Fourth National Incidence Study of Child Abuse and Neglect (NIS–4)

children represent 58% of all children who met the Harm Standard criteria for any type ofabuse.Sexual abuse. Sexual abuse subsumes a range of behaviors, includingintrusion, child’s prostitution or involvement in pornography, genital molestation,exposure or voyeurism, providing sexually explicit materials, failure to supervise thechild’s voluntary sexual activities, attempted or threatened sexual abuse with physicalcontact, and unspecified sexual abuse. For intrusion and genital molestation, the HarmStandard guidelines permit assuming that serious emotional harm occurred even ifexplicit symptoms are not yet observable. (Ensuing sections refer to this maltreatmentoutcome as “inferred harm.”) However, for the remaining abusive actions, the NISdefinitions count children as sexually abused under the Harm Standard only if theyexperienced moderate injury or harm (physical, emotional, or behavioral) from thatmaltreatment.An estimated 1.8 children per 1,000 (or a total of 135,300) experienced HarmStandard sexual abuse in the NIS–4 study year. Sexually abused children constitute 24%of the total who suffered Harm Standard abuse.Emotional abuse. In the NIS definitions, this category includes closeconfinement, verbal or emotional assaults, threats of sexual abuse (without contact) andthreats of other maltreatment, terrorizing, administering unprescribed substances, andother or nonspecific abuse. Close confinement refers to tying, binding, and otherinappropriate confinement or physical restriction. Verbal or emotional assault involvessystematic patterns of belittling, denigrating, scapegoating, or other nonphysical forms ofovertly rejecting treatment. Emotional abuse also includes all varieties of abusive,exploitative, or overtly punitive behaviors where actual physical contact did not occur(such as intentional withholding of food, shelter, sleep, or other necessities, or excessiveresponsibilities or excessive demands for income-producing work by a child). For themore extreme forms of tying and binding, Harm Standard guidelines permit “inferredharm.” That is, they permit assuming that serious emotional injury occurred in theabsence of explicit symptoms, which allows the child to qualify as emotionally abusedunder the Harm Standard. However, for all other forms of emotional maltreatment, theHarm Standard requires direct or circumstantial evidence of moderate injury orimpairment.3–7