Epidemiology
Child abuse is a worldwide phenomenon and can affect children of all ages; however, the highest incidence occurs to infants and toddlers. The definition and perception of what constitutes child abuse varies over time and between different cultures and ethnic groups.
The clinical consequences of physical child abuse were first described in the medical literature by Tardieu in 1860.[7] Caffey in 1946 and Silverman in 1953 described multiple fractures and subdural hematomas, and suggested that they resulted from intentional trauma and not organic disease, as commonly thought.[8][9] Since that time it has become apparent that the spectrum of child abuse encompasses a magnitude of possible injuries to children.
It is difficult to gain a true estimate of child abuse due to the hidden nature of the problem and lack of mandatory reporting systems.[2][10] In 2021, the US Department of Health & Human Services reported 588,229 documented cases of child abuse and neglect nationwide, or a prevalence of 8 victims per 1000 children. Of these, 76% were victims of neglect, 16% of physical abuse, and 10% of sexual abuse. 52% of victims were girls and 48% were boys, and children less than one year old had the highest victimization rate, at 25 victims per 1000 children in the population of the same age.[11]
A review of child maltreatment in high-income countries estimated that 4% to 16% of children are physically abused, around 10% are neglected or emotionally abused, 5% of boys and 5% to 10% of girls are exposed to penetrative sexual abuse, and 30% are exposed to any form of sexual abuse. Around 80% of child abuse is perpetrated by caregivers or parents.[12]
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