How Children are Harmed

Detailed comments for Q&A # 41: “What kinds of harm do we need to be concerned about protecting children from?”

Children are the most vulnerable members of any society. Prone to harm, they are largely defined by their need to be protected. Children can be harmed in many ways: by accidents, by disease, by unfulfillment of basic needs, by animal attacks, or by the actions of other chldren or adults. It is one of the most important roles of a society to ensure that its children are nurtured and protected from harm where possible. This is why many governments take on the responsibility for education and vaccination of children, for rearing of orphans and other children without suitable guardians, and for punishing people who use children for sexual gratification or harm them in other ways.

Protection of children does not always work. This report looks at three types of harm that befall children: harm at the hands of other individuals, failure of society to look after those whose parents can’t, and, ironically, harm at the hands of their own governments.




Children Harmed by Individuals

  Image of child physical injury from Time magazine
Image of child physical injury from Time

The Children’s Bureau of the US Department of Health and Human Services (HHS) keeps statistics on maltreatment of children. The types of maltreatment with the highest incidence are:1

  • Neglect: “… failure … to provide needed, age-appropriate care although financially able …”
  • Physical injury: “… physical acts that caused or could have caused physical injury …”
  • Sexual activity: “involvement of the child in sexual activity to provide sexual gratification or financial benefit to the perpetrator [who may be another child]”

HHS publications designate the second and third types of maltreatment as physical and sexual abuse. However, the word “abuse” is used in different ways in different places with little agreement on a consistent meaning. For this reason, SOL Research avoids using this word and refers to these forms of maltreatment by the above, more descriptive, terms.

Neglect is the most common type of maltreatment, with a fairly constant incidence rate of about ¾ percent. Physical injury, the most dangerous of the three because it involves actual or potential physical injury, is the next most common and declined from a rate of 3.6 cases per thousand children to 2.1 from 1995 to 2004. Sexual activity is the least common, with incidence declining from 1.9 to 1.2 cases per thousand. These statistics are shown in the following graph and table.

US Child Maltreatment Data, 1995-2004
YearNeglectPhysical InjurySexual ActivityFatalities
 per 1,000 childrenper 100,000
Source: Children’s Bureau, US Department of Health and Human Services2
     Data are duplicative, meaning that cases involving multiple types of abuse are counted in each applicable category. Data include cases reported to and substantiated by a Child Protective Services (CPS) agency.

The table also includes data for related fatalities, defined as the death of a child as a result of maltreatment. The numbers for this have been increasing over the same ten year period, from 1.7 deaths per 100,000 children in 1995 to 2.0 in 2004.

Note on under-reporting and over-reporting:

The data presented above are based on reports to Child Protective Services agencies where the allegations of maltreatment were substantiated by the agency. These reports include criminal cases that were handled by police and the courts, as well as family matters that were handled by CPS outside the criminal justice system.

As with most crimes and other social problems, most incidents are handled by the individuals and families involved without reporting to any government agency. In criminal matters, under-reporting is common for all categories of crime, with special exceptions, such as homicide.3

Research indicates that the three predominant types of child maltreatment are likewise under-reported.4 Cases included in the data above are those that did come to the attention of authorities, either by the choice of an involved party or because some evidence of the problem rose to the surface to attract official attention. While this is often emphasized in the context of sexual activity, studies indicate that it is also true of physical injury and neglect.5

With regard to sexual activity, while a good number of cases undoubtedly still go unreported, it is likely that heightened sensitivity and mandatory reporting (see Q&A # 23) by professionals have been leading to a good deal of over-reporting and false substantiation of baseless cases. The HHS reports that in 2004 allegations of sexual activity with juveniles were substantiated at a rate about 71 percent higher than those of physical injury.6

Another problem of over-reporting of sexual activity with juveniles is that cases represented in the statistics include consensual sexual experimentation by teenagers and even innocent play by young children (“playing doctor”). For more information on this issue, see the SOLR report, Criminalizing Child’s Play.

See also Q&A # 21 regarding under-reporting and over-reporting of rape.  

Children Harmed by Government

It is a startling irony when government agencies purporting to uphold laws to protect children from maltreatment end up maltreating children in the execution of their duties. Two examples of this are discussed briefly here, with reference to other SOLR reports for more information.

Prosecution of Consensual Childhood and Teenage Sex-Play

Harsh punishments originally intended for adults who make sexual advances on children are today being applied to children and adolescents themselves who are caught in innocent or consensual sexual behaviors with other kids, including those their own age. When these young defendants are released from custody, they are usually then put on the sex crime registry, which in most states limits where they can live, what kind of work they can do, and puts their neighbors on notice that they are dangerous people who must be kept away from children. Initial estimates indicate that there are approximately 19,000 people on the sex crime registries in the United States based on behaviors committed before they were 18 years old, some as young as ten. Any possibility of a normal life and livelihood has been destroyed for these people.

Age of consent laws are supposed to protect juveniles from sexual exploitation by adults. But here we have a situation where these laws and the way they are enforced are ruining the lives of thousands of those very same juveniles.

For information on and cases of the criminal prosecution of children and adolescents for innocent or consensual sexual behavior, see the SOLR report, Criminalizing Child’s Play.

Coercion of Child Testimony

The SOLR report, False Accusations of Sex with Juveniles, presents numerous cases in which prosecutors used abusive behavior in order to coerce young children into providing false testimony. These include:

No prosecutor has ever even been investigated for wrong-doing in any of these cases, much less actually charged with a crime or professionally sanctioned for such behavior.  

Children Harmed by Society

If it is the responsibility of a society to protect children from harm, then when children suffer and their harm is preventable, the society has failed its children.


Poverty is a state in which people do not have enough of what they need to survive in a healthy fashion. When an adult is poor, one can debate how much responsibility for that ought to go to the individual versus to society, the community, and the government. But when a child lives in poverty, there is no room to blame the child. If society has a responsibility to protect children from harm, then children in poverty are a major responsibility. One can debate whether others in society ought to help the parents to provide for the children or ought to help the children directly. Yet it is clear that if children are hungry and there are enough resources available to feed them, then a responsibility is being shirked at some level.

According to the US National Center for Children in Poverty (NCCP), “Research is clear that poverty is the single greatest threat to children’s well-being.”7 An example of such research is a comprehensive statistical analysis of child poverty in the Unted States in 1997, finding that children are harmed and damaged by poverty in the following ways:8

  • Physical health:
    • Poor child 70% more likely to die in infancy than non-poor child
    • 80% more likely to be in fair to poor health
    • Twice as likely to be under-height
    • Twice as likely to require stay in a hospital
    • 50% more likely to die before age 15
  • Cognitive development:
    • Poor child 30% more likley to have a developmental delay
    • 40% more likley to have a learning disability
  • School achievement:
    • Poor child twice as likely to repeat a grade, to be expelled, and to drop out of high school
  • Emotions and behavior:
    • Poor child 30% more likely to have persistent emotionalal or behavioral problems
    • Three times as likely for a girl to give birth unmarried
  • Victimization:
    • Poor child almost seven times as likely to be maltreated (neglect, physical injury, or sexual activity)
    • Twice as likely to experience violent crime in the family
    • Twice as likely to be afraid to go outside the home
  • Economic:
    • Poor child ten times as likely to go hungry at least once in a year
    • 90% more likely to be neither employed nor in school after reaching adulthood

Worldwide, poor children are four to five times more likely to die before their fifth birthday than children who are not poor.9 The United Nations reported in 2001 that between 30 million and 70 million children were living on the streets in Africa and Southeast Asia and that homelessness was increasing.10 UNICEF reported in 2008 that over 23 percent of the world’s children are underweight and 28 percent are under-height.11

Child poverty is not a problem only in poor countries. The NCCP reports that 18 percent of children in the United States — more than 13 million — live in families below the official poverty level, and 39 percent — 28 million — are in families that do not have enough money to provide basic necessities.12

For more on child poverty and its effects, see:

Inattention to Physical Injury

The US Department of Justice has sponsored numerous studies of online sexual exploitation of children, which consistently return the result that it is a relatively small pocket of activity on the national crime stage.13 Conversely, we see from the data above that neglect and physical injury are the most common crimes against children, injuring hundreds of thousands every year. Yet in May 2006, when the Department officially kicked off14 its Project Safe Childhood15 initiative, it said nothing about physical injury or neglect, but made its mission specifically to “protect children from online exploitation and abuse.” Since that time, it has announced hundreds of successful prosecutions,16 all of them for sexual crimes, especially child pornography, and not one conviction for causing physical injury to a child.  


1. Definitions from Child Maltreatment 2004 (, ), Children's Bureau (US HHS), 2006 (Link, Link), glossary

2. Data from
Victimization Rates by Maltreatment Type: 1995-99, 2000-04, from Child Maltreatment, Children’s Bureau, US Department of Health and Human Services
Child Fatality Rates per 100,000 Children: 1995-99, 2000-04, from Child Maltreatment, Children’s Bureau, US Department of Health and Human Services

3. The Challenge of Crime in a Free Society, President's Commission on Law Enforcement and Administration of Justice (U.S.A.), February 1967. See Table 4, Comparison of Survey and UCR Rates, page 21.
    This table compares the results of a survey about criminal incidents with the corresponsing official government statistics. While the government records indicated more murders and vehicle theft than the survey, the reverse was true for the other five categories of crime included. The highest discrepancy was for rape, with 3.7 times higher incidence in the survey than in the government database, followed by burglary with a factor of 3.2. The overall factors were 1.9 for violent crimes and 2.2 for property crimes.

4. Burden and consequences of child maltreatment in high-income countries by Ruth Gilbert, Cathy Spatz Widom, Kevin Browne, David Fergusson, Elspeth Webb, Staffan Janson, Lancet, December 3, 2008 (abstract and buy)
     Study: Most Child Abuse Goes Unreported, Time, December 2, 2008

5. Uncovering child abuse: Physical abuse is an underreported and often unnoticed problem — A new clinical report outlines the critical components of the medical assessment. — AAP News, American Academy of Pediatrics, June 6, 2007 (abstract and buy link)
     Child Physical Abuse Under-Reported By Healthcare Staff And 1 In 5 Worry About Getting It Wrong, Medical News Today, October 30, 2006

6. Child Maltreatment, 2004, Chapter 3, Factors Influencing the Determination that a Child is a Victim of Maltreatment

7. Child Poverty, National Center for Children in Poverty (U.S.A.)

8. The Effects of Poverty on Children () by Jeanne Brooks-Gunn and Greg J. Duncan, Future of Children, Princeton University / Brookings Institution, June 1997 (Link. V. 7, # 2, pg 55)Table 1: Selected Population-Based Indicators of Well-Being for Poor and Nonpoor Children in the United States, page 58..9

9. The World Health Report, World Health Organization, 1999, Annex Table 7: Country performance on equity: health conditions of advantaged and disadvantaged groups, around 1990, page 114

10. 100 Million Homeless Worldwide, UN Reports, U.N. Wire, United Nations Foundation, February 23, 2001
     But note the following: “Estimating numbers of ‘street children’ is fraught with difficulties. In 1989, UNICEF estimated 100 million children were growing up on urban streets around the world. 14 years later UNICEF reported: ‘The latest estimates put the numbers of these children as high as 100 million’. And even more recently: ‘The exact number of street children is impossible to quantify, but the figure almost certainly runs into tens of millions across the world. It is likely that the numbers are increasing’. The 100 million figure is still commonly cited, but has no basis in fact. Similarly, it is debatable whether numbers of street children are growing globally or whether it is the awareness of street children within societies which has grown.”
          — State of the World’s Street Children: Violence, Consortium for Street Children, 2007, page 64

11. The State of the World’s Children: 2009, United Nations Children’s Fund (UNICEF), December 2008, Table 2: Nutrition, page 125

12. Who are America’s Poor Children?: The Official Story, National Center for Children in Poverty (U.S.A.), October 2008

13. Online Victimization: A Report on the Nation’s Youth by David Finkelhor, Kimberly J. Mitchell, and Janis Wolak, Crimes against Children Research Center, June 2000 (Link. Highlights)
     Internet-initiated Sex Crimes against Minors: Implications for Prevention Based on Findings from a National Study by Janis Wolak, David Finkelhor, and Kimberly Mitchell, Journal of Adolescent Health, November 2004 (Link. V. 35, # 5, pg 424.e11..20)
     Online Victimization of Youth: Five Years Later (), National Center for Missing & Exploited Children (NCMEC) (U.S.A.), 2006 (Link)
     Juvenile Offenders and Victims: 2006 National Report by Howard N. Snyder and Melissa Sickmund, National Center for Juvenile Justice (US DoJ), March 2006 (, Link. Previous editions also at Publications page.), page 38..9

14. Attorney General Alberto R. Gonzales Announces Implementation of Project Safe Childhood Initiative, US Department of Justice, May 17, 2006

15. Project Safe Childhood: Protecting Children from Online Exploitation and Abuse, US Department of Justice

16. Press Releases at Project Safe Childhood: Protecting Children from Online Exploitation and Abuse, US Department of Justice


Page posted on August 24, 2007, updated January 10, 2008, January 16, 2008, January 25, 2008, moved September 7, 2008, January 28, 2009, updated January 28, 2009.
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