America's child death shame

Behind closed doors

Find out more about the US's hidden crisis

Introduction

Scale of abuse

Emma's story

Who's to blame?

How to stop it

Cycle of violence

Introduction

Every five hours a child dies from abuse or neglect in the US.

The latest government figures show an estimated 1,770 children were killed as a result of maltreatment in 2009.

A recent congressional report concludes the real number could be nearer 2,500.

In fact, America has the worst child abuse record in the industrialised world. Why? The BBC's Natalia Antelava investigates.

'Major epidemic' Reporter Natalia Antelava on the untold story of child abuse in the US
Scale of abuse

Sixty-six children under the age of 15 die from physical abuse or neglect every week in the industrialised world. Twenty-seven of those die in the US - the highest number of any other country.

Even when populations are taken into account, Unicef research from 2001 places the US equal bottom with Mexico on child deaths from maltreatment.

In Texas, one of the states with the worst child abuse records, the Dallas Children's Medical Center is dealing with a rising number of abused children and increasing levels of violence. Meanwhile, the Houston Center is expanding its services to deal with the rising problem of child sex abuse.

The doctor's experience

Inside a Houston help center
Emma's story

Emma Thompson was just four years old when she was beaten to death in 2009. Her injuries included broken ribs, a bloodied lip, widespread bruising and a fractured skull. She had also been raped.

Her mother and her mother's partner have been jailed over the abuse. But Emma's father, Ben, believes his daughter was let down by everyone around her.

'Everybody missed the signs' Ben Thompson on the pain of losing a daughter to abuse
Who's to blame?

Just like Emma Thompson, hundreds more children fall through the cracks of the child protection system.

Some blame overworked investigators and inefficient management, while others say it's the federal government's drive to keep families together that is the problem.

But child protection officials in Texas, a state with one of the highest total number of child deaths from abuse and neglect in the US, say such cases are complicated and difficult to assess - especially when a child's guardians are hiding what is really going on.

The Texas experience

The child protection challenge
How to stop it

In Washington, politicians are beginning to recognise what some now describe as a "national crisis".

A congressional hearing in July heard from experts in the field about what can be done to prevent deaths from child abuse. A national commission is being set up to coordinate a country-wide response.

Many believe home visits to new parents by qualified health professionals, preparing them for the difficulties of family life, are key to that strategy.

Teaching parents to be parents Teenagers describe the challenges of having children young
Cycle of violence

While child abuse blights the lives of victims' families, its devastating impact is felt far beyond relatives and friends.

Abused children are 74 times more likely to commit crimes against others and six times more likely to maltreat their own children, according to the Texas Association for the Protection of Children.

For this reason, experts believe it is in the US government's as well as society's interest to ensure children are protected from abuse. Each and every citizen, they say, has a responsibility to help break this cycle of violence.

'You only know anger and violence' Victim Stacey Kananen on the lasting impact of abuse