Child abuse is when a parent or caregiver, whether through action or failing to act, causes injury, death, emotional harm or risk of serious harm to a child.

There are many forms of child maltreatment, including neglect, physical abuse, sexual abuse or exploitation and emotional abuse.

• Physical abuse is non-accidental physical injury to a child. Twenty-eight percent of adults report being physically abused as a child.

• Sexual abuse occurs when an adult uses a child for sexual purposes or involves a child in sexual acts. Twenty percent of adults report being sexually abused as a child.

• Emotional abuse is when a parent or caregiver harms a child’s mental and social development causing severe emotional harm. A single incident may be abuse. However, most often emotional abuse is a pattern of behavior that causes damage over time. Ten percent of adults report emotional abuse as a child.

• Child neglect is when the parent or caregiver doesn’t give the care, supervision, affection and support needed for a child’s health, safety and well-being.

Historically, children were considered property. Up to the second century in the State of Rome the oldest living male in the household had complete control and could decide if the child lived or died, was sold into slavery or was abandoned. In the fourth century, Constantine introduced reforms that fathers could no longer decide whether or not children lived or died. Only children with defects could be abandoned.

In 1874, the issue of child abuse was put under a spotlight when a small child, M.E., was found being abused by her foster parents. They hit her, tied her to the bed and deprived her of food. The police force of New York couldn’t interfere as there were no child protection laws. It was only possible to protect M.E. from abuse after a law for protection of animals was put to use. Only then was there the creation of the New York Society for the Prevention of Cruelty to Children, the world’s first entity devoted entirely to child protection.

In 1946 in the United States, John Caffey, a radiologist, described six infants with long bone fractures from “obscure” traumatic origins. Following this report in 1962, some of Caffey’s associates collaborated with C. Henry Kempe and described a new syndrome, “The Battered Child Syndrome” — just 68 years ago.

The modern study of child maltreatment continues to evolve. The more we know about abuse the better we, as a society, can ensure safety, provide services and potentially prevent it.

A confidential 24-hour hotline with resources to aid every child abuse situation is available at 800-422-4453 or

If you think you need help or know someone who does, please reach out.

Sally Robinson is a clinical professor of pediatrics at UTMB Children’s Hospital. This column isn’t intended to replace the advice of your child’s physician.

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