Defining the Problem: Child Maltreatment

In 2023, 3.081 million children received child protection services either through investigation or alternative response according to statistics gathered annually by the United States Department of Health & Human Services, Administration for Children and Families (hereinafter DHHS Study).¹ This represents a decrease in the number of children for whom a child protection investigation or alternative response was initiated compared to data from 2016-2020; however, this decrease in the number of children who were provided child protection services may well be the result of lack of access rather than lack of need. Children were homebound in 2020 due to the COVID 19 pandemic. Teachers and other mandated reporters did not have as much in-person contact with them, allowing indicators of abuse or neglect to go unnoticed.

For the purposes of the DHHS Study, evaluators collected data on neglect, physical abuse, sexual abuse, and sex trafficking from investigations in all 50 states, the District of Columbia, and Puerto Rico. In 2023 the study found that an estimated 546,159 children were substantiated victims of maltreatment. Data from 2020 demonstrated that of the victims, approximately 76.1% were neglected, 16.5% were physically abused, 9.4% were sexually abused, and 0.2% were sex trafficked with some overlap occurring. Another 6% fell into the other category (e.g., threatened abuse, lack of supervision). The 2023 analysis differed in that victims were counted for each investigation that resulted in a substantiation and displayed with a single type of maltreatment at the state level. If a victim had two or more substantiated maltreatment types in the same report, the victim was counted in the multiple maltreatment type category. For 2023, 64.1 percent of duplicate victims experienced neglect only, and 10.6 percent experience physical abuse only. Fewer than 10 percent of duplicate victims experienced sexual abuse only (7.5%) or psychological abuse only (3.5%) substantiated maltreatment types. Of these victims, The percentages of child victims by sex are 52.0 percent for girls and 47.6 percent for boys. The sex is unknown for 0.4 percent of victims. The 2023 victimization rate for girls is 7.9 per 1,000 girls in the population, which is higher than the rate for boys at 6.9 per 1,000 boys in the population.

Of the total number of substantiated maltreatment victims, approximately 2,000 children died in 2020. Of the children who died, 78.0 percent experienced neglect and 41.6 percent suffered physical abuse either exclusively or in combination with another maltreatment type. The rate of fatality was higher for boys at 58.7% than for girls at 40.9%.

Child maltreatment occurs in all ethnic, cultural, and socioeconomic segments of American society. The DHHS Study identified several caregiver risk factors for the perpetration of child maltreatment: Alcohol Abuse, Domestic Violence, Drug Abuse, Financial Problem, Inadequate Housing, Public Assistance, and Any Caregiver Disability.¹ The two risk factors resulting in the largest percentages of victims were domestic violence and drug abuse. 2023 data shows 89.0 percent of victims are maltreated by one or both parents. The parent(s) could have acted together, acted alone, or acted with up to two other people to maltreat the child. The parent categories with the largest percentages are victims maltreated by a mother acting alone (37.2%), victims maltreated by a father acting alone (24.6%), and victims maltreated by both parents (19.4%).

This course utilizes a broader definition of maltreatment than the DHHS Study. Child maltreatment as set out in the Child Abuse Prevention and Treatment Act of 1974 includes the following: “Any recent act or failure to act on the part of a parent or caretaker which results in death, serious physical or emotional harm, sexual abuse or exploitation; or an act or failure to act, which presents an imminent risk of serious harm".² Because states have different statutory definitions for physical abuse, sexual abuse, emotional or psychological abuse, and neglect, it is important for practitioners to know their states’ specific statutes.

All states, the District of Columbia, and the territories have laws that mandate reporting of various types of maltreatment.³ Reporting was limited to physical abuse in the early 1970s, but in the early 1980s, reporting was expanded to include sexual abuse.⁴ When psychological or emotional maltreatment was recognized as a residual effect of neglect and also as a separate form of abuse, the reporting of neglect and psychological/emotional abuse was added to mandatory reporting statutes.⁵