Should I Assess for Animal Cruelty as Part of All Routine Child Health Visits?

Mary E. Muscari, PhD, CPNP, APRN-BC,CFNS


May 06, 2003


During a routine check-up, the father of a 4-year-old laughingly told me his son pulls the wings off butterflies. I know that there is a connection between animal cruelty and human violence, but are interventions really necessary for this child who is just harming insects?

Response From the Expert

Mary E. Muscari, PhD, RN, CRNP, CS
Associate Professor, University of Scranton, Scranton, Pennsylvania


Animal cruelty is one of the earliest and most reliable predictors of later violent behavior, particularly if the child exhibits direct involvement in the cruelty, lack of remorse, engagement in a variety of cruel acts, victimization of different species, and/or mistreatment of valued animals such as dogs.[1] Although many animal-abusing children grow up to be nonviolent, most of the school shooters, including Eric Harris and Dylan Klebold of Columbine High School, had histories of animal cruelty, as did many serial killers.

Assessing for animal cruelty should be part of all routine child health visits, as well as episodic visits when children present with aggressive behaviors or signs of child abuse. Asking the age of the household pets may prove significant, as abused pets rarely live past 2 years because they get killed, die of neglect, or run away to escape the abuse. At the very least, in homes where this constant turnover takes place, children suffer from repeated cycles of attachment and loss.[1]

Formal assessment protocols are in their formative stage of development. In the interim, nurse practitioners can use questions adapted from the Boat Inventory of Animal-Related Experiences,[2] which can be integrated easily into the psychosocial history:


  • Do you have any pets or other animals in your house?

  • What kind? What are their names? How old are they?

  • Who takes care of [the pet/animal]?

  • Have you ever lost a pet/animal you cared about?

  • Do you worry that something bad will happen to [the pet/ animal]?

  • Does anyone ever hurt [the pet/ animal]? Who? How was [the pet/animal] hurt?

  • If an animal has been abused and/or if there is a question of child abuse in the family, ask: "Has anyone ever touched [the pet/ animal] sexually or had sex with [the pet/animal]? Who? What did [the person] do to the pet/animal?"

All episodes of cruelty, even those done out of curiosity, warrant intervention. Definitive classifications and treatment protocols have yet to be developed. However, Ascione[3] created a typology with suggested interventions that can serve as baseline for NPs:


  • Exploratory/curious animal abusers are typically preschoolers or very early school-age children who lack training on the physical care and humane treatment of animals. Developmentally delayed children may also fit into this category. Humane education tends to be sufficient intervention. However, age should not be the only determining factor since animal cruelty is the earliest sign of conduct disorder.

  • Pathological animal abusers are usually, but not necessarily, older. These children may demonstrate symptoms of psychological disturbances of varying severity, and/or may have a history of physical abuse, sexual abuse, or exposure to domestic violence. Professional counseling is warranted.

  • Delinquent animal abusers tend to be adolescents with other antisocial behaviors, sometimes drug-, gang-, or cult-related. Both clinical and judicial interventions may be required.

A 4-year-old who pulls the wings off butterflies may be classified as an exploratory/curious abuser if he has no awareness of the implications of his actions, does not take pleasure in the behavior, and shows some remorse. However, if a parent finds cruel behavior humorous, further family assessment is necessary to assure that violent values and behaviors are not part of the household.


Comments on Medscape are moderated and should be professional in tone and on topic. You must declare any conflicts of interest related to your comments and responses. Please see our Commenting Guide for further information. We reserve the right to remove posts at our sole discretion.