The rates of physical and sexual child abuse have declined in the past 20 years, according to a new report from the Institute of Medicine. However, rates of psychological and emotional child abuse appear to have increased during that same time frame.  Data varies significantly about whether or not child neglect has increased, decreased or remained the same.

Determining the incidence of child abuse and neglect presents numerous challenges because cases could be under reported and definitions of abuse and neglect tend to vary among entities that collect this type of data. In order to treat and prevent the problem effectively, both causes and consequences of child abuse and neglect need to be better understood, according the report. It also calls for a national surveillance system to improve accuracy of identified cases. This information is an update of the 1993 National Research Council report Understanding Child Abuse and Neglect.

“Child abuse and neglect are a serious public health problem that has broader and longer-lasting effects than bruises, broken bones, or psychological trauma,” said Anne Petersen, chair of the committee that wrote the report and research professor at the Center for Human Growth and Development at the University of Michigan, Ann Arbor. “The impacts cascade throughout victims’ lifetimes, not only affecting them but also their families and society.”

Despite challenges, enough data is available to estimate the scope, prevalence and characteristics of child abuse and neglect in the United States. Based on information from the National Child Abuse and Neglect Data System (NCANDS), the official reporting system for cases that have been referred to state child protection authorities, around three quarters of reported cases in 2011 were classified as neglect, 15 percent as physical abuse and about 10 percent as sexual abuse. Young abuse and neglect victims were almost evenly represented among males and females. Around 80 percent of perpetrators are parents, 87 percent of which are biological parents. Over half of those perpetrators are female.

Research conducted since 1993 has generated a lot of information that can be used to inform programs and policies, but some gaps remain. A better understanding is needed of why physical and sexual abuse is declining, but neglect has not, why children have different sensitivities to abuse, why some children respond to treatment and others do not, how different types of abuse impact development and how culture and social stratification have an effect on the causes, consequences, prevention and treatment of child abuse and neglect.