Child Abuse And Neglect: An Ongoing Tragedy

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Dr. David J. Holcombe
Dr. David J. Holcombe

April is National Child Abuse Prevention Month.  Child “maltreatment”, as it is called, remains a serious problem in the United States and in Louisiana.  There were 3.4 million referrals to child protective services in the U.S. in 2012, of which over 700,000 (or 9.2/1,000) were confirmed cases of “maltreatment”.  Most of the victims (78%) were neglected, 9% sexually abused and 11% suffered other forms of maltreatment (i.e. emotional abuse, lack of supervision, parental substance abuse or other).

 

Reported cases dwarf unreported cases and child protective services estimates that 25% of all children are maltreated during their childhood.  This results in over 1,600 child deaths a year (in 2012), most of these cases being children under the age of 3 years old (27%).  More boys than girls die (2.5 vs. 1.9/100,000) and more African-American children than whites (4.7 vs. 1.6/100,000).  The economic cost is also staggering, with an estimated $124 billion dollar in the U.S. and over $2.7 million in Central Louisiana ($1.1 million in Rapides Parish alone).

 

Who are the perpetrators of these crimes?  Not surprisingly, 80% are parents, and around 6% are other relatives, with 4.2% being unmarried parents of the victim.  Most of the perpetrators are between 18 and 44 years of age (82%) and many are women (54%).

 

Risk factors vary for the perpetrators (mostly parents) and children.  Parental risk factors include depression, domestic violence or history of childhood victimization, substance abuse, separation or divorce, single parent households, social isolation, poverty, unemployment and high-risk neighborhoods. Child risk factors include prematurity (low birth weights), disability (physical or mental), young age and behavioral issues (sometimes a result of persistent neglect).

 

Sadly, only 25% of children report abuse or neglect when it occurs, and only another 25% will report it prior to their 18th birthday.  That means 50% will never disclose their victimization prior to adulthood, and among those non-reporters, some will continue the cycle of abuse with their own children.  Reporting cases by those in contact with victims becomes critical to stopping this destructive cycle.

 

There are a host of mandated reporters including:  health providers (including mental health), social workers, clergy, child care providers, teachers, law enforcement, mediators, CASA personnel, youth activity providers, film processors and all adults who have witnessed sexual abuse of a child.  Cases should be reported immediately, with the name, address, sex and race of the child and what you have witnessed.  Reporters are not investigators.  Reports should be made at (855) 4LA-KIDS, (855) 452-5437, 24 hours a day, 7 days a week, or by calling 911.

 

The assessment of the situation includes an evaluation of the extent of danger (present or impending), the extent of the maltreatment, circumstances, functional capacity of the child and caregiver, parental practices (including discipline).  The functional level of the care giver (intoxication, violence, hostility to intervention and level of control) and child (anxiety, independence, mental and physical state) should also be determined.

 

Failure to report cases of child sexual abuse by any mandated reporter can result in a $10,000 fine, 5 years in prison (possibly with hard labor) and felony charges.  Worse yet, there is a good chance that victimization will continue, with increasing physical and psychological consequences, possibly resulting in death.  Reporters, once they have filed a report, need not inform their supervisors, who cannot prevent reporting under any circumstances.  Your name, as a reporter, cannot be released.  Should another episode of abuse be witnessed, re-reporting is necessary.

 

Child maltreatment is pervasive and destructive.  Addressing social determinants (income, educational level and social status), as in most issues related to mental and physical health, plays a critical role in prevention and treatment.  The psychological scars of victimization last a lifetime and pre-dispose victims to a cycle of repeated abuse.  Let’s stop the harm now and make Louisiana a better and safer place for its most vulnerable citizens.

 

Report child maltreatment (abuse and neglect) to (855) 452-5437 or 911.  Make the call, it’s the law!