An estimated 3.3 to 10 million American children witness domestic violence in their homes each year. Find out how the exposure can have devastating effects.

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Every minute, approximately 24 people in the United States are physically attacked, sexually assaulted, or stalked by a current or former partner, according to the Center for Disease control. Many victims believe they can keep the abuse hidden from their children, but experts say they're rarely successful. "Domestic violence is a family affair and is impossible to hide when it occurs, even if children are sleeping or otherwise not present," says Alicia H. Clark, Psy.D., a clinical psychologist in Washington, D.C. Even if kids don't witness the incident itself, they can still feel the tension, they might hear the violence, and they're likely to notice the aftermath including injuries or the distance between mom and dad, she says.

Regardless of how kids learn of the abuse, the exposure to domestic violence can cause negative consequences in many areas of their lives.

Physical health. "[People have] a very strong mind-body connection, so for many children, the stress of living with domestic violence is expressed in physical ways," says Cindy W. Christian, M.D., chair of child abuse and neglect prevention at The Children's Hospital of Philadelphia. Headaches, stomachaches, change in appetite, insomnia, nightmares, bedwetting, and other sleep issues are all common in children living in abusive homes. Long-term, children who go through adverse childhood experiences, such as exposure to domestic violence, are at increased risk for health issues such as substance abuse, autoimmune diseases, heart disease, and cancer.

Mental and emotional issues. Children may experience fear, anxiety, depression, post-traumatic stress disorder, an inability to control their emotions, and suicidal feelings as a result of witnessing violence between adult caregivers, according to the Centers for Disease Control. Worrying that she is at fault can take a toll on a child's mental and emotional well-being. Kids often feel guilty for not being able to help the situation or for sparking an abusive outburst, says Dr. Clark.

Behavior. Kids may have more tantrums, become clingy, withdraw, overreact to situations, and regress to earlier behavior such as thumb-sucking, wanting to be held like a baby, wetting themselves, or using baby talk. Parents should also be on the lookout for signs of anger and changes in appetite and sleeping habits. Teens exposed to parental violence may skip school or use drugs and alcohol.

Relationships with peers. Children first learn how to interact with others by watching their parents. When parents physically harm each other or have a volatile relationship, kids become distrustful and reluctant to form bonds. In addition to withdrawal and social isolation from peers, children living in homes with abuse may have poor communication skills and lack of conflict resolution skills and are at increased risk for bullying or being bullied. Children who witness violence between parents are also more likely to be involved in abusive relationships, as either the abuser or victim, when they're older, according to the U.S. Department of Human Health and Services.

Relationships with parents. Naturally, domestic abuse affects the relationship between children and their parents. Research shows that infants exposed to family violence may have difficulty developing attachments with their caregivers, and an older child's interactions with parents could change as well. Dr. Clark says some kids may feel rage at the abusive parent, anger at the victim for not being able to avoid the abuse or protect herself, or pity for the abused parent. These feelings could cause the child to withdraw or lash out at one or both parents, be disobedient, become excessively clingy, or take on a parental role towards the abused parent.

Learning issues. Worries about home life, or being awakened at night by shouting and fighting, can cause children to have difficulty focusing or concentrating at school. Often, kids blame themselves for what happens in their parents' lives. As a result, they may put extreme pressure on themselves to do well in school because they're afraid of angering their parent if they get a bad grade.

Abuse. Children exposed to domestic violence are at increased risk of being abused themselves, either by the abuser, by the victim lashing out at the kids, or by both parents being so entangled in the abuse that they don't care for the children properly. Research shows that 30 to 60 percent of domestic violence cases also include child abuse or neglect.

Although it may seem some children aren't affected by domestic violence, experts say any exposure can be detrimental to a child's well-being. If you're involved in an abusive relationship, or know someone who is, contact a local domestic violence program or the National Domestic Violence Hotline (1-800-799-7233).

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