Children have been maltreated and exploited throughout history. Evidence even exists that child abuse existed during the prehistoric period. Children have long been considered family property. Fathers in ancient times could sell, mutilate or kill their children. Many religions used child sacrifice to please and appease gods. Infanticide was common. Children born with infirmities, retardation or deformity were killed to maintain and strengthen society. In most cultures, severe punishment and harsh treatment were deemed necessary for rearing and educating children.
In Canada children were considered cheap farm labour until the end of the 19th century. As an economic asset they were counted and treated as such along with cows, chickens and horses. The residue of this history remains in current Canadian attitudes towards the use of corporal punishment and in the legal sanction of physical punishment by parents provided by current provisions of the Criminal Code of Canada.
Today child abuse is considered a worldwide social problem. Although it has been widely condemned, it remains a persistent, nondiminishing threat.
Forms of Child Abuse
A useful general definition of abuse is the placement of impediments to a child's social, emotional, cognitive and physical development by individuals or institutions. The most frequent further characterization of abuse has been as acts of commission and omission: physical abuse, sexual abuse, emotional abuse and neglect. Physical abuse occurs when a care giver inflicts or allows physical injury to a child that results in bruises, burns, broken bones and internal or skin injury. Sexual abuse involves any sexual use of a child by an adult. Emotional abuse is the use of threat, terrorism, rejection, diminishment or disparagement by a child's care giver which reduces self-esteem or contributes to insecurity. Neglect occurs when insufficient care is taken to provide for a child's needs. All Canadian provinces use similar definitions for legislation defining "a child in need of protection," but only some define the term "child abuse" by statute.
Incidence and Prevalence of Abuse
Statistics on rates of child abuse are controversial and challenge the capacity of current survey methods. Incidence refers to the number of new cases of abuse recorded each year. Prevalence refers to the percentage of abused children in a population. Periodic recording of incidence and prevalence are necessary in order to evaluate the effectiveness of public policies and prevention efforts. Disagreements about definitions of abuse, reliance on information obtained in other countries, and the diversity that characterizes Canadian society have, however, hampered efforts to obtain an adequate picture of child abuse in Canada. This situation is beginning to change with the appearance of the 2 surveys looked at below.
A province-wide incidence study in British Columbia (Adolescent Health Survey, 1993) found that almost one in 4 girls and one in 5 boys in grades 8 and 9 report having been physically abused. Twenty percent of girls and 3 percent of boys in grade 9 report being sexually abused.
Trocme and associates (1994) have provided a model study of child abuse reports in Ontario. They found the incidence of investigated cases to be 21 per thousand children. This figure represents almost 47 000 children. Child abuse was substantiated in 27% of these cases, suspected in 30% and found unsubstantiated in 42%. Almost 41% of the cases involved physical abuse, 21% sexual abuse, 30% neglect and 10% emotional maltreatment. A conservative estimate, based on the assumption that there exists an equal number of cases that remain unreported, is that there are approximately 94 000 Ontario children each year in situations that may be abusive. These figures correspond to recent US statistics. The US Department of Health and Human Services (1994) reported that in 1992 all the states referred for investigation 1.89 million reports on approximately 2.8 million children who were the alleged victims of child abuse. Forty-six percent were victims of neglect, 22% of physical abuse, and 13% of sexual abuse. The US-based National Committee for the Prevention of Child Abuse estimated that in 1992 there were 1 160 400 victims in substantiated cases of child abuse. Broken down, this figure involves a 45% incidence of neglect , a 27% incidence of physical abuse, a 17% incidence of sexual abuse , and a 7% incidence of emotional abuse. The Committee also reports fatalities as a result of child abuse have increased from 1.3 per 100 000 children in 1985 to 1.94 in 1992. In the group of 1261 children that likely died of child abuse that year, 87% were under 5, and 46% were less than a year old.
These findings help to place in context the calculation that 1 in 8 Canadian children experiences some sort of abuse. This figure represents 900 000 children. Moreover, it is well documented that largely preventable injuries are the single most common cause of child death in Canada.
Child Abuse Prevention
These statistics indicate that child abuse is a serious and widespread social problem. The problem is of such significance that it is unlikely that it will ever be eradicated. A more feasible approach is to reduce its incidence through prevention.
The prevention of child abuse is, however, extremely difficult. Many early prevention efforts were based on the belief that child abuse could follow the same model as pathology prevention in public health. Although mass communicable diseases were controlled by this approach, child abuse was different. There were no bacteria to attack through inoculation.
Currently child abuse is understood as a problem more associated with alienation, anomie and the misuse of power than a disease to be eradicated. Attention has shifted from a disease model to a need for social change and engineering. Social and economic impoverishment are likely the most important features that help explain the maltreatment of children.
Recent initiatives include attention to both individual needs such as social skills training, and social structural issues such as child poverty. Within this perspective personal problems are considered in both their interpersonal and sociocultural dimensions. This view of human development and social issues has helped to develop optimism that something can be done about the problem of child abuse, particularly if communities work in concerted and integrated ways to solve problems they share.