The Real Faces of Child Abuse—and How to Prevent It

It’s the secret next door, or even in your own home. Someone has reached a breaking point, and now a child is in danger. In an exclusive visit to a national child-abuse hotline, we learned from trained counselors who take anonymous calls from desperate parents—and find ways to keep children safe. 

Real Faces of Child Abuse Illustration of Mother Holding Child Shout
On a Wednesday morning, one frazzled young mother realized the moment had come to reach out for help. She sobbed as she spoke into the phone. She was at her wits’ end, she told the crisis counselor who answered the call. Her energetic 5-year-old has always been a challenge, but today she lost her cool. When he refused to behave, she suddenly yanked his hair. Startled by her anger and filled with remorse, she had to do something. She put her son safely in his room, and called the crisis hotline.

This type of call—one initiated by a frustrated and terrified parent—is precisely what a national child abuse hotline, a counseling service provided by the nonprofit organization Childhelp, is prepared for. Around the clock, parents call its toll-free number, 800-4-A-CHILD, from every corner of the country. They’re looking for advice, parenting resources, and, sometimes, a way to calm down. “The goal is prevention,” explains Michelle Fingerman, director of the hotline, which receives more than 100,000 calls a year. (About 75 percent of calls are from women.) Studies have shown that impulsive, uncontrolled behavior that results in pulling a child’s hair or slapping a child can lead to more severe violence. Further, even when a smack or a spanking is a family’s customary discipline, the intensity of punishment can easily rise to abusive levels.

To get a glimpse of what families are facing, and what counselors on the line do to try to help parents through those moments that feel overwhelming, I boarded a flight from my home in St. Paul, Minnesota, and visited Childhelp’s headquarters in Phoenix, Arizona. One of the hotline’s crucial attributes is its confidentiality. The calls are not recorded or tracked. “People call knowing we’re not going to ask who they are or where they live,” says Fingerman. “They can be honest about what they’re dealing with at home or what they’ve witnessed in their community.” 

That trust is key, explains executive director Sara O’Meara, who founded Childhelp in 1978 with fellow former actress Yvonne Fedderson. The two established residential programs across the country for children recovering from severe and chronic abuse. The hotline was set up in 1984 as a means to keep abusive situations from escalating. “A call may be the first step so that ongoing abuse might be stopped or perhaps kept from occurring at all,” O’Meara says. Many of the calls are from bystanders alarmed about something they’ve seen, either in public or in their own family. They’re often afraid to file a report because they don’t want to anger a parent or they fear making a child’s situation worse. However, the more prudent action is to call the police, say child advocates. “If you see something, say something,” says Mary Pulido, director of The New York Society for the Prevention of Cruelty to Children, the nation’s oldest child-advocacy organization. “If you see a bruise on a child that’s not in a normal place for children to get bruises, like on the neck or the back of the upper arms, or if the child has a black eye, speak up.” As Fingerman puts it: “You might be the only voice that child has.”

During my 24-hour visit to the hotline, I sat in the phone-bank area and talked with the two counselors on duty during each four-hour shift. According to Childhelp’s policy, I wasn’t allowed to hear the callers and was privy only to summaries of the calls afterward.

Terrified Calls

9:30 a.m. A woman phones in from a Midwestern state, concerned about the 2-year-old son of her friend, a man whose wife has been acting strangely. The wife has been ripping food away from the child when the boy doesn’t eat quickly enough and calling her husband at work threatening to beat their son up if he doesn’t come home right away. The dad is worried, but he doesn’t want to call the authorities because he’s afraid their son will be taken away from home. 

The hotline doesn’t file reports, the way the police or a local government agency responsible for child safety does. Instead, the counselors, nearly all of whom have a master’s degree in social work, counseling, or education, can advise callers about the steps to keep a child from being hurt. A call to 911 will summon police to prevent violence in the moment or to direct a neglected child to safety. But in this case, the counselor advises the importance of the dad calling his local department for child-protective services for help before the situation spirals further out of control. 

The role of that agency is to investigate a child’s environment, which typically involves a home visit or an interview. Despite what many people think, this government agency (which may be called “child protective services” in some states or the “department of child safety,” or something similar, in others) rarely removes a child from home. In Arizona, for instance, only 10 percent of calls result in a child’s relocation, and when it does happen, the counselor tells me, it’s because the child is in imminent danger. A government-run child-protection agency may recommend supportive services—such as therapy, treatment for postpartum depression, parenting education, or substanceabuse rehabilitation—to help a family function better. 

12 p.m. A grandmother calls, not sure what to do about her daughter who has four children under the age of 4. The mother frequently yells at the kids and berates them. The 4-year-old has recently said that she hates her life. The counselor, who has worked in group homes for kids and in a pediatric psychiatric inpatient unit, advises the grandmother to document the events she sees. A local child-protective services agency typically won’t investigate verbal abuse, but a list of incidents might make a stronger case to get help. “Emotional abuse can be worse than physical abuse because the scars are invisible,” the counselor notes after the call ends. Children who are repeatedly screamed at, told they’re worthless, and made to feel unwanted may grapple with feelings of fear, anxiety, shame, and rage.

A growing body of research is showing that the effects of abuse can last a lifetime. One study in JAMA Pediatrics reported that children who suffer abuse—even emotional wounds—have higher rates of obesity, sexually transmitted diseases or risky sexual behavior, mental-health issues, delinquency, and even early mortality. The hotline frequently receives calls from adult survivors of childhood abuse who are still grappling decades later with flashbacks, depression, and anxiety. They call seeking information about therapy or online support groups or just to talk for a little while with a counselor, until they feel at ease again.

2:30 p.m. A counselor takes a call from a boy in middle school who phones from a police station. His mother has been beating him and his 3-year-old brother during their custody visitations. The police have taken him to the station; the father has taken the younger son to the E.R. Calls from children in crisis are, unfortunately, common. Often, the counselor helps them call the police. In this case, the boy explains that a social worker has already been called. The counselor says she’ll stay with him on the phone till the social worker arrives. The father is a safe adult, she learns as they chat, and she encourages the boy to confide in him. “We want kids to be able to identify adults they can trust,” she says. “We help them see they’ve got support.” 

Lashing Out

The common thread in many cases is a parent under enormous pressure. The possibility of abuse increases when there are several children in a household; when a child has special needs; when someone in the family is chronically ill; or when a parent has problems with drugs or alcohol. According to data gathered by the Iowa Department of Health and Human Services, other risk factors for repeat abuse include younger caregivers, single-parent households, lack of a support system, and extreme financial strain. “None of these situations means a person will definitely be an abuser,” explains Karen Kay Imagawa, M.D., director of the child-protection center at Children’s Hospital, Los Angeles, “but these are some factors that put a child at risk.” Another issue is isolation, says a counselor, recalling a recent 45-minute call with a mom who phoned from a U.S. military base overseas where her family was stationed. She was frantic after having slapped her toddler. The counselor helped her to identify support on the base and also to come up with ways to calm herself instead of lashing out. She also emphasized ways in which the boy’s behavior was age-appropriate so that the mom might better understand and accept her son’s antics.

The pressure to look like a perfect parent can also compound isolation, Fingerman says: “There’s a stigma to not being able to handle parenting. Even when people have family members nearby, they don’t always want anybody to know they’re feeling overwhelmed, or stressed, or have feelings of anger toward their kids.” That’s why, when parents call the hotline in distress, the counselors are quick to assure them that good parents often need help too.

10 p.m. The caller is a mom worried about whether her 2-year-old is being abused by her ex-husband. The child is excessively clingy when the father comes to pick the child up, even when he offers candy. Document each incident, says the counselor, who also asks whether the child is seeing a therapist. Even young children can work through emotions during play therapy, and having a therapist is also a way to enlist a mandated reporter (someone who is required by law to report suspected child abuse). The counselor offers phone numbers for local organizations (if the caller chooses to disclose the city) that provide family counseling, shelters, or other forms of help. For instance, many states have “crisis nurseries,” temporary shelter for children from birth to middle school. Parents can drop off children, for periods up to 72 hours, when feeling they absolutely cannot handle pressures in their life. Those who bring their kids to these centers agree to use supportive services following the crisis. 

Because the hotline doesn’t track calls or conduct follow-ups, the counselors have no formal way to know if their conversations reduce abuse. But some people call back days later to express their gratitude. Sometimes, it’s clear that a call has helped. One counselor was moved by a recent 3 a.m. caller, an exasperated mom whose colicky 3-month-old baby bawled in the background. Aware that a frustrated, exhausted parent is at greater risk of shaking an infant, the counselor told the mom to take a calming breath. Together they talked about what might be causing the crying, and the counselor stayed on the line as the mom tried soothing techniques, like swaddling and making shushing noises. The call took more than an hour, but the baby finally calmed down, and the mom did too. 

“Parenting isn’t easy,” says Fingerman. “It’s not uncommon to feel you’re at the end of your rope,” Fingerman emphasizes. “But it’s the ability to have self-control or take a break, or pick up the phone to call, that can make all the difference.” 

Who’s At Risk

Violence against children continues to be an epidemic, according to the most recent report by the U.S. Department of Health and Human Services. In 2012 nearly 680,000 kids were victims of physical, emotional, or sexual abuse, as well as neglect. Of nearly 1,600 children who died from abuse and neglect, most were under the age of 3. Among infants, the incidents often involved vigorous shaking by a caregiver or parent whose child wouldn’t stop crying. The U.S. government estimates that each year 1,200 infants are seriously injured as a result of shaken baby syndrome.

Unfortunately, there’s no clear profile to predict who’s at risk for harming a child. “Child abuse occurs across all communities and all socioeconomic groups,” says Dr. Karen Kay Imagawa. The HHS report estimated mothers to be the abuser in 27 percent of cases and fathers in 17 percent of cases. In approximately 20 percent of cases both parents acted together. Parents who abuse their kids often have low self-esteem, depression, anxiety, and the sense of not having control over one’s circumstances

How to Report Child Abuse and Neglect: If you witness abuse happening in the moment, or you’re worried about a young child who’s unsupervised and unsafe for a length of time, dial 911. If you suspect abuse is occurring, or if a child has confided in you about abuse at home, call Child Protective Services in your area. You can Google your nearest office or find it by dialing 800-4-A-CHILD (800-422-4453).