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What is child abuse?

While legal definitions of child maltreatment vary by state, four types are generally recognized: physical abuse, sexual abuse, neglect (including educational neglect, medical neglect, and other forms), and emotional maltreatment.

An estimated 1,770 children died from abuse and neglect in the United States in 2018 (1), the most recent year for which there is national data. But child abuse fatalities are not the only consequences abused children suffer. Sexual abuse, physical abuse, and neglect are forms of adverse childhood experiences (ACEs) that researchers have linked to mental health problems, such as mood disorders, anxiety, substance abuse, and impulse control disorders. (2) Child abuse often co-occurs with other ACEs, like the witness to domestic violence or community violence, traumatic loss or separation, or sexual assault. Adults with multiple ACEs have even been shown to be more likely to endure poor health outcomes like diabetes, STDs, heart disease, and early death.

National Statistics

  • Nearly 700,000 children are abused in the U.S each year.1
  • An estimated 678,000 children (unique incidents) were victims of abuse and neglect in 2018(1), the most recent year for which there is national data. That’s about 1% of kids in a given year. However, this data may be incomplete, and the actual number of children abused is likely underreported.2
  • 1 in 5 girls and 1 in 20 boys is a victim of child sexual abuse.
  • Neglect is the most common form of abuse. However, Child Advocacy Centers (CACs)* serve far more sexual abuse cases reporting 243,039 investigations involving sexual abuse allegations in 2019.2

State of California

In 2017

  • California had 400,187 total referrals for child abuse and neglect.
  • There were 65,342 victims of abuse or neglect. Of these children:
    • 57,027 were neglected
    • 5,321 were physically abused
    • 3,497 were sexually abused
    • There were 147 child deaths resulting from abuse or neglect reported. (CWLA, 2019)

In 2019(3)

  • California had 477,047 total referrals for child abuse and neglect.
  • There were 69,652 victims of abuse or neglect. Of those children:
    • 10,440 children were under 1 year old.
    • 23,291 entered foster care


  • In 2019, of the 2,033 children who received a forensic interview and/or exam by the Riverside County Child Assessment Team (RCCAT), 242 or 11.9% were children referred from the San Jacinto Valley.
  • REACH’s service area has the highest child forensic interviews/exams per capita by population in Riverside County

REACH Statistics

From October 1, 2019, to September 30, 2020, REACH:

  • Provided services to 283 victims of child abuse
    • 63 Crisis Intervention Contacts
    • 874 Individual Counseling Sessions

*What is a child advocacy center (CAC)? 

Child advocacy centers (CACs) are community-based, child-friendly, multidisciplinary services for children and families affected by sexual abuse or severe physical abuse. CACs bring together, often in one location, child protective services investigators, law enforcement, prosecutors, and medical and mental health professionals to provide a coordinated, comprehensive response to victims and their caregivers.4

Riverside County’s Child Advocacy Center is housed at Riverside University Health Systems in Moreno Valley.

Child abuse and neglect affect minors under the age of 18.  The CDC lists the following types of child abuse:

  • Physical abuse is the intentional use of physical force that can result in physical injury. Examples include hitting, kicking, shaking, burning, or other shows of force against a child.
  • Sexual abuse involves pressuring or forcing a child to engage in sexual acts. It includes behaviors such as fondling, penetration, and exposing a child to other sexual activities.
  • Emotional abuse refers to behaviors that harm a child’s self-worth or emotional well-being. Examples include name-calling, shaming, rejection, withholding love, and threatening.
  • Neglect is the failure to meet a child’s basic physical and emotional needs. These needs include housing, food, clothing, education, and access to medical care.

Additional types of child abuse:

  • Exposure to family violence, can include knowledge of or witnessing violence happening between adults in the home.
    • The health, wellness and safety of children can also be affected by exposure to substance use or abuse by parents, guardians, or caretakers.
  • Exploitation – See Human Trafficking

Specific signs and symptoms depend on the type of abuse and can vary. Keep in mind that warning signs are just that, warning signs. The presence of warning signs doesn’t necessarily mean that a child is being abused.

Potential Signs of Physical abuse

  • Unexplained injuries, such as bruises, fractures or burns
  • Injuries that don’t match the given explanation

Sexual Abuse

  • Sexual behavior or knowledge that’s inappropriate for the child’s age
  • Pregnancy or a sexually transmitted infection
  • Blood in the child’s underwear
  • Statements that he or she was sexually abused
  • Inappropriate sexual contact with other children

Emotional Abuse

  • Delayed or inappropriate emotional development
  • Loss of self-confidence or self-esteem
  • Social withdrawal or a loss of interest or enthusiasm
  • Depression
  • Avoidance of certain situations, such as refusing to go to school or ride the bus
  • Desperately seeks affection
  • A decrease in school performance or loss of interest in school
  • Loss of previously acquired developmental skills


  • Poor growth or weight gain or being overweight
  • Poor hygiene
  • Lack of clothing or supplies to meet physical needs
  • Taking food or money without permission
  • Hiding food for later
  • Poor record of school attendance
  • Lack of appropriate attention for medical, dental or psychological problems or lack of necessary follow-up care

Parental behavior

Sometimes a parent’s demeanor or behavior sends red flags about child abuse. Warning signs include a parent who:

  • Shows little concern for the child
  • Appears unable to recognize physical or emotional distress in the child
  • Blames the child for the problems
  • Consistently belittles or berates the child, and describes the child with negative terms, such as “worthless” or “evil”
  • Expects the child to provide him or her with attention and care and seems jealous of other family members getting attention from the child
  • Uses harsh physical discipline
  • Demands an inappropriate level of physical or academic performance
  • Severely limits the child’s contact with others
  • Offers conflicting or unconvincing explanations for a child’s injuries or no explanation at all

Child health experts condemn the use of violence in any form, but some people still use corporal punishment, such as spanking, as a way to discipline their children. Any corporal punishment may leave emotional scars. Parental behaviors that cause pain, physical injury or emotional trauma — even when done in the name of discipline — could be child abuse.

For More information on making a child abuse report, click here.

Adapted from the Mayo Foundation for Medical Education and Research, 2021.