Approximately 3.4 million cases of child abuse and neglect were reported in the United States in 2011 . Learn why child abuse happens and what you can do to prevent it.

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We've all read the headlines or heard the term, but do you really know what child abuse is? Does spanking your child mean you're abusive? Is telling your child to "shut his mouth" emotional abuse? Are you being neglectful if you walk away from your daughter while she's having a screaming tantrum?

Knowing what is considered child abuse can be challenging, as each state is responsible for providing its own definition, according to Another reason it can be difficult for some people to recognize abuse is their own upbringing. Many parents have experienced extreme "discipline" themselves as a child and because it was normal in their home, they believe it is not abusive, says Renee Dominguez, Ph.D., a clinical psychologist and Interim Program Director at the Chicago Child Trauma Center at La Rabida Children's Hospital.

So what is child abuse?

  • Physical Hitting, shaking, kicking, pinching, slapping, throwing, hair pulling, and burning the child with scalding water or other hot objects. Spanking or paddling isn't considered abuse as long as it is reasonable and does not cause any injury to the child.
  • Sexual Any sexual contact between an adult and a child is sexual abuse. It includes intercourse of any kind, inappropriate touching, exposing children to adult sexuality by showing pornographic images, and performing sex acts in front of the child.
  • Emotional Name-calling, threats, constant criticism, withholding love, and any other behaviors that damage the child's self-esteem or emotional health.
  • Neglect Failing to meet the basic needs of a child, including food, clothes, shelter, hygiene, necessary medical and mental care, and education. In many states, leaving a child home alone beyond a specific period of time or in a situation in which he could be or is harmed is considered a form of neglect.

How does abuse affect children?

Child abuse can affect children in a number of ways. "First, there is always a chance that they can sustain permanent, severe or sometimes even fatal injuries," says Cindy W. Christian, M.D., chair of Child Abuse and Neglect Prevention at The Children's Hospital of Philadelphia. With or without physical mistreatment, the scars of abuse can be devastating. Abused children may experience impaired brain development, anxiety, depression, low academic achievement, and social difficulties, according to the Children's Bureau of the U.S. Department of Health and Human Services. During adolescence, failed grades, substance abuse, delinquency, sexual risk-taking and pregnancy aren't uncommon. As adults, children who were abused are nine times more likely to participate in criminal activities. Kids who are abused are also more likely to be the victim or the aggressor in an abusive relationship when they're older and abuse their own children. Sadly, child abuse can affect kids' health long after adolescence. Studies supported by the Centers for Disease Control and Prevention show when children have exposures to adverse events in childhood, they have higher rates of heart disease, cancers, mental illness and other diseases as adults, says Dr. Christian.

Why do parents abuse their kids?

There are many things that could contribute to a parent's abusive behavior, including the parent's abuse as a child, mental health issues, substance use, poor coping skills, stress levels and limited support system, says Dr. Dominguez. But it's important to remember that the cause doesn't excuse the behavior. Abuse is wrong, regardless of the reason.

What should you do if you witness child abuse in public?

Although you may want to intervene, don't confront the abuser. Instead, contact management or security at the location. If the situation is out of control, call 911 for help. Be sure to provide a general description of the child and the abuser, what they are wearing, and the make, model, and license plate number of the car (if applicable).

If you suspect a friend, neighbor, or relative of child abuse, or witness such behavior, you can report it to your local police or the Childhelp National Child Abuse Hotline (1-800-4-A-CHILD). Certain professionals, such as teachers and doctors, are required to report abuse and neglect. Some states require all adults to report suspected child abuse.

What should you do if you think you or your partner is abusive?

If you know there's been abuse, contact your local child protective services agency. If you're afraid you're skirting the line of mistreatment, feel bad about how you treat your child, know you lose control often, and notice many of your interactions with your child are negative, contact the agency. Don't think doing so means you'll lose custody of your kids. Barring extreme circumstances, children aren't removed from the home in the majority of cases, says Dr. Christian. What's more likely to happen when you reach out for help is that you will get the support and tools you need to raise healthy and safe children.