PHYSICAL ABUSE OF CHILDREN

Abstract

One of the basic obstacles to the development of effective countermeasures against accidental injury is the fact that the intensity of public concern over a particular type of injury-producing episode bears little relationship to its prevalence or to the seriousness of its consequences. An aircraft accident that takes 40 lives receives national attention through the mass media, whereas the fact that 150 persons died on the highways on the same day (and on every subsequent day) goes virtually unnoticed. The entrapment of a handful of children in discarded refrigerators has produced major changes in federal, state, and local laws; the death and injury of fifty times that number from accidental gunshot wounds has failed to produce even minimally effective legislation for the regulation of firearms. The "box office" appeal of various types of accident would make an interesting study; certainly in the absence of some knowledge of this phenomenon the cost-effectiveness principle is almost impossible to apply to accident counter-measures. The following paper deals very productively with this problem. For a number of years the "abused" or "battered" child has elicited very strong concern on the part of professionals in law, medicine, social work, and child care. And one consequence of this concern has been the establishment of legislative machinery and a reporting system. Good epidemiological research reveals, however, that child abuse, despite the intense response that it has aroused, has, in fact, relatively low prevalence and that, by implication, the funds and manpower that it now absorbs more appropriately be devoted to a more signfficant cause of childhood injury. Unfortunately, legislative and administrative routines, once established, tend to perpetuate themselves. It will be interesting to note whether, in the light of the epidemiological findings, the reporting requirements will be withdrawn. Another major contribution of this paper is its attribution of child abuse to the social rather than the psychological characteristics of the parents. Although the past decade has witnessed an increasing concern with poverty and the poor, virtually no attention has been devoted to the differential vulnerability to accidental injury of children in various socioeconomic levels ard subcultural groups. Our increased understanding of cultural deprivation and of lower-class life style gives us ample material for speculation about this differential, but such speculation is hazardous, and systematic empirical research must be undertaken. Meanwhile the present paper and the one by Kravitz and Driessen offer us useful guidelines.