FactSheet 

April 2008 

Disponible en español 

www.childwelfare.gov/pubs/ 

factsheets/sp_long_term_ 

consequences.cfm 

Long-Term Consequences 

of Child Abuse 

and Neglect 

An estimated 905,000 children were victims of 

child abuse or neglect in 2006 (U.S. Department of 

Health and Human Services, 2008). While physical 

injuries may or may not be immediately visible, 

abuse and neglect can have consequences for 

children, families, and society that last lifetimes, if 

not generations. 

The impact of child abuse and neglect is often 

discussed in terms of physical, psychological, 

What’s Inside: 

• Factors affecting the consequences of

child abuse and neglect 

• Physical health consequences

• Psychological consequences

• Behavioral consequences

• Societal consequences

U.S. Department of Health and Human Services

Administration for Children and Families

Administration on Children, Youth and Families

Children’s Bureau

Child Welfare Information Gateway 

Children’s Bureau/ACYF 

1250 Maryland Avenue, SW 

Eighth Floor 

Washington, DC 20024 

703.385.7565 or 800.394.3366 

Email: info@childwelfare.gov 

www.childwelfare.gov 
behavioral, and societal consequences. In 

reality, however, it is impossible to separate 

them completely. Physical consequences, 

such as damage to a child’s growing brain, 

can have psychological implications such 

as cognitive delays or emotional difficulties. 

Psychological problems often manifest as 

high-risk behaviors. Depression and anxiety, 

for example, may make a person more likely 

to smoke, abuse alcohol or illicit drugs, or 

overeat. High-risk behaviors, in turn, can 

lead to long-term physical health problems 

such as sexually transmitted diseases, cancer, 

and obesity. 

Long-Term Consequences of Child Abuse and Neglect www.childwelfare.gov 

This factsheet provides an overview of 

some of the most common physical, 

psychological, behavioral, and societal 

consequences of child abuse and neglect, 

while acknowledging that much crossover 

among categories exists. 

Factors affecting the 

consequences of child 

abuse and Neglect 

Not all abused and neglected children 

will experience long-term consequences. 

The Federal Government has made a considerable investment in research regarding the 

causes and long-term consequences of child abuse and neglect. These efforts are ongoing; 

for more information, visit the websites listed below: 

LONGSCAN (Longitudinal Studies of Child Abuse and Neglect) is a consortium of 

longitudinal research studies on the causes and impact of child abuse and neglect, initiated 

in 1990 with grants from the National Center on Child Abuse and Neglect. The size and 

diversity of the sample (1,354 children from five distinct geographical areas) enables 

LONGSCAN to examine the relative impact of various forms of maltreatment, alone and 

in combination. LONGSCAN studies also evaluate the effectiveness of child protection and 

child welfare services. 

www.iprc.unc.edu/longscan 

NSCAW (The National Survey of Child and Adolescent Well-Being) is a project of the 

Administration on Children, Youth and Families to describe the child welfare system and 

the experiences of children and families who come in contact with the system. Its 2005 

report provides a snapshot of the functioning and the potential service needs of children 

and families soon after a child protective services investigation has taken place. NSCAW will 

continue to follow the life course of these children to gather data about services received 

during subsequent periods, measures of child well-being, and longer-term results for the 

study population. This information will provide a clearer understanding of life outcomes for 

children and families who come into contact with the child welfare system. 

www.acf.hhs.gov/programs/opre/abuse_neglect/nscaw/index.html 

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Outcomes of individual cases vary widely 

and are affected by a combination of 

factors, including: 

• The child’s age and developmental status 

when the abuse or neglect occurred 

• The type of abuse (physical abuse, 

neglect, sexual abuse, etc.) 

• The frequency, duration, and severity 

of abuse 

• The relationship between the victim and 

his or her abuser (English et al., 2005; 

Chalk, Gibbons, & Scarupa, 2002) 

Researchers also have begun to explore why, 

given similar conditions, some children 

experience long-term consequences of abuse 

and neglect while others emerge relatively 

unscathed. The ability to cope, and even 

thrive, following a negative experience is 

sometimes referred to as “resilience.” A 

number of protective and promotive factors 

may contribute to an abused or neglected 

child’s resilience. These include individual 

characteristics, such as optimism, selfesteem, intelligence, creativity, humor, and 

independence, as well as the acceptance 

of peers and positive individual influences 

such as teachers, mentors, and role models. 

Other factors can include the child’s social 

environment and the family’s access to 

social supports. Community well-being, 

including neighborhood stability and access 

to safe schools and adequate health care, 

are other protective and promotive factors 

(Fraser & Terzian, 2005). 

Physical health 

consequences

The immediate physical effects of abuse or 

neglect can be relatively minor (bruises or 

cuts) or severe (broken bones, hemorrhage, 

or even death). In some cases the physical 

effects are temporary; however, the pain 

and suffering they cause a child should 

not be discounted. Meanwhile, the longterm impact of child abuse and neglect 

on physical health is just beginning to 

be explored. According to the National 

Survey of Child and Adolescent WellBeing (NSCAW), more than one-quarter of 

children who had been in foster care for 

longer than 12 months had some lasting or 

recurring health problem (Administration 

for Children and Families, Office of 

Planning, Research and Evaluation [ACF/ 

OPRE], 2004a). Below are some outcomes 

researchers have identified: 

Shaken baby syndrome. Shaking a baby 

is a common form of child abuse. The 

injuries caused by shaking a baby may not 

be immediately noticeable and may include 

bleeding in the eye or brain, damage to 

the spinal cord and neck, and rib or bone 

fractures (National Institute of Neurological 

Disorders and Stroke, 2007). 

Impaired brain development. Child 

abuse and neglect have been shown, in 

some cases, to cause important regions of 

the brain to fail to form or grow properly, 

resulting in impaired development (De 

Bellis & Thomas, 2003). These alterations 

in brain maturation have long-term 

consequences for cognitive, language, and 

academic abilities (Watts-English, Fortson, 

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Gibler, Hooper, & De Bellis, 2006). NSCAW 

found more than three-quarters of foster 

children between 1 and 2 years of age to be 

at medium to high risk for problems with 

brain development, as opposed to less than 

half of children in a control sample (ACF/ 

OPRE, 2004a). 

Poor physical health. Several studies have 

shown a relationship between various 

forms of household dysfunction (including 

childhood abuse) and poor health (Flaherty 

et al., 2006; Felitti, 2002). Adults who 

experienced abuse or neglect during 

childhood are more likely to suffer from 

physical ailments such as allergies, arthritis, 

asthma, bronchitis, high blood pressure, and 

ulcers (Springer, Sheridan, Kuo, & Carnes, 

2007). 

Psychological 

consequences

The immediate emotional effects of 

abuse and neglect—isolation, fear, and an 

inability to trust—can translate into lifelong 

consequences, including low self-esteem, 

depression, and relationship difficulties. 

Researchers have identified links between 

child abuse and neglect and the following: 

Difficulties during infancy. Depression and 

withdrawal symptoms were common among 

children as young as 3 who experienced 

emotional, physical, or environmental 

neglect (Dubowitz, Papas, Black, & 

Starr, 2002). 

Poor mental and emotional health. In 

one long-term study, as many as 80 percent 

of young adults who had been abused 

met the diagnostic criteria for at least one 

psychiatric disorder at age 21. These young 

adults exhibited many problems, including 

depression, anxiety, eating disorders, and 

suicide attempts (Silverman, Reinherz, 

& Giaconia, 1996). Other psychological 

and emotional conditions associated with 

abuse and neglect include panic disorder, 

dissociative disorders, attention-deficit/ 

hyperactivity disorder, depression, anger, 

posttraumatic stress disorder, and reactive 

attachment disorder (Teicher, 2000; De Bellis 

& Thomas, 2003; Springer, Sheridan, Kuo, & 

Carnes, 2007). 

Cognitive difficulties. NSCAW found that 

children placed in out-of-home care due 

to abuse or neglect tended to score lower 

than the general population on measures of 

cognitive capacity, language development, 

and academic achievement (U.S. 

Department of Health and Human Services, 

2003). A 1999 LONGSCAN study also 

found a relationship between substantiated 

child maltreatment and poor academic 

performance and classroom functioning for 

school-age children (Zolotor, Kotch, Dufort, 

Winsor, & Catellier, 1999). 

Social difficulties. Children who experience 

rejection or neglect are more likely to 

develop antisocial traits as they grow up. 

Parental neglect is also associated with 

borderline personality disorders and violent 

behavior (Schore, 2003). 

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Long-Term Consequences of Child Abuse and Neglect www.childwelfare.gov 

Behavioral 

consequences

Not all victims of child abuse and neglect 

will experience behavioral consequences. 

However, behavioral problems appear to 

be more likely among this group, even at a 

young age. An NSCAW survey of children 

ages 3 to 5 in foster care found these 

children displayed clinical or borderline 

levels of behavioral problems at a rate more 

than twice that of the general population 

(ACF, 2004b). Later in life, child abuse and 

neglect appear to make the following more 

likely: 

Difficulties during adolescence. Studies 

have found abused and neglected children 

to be at least 25 percent more likely to 

experience problems such as delinquency, 

teen pregnancy, low academic achievement, 

drug use, and mental health problems 

(Kelley, Thornberry, & Smith, 1997). Other 

studies suggest that abused or neglected 

children are more likely to engage in sexual 

risk-taking as they reach adolescence, 

thereby increasing their chances of 

contracting a sexually transmitted disease 

(Johnson, Rew, & Sternglanz, 2006). 

Juvenile delinquency and adult 

criminality. According to a National 

Institute of Justice study, abused and 

neglected children were 11 times more 

likely to be arrested for criminal behavior 

as a juvenile, 2.7 times more likely to be 

arrested for violent and criminal behavior 

as an adult, and 3.1 times more likely to be 

arrested for one of many forms of violent 

crime (juvenile or adult) (English, Widom, & 

Brandford, 2004). 

Alcohol and other drug abuse. Research 

consistently reflects an increased likelihood 

that abused and neglected children will 

smoke cigarettes, abuse alcohol, or take 

illicit drugs during their lifetime (Dube et 

al., 2001). According to a report from the 

National Institute on Drug Abuse, as many 

as two-thirds of people in drug treatment 

programs reported being abused as children 

(Swan, 1998). 

Abusive behavior. Abusive parents often 

have experienced abuse during their own 

childhoods. It is estimated approximately 

one-third of abused and neglected children 

will eventually victimize their own children 

(Prevent Child Abuse New York, 2003). 

Societal consequences

While child abuse and neglect almost always 

occur within the family, the impact does not 

end there. Society as a whole pays a price 

for child abuse and neglect, in terms of both 

direct and indirect costs. 

Direct costs. Direct costs include those 

associated with maintaining a child welfare 

system to investigate and respond to 

allegations of child abuse and neglect, as 

well as expenditures by the judicial, law 

enforcement, health, and mental health 

systems. A 2001 report by Prevent Child 

Abuse America estimates these costs at $24 

billion per year. 

Indirect costs. Indirect costs represent the 

long-term economic consequences of child 

abuse and neglect. These include costs 

associated with juvenile and adult criminal 

activity, mental illness, substance abuse, and 

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domestic violence. They can also include 

loss of productivity due to unemployment 

and underemployment, the cost of special 

education services, and increased use of the 

health care system. Prevent Child Abuse 

America estimated these costs at more than 

$69 billion per year (2001). 

Ultimately, due to related costs to public 

entities such as the health care, human 

services, and educational systems, abuse and 

neglect impact not just the child and family, 

but society as a whole. 

Summary 

Much research has been done about the 

possible consequences of child abuse and 

neglect. The effects vary depending on 

the circumstances of the abuse or neglect, 

personal characteristics of the child, and the 

child’s environment. Consequences may 

be mild or severe; disappear after a short 

period or last a lifetime; and affect the child 

physically, psychologically, behaviorally, 

or in some combination of all three ways. 

ResouRCes on the ChIld 

WelfaRe InfoRmatIon 

GateWay WebsIte 

Child Abuse and Neglect

www.childwelfare.gov/can/index.cfm 

Defining Child Abuse and Neglect

www.childwelfare.gov/can/defining/
¬

Preventing Child Abuse and Neglect

www.childwelfare.gov/preventing/ 

Reporting Child Abuse and Neglect

www.childwelfare.gov/responding/ 

reporting.cfm

Long-Term Consequences of Child Abuse and Neglect www.childwelfare.gov 

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