The first step in preventing and treating child abuse and neglect effectively is to reach a common understanding of the definition of the phenomenon and its causes. Unfortunately, the field lacks consistent definitions and faces difficulty in developing valid instruments to identify and assess maltreatment. The very nature of child maltreatment, which tends to co-exist with many other problems, including individual psychopathology, poverty, domestic violence and other forms of victimization, as well as substance abuse, makes it difficult to define it conclusively and isolate key factors in its causation (National Research Council, 1993). Despite the difficulty in determining its causes, there is some consensus on its definition. For working purposes, child maltreatment is commonly divided into four categories: (1) physical abuse; (2) neglect; (3) sexual abuse; and (4) emotional maltreatment. The Child Abuse Prevention and Treatment Act of 1996 (CAPTA, P.L. 104-235) contains definitions of child abuse and neglect and sexual abuse for purposes of interpreting the legislation. The law states, "the term 'child abuse and neglect' means, at a minimum, any recent act or failure to act on the part of a parent or caretaker, which results in death, serious physical or emotional harm, sexual abuse or exploitation, or an act or failure to act which presents an imminent risk of serious harm" (Section 111(2)).
Although it is difficult to isolate the causal factors of child maltreatment, much progress has been achieved by researchers and practitioners who study and work with abusive and neglectful families. Anecdotal assumptions have been refined to incorporate research findings about the nature of child maltreatment, the characteristics of individuals, families, neighborhoods, and social and cultural values that affect the presence or absence of abuse and neglect. The importance of the developmental level of the child has been recognized in studying the consequences of child maltreatment and in designing prevention and intervention programs. The relationship between experiences with child maltreatment and a broad range of health and behavioral disorders has been explored through longitudinal studies with increasingly larger samples (National Research Council, 1993).
The original notion of the nature of child maltreatment was univariate, centering on the portrait of "the battered child," and referring primarily to physical abuse perpetrated by a mentally unstable and cruel parent (National Research Council, 1993). The current perspective on the problem of child maltreatment is more ecological, encompassing not only a broader range of causes, both intrinsic and extrinsic to the individual, but also a wider continuum of types and severity of abuse. Each category covers a range of behaviors, and is not perfectly discrete from the others. Despite this, each category has become the focus of separate studies of incidence and prevalence, etiology, prevention, consequences, and treatment. These studies have led to the development of unique frameworks for each type of abuse, revealing certain similarities (such as the importance of developmental perspectives in considering the consequences of maltreatment), but also important differences (such as the predatory behavior associated with some forms of sexual abuse that do not appear with other forms of child maltreatment) (National Research Council, 1993).