By far the most troublesome outcome of physical abuse is the possibility of permanent damage or even death. As we say in our sexual abuse prevention efforts, we’d rather see 1,000 more children be molested than to create policies that has one more child lose their life. The proper therapeutic efforts can heal every one of those 1,000 kids quickly and completely, so long as we intervene in prosocial ways. But to date, no one knows how to bring a child back from the dead. While the physical abuse of children causes physical hurt and implicit social/emotional injury, it can be dealt with. Death, brain damage, or other permanent injuries cannot, and it’s a lot easier to kill or maim a child than most adults realize. As tough as children can seem at times, they break rather easily when pitted against the rage of an adult. One moment of anger can have disastrous results.

Around 1,500 kids are killed every year due to child abuse and neglect, about 500 of whose deaths are attributed solely to physical abuse sustained during an outburst. (Sirotnak, Grigsby, and Crugman, 2004; in other cases, a mixture of physical abuse and neglect might be present, but neglect gets blamed for both deaths.) To put this in perspective, imagine your child’s entire elementary school (or perhaps two, depending on the size), brimming with bright young faces, who are murdered each year, victims of physical abuse. They are beaten to death, thrown against walls, hit with objects, swung around or shaken, sometimes tortured to death for weeks or months. They are often burned, bitten, cut with knives, beaten with whips, doused in scalding water, forced to drink toxic chemicals, locked inside closets without food, and left with broken bones and other serious injuries to heal without medical treatment.

But these numbers don’t really tell the whole story. Much like there are 5,000 drownings for every 1,000 drowning deaths, numerous children are permanently disabled from physical abuse but live through it. These kids aren’t included among the death statistics, yet their stories can be every bit as tragic:

1. A child who was beaten into a coma with a baseball bat was ordered taken off life support to die. When they pulled the plug, she started breathing on her own and eventually partially recovered. Yet the beating took its toll. She is now severely and permanently brain damaged and although she can communicate with her caretakers now, she’ll never be the same child she was. (,)

2. A 10-year-old girl who was shaken once by her father as a baby has suffered the effects ever since. She is now blind, can’t speak or eat solid food, and needs oxygen to breathe at night and medication in order to sleep. (Newman, 7-22-08) For all intents and purposes, her life has been taken away.

3. A three year old girl is now blind had sever cerebral palsy and severe seizure disorder after being beaten and shaken as a baby. (USAToday, 4-10-2008, p. 8A)

4. One little girl was abused so badly by her mothers boyfriend that she needed to have both her legs amputated. (USAToday 5-18-2010, p. 7A)

5. A father had a habit of pulling his belt out of his pants to hit his child whenever the boy misbehaved. One day he pulled the belt from the wrong end. The buckle struck the child over his eyes, blinding him. (Frieman, 2005)

Permanent damage can also be much more subtle. Elmer and Gregg (1967) have observed the presence of mental retardation, central nervous system damage, and speech defects in physically abused children. Brain damage, emotional problems, and failure to grow also have been documented by Wright (1970), Kempe and Helfer (1972), and Evans, Reinhart, and Succop (1972).

The majority of serious and/or deadly abuse cases involve very young children, generally under the age of five. However, this has led to the rather errant perception that young children are abused more severely than older ones. The reason so many fatalities involve younger children is not because they are abused more often or more severely, but because there is a tiered vulnerability level to the abuse that does occur.

As David Walters (1975, p. 159) explains, “If an adult man weighing 180 pounds struck another man of the same size, the victim might be knocked off balance. If the same adult struck a 12-year-old with the same force, he might break the child’s nose. If the child is 6, the blow might knock him unconscious and perhaps cause injuries when the child struck the floor. A one-year-old child struck with the same amount of force will most likely be killed, and if only six weeks old, the child will certainly die.” His analogy might be a little bit on the dramatic side, but you get the idea.