The old playground rhyme got it wrong. Although sticks and stones do break bones, words can have devastating consequences as well. And when those words come from a child’s parent or caregiver, the repercussions for the child’s psychological and emotional health can be long lasting.

A recent clinical report from the American Academy of Pediatrics (Pediatrics, July 20, 2012) describes the behaviors of emotionally abusive parents/caregivers and outlines the risks to children who are subjected to this abuse. Lead author Roberta Hibbard, MD, director of child protection programs at Indiana University and Riley Hospital for Children in Indianapolis, asserts that the emotional maltreatment of children deserves the same level of attention that physical and sexual abuse is given.

Hibbard and her coauthors describe the different forms that psychological abuse of children can take, including:

  • spurning, that is, belittling or ridiculing the child in public;

  • terrorizing, or exposing the child to dangerous or chaotic situations;

  • isolating, or shutting the child out of interactions or relationships;

  • exploiting or corrupting the child; and

  • neglecting the child’s health or education.


According to the report, emotional abuse by a parent/caregiver may be verbal or nonverbal, active or passive, and with or without intent to harm. But regardless of the form or intent, these behaviors are harmful to a child’s cognitive, social, emotional, and even physical development. “Psychological maltreatment has been linked with disorders of attachment, developmental and educational problems, socialization problems, disruptive behavior, and later psychopathology,” says Hibbard.

In her July 30 article, “Childhood Mental Abuse Under the Radar?,” MedPage Today staff writer Nancy Walsh summarizes the AAP report and describes some of the challenges for mental health care providers in identifying and treating emotional abuse. “Although it can be difficult to determine the actual prevalence of psychological and emotional maltreatment of children, an estimated 4% of men reported having experienced some form of this abuse as children, as did 8% to 9% of women,” says Walsh. “The problem most often is found in families with high levels of conflict, and where substance abuse, violence, and parental mental health difficulties such as depression exist.”

Support for parents and early intervention may be the key to reducing these numbers, according to the AAP report. “Prevention before occurrence will require both the use of universal interventions aimed at promoting the type of parenting that is now recognized to be necessary for optimal child development, alongside the use of targeted interventions directed at improving parental sensitivity to a child’s cues during infancy and later parent-child interactions,” says Hibbard. “Intervention should, first and foremost, focus on a thorough assessment and ensuring the child’s safety. Potentially effective treatments include cognitive behavioral parenting programs and other psychotherapeutic interventions.”

What do you think? What can be done to increase awareness about the emotional maltreatment of children and to support parents who may be at risk for these behaviors? PAR wants to hear from you, so leave a comment and join the conversation!