Abstract:
Each year within the US alone over 770,000 children are victimized by
abuse and neglect (US Department of Health and Human Services, 2010),
and this figure is likely to underestimate the extent of the problem.
Researchers have long recognized that maltreatment has adverse effects
on children’s mental health and academic achievement. Studies of adults
show that adverse childhood experiences like maltreatment increase risk
for chronic diseases of aging, including Type II diabetes and cardiovascular disease.
What the field does not fully understand is why maltreatment has such pervasive effects.
Studies on the neuroscience of maltreatment have begun to offer some clues.
Victims of maltreatment differ from non-victims with respect to brain structure and
function, hypothalamic-pituitary-adrenal-(HPA) axis and autonomic nervous system
function, immune function, and epigenetic markers. These studies identify potential
mechanisms by which maltreatment increases risk for poor mental and physical health
and poor school performance by affecting systems that subserve memory, attention,
the response to stress, and inflammation. The findings highlight the importance of
broadening the scope of child welfare beyond child protection to include child wellbeing.
A focus on child well-being would require integrated services, wherein comprehensive
mental and physical health care are routinely offered to victims of maltreatment
and case workers, pediatricians, and psychologists would work as teams to
determine how best to deliver care to children and families in the child welfare system.
In working with the family, such efforts could potentially reduce the risk of re-victimization
which commonly jeopardizes long-term gains in child well-being.