Lancet: Child abuse / neglect is far more common than thought - apparently
From the Lancet today:
Child maltreatment remains a major public-health and social-welfare problem in high-income countries. Every year, about 4–16% of children are physically abused and one in ten is neglected or psychologically abused. During childhood, between 5% and 10% of girls and up to 5% of boys are exposed to penetrative sexual abuse, and up to three times this number are exposed to any type of sexual abuse. However, official rates for substantiated child maltreatment indicate less than a tenth of this burden.
Exposure to multiple types and repeated episodes of maltreatment is associated with increased risks of severe maltreatment and psychological consequences. Child maltreatment substantially contributes to child mortality and morbidity and has longlasting effects on mental health, drug and alcohol misuse (especially in girls), risky sexual behaviour, obesity, and criminal behaviour, which persist into adulthood. Neglect is at least as damaging as physical or sexual abuse in the long term but has received the least scientific and public attention. The high burden and serious and long-term consequences of child maltreatment warrant increased investment in preventive and therapeutic strategies from early childhood.
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The excerpt is all you get to read, sunshine. So you will have to take part in the complex debate based on secondhand accounts and shouty newspapers.
Detailed definitions of terms are absolutely critical here, and I have seen any in any of the early news reports, nor am I hearing any on the BBC: definitions such as “persistently made to feel useless or worthless” is not good enough or clear enough for such an important debate. We need the detail before we can have an intelligent conversation.
Combine that with the tendency of lobbying groups to obfuscate any difference between reasonable parental discipline (”smacking”) and abuse (”hitting” or “beating up”), and subsume it all into a blood-red cloud of “violence against children” which demonises anyone who disagrees with the “ban all smacking” view, and you see the problem.
I’m not going near the detail of this report until I have seen the full definitions of the terms used, but I will not be surprised if it turns into a professional political football very quickly.
The thing that worries me is that we may get a “we must do something and this government is going to ACT” reaction, since to date I am reasonably persuaded by the view that taking a child away from its parents is quite likely to cause more damage than the original issue if there is not a really serious problem. The New Labour gut reaction will be - as it always is - more government, more regulation, more control, more supervision, more expenditure, more removals of children, more databases, more agencies, and more of everything else; I wonder what we could do to make it different this time? The current system is in something of a mess, and I don’t think that making the mess bigger will fix it.
Perhaps - against the noise - one thing that we can learn from the Baby P case is that a proliferation of government activity is the one thing that is unlikely to work, since that was what they tried last time and it just seems to have created more cracks for cases to fall down.
My first tentative thought is that one of the key philosophical principles we need to turn to is to rebuild human relationships in human communities on a human scale. Maybe we need a second Schumacher to write about child-rearing and letting children get on with it, and better relationships with our spouses and extended familes, rather than 687245 more parenting-inspectors and 24683 extra people with clipboards to audit social workers and then fill in a tickbox.
Personally, if I had children and could afford it, I would be sorely tempted - like Longrider - to leave the country to get away from the random blunderings and meanderings of our present government, and work here virtually if at all. Alas - I have no farmhouse in Southern Europe.
Tags: child abuse, child neglect, child protection, lancet, social work
Categories: All WW, Comment, News - Current Affairs, Politics
I saw mention of the Lancet piece in Time, and the first thing that occurred to me was the near-continuous broadening of the definition of abuse over the past several decades. As you mention above, this broadening brings with it a conflation of physical discipline and real abuse. In their zeal, though, the “abuse”-broadening advocates create a cultural context in which the distinction is blurred, and there seems to be little consideration of the downsides of this confusion. It lowers the threshold at which one might consider oneself an abuser, adding a note of anxiety and fatalism to moments when anger-management taxes one’s resources. It breeds disrespect for the arbiters of abuse standards, in the way that stupid laws undermine respect for the law generally. It sets up potentially arbitrary enforcements, by which anyone scolding or punishing a child can be penalized if exposed to zealots in the judicial system. It undermines parental autonomy, though families are still the most effective institutions for child-rearing. I wonder about the degree to which this sets in motion a self-fulfilling prophecy, too, according to which parents come to view themselves as less centrally responsible for their children’s outcomes, and become less engaged, thereby increasing the neglect problem.
—I have personally observed many zealously “non-violent” parents resorting to more subtle emotional manipulativeness (and many of the methods of discipline in parenting advice books amount to manipulativeness). This models for a child a deceitful method of anger-management, that conceals anger while finding covert ways to gain control over others’ behavior. Anger done well includes an element of vulnerability and intimacy, but a child exposed only to the “most effective” means of behavioral training never learns of this intimacy, and learns only that signals a time to covertly exercise power.
—A child who is spanked or yelled at has an obvious opportunity to become angry him- or herself, and in a loving household, an opportunity to go through the whole sequence of anger management, both internally and in the parent’s behavior-modeling, from initial feelings to making up afterward. And in a loving household, the limits of anger-expression observed by the parents demonstrate that some of the unpleasant events of human interactions are forgivable, and not occasions for vindictiveness.
—-The “most effective” methods of controlling a child’s behavior accustom that child to being manipulated and to manipulating others as a matter of course. The more primitive expressions of anger are more within a child’s grasp, and don’t render the child clueless in the exchange.
—Social scientists as a group are among the least ideologically diverse of occupational groups, especially over the past couple of decades. Conventional wisdom and peer pressure have created a context ill-equipped for open-mindedness, and social-science research should be taken with a grain (truckload?) of salt as a result.
—What else should one expect, though, from a discipline that models its understanding of the human spirit on the mechanistic physical sciences? Though quantum physics has been around for 3/4 of a century, the social sciences still seem incapable of incorporating its implications of spontaneity and ambiguity into their explanatory scheme, and persist in passive, externally-causal explanations that treat nature and nurture as the complete range of how a person becomes a person. Or else, they go postmodernist and skeptical about the possibility for general truths about the human condition because of the primacy of subjectivity and arbitrariness, as if nothing can be truly said about the dynamics of spontaneity within a world that is largely physically stable and determinate.