Infants and Toddlers

The following are typical consequences of abuse and neglect on the development of infants and toddlers.

Physical

• Chronic malnutrition of infants and toddlers results in growth retardation, brain damage, and potentially, mental retardation.

• Head injury can result in serve brain damage, including brain stem compression and herniation, blindness, deafness, mental retardation, epilepsy, cerebral palsy, skull fracture, paralysis, and coma or death.

• Injury to the hypothalamus and pituitary glands in the brain can result in growth impairment and inadequate sexual development.

• Less severe but repeated blows to the head can also result in equally serious brain damage. This type of injury may be detectable only with a CT scan, and, in the absence of obvious signs of external trauma, may go unnoticed.

• Shaking can result in brain injury equal to that caused by a direct blow to the head, and spinal cord injuries with subsequent paralysis.

• Internal injuries can lead to permanent physical disability or death.

• Medical neglect, as in withholding treatment for treatable conditions, can lead to permanent physical disability, such as hearing loss from untreated ear infections, vision problems from untreated strabismus (crossing of the eyes), respiratory damage from pneumonia or chronic bronchitis, etc.

• Neglected infants and toddlers have poor muscle tone, poor motor control, exhibit delays in gross and fine motor development and coordination, fail to develop and perfect basic motor skills.

Emotional

• Abused infants often exhibit a state of "frozen watchfulness," that is, remaining passive and immobile, but intently observant of the environment. This appear to be a protective strategy in response to a fear of attack.

• Abused toddlers may feel that they are "bad children." This has a pervasive effect on the development of self-esteem.

• Punishment (abuse) in response to normal exploratory or autonomous behavior can interfere with the development of healthy personality. Children may become chronically dependent, subversive, or openly rebellious.

• Abused and neglected toddlers may be fearful and anxious, or depressed and withdrawn. They may also become aggressive and hurt others.

Preschool Children

The following are common outcomes of abuse and neglect in preschool children.

Physical

• They may be small in stature, and show delayed physical growth.

• They may be sickly, and susceptible to frequent illness -- particularly upper respiratory illness (colds, flu) and digestive upset.

• They may have poor muscle tone, poor motor coordination, gross and fine motor clumsiness, awkward gait, and lack of muscle strength.

• Their gross motor skills may be delayed or absent.

Cognitive

• Speech may be absent, delayed, or hard to understand. The preschooler whose receptive language far exceeds expressive language may have speech delays. Some children do not talk, even though they are able.

• The child may have poor articulation and pronunciation, incomplete formation of sentences, or incorrect use of words.

• Cognitive skills may be at the level of a younger child.

• The child may have an unusually short attention span, a lack of interest in objects, and an inability to concentrate.

 

School-Age Children

The following are common outcomes of abuse or neglect in school-age children.

Physical

• The children may show generalized physical developmental delays; may lack the skills and coordination for activities that require perceptual-motor coordination. The child may be sickly or chronically ill.

Cognitive

• The child may display thinking patterns that are typical of a younger child, including egocentric perspectives, lack of problem-solving ability, and inability to organize and structure thoughts.

• Speech and language may be delayed or inappropriate.

• The child may be unable to concentrate on school work, and may not be able to conform to the structure of a school setting. The child may not have developed basic problem-solving and may have considerable difficulty in academics.

Social

• The child may be suspicious and mistrustful of adults or overly solicitous, agreeable, and manipulative, and may not turn to adults for comfort and help when in need.

• The child may talk in unrealistically glowing terms about her family; may exhibit "role reversal" and assume a "parenting" role with the parent.

• The child may not respond to positive praise and attention or may excessively seek adult approval and attention.

• The child may feel inferior, incapable, and unworthy around other children; may have difficulty making friends, feel overwhelmed by peer expectations for performance, may withdraw from social contact, and may be used as a scapegoat by peers.

Emotional

• The child may experience damage to self-esteem from denigrating or punitive messages from an abusive parent or lack of positive attention in a neglectful environment.

• The child may behave impulsively, have frequent emotional outbursts, and be unable to delay gratification.

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