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NCPC Resource Sheet, April 2010

The prevalence of child abuse and neglect

Compiled by Rhys Price-Robertson, Leah Bromfield and Suzanne Vassallo
National Child Protection Clearinghouse
Published by the Australian Institute of Family Studies
ISSN 1448-9112 (Online) ISBN 978-1-921414-30-5

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The purpose of this Resource Sheet is to summarise the state of our knowledge about the prevalence of child abuse and neglect. It provides an overview of Australian studies that have estimated the prevalence of the different forms of child maltreatment (i.e., physical abuse, neglect, emotional maltreatment, the witnessing of family violence, and sexual abuse). In this Resource Sheet the terms "child abuse and neglect" and "child maltreatment" are used interchangeably.

What is prevalence?

Prevalence refers to the proportion of a population that has experienced a phenomenon, for example, the percentage of Australians aged 18 years and over in 2009 who were ever abused or neglected as a child. Incidence refers to the number of new cases occurring over a specified period of time (normally a year), for example, the number of Australian children aged 0-17 years who were abused or neglected during 2009.

Although every attempt was made to identify recent Australian child maltreatment prevalence studies, it is possible that some were missed. If you know of findings that could be included in an update of this Resource Sheet, please contact the National Child Protection Clearinghouse at: <www.aifs.gov.au/nch/contact.html>.

Australian research measuring the prevalence of child abuse and neglect

There has been no methodologically rigorous, nation-wide study of the prevalence or incidence of child abuse and neglect in Australia. There are, however, a number of recent studies that have either measured one or two maltreatment types in detail, or have superficially measured all individual maltreatment types as part of a larger study. Sixteen such studies are reviewed in this Resource Sheet.

Methodological issues involved in the measurement of maltreatment prevalence

There is wide variance in the prevalence estimates between studies. It is likely that the reason for this variance is differences in how the data were collected, that is, methodological issues. Four methodological issues that have a particularly strong influence on prevalence estimates are discussed below:

Definitions of maltreatment: Prevalence figures can differ substantially depending on the definition of maltreatment that is used. For example, a broad definition of sexual abuse - one that includes experiences such as exposure to pornographic material or exhibitionistic "flashing" - will produce a much higher prevalence estimate than a definition that includes only the most severe and intrusive forms of sexual abuse such as molestation or rape.
The wording of questions: Differences in the wording of questions or items can lead to dramatic differences in prevalence figures. For example, a question such as "Were you emotionally maltreated as a child?" requires people to categorise themselves as "victims of emotional maltreatment". Many people - especially males - will resist this categorisation even if they have been subjected to behaviours that constitute emotional maltreatment. Alternatively, questions that involve behavioural descriptions (e.g., "Did your parents routinely humiliate or verbally bully you?") are more likely to elicit an accurate response.
The number of questions used: The number of questions that researchers ask can have a strong impact on prevalence estimates. Peters, Wyatt, and Finklehor (1986) found that studies that asked four or more questions on sexual abuse produced the highest estimates. They argued that the shock associated with a single sexual abuse question can elicit an almost automatic denial in study participants. In contrast, multiple questions allow participants to overcome their hesitation to define themselves as someone who was abused.
The population from which the research sample is drawn: Different prevalence rates are found in different samples of people. For example, it is likely that higher prevalence estimates will be found among inpatients at a psychiatric clinic than in a sample of people randomly selected from the general community. Although it is preferable to use a sample of participants that represents the characteristics of the broader population (i.e., a "representative sample"), this can be very difficult to achieve. Many of the studies in this review acknowledge that their samples are not entirely representative.

How many Australian children are physically abused?

Physically abusive behaviour refers to any non-accidental physically aggressive act towards a child. Physical abuse may be intentional or may be the inadvertent result of physical punishment. Physically abusive behaviours include shoving, hitting, slapping, shaking, throwing, punching, biting, burning and kicking (Higgins, 1998; James, 1994; US National Research Council, 1993).

Six contemporary Australian studies have measured the prevalence of child physical abuse within relatively large community samples. Prevalence estimates ranged from 5% to 18%, with the majority of studies finding rates between 5% and 10% (see Table 1). The discrepancy between the two studies with lowest and highest prevalence estimations can likely be attributed largely to differences in the definitions of physical abuse.

The majority of studies found the prevalence of child physical abuse in Australia to be between 5% and 10%.

Table 1: Prevalence of child physical abuse in contemporary Australian studies

	N	Age	Sample	Location	Definition of childhood	Measure of abuse	Rates %
Cohen et al. (2006)	1,296	18-70 years	Community- Self-selected	Adelaide & Sydney	"childhood"	Small range of questions (e.g., "Were you physically mistreated as a child or teenager?")	5.0%
Rosenman & Rodgers (2004)	7,485 (3,674 males, 3,809 female)	3 age bands: 20-24 years 40-44 years 60-64 years	Community- Electoral Role	ACT & NSW	"childhood"	(1) Self report of "physical abuse". (2) "Too much physical punishment".	(1) 5.2% (2) 8.2%
Price-Robertson, Smart, & Bromfield (in press)	1,000 (390 males, 610 females)	23-24 years	Community-Longitudinal	VIC	<18 years	Harsh physical punishment with effects (e.g. bruising) lasting at least until next day.	6%
Mazza, Dennerstein, Garamszegi, & Dudley (2001)	362 females	51-62 years	Community-Longitudinal	Aust.	<16 years	Range of violent behaviours from "minor" (e.g. grabbed, shoved, slapped) to "severe" (e.g. beat up, choked).	F: 9%
Australian Bureau of Statistics (2005)	16,500 (4,600 males, 11,900 females)	18+ years	Community	Aust.	<15 years	Any deliberate physical injury inflicted by an adult.	M: 9.4% F: 10%
Mouzos & Makkai (2004)	6,677 females	18-69 years	Community	Aust.	<16 years	Was parent/guardian "physically violent"?	F: 18%

Note: M = Male, F = Female

How many Australian children are neglected?

Neglectful behaviour refers to the failure (usually by a parent) to provide for a child's basic needs. Physically neglectful behaviours include a failure to provide adequate food, shelter, clothing, supervision, hygiene or medical attention. Some studies also include measures of emotional neglect (Higgins, 1998; James, 1994; Miller-Perrin & Perrin, 2007; US National Research Council, 1993). See the description of emotional maltreatment below for a definition of emotionally neglectful behaviours.

Three contemporary Australian studies have measured child neglect in community samples. Prevalence estimates of neglect ranged from 2% to 12% (see Table 2). The two studies with the lowest prevalence estimates shared limitations that could have led to conservative estimates. Firstly, both Price-Robertson, Smart, and Bromfield (in press) and Rosenman and Rodgers (2004) used limited, single item measures of neglect. Secondly, while both studies were reasonably representative of the general community, their samples slightly under-represented those most at risk of experiencing neglect - people with a low socio-economic status. This was due to factors such as sample attrition (i.e., participants dropping out of the study). The best available evidence suggests that the prevalence rate for neglect in Australia is 12%. However, this research was conducted with a relatively small sample (n = 270). More research is needed to comprehensively measure the prevalence of child neglect in Australia.

More research is needed to obtain an estimate of the prevalence of child neglect in Australia.

Table 2: Prevalence of neglect in contemporary Australian studies

	N	Age	Sample	Location	Definition of childhood	Measure of abuse	Rates %
Rosenman & Rodgers (2004)	7,485 (3,674 males, 3,809 females)	3 age bands: 20-24 years 40-44 years 60-64 years	Community- Electoral Role	ACT & NSW	"childhood"	"I was neglected."	1.6%
Price-Robertson, Smart, & Bromfield (in press)	1,000 (390 males, 610 females)	23-24 years	Community-Longitudinal	VIC	<18 years	"the care taken of you by your parent/s was the right amount (e.g., they watched out for you, fed you properly, gave you attention)" (reverse- scored).	2.7%
Straus & Savage (2005)	270 (80.7% female)	Mean = 23.3 years	University	Adelaide	Unspecified	A range of questions measuring cognitive, emotional, physical, and supervisory forms of neglect.	12.2%

How many Australian children are emotionally maltreated?

Emotional maltreatment can consist of both acts of commission (e.g., verbal abuse) or omission (e.g., withholding of affection or attention). Specifically, emotional maltreatment refers to inappropriate verbal or symbolic acts and a failure to provide adequate non-physical nurture or emotional availability. Emotionally abusive behaviours include rejecting, ignoring, isolating, terrorising, corrupting, verbal abuse, and belittlement. Emotionally neglectful behaviours include the withholding of affection or attention and the failure to provide a child with the appropriate support, security or encouragement (note that these behaviours may be regarded as a form of neglect by some researchers) (Higgins, 1998; James, 1994; US National Research Council, 1993).

Three recent Australian studies have estimated the prevalence of emotional maltreatment. Although the studies were all conducted with relatively large community samples, their prevalence estimates were quite different, ranging from 6% (Rosenman & Rodgers, 2004) to 17% (Price-Robertson et al., in press) (see Table 3). This large range is likely due to differences in the wording of questions. For example, Rosenman and Rodgers defined emotional maltreatment using stronger terms (e.g., "mental cruelty") than Price-Robertson and colleagues (e.g., "humiliated"). The best available evidence suggests that the prevalence rate for emotional maltreatment in Australia is 11%. More research is needed to comprehensively measure the prevalence of emotional maltreatment in Australia.

The best available evidence suggests that the prevalence rate for emotional maltreatment in Australia is 11%.

Table 3: Prevalence of emotional maltreatment in contemporary Australian studies

	N	Age	Sample	Location	Definition of childhood	Measure of abuse	Rates %
Rosenman & Rodgers (2004)	7,485 (3,674 males, 3,809 females)	3 age bands: 20-24 years 40-44 years 60-64 years	Community- Electoral Role	ACT & NSW	"childhood"	1) "I was verbally abused by a parent". 2) "I suffered humiliation, ridicule, bullying, or mental cruelty from a parent".	1) 6.5% 2) 5.8%
Cohen et al. (2006)	1,296	18-70 years	Community - Self-selected	Adelaide & Sydney	"childhood"	Small range of questions (e.g., "Did your parents ridicule you?")	11.3%
Price-Robertson, Smart, & Bromfield (in press)	1,000 (390 males, 610 females)	23-24 years	Community - Longitudinal	VIC	<18 years	"... you experienced verbal treatment from your parent/s that made you feel embarrassed, humiliated or scared (e.g., shouting, name calling, threats)".	17.1%

How many Australian children witness family violence?

The witnessing of family violence refers to "a child being present (hearing or seeing) while a parent or sibling is subjected to physical abuse, sexual abuse or psychological maltreatment, or is visually exposed to the damage caused to persons or property by a family member's violent behaviour" (Higgins, 1998, p. 104).

Four community based studies have estimated the extent to which Australian children witness family violence. Prevalence estimates ranged from 4% to 23% of children (see Table 4). The most likely source of variation in estimates is the number of questions used to measure the witnessing of family violence. Indermaur (2001) (23%) and Cohen et al. (2006) (12%) used multiple questions, while Rosenman and Rodgers (2004) (6%) and Price-Robertson et al. (in press) (4%) used only one question.

The best available evidence suggests that the prevalence rate for the witnessing of family violence is between 12% and 23%.

Table 4: Prevalence of the witnessing of family violence in contemporary Australian studies

	N	Age	Sample	Location	Definition of childhood	Measure of abuse	Rates %
Price-Robertson, Smart, & Bromfield (in press)	1,000 (390 males, 610 females)	23-24 years	Community - Longitudinal	VIC	<18 years	"... there was physical violence between the adults caring for you".	4.3%
Rosenman & Rodgers (2004)	7,485 (3,674 males, 3,809 females)	3 age bands: 20-24 years 40-44 years 60-64 years	Community- Electoral Role	ACT & NSW	"childhood"	"I witnessed physical or sexual abuse of others in family".	5.5%
Cohen et al. (2006)	1,296	18-70 years	Community- Self-selected	Adelaide & Sydney	"childhood"	Small range of questions (e.g., "Did you witness physical mistreatment of another family member?")	11.8%
Indermaur (2001)	5,000	12-20 years	Community	Aust.	<20 years	Witnessing of a range of violent behaviours perpetrated against mother/stepmother ranging from "tried to hit" to "used knife or gun".	23%

How many Australian children are sexually abused?

Sexually abusive behaviour refers to any sexual activity between an adult and a child below the age of consent; non-consensual sexual activity between minors (e.g., a 14 year old and a 10 year old); or any sexual activity between a child under 18 years old and a person in a position of power or authority (e.g., parent, teacher). Sexual activity includes fondling genitals, masturbation, oral sex, vaginal or anal penetration by a penis, finger or any other object, fondling of breasts, voyeurism, exhibitionism and exposing or involving the child in pornography (Higgins, 1998; James, 1994; US National Research Council, 1993).

Fourteen contemporary Australian studies¹ have investigated child sexual abuse within community samples. Prevalence estimates ranged from 1% of all children for abuse by a parent (Rosenman & Rodgers, 2004) to 45% of females when a broad definition of abuse was used (e.g., including exhibitionistic "flashing" by a stranger) (Watson & Halford, in press). It is likely that the wide variance in prevalence estimates stems from all four of the methodological issues previously discussed: definitions of maltreatment, the wording of questions, the number of questions used, and the population from which the research sample is drawn.

Of the 14 contemporary studies investigating the prevalence child sexual abuse in Australia, four comprised comprehensive measures that specified participant gender and the severity of abuse (e.g., penetrative versus non-penetrative). The findings from these studies are presented in Table 5 and summarised below.

Studies that comprehensively measured the prevalence of child sexual abuse found that males had prevalence rates of 4-8% for penetrative abuse and 12-16% for non-penetrative abuse, while females had prevalence rates of 7-12% for penetrative abuse and 23-36% for non-penetrative abuse.

Table 5: Prevalence of child sexual abuse in comprehensive contemporary Australian studies

	N	Age	Sample	Location	Definition of childhood	Measure of abuse	Rates %
Mamun et al. (2007)	2,578 (1273 males, 1305 females	21 years	Community-Longitudinal	QLD	<16 years	A range of behaviours from non-penetrative (e.g., exposure to masturbation) to sexual intercourse.	M: 10.5% (non-penetrative), M: 7.5% (penetrative) F: 20.6% (non-penetrative), F: 7.9% (penetrative)
Najman, Dunne, Purdie, Boyle, & Coxeter (2005)	1,793	18-59 years	Community- Electoral Role	Aust.	<16 years	A range of behaviours from non-penetrative (e.g., try to sexually arouse you) to vaginal or anal penetration.	M: 12% (non-penetrative), M: 4% (penetrative) F: 23% (non-penetrative), F: 12% (penetrative)
Dunne, Purdie, Cook, Boyle, & Najman (2003)	1,784 (876 males, 908 females)	18-59 years	Community-Electoral Role	Aust.	<16 years	A range of behaviours from non-penetrative (e.g., try to sexually arouse you) to vaginal or anal penetration.	M: 15.9% (non-penetrative), M: 4% (penetrative) F: 33.6% (non-penetrative), F: 12% (penetrative)
Mazza, Dennerstein, Garamszegi, & Dudley (2001)	362 females	51-62 years	Community-Longitudinal	Aust.	<16 years	A range of behaviours from non-contact (e.g., masturbate in front of child) to contact (e.g., fondling of breasts) to penetration.	F: 42% (non-contact), 36% (contact), 7% (penetrative)

Note: M = Male, F = Female

Conclusion

This Resource Sheet has reviewed recent studies that have estimated the prevalence of child abuse and neglect in Australia, and explained some of the reasons why these estimates can vary so significantly. Measuring the extent of child maltreatment is not an easy undertaking. Definitions of abuse and neglect differ from study to study. While some behaviours are considered to be abusive by almost all people (e.g., sexual abuse), other behaviours are more equivocal (e.g., exhibitionism, smacking), and their inclusion or exclusion in particular maltreatment studies can lead to widely divergent findings. There are also considerable practical and ethical difficulties involved in the measurement of maltreatment, which can influence prevalence estimates. For example, the sensitive nature of the topic may deter some people from participating in research or necessitate therapeutic support after a disclosure of maltreatment is made.

The variance in prevalence figures signals that care is needed when interpreting and discussing study findings. Meaningful discussion of the prevalence rates of child abuse and neglect precludes unqualified statements such as "X percent of children are maltreated". The behaviours that are being defined as maltreatment should always be identified, and, given the limited data currently available in Australia, a range of prevalence estimates should be given. Popular conceptions of child abuse can differ considerably from the academic definitions used to generate prevalence estimates. When high maltreatment prevalence figures are presented to a general audience out of context and without qualifications, a sense of incredulity can be the result. This can counter efforts to raise awareness of child maltreatment.

Care should also be taken when attempting to ascertain an overall child maltreatment prevalence rate. Research has demonstrated that maltreatment sub-types seldom occur in isolation (e.g., sexual abuse is often accompanied by psychological maltreatment or physical abuse) (Higgins & McCabe, 2001). Given this high degree of co-occurrence, any attempt to calculate a single child maltreatment prevalence rate by simply adding together the prevalence figures of the individual sub-types will result in over-estimation.

Despite the difficulties involved in measuring the extent of child maltreatment, some findings emerged unequivocally from this review: all five types of child maltreatment occur at significant levels in the Australian community.

NCPC Resource Sheet, April 2010

The prevalence of child abuse and neglect

What is prevalence?

Australian research measuring the prevalence of child abuse and neglect

Methodological issues involved in the measurement of maltreatment prevalence

How many Australian children are physically abused?

Table 1: Prevalence of child physical abuse in contemporary Australian studies

N

Age

Sample

Location

Definition of childhood

Measure of abuse

Rates %

How many Australian children are neglected?

Table 2: Prevalence of neglect in contemporary Australian studies

N

Age

Sample

Location

Definition of childhood

Measure of abuse

Rates %

How many Australian children are emotionally maltreated?

Table 3: Prevalence of emotional maltreatment in contemporary Australian studies

N

Age

Sample

Location

Definition of childhood

Measure of abuse

Rates %

How many Australian children witness family violence?

Table 4: Prevalence of the witnessing of family violence in contemporary Australian studies

N

Age

Sample

Location

Definition of childhood

Measure of abuse

Rates %

How many Australian children are sexually abused?

Table 5: Prevalence of child sexual abuse in comprehensive contemporary Australian studies

N

Age

Sample

Location

Definition of childhood

Measure of abuse

Rates %

Conclusion

Further reading – NCPC Resource Sheets

References

Acknowledgements

Authors

Endnote

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