The Role of the Child in Physical Abuse: A Reappraisal
Ammerman, Robert T., Violence and Victims
Friedrich and Boriskin's (1976) seminal review presented compelling evidence pointing toward the contribution of child factors in heightening risk for physical abuse. Indeed, many authors currently accept that certain child characteristics (e.g., prematurity, low birthweight) can directly lead to abuse. Much of the data in this area, however, is based on methodologically weak designs, and recent findings do not support the premise that children have a major role in the etiology of abuse. There is some suggestion that children with relatively circumscribed features may add to risk in families that already exhibit additional factors predisposing them to maltreatment. This paper re-examines the role of the child in abuse, reviews recent relevant research findings, and offers new directions that research in this area might take.
There has been a growing awareness among clinicians and researchers alike of the alarming prevalence of child physical abuse. Indeed, recent reports document the rise in reported instances of child abuse (American Association for Protecting Children, 1988). Moreover, survey investigations confirm the high occurrence of family violence in general, and child abuse in particular (Straus & Gelles, 1986). For example, based upon their survey of American families, Straus and Gelles (1986) estimate that 750,000 children are abused each year in the U.S.A. From the earliest years of research on child abuse, there has been considerable effort directed toward discovering the etiology of and identifying reliable risk factors for abuse. Such elements are critical in (a) screening groups at high risk for abuse in order to provide preventative interventions, and (b) recognizing abused children and their families so that appropriate treatments can be implemented to remediate the short- and long-term deleterious effects associated with maltreatment (see Ammerman, Cassisi, Hersen, & Van Hasselt, 1986).
Prior to the mid-1970s, the primary emphases in elucidating the causes of child abuse were on societal factors and parental characteristics. These remain among the most important components in our understanding of how abuse develops and is maintained. As researchers focused their efforts on situational variables in abuse (Parke & Collmer, 1975), however, attention was directed toward the possible contribution of the child in the etiology of abuse. Friedrich and Boriskin's (1976) seminal review on the role of the child in abuse can be credited with stimulating a dramatic increase in research in this area. In fact, the influence of this article is demonstrated by the fact that it has been cited 49 times in other articles from 1977 to 1988 (Institute for Scientific Information, 1989). Although acknowledging the paucity of research on the role of the child in abuse, Friedrich and Boriskin (1976) conclude that a number of child characteristics (e.g., prematurity, low birthweight, difficult infant temperament, presence of a handicap) increase risk of mistreatment in some families. More recent reports concur with this conclusion. Consider the following statements:
The increased risk of child abuse when the pregnancy is complicated by premature delivery and neonatal problems is well recognized (Gates, Davis, Ryan, & Stewart, 1979, p. 553).
Stress produced by child-related factors can also lead to abuse. Low birthweight babies, premature children, and handicapped, retarded, or developmentally disabled children are at higher risk for abuse than children without these conditions (Gelles, 1987, p. 231).
Characteristics that have been implicated in precipitating abuse are... hyperactivity, coordination problems or physical handicaps, prematurity at birth, and low intellectual ability or retardation (Walker, Bonner, & Kaufman, 1988, p. 26).
A considerable amount of data addressing this issue has accrued since the publication of Friedrich and Boriskin's (1976) review. …