National Child Abuse Prevention Month: Part I


Reconciling the perceptions of child abuse

(Editor’s note: In recognition of Child Abuse Prevention Month, Siuslaw News will be offering feature stories, guest viewpoints and editorials focusing on this issue, beginning with this special two-part series to help identify child abuse and some of the local resources for victims as well as abusers.)        

April 7, 2018 — April marks Child Abuse Prevention Month, an annual observance dedicated to raising awareness and promoting community efforts to address child abuse.

The 90by30 program, a University of Oregon-based nonprofit, will plant blue pinwheel gardens across the county this month and encourage volunteers to join local efforts that will benefit future generations.

As its name suggests, the organization aims to reduce child abuse in Lane County 90 percent by the year 2030 through coordinated programs and public education.

Suzanne Mann-Heintz, co-chair of 90by30’s West Lane Regional Leadership Team, is helping to spread awareness in Florence.

“Creating a community where children are safe and happy is the goal of this project,” she said.

Child abuse remains a pervasive issue worldwide and continues to be a problem in the U.S. According to the U.S. Department of Health & Human Services, an estimated 676,000 children were victims of child abuse or neglect nationally in 2016, a 3 percent increase over the previous four years.

“The estimate is that only about a third of cases get reported,” said Mann-Heintz.

In 2017, Child Protective Services received 80,683 reports in Oregon.

“So you multiply that number by three,” she said.

Typically each year, a little more than half of received reports are referred for investigation and a quarter of those are founded for abuse or neglect. Oregon totaled 7,063 cases and 11,077 victims in 2017.

Other reported cases were either dismissed or handled with alternative methods such as parental assistance.

Though definitions of abuse differ state by state, these numbers are reflective of nationwide trends and tend to stay relatively proportional as they scale more locally.

While the number of reports received across the nation scores in the millions, nearly half are screened out of the system, lending suspicion to a lack of understanding about when abuse is taking place. Indeed, public attention toward child abuse often skews in the direction of the more emotionally evocative forms of physical or sexual abuse.

“That’s actually much less the case,” said Mann-Heintz. “The most frequent form of abuse is neglect.”

The Oregon Department of Human Services (ODHS) reports neglect as accounting for about 47 percent of cases in Lane County and 46 percent statewide.

The high numbers of neglect reflect its broad criteria.

“Neglect includes things like malnutrition, sanitation and inadequate supervision,” Mann-Heintz explained.

Also on that list may be non-compliance with healthcare recommendations, being deprived of education and exposure to drugs or violence.

The prevalence of neglect points to parents’ and caregivers’ lack of education about child-rearing, though a general confusion as to what constitutes “abuse” could also play a role.

Precise definitions of child abuse can be elusive. The perimeters vary by family and culture worldwide, including what constitutes responsible parenting and acceptable disciplinary action.

Further muddying the waters is the pragmatic question of whom a definition aims to inform. A definition to raise public awareness, for instance, differs from definitions serving legal, service or research purposes.

Nonetheless, in an effort to reconcile the diversity of perceptions, the World Health Organization (WHO) Consultation on Child Abuse Prevention in 1999 drafted a broad and adaptable definition:

“Child abuse or maltreatment constitutes all forms of physical and/or emotional ill-treatment, sexual abuse, neglect or negligent treatment or commercial or other exploitation, resulting in actual or potential harm to the child’s health, survival, development or dignity in the context of a relationship of responsibility, trust or power.”

Although determining which cases meet the criteria may still be a source of disagreement, there is near consensus on classification.

Types of abuse typically fall under four categories: physical, sexual, psychological (or emotional) and neglect.

Like neglect, psychological abuse is fairly nebulous in its definition and characterizing it can pose a challenge. The psychological and emotional well-being of a child is complex in contrast to physical health and its effects are not always immediately obvious.

Indeed, the WHO has lamented in its World Report on Violence and Health that psychological abuse is given less attention worldwide than physical or sexual abuse.

Locally, the prevalence of the problem is unclear.

Though OHDS keeps a record of “mental injury,” Oregon holds a separate, broad category for “threat of harm,” which under national criteria may qualify as psychological, physical, sexual abuse or neglect. Endangering a child by leaving them in a life-threatening situation, for example, may be recorded under the same category as exposing them to domestic violence.

Representing 41.6 percent of incidents, this form of abuse is second only to neglect in Lane County.

Mann-Heintz points out that verbal abuse and threats of violence play no small part in this.

“I hear people say things to children that they would never say to another adult,” she said. “And yet they talk to their kids that way.”

Though the effects of psychological abuse are not always apparent, it is no less insidious. The consequences are wide-ranging and vary from person to person. Often, the victim’s interpersonal relationships suffer in a myriad of ways, and the victim may later turn to substance abuse or self-harm to dampen overwhelming emotions such as anxiety or depression.

Physical abuse, which accounts for only 6 percent of cases in Lane County, is not the most prominent of abuse types, yet remains a controversial issue due to disagreements about discipline.

Forms of corporal punishment which do not cause physical injury or “substantial pain” are legally accepted in Oregon. ODHS has stated, “Although not recommended, spanking is not abuse. However, a spanking that leaves marks or bruises on a child might be abuse. Spanking a baby is always a concern.”

Mann-Heintz comes down firmly on one side of the argument.

“I personally think that hitting children is never a good option,” she said. “It only maintains an abusive cycle.”

The United Nations Convention on the Rights of the Child requires states to protect children from “all forms of physical or mental violence” while under care. The United Nations Committee on the Rights of the Child has affirmed that corporal punishment is incompatible with this requirement.

Mann-Heintz stressed that parents should know their children well enough to choose corrective methods that are the most effective yet mild.

“Adults need to learn that discipline is a conscious act, not a reaction,” she said.

In the worst cases, physical health consequences of abuse on small children include brain damage, central nervous system injuries and bone fractures, all of which could lead to life-long disabilities.

Accounting for the fewest cases across data sets is sexual abuse. There were 61 incidents in Lane County for the 2017 fiscal year, making up just over 4 percent of the county’s total abuse and neglect cases.

Though relatively rare, sexual abuse is no less serious as it can cause reproductive health problems, sexually transmitted infections and unwanted pregnancies — all this before the potential psychological damage and resulting difficulties imposed upon the child’s life.          

Fatalities resulting from abuse or neglect are even rarer, but also cause for concern. There were 30 deaths attributed to abuse or neglect in Oregon during 2017, with 20 being determined as the result of neglect; more than half of all victims were under the age of five.

Numbers like these reflect a trend across data sets. Neglect is far more common than other forms of abuse and data suggest the risk of victimhood increases with youth — the younger the child, the higher the victim rate. Nationwide, children less than one year old constitute nearly 25 percent of cases.

Though that number is just 12.4 percent in Oregon, there is a marked drop in victimhood rates after a child reaches his or her first birthday, highlighting the vulnerability of this age group and the importance of parental education.

The issue of child abuse pervades nearly all cultures and communities worldwide. Its prevalence has deep-running implications for any social fabric. Abused children are more likely to grow up with heavier burdens in their lives and consequently project those burdens onto others and into their community in various ways.

Increased rates of child abuse have been linked to poorer health, both physically and psychologically. A 2012 systematic review found that emotionally abused subjects were three times more likely to develop a depressive disorder than non-abused individuals.

The same study concluded a strong causal relationship between non-sexual maltreatment and a range of mental disorders, risky sexual behavior and drug use.

Rising health concerns inevitably bring financial burden. Besides health costs, funding must also be diverted to such areas as child welfare services, foster care and the criminal justice system.

A 2011 study from the Centers for Disease Control and Prevention estimated that the financial costs associated with confirmed cases of child maltreatment amounted to $124 billion per year — more than annual federal spending on education.

Reducing these burdens means addressing cycles of abuse and identifying risk factors.

“The biggest issue is poverty,” said Mann-Heintz. “When adults are stressed, they don’t always use the best parenting practices.”

Poverty consistently shows up as a risk factor in child abuse studies as it’s a lightning rod for a host of other troubles including stress, substance abuse and chaotic housing situations.

Government systems exist to relieve some parental burdens and enforce corrective measures, but a great deal of reform efforts start with grassroots organizations and robust community support.

Moreover, studies suggest strong communities raise the tide for all. According to the WHO’s World Report on Violence and Health, strong social cohesion in a community overrides risk factors such as poverty, violence, substance abuse and parents who lack education.

“Societal support for parents is critical to making kids safe,” said Mann-Heintz.

Because child welfare services and other governmental entities’ methods can sometimes be punitive, they tend to be among the least trusted sources of aid. As a result, parents or guardians in need are more comfortable reaching out to their neighbors and friends.

On child abuse prevention, ODHS states, “All citizens have a responsibility to prevent child abuse and protect children. An individual can help children in a variety of ways, from simply being a friend to protecting them from abuse.”

 

In Part II of this series next week, Siuslaw News will explore the programs, options and efforts to reduce the risk factors of abuse and offer support for child abuse victims.

For more information about Child Abuse Prevention Month, visit getinvolvedlanecounty.org.

Note: This is part 1 of a 2 part series. Find additional installments in the Special Series Archive, located here.