children. Research has shown that children exposed to domestic violence increases the chances of experienced behavioral and emotional problems (depression, irritability, anxiety, academic problems, and problems in language development). Overall, emotional effects caused by child abuse and even witnessing abuse can result in long-term and short-term effects that ultimately affect a child's upbringing and development. Physical The immediate physical effects of abuse or neglect can be relatively minor (bruises or cuts) or severe (broken bones, hemorrhage, death). Certain injuries, such as rib fractures or femoral fractures in infants that are not yet walking, may increase suspicion of child physical abuse, although such injuries are only seen in a fraction of children suffering physical abuse. Cigarette burns or scald injuries may also prompt evaluation for child physical abuse. The long-term impact of child abuse and neglect on physical health and development can be: Shaken baby syndrome. Shaking a baby is a common form of child abuse that often results in permanent neurological damage (80% of cases) or death (30% of cases). Damage results from intracranial hypertension (increased pressure in the skull) after bleeding in the brain, damage to the spinal cord and neck, and rib or bone fractures. 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. Structural brain changes as a result of child abuse or neglect include overall smaller brain volume, hippocampal atrophy, prefrontal cortex dysfunction, decreased corpus callosum density, and delays in the myelination of synapses. These alterations in brain maturation have long-term consequences for cognitive, language, and academic abilities. In addition, these neurological changes impact the amygdala and hypothalamic-pituitary-adrenal (HPA) axis which are involved in stress response and may cause PTSD symptoms. Poor physical health. In addition to possible immediate adverse physical effects, household dysfunction and childhood maltreatment are strongly associated with many chronic physical and psychological effects, including subsequent ill-health in childhood, adolescence and adulthood, with higher rates of chronic conditions, high-risk health behaviors and shortened lifespan. Adults who experienced abuse or neglect during childhood are more likely to have physical ailments such as allergies, arthritis, asthma, bronchitis, high blood pressure, and ulcers. There may be a higher risk of developing cancer later in life, as well as possible immune dysfunction. Exposure to violence during childhood is associated with shortened telomeres and with reduced