the availability of
information, another factor became apparent during the research. Since the
mid-1970's, international child abuse and neglect conferences have been held
regularly. While nominally international in scope, in fact, the presentations
have been highly skewed not only to the industrialized world and certain more
advanced emerging nations, but also, and more importantly, skewed to those
nations in physical proximity of the conference site as well as to those with
the financial resources for international travel. Since the proceedings of
such meetings are usually published and make up a large portion of the
available information on child abuse, information on these countries tends to
dominate publications.
And, finally, the scope of the research is further limited by the
fact that I have not been able to find anything of substance on child abuse in
eastern European and other socialist countries, the Middle-East, and Latin
America. For political reasons some countries do not publish data on social
problems nor discuss them in public. Others deny their existence, while yet
others either are not concerned, have no communication network, do not publish
in international sources, or are not studied by foreign researchers who do
publish internationally.
Sadly, then, the results of this research must be recognized as being
severely limited and imprecise.
* * * * * * * *
Ideally, one might expect simply to inquire into the various ways in
which the societies of the world respond to child abuse. This inquiry,
however, reveals that not all societies are at the same level of development
of awareness, much less organized response, to the problem. Therefore, I have
regarded any writing about child abuse to be a form of response to the
problem. For example, if a particular society is just becoming aware of child
abuse and is for the first time carrying out research into the incidence of
child abuse, I have called that a social response. Similarly, a society may
not have, for a variety of reasons, a legal definition of child abuse, yet if
that society has expressed concern for the health and welfare of its children
in other ways, concern for nutrition, as an example, I have called that also a
social response. This also points up my belief that a discussion of
cross-cultural responses is not separable from one of definition.
It is further important to note, that much of the discussion of child
abuse in pre-industrial (tribal) and so-called Third World societies has not
been written by natives of those societies, but rather by outsiders,
Westerners in particular. Therefore, whatever we may think we know about
these societies will necessarily be colored by the views of others.
In order to facilitate presenting the breadth of world-wide responses to
child abuse, I have deliberately de-emphasized what has been happening in the
United States. The reason for this is that because of the extent of the
activity, the degree of development of social services legal responses, and
the sheer quantity of publications and publicity, I am afraid that the
American scene would quickly obscure important activities and perspectives
elsewhere. I will discuss American activities as part of the total picture,
but will make no attempt to present them in totality or relative frequency.
The discussion of sexual abuse will appear in a separate section at the
end of the paper.
Social responses to child abuse: Discovery.
Without discovery of something, there can be no response to it. Thus,
the act of discovery itself, may be said to be the most fundamental response
to it. If any single thing could be said to have characterized social
response to child abuse during the past two decades, it has been discovery.
Since Kemp et al.'s l962 article [99], the Western industrial world, notably
the United States and the English-speaking world, has discovered child abuse,
and, as a result, has spawned a host of laws, programs and activity
concerned with its prevention and treatment. On the other hand, child abuse
in much of the rest of the world, and especially the Third World, is just
beginning to be discovered.
To a certain extent, discovery is a function of the willingness and
ability to question that which otherwise has been accepted an normal. In this
regard, discovery must be seen as intimately related to the problem of
definition. And when, for whatever reasons, people begin to define their
world as problematic, they then begin to question accepted definitions and
discover things which either they had not noticed or had not attracted their
attention.
An important question, in this regard, is who is doing the discovering,
the people affected or someone outside the group? When people themselves, as j
opposed to others, discover the truth of something about themselves for
themselves, not only are they are more likely to take action, but that action
will take a different form than if others' view of reality were determinate.
The literature surveyed here suggests widespread discovery, yet what is
being discovered by some in one area is not necessarily the same as that which
is being discovered in the same area by others. Nutritional problems, for
instance, are, apparently, of greatest concern to African social welfare
workers [87,145,146], whereas Westerners writing about Africa are more much
likely to emphasize abusive and neglectful child-rearing practices
[48,116,117,119]. All have discovered, however, that abuse where parents
attacking their own children in anger, as is often found in the West, is
relatively uncommon.
In countries having historically close ties to Western development
through colonialism, but also less developed, discovery is much more likely to
be by those involved in their own social services than by outsiders. Because
of the internal origins of the discovery, they emphasize those factors which
they find important to their own societies, such as abandonment, neglect and
trafficking of children in India [131] and Thailand [164], foot-binding and
related treatment of women in China [8], or abandonment and infanticide in
Japan [84,187]. Westerns, outsiders, also are discovering child abuse in such
countries as India [156], Sri Lanka [33], Thailand [154], and Malaysia [141].
The incidence of abuse being discovered in these areas, too, especially China
and Japan, seems to be quite low in comparison with the West.
Given the relatively early discovery of child abuse in the West,
discovery of child abuse in the West, the nature of present discovery is
becoming ever more esoteric and much more likely to be a refinement of
previous inquiry and understanding. Examination of incidents of
non-accidental immersion in the bath or follow-up inquiries into
failure-to-thrive in Australia [143,144], for instance, are elaborations on a
previous and highly developed awareness of child abuse.
Indeed, entirely new forms of child abuse are being discovered in those
countries where the issue has long been well-developed. Sexual abuse, as an
example, has become a most prominent concern in the West, especially in the
U.S. and U.K. [121,127,143,137,188]. Other forms of abuse now being
discovered include the inadvertent consequences for a child of parental
lifestyle, such pre-natal drug addiction [13], neglect while in the womb [18],
religious practices [136], and even the consequences for children of
governmental budget cuts [91].
Other countries, such as Greece, also indicate an increasingly refined
awareness by looking now at child welfare institutions themselves as sources
of abuse [2] as well as socio-medical aspects and the consequences for the
mental health of siblings of abused children [3,139], yet this awareness is of
rather recent in origin and, hence, not indicative of a wide-spread or deeply
developed discovery of child abuse. In the case of Greece, the first study of
the incidence of child abuse was reported only in 1979 [122].
Once a general awareness has been developed, it seems not uncommon that
sub-groups within a dominant culture then become the subject of discovery by
members of the aware dominant group. As a case in point, the Danes have
become aware of torture of Chilean immigrant children in Denmark [31], and
Americans are becoming aware of child maltreatment among Asian-Americans
[36,37] and illegal, Spanish-speaking aliens [159].
Unfortunately, due to the limitations of the literature mentioned
earlier, we can gain no real sense of child abuse as a world-wide issue. We
know nothing of the discovery of child abuse in east European countries, most
of the Third World, and Latin America. Indeed we know rather little of the
West, even, insofar as the professional literature presents only a most
limited perspective. An examination of the popular press would probably give
us a better sense of the extent to which people have discovered child abuse
and the sorts of things they are discussing.
Social responses to child abuse -- Definition.
Whether people discover and become concerned with behaviors said to be
abusive of children is a function of how they understand the nature of
children, the parent-child relationship, the goals and values of the society,
and the conditions under which that society has to live.
Social beings tend to interpret the world according to the conditions
under which they themselves live and in terms of the values and practices
which govern their own lives. As regards child abuse, we may have clear ideas
about how children should be raised, and in terms of these we criticize,
tolerate, or praise the way others raise their children.
Yet, reviewing the world-wide literature on child abuse makes one thing
clear: the variety of ways by which children may be raised is legion, and in
spite of the fact that children are not necessarily raised in ways we in the
West might approve, countless millions of children grow up every day and
become productive members of society.
Defining child abuse not only is not simple, it may well be impossible
since it involves issues which lie at the heart of the parent-child
relationship and the relations between the generations in any society. For
better or worse, each child is born into a world not of its making. And, for
better or worse, it is up to the adults of that society to take that child and
create out of it a useful social being. Given the inordinately long period of
dependency and helplessness of the human specie, there is simply no
alternative to adults using their own and their own society's conception of
right and wrong, appropriate and inappropriate, as goals for the child. The
kind of person a child should be will always be determined by adult
interests and goals, and if not by the parents, then by some other adults. It
is, therefore, not a question of whether a child will be socialized by
adults and in terms of adult interests, but by which adults and
which interests [183].
The issue here, of course, is the methods by which a child is to be
socialized. How should children be raised? Kobrin makes the important point
that in cross-cultural studies of child abuse and neglect, definition and
cultural considerations are of prime consideration. She suggests three levels
of consideration: (1) practices which are viewed by one culture as abusive
and by another as acceptable, (2) detrimental environmental and economic
conditions not related to cultural practices, and (3) idiosyncratic abuse
which falls outside all social definitions [107]. She further argues that the
key to understanding child rearing, as opposed to child abuse, in
cross-cultural perspective, is the distinction between the "emic" perspective
-- seeing an act from the participants point of view -- and the "etic"
perspective -- the broader trans-societal point of view [106].
We must be careful not to fall into a trap of absolute cultural
relativism when viewing child-rearing. Some practices may reflect cultural
values and be important; others may reflect cultural values and be harmful;
and still others may merely seem to reflect cultural values and be
harmful; and yet others may not reflect cultural values at all be may be
simply harmful individual acts. Understanding the difference is what our work
should be about.
A review of the literature indicates that most descriptions of abusive j
child rearing practices around the world fall into the first of Kobrin's
categories, that is, practices which are approved by one culture but
disapproved by another. Moreover, most of the descriptions of Third World and
non-industrialized societies come not from the inhabitants themselves, but
Westerners, usually with anthropological backgrounds and interests. In
describing Africa, for example, Levine and Levine [116], point to the practice
of early withdrawal of emotional support by fostering children with other
families in order to facilitate training the child for family economic roles
and developing a sense of responsibility. To question such a practice without
considering the practical reality of the people concerned and how they and
their children experience each other and their environment, would clearly be
judgement reflecting alien values.
Similarly, condemnation of ritual circumcision, and especially female
genital mutilation (sic), and precocious marriage in Africa [179], as well as
ritual defloration of brides in New Guinea by older males, often their own
fathers, and ceremonial redressing of parental grievances against their
children [116], independent of the social functions it serves, seems to be an
ethnocentric value judgement, and suggests that if there is a problem, we
"cosmopolitans" in the West must first convince the "locals" that they have a
problem based on our conception of reality. That stamping out such practices,
which may well have fundamental value to the practitioners, may cause severe
personal and social trauma due to disrupted collective solidarity, would seem
to be irrelevant to some observers [89]. Stopping infanticide as a population
control measure, in the absence of effective alternatives, would have
disastrous effects on the well-being of the living.
It is interesting to note that criticism of "primitive" practices is
often accompanied by descriptions of such societies as being permissive and
claims that "usual" child abuse, that is, direct violence against children,
seldom occurs [109,116,160,179]. Indeed, some would argue that the Western
practice of withdrawing affection as punishment ("Mommy doesn't love you
anymore. Go to your room."), would be considered by many "primitive" people
to be the grossest form of abuse [160].
But others, especially Third World natives, define and describe child
abuse by pointing to the consequences of the disruption and decline of the
family in the face of modernization, urbanization, and industrialization
[48,69,146]. This raises the issue of Kobrin's second consideration, the
consequences of detrimental environmental and economic conditions not
specifically related to cultural practices. For example, the practice of
fostering out of children within a community, which in traditional, stable
times is a functional practice, produces instead disaster when applied to an
urban setting by families who expect the same concern and supervision of the
child as in the traditional village. Exploitation, physical hardship,
intolerable living conditions, and virtual slavery often occur at the hands of
unscrupulous persons who promise good things to parents for a fee. Instead,
though, they take advantage of the naivete of the family and the helplessness
of the child [116]. Indeed, in the face of industrialization and the
increasing marginalization of the role of children, abandonment and often
consequent child labor and trafficking in children for sexual and other
commercial ends, often accompanied by physical abuse and neglect, is coming to
be defined as a problem of monumental proportions [69,115,131,164].
Africans inclination to define nutritional problems as a form of child
abuse, stems from their experiences with this transition to urban life. The
decline in quantity, not to mention quality of food in urban areas for people
used to a rural lifestyle close to the soil, and neglect caused by family j
breakdown due to industrial labor [87], produces not only malnutrition but
other, attendant forms of hardship for children, such as rejection when
afflicted with severe kwashiorkor [85] and low birth-weight [88]. The
emotional consequences of this malnutrition, as well as the malnutrition
itself, which are to be found everywhere throughout the Third World, give rise
to yet another definition of abuse, such as, in India [11].
Yet, in the face of this, idiosyncratic abuse may be seen to occur even
in societies which, by Western standards, may be said to be "permissive" or
"bizarre" or which may be in the throes of severe cultural disruption.
Natives are quite capable of, and in fact do, recognize and intervene when
individuals overstep the bounds of cultural propriety [109].
Definition of child abuse in the industrial world, or those parts of the
Third World which have large industry and close cultural-historical ties to
the West, i.e., China, India, Sri Lanka, etc., are much more concerned with
self-critical analysis of their own historical child rearing practices and
values. China, for instance, notes proudly its war on infanticide and the
abolition of foot-binding. In each instance, the practice was primarily
oriented toward girls, and Chinese reform since 1949 has made it a point to
alter traditional devaluation of females, as well as improving immensely
health care, education, and the general lot of children [8,105] Clearly, the
Chinese define these as abusive, although they do not use the term.
Similarly, in Greece, even though the country has experienced severe
problems of economic development and even though awareness of child abuse is
recently new, definition of abuse centers greatly on cultural values
supporting a strong, often authoritarian patriarchy in which physical violence
has been the norm [3,33,122,139].
The rest of the West (North America, Europe, Australia), for the most
part, tends to define uncritically any form of force in the home as abuse, and
the debate has centered on the historical-cultural practices within the
society, most notably, issues associated with male domination and the male's
presumed propensity to solve problems with violence.
But in a complex, heterogenous society, definitions abound, and serious
questions have been raised about inconsistencies in these definitions.
Gelles, for example, has pointed out that agency personnel may well look less
to the acts themselves or their outcomes than to the parent' motivation, a
"willful" act being more serious, regardless of the consequences to the child
[54]. This seems to be done in spite of the fact that major legislation of
the 1970's focused on the behavior of the caretaker and the consequences of
the act and ignored intent [93]. Giovannoni and Becerra further found that
definitions of tolerable violence differ markedly for various categories of
persons. They found that social workers and lawyers, for example, tended to
be more tolerant of harsh treatment of children than were neighbors and police
officers. And among neighbors, the white middle-class was more tolerant of
harsh treatment of children by parents than were its minority counterparts
[62]. While neighbors in Finland seem not inclined to define many behaviors
as abuse [92,151], Sweden is less tolerant and inclined even to view
"ordinary" spanking as abuse [169]. The problem of definition becomes even
more pointed and poignant when the values of minority religious groups affect
their child-rearing practices in ways the dominant group does not approve,
such as in the case of Jehovah's Witnesses [136].
Thus, what one is to call abuse is not at all agreed upon universally. In
general, however, severe corporal punishment seems to be that which is
regarded most importantly when thinking of child abuse in most Western
countries, such as the U.K. [28,32], the U.S. [175], Canada [93,191], and
Germany [20,93,129].
The definition is broadening, however. Sexual abuse is emerging as a new
and widely discussed issue, at least in the U.S. [134], as is the treatment of
children in institutional arrangements, such as hospitals, which are usually
thought to have the best interests of children at heart [64,172]. The
psychological, and sometimes physical, trauma of educational systems are also
coming to be defined as abuse [129,130,135]. Some even, as in Germany, would
expand the definition of abuse to include anything which harms a
child's physical, mental, emotional, or spiritual development [129].
Among socialist countries, Poland defines the problem loosely as one of
children deprived of good care, and Yugoslavia defines it simply as inadequate
care of children by parents [93].
The question of definition, then, is of no small concern. It would seem
clear that unless we can come to terms with what it is that is going to be
said to be abusive, it will be impossible to identify, much less treat, those
who are said to be victims.
Responses to child abuse -- Explanations.
People may be aware of a problem and they may have developed definitions
which allow them to distinguish appropriate from inappropriate behavior. But
what they do about the matter is another matter entirely. What they do about
it will be a direct function of how they perceive its causes. A society is
likely to respond quite differently to a problem which is thought to be, say,
of divine origin than one which is believed to be caused by human action. In
the former case, prayer or ceremonial atonement might be expected, whereas in
the latter, punishment or correction.
Explanations of the causes of child abuse are actually few in number. As
far as native speakers, and other observers of the Third World are concerned,
the singly most important cause of serious child abuse is social change.
Urbanization, with its consequent social disorganization, disintegration of
the family, parental stress, neglect, poverty, and exploitation, is the direct
cause of all that is wrong with Third World countries
[4,5,33,48,69,87,88,89,119,141, 146,179]. Because of the breadth and depth of
the problem, it follows, then, that whatever needs to be done, needs to be
done on a broad and fundamental scale. There is little agreement, however, on
what is to be done.
Elsewhere in the Third World, and especially in more politically
developed countries, cultural-political factors are held responsible. The
Chinese, both in the Peoples' Republic and on Taiwan, see residues of feudal
domination by males and the principle of filial piety, as being the root of
what child abuse they have, that is, female infanticide and foot-binding, the
preference for male children over female, and excessive pressure on males
[105,194]. Similarly, the diminished cultural value placed on females in
India and Sri Lanka are cited as the cause of much childhood misery [33,156].
Although the West is the embodiment of and industrialization and
urbanization, little attention is given there to the same processes of change
which preoccupy the Third World. Instead, heavy emphasis is placed on
cultural factors, on the one hand, and on individual psychological factors, on
the other, although some believe that strict psychological explanations are
waning in influence [55]. Many blame a culture that is said to solve problems
through violence and which believes in the efficacy of physical punishment
[191]. For others, at the heart of this is the rigid, patriarchal,
authoritarian family, whether it be Germany [20,199], Greece [3,42,122,182],
or the U.S. [169,175], this in spite of evidence that suggests little if any
correlation [117]. And while it is not a prevalent theme, even national
character is sometimes said to be a factor, with the finger pointed especially
at German character [9,129]. In this regard, Germans seem to be particularly
self-consciousness, and Wolff, while ostensibly seeking a general theory of
child abuse, by calling it an ethnos-psychic disorder [192], seems to base his
thinking more on the German and Anglo-Saxon cultural experience, than the
human experience in general.
Organized social responses to child abuse in the Third World and Asia
The most striking thing about the literature on child abuse in
cross-cultural perspective, is that there is nothing on organized social
responses outside of the West, except in China and Indonesia. The Third World
is almost totally excluded. There are several reasons for this, perhaps. For
there to be a an organized response to a social problem, there must be a
government with some stability and a clear span of organized, bureaucratic
control. This is often not the case in Third World countries. Moreover,
child abuse is a family matter, and in most countries the family is still the
most basic and stable social institution, given the economic and political
problems of these countries, families are left to their own resources.
Nigeria and Zambia are a notable exception, but even there, authors have
only bad news to report. In Nigeria, social workers and agencies clearly
exist and are active -- the only publications I found were by social workers
-- yet their message was one of despair. Their basic message was that, in the
face of the monumental problems a developing nation experiences, i.e., family
breakdown, poverty and malnutrition, transportation, etc., their system was
ineffectual [199]. In the face of the poor conditions in available
institutions and otherwise lack of resources for meeting family needs, social
workers, it is argued must take a personally more active role in bridging the
transition for children. Homes are too poor for the child's own good and need
more constant supervision [210]. There are virtually no support services for
mothers in urban areas, and great neglect follows when children are delegated
to older siblings, neighbors or others who care very little about the
children. Parents spend their money on trinkets and ceremonies with little
attention being given to the child's needs. Kwashiorkor (severe protein
deficiency) may be seen more as the result of this kind of neglect, which
adequate social services could deal with, than of poverty and ignorance [127].
In Zambia, which is experiencing similar problems of urbanization and family
disruption, the state and public agencies are being forced to deal with
adoption and foster care, issues which heretofore have been family matters
[189].
The tendency is to define cruelty to children as the only form of child
abuse into which the state should intervene, as is the case in Indonesia [69].
The role of the state in general, and courts specifically, is often limited to
adoption, such as in India [133], Indonesia [69], and Zambia [72]. In
Thailand the Foundation for Children, a private philanthropic organization,
provides child care in the absence of state action [164], and in order to
counter the pervasive lack of state action on child labor in the Third World,
an independent, voluntary international organization, the Anti-Slavery Society j
for the Protection of Human Rights, has been established [115].
Chinese society itself might be said to be one big child abuse prevention
and treatment agency. The revolution brought major reforms in child care as
well as intense organization of the society as a whole. Because of the
extensive system of child care and neighborhood monitoring of behavior by
neighbors and public officials, disapproved behaviors, such as corporal
punishment, are generally detected early before things go too far. Emphasis
is placed on condemning acts and not the inner man. Day care is seen as a
positive thing and is strictly monitored and regulated. Adoptions may be by
other family members, as well as by non-family. Adoptions are subsidized by
the state [105].
In Japan there is little treatment for the small amount of child abuse
that occurs, and then only in hospitals or similar institutions. Parents have
very strong rights and can take the child again if they promise not to harm it
any more. Agencies have no power to follow up cases [84].
Indonesia has no specific child abuse laws, only laws against cruelty to
children in general. While there is a child welfare act, it has no specific
provisions for child abuse, and reporting families is not a customary thing.
Sayap Iba is a private institute for child protection which provides temporary
protective nurseries for small children to which mothers may bring children
for adoption and to which abandoned children are also brought. These
nurseries also serve as adoption agencies [69].
Organized responses to child abuse in the Western World
Kjonstad's description of twelve fundamental principles of law upon which
the Scandanavian (Norwegian) child abuse policy is based, seems to speak
generally for the concerns of Western law. The principles are:
1. the best interests of the child should guide the shaping of child welfare
legislation;
2. parent's have the right (authority) to make decisions on behalf of their
children in personal matters;
3. parents have an obligation to take care of their children. This
obligation includes
4. the duty to maintain their children economically, i.e., food, clothing,
shelter, etc.;
5. maintenance of stabile living arrangements for the child must be
maintained, which usually means non-removal from the home if possible;
6. secrecy of information must be maintained in order to permit a
relationship of trust between agency personnel and client/patient;
7. citizens are not duty bound to report or give information about families
in general and child abuse in particular; and correspondingly
8. no legal protection will be provided for people who report others and who
want to remain anonymous;
9. others involved cannot guarantee protection for sources of information,
either;
10. persons have the right to enjoy peace of private life and
non-interference by the state, which includes home visits;
11. all actions which would interfere with the rights of citizens can occur
only when authorized by legislation and in accordance with legal principles;
and, finally,
12. the coercive aspects of law should b handled by one set of agencies and
the helping side of law should be handled by others [100].
Scandinavia
The Norwegian system, has developed a system where in communities have
standing in law to become directly involved in dealing with child abuse.
Child welfare boards have been established which are empowered to handle
informally cases of abuse which come to their attention. Most cases will
be handled this way. When medical personnel become involved, the rule of
secrecy prevents them from revealing information to the authorities, and,
consequently, it is only the most serious cases which ultimately will come to
the attention of the prosecutor. Multiple definitions of child abuse prevail
at the various levels of intervention [100]. Still, professionals are trained
to interview and deal with children and parents in such a way as to foster
cooperation and minimize conflict [74].
In Denmark and Sweden similar principles and practices apply, although
reporting is mandatory [66,152,186] as it is in Finland [177]. More recently,
however, Sweden, has taken specific legal steps to define corporal punishment
by parents as abuse and to prohibit it under all circumstances [197]. This
has given rise to increasing caseloads as have other form of abuse which have
not been seen before, such as, increasing drug abuse among dysfunctional
parents as well as children born to addicted mothers [13,111]. Questions are
being raised about the ability of social workers to cope with the changing
population [111]. In general, Sweden explains its reportedly low abuse rate
as a function of its comprehensive family policy [93] and its medical program
which regards child abuse as a public health problem [152]. It believes that
its program of health care screening for pre-school children is part of the
reason [78]. This screening program has resulted in an increase in hospital
admissions for infants due to maternal inadequacy and has also resulted in
increases in adoption and foster care action [110].
In the case of Denmark, there is general opposition to all authorities,
including child welfare, and reports are even rarer than the low incidence
would dictate. When cases come to the attention of the police, however, they
are invariably handled as criminal matters, but since psycho pathology is
believed to be the cause, parents are seldom punished [186]. Although all
citizens are required to report child abuse, cases are often not brought to
court because of inability to prove the charges. Heavy weight is placed on
forensic testimony. Even then, courts prefer to leave children in the home
[66].
Finnish law requires reporting, although officials are reportedly
reluctant to do so even though official emphasis is on helping persons rather
than judging persons. In 1980, the government created an official working
body to disseminate information, facilitate interagency cooperation, and
increase level of professional skill in working with families. Emphasis is
placed on dealing with high risk situations rather than high risk persons
[177].
United States
The debate of Kjonstad's principles in the American states, on the other
hand, has led to attempts to define child abuse in concrete terms and to
define the responsibilities of legal entities, child-service related
professionals, and the community.
By this time all American states have laws defining child abuse and
mandating reporting [127]. The definition generally describes child abuse as
willful injury or harm inflicted by a parent or parent substitute, and
generally requires that certain parties, notably medical personnel,
counselors and professional educators, are required to report suspected
abuse. A minor criminal penalty is attached for failure to report and damage
claims against such a person for reporting under the law are precluded. Other
persons not in these categories are permitted to report without fear of legal
repercussions as long as the report was not maliciously intended [127].
While this may appear to be a decisive response to child abuse, in
reality the situation is not substantially different from other countries
which do not have legal definitions. The problem hinges on the interpretation
of the words "willful", "harm", and "suspected". Establishing the willfulness
of an act is made difficult by problems of identification, the accident-prone
nature of children, and the general, if unclearly defined, parental right to
treat their children intentionally harshly when in the interest of the child's
moral upbringing.
By the same token, "harm" is not always clearly defined. Newspaper
accounts, which emphasize clearly heinous and often deliberately cruel or
malicious acts, make it seem as if the issue were simple. Everyone knows the
difference between midnight and noon. But who can tell the point at which day
becomes night or when "normal" child-rearing practices become abuse?
Practically speaking, unless severe bruises are present, bones broken, blood
flowing, or organs damaged, it is unlikely that the definition of child abuse
will ever be applied. And if these characteristics are present, it is
unlikely that most modern countries would ignore the harm, with or without
legislation. Anything less than demonstrable physical harm is likely not to
be treated seriously, or at least will be given lower priority.
Furthermore, there is no way to compel a person to suspect child abuse
nor is there often an opportunity to determine if the person did suspect abuse
and deliberately did not report it. Stating such a requirement in the law,
then, seems to be more of a moral statement about the desirability of taking
the plight of children seriously while relieving observers of the fear of the
consequences of reporting. Indeed, for all definitions and legal sanctions,
the laws have seldom been enforced, and then only against physicians who have
had clear medical knowledge of a history of serious physical injuries which
generally accepted medical practice would have indicated could not have
occurred as allege. In some instances, parents even have told the physician
what happened. Short of such evidence, though, it is very difficult to
demonstrate adequately that suspicion was present. Nevertheless, reporting
has increased dramatically as a result of these laws.
An inadvertent consequence of such extensive reporting laws, and their
accompanying twenty-four hour reporting "hot-lines", has been to increase the
level of reports beyond the capacity of existing social services to handle
them [200].
The legal institutionalization of central registries has accompanied the
development of definitions and mandatory reporting laws. Such registries have
had four primary reasons stated for their existence: (1) to facilitate
management planning by keeping statistics, (2) to assist assessment of danger
to children by providing personnel with information on prior reports and
treatment, (3) to encourage reporting, and (4) to improve child protective
services accountability [148]. Registries, and the general movement to make
family life more subject to public scrutiny, has raised serious concerns about
personal rights and the privacy of families [27,70].
As the system become more complete and bureaucratic, the definition of
child abuse becomes increasingly broad. With the definition of abuse now
encompassing emotional abuse [52], sexual abuse [188], religious abuse [136]
and even neglect to unborn children [18] fear increasingly is expressed
whether anyone is "safe" from criticism and prosecution. With the development
of the child advocacy movement which seeks to bring political pressure to bear
on legal bodies on behalf of children's interests, entirely new legal
principles are emerging, such as the use of hearsay statements in child sexual
abuse criminal cases, the long term effects of which are unknown
[38,44,70,195]. As the definition of child abuse is broadened, medicine and
law become more powerful and more capable of imposing their models of reality
and criteria of conduct on an increasingly more vulnerable public [142].
Yet, even as the American system seems to become more punitive, the
courts are being restructured to facilitate handling family problems more
equitably. The concept of guardian ad litem, a court appointed attorney for a
dependent child, is to be found in nearly all jurisdictions by this time
[35,47], Family difficulties are widely being treated more informally and
with greater flexibility than in the past [35].
In the U.S., which has been generally setting the pace since the early
1960's, Child Protective Services (CPS; the name may vary slightly from
jurisdiction to jurisdiction) is the agency which has the primary
responsibility for child abuse . CPS is a branch of the state department of
social services and is empowered by law to investigate reports of child abuse;
take temporary custody of abused, neglected or otherwise dependent children;
arrange and supervise foster care; investigate and arrange adoptions; and make
recommendations to the Juvenile Court [24,127].
Kemp [97] points to six recent changes in the activities and orientation
of CPS in the U.S.:
1. change from a closed system of child protection to a more open system
involving many professions and the public at large [40,127,163],
2. early treatment of the abused child and his siblings,
3. growing recognition of sexual abuse as widespread and serious
[45,127],
4. institutional abuse that occurs when society's intervention is more
harmful than if intervention had not occurred [127,157],
5. concepts of the guardian ad litem [47,140] and relaxed legal requirements
for freeing the child for adoption, and
6. prevention, especially in prenatal identification of potential abusers,
parent effectiveness training, crisis intervention, and treatment for abuse
victims [127].
To this list must be added emergency shelters to which children may be
brought for temporary care when family stress threatens to get out of hand
[181], central registries for tracking known abusers [148], parent-aide and
home-maker programs in which experienced lay persons enter homes to help
high-risk families cope with problems of daily life [25,58], sponsorship of
various forms of parenting training, and individual and group therapy
programs, chemical treatment of abusers [150], and training professionals and
para-professionals [6]. Private programs, such as, Parents Anonymous [118],
child advocacy programs [101], and community councils for child prevention
[116], complement state efforts.
Such programs and directions, while quite wide-spread, have not been
without their problems. Criticism has been expressed that the medical and
legal professions have come to gain too much influence in public policy [142],
rigid bureaucratic requirements of case management may add trauma to an already
traumatized child [64,157], social workers' conception of abuse be divergent
enough from the community's that people will no longer report in the belief
that nothing will be done [62], and parents' rights are run over roughshod by
zealous case workers [183]. When we also consider that social workers
complain of severe burnout, lack of support by administrative staff, and lack
of legal protection and due process for them [43], one sees that having a
well-developed public response to child abuse does not necessarily mean that
problems are solved. Indeed, more may be created.
Canada
In Canada, the provinces and regional court system sets the basic policy,
and some provinces have created laws define abuse and mandate reporting as in
the U.S. [93]
Even though Canada does not have elaborate legal definitions and
penalties in all provinces, still a physician would be subject to civil
damages for allowing a child to continue to be subjected to demonstrable abuse
[41]. Public schools, in Toronto, at least, have established their own
definitions and reporting procedures [128]. But even at that, as long as
teachers insist that corporal punishment is necessary for maintaining
classroom control, some argue that it is unlikely that definitions and
reporting protocols will have a great deal of effect [191].
Canada, also, pursues a multi-disciplinary approach [126]. The system
has established few demonstration projects to encourage development of new
approaches [93], but it has shown the flexibility to try new treatment
approaches. For example, on the theory that abuse is a function of lack of
nurturing skills, and that lack of nurturing skills is a function of lack of
adequate nurturing, one agency program has sought to develop problem-solving
skills while providing the mothers with nurturing (in the form of
hair-dressing) [16]. The public schools are actively involved in child abuse
prevention through the establishment not only of reporting protocols, but also
training of teachers and other personnel in identification and treatment
techniques [128].
The United Kingdom
By this time the American practices described here have been extended to
much of the English-speaking, industrial world. Gaining a complete
perspective on their structure and functions elsewhere, however, is quite
difficult with the literature available.
In the United Kingdom there are no mandatory reporting laws [90], and
several different laws govern the management of child abuse [168]. Local
authority has the primary responsibility for such matters [120]. Under the
British system, care proceedings may be brought either by a local authority,
the police, or the N.S.P.C.C. (National Society for the Prevention of Cruelty
to Children), but more likely by the former two [168]. The N.S.P.C.C. as a
nationally chartered private philanthropic association actively concentrates
on the direct treatment of abuse victims by utilizing interdisciplinary teams
and continued monitoring of the child's circumstances in the home even long
after it appears that the problems has been solved. It, as other aspects of
the British system, takes the position that the interests of the child
outweigh the interests of the parents, and hence focus is always on the child
[180].
Still, policy emphasizes non-legal intervention. It is not enough to
prove that a child has been abused or neglected. For a court to justify legal
intervention, it must be convinced that adequate care would be unlikely
without judicial intervention [93].
While the actual source of authority specific activities is not always
clear from the literature, a number of programs, which suggests the direction
and scope of child abuse activity, are operating. Central registries are
maintained [90,125], area review committees, which are interdisciplinary and
interagency in nature, manage cases [120], a health visitors' program which
helps catch incipient abuse and neglect in the home itself [34], and there is
great support for voluntary agencies, such as, Home Start, a voluntary
home-visitation program for young families [73]. Indeed, the British system
seems to have spawned more volunteer and self-help community-based programs
than many other countries which are more dependent on central authority. The
very rigidity of the British system seems to encourage voluntarism to avoid
state intervention.
Child abuse treatment and prevention programs in recent years have much
more come to characterized by Parents Anonymous-type self-help groups [19],
crisis nurseries, drop-in foster mothers, and family development centers [26].
There is, for example, the Eaton-Socon Family Walk-in Centre for parakeets
under stress which provides counseling on such things as child-rearing,
marital problems, slimming, etc. [155]. A similar program for new families is
the SCOPE program which attempts to deal with isolation and loneliness and
provides health, welfare, and educational support for parents. Most families
become involved with this program by referral from social agencies [158]. In
general, much emphasis is placed on group-therapeutic activities, organized
both by volunteers and professionals, especially for mothers, which are
intended to reduce isolation, develop self-esteem, and teach trust [161,162].
And indeed there are even entirely volunteer social service agencies in which
teams work on interrelated problems. Parents work directly with their
children and are helped to develop more realistic execrations and reduce the
level of their stress and isolation [32]. Being close to the grass-roots,
programs seem more eager to evaluate their effectiveness directly through
feedback from clients as well as from social agencies [51].
The definition of abuse has been changing over time from one of "cruelty
to children" to abuse of parent authority [74], but the system has come in for
criticism of late for excessive support of parental rights [71]. While some
claim the central registeries to be statistically successful [125], other
criticize them for violating civil liberties, using machines to solve human
problems, and being time consuming and costly [90].
Making comparisons of systems is difficult, but Christopherson, in
comparing the British and the Dutch systems, points the rigidity of the
British model, which is a legal model, compared to the flexibility of the
Dutch, which is a medical model. The British system, on the other hand, gives
rise to more self-help activities in an effort to avoid the intervention of
the state, whereas the Dutch system, in its paternalism, generates more
dependency [29].
But, while the British system may be criticized for its rigidity, its
court structure seems to bend over backwards to protect the interests of
children. The juvenile court has complete jurisdiction over child abuse cases
and the parents have no standing in the court at all. The child is provided
with a guardian ad litem as a matter of course. Only the child has a right of
appeal; the rights of parents are restricted solely to responding to
allegations. The object of a hearing is to protect the interests of the child
and not to demonstrate guilt or innocence [14].
One should not assume, however, that such practices are necessarily
uniform throughout the U.K. In Scotland, for instance, lay volunteers are
appointed to hold hearings on acts of juvenile delinquency, and child abuse
falls within their jurisdiction. Critics hold this system not to be entirely
adequate to deal with child abuse and neglect insofar as social workers' views
are thought to have too much weight with the panel, there is often a
reluctance to discuss sensitive matters, and there is generally a lack of
interest in making special arrangements for abused children [123].
Germany
Neither does Germany have a mandatory reporting law; furthermore, there
is not much support for one. It is argued that existing laws which require
any citizen to report a crime is adequate. More to the point, perhaps, is the
German fear of laws which require neighbors and professionals to report
incidents to the police. It smacks of the denunciation which characterized
Nazi Germany [20,129]. That is a thought which other so-called "progressive"
lands seem not to contemplate in their zeal. In any case, child abuse is
reported. The prevailing definition is sone that stresses intent and
non-accidental use of force on the part of a caretaker [93].
In Germany, legal responsibility for child abuse matters falls, depending
on the area, to the juvenile court or the department of social services.
Ordinarily, when a matter comes to the attention of the police, it will be
handled as a criminal matter, and the parents will be treated punitively
[93,129] Social services will be responsible for placing the child in foster
care and attending to its immediate needs, but programs for parents are
virtually non-existent.
Into this situation has developed a series of grass-roots private
agencies which encourage people to report to them suspected abuse as
alternatives to police and state social services. Professionals and lay aides
visit families, provide therapy, counseling and social support, all the while
attempting to insure the safety of the child, heal the family, and keep the
parents out of the hands of the law [1,80,81,129].
The Netherlands and Belgium
In the Netherlands, the legal definition of child abuse and neglect is
left to the Confidential Doctor, a legal entity established in 1972 which had
expanded to eleven offices by 1982, enables children to be protected and
abusive parents to get help without fear of legal repercussions
[29,153,185,193]. The confidential doctor, a counterpart of which also having
been developed in Belgium [30,170], is empowered to investigate cases, make
recommendations and take action to stop and remedy abuse without taking the
matter to the police or prosecutor. He operates informally with families and
relies on parental interest in their children and their desire to keep the
family together to accomplish his task. In the event that parents are
uncooperative, he still has the option of invoking legal remedies through the
prosecutor's office, but that is said to be seldom the case. Because of his
ability to operate independently of the legal system, the confidential doctor,
a medical person who is assisted by non-medical social work and psychiatric
personnel, is free to seek alternative forms of assistance. As the name
implies, cases are handled in confidence with the hope that the stigma
attached to the accusation of child abuse, will be minimized and parents
thereby encouraged to come and cooperate voluntarily. The prosecutor may,
however, participate in case investigations.
The Dutch experiment freely with treatment methods. The Triangel, for
instance, is described as a socio-therapeutic institute which provides a
live-in, therapeutic living environment for six months or more. The purpose
is to bring dysfunctional families together, and it provides medical,
psychiatric and other therapy. It is voluntary on the part of the client
families who apply upon referral by social service agencies [184]. Still,
while many programs are being generated, along with much excitement as long as
the child is present, evidence indicates that long-term care and follow-up
after the child leaves the custody of the social workers, is not adequate.
Often agencies do not know what further steps to take and who should assume
responsibility, and very often it is not even clear who is to take
responsibility for and coordination of aftercare policy [193].
Australia
In Australia, the states empower agencies, such as the Department of
Youth and Community Services in New South Wales, to deal with child abuse and
neglect. Services are comprehensive and multi-disciplinary and places
emphasis on inter-agency cooperation. Recently, laws have been adopted
requiring reporting and have incipient public and private programs [7,79].
Emphasis is placed on service delivery as well as public education about
problems of parenting [15]. Interdisciplinary and interagency cooperative
arrangements seem to be the rule in Australia [46,72,79] which enhances
flexibility and innovation in service delivery, such as the Residential
Weekend Program for parents and children which gives agency personnel the
opportunity to observe family interaction in a protected and enjoyable setting
[10], and drop in centers for parents which help overcome isolation and lack
of extended family contacts [7]. Private agency activities also supplement
state activities, such as The Prevention Service, a private telephone crisis
line [61], and the Parent Support Service, a private, volunteer counseling
service [167]. Lack of sensitivity on the part of medical personnel to key
characteristics of babies and new mothers, such as, low birth weight,
premature birth, and ailments that cause stress for the mother, have given
rise to programs for professional education [67].
France
France, like Sweden and other countries, takes the position that child
protection is met best with basic family policy, and personal social service
delivery systems cannot substitute for this. There are no special programs to
intervene in situations of child abuse or neglect. Instead, extensive family
benefits are believed to be the appropriate forms of effort, and danger to
children is the focus of attention rather than the guilt of parents.
Primary identification comes from regular community health screening and
day care facilities. In the case of great danger or lack of cooperation by
parents, police can intervene and the court can become involved. Reporting is
mandatory, however [93,111,113,174,196].
Italy
In Italy, reporting is mandatory for professionals and all reports go
directly to the prosecutor or the police. There is no specific legislation
dealing with child abuse, and as such, child abuse is considered criminal
activity as any other. Abusing parents seldom escape punishment once brought
to court, and parents are frequently and easily deprived of their children.
The judge has almost no discretion is applying penalties and the child has no
independent representation in court. The laws that govern the matter were
originally written during the Fascist regime, and are seen by critics to
reflect that same dictatorial, authoritarian quality [178]. As an indication
of a growing movement for reform of child abuse policies in Italy, recently
(1980) the Italian Association for the Prevention of Child Abuse was formed
[22].
Other countries
Little of substance is known about specific legal or social service
practices concerned with child abuse in the rest of the world. But in
general, specific legislation dealing with child abuse seems to be uncommon in
the rest of the world. Law tends to reflect the interests of strong,
patriarchal family structure, such as in Greece [182] and Turkey [147].
There is little sentiment for a separate child abuse policy, and general
family policy is often seen as being adequate to deal with the issues, as in
Israel, for example [93]. Therapeutic teams are active in Switzerland with
their goals being to protect against recurrence, establish an alliance with
the parents, and change the structural relationships within the family such
that the child receives adequate care. Emphasis is placed on tri-generational
disturbances in abusing families [124].
As indicated earlier, little is known about child abuse policy in Eastern
Europe. In general, existence of child abuse and neglect is denied in
socialist countries, especially in the U.S.S.R. [95]. It is known, however,
that reporting is mandatory in the German Democratic Republic and Yugoslavia.
In Poland the nation national government sets the policy and determines what
will occur, while in Yugoslavia the national government sets no policy. In
Poland universal free child health programs exist throughout the country,
however only fifty percent of school-age children participation regular
medical examination which could screen abuse [93].
Social responses to sexual abuse
Although the discovery of sexual abuse in recent years has given rise to
an immense amount of legal and social service activity in the U.S., there is
little evidence that this excitement has spread very far beyond.
Apart from casual observations about the decline of female circumcision
with the increase in urbanization [146] and the reluctance of adults in India
to talk about sexual abuse for fear of harming a girl's future [132], issues
related to sexual abuse in the Third World are not mentioned at all by native
speakers. Only Westerners comment on Third World practices which would be
said to be abusive in the West, such as, ritual defloration of brides by
older men [109], female circumcision [116], and adult female admiration and
twitching of male children's genitals in public [147]. The Third World is
much more concerned with inadequate nutrition and family disintegration.
In the West, most activity is to be found in the U.S. Indeed some, as in
Italy , do not think sexual abuse should be considered under the topic of
ill-treatment; rather, it should be simply a criminal offense [178]. The
U.S., however, has been developing extensive experience in non-punitive
therapy. Individual and group therapy, couples and family therapy are all
used in various programs for both victims and offenders [45,57,165]. At the
same time the criminal law is used to gain cooperation of the offender.
Usually, a guilty plea is exchanged for a promise of a suspended sentence if
therapy is entered and successfully completed. Evidence indicates a high
success rate [57]. In some areas, law enforcement officers are being trained
to act as therapists to ease the pain of investigation for victims [173]. To
increase conviction rates, though, legal principles are being redefined to
permit more effective prosecution. Hearsay testimony is now widely permitted
when the victim is a child and there is supporting evidence [195].
Conclusion
Social responses to child abuse may be summarized as follows:
1. Little of substance is known about the problem outside of the West, and
especially outside of the English-speaking world.
2. Definitions of child abuse vary widely and wildly.
3. The Third World sees the problem in terms of the breakdown of the
traditional family and culture. The Western World sees the problem in terms
of the perpetuation of the traditional family and culture.
4. That which is known about the Third World is to a large extent reported by
Westerners who view the Third World in terms of Western values.
5. Whether individual service delivery or a comprehensive family policy is
the best way to deal with the problem is a matter of wide debate.
6. There is no clear evidence that any existing policy or program is entirely
successful in stopping or preventing child abuse. Either the problem as
defined continues in spite of the policy, other factors may be said to
contribute to apparent success, or necessary information is not available to
back up claims of success.
The matter of definition, in my view, is the most important
consideration, and it does not lend itself to easy resolution or, perhaps, any
resolution. The question of child-rearing is at root a matter of values, not
empirical science or bureaucratic programs and policy. The ultimate questions
to be answered are: What does it mean to be a competent adult? By what means
is such a person to be created? How is it that so many people survive to
become functioning, contributing human beings in spite of the means used to
raise them?
This is not a call for cultural relativism. Total cultural relativism is
not a useful perspective insofar as cultural practices devised under certain
conditions and with respect to certain values, may not be adequate to deal
with changing circumstances. This would surely seem to be the case with much
of the Third World, and the Industrial World, too, for that matter. The Third
World must know that the conditions of modern life require new conceptions of
both competent adults as well as the means to achieve them. But, by the same
token, the Industrial World must also know that the conditions of modern life
may require re-establishment of long-lost conceptions of competent adults and
the means to achieve them.
It is in these areas that child abuse research and analysis must be
directed, in my view. I believe that a truly international analysis of the
problem must take place, however, for as this review indicates, Western
research tends to dominate the field and reflect Western values and
perspectives which themselves are deficient. As long as that continues, the
results necessarily will be negatively affected.
The information about child abuse must also be improved. The field of
child abuse has experienced a massive explosion of information which by now is
as practically unmanageable as it is intellectually useless. Most of the
literature available is of mere descriptions of a-theoretical local programs
or a-theoretical and ill-conceived, narrowly defined and poorly executed
research on non-generalizable populations.
Beyond that, the usual academic and professional sources are quite
inadequate to the task. In many cases, they are hopelessly out of date,
sometimes even by the time they appear in print. This obsolete information
then remains in libraries, sometimes not being updated for years, if ever.
The local popular press, print and electronic, is a much more current source
of information, and more effort should be dedicated to exploiting it as a
source of information.
In my opinion, concerned scholars should address themselves in
international concert first to the philosophical problems of child rearing;
then to the empirical observation of society in the broadest possible,
international context; and, finally, to work for the establishment of
effective, current information from the entire world, and most especially from
the Third World, Eastern Europe and Latin America. If anything is to
contribute to the world-wide welfare of children, it will more likely spring
from such endeavor and not from ill-considered state intervention or the
mindless continued development of programs.
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41 Endicott, O. Civil liability for failure to report child abuse. Child Abuse & Neglect 3:633-641 (1979)
42 Engfer, A. & Schneewind, K. Causes and consequences of harsh punishment: An empirical investigation in a representative sample of 570 German families. Child Abuse & Neglect 6:129-139 (1982)
43 Fauri, D. Protecting the child protective service worker. Soc Work 23:62-4 Ja l978
44 Feshbach, S. & Feschbach, N. Child advocacy and family privacy. J Soc Issues 34 no2:168-78 l978
45 Forseth, L. & Brown, A. A survey of intrafamilial sexual abuse treatment centers: Implications for intervention. Child Abuse & Neglect 5:177-186 (1981)
46 Fotheringham, B. Interdisciplinary approaches to the problems of child abuse in South Australia. Child Abuse & Neglect 1:241-244 (1977)
47 Fraser, B. The concept of a guardian ad litem. Child Abuse & Neglect 1:459-468 (1977)
48 Fraser, G. & Kilbride, P. Child abuse and neglect - rare, but perhaps increasing, phenomena among the Samia of Kenya. Child Abuse & Neglect 4:227-232 (1980)
49 Fraser, J. Child abuse in America: A de facto legislative system. Child Abuse & Neglect3:35-43 (1979)
50 Fraser, M. Child pornography. New Statesman 95:213 F 17 1978
51 Fry, A. Assessment in child abuse: An account of a system operated in the Metropolitan Borough of Barnsley by the NSPCC Special Unit. Child Abuse & Neglect 5:159-165 (1981)
52 Garbarino, J. The elusive 'crime' of emotional abuse. Child Abuse & Neglect 2:89-99 (1978)
53 Gelles, R. & Cornell, C. International Perspectives on Child Abuse Child Abuse & Neglect 7:375-386 (1983)
54 Gelles, R. Problems in defining and labeling child abuse. in Starr (ed.) pp 1-30.
55 Gelles, R. Child abuse as psychopathology: A sociological critique and reformulation. American Journal of Orthopsychiatry 43:611-621 (1973)
56 Gelles, R. Violence towards children in the United States. American Journal of Orthopsychiatry 48:580-592 (1978)
57 Giaretto, H. Humanistic treatment of father-daughter incest. Child Abuse & Neglect 1:411-426 (1977)
58 Gifford, C. et al. Parent Aides in Child Abuse and Neglect Programs. DHEW Publ. no. (OHDS) 79-30200 Ag l979
59 Gil, D. Violence Against Children: Physical Abuse in the United States. Cambridge, Mass.: Harvard University Press, 1970.
60 Gil, D. (ed.) Child Abuse and Violence. New York: AMS Press, 1979
61 Ginn, D. The Prevention Service. Child Abuse & Neglect 1:125-131 (1977)
62 Giovannoni, J. & Becerra, R. Defining Child Abuse. New York: The Free Press, 1979
63 Girodet, D. La violence medicale envers les juenes enfants. Child Abuse & Neglect 5:335-342 (1981)
64 Goldstein, J. et al. Beyond the Best Interests of the Child. New York: Free Press, 1973
65 Gray, J. & Kaplan, B. The Lay Health Visitor Program: an eighteen-month experience. in Kempe, C. & Helfer, R. (eds.) pp 373-378.
66 Gregersen, M. & Vesterby, A. Child abuse and neglect in Denmark: Medico-legal aspects. Child Abuse & Neglect 8:83-91 (1984)
67 Gurry, D. Child abuse: Thoughts on doctors, nurses and prevention. Child Abuse & Neglect 1:435-443
68 Guyer, M. child abuse and neglect statutes: Legal and clinical implications. Am J Orthopsych 52:73-81 Ja l982
69 Haditono, S. Prevention and treatment of child abuse and neglect among children under five years of age in Indonesia Child Abuse & Neglect 5:97-101 (1981)
70 Hafen, B. Puberty, privacy, and protection: The risks of children's rights; does the movement toward children's rights contain the seeds of destruction for the family? Am Bar Assn J 63:1383-8 O l977
71 Hall, J. & Mitchell, B. The role of the law in protecting the child: A critique of the English system. Child Abuse & Neglect 6:63-69 (1982)
72 Hamory, J. & Jerrery, M. Flexibility and innovation in multi-disciplinary management of child abuse in Western Australia. Child Abuse & Neglect 1:217-239(1977)
73 Harrison, M. Home-Start: A voluntary home-visiting scheme for young families. Child Abuse & Neglect 5:441-447 (1981)
74 Heap, K. Work with parents of abused and neglected children. Child Abuse & Neglect 6:335-341 (1982)
75 Heinsen, E. Wie gross is das Ausmass von Gewalt gegen Kinder? Probleme mit Zaehlungen und Schaetzungen zur Kindesmisshandlung. in Honig, M. (ed.); pp. 95-126
76 Helfer, R. A review of the literature on the prevention of child abuse and neglect. Child Abuse & Neglect 6:251-261 (1982)
77 Helfer, R. & Kempe, C. (eds.) Child Abuse and Neglect: The Family and the Community. Cambridge, Mass.: Ballinger, 1976.
78 Hersch, S. Sweden's approach to health screening for pre-school children. Am J Orthopsych 48:33-9 Ja l978
79 Heyworth, B. S.C.A.N. teams in Queensland--New legislation to combat child abuse. Child Abuse & Neglect 5:257-265 (1981)
80 Honig, M. Was tun Jugendaemter in Faellen von Kindesmisshandlung? Ergebnisse einer Umfrage. in Honig, M. (ed.); pp. 127-170
81 Honig, M. & Wolff, R. Neue Kinderschutz-Arbeit in der Bundesrepublik - eine Zwischenbilanz. Soziale Arbeit 32:613-622 (1983)
82 Honig, M. (ed.) Kindesmisshandlung. Munich: Juventa Verlag, 1982
83 Howell, J. The role of law enforcement in the prevention, investigation and treatment of child abuse. in Kempe, C. & Helfer, R. (eds.); pp. 306-315.
84 Ikeda, Y. A short introduction to child abuse in Japan. Child Abuse & Neglect 6:487-490 (1982)
85 Izuora, G. & Ebigbo, P. Emotional reactions of adult Africans to children with severe Kwashiorkor. Child Abuse & Neglect 7:351-356 (1983)
86 Jacobson, R. & Straker, G. Peer group interaction of physically abused children. Child Abuse & Neglect 6:321-327 (1982)
87 Jinadu, M. The role of neglect in the aeteology of protein-energy malnutrition in urban communities of Nigeria. Child Abuse & Neglect 4:233-245 (1980)
88 Jinadu, M. et al. Some factors affecting mother-child relationships following low birth-weight deliveries in a Nigerian sociocultural environment. Child Abuse & Neglect 6:57-62 (1982)
89 Johnson, O. The socio-economic context of child abuse and neglect in native South America in Korbin, J. (ed.); pp. 56-70
90 Jones, D. et al. Central child abuse registers: The British experience. Child Abuse & Neglect 3:157-166 (1979)
91 Jones, S. Reganomics as child-abuse: Case study Milwaukee. [impact of federal budget cuts on child welfare programs in the city.] Pol Affairs 60:16-18+ N l981
92 Justander, K. Report of a child abuse awareness campaign in Finland. Child Abuse & Neglect 7:485-486 (1983)
93 Kahn, A. & Kamerman, S. Child abuse: A comparative perspective. in Gerbner, G. et al. (eds); pp. 118-132
94 Kahn, A. & Kamerman, S. Social Services in International Perspective. DHEW Publ. No. (SRS) 76-05704, 1976
95 Kaiser, G. Child abuse in West Germany. Victimology 2:294-306 (1977)
96 Kamerman, S. Eight countries: Cross national perspectives on child abuse and neglect. Children Today 4:34-37 (1975)
97 Kempe, C. Recent developments in the field of child abuse. Child Abuse & Neglect 2:261-267 (1978)
98 Kempe, C. & Helfer, R. (eds.) The Battered Child (3rd ed.) Chicago: University of Chicago Press, 1980.
99 Kempe, C. et al. The battered-child syndrome. Journal of the American Medical Association 181:17-24 (1962)
100 Kjonstad, A. Child abuse and neglect: Viewed in relation to 12 fundamental principles in a western social and legal system. Child Abuse & Neglect 5:421-429 (1981)
101 Knitzer, J. Child advocacy: a perspective. Am J Orthopsych 46:200-16 Ap 1976
102 Komlosi, S. changes in Hungarian families. Ekistics 45:369-70 S l978
103 Korbin, J. A cross-cultural perspective on the role of the community in child abuse and neglect. Child Abuse & Neglect 3:9-18 (1979)
104 Korbin, J. Anthropological contributions to the study of child abuse. Child Abuse & Neglect 1:7-24 (1977)
105 Korbin, J. 'Very few cases': Child abuse and neglect in the People's Republic of China. in Korbin, J. (ed.); pp. 166-185
106 Korbin, J. The cross-cultural context of child abuse and neglect. in Kempe, C. and Helfer, R. (eds.) pp. 21-35.
107 Korbin, J. Child Abuse and Neglect: Cross-Cultural Perspectives: Introduction and Conclusion. in Korbin, J. (ed.); pp. 1-12, 205-210.
108 Korbin, J. (ed.) Child Abuse and Neglect: Cross-Cultural Perspectives. Berkeley, Cal.: University of California Press, 1981
109 Langness, L. Child abuse and cultural values: The case of New Guinea. in: J. Korbin (ed.) pp. 13-34
110 Larsson, G. & Ekenstein, G. Institutional care of infants in Sweden: Criteria for admission in 1970, 1975 and 1980. Child Abuse & Neglect 7:11-16 (1983)
111 Larsson, G. et al. Are the social workers prepared to assist a changing population of dysfunctional parents in Sweden? Child Abuse & Neglect 8:9-14 (1984)
112 Lavaud, J. et al. Serious cases of battered children: Experience of a multi-service pediatric intensive care department. Child Abuse & Neglect 6:231-232 (1982)
113 Lefeuvre, E. Intervention de la police en France, dans le milieu familial, en cas de mauvais traitements a enfants. Child Abuse & Neglect 6:193-198 (1982)
114 Lempp, R. Psychological damage to children as a result of sexual offences. Child Abuse & Neglect 2:243-245 (1978)
115 Levin, L. Anti-slavery Society for the Protection of Human Rights: Child labor programme. Child Abuse & Neglect 7:119-121 (1983)
116 LeVine, S. & LeVine, R. Child abuse and neglect in sub-saharan Africa in Korbin, J. (ed.) pp. 35-55
117 Levinson, D. Physical punishment of children and wifebeating in cross-cultural perspective. Child Abuse & Neglect 5:193-195 (1981)
118 Lieber, L. & Baker, J. Parents-Anonymous - Self-help treatment for child-abusing parents. Child Abuse & Neglect 1 (1977)
119 Loening, W. Child abuse among the Zulus: A people in transition. Child Abuse & Neglect 5:3-7 (1981)
120 Lupton, G. Prevention recognition management and treatment of cases of non-accidental injury to children: Arrangements in the United Kingdom. Child Abuse & Neglect 1:203-209 (1977)
121 Manchester, A. The law of incest in England and Wales. Child Abuse & Neglect 3:679-682 (1979)
122 Marcoulis, H. Child abuse: The Greek scene. Child Abuse & Neglect 3:185-190 (1979)
123 Martin, F. et al. The role of children's hearings in child abuse and neglect. Child Abuse & Neglect 6:313-320 (1982)
124 Masson, O. Mauvais traitements envers les enfants et therapie familiale. Child Abuse & Neglect 6:47-56 (1982)
125 Maton, A. & Pickett, J. Central registration of child abuse. Child Abuse & Neglect 3:167-174 (1979)
126 Matthews, P. A multidisciplinary urban response to child abuse and neglect. Child Abuse & Neglect 1:245-254 (1977)
127 Mayhall, P. & Norgard, K. Child Abuse and Neglect: Sharing Responsibility. New York: Wiley, 1983.
128 McClare, G. The management of child abuse and neglect cases in schools: The Toronto model. Child Abuse & Neglect 7:83-89 (1983)
129 McGehee, C. Child abuse in the Federal Republic of Germany. Victimology 6:215-233 (1981)
130 Mehra, B. Highlights on abuse in education: A view from India. Child Abuse & Neglect 6:225-228 (1982)
131 Mehta, M. Physical abuse of abandoned children in India. Child Abuse & Neglect 6:171-175 (1982)
132 Mehta, M. & Bhatt, S. 'Rape' in children. Child Abuse & Neglect 3:671-677 (1979)
133 Mehta, M. et al. Adoptions: Follow-up from an orphanage in Bombay. Child Abuse & Neglect 7:79-82 (1983)
134 Meiselman, K. Incest. San Jose, CA.: Jossey-Bass, 1978.
135 Micozzi, M. Childhood hypertension and academic standing in the Philippines. Am J Pub Health 70:530-2 My l980
136 Morris, B. Value difference in definitions of child abuse and neglect. Jehovah Witnesses: a case example. Child Abuse & Neglect 3:651-655 (1979)
137 Mrazek, P. et al. Sexual abuse of children in the United Kingdom. Child Abuse & Neglect 7:147-153 (1983)
138 Mumba, J. Adoption in Zambia. Child Abuse & Neglect 5:197-199 (1981)
139 Nakou, S. et al. Health status of abused and neglected children and their siblings. Child Abuse & Neglect 6:279-284 (1982)
140 National Center on Child Abuse and Neglect. Representation for the Abused and Neglected Child: The Guardian Ad Litem and Legal Counsel. DHHS Pub. No. (OHDS) 80-30272
141 Nathan, L. & Hwang, W. Child abuse in an urban centre in Malaysia. Child Abuse & Neglect 5:241-248 (1981)
142 Newberger, E. & Bourne, R. Medicalization and legalization of child abuse. Am J Orthopsych 48:593-607 O l978
143 Nixon, J. & Pearn, J. Non-accidental immersion in the bath: another extension to the syndrome of child abuse and neglect. Child Abuse & Neglect: 1:445-448 (1977)
144 Oates, R. & Hufton, I. The spectrum of failure to thrive and child abuse: a follow-up study. Child Abuse & Neglect 1:119-124
145 Ojofeitimi, E. & Odusote, A. Assessment of marginal nutrition and means of preventing communicable diseases in twins: An implication for intensive follow-up. Child Abuse & Neglect 6:295-297 (1982)
146 Okeahialam, T. Child abuse in Nigeria. Child Abuse & Neglect 8:69-73 (1984)
147 Olson, E. Socio-economic and psycho-cultural contexts of child abuse and neglect in Turkey. in Korbin, J. (ed.); pp. 96-119
148 Olson, J. Using central registers to monitor and guide child abuse treatment activities. Child Abuse & Neglect 3:151-156 (1979)
149 Oyemade, A. Child care practices in Nigeria - an urgent plea for social workers. Child Abuse & Neglect 4:101-103 (1980)
150 Panter, B. Lithium in the treatment of a child abuser. Am J Psych 134:1436-7 D l977
151 Peltoniemi, T. Child abuse and physical punishment of children in Finland. Child Abuse & Neglect 7:33-36 (1983)
152 Petersson, P. Child abuse and neglect as a public health problem. Child Abuse & Neglect 1:199-201 (1977)
153 Pieterse, J. The Confidential Doctor in the Netherlands. Child Abuse & Neglect 1 (1977)
154 Pilger, J. Frogmarched into slavery. New Statesman 104:10-12 Ag 20 l982
155 Pillai, V. et al. Family walk-in centre--Eaton Socon: Evaluation of a project on preventative intervention based in the community. Child Abuse & Neglect 6:71-79 (1982)
156 Poffenberger, T. Child-rearing and social structure in rural India: Toward a cross-cultural definition of child abuse and neglect. in Korbin, J. (ed.); pp. 71-96
157 Polier, J. Professional abuse of children: Responsibility for the delivery of services. Am J Orthopsych 45:357-62 Ap l975
158 Poulton, G. & Poulton, L. SCOPE - for parents and children. Child Abuse & Neglect 3:351-355 (1979)
159 Reid, S. Cultural difference and child abuse intervention with undocumented Spanish-speaking families in Los Angeles. Child Abuse & Neglect 8:109-112 (1989)
160 Ritchie, J. & Ritchie, J. Child rearing and child abuse: The Polynesian context. in Korbin, J. (ed.); pp. 186-204
161 Roberts, J. & Lynch, M. Residential assessment and treatment of abused children and their families. Child abuse & Neglect 1:489-490 (1977)
162 Roberts, J. et al. Prevention of child abuse. Group therapy for mothers and children in the community. Child Abuse & Neglect 1:487-488 (1977)
163 Schmitt, B. et al. The child protection team: a problem-oriented approach. in Helfer, R. & Kempe, C. (eds.) pp. 91-113.
164 Sereewat, S. The work of the Foundation for Children in Thailand. Child Abuse & Neglect 7:359-361 (1983)
165 Shamroy, J. A perspective on childhood sexual abuse. Social Work 25:128-31 Mr l980
166 Shay, S. Community Council for Child Abuse Prevention. in Kempe, C. & Helfer, R. (eds.)
167 Smart, E. & Hicks, B. The Parent Support Service (Australian Capital Territory). Child Abuse & Neglect 3:357-362 (1979)
168 Smith, S. The Battered Child Syndrome London: Butterworths, 1975
169 Solheim, J. A cross-cultural examination of use of corporal punishment on children: A focus on Sweden and the United States. Child Abuse & Neglect 6:147-154 (1982)
170 Soumenkoff, G. et al. A coordinated attempt for prevention of child abuse at the antenatal care level. Child Abuse & Neglect 6:87-94 (1982)
171 Starr, R. (ed.) Child Abuse Prediction: Policy Implications. Cambridge, Mass.: Ballinger, 1982
172 Stenbak, E. Preparation of healthy children for a hospital environment. Child Abuse & Neglect 6:485-486 (1982)
173 Stone, L. et al. Law enforcement officers as investigators and therapists in child sexual abuse: A training model. Child Abuse & Neglect 8:75-82 (1984)
174 Straus, P. L'ecole maternelle et les enfants maltraits. Child Abuse & Neglect 3:191-197 (1979)
175 Strauss, M. et al. Behind Closed Doors: Violence in the American Family. Garden City, NY: Anchor/Doubleday, 1980.
176 Takinishi, R. Childhood as a social issue: Historical roots of contemporary child advocacy movements. J Soc Issues 34 no2:8-28 l978
177 Taskinen, S. The Finnish approach to helping personnel deal with child abuse and neglect. Child Abuse & Neglect 8:113-115 (1984)
178 Tauber, E. et al. Child ill-treatment as considered by the Italian criminal and civil codes. Child Abuse & Neglect 1: (1977)
179 Tevoedjre, I. Violence and the child in the adult world in Africa. Child Abuse & Neglect 5:495-498 (1981)
180 Trowell, J. & Castle, R. Treating abused children: Some clinical and research aspects of work carried out for the NSPCC to children in the UK. Child Abuse & Neglect 5:187-192 (1981)
181 Trzcinski, J. Emergency shelter: The vital link in protective services. Soc Casework 59:621-5 D l978
182 Tsiantis, J. et al. Parents of abused children in Greece: Psychiatric and psychological characteristics: Results of a pilot study. Child Abuse & Neglect 5:281-285 (1981)
183 Uviller, R. Save them from their saviors: the Constitutional rights of the family. in Gerbner et al. (eds.); pp. 147-155.
184 van Rees, R. et al. The Triangel (socio-therapeutic institute) Child Abuse & Neglect 2:207-215 (1978)
185 Van Ruller, E. The confidential doctor in the Netherlands. Child Abuse & Neglect 5:491-493 (1981)
186 Vesterdal, J. Handling of child abuse in Denmark. Child Abuse & Neglect 1:193-198 (1977)
187 Wagatsuma, H. Child abandonment and infanticide: A Japanese case. in Korbin, J. (ed.); pp. 120-138
188 Walters, D. Physical and Sexual Abuse of Children: Causes and Treatment. Bloomington, Ind.: University of Indiana Press, 1975
189 Welch, M. Childhood socialization differences in African and non-African societies. J Soc Psychol 106:11-15 O l978
190 Wichlacz, C. & Wechsler, J. American Indian law on child abuse and neglect. Child Abuse & Neglect 7:347-350 (1983)
191 Wilson, F. A look at corporal punishment and some implications of its use. Child Abuse & Neglect 6:155-164 (1982)
192 Wolff, R. Origins of child abuse and neglect within the family. Child Abuse & Neglect 5:223-229 (1981)
193 Wolters, W. & Dekker-Roelofs, M. The battered child: A study of the role of services in 25 cases of child abuse in the Netherlands. Child Abuse & Neglect 7:301-307 (1983)
194 Wu, D. Child abuse in Taiwan. in Korbin, J. (ed.); pp. 139-165
195 Yun, J. A comprehensive approach to child hearsay statements in sex abuse cases. Columbia Law R 83:1745-66 N l983
196 Zeiller, B. Sevices physiques et psychiques: Devenir d'adolescents mailtraites et delinquants. Child Abuse & Neglect 6:207-210 (1982)
197 Ziegert, K. The Swedish prohibition of corporal punishment: A preliminary report. J Marr & Fam 45:917-26 N 1983
198 Zimrin, H. Building up a new service for the abused child. Child Abuse & Neglect 7:55-60 (1983)
199 Zinn, H. Influence of home environments on the socialization of children. Ekistics 47:98-102 Mr l980
200 Solnit, A. Too much reporting, too little services: Roots and prevention of child abuse. in Gerbner et al. (eds.); pp. 135-146
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