Recognize, prevent child abuse Published Nov. 29, 2006 By Staff Sgt. Amanda Mills Public Affairs Vance Air Force Base, Okla. -- She sits happily in front of the television, watching cartoons and eating her marshmallow cereal. Suddenly, her mother's angry voice bellows from the bedroom. "Sarah! Come here right now!" Knowing this means trouble, Sarah hesitantly obeys her mother's order. As soon as she enters, she feels the common sting of her mother's hand across her face. April is Child Abuse Prevention Month. Although the above story is fictional, child abuse affects children of every age, race and income level. It often takes place in the home and comes from a person the child knows and trusts. There are four major types of child maltreatment: neglect, physical abuse, sexual abuse and emotional abuse. Neglect is failure to provide for a child's basic needs such as food, clothing, shelter, medical care, education or proper supervision. Signs of neglect can include malnutrition or the child has unattended physical or medical problems. Physical abuse is intentional injury inflicted upon a child. It may include severe shaking, beating, kicking, punching or burning. Possible signs of this include broken bones or unexplained bruises, burns or welts; or the child is unusually frightened of a parent or caretaker or is afraid to go home. Sexual abuse refers to any sexual act with a child by an adult or older child. It includes fondling or rubbing the child's genitals, penetration, incest, rape, sodomy, indecent exposure and using the child for prostitution or the production of pornographic materials. Sexual abuse signals can include pain or bleeding in the child's anal or genital area with redness or swelling; or the child displays age-inappropriate play. Emotional abuse may occur when a parent fails to provide the understanding, warmth, attention and supervision the child needs for healthy psychological growth. Signs of emotional abuse can include a parent visibly criticizing, threatening, belittling, insulting or rejecting the child; or the child exhibits extremes in behavior. "Child abuse has been linked to a wide range of negative consequences for children including low self-esteem, aggression, peer rejection, cognitive/academic delays and increased delinquency/substance abuse in adolescence," said Capt. (Dr.) Matthew Miller, 71st Medical Group life skills. At Vance Air Force Base and in the Enid community, suspicion of child abuse can anonymously be reported to the medical group clinic, the family advocacy office, the chapel, security forces or to a command representative. Children deserve loving, non-abusive living environments. For questions regarding the medical child abuse assessment procedure at Vance, call the family advocacy office at 7419. (Information from the Department of Health and Human Services contributed to this article.)