Know Risk Factors, Speak Up if You Suspect Abuse
April is child abuse prevention month. Child abuse is a difficult topic for me to talk about because the idea of it is just so despicable. I have to admit I feel physical symptoms of nausea when I see a report of another child or baby being abused or killed by a caretaker. However, if it is not discussed, people may not be aware of just how serious a problem it is. I am afraid we have become numbed by the news reports because they are so frequent. Since most of the time children cannot speak for themselves, it takes adults to recognize and report concerns.
I look at child abuse as falling into three categories. There are people who are just plain evil and knowingly abuse children by locking them in cages, physically abusing them for what they interpret as discipline, depriving them of an education, sexually abusing them or starving them. Then there are the people who are not committed to the responsibility of raising a child and for selfish reasons put their own desires ahead of the needs of their children. The children end up harmed by lack of care and supervision. The third category is the caretaker who does not have the knowledge, skills and maturity to be able to deal with the demands of caring for a baby or young child and is prone to lose control and physically harm an innocent child.
Statistics on child abuse are likely inaccurate since child abuse tends to be under reported. However, the statistics show more than four children die of child abuse every day in the U.S. There are about 700,000 child abuse cases reported yearly. Child Protective Services (CPS) has more than 3 million cases with over 7 million children being enrolled in their services. The types of abuse reported with the most common to the least are: neglect, physical abuse, sexual abuse and psychological abuse.
Most of the deaths are infants younger than 1-year-old. These are the most vulnerable and the least able to report a problem. Babies cry and are demanding. They are totally dependent on their caregiver. Babies cry to communicate that they are hungry or uncomfortable. Sadly, persons responsible for recent infant deaths in our area reported they did it because they could not get the baby to stop crying.
Risk factors can identify circumstances where abuse is more likely to occur. These factors do not mean a child will be abused, it means there is a higher likelihood. Some factors are related to the child. These include children who have special needs, younger age and children with emotional or health problems. Other factors are dependent on the caregiver. These include parents who are young, have low education levels, low socioeconomic status, single, caregivers who are not biologically related to the child in the home, drug or alcohol abuse, mental health issues, history of abuse as a child and basic lack of knowledge of the needs, normal behaviors, and demands of caring for a child.
Family members, healthcare workers, friends, neighbors or teachers may be able to recognize the signs of abuse and report their concerns to authorities. An abused child needs someone to speak up for them. Sometimes the parent or parents themselves may be able to recognize they need help. I pray that the parents of babies in high-risk situations who are not able to care for a child would choose to give the child up for adoption. Adoption could fulfill the dream of adoptive parents, give the child a safe place to live and relieve the burdens faced by a stressed out biological parent.
Child abuse accounts for preventable death and suffering for the most vulnerable in our society. Awareness of child abuse is the first step in helping prevent it. Consider helping raise awareness and money for child abuse prevention while being physically active by participating in the 5K run/walk sponsored by the Berlin Boys and Girls Club on April 7. Stay healthy my friends.
Michael Shattuck, MD, is an emergency department physician at ThedaCare Medical Center-Berlin.
