At least one in every four American children is abused or neglected at some time in their life. In 2017, the Centers for Disease Control and Prevention (CDC) says an estimated 1,720 children died from abuse or neglect. Child advocates say those statistics are just the tip of the iceberg.

April – child abuse awareness month – is a good time to look at what abuse can include and how to recognize it. Abuse and neglect come in many forms.

  • Physical abuse is when someone seriously hurts or injures a child on purpose. It does not include accidents.
  • Neglect is when a child’s basic human needs are not met – a safe place to live, enough food to stay healthy, health care and adult supervision.
  • Emotional abuse includes repeatedly making fun of, threatening, ignoring, bullying, belittling or doing other things that harm a child’s emotional health.
  • Sexual abuse is when an adult inappropriately touches a child or has a child inappropriately touch them. This includes touching “private” areas, taking sexual photos of a child or showing sexual photos or videos to a child. Fully 90% of child sexual abuse is done by someone the child or the child’s family knows.

Lifelong harm

A child who suffers abuse, neglect and other adverse childhood experiences (ACEs) has a significant disadvantage in terms of future health. The lifelong consequences include:

  • Disrupted or impaired brain development
  • Poor school achievement
  • Social and emotional behavior problems due top impaired development
  • Adopting risky health behaviors as an adult such as drug or alcohol abuse
  • Higher risk of contact with law enforcement; incarceration
  • Higher rates of disease and disability
  • Social adjustment problems
  • Early death
  • Altered DNA due to toxic stress, increasing the risk for the same problems in the abused child’s future children

The cost of child neglect and abuse was $124 billion in 2008, comparable to the costs of strokes or diabetes.

Childhood violence increases immediate physical injuries, of course. But, if left untreated, it increases the long-term chances of future victimization, becoming a perpetrator of violence, engaging in substance abuse, getting sexually transmitted diseases, having reproductive health problems, involvement in sex trafficking, lower school achievement and limited employment opportunities.

How to spot abuse

While cuts and bruises are easy to see, most child abuse and neglect is invisible. It’s often hard to know if a child is being hurt. We only see signs, or have a hunch, of what could be happening. These signs may mean abuse is occurring, but there could be other causes, too. These are examples of signs a child may be abused or neglected or otherwise needs help:

  • Has injuries (bruises, burns, cuts) that the child can’t or won’t explain, or explanation doesn’t make sense
  • Is frightened of parents or other adults
  • Hurts pets or other animals
  • Spends a lot of time at home without a parent or other caregiver
  • Uses alcohol or drugs
  • Avoids going home or spending time with a specific adult
  • Comes to school in dirty clothes
  • Child tells you he or she is being harmed

If you feel like something isn’t right about how a parent or other caregiver treats a child or how a friend is acting towards a child, you need to get help for the child. If a child is in immediate danger, call 9-1-1.

The best way to help a child is to listen to what they have say. Tell the child you care and want to help. Be sure the child knows he or she is not alone and what is happening is not the child’s fault. Help the child find a trusted adult they can talk to. There are national and local hotlines they can call for help. The Childhelp National Child Abuse Hotline (1-800-422-4453) has counselors available 24 hours every day to talk with children and adults about abuse and neglect; or visit the Childhelp web page.

Understanding risk for abuse

Although child abuse and neglect happen in all kinds of families, children living in poverty experience as much as five times more neglect and abuse. Other factors that increase the chances of abuse and neglect are:

  • Age 4 years or younger
  • Having special needs (disability, behavioral health issues or chronic physical illness)
  • Parents who do not understand children’s needs or development
  • Parents who were themselves abused or neglected
  • Family members who have substance abuse or mental health issues
  • Parents are young, single, have limited education, low income and who have many children
  • Nonbiological or transient caregivers in the home (mom’s boyfriend)
  • Parents whose emotions or beliefs support or justify mistreatment
  • Parents who feel isolated or overwhelmed
  • Family stress from divorce, separation, violence or money problems

Preventing child abuse and neglect can also prevent other forms of violence. Different types of violence have the same risks and protective factors and share many of the same prevention methods.

Helping each other

Research tells us that parents and caregivers who have support from family, friends, neighbors and their community are better parents. They are more likely to provide safe and healthy homes for their children. Without support, parents can feel isolated and overwhelmed. They are more likely to make poor decisions that lead to neglect or abuse. When parents learn good parenting skills (which may have been absent in their own parents), they are far better equipped to make good decisions involving their children. There’s more information here.

Children need safe, stable and nurturing environments to prevent child abuse and neglect. They need relationships with adults in their lives – parents, grandparents, family, teachers, medical professionals, neighbors – who can provide that safety and stability.

The following are other protective factors that we know can help reduce child abuse and neglect and build resilience against ACEs.

  • Stable family relationships
  • Basic needs are met, including housing and health care access
  • Parental employment and education
  • Preschool and kindergarten enrichment that engages family
  • Supportive family and social support network
  • Parenting skill development
  • Home visitation in early childhood

Consider supporting these programs in your community. Ask elected representatives to support them with laws and policies. Do your part to be sure every child has a safe, loving family and has their basic daily needs met.

To report suspected child abuse or neglect, call the Arkansas Child Abuse hotline at 1-844-728-3224 or toll-free at 1-800-482-5964. Find a Child Advocacy Center near you at

Children must rely on adults to secure these basic needs. That means all adults – regardless of whether they are parents or not – share the responsibility to make sure every child has these things. Healthy, happy childhoods are everyone’s responsibility.