Child abuse involves doing something or failing to do something that results in harm to a child or puts a child at risk of harm. Child abuse can be physical, sexual or emotional. Neglect, or not providing for a child's needs, is also considered to be a form of abuse. Munchausen's by Proxy syndrome is a unique form of abuse where a parent or caregiver misleads others into thinking that the child has medical problems by deliberately creating or exaggerating the child’s symptoms in several ways. They might lie, falsify medical records, or induce symptoms by giving the child medicine or toxic substances. As a result, doctors usually order tests, try different types of medications, and may even hospitalize the child or perform unnecessary surgery.
Most child abuse occurs within the family, often by parents or relatives who themselves were abused as children. Neglect and mistreatment of children is also more common in families living in poverty and among parents who are teenagers or are drug or alcohol abusers. According to the American Bar Association, child protective services agencies received nearly 3.2 million reports of child maltreatment but were only able to investigate a little more than half of these cases. The recession is inflicting a further hit, with many states imposing budget cuts that affect child welfare programs. Inadequate resources are stretching state child protection agencies too thin to properly serve at risk children and their families.