Extent of Abuse

The true prevalence of child abuse is difficult to determine in all countries. Official estimates will only represent a fraction of the total number of cases, because many go unreported or unrecognized, and information systems are incomplete or track just one limited part of the picture. In the United States, the referral rate for child abuse investigations is three times higher than in the United Kingdom, and twice as many children are in state care, with four times as many child abuse deaths (9).

In the United Kingdom, child protection registers hold statistical information on children identified by agencies as at risk of significant harm and for whom a child protection plan has been developed. However, these figures record professional activity and the numbers of children registered, not the numbers of children who have been abused. They exclude cases where abuse has occurred but the child is otherwise protected or no longer at risk, cases where abuse has not been recognized, or cases where the child has not been registered but may still be subject to abuse. In 2002, there were 23 children per 10,000 aged less than 18 years on the child protection register, and 19% were registered under the category of physical injury, the second most frequent type of maltreatment (10).

The 2001 annual statistics on child maltreatment from state child protective services (CPS) agencies in the United States revealed a victimization rate of 12.4 per 1000 children in the population (19% suffered physical abuse) and a child fatality rate of 1.81 children per 100,000 children in the population (11). Neglect is the most common category of registration or type of maltreatment in both the United Kingdom and the United States.

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