By 1966, all fifty states had passed legislation regulating child abuse, all of which mandated reporting. By 1986, every state but one required reporting of neglect, and forty-one states made explicit reference to reporting of emotional or psychological abuse. Initially mandated reporting was limited to physicians, but this was eventually extended to include teachers, nurses, counselors, and the general public. The state mandated reporting laws resulted in a meteoric rise in child abuse reports across the United States. In 1962, when Kempe and his

Neglect represents the most common type of reported and substantiated form of maltreatment. In 1996, 25 states provided the following breakdown of reported cases: 62% involved neglect, 25% physical abuse, 7% sexual abuse, 3% emotional maltreatment, and 4% other. Also in 1996, an estimated 3,126,000 children were reported to Child Protective Services (CPS) agencies as alleged victims of child maltreatment. Child abuse reports have maintained a steady growth for the past ten years, with the total number of reports nationwide increasing 45% since 1987. In 1995, an estimated 1,215 child abuse and neglect related fatalities were confirmed by CPS agencies. Since 1985, the rate of child abuse fatalities has increased by 39%. Based on these numbers, more than three children die each day as a result of child abuse and neglect. Approximately 54% of the deaths were due to physical abuse while 43% were from neglect. A study found that 82 % of these children were under the age of five while an alarming 42% were under the age of one at the time of their death.

These programs do things such as educate health and child welfare agencies about the prevalence of domestic violence and its affects on children. They also involve the community in a multidisciplinary approach to provide intervention and prevention services to those families in need and educate the public about domestic violence and child abuse and the long-term costs to society. These programs also provide access to self-help groups and other supportive services for all perpetrators, victims, and survivors of abuse. They educate all who work with children and families, including teachers, service providers, and health care professionals about interplay between domestic violence and child abuse.

There are many signs to be aware of that a child is being abused at home. Some signs are withdrawn behavior, fear of an individual or place, depression, aggression, anxiety, poor self-esteem, and suicidal gestures. There are many other signs to be aware of such as running away, self-mutilation, fire setting, phobias, drug abuse, eating disorders, sleep disorders, and the list goes on. Behaviors associated with sexual abuse are seductive behavior, sexualized activity with peers, animals, or objects, and age-inappropriate sexual knowledge and curiosity.

Three in ten Americans have witnessed an adult physically abuse a child and two in three Americans have seen an adult emotionally abuse a child. Yet nearly half of these Americans failed to respond to the incident, according to a study released by Prevent Child Abuse America. Of the 1,250 Americans surveyed, 44 % failed to respond upon observing child abuse, with one-half of these individuals reporting that they had no idea how to respond effectively. Of those who claimed to have done something in response to the situation, 55 % reported that they had given the offending adult a disapproving look and 63% claimed to have verbally reprimanded the adult. According to Prevent Child Abuse America, these responses can be counterproductive and may further endanger the child.

Child abuse and neglect can have serious effects on the child and even the parent. Long term effects of child abuse include fear, anxiety, depression, anger, hostility, inappropriate sexual behavior, poor self-esteem, tendency towards substance abuse, and difficulty with close relationships. Almost all victims experience guilt. Adults who viewed domestic violence in the home as children have a greater difficulty holding jobs, maintaining relationships with their peers, and have a higher risk of developing mental health disorders. Clinical findings of adult victims of sexual abuse include problems in interpersonal relationships associated with underlying mistrust. Generally, adult victims of incest have a severely strained relationship with their parent that is marked by feelings of mistrust, fear, ambivalence, hatred, and betrayal. These feelings may extend to all family

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