Child Abuse and Neglect
Fact Sheet
 Fatal child abuse or neglect is the fatal physical injury or negligent treatment of a child by a person who is responsible for the child’s welfare. It is reported that more than 2,000 children in the U.S. die of child abuse and neglect each year, and the actual number of abuse and neglect deaths is estimated to be much higher than that reported by vital statistics data.

Most child maltreatment deaths result from physical abuse, especially children receiving injuries to their heads. Known as abusive head trauma, these injuries occur when a child’s head is slammed against a surface, is severely struck or when a child is violently shaken. There have been major improvements in the ability to diagnose abusive head trauma and in investigators’ abilities to recognize when a caregiver’s explanation for injuries do not match the severity of the injuries. For example, it is now widely accepted that falls from short heights or a child being accidentally dropped rarely cause extensive and severe head injuries.

The next most common cause of physical abuse deaths is punches or kicks to the abdomen, leading to internal bleeding. Other forms of fatal physical abuse include immersion into hot water, drowning and smothering. Many children who die from physical abuse have been abused over time, but a one-time event often causes a death. The most common reason given by caretakers who fatally injure their children is that they lost patience when the child would not stop crying. Other common reasons given by the abusers include bedwetting, fussy eating and disobedient behavior.

Fatalities from neglect include a number of different ways in which caregivers fail to adequately provide for or supervise their children. Caregivers may fail to provide food and nurturing to their child, leading to malnutrition, failure to thrive, starvation or dehydration. Caregivers may fail to seek medical care when their child is ill, leading to more serious illness and death. Neglect cases can also result from intentional or grossly negligent failure to adequately supervise a child, resulting in bathtub drowning, suffocations, poisonings and other types of fatal incidents.

Young children are the most vulnerable victims. National statistics show that children under six years of age account for 86% of all maltreatment deaths and infants account for 43% of these deaths. Fathers and mothers’ boyfriends are most often the perpetrators in the abuse deaths; mothers are more often at fault in the neglect fatalities. Fatal abuse is interrelated with poverty, domestic violence and substance abuse.

National studies report that it is difficult to predict a fatal abuse event. In the U.S., studies find that the majority of child victims and their perpetrators had no prior contact with Child Protective Services (CPS) at the time of the death, yet many children had previous injuries that were not reported to CPS systems.
 
Major Risk Factors
  • Younger children, especially under the age of five.
  • Parents or caregivers who are under the age of 30.
  • Low income, single-parent families experiencing major stresses.
  • Children left with male caregivers who lack emotional attachment to the child.
  • Children with emotional and health problems.
  • Lack of suitable childcare.
  • Substance abuse among caregivers.
  • Parents and caregivers with unrealistic expectations of child development and behavior.
Records Needed for Case Review
  • Autopsy reports
  • Scene investigation reports and photos
  • Interviews with family members
  • Names, ages and genders of other children in home
  • Day Care Licensing investigative reports
  • EMS run reports
  • Emergency Department reports
  • Prior CPS history on child, caregivers and person supervising child at time of death
  • Child’s health history
  • Criminal background checks on person supervising child at time of death
  • Reports of home visits from public health or other services
  • Any information on prior deaths of children in family

GAO Report on Child Maltreatment

Resources

Prevention
  • Training hospital emergency room staff to improve their ability to identify child abuse fatalities and improve reporting to the appropriate agencies.
  • Providing an advisory on the mandated reporting of child abuse and neglect to local human service agencies, hospitals and physicians.
  • Case management, referral and follow-up of infants sent home with serious health or developmental problems.
  • Media campaigns to enlighten and inform the general public on known fatality-producing behaviors, i.e., violently shaking a child out of frustration.
  • Crisis Nurseries which serve as havens for parents “on the edge” where they can leave their children for a specified period of time, at no charge.
  • Intensive home visiting services to parents of at-risk infants and toddlers.
  • Education programs for parents such as the Parent Effectiveness Training (P.E.T.), the Parent Nurturing Program and Systematic Training for Effective Parenting (S.T.E.P.).