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A Comparison of Abused Children and

Their Nonabused Siblings

Ellen C. Herrenkohl, Ph.D. and Roy C. Herrenkohl, Ph.D.

Abstract, We compared 295 targets of abuse to 284 nonabused siblings with reference to birth
record data and maternal perceptions of the birth and subsequent development of the child.
Prematurity; Apgar scores; age of mother at child's birth; self-reports of postpartum depres-
sion; maternal perceptions of emotional difficulties of the child, of the child's ability to be
influenced by the mother, and of negative characteristics of the child re-miniscent of others
were related to certain types of abuse and gross neglect. Explanatory hypotheses include
weakened attachment bonds and maternal projection of negative attributes and feelings of
he] plessness.

In recent years, research on child abuse has generated several


broad explanations for the occurrence of child abuse. Among these
are explanations based on the personality and/or behavior of the
abuser (or perpetrator of abuse), the dynamics of the family and
the marital interaction, the socioeconomic and cultural milieu
status of the family, and the contributions of the child in eliciting
abuse.
This report will focus on the role of the child-related characteris-
tics in the occurrence of abuse. Clinicians (Helfer, 1975; Kempe et
al., 1962; Steele and Pollock, 1968) have noted that the child may
unwittingly (or, in some cases, deliberately) provoke abuse by virtue
of being unwanted or difficult to care for. A recent review of the

Dr. nun Herrmkohl is a Research Scientist, and Dr. Roy C. Hrrrrnkohl is Director, Center for
Social Research, Lehigh University ( / 0 West Fourth Street, Bethlehem, PA /80/5), where reprints may
be requested.
The authors are grateful to the Children's BureaU.< of Lehigh and Northampton Counties (PA) and to
the numerous hospitals which cooperated in the research activities reported here. The authors also wish to
express their appreciation to Monica Such. Marlee Campbell, Lori Toedter, Candice Crawford, and
Brenda Egolf, who assisted with the study.
The research reported here was supported by Grant #90-C-428, awarded by the National Center on
Child Abuse and Neglect, Children's Bureau/Administration for Children, Youth and Families, U.S.
Department of Health, Education and Welfare and in part by Grant #MH 2629/ awarded by the
National Institute of Mental Health.
0002-7138/79/18024>260 $00.95 e American Academy of Child Psychiatry.

260
Abused Children and Their Nonabused Siblings 261

literature on this issue (Friedrich and Boriskin, 1976) summarized


the findings of published reports as they related to the relationship
between abuse and prematurity, physical handicaps, mental retar-
dation, congenital factors, and parental perceptions of the child as
"different" from other children. The findings reported below will
focus on some of these issues while exploring three central ques-
tions: Do children who are abused differ in identifiable ways from
their nonabused siblings? Are there child-related factors associated
with particular categories of abuse (physical, emotional, sexual
abuse, or gross neglect)? How important is the role of the child in
the occurrence of child abuse?

METHOD

During the years between 1967 and 1976, 328 families in a bi-
county area of Eastern Pennsylvania were cited for child abuse and
subsequently provided service by the respective county child wel-
fare programs. A follow-up study of these families was conducted
in which the child welfare case records of these families were
analyzed , and the heads of household were located and interviewed
whenever cooperation could be obtained. In addition, where per-
mission of a parent was obtained the hospital birth records of his or
her children were read and analyzed. The goal of the follow-up
study was to explore the extent of discontinuation or recurrence of
child abuse, as well as the psychological, social, and environmental
conditions associated with abuse and its recurrence .
Participants
Interviews were conducted with 151 female heads and 66 male
heads of household (i.e., heads of household at the time of the abuse
incident) . The interview results reported below are based on the
interview data of the females. or these women, 83.4% were Cauca-
sian, with 4 I % being all or partially of Pennsylvania Dutch back-
ground; 12% had Spanish surnames, and 4.6% were black.
Data were collected on a total of 579 children in the families of
the interview respondents. Of these , 295 (50.9%) were targets of
one or another (or combination of) type of abuse. The largest
proportion (approximately 60%) were younger than 6 years old
when first a target of child abuse. Boys were 50.9% of targets and
55 .5% of nontargets .
262 Ellen C. Herrenkohl and Roy C. Herrenkohl

Measurement Instruments
The case records of all 328 families were analyzed. The case record
coding system involved a coding of all critical incidents in the rec-
ord by type, date of occurrence, persons involved in the incident,
and outcome.
These data provided the basis for identifying those children who
had been targets of abuse, and the types of abusive incidents which
had occurred. The latter included physical abuse, emotional abuse
(threats of violence or of abandonment, or use of psychologically
terrifying punishments such as locking a child in a dark room),
sexual abuse, and gross neglect (failure to provide emergency med-
ical treatment or poor care resulting in failure-to-thrive of the in-
fant). Those abuse incidents which resulted in legal "citations" of
the family for abuse were identified, in addition to those that were
not legally cited but were described in the record. Each child thus
received a sum score for number of physical, emotional, sexual
abuse, and gross neglect occurrences and citations.
Through visits to local hospitals and mail contacts with out-of-
town hospitals, the birth records of 314 children from 97 families
were obtained, coded, and analyzed. Data were gathered on birth
weight, weeks of gestation, age of mother at child's birth, indi-
cations of pregnancy problems, delivery problems, and abnor-
malities of the baby. Of those children on whom birth record data
were gathered, 147 (49.8%) were known to be targets of abuse on
the basis of the case record analyses.
The interview with the parent was an extensive one, and in-
cluded questions about the marital relationship, the stresses on
family life, the parent's family and discipline experiences as a child,
and the history and quality of the parent's relationship with each of
the children in the family. It is the latter results which will be
described in this paper-specifically, the nature of the parent's per-
ceptions of the child and feelings surrounding the pregnancy and
birth of the child.
Data Analysis
The results reported below focus on two variables: (I) whether a
child was a target of abuse or not; and (2) the number of different
types of abuse incidents a child had experienced at the time the
case record was read. Data analysis involved the use of cross-
tabulation to obtain frequencies and percents, and Pearson
product-moment correlations to determine degree of association
Abused Children and Their Nonabused Siblings 263

and statistical significance. Multivariate analyses of the data were


not done because the different subsets of variables were not com-
mon to enough participants.

RESULTS

Prematurity
A number of investigators have found a relationship between pre-
maturity of the infant and subsequent abuse (Elmer and Gregg,
1967; Klein and Stern, 1971; Lynch, 1976; Martin, 1976; Smith,
1976). Friedrich and Boriskin's (1976) review of the research
suggests that prematurity does appear to be more common among
infants who are later abused than it is among the general popu-
lation.
In the present study, the rate of prematurity among targets of
abuse was compared to the rate among their nonabused siblings. A
significant although small correlation was found between target
status and premature birth (less than 36 weeks gestation) (I' = .12,
P < .05).
Among the abused children for whom the gestational period was
known, 6.9% were born prematurely as compared to 1.5% of their
nonabused siblings. The larger proportion of premature babies
among the abused children parallels the findings of others that
children born prematurely are at greater risk for subsequent abuse
than full-term newborns.
The hypothesized explanations for the positive relationship be-
tween prematurity and abuse include such factors as the increased
sensitivity to handling on the part of premature babies, their
greater tendency to exhibit colic, distractibility, and sleep distur-
bances. Others (Klaus and Kennell, 1970) have suggested that sep-
aration of the premature newborn from its mother in an isolette
weakens the early attachment bonds that are normally being
formed between mother and child in the first hours and days of
life. With this issue in mind, the respondents were asked to esti-
mate how soon after their babies' births they were able to see,
touch, or hold them. Mothers of children born earlier than 36
weeks gestation as compared to mothers of full-term babies re-
ported significantly greater time lags before touching or holding
those same children (r = .20, P < .01). These findings lend some
support to the notion that a greater than usual degree of separa-
tion of premature infants from their mothers may increase their
264 Ellen C. Herrenkohl and Roy C. Herrenkohl

risk for subsequent abuse by adding obstacles to the formation of


strong bonds of attachment between mother and child. In this re-
gard, an unanticipated finding that all the breech births in the
analyzed birth records (N = 9) were found to be nonabused sib-
lings of targets is provocative. One possible explanation which
would require additional documented information about the de-
liveries involves the "attachment" hypotheses, and is based on the
assumption that breech births are often carried out with no anes-
thesia, or only minimal anesthesia, in order to allow the mother to
aid in the delivery process; possibly, the mother's more active par-
ticipation and alert state in this case allow for more immediate
bonds of attachment to the baby to be formed, providing a greater
safeguard against subsequent abuse.
An additional finding that reflects on the relationship of pre-
maturity to subsequent abuse is that mothers admitted more often
to having thought about preventing the birth of those children who
were subsequently born prematurely than they did while carrying
their term-birth infants (r = .15, P < .05). Other researchers have
reported a relationship between psychological stress during preg-
nalH.:y and prematurity as well as other obstetrical com plications
(Ferreira, 1965). Prematurity thus might be a result of prior emo-
tional stress surrounding the pregnant woman's anticipation of an
unwanted child. As such prematurity could reflect maternal pre-
disposition to reject the child as much as a potentially difficult
infant-care situation which ends in abuse as a result of maternal
frustration.
Physical Handicaps
Contradictory findings have been reported about the relationship
between congenital physical anomalies and subsequent abuse, with
some researchers reporting a positive relationship and others re-
porting no relationship (Friedrich and Boriskin, 1976; Martin,
1976; Smith, 1976). In the current study, no relationship was
found between physical abnormalities of the baby at birth accord-
ing to hospital records, and subsequent abuse.
While physical abnormalities at birth were not found to be re-
lated to abuse, children who were described by their mothers as
having more infancy-related and developmental problems (e.g., ex-
cessive crying, slow weight gain, overall slow development, coor-
dination problems) were more likely than their siblings not so de-
scribed to have been targets of gross, or life-threatening, neglect (r
Abused Children and Their Nonabused Siblings 265

= .12, P < .(1), one of the types of abuse for which families can be
cited. In addition, infants whose first Apgar scores were less than 8
were significantly more likely to be cited as targets of gross neglect
(I' = .22, P < .(1) than those with Apgar scores of 8 or above.
Apgar scores were available Ior a total of 184 children, 36 of whom
had been targets of neglect. Of these 36 children, 13.9% were
found to have Apgar scores of less than 8 as compared to 6.1 % of
the non neglected children for whom these data were available (N
= 148). These children with low Apgar scores were also more likely
to be described by their mothers as having had "birth defects" (I' =
.24, P < .0 I). There was a nonsignificant trend indicating that the
mothers tended to have experienced postpartum depression (ac-
cording to their own reports) more often after the births of these
babies (I' = .12, P < .10).
While physical problems at birth do not have a significant corre-
lation to abuse as a broadly defined phenomenon, they do, in these
findings, appear to be related to abuse of a specific type, namely,
Iife-threaten ing neglect. 1t is not clear from these findings whet her
the special characteristics of the infants made them more difficult
and less gratifying to care for and thus less likely to thrive, or
whether the emotional problems of the mother during pregnancy
were reflected in postpartum depression and were an antecedent
condition to the physical state of the infant which resulted in a
citation for neglect.
Parents' Perceptions of the Child as Differmt
While some research (Friedrich and Boriskin, 1976) has lent sup-
port to the notion that one child in a family is singled out for abuse
as the family scapegoat, the present study found, to the contrary,
that almost half (46.5%) of the families in the abusive population
had more than one target of abuse, and one-fifth (20.6%) had
more than two targets of abuse.
However. those children who were targets or abuse were de-
scribed by their mothers as having exhibited more types of difficul-
ties in their development (1' = .20, P < .01), and specifically more
emotional difficulties (1' = .21, P < .01), e.g., excessive eating or
refusal to eat, eating bizarre materials (pica), frequent temper tan-
trums, sleeping problems, head banging, behavior problems,
moodiness. These findings applied specifically to those children
who were targets of physical or emotional abuse. The findings, of
course, do not allow one to distinguish between behavior and erno-
266 Ellen C. Herrenkohl and Roy C. Herrenkohl

tional problems which arc the result of abuse, and those which
might have provoked abuse . The y do, howe ver, underscore the
fact that abused child re n are perceived by their mothers to be
"difficult" children. Others who have studied abu sed child ren re-
port sim ilar portraits of su ch children (Galdston, 1965; Green,
1978b; Johnson and Morse ; 1968 ; Martin, 1976) and generally
agrce that the behavioral and emotional problems are the result of
the mistreatment.
The targets of physical abuse also tended to be described by their
mothers as having physical, personality, or behavior characteristics
that reminded them of relatives or of themselves in negative ways
(e.g., "thick-headed," "big mouth," "clumsy," "temper," "two-faced,"
"bad," "crabby").
Additional evidence that the abused child is often viewed as
difficult to raise and a "problem" child by the parents comes from
descriptions of their childhoods offered by abusing parents who in
this study and in the experience of others (Steele and Pollock,
1968) were often abused themselves. Such respondents said of
th emselves as children, "I was considered the black sheep in the
fam ily:' or "they thought I was slow, the dumb one," or "my
mother told me if I hadn 't been such a rotten kid , I wouldn't have
been taken from hCL"
Respondents were also as ked to describe the amount of influence
the y felt they had over each of their children's happiness, general
behavior. achievement in school, and ability to get along with
others. The perceived ability to influence the happiness of the child
was significantly and negati vely related to the number of recorded
physical abuse incidents (I' = - .14, P < .01) as well as the number
of sexual abuse incidents for the child (I' = -. I I, P < .0 I). The
perceived ability to influence the child's achievement level in school
was negatively related to the number of recorded sexual abuse in-
cidents (I' = -. I I, P < .0 I). The perceived ability to influence the
child's overall behavior was negatively related to the number of
recorded emotional abuse incidents (I' = -.15, P < .0 1) and physical
abuse incidents (I' = -.1 I , P < .0 I) recorded for the child. Finally,
the perceived ability to influence the child's capacity for getting
along with others was negatively related to the number of emo-
tional abuse incidents recorded for the child (I' = - .17, P < .01).
Mothers of abused children ma y be said to perceive themselves
to have less control or influence over these children than they feel
they have over the nonabused siblings of these children .
Abused Children and Their Nonabused Siblings 267

A final result which bears upon all of the above findings is the
significant negative correlation which was found between age of
the mother at the time of the child's birth and subsequent physical
abuse of the child (1' = - .17, P < .01) or gross neglect of the child
(1' = -.13, P < .01). Younger mothers were more likely to have
children who were later abused or grossly neglected. Of the tar-
gets of abuse for whom mother's age at child's birth was known,
32.4% were born to mothers under 20; 14.9% of their nonabused
siblings were born to mothers under 20. Teenage mothers were
also more likely than mothers 20 years or older at the time of the
child's birth to feel they had little influence over the child's happi-
ness and general behavior.

DISCUSSION

The reported results do not include findings related to the person-


ality characteristics of the abusers, nor do they refer to the family,
social and cultural climate in which abuse occurs. They focus on
the child-related characteristics of abused children as compared to
their nonabused siblings, and, from this narrowed perspective,
highlight certain aspects of the antecedents and consequences of
child abuse.
There are suggestions from the data reported that some chil-
dren, born prematurely and/or with deficiencies in functioning at
birth, may be at higher risk than full-term infants for abuse or
gross neglect on the part of their mothers. Early failure to establish
strong bonds of attachment may be implicated in these conse-
quences, perhaps as a consequence of early separation between
mother and child, perhaps as a consequence of early rejection of
the baby by the mother. The babies of teenage mothers, on the
whole, appear to be at higher risk for subsequent abuse and ne-
glect, and appear to be seen by their mothers as less open to their
influence. This in turn may reflect the mothers' feelings of helpless-
ness and loss of a sense of control over their lives with the arrival
of children so early in their own development.
By and large, little support was found for the notion that chil-
dren who are targets of physical, emotional, or sexual abuse are
"different" from birth. Pregnancy problems, delivery problems,
and physical abnormalities of the baby were unrelated to these
kinds of abuse.
These children are, however, viewed more negatively by their
268 Ellen C. Herrenkohl and Roy C. Herrenkohl

parents than their nonabused siblings. They are also seen as more
"difficult" children, as exhibiting more behavioral problems than
their nonabused siblings. They are more likely to remind their
parents in negative ways of themselves or others and may serve as
the target of projections on the part of their mothers, which make
them vulnerable, in time, to being targets of abuse (see, for exam-
ple, Kaufman et al., 1954). Indeed, as Green (1976, 1978a) and
others have pointed out, the negative perception of the child can
interfere with therapeutic treatment plans for the child if not dealt
with simultaneously with the child's treatment program.
Finally, it should be noted that the correlations discussed above,
while significantly different from chance, are modest correlations
which, on the whole, account for a fraction of the variance as-
sociated with the extent of abuse. Thus the role of the "child" in
child abuse, while real, is only a small part of the total picture.
Filling out the picture requires focusing, in turn, on the history of
the perpetrator, the family environment as a whole, and the gen-
eral cultural climate in which the abuse takes place.

IMPLICATIONS FOR TR~:ATM~:NT AND Rt:S~:ARCH

One implication for programs aimed at prevention of abuse is the


importance of such services for very young mothers early in the life
of the baby. Prenatal clinics and hospital maternity wards may be
critical sites for early detection of parent-child couples who could
be headed for traumatic interactions. Young mothers, depressed
mothers, mothers of premature babies, and mothers of hypoactive
infants could be given extra support and enrolled in continuing
parent education programs before being discharged with their
babies and before the negatively reinforcing pattern of parental
abuse-or-neglect and disturbed child behavior has a chance to de-
velop. Additionally, recent trends toward popularizing "rooming-
in" practices in the maternity wards, and minimizing the amount of
anesthesia routinely administered in deliveries should be studied
to identify their impact on subsequent parent-child interaction.
A second implication is the importance of parental perceptions
of the abused child in the quality of the parent-child interaction.
Successful treatment programs for abusive families might be ex-
pected to result in less negative and more positive parental percep-
tions of the abused child. Evaluations of treatment programs might
do well to include this dimension among those that are used for
comparing the effectiveness of diverse treatment approaches.
Abused Children and Their Nonabused Siblings 269

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