“Don’t call me stupid”: how to avoid hurting your kids with words

When parents label their children fat, lazy, dumb, or ugly, they may need to come to grips with their own lack of self-esteem.

by Jean Guarino

When children are young, parents protect their physical health by teaching them to stop and think before they cross a busy street or do anything that might cause bodily harm. Yet in moments of stress, how often do parents fail to stop and think to themselves before saying hurtful things to their children–things that can have a devastating impact on their emotional health?

According to Stephanie Ferrara, a Chicago psychotherapist specializing in family therapy, “Many parents put their mouths on automatic and just say the first thing that pops into their heads without thinking of the terrible effect their words have on their children. Adults who are more resilient and can shrug off the put-downs of their bosses and co-workers think their young children should be able to do the same. They are larger than life figures to their children, who accept as fact everything their parents tell them. If their parents say they are dumb, no good, and a failure, then it must be true.”

How often do parents make these or similar comments to their children: You’re more trouble than you’re worth! You’re pathetic! You can’t do anything right! Get out of here! I’m sick of looking at your face! I wish you were never born! You disgust me! Just shut up! You’re a failure just like your father!

And although most parents regret these remarks later when they’ve had a chance to cool down, by then the damage has been done. Like a virulent weed growing in a beautiful garden, this verbal abuse can only be uprooted by the determined effort of the person responsible for planting it.

For instance, Jennifer is a pretty 12-year old who cheats, lies, steals, and avoids schoolwork. She doesn’t believe she can do the work, so she copies the work of others. She gives money or things she has stolen to other kids hoping it will make them like her. This is due to the fact that Jennifer doesn’t believe she is worth anything to anyone. Since she was a little girl, her parents have told her: “You can’t do anything right. You’re stupid. I’ll do it myself; you’ll ruin it.” Her brothers and sisters also pick on her the same way.

Jennifer is a victim of emotional child abuse. Her bruises, invisible to her teachers and other authorities, will remain undetected and untreated. Yet eventually these unseen wounds will leave scars far more damaging than the welts and cuts on a child who has been physically abused.

Judy Keith-Oaks, director of the Center for Personal Recovery in Jonesboro, Tennessee asserts, “While emotional abuse cannot directly kill, its effects are insidious. Instead of murdering the child, the result is a destruction of the spirit, a loss of the sense of self, a reflection on the ability to succeed, and a barrier to healthy interaction with people.”

This sense of self, or lack thereof, reveals itself in the story of John. John’s dad has very clear ideas about how to run things in his house–John, 7, should be kept on his toes. His dad joshes John a lot in front of family and friends; and to keep John jumping, he plays games with him. If John wins a game, his dad makes fun of him for being an egghead; if he loses, he makes fun of him for being a dummy. Unfortunately it’s the same with affection. John’s dad will call him over for a hug; and when John responds, his dad pushes him away telling him he’s getting to be a sissy. John literally cannot win.

I want to be somebody
Everyone yearns to be loved, accepted, and heard. And people desire worth, esteem, and praise. Everyone wishes to be a somebody. The roots of a person’s “somebodiness” lies in his or her childhood. Parents, siblings, grandparents, aunts and uncles, teachers, coaches, friends, and neighbors all feed into people’s beliefs about their basic sense of worth.

Ron is the fifth of seven children, and with both parents working to keep afloat and no other relatives, there is not much attention to go around. In addition, Ron’s parents don’t believe in talking about feelings or saying things such as ‘I love you’ to their children. Ron fights at school, has no friends, and has been caught more than once torturing animals. At age 10 he has nothing to say about what he feels.

“Children like Ron,” says Ferrara, “are especially vulnerable because with no relatives to fall back on for nurturing, he feels isolated and cut off from society. It takes more than parents to raise a child. It takes grandparents, aunts, uncles, and cousins. The extended family is the best support system ever invented. If Ron’s dad can’t spend much time with him, a grandfather or uncle could do a lot in taking his place.”

According to Jim Egan, a Washington, D.C. clinical psychiatrist, “In too many homes today the lights are on but no one is home. People are there, but not there. Inattentive parents are producing children who seem normal but are not what they should be, not what they could have been.”

Nathaniel Branden, author of How to Raise Your Self-Esteem, says that a healthy self-esteem–the value we place on the self–leads to a childhood and adulthood of happiness, success, wise decisions, good friendships, confidence, hope, outreach to others, and a close relationship with God. Lack of self-esteem, on the other hand, brings irresponsibility, internal conflicts, rocky relationships, poor choices, confusion, loneliness, spiritual bankruptcy, and a tendency to perpetuate a pattern of emotional abuse on one’s own children–which is the most damaging effect.

The sins of the father
“What I remember most about my childhood is my father calling me stupid,” says Janice, 24. “He’d ask me to read for him; and if I stumbled or missed a word, he’d say, ‘You’re so damn stupid!’ I remember crying about that. His words hurt a lot.” But in high school Janice learned that her father was illiterate. Therefore, when he called her stupid, he was projecting his negative feelings about himself onto her. When parents label their children fat, lazy, dumb, or ugly, they may need to come to grips with their own lack of self-esteem.

Janice admits that she picked up her father’s hurtful habits and began verbally abusing her own son. “I started calling my son stupid, bad, and lazy when he was around 3 years old. Finally when he was 5, he said to me, ‘Don’t call me stupid. I don’t like it.’ When he said that, I flashed back to my own childhood and started crying. I resolved to change the way I was dealing with my son.”

How do parents prevent the words that hurt? How do they stop the patterns of behavior that lead to emotional maltreatment?

Bob Noone, director of Family Services in Wilmette, Illinois says, “The first step a parent must take to begin to heal the damage that has been done to the child is to assume some responsibility for the conflict.

“Next they have to resolve to change whatever it is in their lives that is poisoning their relationship with their son or daughter. Whatever the stresses are that cause them to lash out at the child must be changed. It isn’t easy, and it requires a high level of determination. But nothing will change unless the parent consciously wants it to change,” says Noone.

Ideally this should be a joint effort. But what can one parent do if his or her spouse denies that there is a problem and refuses to make any effort to change? “The motivated spouse certainly shouldn’t force a confrontation,” according to Noone. “It would be viewed as a criticism by his or her partner and make them even more defensive.”

In these cases, Noone suggests that the motivated parent should continue to make a determined effort to directly improve his or her rapport with the child while, at the same time, indirectly trying to do the same with the spouse. For example, if a husband tries to improve his relationship with his wife, he will help diminish the stress and anxiety level that has existed in the home and triggered his wife’s abusive behavior toward their child.

But how can parents gauge their chances of success once they attempt to reverse their behavior?

“The best prognosis is for those parents who express love for their children but are inconsistent and fluctuate between moods of affection and abusive behavior,” says James Garabarino, president of the Erickson Institute for Advanced Study in Child Development. “These parents have something to work with because they are aware of the damage they are doing.”

However, Garabarino adds, “The prognosis is not as good for those families in which the relationship between parent and child is weak or absent and where there is rejection and neglect. Here the task is literally to construct a relationship.”

But even when parents love their children and want to do well by them, families can become caught in a vicious cycle of harsh words that poison a family’s time together. It’s frightening for both parents and children to think that they are locked into a system of anger and fear that seems to have a life of its own and is out of control.

Help is only as far as the phone for parents under pressure who have slipped over the edge and chronically vent their anger on those around them least able to defend themselves–their children. They can call other parents who have learned to control their own abusive behavior.

Learn to back off
However, in many cases, it is not necessary to use the services of either a hotline or professional counselor. There are many common-sense things people can do to help defuse the tensions in their homes without seeking outside help.

The first and most obvious step is for people to re-evaluate their priorities. Stress is necessary to keep people energized and motivated. But if they find themselves subject to massive amounts of stress and feel burned-out, it’s time to eliminate some of the pressures that cause them to blow a fuse.

What situations cause people the most stress? Can they free themselves from some situations that are not really important to them?

“I never learned to say ‘no’,” says a harried mother who works full-time, serves on the school board, is a den mother, and then committed herself to directing the parish variety show. “The pressure made me a crazy woman,” she admits. “I was yelling at the kids every time they opened their mouths. Finally my husband just said, ‘Enough!’

“I’m honoring my commitment to direct the show,” she says, “but that will be over in another month. But I resigned from the school board, which was very time-consuming. Now I enjoy being a den mother, and I can finally talk to my kids without snapping their heads off.”

Parents must learn to listen to their children. And they must give their children positive attention. If all they’ve done in the past is react to negative behavior, they should try complimenting their children when they do something well. Parents should tell their children they are smart, pretty, handsome, clever, resourceful, fun, a good sport, and kind.

“When my son was little, I never told him I loved him or that he was smart,” says Janice. “I do it now, and he responds to me better. He gets higher grades and is more cooperative.”

When things happen that can set off an explosion, parents need to take time out. They shouldn’t let the explosion happen. Parents must wait. And then wait some more. When people hold their tongues until the heat of the moment has passed, it’s a lot easier to respond with love and guidance rather than with anger and harsh words.

And parents need to be people that their children know they can count on. This doesn’t mean that they never get angry. But it does mean that a child needs to know that his or her parents love him or her even when one or both of those parents are angry. Parents need to be flexible and willing to stop and peek in on their child’s world. The child will feel more valuable because of it.

“Joe had a real talent for demanding my attention at the wrong time,” says one mother who runs a secretarial service from her home. “He used to come home from school and get really obnoxious if I couldn’t stop and talk the minute he’d walk in the door. So naturally I’d blow up and say all sorts of terrible things.
“But finally we struck a deal. Joe has learned I just can’t drop everything the minute he wants to talk. But I do make an effort to wind up whatever I’m working on and take a break when he gets home. We have a snack together and talk about our day. It’s important that he knows I really want to talk.”

Watch what you say
A parent must guard his or her vocabulary. There are some words that people should never say to each other in a family. Words such as stupid, dummy, idiot, worthless, freak, dope, and jerk have no place in the interactions of parents and their children.

As parents, people should avoid absolute statements, such as “You never. . .” or “You always . . .” They should have a sense of good manners with their families. However, this doesn’t mean that parents must avoid all conflict or can’t set limits.

Signs of unconditional approval by a parent should be evident to a child. Unconditional love doesn’t mean parents always approve of a child’s behavior, but it does mean they care no matter what. One way of showing acceptance is through undivided attention in such a way that the child feels truly loved.

One mother of four says, “Every month we give each of our boys a chance to do something alone with us. It’s his special time when he knows he can spout off about things he might not want to talk about in front of his brothers, and he knows we’ll listen.”

These special times don’t have to be elaborate or expensive. They can involve such simple activities as riding bikes, stopping for a snack, seeing a movie, going to a ball game, or working on a scout project. The important thing is that children feel cherished during their special times.

And parents need to let their children hear them acknowledge their own mistakes. They need to become humble. Parents should say “I’m sorry” to their children whenever appropriate. Apologizing reveals that the truth is larger than their egos and feelings are more important than their pride.

Children need to witness their parents confronting their shortcomings and strengths. It’s all right for parents to lose their cool and yell at their kids with little provocation. But the important thing is to apologize once they’ve calmed down. If parents do, they will have taught their children an important lesson.

Finally parents must help their children see God within themselves. They should inspire their children to be forever God-centered, putting God first in all things. They need to coach by their examples. They should talk about God to their children. And they must put their beliefs into words and actions. Attending Mass regularly and receiving the sacraments are ways of expressing their beliefs.

As children grow in their understanding of God and realization of God’s love for them, their own self-regard can’t help but grow. And so will their respect for others.

The bad news is that the potential for the most destructive action is present in each of us. Paul tells us that no one is immune to destructive behavior: “Let anyone who thinks he stands take heed lest he fall” (1 Cor. 10:12).

But the good news also comes to us through Paul: “God is faithful and will let you be tempted beyond your strength; but with the temptation he will also provide the way of escape that you may be able to endure it” (1 Cor. 10:13).

We can escape the temptation to abuse simply by walking into another room or getting a baby-sitter and going out. Escape can come through parenting classes, activities with friends, conversations on a hotline with other parents, or professional counseling.

But most of all, escape will come through prayer and an absolute faith that God has not abandoned us. Isaiah comforts us with these words: “If you do away with the yoke, the clenched fist, the wicked word . . . Yahweh will give strength to your bones and you shall be like a spring of water whose waters will never run dry” (Isa. 58:9-11).

Reprinted with permission
Copyright 1992 U.S. Catholic Magazine.

Six Things Parents Should Never Say To Their Children

In the past 20 years, the problem of child abuse has received extensive attention. But for the most part, that attention has focused on physical abuse. Recently, however, the impact of verbal abuse has gotten increased attention, and it is thought that in some children could be even deeper.

“Sometimes what a parent says can cut deeper,” said Dr. Frederick Green, president of the board of directors for the National Committee for Prevention of Child Abuse. “A child is literally defenseless against the parent,” said Dr. Green, a New York psychologist. “There is serious impact from things said to children by the parent because of authority and kinship.” Dr. Green’s organization is sponsoring a series of television and print ads and even a comic book featuring Spiderman to call further attention to the problem.

One of the ads features six statements made by parents that are especially damaging to children: 1) “You disgust me!” 2) “You’re pathetic. You can’t do anything right!” 3) “You can’t be my kid” 4) “Hey stupid! Don’t you know how to listen” 5)“I’m sick of looking at your face!” and 6) “I wish you were never born!”
The last statement, according to Dr. Green, is the worst.

“That is the ultimate rejection,” he said. “You are born with two basic fears, the fear of falling, and the fear of abandonment. To hear your parent say something like that is tantamount to saying ‘I wish you never existed,’” he said. “It really is bad if it is not only said once, but is repeated, because then it is reinforced in the young mind. If you keep saying it, the kid’s going to believe it.

“Something like that should never be said, even in jest,” continued Dr. Green. “But if it is said in jest, the parent should at least give the child a hug to let them know they didn’t mean it.”

Dr. Green said that when a parent tells a child that he is “sick of looking at your face,” it really tells the child that the parent doesn’t want see them, period. “That’s really heavy,” he said, though he noted, “all of these things have negative consequences.

“When a parent tells a child that he can’t do anything right, it really has a negative impact on their self-esteem. And if the teacher also says that–which is not unusual–if the kid gets it from home and at school, is it any surprise that the kid doesn’t do anything right?” said Dr. Green.

Dr. Green said that recent studies have shown that there has been an increase in the instance of child abuse among younger parents.

“Surprisingly, it is usually the two-parent younger families,” he said noting that those young parents also have the stress of their own relationships. “Those stresses pile up, and sometimes, they explode,” he said. “We all live with a certain degree of stress, but everybody has a breaking point.”

Ironically, Dr. Green said that Black children have traditionally been spared from the devastating impact of emotional and verbal abuse.
“It’s not that those things were not said,” he said, “but because we always had those extended families, those ‘aunts’ who were really only good friends of the family, or grandmothers and grandfathers. There was always some other parent-figure to comfort the child.”

Dr. Green said that is changing, with families moving away from home and the rise in single-parent households. “If a single parent tells the child one of these six things, there is no one around to offer a different opinion. That feeling can be reinforced, Dr. Green observed.
According to the National Committee for Prevention of Child Abuse, there are some alternatives to lashing out at your kids. They are:

First appeared in Children Today. Reprinted with permission.

Crossing the ‘borderline’ of child abuse

by B. Bower

Boston researchers report that child abuse often lurks in the background of adults with borderline personality disorder, a controversial diagnosis applied to about 20 percent of hospitalized psychiatric patients and people seeking psychotherapy.

Child abuse alone does not cause borderline personality disorder, say psychiatrist Judith L. Herman and her colleagues at Harvard Medical School, but it appears to play an influential role in many cases.

“Borderlines” are characterized by intense and unstable relationships, self-destructive and impulsive behavior (such as drug abuse), fears of abandonment, suicide attempts aimed at manipulating others, feelings of emptiness, and rage alternating with a childish dependency on others. Many borderlines slip into a temporary psychosis under stress or the influence of drugs.

Herman and her co-workers conducted intensive interviews with 21 individuals meeting diagnostic criteria for borderline personality disorder, 11 falling short of the diagnosis but possessing several “borderline traits” and 23 with related diagnoses such as antisocial personality disorder (persistent violence and lawbreaking).

The great majority of the borderlines–17 of 21–reported a history of trauma before age 18, including physical abuse, sexual abuse and witnessing serious domestic violence. Childhood trauma was reported by 8 of 11 individuals with borderline traits and 12 of 13 subjects with related disorders, the researchers note, but their abusive experiences were less frequent and less severe than those of the borderlines.

Multiple episodes of abuse before age 6 were almost exclusively reported by subjects with borderline personality disorder, the scientists say.

The psychological vulnerability imposed by child abuse may help explain why women borderlines outnumber men 2.5 to 1, they maintain. Girls are at far greater risk for sexual abuse than boys, and their sexual abuse apparently is more common and longer in duration than the physical abuse boys are more likely to experience.

The findings have significant treatment implications, the researchers conclude in the April American Journal of Psychiatry. Many borderline patients may need to confront traumatic memories and explore the intense emotions surrounding childhood abuse before they can develop rewarding relations with others.

First appeared in Children Today. Reprinted with permission.

The Face of Abuse

by Ruth J. Moss

Abusive parents may misread signs of pain, hunger and distress in their children. This lack of empathy, recent research suggests, can heighten the frustration these parents feel, and contribute to their abusive behavior.

Family therapist Joseph P. Kropp and graduate student O. Maurice Haynes showed 14 slides of baby faces to abusive and nonabusive mothers. The slides depicted positive emotions including surprise, joy and interest, and negative ones, such as sadness, fear and anger. The researchers flashed two slides of each emotion in random order and asked, “How would you respond to this baby?” and “What is this baby feeling?”

Kropp and Haynes found that abusive mothers were less likely to identify the babies’ emotions correctly. In fact, they were more likely to see negative emotions as positive ones.

Previous research has identified a lack of empathy on the part of abusive parents, implying that such parents recognize their children’s emotional signals, but fail to respond to them. Kropp and Haynes say their findings suggest that abusive parents do not ignore their children’s emotional displays, but instead misinterpret their meaning, leading them to respond inappropriately. A parent, for example, may try to feed a child who is actually crying in pain.

This adds fuel to the fire, Kropp explains. “It’s frustrating for the mother if she’s trying to help her baby but is missing the boat–not catching on to emotional signals,” he says. “And, as frustration builds, so do the chances of child abuse.”


Joseph P. Kropp, Ph.D., is at the Kirksville College of Osteopathic Medicine in Missouri. O. Maurice Haynes is at the University of Delaware. Their study appeared in Child Development (Vol. 58, pp. 187-190).

Does abuse beget abuse?

by Anne H. Rosenfeld

“Adults who were maltreated [as children] have been told so many times that they will abuse their children that for some it has become a self-fulfilling prophecy,“ say graduate student Joan Kaufman and psychologist Edward Zigler. Even when some people manage to break the cycle, the researchers say, they “are left feeling like walking time bombs.”

Many people believe that child abuse inexorably repeats itself in successive generations, and a large body of research appears to support their belief. However, after a close look at the evidence, Kaufman and Zigler conclude that for a variety of methodological reasons, many of these studies severely overestimate the risks of repeated abuse.

Kaufman and Zigler’s analysis of the child-abuse literature suggests that while the vicious cycle certainly occurs, and is cause for concern, it’s the exception, not the rule; only about 30 percent of people who are abused as children complete the cycle with their own offspring. The researchers note, however, that this rate is six times higher than the rate of child abuse in the general population.

Kaufman and Zigler stress that it’s time researchers stop asking, “Do abused children become abusive parents?” and start asking, “Under what conditions is the transmission of abuse most likely to occur?” Two of the studies they reviewed provide clues to the answers. They show that the cycle is is likely to repeat in people who, as children, had the loving support of a parent or foster parent, and in those who, as adults, have a loving, supportive relationship with a spouse or lover and have relatively few stressful events in their lives. An additional brake on the cycle includes being aware of having a history of abuse and consciously resolving not to repeat it.

“Being maltreated as a child puts one at risk for becoming abusive,” Kaufman and Zigler conclude, “but the path between these two points is far from direct or inevitable.”

Joan Kaufman and Edward Zigler, Ph.D., are at Yale University. Their report appeared in American Journal of Orthopsychiatry (Vol. 57, pp 186-192).

Charting the Aftermath of Child Abuse

Children experiencing physical abuse at home show an excess of aggressive and violent behavior by the time they enter Kindergarten, regardless of whether they come from well-off or poor families, live in two- or one-parent homes, or regularly observe cooperative or physically violent behavior among adults, according to a report in the Dec. 21 Science.

Many abused children display remarkable emotional resilience, says psychologist Kenneth A. Dodge of Vanderbilt University in Nashville, who conducted the study with John E. Bates of Indiana University in Bloomington and Gregory S. Pettit of Auburn (Ala.) University. But at school, about one-third of these kids continually express anger and provoke conflict. Abused children often misinterpret frustrating social encounters, unfailingly attribute hostile intentions to others, and view aggression as the only solution to problems with teachers or classmates, Dodge says.

The researchers studied 309 kindergarteners, all 4 years old when the study began. Physical examinations and interviews with mothers identified 46 children subjected to consistent physical abuse at home. A nearly equal number of boys and girls fell into the abused category, Dodge notes.

Aggressive behavior was calculated through teacher and classmate ratings, as well as experimenter observations. Children also viewed videotape depictions of negative events, such as having one’s building blocks knocked over by a peer, and described how they would handle the situation.

More than one in three abused children displayed unusually high levels of aggression and deficient social skills, compared with about one in eight of the other youngsters. The findings strongly support the notion that physical abuse leads to a cycle of violence, particularly among boys, Dodge contends.

Abused children also showed more signs of emotional withdrawal and social isolation than their peers, he says.

The researchers hope to follow the entire sample into adolescence to see if the abused children develop high rates of delinquency, drug abuse, depression and anxiety.

In a separate, multi-university study, Dodge and others will chart the effectiveness of social-skills training for highly aggressive (but not necessarily abused) first graders, combined with behavior-management training for their parents.

Reprinted with permission
Copyright 1991, Children Today.

Why Leave Children With Bad Parents?

Family: Last year, 1,300 abused kids died–though authorities knew that almost half were in danger. Is it time to stop patching up dead-end families?

The report of drug peddling was already stale, but the four Chicago police officers decided to follow up anyway. As they knocked on the door at 219 North Keystone Avenue near midnight on Feb. 1, it was snowing, and they held out little hope of finding the pusher they were after. They didn’t. What they discovered, instead, were 19 children living in horrifying squalor. Overnight, the Dickensian images of life inside the apartment filled front pages and clogged network airwaves.

For the cops that night, it seemed like a scavenger hunt gone mad, each discovery yielding a new, more stunning, find. In the dining room, police said, a half-dozen children lay asleep on a bed, their tiny bodies intertwined like kittens. On the floor beside them, two toddlers tussled with a mutt over a bone they had grabbed from the dog’s dish. In the living room, four others huddled on a hardwood floor, crowded beneath a single blanket. “We’ve got eight or nine kids here,” Officer John Labiak announced. Officer Patricia Warner corrected him: “I count 12.” The cops found the last of 19 asleep under a mound of dirty clothes: one 4-year-old, gnarled by cerebral palsy, bore welts and bruises.

As the police awaited reinforcements, they could take full measure of the filth that engulfed this brigade of 1- to 14-year-olds. Above, ceiling plaster crumbled. Beneath their feet, roaches scurried around clumps of rat droppings. But nothing was more emblematic than the kitchen. The stove was inoperable, its oven door yawning wide. The sink held fetid dishes that one cop said “were not from that day, not from that week, maybe not from this year.” And though the six mothers living there collected a total of $4,500 a month in welfare and food stamps, there was barely any food in the house. Twice last year, a caseworker from the Illinois Department of Children and Family Services (DCFS) had come to the apartment to follow up reports of serious child neglect, but when no one would let her in, the worker left. Now, it took hours to sort through the mess. Finally, the police scooped up the children and set out for a state-run shelter. As they left, one little girl looked up at Warner and pleaded, “Will you be my mommy?”

Don’t bet on it. Next month the children’s mothers–Diane Melton, 31; Maxine Melton, 27; May Fay Melton, 25; Denise Melton, 24; Casandra Melton, 21, and Denise Turner, 20– will appear in Cook County juvenile court for a hearing to determine if temporary custody of the children should remain with the state or be returned to the parents. Yet, for all the public furor, confidential files show that the DCFS is privately viewing the 19 children in the same way it does most others–“Goal: Return Home.”

Why won’t we take kids from bad parents? For more than a decade, the idea that parents should lose neglected or abused kids has been blindsided by a national policy to keep families together at almost any cost. As a result, even in the worst cases, states regularly opt for reunification. Even in last year’s budget-cutting frenzy, Congress earmarked nearly $1 billion for family-preservation programs over the next five years. Yet there is mounting evidence that such efforts make little difference–and may make things worse. “We’ve oversold the fact that all families can be saved,” says Marcia Robinson Lowry, head of the Children’s Rights Project of the American Civil Liberties Union. “All families can’t be saved.”

Last year there were 1 million confirmed cases of abuse and neglect. And, according to the American Public Welfare Association, an estimated 462,000 children were in substitute care, nearly twice as many as a decade ago. The majority of families can be repaired if parents clean up their acts, but experts are troubled by what happens when they don’t : 42 percent of the 1,300 kids who died as a result of abuse last year had previously been reported to child-protection agencies. “The child-welfare system stands over the bodies, shows you pictures of the caskets and still does things to keep kids at risk,” says Richard Gelles, director of the University of Rhode Island’s Family Violence Research Program.

Nowhere has the debate over when to break up families been more sharply focused than in Illinois, which, in the last two years, has had some of the most horrific cases in the nation. Of course, it’s not alone. But unlike many states, Illinois hasn’t been able to hide its failures behind the cloak of confidentiality laws, largely because of Patrick Murphy, Cook County’s outspoken public guardian, who regularly butts heads with the state over its aggressive reunification plans. The cases have turned Illinois in to a sounding board for what to do about troubled families.

The Chicago 19 lived in what most people would consider a troubled home. But to veterans of the city’s juvenile courts, it’s just another “dirty house” case. In fact, Martin Shapiro, the court-appointed attorney for Diane Melton, plans to say that conditions could have been worse. He can argue that Melton’s children weren’t malnourished, weren’t physically or sexually abused and weren’t left without adult supervision. He’s blunt, “Returning children to a parent who used cocaine–as horrific as that might seem–isn’t all that unusual in this building.” If only all the cases were so benign.

What Went Wrong?
On the last night of Joseph Wallace’s life, no one could calm his mother’s demons. Police say that Amanda Wallace was visiting relatives on April 18, 1993, with 3-year-old Joseph and his 1-year-old brother, Joshua, when she began raving that Joseph was nothing but trouble. “I’m gonna kill this bitch with a knife tonight,” Bonnie Wallace later told police her daughter threatened. Bonnie offered to keep the boy overnight, but Amanda refused, so Bonnie drove them to their apartment of Chicago’s impoverished West Side. It’s unclear what forced Amanda’s hand, but authorities tell a harrowing tale: at about 1:30 a.m., she stuffed a sock into Joseph’s mouth and secured it with medical tape. Then she went to the kitchen, retrieved a brown extension cord and wrapped it around Joseph’s neck several times. She carried her son to the living room, stood him on a chair, then looped the cord around the metal crank arm over the door. In the last act of his life, Joseph waved goodbye.

Amanda Wallace, 28, has pleaded not guilty to charges of first-degree murder. No one ever doubted that Amanda was deeply troubled. When Joseph was born, she was a resident at the Elgin Mental Health Center in suburban Chicago, and a psychiatrist there warned that Amanda “should never have custody of this or any other baby.” Three times, the DCFS removed Joseph from his mother. Yet three times, judges returned him to Amanda’s dark world. Six months after the murder–which led to the firing of three DCFS employees– a blue-ribbon report blasted the Illinois child-welfare system, concluding that it had “surely consigned Joseph to his death.”

Even in the most egregious instances of abuse, children go back to their parents time and again. In Cook County, the public guardian now represents 31,000 children. Only 963 kids were freed for adoption last year. But William Maddux, the new supervising judge of the county’s abuse and neglect section believes the number should have been as high as 6,000. Nationwide, experts say perhaps a quarter of the children in substitute care should be taken permanently from their parents.

But it’s not simply social custom that keeps families together, it’s the law. The Adoption Assistance and Child Welfare Act of 1980 is a federal law with a simple goal– to keep families intact. The leverage: parents who don’t make a “reasonable effort,” to get their lives on track within 18 months risk losing their kids forever. The law itself was a reaction to the excesses of the ’60s and’70s, when children were often taken away simply because their parents were poor or black. But the act was also one of those rare measure that conservatives and liberals embraced with equal passion–conservatives because it was cheap, liberals because it took blame away from the poor.

By the mid-’80s, though, the system began to collapse. A system built for a simpler time couldn’t handle an exploding underclass populated by crack addicts, the homeless and the chronically unemployed. At the same time, orphanages began shutting their doors and foster families began quitting in droves. The system begged to know where to put so many kids. It opted for what was then a radical solution: keeping them in their own homes while offering their parents intensive, short-term support–child rearing, housekeeping and budgeting. But as family-preservation programs took off the threat of severing the rights of abusive parents all but disappeared. What emerged, Gelles argues, was the naive philosophy that a mother who’d hurt her child is not much different from one who can’t keep house–and that with enough supervision, both can be turned into good parents.

In hindsight, everyone in Chicago agrees that Joseph Wallace’s death was preventable, that he died because the system placed a parent’s rights above a child’s. Amanda could never have been a “normal” parent. She had been a ward of the state since the age of 8, the victim of physical and sexual abuse. Between 1976 and Joseph’s birth in 1989, her psychiatrist told the DCFS, she swallowed broken glass and batteries: she disemboweled herself, and when she was pregnant with Joseph, she repeatedly stuck soda bottles into her vagina, denying the baby was hers: Yet 11 months after Joseph was born, a DCFS caseworker and an assistant public defender persuaded a Cook County juvenile-court judge to give him back to Amanda, returning him from the one of the six foster homes he would live in. The judge dispatched Amanda with a blessing: “Good luck to you, Mother.”

Over the next two years, caseworkers twice removed Joseph after Amanda attempted suicide. But a DCFS report, dated Oct. 31, 1992, said she had gotten an apartment in Chicago, entered counseling and worked as a volunteer for a community organization. And though the report noted her turbulent history, it recommended she and Joseph be reunited. Joseph Wallace was sent home for the last time 62 days before his death, by a judge who had no measure of Amanda’s past. “Would somebody simply summarize what this case is about for me and give me an idea why you’re all agreeing?”, the judge asked. Amanda’s lawyer sidestepped her mental history. Nevertheless, the DCFS and the public guardian’s office signed on. When Amanda thanked the judge, he said, “It sounds like you’re doing OK. Good luck.”

Murphy says that deciding when to sever parents’ rights should be obvious: “You remove kids if they’re in a dangerous situation. No one should be taken from a cold house. But it’s another thing when there are drugs to the ceiling and someone’s screwing the kids.” Ambiguous cases? “There haven’t been gray cases in years.”

No one knows that better than Faye and Michael Callahan, one of the foster families who cared for Joseph. When Joseph first came to them he was a happy, husky baby. When he returned after his first stretch with Amanda, “he had bald spots because he was pulling his hair out,” Faye says. By the third time, she says, Joseph was “a zombie. He rocked for hours, groaning, ‘Uh, uh, uh, uh,’.” The fact that he was repeatedly sent home still infuriates them. Says Michael: “I’d scream at those caseworkers, ‘You’re making a martyr of this little boy!’”

See No Evil, Hear No Evil
Early last thanksgiving, Aretha McKinney brought her young son to the emergency room. Clifford Triplett was semiconscious, and his body was pocked with burns, bruises and other signs of abuse, police say. The severely malnourished boy weighed 17 pounds–15 percent less than the average 1-year-old. Except Clifford was 5.

This wasn’t a secret. In a confidential DCFS file obtained by Newsweek, a state caseworker who visited the family last June gave a graphic account of Clifford’s life: “Child’s room (porch) clothing piled in corner, slanted floor. Child appears isolated from family–every one else has a well furnished room. Child very small for age appears to be 2 years old. Many old scars on back and buttocks have many recent scratches.” In April, another caseworker had confronted McKinney’s live-in boyfriend, Eddie Robinson, Sr., who claimed that Cliff was a “dwarf” and was suicidal–neither of which doctors later found to be true. Robinson added that Cliff got “whipped” because he got into mischief. “I told him that he shouldn’t be beat on his back,” the caseworker wrote. “Robinson promised to go easy on the discipline.”

It’s one thing to blame an anonymous “system” for ignoring abuse and neglect. But the real question is a human one: how can caseworkers walk into homes like Clifford’s, document physical injury or psychological harm and still walk away? A Cook County juvenile-court judge ruled last month that both McKinney and Robinson had tortured Clifford (all but erasing the possibility that he’ll ever be returned to his mother). But caseworkers are rarely so bold.

SOURCE:  American Public Welfare Association

In Clifford’s case, the April worker concluded that abuse apparently had occurred, but nine days later another found the home “satisfactory.” Says Gelles: “Caseworkers are programmed by everything around them to be deaf, dumb and blind because the system tells them, ‘Your job is to work to reunification’.”

Murphy charges that for the past two years, Illinois has made it policy to keep new kids out of an already-clogged system. “The message went out that you don’t aggressively investigate,” he says. “Nobody said, ‘Keep the f–ing cases out of the system’.” But that, he says, is the net effect. “That’s just not true,” says Sterling MacRyder, who took over the DCFS late in 1992. But he doesn’t dispute that the state and its caseworkers may have put too much emphasis on reunification–in part because of strong messages from Washington.

The problems may be even more basic. By all accounts, caseworkers and supervisors are less prepared today than they were 20 years ago, and only a fraction are actually social workers. Few on the front lines are willing, or able, to make tough calls or buck the party line. In the end, says Deborah Daro, research director of the National Committee to Prevent Child Abuse, “the worker may say, ‘Yeah, it’s bad, but what’s the alternative? I’ll let this one go and pray to God they don’t kill him’.”

From Newsweek , April 24, 1994, Ó 1994 Newsweek, Inc. All rights reserved. Reprinted by permission.
 

Stop the Child-Killers

No one has precise statistics, but we know this for sure–some parents are getting away with murder

by Peter Michelmore

Reprinted with permission from the February 1992 Reader's Digest.
Copyright 1992 by The Reader's Digest Assn., Inc.

Pathologist Eva Vachal was conducting an autopsy on four-year-old Jose Lumbrera, of Garden City, Kan. He had been sick with stomach cramps, his mother said, and was resting in bed. Checking on him, she found he had stopped breathing.

Reading a social worker's report, Dr. Vachal learned that Diana Lumbrera, 31, had borne five previous children by three different husbands. Every one of those kids had died in small towns in the Texas Panhandle, where the mother had lived before. Authorities had certified one cause of death as pneumonia or sudden infant death syndrome (SIDS), one as blood poisoning, one as acute heart failure and two as aspiration, or choking on vomit. “These are wastebasket diagnoses,” Vachal thought,
“They didn't know how the kids died.”

Vachal's autopsy showed Jose seemed perfectly healthy. What was unusual, however, were the pinpoint hemorrhages around the boy's eyelids and on the membrane covering each eye. The only explanation was a sudden cutoff of oxygen and a sharp rise in blood pressure. That meant asphyxiation. Vachal came to a chilling conclusion: Jose had been smothered.

Vachal reported her finding to Garden City detectives, and Diana Lumbrera was arrested and charged with murder. In October 1990, a jury found Lumbrera guilty, sentencing her to life in prison. Two additional life sentences were added when she pleaded “no contest” to killing two of her other children.

Belated Inquiry
Lumbrera is only one of many parents nationwide who have hoodwinked coroners, doctors, lawmen and spouses, and are getting away with child murder.

In Minnesota, a suburban mother walked free for 22 years before she was convicted of murdering her three-year-old adopted son. Despite numerous injuries to the boy's body, the coroner attributed the death to peritonitis. When the natural mother at long last discovered the boy's fate, she approached the medical examiner. He called the case a homicide and began an investigation. Belatedly, witnesses told how the child had been repeatedly beaten, burned, and held underwater. The adoptive mother is now serving a 25-year prison term.

Child-maltreatment deaths in the United States are put at several thousand a year, according to the National Committee for Prevention of Child Abuse. Based on reports from social-services departments, this figure does not include suspicious deaths or those deaths not specifically reported to social-services departments. A Pulitzer Prize-winning series on child death by the Gannett News Service in 1990–developed from interviews with experts in 32 states–estimates the number of child-maltreatment deaths at six per day, almost twice what is reported.

Efforts to get a handle on such deaths are complicated by slipshod reporting. Some death certificates simply read “DOA.”

Typical of many states was the poor documentation in Missouri. There, doctors studied the records of all 364 children ages four and under who died of injuries between 1983 and 1986. They found that abuse or neglect could be eliminated as a cause of death in only one-quarter of the cases. About one-third were reported at the time as child-abuse or neglect fatalities. In the remaining cases, either the circumstances were highly suspicious, or the records were so skimpy that researchers could not judge whether injuries resulted from abuse, neglect or other causes.

Familiar Scenario
Another problem is that numerous questionable deaths attributed to SIDS. The Centers for Disease Control estimates that between one and ten percent of the 6,000 SIDS cases each year may be attributed to abuse or neglect.

A typical scenario in a suspicious death is for a doctor to report it to a coroner or medical examiner, who decides whether to hire a pathologist for an autopsy. If there is medical evidence of homicide, police investigate. Then it’s up to a prosecutor. Any one of these people may slip up, say abuse experts. Or a case may not be pursued at all because an emergency-room physician does not want to spend time in court.

Douglas Besharov, a child-abuse authority with the American Enterprise Institute, estimates only 30 percent of abuse and neglect deaths fall through the cracks. “I’d classify unreported fatal child abuse as a serious problem,” he says, “not a national crisis.”
However, forensic pathologist Mary Case, chief medical examiner for St. Louis County, sees the problem as epidemic. “If it was a disease killing this number of children,” she says, “people would be up in arms.”

Trigger for Reform
Recently Dr. Case has seen dramatic improvements in the way her state handles suspicious cases. The changes have come largely as a result of a 1990 maltreatment death.

While preparing three-year-old Justin Minogue for embalming, John and Tom Clary, father and son morticians, stared in horror. From head to toe, the boy’s body was discolored with bruises. Scabs and burn scars showed on his stomach and limbs. On his back and legs the flesh was welted with strap marks that indicated a thrashing with a leather belt.

The two men drove to Justin's house in Alton, Mo., and confronted the stepfather, Leon Williams II, who had been looking after the boy while the mother was away. Calmly, Williams explained Justin was under medical care for an eating disorder that caused him to bruise at the slightest touch. The child, he said, had suffered the burns when a pan of grease accidentally tipped over. He conceded he had disciplined the child but had used his hands, not a belt. John Clary, also the town coroner, ordered an autopsy. A general pathologist determined that Justin had died of peritonitis from a ruptured intestine. It had been a natural disease process, he said. The murder investigation was dropped.

The story would have ended there if Justin’s maternal grandparents had not insisted on his burial in St. Louis. At the request of the family, veteran mortician Ferd Lang drove to Alton to get the body. Unwrapping the sheet that covered the child, Lang gave a start at Justin’s battered remains. “The little guy was killed,” Lang later told his wife, “and someone is going to pay for it.”

Lang and his local police department arranged for a second autopsy by Mary Case. She ruled that Justin had been punched or kicked in the stomach with such brute force that his intestines had ruptured. The stepfather was charged with murder and is awaiting trial.
In the wake of the Minogue case and others, Missouri joined a number of states in instituting a team-review system in cases of child death.

The review system was pioneered in the late 1970s by Dr. Michael Durfee, a child psychiatrist who directs the child-abuse-prevention program for the Los Angeles County Department of Health. After studying coroners’ findings, Durfee became convinced many probable maltreatment deaths were being missed. Doctors, police officers, public-health nurses or children’s-service workers might have suspicions, but there was no way to pool information. Durfee built a team of these people.

Every day, the Los Angeles County coroner’s office notified the district attorney’s office of unexplained child deaths. The information was then sent to other team members, who pulled pertinent medical, police and social-services records. Each month, they produced a list of cases for review.

The team took up the case of a two-year-old boy whose death was marked accidental. Autopsy had revealed old and new internal injuries. Cause of death was a torn liver, which the coroner surmised was due to a fall. “No way,” was the team consensus.

Creating Awareness
Supported by expert medical testimony, a prosecutor showed a pattern of abuse and proved it to a jury. The father was safely locked away from his other children.

“Our cases were sometimes shot down, but we kept trying,” says Superior Court Judge Jean Matusinka, a former prosecutor and team member. “It was important to make the community aware that kids were dying at the hands of others.”

Soon multidisciplinary review panels began appearing in counties all over California. Other states followed, including Colorado, Georgia, Maryland, Michigan, Minnesota, Missouri, Oregon, South Carolina and Vermont.

The teams do more than investigate suspicious cases. By studying fatalities, they can profile families with a potential for fatal maltreatment and better target intervention programs. They also exonerate people falsely accused of abuse deaths.

Indeed, with the aid of child-review boards, mistakes are quickly corrected. In Denver, a 16-month-old boy was admitted to the hospital with massive head trauma and died soon afterward. The mother’s boyfriend said the child had fallen from a couch. Attending physicians suspected abuse, but a pathologist listed cause of death as an ear infection.

A review-team doctor disputed the pathologist, and the district attorney, also a team member, called for an outside opinion. A Chicago medical examiner found the ear infection had developed after the child was admitted too the hospital. The boyfriend was convicted of “child abuse resulting in death.”

“The key to success is collaboration,” says Jane Beveridge, a social-services official and co-chairman of the Colorado team. “Investigation must involve everyone from the emergency-room physician to law enforcement. This way we’re all accountable.” Just as important, adds Dr. Janice Ophoven, a pediatric forensic pathologist with the Minnesota team, is “to stop giving priority to family, ahead of the safety of the kids.”

Ophoven says many people are blind to the extent of fatal abuse because they don't want to believe it happens. “The children we see tell a different story,” she stresses. Cruelty must be exposed and confronted.

The Biological Roots of Good Mothering

by Art Levine

Studies of man’s closest evolutionary cousins may offer lessons on how to prevent child abuse.

On most counts, humans outdo apes. But no matter how much men and women pride themselves on the table manners and heavenly symphonies that raise them above the animal world, the “inferior” primates may still have lessons to teach their evolutionary betters about one of the most troublesome social issues of the 1990s: child abuse.

The provocative notion that parents could learn from aping the apes is based on a series of recent studies of captive primates. In zoos and research centers across the country, primatologists and zoo keepers are discovering that they can dramatically reduce mothers’ maltreatment of their infants through a few simple strategies: by providing more livable quarters, by allowing other female primates–the equivalent of aunts and cousins–to help out and reduce the stress of parenting, and by exposing inexperienced mothers to good mothers in action. These examples from the animal world are beginning to catch the attention of pediatricians, some of whom are calling for similar reforms in human child abuse prevention programs.

Finding the culprit
Primatologists only began reducing neglect and abuse among apes when they discovered that their efforts to protect primate infants often had the paradoxical effect of endangering them. Due largely to now outmoded ideas on how to protect newborn primates from disease and assault, zoo keepers used to remove new mothers and their infants from the simian community, or remove the infants from the mothers and raise them in a “nursery.”

But scientists began to notice that primates born and raised in this manner often grew up to be lousy parents. Roughly 3 out of 4 of the so-called motherless mothers rebuffed the approaches of their own infants, sometimes beating–and in extreme cases fatally injuring–their own babies. The researchers subsequently identified the unnatural social isolation imposed on the primates in captivity as the leading culprit in abuse. And faced with declining primate populations and international limits on animal imports, many researchers realized they had to alter the primates’ environment if the animals were to thrive. They made sure biological mothers reared infants in more spacious group settings, comparable to what they would experience in the wild. They similarly exposed the previously motherless primates to play with infants and peers, and introduced older mothers to help with the new mothers’ caretaking. They found that inexperienced and even abusive mothers, once given examples of good mothering and a chance to play with infants, became competent parents themselves. Today, as few as 2 percent of primate mothers abuse or neglect their babies, compared to an incidence of about 75 percent in the 1970s.

Animal research findings don’t often translate easily into solutions to human problems, and the ape work is no exception. But at least one existing social service program that exploited very similar principles suggests that zoo keepers and social workers ought to talk. In a University of Rochester-run program, nurses cultivated warm relationships with new mothers by regularly visiting them in their homes, from near the onset of pregnancy until the children’s second birthday. The nurses showed the new mothers how to play and talk to a child, much as older primates demonstrate mothering skills. Just as researchers have learned the value of keeping new monkey mothers with the pack, the nurses encouraged close friends and relatives to assist new mothers. Perhaps equally as crucial, they reduced stress in ways comparable to the measures used with apes and monkeys: Where the primatologists sought to case stress caused by cramped or barren housing, the Rochester nurses reduced family tensions by helping the impoverished mothers find jobs and obtain benefits. In the end, only 4 percent of the low-income teen mothers who received nurse visits neglected or abused their children, compared with 19 percent of those who did not. They even succeeded with the equivalent of motherless mothers, teaching parents who were themselves abused as children how to trust in their abilities as nurturing parents.

There is one important difference, however, between abusive humans and animals: Primates apparently learn much more quickly. National Institutes of Health primatologist Stephen Suomi says just two days of contact with newborn infants made primate females more likely to hug and feed their own infants. By contrast, researchers such as David Olds, designer of the Rochester program, have found that the only programs that really reduce abuse are intensive and long-lasting.

Innovative researchers learned how to reduce abuse among monkeys and apes because they couldn’t tolerate seeing their animals maltreated. But that sense of necessity is not yet so evident to man. Just recently, pediatrician Ray Helfer, co-author of “The Battered Child,” discharged a teenage mother from the hospital to a cramped two-room apartment in a cocaine-infested neighborhood: Helfer says he couldn’t have legally sent a chimp to such a place, “The animals are telling us children’s lives can be turned around,” says Helfer, “but we have to put our minds to it.”

Copyright, Feb. 25, 1991, U.S. News & World Report.
Reprinted with permission.

Breaking Out of a Vicious Circle

by Alice Johnson

I am tired of reading in the popular press, and other so-called enlightened journals, that abused children grow up to become abusers of their own or other people’s children. So far as I have been able to discover, no one has ever been interested enough to do a study of those individuals who were abused as children but who grew up deciding that “never will I allow my child or any child to suffer the abuses I endured.” Instead, it appears that certain psychologists who function as 20th-century prophets, seers, or sages– operating as if they had talked with the Supreme Being himself/herself–assure us that the young abused are predestined to become adult abusers. According to this Pavlovian theory, it is all mechanicalistically and automatically determined: the abused child will grow up to become an abuser of the next generation. If one were to follow this absurd logic through, it would mean that generations of abusers will abound ad infinitum.

There are, of course, different kinds and degrees of child abuse. Beatings, burnings and brutal sexual assaults are the principal acts we read about daily in the major newspapers and see depicted on national television. But there is also a subtler kind of child abuse that can only be described as “benign neglect.” Children who suffer from this common garden-variety blight are never beaten, burned or otherwise physically tortured. They are merely ignored by busy, noncaring parents who provide all the prerequisites of the good life but deny their offspring the most important and vital ingredients: love and personal attention.

Neglect
Both brutal and benign abuse are almost equally destructive to the young person’s sense of dignity and self-worth. The child looks to these first authorities–the parents–and suffers a deep feeling of guilt. To be beaten or to be ignored must mean that in some mysterious way the child has deeply offended its parents and is convinced that “it’s all my fault.” It can take years to wipe out the stain of guilt impressed upon the child’s psyche–years before, if ever, the young adult can look back with perspective and realize that “it was not, after all, my fault. I was the victim, not deserving of such abuse or neglect.” All too often, the stigma remains and takes its toll on the many who never get over the feeling that “I am worthless. That is why my parents beat me, burned me, assaulted me or just plain ignored me.”

My protest against the conventional wisdom that child abuse is an almost inherited, determined characteristic is based on many years of listening to young college students–men and women, black and white, rich and poor–who suffered abuse or neglect as children. The fine art of incest, for example, is too frequently practiced everywhere from the ghetto tenement to the biggest mansion in the land. The scars from cigarette burns that I have seen are permanent reminders for those young sufferers of the evils of physical abuse.

For those “fortunate” children who were sent to Europe every summer to Bermuda every Christmas holiday and the Bahamas every spring vacation because their parents didn’t really care to spend any time with them, the sense of loneliness and neglect is also a perpetual and painful memory. I remember one student in particular who when asked why she needed to postpone a scheduled examination in order to go to Boston to see her parents off on an African safari said, “Well, it’s just that I haven’t seen them for about two years.” And, in fact, she had not. For she was either sent away directly from school at vacation times (her parents having made all the necessary arrangements in advance) or they had decamped, leaving her to rattle around in a large house with the housekeeper and the gardener for company.

From these young people I received a different message. While working their way through adolescence and into young adulthood, they fought to overcome their sense worthlessness. They came to the realization that only the accident of fate placed them where they began life. Many of these young women and men eventually were able to perceive themselves as decent human beings who might even have qualities that may be admired.

These are the ones who did more than survive: they emerged scarred in mind and heart, but they concluded that certain patterns of irrational or thoughtless or careless adult behavior do not have to, and must not, be repeated. Over and over, I have heard these young people discuss how they plan to treat their own children if they decide–and some do not–to become parents themselves. Mostly, they talk about loving and caring and paying attention and assuring their own children how much they are wanted. These are their promises to the future unborn.

Indulged
Cynics, of course, will dismiss these youthful assertions as mere sentimentality because when these survivors do become parents they should inevitably behave as did their parents. The cynics are not always right. When many of these students return after graduating from college to display with pride and love their own offspring, one is forced to believe that their promises have been kept. Their children are open, friendly and secure. They do not know abuse for they have known only love. If anything, these youngsters may be indulged too much by way of compensation.

These formerly abused individuals who turn out to be good parents are not dramatically interesting: their names do not appear in newspaper headlines nor do their faces appear on television screens. That would make for very dull copy. The generally accepted assumption, that the abused are destined to become abusers, is simply too facile. Certainly, we hear about many of those who do repeat the evil pattern imposed upon them. Who knows how many thousands out there, right now, are making sure that the pattern of abuse and/or neglect is reversed. I don’t know. But I do know that I, too, was once one of those victims of child abuse.

Johnson is dean emeritus and professor of English at Connecticut College.


Copyright 1984 Newsweek Magazine
Reprinted by permission.

Protecting the Kids

How retail people are shaping programs aimed at preventing abduction, abuse

by Katherine Joyce

Retailers have been among the leaders in a march of companies joining up to protect America’s children. Their tactics include special events and on-going programs on preventing child abduction or abuse.

Bradlees, The Broadway Southwest, Diamond’s, Foley’s and Jamesway are a few of the stores to sponsor programs so far. Wal-mart, K-mart, Hess’s and Macy’s have also been involved.

For Foley’s, Houston, the latest effort involved a joint program with the Houston Chronicle for Child Safety Week. Together, the store and the newspaper worked with Marvel Comics to distribute a special Spiderman comic book written in cooperation with the National Committee for the Prevention of Child Abuse. The book dramatized two different types of child molestation and provided helpful suggestions, written for children, on how to cope with such problems.
Myrna Phillips, Foley’s vice president, advertising and sales promotion, describes other events during the week of January 27 that were aimed at “raising community awareness of child abuse and how it can be prevented.”

In addition to in-store and newspaper circulated distribution of the comic book, the store sold a cassette tape for parents called “How to Abuse-Proof Your Child.”
Foley’s also scheduled seminars on child abuse awareness and prevention, including fingerprinting and photography programs. A special program was provided for area schools to use.

Fingerprinting was part of the service Macy’s in Toledo, Ohio, offered last year. And during this year’s Salute to Volunteers of Toledo, a number of resource organizations were invited to display information and offer their services in the store.

Bradlees, Brainfree, Mass., is merchandising a video tape created by Paramount, selling it at cost to customers, plus donating two copies to the libraries in communities it serves.

Karen Zahn, Bradlees’ director of consumer affairs, says, “It is an important way to deal with the issue of child safety. Strong Kids/Safe Kids is only a part of an ongoing community relations project for us. We hope to benefit not only the shoppers, but all people in the markets we serve.”

To accompany the launch of Strong Kids/Safe Kids in mid-February the store took major newspaper ad space to promote the tape, and reprinted a brochure that was developed with the program for in-store distribution. The pamphlet gives safety tips and stresses the importance of parental awareness of the problem.

In addition, Zahn points out, Bradlees has provided store employees with free fingerprinting and videoprinting or photography for their children. It has also conducted educational sessions at headquarters.

For the last two years, Diamond’s, Tempe, Ariz., has created parenting and safety programs timed for back-to-school. The 1984 program, Back to School Safely, had two-weeks of events in August that included fingerprinting, lectures, seminars, and free police whistles distributed to children.

Barbara Bonneville, Diamond’s special events, says another program is being developed this year, based on positive response and “tremendous attendance.”
A complete identification program has been part of the on-going child safety program at The Broadway Southwest, Mesa, Ariz.

Sheila Carstens, special events, recalls last years back-to-school event was Childsafe, in all 10 stores. Events included creating a complete child dossier with dental wax impressions, photographs, fingerprinting, blood typing, hair samples, a list of vital statistics and distinguishing features, and complete dental/physical exams.

“The response was really wonderful,” she says. “In fact, people told us they were more comfortable attending a program like this in a department store. They were also glad to have access to a full range of services in one location.”

In addition, parent seminars conducted by local police and FBI groups taught prevention techniques. Safety skills for children, performed by a local theater group, taught kids the “ABC’s of Abduction” in-store, while they waited to be tested or printed.

A keynote speaker for The Broadway, John Walsh, has become a national figure based on his work for missing children. He is the father of Adam Walsh,a six year old who was abducted and killed, and was the subject of a television film called “Adam”, which has generated much publicity and public interest each time it has aired.

This past Easter, The Broadway held an Easter Egg Hunt as a fundraiser to benefit OCID–Operation Child I.D. The commitment is on-going, Carstens claimed, noting free fingerprinting is offered year-round, and ads remind the community the service is available.

She concludes, “We get a really wonderful awareness and positive impression from doing this for our communities.”

At Jamesway, Secaucus, NJ, the programs the chain has developed ties closely with other industries’ efforts. What are, sadly, becoming a familiar sight–photos of missing children with brief details about them–are part of the national push to bring lost kids home safely.
“WE CARE” is the name of Jamesway’s effort, including a shopping bag program, which many supermarkets have begun to participate in, that shows the kids’ pictures on one side, and offers safety tips on the other.

The store is also printing handouts with the kids’ pictures and safety tips. Says the store’s sales promotion vice president, Victor Scire, “The police in our trading areas believe the pictures are more an awareness impact, while the tips are most vital. We work closely with state and local police to develop tools and seminars for child safety.”

He points out Jamesway has long had a commitment to this type of community program, citing an annual Muscular Dystrophy fundraiser as one example.

“Our corporate office gives the stores budgets and permission to use store space for this type of thing, Scire adds. “It is a major commitment.”

Jamesway’s shopping bag program uses a new group of photos every three weeks. The company has also produced 52,000 child safety coloring books for state police to distribute to schools and in safety seminars. Such seminars are scheduled for in-store as well.
Beginning in April, Jamesway aired radio and TV public service announcements to promote the seminars, along with newspaper ads.

Also, as supermarkets are now doing, Jamesway has agreed to work with Supermarket Communications, Norwalk, Conn., to display missing kids’ pictures at entrance bulletin boards.

SC’s director of operations, LuAnn Romanillo, says about 5,700 stores are participating: Jamesway and Zayre among them. The sponsor of this program is Nestle.

Wal-Mart’s Enterprise, Ala., store held a Child Safety Day event during which over 450 children were fingerprinted by the local sheriff’s office.

A similar event was staged at Hess’s, Allentown, Pa., called Child Awareness Day. Fingerprinting, videotaping and photographs were offered in-store, as were a number of skits and plays for kids, plus exhibits from resource groups for parents. Coca-Cola and a local TV station joined Hess’s in sponsoring Child Awareness Day.

K-mart has joined in with a shopping bag program, plus free identification cards issued to kids in-store.

International Paper Co. is a corporate sponsor of the shopping bag program: the company is providing free printing plates to retailers, and is the source for pictures and safety tips now seen on milk cartons, as well.

Foodtown Supermarkets was among the first companies to join up. The chain’s president, Calvin Bell, says, “If we can help make people aware of the dangers to these kids, and to be on the lookout for them, we’ll have done what we set out to do. And if any one of us can bring one child home safe and sound–that’s what it’s all about.”

And now Shop Rite supermarkets has joined in, offering an I.D. card program free to children in 110 stores.

Howard Wilkinson is president of the National Child Safety Council, a group he founded 30 years ago. His is only one of a number of organizations working toward child safety, but Wilkinson has been instrumental in instituting a number of recent programs.

“Utility companies are now involved, using stuffers with their bills that show two different children each month. They also publish a directory of missing children which is provided to every state police and local police force in the country. This group is completely industry-sponsored, but people are eager to help.”

Wilkinson considers retail involvement important, saying, “When a child has not been abducted by a family member, stores and shopping centers are among the first places they disappear from. It would be a tremendous service for these two sectors to make a stand.

Reprinted from STORES Magazine copyright NRF Enterprises Inc., 1985.

Parents Spending Insufficient Time With Children

The one gift contemporary parents may not be giving their children is the gift of time, according to a University of Southern California study. Published in the March 1991 issue of the journal, Population Development Review, the report examines the childrearing attitudes of a nationally representative sample of prospective parents, comparing the views of high school seniors in 1976 and 1986. About three-fourths of the survey respondents–who would now be in their 20s and 30s–said they planned to get married and have children.

“High school seniors overwhelmingly want to give their children better opportunities than they had themselves, and that desire was even more prevalent among the seniors of 1986 than it was among the seniors of a decade before,” says Eileen Crimmins, Ph. D., associate professor of gerontology and sociology at USC’s Leonard Davis School of Gerontology.

But whatever they meant by “better opportunities,” it wasn’t more parental time, the report indicates. Only 26 percent of the women graduating in 1986 thought that most mothers should spend more time with their children, compared to 38 percent who thought so in 1976.

Dr. Crimmins is the first author of the journal article. The co-authors are Richard A. Easterlin, Ph.D., professor of economics at the USC College of Letters, Arts, and Sciences, and Yasuhiko Saito, a Ph.D. candidate in the USC department of sociology.

Instead of giving their children the “gift of time,” the high school seniors who graduated in 1986–today’s young parents–seemed to be placing an increasing emphasis on material goods, both for themselves and for their children. For example, the percentage of seniors who said it would be quite or extremely important to have at least two cars and clothes in the latest style increased from 29 percent in 1976 to 56 percent in 1986.

“Anecdotal experience and TV commercials also suggest that parents increasingly substitute goods for their own time in bringing up their children,” Crimmins notes. “Who would have foreseen a decade ago that clothes with designer labels and Nintendo would be ‘essential’ in raising a happy child?”

One of the strongest trends the USC researchers identified was the change in women’s sentiment toward staying home to care for preschool children. In 1986, the proportion of 18-year-old females who expected to be full-time homemakers at age 30 was just three percent–down from 12 percent in 1976.

“Moreover,” says Crimmins, “only about one-fifth of the women who graduated in 1986 felt it was desirable for them not to work outside the home if they had preschool children, compared to almost 43 percent who felt that way in 1976.

“Even among males, who are considerably more inclined to want the mother to be at home with their preschoolers, only a little more than a third favored this arrangement in 1986–down from half the male seniors surveyed in 1976.”

Crimmins points out, too, that only 12 percent of the women polled in 1986 thought that preschoolers are likely to suffer if their mothers work, compared to almost 30 percent who thought so a decade earlier.

The researchers caution that the preferences young men and women express on the eve of high school graduation are by no means immutable. As their plans and desires collide with the constraints imposed by economic and social realities, their attitudes about childrearing and other issues may well change.

Still, the researchers observe, the 1986 graduates and their predecessors of a decade earlier started out with markedly different aspirations as prospective parents. And the direction of change suggests that materialism has made deep inroads into a realm that was long considered immune to money–relations between parents and their children.

The USC researchers analyzed data from an annual survey, conducted by researchers at the University of Michigan, of a nationally representative sample of 3,000 high school seniors from about 125 schools. Their study was funded, in part, by a grant from USC’s Faculty Research and Innovation Fund.

Further information on the study is available by contacting Rob Asghar, USC News Service, University of Southern California, KAP 248, Los Angeles, California 90089.


Reprinted with permission from Children Today Vol. 21, No. 1, 1992 Copyright 1992.

Child Abuse and Society’s Response

by Cleo Kocal

Before 1874, the United States had no child abuse laws. Henry Bergh, founder of the American Society for the Prevention of Cruelty to Animals, brought the first case to court. A little girl was repeatedly stabbed with scissors by her parents who claimed she was a witch. Bergh said that children ought to be as worthy of protection from abuse as dogs and cats.

But have we really progressed since then in protecting our children? The following illustrate what’s happening.

Case number one asks: should our laws put the welfare of children after the civil liberties of criminal defendants who happen to be their parent or parents?

According to an article by Sheila Weller in the May 1988 issue of Ms., the facts of the case are that battered wife and mother Diane Pikul, an employee at Harper’s magazine, planned to leave her abusive husband, a Wall Street securities analyst. Joe Pikul was a violent man who exhibited violence to his family as well as to others. He locked their young son in his room after he “failed” to get into a good private nursery school. He spanked their daughter with a belt. She appeared in school with bruises. He also threatened to kill his wife if she left. Soon after that, Diane was murdered near the Pikul’s beach house. No one knows whether or not the children witnessed the murder. Although Joe Pikul was indicted for his wife’s murder, it could not be used against him in the subsequent custody hearing. The children are currently with him.

Case number two asks: how many facts are necessary before action is taken by authorities? Is what happens in a family really nobody else’s business? Are children private property?

In another article, this time in the June 1988 issue of McCall’s, Sheila Weller reports these facts of case two: Eli Creekmore’s grandmother repeatedly told child-protection workers that the boy was being brutally abused by his father. Many times, Eli was treated by hospital emergency workers for bruises and lacerations. Doctors detected bone fractures many months old. On his third birthday, Eli was taken by his grandmother for a birthday dinner. The little boy had bruises on his face and arms. When he ate his ice cream,blood came from his mouth. That night, Eli was kicked to death by his father.

The third case asks: should we turn our heads if the abuse is sexual? Are mothers who protest this type of activity complaining about nothing? Are mothers who take their children for medical care abusing their children? That is what Judge Sebe Dale, Jr., of Gulfport, Mississippi, said.

According to an article by Eleanor J. Bader in the March/April 1988 issue of New Directions for Women, in a divorce trial, Karen Newsome won primary custody of her two children, a boy and a girl. Her ex-husband had regular visitation rights. When, at age two-and-a-half, Katie returned home with a swollen labia and rectal bleeding, her mother rushed her to a physician. During subsequent visits to a psychologist, the child acted out fellatio with anatomically correct dolls and pictorially showed that her father rubbed her vaginal area with his penis. Both children (the boy was fifteen months old) responded to medical examination of their genital areas with great anxiety. The mother challenged the father’s visitation rights. After two days of testimony and the introduction of reams of medical evidence indicating abuse, the judge awarded full custody of both children to the father, stating that the mother was an unfit parent and charging that she had abused the children by taking them to numerous doctors.

The fourth case asks these questions: if my child is a boy, is he safe from sexual abuse, and should one automatically trust a man or woman of the cloth?

Annie Laurie Gaylor’s Betrayal of Trust: Clergy Abuse of Children recounts case four. Devout Catholics, the Gastals, who were overjoyed when their seven-year-old son became an altar boy. That same day, the boy’s sexual abuse began with sodomy. He was told by his priest, the Reverend Gilbert Gauthe, that sex with priests was a special religious rite chosen by God. The priest had guaranteed the boy’s silence by threatening that “he would hurt my daddy; he’d kill him.” The molestation continued for years, with anal and oral rape taking place in the rectory, sacristy, confessional, and the priest’s camper. The priest also took pornographic photographs of the boy. The Gastals would not settle out of court with the Catholic church. They were ostracized and harassed by their community until it was discovered that the priest had molested thirty-seven other boys and one girl. Subsequently, in court, the Gastals were awarded monetary compensation for the damage inflicted.

The facts are that there aren’t enough abuse prevention programs and those that exist are poorly funded. The cases cited are not isolated incidents. Neither were they chosen because they were “worse” than any others. They are simply typical. It is time for our legislators to stop talking and to begin acting. Why must children be irreparably damaged or killed before we pay attention?

Cleo Kocal, a writer and actor from Seattle, Washington, has served on the board of directors of the American Humanist Association and as chairperson of its Feminist Caucus.

Reprinted with permission from The Global Weekly of Research Science, Vol. 244, April 1989.
Copyright 1989 American Association for the Advancement of Science.


The Cycle of Violence

by Cathy Spatz Widom

The scholarly literature on family violence has grown enormously during the last 20 years. One of the most pervasive claims that appears in both academic and popular writings refers to the cycle of violence: abused children become abusers and victims of violence become violent offenders. Over 25 years ago, in a brief clinical note entitled “Violence breeds violence–perhaps?” Curtis expressed the concern that abused and neglected children would “become tomorrow’s murderers and perpetrators of other crimes of violence, if they survive.”

Indeed, the notion of an intergenerational transmission of violence has become the premier developmental hypothesis in the field of abuse and neglect. In this article I review the current empirical status of this hypothesis, drawing on data from different disciplines–psychology, sociology, psychiatry, social work, and nursing; comment on methodological problems; and describe new research developments in the field. Although people maintain strong feelings about this topic, they ought to be aware of those aspects of the cycle of violence hypothesis that have received support and of areas where unresolved questions remain.

Literature Review
Researchers and professionals have used the phrases “cycle of violence” and “intergenerational transmission of violence” loosely to refer to assumptions or hypotheses about the consequences of abuse and neglect in relation to a number of different outcomes. Some writers refer exclusively to the hypothesized relation between abuse as a child and abuse as a parent. Others focus on the relations between child abuse and neglect and later delinquent, adult criminal, or violent behaviors.

Because there are difficult methodological problems confronting social science research, most investigations of child abuse have been criticized as methodologically flawed and limited in how the results can be generalized, their scientific validity, and ultimately policy relevance. There remains considerable debate about the definition of child abuse and, consequently, much uncertainty about its prevalence. Even less is known about its effects. For children who have been abused or neglected, the immediate consequences may involve physical injuries or psychological trauma. In addition, the emotional and developmental scars of these children and those who witness severe family violence may persist. Furthermore, because many other events in the child’s life may mediate the effects of child abuse or neglect, the long-term consequences of such childhood victimization are difficult to determine.

Abuse leads to abuse. In a recent review of empirical studies relevant to the intergenerational transmission of violence hypothesis, Widom noted that there is surprisingly little empirical evidence to support the claim that abuse leads to abuse. Existing studies suggest that there is a higher likelihood of abuse by parents if the parents were themselves abused as children. Among abusing parents, estimates of a history of abuse range from a low of 7% to a high of 70%. Among adults who were abused as children, between one-fifth and one-third abuse their own children.

Many studies are methodologically weak and limited because of an overdependence on self-report and retrospective data, inadequate documentation of childhood abuse and neglect, and infrequent use of baseline data from control groups. In a comprehensive review of this literature, Kaufman and Zigler concluded that the unqualified acceptance of the intergenerational transmission hypothesis–from abuse as a child to becoming an abusive parent–is unfounded.

Small-scale clinical reports.  A number of frequently cited writings describe prior abuse in the family backgrounds of adolescents who attempted or succeeded in killing their parents, and of murderers, or of those charged with murder. These reports, offered as support for the cycle of violence, present provocative clinical accounts by astute observers; yet their own statistical usefulness is limited because of small sample sizes, weak sampling techniques, questionable accuracy of information, and lack of appropriate comparison groups.

As Monahan argued, the most important piece of information researchers can have in the prediction of violence is the base rate of violent behavior in the population with which they are dealing. Particularly in the areas of abuse and neglect, there is a tendency to overemphasize individual case information at the expense of base rates. Appropriate control groups are necessary to assess the independent effects of early childhood victimization because many of the same family and demographic characteristics found in abusive home environments also relate to delinquency and later criminality. Without control groups to provide an estimate of such base rates, it is difficult to assess the magnitude of relationships.

In the United States, for example, groups with different demographic characteristics (males/females, blacks/whites, rural/urban) have different base rates off arrest for violent crimes. Thus, base rates–from the same general population of people at the same time period–must be taken into account in assessing the cycle of violence.

Delinquency.  Another facet of the cycle of violence hypothesis refers to the relation between abuse and neglect and delinquency. The majority of studies that address this relation are retrospective ones in which the researcher typically asks delinquents about their early backgrounds. Estimates of abuse from these retrospective studies generally range from 9 to 29%. In prospective studies that follow up individuals who had been abused or neglected as children, the incidence of delinquency was between 10 and 17%. Of three prospective studies, two lacked control groups (non-abused comparisons). Most studies of delinquents report that the majority were not abused as children. In at least one study, rejected children had the highest rates of delinquency. However, without appropriate control groups and improved methodology, any conclusions remain highly ambiguous.

Violent behavior.  Several studies involving delinquents and psychiatric patients suggest that abuse and neglect are related to violent criminal behavior. However, findings are contradictory. Some provide strong support for the cycle of violence hypothesis; in others, abused and non-abused delinquents did not differ; and in at least one study, abused delinquents were less likely to engage in aggressive crimes later. Each of these studies has methodological problems, not the least of which is the universal lack of normal comparison groups providing baseline data. Furthermore, since existing studies focus primarily on violence among delinquents and adolescents, whether these childhood experiences have direct and lasting consequences for the commission of violent crimes into adulthood is unknown.

Aggressive behavior in young children.  Another body of studies focuses on the relation between abuse, neglect, and aggressive behavior in young children. This work is based on experimental research and laboratory observations. Age groups vary, as do definitions of child abuse and outcome measures. However, these studies indicate with some consistency that abused children, as young as infants and toddlers, manifest significantly more aggressive and problematic behavior than non-abused or neglected children.

These studies also suggest the need to consider neglect as distinct from abuse, because in some reports neglected children appeared more dysfunctional than those abused. With one exception, only these developmental psychology studies have systematically examined and reported differences between separate samples of abused and neglected children. By combining abused and neglected groups, or by studying only physically abused children, important differences in consequences may be obscured.

Observing violence.  In addition to studies of children directly victimized, the indirect effects on children observing family violence have also been investigated in two types of studies. First, large-scale self report surveys have found a modest, although fairly consistent, association between exposure to family violence and approval of violence or marital violence as an adult. Second, studies of the children of battered women suggest that observing abuse or extreme marital discord may be as harmful to the development of the child as physical abuse, although other factors might contribute to these findings.

Despite widespread belief in the intergenerational transmission of violence, methodological limitations substantially restrict our conclusions about the long-term consequences of early childhood victimization. The research described here was designed to overcome some of the methodological problems that have hindered the empirical documentation of the cycle of violence.

New Research Developments
During a 2-year research project, I examined a number of basic questions about the relationship between child abuse and neglect and later violent criminal behavior. This research was designed to incorporate methodological improvements. These included a relatively unambiguous operational definition of abuse and neglect; a prospective design; separate abused and neglected groups; a large sample to allow for subgroup comparisons and to allow for conclusions with respect to violent criminal behavior; a control group matched as closely as possible for age, sex, race, and approximate social class background; and assessment of the long-term consequences of abuse and neglect beyond adolescence or juvenile court into adulthood.

The purpose of this project was to identify a large sample of substantiated and validated cases of child abuse and neglect from approximately 20 years ago, to establish a matched control group of non-abused children, and to determine the extent to which these individuals and the matched control group subsequently engaged in delinquent and adult criminal and violent criminal behavior. At present, this research involves (and is limited to) the collection, tabulation, and analysis of official records.

The decision to use official arrest records for the dependent variable was made for several reasons. Arrest records are relatively easy to locate, and reasonable complete information on arrests in official records can be collected retrospectively. Results of self-report studies and research with the use of official records have been fairly consistent in terms of the correlates of crime. Although self-reports are basically reliable and valid for relatively minor offenses, more serious offenses are more efficiently revealed (and with fairly little bias) by some official data. Arrest records were also chosen because interviewing a large number of abused and neglected cases would be extremely costly. Compared to a good survey by interviewers, a register study such as the one described here tends to be much less expensive per case.

Design.  This study is based on a standard design referred to as specialized cohorts or observational cohorts. In a matched cohort design, both groups are free of the “disease” in question (violent or delinquent behavior) at the time they are chosen for the study and, because of matching, are assumed to differ only in the (risk) attribute to be examine (having experienced child abuse or neglect). Because it is not possible to randomly assign subjects to groups, the assumption of equivalency for the groups is an approximation.

In studies of the relation between child abuse and neglect and later delinquency or criminality, it is important to avoid ambiguity in the direction of causality of the events. Specifically, cases occur where delinquency precedes abuse or neglect in time and cases where delinquency itself may actually provoke the abuse or neglect of the child. Thus, to minimize this ambiguity and to maximize the likelihood that the temporal direction is clear (that is, abuse or neglect leading to delinquency or criminality), abuse and neglect cases were restricted to those in which children were less than 11 years of age at the time of the abuse or neglect.

In comparisons of delinquent or violent behavior, it is also difficult to judge what portion of the differences is due to the experience or factors under study and what portion is due to being labeled a delinquent or violent offender. My research does not totally avoid this problem, but by use of prospective design, with data collection started at the point of abuse or neglect and before the onset of delinquency and violent behavior, the problem is minimized.

Abuse and neglect cases.  All cases of physical and sexual abuse and neglect processed during the years 1967 through 1971 in the county juvenile court (situated in a metropolitan area in the Midwest) and validated and substantiated by the court were initially included. Abuse and neglect cases from the adult criminal courts were also included. In these cases, a criminal charge was filed against the adult defendant. During 1967 through 1971, there were 140 cases (physical and sexual abuse and neglect) processed in adult criminal court in which the victim was 11 years of age or less. After examining 2623 abuse and neglect petitions, a total of 908 cases were retained for this study.

Definitions.  Physical abuse refers to cases in which an individual had “knowingly and willfully inflicted unnecessarily severe corporal punishment” or “unnecessary physical suffering” upon a child or children (for example, striking , punching, kicking, biting, throwing, or burning). Sexual abuse refers to a variety of charges, ranging from relatively nonspecific charges of “assault and battery with intent to gratify sexual desires” to more specific and detailed charges of “fondling and touching in an obscene manner,” sodomy and incest. Neglect refers to cases in which the court found a child to have no proper parent care or guardianship, to be destitute, homeless, or to be living in a physically dangerous environment. The neglect petition reflects the judgement that the behavior represents a serious omission by the parents–beyond acceptable community and professional standards at the time–to provide to children needed food, clothing, shelter, medical attention, and protection from hazardous conditions.

Matched control group.  One of the critical elements of this research design is the establishment of a control group, matched as closely as possible on the basis of sex, age, race, and approximate family socioeconomic status during the time period under study (1967 through 1971). To accomplish this matching, the sample of abused and neglected cases was first divided into two groups on the basis of their age at the time of the abuse or neglect incidents: those under school age and those of school age.

Children who were under school age at the time of abuse or neglect were matched with children of the same sex, race, date of birth (± 1 week), and hospital of birth through the use of county birth record information. Of the 319 abused and neglected children under school age, there were matches for 229 (72%).

For children of school age, records of more than 100 elementary schools for the same time period were used to find matches with children of the same sex, race, date of birth (± 6 months), same class in same elementary school during the years 1967 through 1971, and home address, preferably within a five-block radius of the abused or neglected child. Out of 589 school-age children, there were matches for 438, representing about 74% of the group. Overall, there were 667 matches (73.7%) for the abused and neglected children.

This cohort design involves the assumption that the major difference between the abused and neglected group and the controls is in the abuse or neglect experience. Official records were checked to determine if the proposed control subject had been abused or neglected. If there was evidence that a control subject had been abused, then he or she was excluded from the control group. This situation occurred in 11 cases.

Demographic characteristics of the groups.  Among the abused and neglected group, there are about equal numbers of males and females (49 versus 51 %) and more whites than blacks (67 versus 31 %). The mean age for the abused and neglected subjects is 25.69 years (SD = 3.53 years). The majority of the sample are currently between the ages of 20 and 30 years (85%), with about 10% under age 20 (the youngest is 16) and 5% older than 30 (the oldest is 32). The current age distribution of the sample indicates that our design has allowed sufficient time for most of the subjects to come to the attention of authorities for delinquent, adult criminal, and violent behavior.

The controls are well matched to the abused and neglected subjects in terms of age, sex, and race. Controls are equally divided between males and females. The racial composition of the group is quite similar to that of the abused and neglected group, although slightly more controls are black (35%). Their mean age is 25.76 years (SD = 3.53 years; range, 16 to 33 years).

Data collection.  Detailed information about the abuse or neglect incident and family composition and characteristics was obtained from the files of the juvenile court and probation department, the authority responsible for cases of abused, neglected, or dependent and delinquent children. Juvenile court and probation department records were also examined for the control subjects. Detailed delinquency and detention information was recorded for both groups. Adult criminal histories for all subjects were compiled from searches at three levels of law enforcement: local, state, and federal. Searches also extended to the Bureau of Motor Vehicles and (for all females) marriage license records to find social security numbers to assist in tracing subjects through criminal records.

The Cycle of Violence: Findings
Abused and neglected children have a higher likelihood of arrests for delinquency, adult criminality, and violent criminal behavior than the matched controls. Table 1 presents the percentage of individuals in the abused and neglected and control groups who have official records for delinquency, adult criminality, and violent criminal behavior. In comparison to controls, abused and neglected children overall have more arrests as a juvenile (26 versus 17%), more arrests as an adult (29 versus 21%), and more arrests for any violent offense (11 versus 8%).

In addition to the extent of involvement, criminality is often described in terms of the number of offenses committed, the age at first arrest, and repetitiveness (or chronicity) of a person’s criminal activity. In comparison to controls, abused and neglected children as a group have a larger mean number of offenses (2.43 versus 1.41, t = 4.49, P < 0.001); an earlier mean age at first offense (16.48 versus 17.29, t = 2.38, P < 0.05); and a higher proportion of chronic offenders, that is, those charged with five or more offenses [17 versus 9%; x2 (1) = 28.86, P < 0.001].

Differences related to demographic characteristics.  To illustrate the independent effects of demographic characteristics, the results of separate analyses for sex and race are included in Table 1.

Sex. Males have higher rates of delinquency, adult criminality, and violent criminal behavior than females (Table 1). Within each sex, a history of abuse or neglect also significantly increases one’s chances of having an official criminal record. Thus, despite the fact that women generally have lower rates of arrests for criminal behavior, abused or neglected females are significantly more likely to have an adult arrest (15.9%) than control females (9.0%), although the difference for females in these groups is not significant for violent crimes.

Race.  Although blacks are statistically more likely to have official criminal records than whites, the same pattern exists across the abused and neglected and the control group for all three levels of criminal activity (delinquency, adult criminal, and violent criminal behavior). For blacks and whites, being abused or neglected increases the likelihood of having a criminal record as a juvenile and as an adult. However, for whites, being abused or neglected does not significantly increase the risk of an arrest for violent criminal behavior.

Age.  Dividing our sample (ages 16 to 33 years) into four age groups of equal size, older subjects in both groups have higher frequencies of an adult criminal record than younger subjects [x2 (3) = 36.17, P < 0.001] and of violent criminal behavior [x2 (3) = 14.05, P < 0.01]. Although this finding may simply reflect the number of years available for the subjects to accumulate criminal records, it also illustrates the complexity of dealing with criminal behavior and the need to control for age.

Continuity.  As seen so far, victims of early child abuse and neglect differ from non-abused and non-neglected children on a number of indices of delinquency, adult criminality, and violent criminal behavior; however, not all aspects of criminal activity differentiate the groups. One example of such a similarity between the groups is provided by findings about the continuity between antisocial behavior as a juvenile and criminal behavior as an adult.

Of those with juvenile offenses, roughly the same proportion of abused and neglected children and controls go on to commit offenses as an adult (53 versus 50%). Similarly, of those with violent offenses as juveniles, approximately the same proportion go on to commit violence as an adult in the abused and neglected group (34.2%) as the controls (36.8%). Thus, despite significant differences in the extent of involvement in criminal activity, non-abused and non-neglected subjects are just as likely as abused and neglected individuals to continue criminal activity once they have begun.

These findings are interesting in light of recent literature in criminology, particularly the current debates on criminal careers. Although my findings indicate that officially recorded abuse and neglect increase one’s likelihood of having an official criminal record and speed up the age at entrance into officially recorded delinquent activities, early childhood victimization does not appear to place one at increased risk for continuing in a life of crime. These findings reinforce the notion that it is important to distinguish factors that may stimulate an individual to become involved in crime from the factors that affect whether the person continues or desists in a criminal career.

Does Violence Beget Violence
In a direct test of the cycle of violence hypothesis, violent criminal behavior was examined as a function of the of abuse or neglect experienced as a child. According to the cycle of violence hypothesis, individuals who experienced childhood physical abuse only should show higher levels of violence that individuals victimized by other forms of abuse or neglect. Table 2 shows that percentage of subjects in each abuse group who have an arrest for any violent offense (juvenile or adult record). As expected, victims of physical abuse had the highest level of arrests for violent criminal behavior followed by victims of neglect. However, types of abuse and neglect are not distributed randomly in the sample across age, sex, and race groups, and thus bivariate analyses present an overly simplistic picture.

Table 1. Extent of involvement in delinquency, adult criminality, or violent criminal behavior among abused and neglected (n = 908) and control (n = 667) groups, NS, not significant.

Need for multivariate models. Since sex, race, and age are independently related to differences in rates of violent criminal behavior, it is necessary to control for the effects of these factors in examining the hypothesized cycle of violence. Thus, data analysis and interpretation of these findings must incorporate and control for sample demographic characteristics.

One statistical technique for analyzing the influence of a set of explanatory variables on a “response” variable that takes a binary form is logistic regression or linear logistic response models. This technique models the log-odds of the presence or absence of a response as a linear function of the independent variable. Models were estimated with the use of iterative maximum likelihood methods, with any arrest for a violent crime as the response variable and race, sex, age, and group status (physical abuse, sexual abuse, neglect, and controls) as explanatory variables.

The estimated coefficients in the resulting fitted model for predicting the log-odds of an arrest for any violent crime are presented in Table 3. Group contrasts are with the control group, so that each pure type of abuse (omitting cases with more than one type of abuse) is compared to the control group, holding other factors constant. The results of this analysis indicate that, controlling for age, sex, and race, the physical abuse and neglect groups have a significantly higher likelihood of having an arrest for a violent offense than the controls. Thus, in the most direct and stringent test of the cycle of violence hypothesis, being physically abused as a child does increase one’s propensity to commit further criminal violence. Although being neglected also increases one’s likelihood of violent behavior, the type of abuse or neglect is not as powerful a predictor of violent criminal behavior as the demographic characteristics of sex, race, and age.

Caveats
My research was explicitly designed to examine the relation between abuse, neglect, and later violent behavior and to overcome methodological shortcomings in previous literature. However, this research has limitations because of its exclusive reliance on official records. Thus, one should be circumspect about these findings and not generalize inappropriately.

Much child abuse and neglect that occurs does not come to the attention of welfare departments, police, or courts. This fact especially applies to official data from the late 1960s and early 1970s, when it is generally believed that only a fraction of all maltreatment cases were reported. The abuse and neglect cases studied here are those in which agencies have intervened and those processed through the social service systems. These cases were dealt with before most states had adopted mandatory child abuse reporting laws and before the Federal Child Abuse Treatment and Prevention Act was passed.

Child abuse researchers have argued that there is bias in the labeling and reporting of child abuse cases and that lower income and minority groups are overrepresented in official reports of child abuse and neglect. The design discussed here does not generally include instances of abuse in higher level socioeconomic families in which such abuse may be more likely to be labeled an accident. On the other hand, national surveys of family violence have found that those with the lowest income are more likely to abuse their children. Even though most poor people do not abuse or neglect their children, there is a greater risk of abuse and neglect among the lowest income groups. Regardless, one cannot generalize from these findings to unreported cases of abuse and neglect, such as those cases handled unofficially by private medical doctors. Similarly, because of the exclusions, these findings are not generalizable to abused and neglected children who were adopted in early childhood.

Table 2. Does violence breed violence? Any arrest for a violent offense as function of type of abuse [x2 (5) = 13.85, p = 0.02].

Other potential biases may be introduced by relying on official records for exposure to abuse or neglect and criminality. Pagelow suggested that the process of intervening and labeling abused and neglected children, disrupting their residence with their family, and stigmatizing the parents (who often receiving little or no assistance to improve), may create a self-fulfilling prophecy that can be difficult to resist or overcome. This implies that it is the official response to abuse, rather than the abuse itself, which begets later criminal behavior. On the basis of this reasoning, strong evidence for the long-term ill effects of childhood victimization would be expected because the children in our abused and neglected sample were processed through the courts and presumably suffered all the negative effects associated with such a process.

On the other hand, because individuals in the control group could have been abused, but not officially reported as abused, the extent of the differences between the abused and neglected group and the controls might be suppressed. Thus, the findings here may represent an underestimate because the differences between the abused and neglected group and the control group may be smaller than would be the case for a “non-abused and non-neglected” control group.

In the case of the dependent variable, reliance on official arrest records for violent criminal behavior also represents an underestimate of potential violent behavior.
These findings do not describe violent behavior, but rather violent criminal behavior. Whether these findings extend to violence in general, to spousal violence, and to violence directed at children is unknown at this time.

Therefore, it is important to locate and conduct a follow-up study with these individuals to determine the extent to which the abused and neglected subjects and controls report having experienced child abuse or neglect and to determine the extent of delinquency, criminality, and violent criminal behavior not disclosed in official records. Eventually, further intergenerational transmission of violence to the offspring of these individuals (currently in their 20s and 30s) should be examined.

Conclusions and Implications
Early childhood victimization has demonstrable long-term consequences for delinquency, adult criminality, and violent criminal behavior. The results reported here provide strong support for the cycle of violence hypothesis. The experience of child abuse and neglect has a substantial impact even on individuals with otherwise little likelihood of engaging in officially recorded criminal behavior. My findings are consistent with previous empirical data; however, there is now baseline data with which to assess the significance and magnitude of the association, and there is an assessment of the consequences of childhood victimization beyond adolescence into adulthood.

In a direct test of the violence breeds violence hypothesis, physical abuse as a child led significantly to later violent criminal behavior, when other relevant demographic variables such as age, sex, and race were held constant. However, being neglected as a child also showed a significant relation to later violent criminal behavior, and type of abuse was not as powerful a predictor of this behavior as demographic characteristics.

These findings indicate that abused and neglected children have significantly greater risk of becoming delinquents, criminals, and violent criminals. These findings do not show however, that every abused or neglected child will become delinquent, criminal, or a violent criminal. The linkage between childhood victimization and later antisocial and violent behavior is far from certain , and the intergenerational transmission of violence is not inevitable. Although early child abuse and neglect place one at increased risk for official recorded delinquency, adult criminality, and violent criminal behavior, a large portion of abused or neglected children do not succumb.

Twenty-six percent of child abuse and neglect victims had juvenile offenses; 74% did not. Eleven percent had an arrest for a violent criminal act, whereas almost 90% did not. These findings mean that prevention programs and intervention strategies aimed at buffering at risk children play a potentially important role in the reduction of further violent criminal behavior.

In addition, alternative manifestations of the consequences of these early abusive experiences should be examined. For example, the effects of early abusive experiences may be manifested in different ways from those already discussed, in particular in withdrawal or self-destructive behavior (50). Thus, one possible explanation for the lack of a more substantial relation between childhood victimization and later delinquency, adult criminality, or violent criminal behavior may lie in more subtle indications of emotional damage such as depression, withdrawal, or more extreme behavior, as in suicide. Given the attrition that typically occurs in longitudinal studies, examination of cases lost because of early death would be particularly revealing. In some ways, studies that focus on violence and criminal behavior may be shortsighted.

Most likely, the long term consequences of child abuse and neglect for females are manifest in more subtle ways. Abused and neglected females may be more prone to suffer depression and perhaps undergo psychiatric hospitalization as a consequence of these early childhood experiences, rather than direct their aggression “outwardly.” Interpretation of results is also complicated because the type of abuse and neglect suffered by females and males differs (more females are sexually abused than males), which in turn may differentially affect the long-term consequences.

Table 3. Predictors of any violent crime: coefficients from linear logistic response model. Likelihood ratio x2 (3) = 10.28, p = 0.016. Number of subjects was 1455.

Abused and neglected children are generally at “high risk” for social problems. It is important to understand the potential protective factors that intervene in the child’s development and to compare the development of those who succumb and those who are “resilient”: and do not. Although one can speculate on why child abuse and neglect should have various outcomes, the substance of what is learned and the intervening linkages that transpire to produce aggression and violent criminal behavior are not well understood. For example, child abuse or neglect may not directly cause delinquency or violent criminal behavior. Rather, these outcomes may be an indirect by-product of these early abusive experiences. There are suggestions in the empirical literature about possible intervening variables. However, more research is needed to look at possible mediating variables that act to buffer or protect abused or neglected children from developmental deficits and later delinquent and adult criminal behavior. Studies must be undertaken to examine the role of what Garmezy has called protective factors–dispositional attributes, environmental conditions, biological predispositions, and positive events–that act to mitigate against early negative experiences.

The scientific issue should not be the “box score” (the magnitude of the association between childhood victimization and later delinquent or criminal behavior), but rather the goal should be further knowledge of the processes involved. Research should be directed at understanding how these early experiences relate to later violent behavior, recognizing the likelihood of multiple pathways, and noting how possible protective factors act to buffer some children from the long-term negative effects of these early childhood experiences.

Can You Help?
Allaying fears about child abuse

Stephanie with six-month-old twin sons and new to North Carolina, felt stranded at home because she didn’t feel she could trust any caregiver (March 1993). Yearning to return to work or school, she needed to know how other moms overcame such fears. Read on for your practical advice.

Parents  Magazine copyright 1993. Reprinted by permission.

Healthy Families America

by Anne Cohn Donnelly, D.P.H.

Child abuse is a public health crisis in the United States. Its prevalence and annual incidence in the population have reached epidemic proportions. Child abuse is also a multifaceted phenomenon: By definition it encompasses physical abuse, sexual abuse, neglect, and emotional maltreatment, each of which has a somewhat different set of underlying causes. These diverse types of abuse are by no means mutually exclusive, nor are they found only in certain population groups. While one type of abuse may predominate in a given population group, incidents involving different types of abuse cut across all groups.

Child abuse hurts. The after effects, which are well documented, are devastating. Abused children suffer a wide range of emotional developmental and physical problems, both acute and chronic. Some children die. These problems of often precipitate such social ills as teenage runaways, adolescent prostitution, drug and alcohol abuse, academic failure and school truancy, and juvenile delinquency.

Child abuse is costly, both in terms of human suffering, and in terms of the financial costs that must be borne by society to remedy the social and psychological maladies emanating from child maltreatment. The case for working to prevent child abuse before it occurs is clear. Prevention spares the hurt and can save lives and money.

A comprehensive approach to combatting the problem would entail a public awareness campaign that educates the community about the magnitude of the problem, explores healthy attitudes toward parenting, and delineates positive methods of parenting. Key preventive and intervention services would be instituted to ensure that all parents under stress have access to crisis and support services; that all victims can obtain the therapeutic assistance necessary to break the cycle of abuse and that all children have the guidance and information they need to learn how to protect themselves from abuse.

In addition, efforts would be directed at eliminating societal obstacles to abuse prevention, including the use of corporal punishment in schools or excessive media violence. Finally, such issues as substance abuse, poverty, and family and community violence would all be addressed. The consensus in the field is clear: No single approach, no single program is sufficient to prevent abuse; all elements of a comprehensive approach ultimately need to be in place. Yet our prevention efforts must begin somewhere.

Targeting New Parents
In 1991, The U.S. Advisory Board on Child Abuse and Neglect declared that a logical place to begin is with new parents, helping them get off to a good start before abusive behaviors are established. With new parents–especially first-time parents–there is ideal opportunity to teach good parenting practices before destructive patterns become entrenched.

New parents are often characterized as “like sponges”–anxious to learn everything they can about their new babies and how to care for them. Most physical abuse and neglect is directed towards the youngest children under age five. By focusing on new parents, child development specialists can target the population group where the incidence of physical abuse and neglect is likely to be the highest.

While there are a variety of approaches to working with new parents, one particularly promising plan for offering assistance is a voluntary program of home visits to new parents and their infants. Home visiting has widespread appeal. It affords the professional or volunteer visitor an opportunity to respond to family members in their own environment, on their own terms, and to learn firsthand the conditions of life for parent and child. The home visiting process tailors the service to the needs and characteristics of the parent and child in their own natural setting.

Home visits present a strategy to reach isolated families, families that typically do not participate in community affairs, families that are too distrustful or too disorganized to make their way to a center-based program or a social worker’s office - in short, families at greatest risk to abuse. From this perspective, home visiting is a constructive force to engage dysfunctional families.

Surveys reveal that the public is most supportive of the home visitor concept. A public opinion poll conducted in 1991 by the National Committee for Prevention of Child Abuse indicates that 86 percent of respondents thought it appropriate to offer home visits and other supportive services to all first time parents.

There is also an expanding evaluative data base– extending over two decades–that documents the efficacy of the home visiting idea. In the early 1970s, the C. Henry Kempe National Center for the Prevention and Treatment of Child Abuse completed a controlled experimental design study focusing on nurse practitioner home visits with a sample of high-risk new parents. The study verified enhanced mother/infant relationships and a decrease in child abuse among the experimental group (Grey et al.).

A Comparison of Service Models
From the mid 1970s through the early 1980s, a number of large scale evaluation studies were conducted on federally funded child abuse service programs (Daro and Cohn). The programs included high risk and abusive clients. The studies compared the relative effectiveness and cost effectiveness of different service interventions. One profile contrasted clients receiving minimal or basic services with those receiving home visiting assistance and other services. The study found that child abuse potential was reduced more dramatically in participants receiving parent aide home visiting services coupled with such services as group therapy. Parents Anonymous support and homemaker services than it was in clients receiving only basic counseling or out-of-home assistance.

In his evaluation of the home visitor model, Dr. David Olds has completed the longest and perhaps most thoroughly designed and carefully controlled studies reflecting a scientific perspective. In Olds’ initial study, 400 first-time mothers were randomly assigned to four groups. Participants of one group were given: (a) intensive pre- and postnatal visits by a nurse practitioner; (b) parental education on fetal and infant development; (c) aid from friends and family in the form of child care and support to the mother; and (d) linkages to health and human services.

At the conclusion of the study, the experimental group showed a 4 percent rate of child abuse in comparison to a 19 percent abuse rate in the control group. Members of the experimental group had fewer accidents, required less use of the emergency room, and demonstrated less need to punish and discipline their children. While Dr. Olds is cautious in generalizing his findings or applying them to populations beyond the young, low-income single mothers served in this project, other research reinforces the practical merits of home visitor services in various settings.

Lutzker and Rice completed a study of the southern Illinois initiative called Project Twelve Ways a multifaceted service program that provided home visits by graduate students to new parents. At the end of the program, abuse had been detected in 2 percent of those receiving the home visits, compared to an abuse level of 11 percent in the control group. The relative effectiveness of the program persisted for at least a year. In a one-year follow-up, abuse was found in 10 percent of the experimental group and in 21 percent of the control group.

Seitz analyzed the impact of intensive home visits to first-time mothers for a period of 20 months after birth. For a decade after the program ended, follow-ups were conducted on 15 of 17 matched sets of families. Seitz documented steady improvements in parenting and family life over this period.

Hawaii has prepared several evaluations of its universal voluntary Healthy Start program, which offers home visits from paraprofessionals to new parents identified at risk of abuse for up to 5 years after their infant’s birth. In addition, this project provides other health and child development services to high-risk parents. Of more than 1,000 high-risk parents served, abuse was reported for only .08 percent.

Merits of Home Visiting
The studies done on home visitor services consistently suggest that this service approach has significant benefits in the prevention of child abuse and related family disorders. However, many questions about home visitor services remain unanswered and need to be addressed.

As with outcome data, our information base about what home visitor programs should look like is growing, although it is still limited. The following guidelines and criteria, however, do appear to be essential for optimum program effectiveness:

Hawaii
An exceptional project patterned after the above criteria and supplying intensive home visitor services to all first-time parents already exists in the state of Hawaii. Since 1985, the state’s Maternal and Child Health Program has pilot-tested, assessed, and implemented a program called “Healthy Start” for more than 50 percent of all new parents. Paraprofessionals–who receive intensive training and ongoing supervision– initiate visits to all new parents in the hospital at the time of the child’s birth. For at risk parents, visits continue during the first critical months–or, if necessary–years of the child’s life.

While visits are not compulsory for these parents, very few of them refuse the assistance offered. Complemented by an impressive array of medical, child development, and social services, “Healthy Start” has virtually eradicated child abuse in the population served.

In partnership with the Ronald McDonald Children’s Charities, the National Committee for Prevention of Child Abuse (NCPCA) this year launched a national initiative entitled, “Healthy Families America,” in order to replicate the Hawaiian model across the country. The NCPCA is working in conjunction with the Hawaii Family Stress Center, the NCPCA chapter network, the state Children’s Trust Funds, the state Maternal and Child Health Departments, and other interested state and national organizations.

The project goal is to lay the groundwork for a nationwide, voluntary, neonatal home visiting system. To date, a network of state level organizations from 36 states that are willing to establish home visitor services has been assembled. Specifically, the NCPCA will compile training materials on how to develop, implement and operate a program like Healthy Start. The materials will outline legislative, funding and operational consideration. The NCPCA will also provide training and technical assistance through conferences, teleseminars and onsite visits to state level organizations that have the interest and capacity to replicate a program like Healthy Start in their states.

The following kinds of outcomes are sought after a 3-year period:
It is expected that more than 25 of the states participating in the “Healthy Families America” endeavor will have initiated for all new parents statewide home visitor-type services designed like Hawaii’s Healthy Start model. It is anticipated that numerous community agencies will have done the same.

At least twice as many at risk new parents will be receiving intensive home visitor services than received these services at the outset of the project.
Child abuse will be reduced by at least 75 percent in the population receiving intensive home visitor services.

An in-depth evaluation of the effort will be conducted to measure the achievement of the projected outcomes.

Is Hawaii’s Healthy Start the best approach to serving new at risk parents? Is it premature to attempt to offer this service to all new parents? Dr. Edward Zigler, a professor of child development at Yale University and one of the original architects of Head Start, has asserted that, “No amount of home visits will take the place of jobs that provide decent incomes, affordable housing, appropriate health care, optional family configurations or integrated neighborhoods where children encounter positive role models.” While Dr. Zigler certainly makes an important point there are compelling reasons to applaud and replicate the Hawaiian experience.

Prevention of child abuse is possible. Now is an ideal time to move forward with one crucial step in a comprehensive approach to prevention–the establishment of a universal system of home visitor programs throughout the country.

Anne Cohn Donnelly has been Executive Director of the National Committee for Prevention of Child Abuse since 1980. She oversees NCPCA’s 50-state network chapters, national center on child abuse prevention research, an extensive publications program, and advocacy efforts. Holding a doctorate in public health, Dr. Cohn has lectured and published widely. She designed the first national evaluation study of child abuse treatment programs, and is currently Secretary of the International Society for Prevention of Child Abuse and Neglect.


References
Cohn, A. and Daro, D. (1988). “Is treatment too late: What ten years of evaluative research tell us.” Child Abuse and Neglect. 11(3), pp. 433-442.

Gray, J., Cutler, C.A., Dean, J.G. and Kem C.H. (1979). “Prediction and prevention of child abuse and neglect.” Journal of Social Issues, (2). pp. 127-139.

Lutzker, J. and Rice, J. (1984). “Project 12-Ways: Measuring outcome of a large in-home service treatment and prevention of child abuse and neglect.” Child Abuse and Neglect. 8, 519-520.

Lutzker, J. and Rice, J. (1987). “Using recidivist data to evaluate Project 12-Ways: an ecobehavioral approach to the treatment and prevention of child abuse and neglect.” Journal of Family Violence 2:4, 283-290.

Olds, D. and Henderson, C., Jr. (1990). “The prevention of maltreatment,” in Cicchetti, D. and Carlson, V. (Eds.). Child Maltreatment.  New York: Cambridge University Press, 722-763.

Olds, D., Chamberlin, R. and Tatlebaum, (1986). “Preventing child abuse and neglect: a randomized trial of nurse home visitation.” Pediatrics. 78, 65-78.

Seitz, V., Rosenbaum, L. and Apfel, N. (1985). “Effects of family support intervention: a ten-year follow-up.” Child Development.  56, 376-391.

Reprinted with permission from Children Today,  Volume 21, No. 2, 1992. Copyright 1992.

The Politics of Child Abuse

by Paul Waller

The recent spate of highly publicized child abuse and sexual molestation cases appears to have had some significant and quite unexpected consequences. Despite superficial media coverage, there are signs of moderately heightened public awareness that something has gone awry in these investigations. Procedures used in the criminal justice system and by mental health professionals are now being more carefully scrutinized.

Jury acquittals and mistrials, like the McMartin preschool case in Los Angeles, have played an important role in gradually expanding public consciousness. Things are much more complex than they originally seemed. Widespread litigation has disclosed various clinical and legal procedures as requiring serious re-evaluation. Their efficacy, objectivity, and legality have been called into question.

Public doubts have been fueled by the high incidence of false or unsubstantiated child abuse charges, including those found in divorce and child custody proceedings. Unprosecuted scandals, such as the Covenant House-Father Bruce Ritter affair, have raised additional concerns about the performance of mental health and social work professionals. Clinical social workers, psychologists and psychiatrists, in their ancillary roles of providing the criminal justice system with expert testimony, analysis and reportage, have been found wanting by child abuse juries, the judiciary, and some fellow professionals.

These child abuse trials and controversies indicate certain political and ideological influences or orientations that have long been at work in the mental health and social work fields. The resultant deterioration in the objectivity of clinical procedures, particularly as revealed in the more sensational child abuse cases, is symptomatic of these tendencies. This condition, affecting all mental health disciplines, is not restricted to their activity on child abuse issues.

The mental health and social work professions, in their ancillary servicing relationship with the legal system, have been active participants and have played an integral role in the operations and procedures of the criminal justice bureaucracies. Organized parental and community groups have also profoundly affected the legal system, in child molestation cases. Clinical objectivity has frequently suffered as a result of all this. It was invariably replaced by procedural methods replete with biased selectivity. These disclosures of the politicization of clinical work are, in turn, indicative of a widespread erosion in ethical standards of professional practice.

Following is a review and analysis of these tendencies in child abuse litigation, as revealed in the social-behavioral science literature. Some of the major cases and issues involved will be closely scrutinized. A clear view of the magnitude of this problem requires a national perspective. Besides the McMartin case in California, there has been similar litigation and controversy in New York City; Westchester County, New York; Essex County, New Jersey; Washington State; Chicago (two cases); Memphis, Tennessee; Oregon; Minneapolis; and Jordan, Minnesota. The list keeps growing.

The issue of veracity and substantiation in the reporting of child abuse is central to this study. Douglas J. Besharov, former director of the U.S. National Center on Child Abuse and Neglect, in an examination of reported abuse in New York State between 1979 and 1983, found that though 23,000 more reports of abuse were filed in 1983 than in 1979, substantiated reports decreased by almost 100. Besharov found that nationally more than half a million families had been investigated on the basis of unsubstantiated reports in each of those years. Besharov’s statistics also have obvious application to daycare centers and preschools. They were cited by Kathleen M. Dillon in her paper “False Sexual Abuse Allegations: Causes and Concerns,” in the November-December 1987 issue of Social Work.

A paper by Douglas and Susan Besharov, “Teaching About Liability,” in the same issue of Social Work, also relates to these issues. They describe the increasing number of lawsuits against social workers in recent years and warn about defamation and unnecessarily intrusive investigations of parents, malicious prosecutions, and successful lawsuits against agencies for not making any “real” inquiry about the truth of allegations. (Mental health professionals, educators and other parent surrogates have also sued successfully.)

In New York State, about 60 percent of child abuse reports are found to be unsubstantiated, according to the State Department of Social Services. National statistics show at least half of all reports of alleged child abuse cases are closed as “unfounded,” for lack of credible evidence or reason to believe that children have been abused.

The issue of constitutional violations (unreasonable searches and seizures) has been raised by a lawsuit in Westchester County, New York. The case involves a subsequently acknowledged false report of child abuse, leading to some of the offenses described by the Besharovs. The investigation guidelines and procedures of the county and state departments of social service are being legally challenged. There has not been a constitutional test case in the New York federal courts or the U.S. Supreme Court. In two similar cases (Chicago, 1986 and Philadelphia, 1989), federal appeals courts have indicated support for the present petitioners’ position that inspection of children for signs of abuse are searches under the Constitution, and that the children and their parents are entitled to some basic protection against violations at the hand of public authorities.

In 1988, two child psychiatrists, Drs. Diane H. Schetky and Arthur H. Green, cited the McMartin case (when the latter was in progress in 1986) to document their assertion that false allegations of child abuse were a significant problem. In their book Child Sexual Abuse they state that this is a “process that may be spread by contagion through exposure to the testimony of other children in preschools and day care settings.”

Regarding false allegations of child sexual abuse in divorce and custody proceedings, Schetky and Green provide much valuable data. They reprint a 1986 study by Green that documents a 36 percent incidence of unfounded allegations, in children alleged to be sexually abused by the noncustodial parent, in child custody and visitation disputes. The authors cite a 1985 study by E. Benedek and Schetky, in which there was a failure to document charges of sexual abuse in 55 percent of children evaluated during custody and visitation disputes. Schetky and Green also cite a 1987 psychiatric paper on child custody and visitation cases, involving preschool children seen at conciliation court. Sexual abuse could be substantiated in less than 20 percent of the cases reviewed. Similar documentation abounds in the professional literature.

The Maine Bar Journal of July, 1990, illustrates how some judges, lawyers, and mental health professionals have been reevaluating legal and clinical procedures in child abuse litigation. In an article, “Social Science and the Law: Evidentiary Problems in Sex Abuse Cases,” the publication reproduces a panel discussion presented at the Maine Judicial Conference on September 25, 1989.

The panel consisted of a judge from the Maine Supreme Court, a prominent local attorney, and psychologist Charles Robinson, Chairman of the Maine Society of Forensic Psychologists. Robinson’s observations got a receptive response from the other panelists. His remarks warrant extensive quotation:

Robinson, among others in the social and behavioral science literature, is concerned about the misuse of child therapy techniques, by unqualified people, in child abuse investigations.

Referring to anatomically explicit dolls, children’s drawings and puppet play, he speaks of the dangers that emerge

Other studies and articles supporting Robinson’s analysis have appeared in the Journal of the Melanie Klein Society, The Journal of the American Academy of Child and Adolescent Psychiatry,  and Social Work.  The McMartin preschool child-abuse case has been analyzed from many different perspectives since January 1990. Various writers have emphasized forensics, the criminal justice system, child psychology, influences of California electoral politics, influences on psychotherapeutic and legal processes by the media and community, parental hysteria and delusions of satanic cult practices, and the possible effects of all of these on interviewing techniques with children.

Mrs. Peggy McMartin Buckey and her son Raymond were acquitted in January 1990, after the first two-and-a-half-year long trial, on all fifty charges of raping, sodomizing or otherwise molesting eleven children at their family-run preschool in a Los Angeles suburb. It was the longest and costliest criminal trial in American history, costing California taxpayers almost $14 million.

Raymond Buckey was subsequently tried again on eight more unresolved counts. (He had previously been jailed for five years, awaiting trial.) His defense attorney charged that the unprecedented second trial was politically motivated, having been sought by Ira Reiner, the Los Angeles County District Attorney. Mr. Reiner was then seeking to run as a Democrat for State Attorney General of California. A successful second prosecution was considered to be most unlikely, given the disposition of the previous jury. This analysis was made despite a wave of organized protests, against the acquittals and demands for retrial of Raymond Buckey, by parents and victims rights groups. In July 1990, a mistrial was declared in the Raymond Buckey case due to a deadlocked jury. The jurors leaned toward acquittal on six of the eight counts against him. The District Attorney announced that he would not try him a third time.

Earlier analysis and commentary on the McMartin case, right after the first trial, revealed that judge and jury found that mental health workers at a Los Angeles child abuse clinic had elicited charges against the school staff by prodding children with leading questions. (Earlier in the investigation, the entire McMartin school staff was charged.) Some lay commentators concluded that these techniques were better suited to psychotherapy than to forensics. They apparently assumed that nobody of any relevant professional consequence would see these interviewing techniques as highly questionable therapeutic procedure. Given the mental health and social work establishment’s lack of guidance on the issue, this response was somewhat understandable.

For an objective evaluation of the clinical methods used, the videotapes seen by the McMartin jurors are an invaluable source. They reportedly were most influential with the jury, ostensibly in ways not intended by the prosecution and its professional witnesses.

In one tape an eight-year-old boy is questioned by a clinical social worker about a game called “Naked Movie Star,” alleged to have been played by the staff with children at the school.

Similar interviewing techniques with other children, elicited testimony that Raymond Buckey stuck silverware in their rectums, took them on trips to cemeteries, killed a horse with a baseball bat in their presence, and sodomized them. One of the children’s parents, who publicly supported all these charges, had also accused an “AWOL Marine” with sodomizing all her children, and the family dog as well. She was subsequently found to be severely mentally disturbed and alcoholic.

In other child-abuse cases, preschool children informed investigators that they had been taken by a teacher to graveyards and forced to witness animal sacrifices. Others told of how they were forced to eat a boiled baby. A preschool teacher was acquitted of traumatizing children by forcing them to watch while she put a bomb in a hamster and exploded it.

On another level, this case has brought to light examples of clinical practice that, unlike the previous illustrations, have not been scrutinized. In all the discussions of child abuse immediately following the first McMartin trial, the crucial role of fantasies in young children was left practically unrecognized. This deficiency is pronounced in much clinical work with allegedly molested children. It has resulted in methods that are unsophisticated at best, and professionally compromised in their more extreme manifestations.

A substantial body of knowledge exists on the relevance of fantasy in normal and pathological childhood development. It relates largely to children’s conflicts, sexual and otherwise, within the family. Clinical (and parental) experience often reveals how intensely children struggle with sexual and other conflicts within the home. Very often this interpersonal battle is shifted, defensively and intrapsychically, onto the realm of fantasy. At other times, this psychological and social drama is acted out in reality, that is, child abuse is instigated by an older and/or more powerful person in the family.

Dr. Leonard Shengold, a clinical professor of psychiatry at New York University School of Medicine, has written most compellingly on this subject. His recent book, Soul Murder, is a scholarly and literate work, displaying a cultivated and politically disinterested mind. Dr. Shengold emphasizes how difficult it is to separate fact from fantasy in children’s reports of child abuse. He urges exploration of both intrapsychic and environmental factors for assessments of children’s current and adults’ retrospective allegation of child exploitation.

In the immediate aftermath of McMartin, commentaries from social workers, psychologists, and representatives of children’s rights groups clearly indicated a twofold environmental bias. Together with almost total avoidance of fantasies, silence also prevailed about children’s frequent blurring of distinctions between fantasies and facts. This may be attributable to a widespread dismissal of Freudian thought, with resultant rejection of the unconscious, of childhood sexuality, the Oedipus complex, and the like. Leaving such theoretical disputes aside, the fact remains that these environment oriented investigators severely limited their focus to the McMartin school staff.

In view of the social work profession’s particular emphasis on family dynamics, an objective psycho-social assessment would have required the inclusion of the family environment as well. Apparently, in the McMartin case only community institutions were to be evaluated. This, despite the fact that most cases of child abuse involve the immediate or extended family, rather than preschools and daycare centers. One could conjecture that explorations into family dynamics might have yielded material of a psychoanalytic cast. Professional investigators would have risked provoking the organized parents and community groups into denouncing them for “blaming the victim.” The scenario that actually emerged was clearly less of social-behavioral science at work than the intrusion of political and ideological tendentiousness.

Dr. Shengold frequently cites the ubiquitousness of psychotic and/or psychopathic (sociopathic) parents when dealing with child abuse and neglect cases. One reads every day of the attendant role of alcohol and drug abusing parents. The original parental complainant in McMartin was a psychotic, alcoholic, apparently delusional mother, now deceased. More probing evaluations of other McMartin case parents and families would have been helpful. (Some disquieting revelations have been supplied by reports detailing parents’ paranoid delusions of satanic cult rituals and orgies in the McMartin school, as well as in other preschool controversies.)

The inextricable link between children’s fantasies and their families was peripherally discussed by one of the McMartin case social workers, Ms. Kee MacFarlane, whose child interviewing techniques have been previously described, defended her coercive methods with children, explaining that abused children often fear to talk about being molested, and that they have antasies about dying, or their parents dying. She did not specify whether such death fantasies were elicited in this case. If they were, she gave no indication of any follow-up exploration to determine why these children should be so concerned about their parents in their fantasies.

There is no intention here to dismiss all this disingenuousness as just a political and ideological symptom. Such unfortunate practice is also the consequence of many inadequately schooled and trained people, who have increasingly gained entrance to the social work and mental health fields. (Direct clinical practitioners, supervisory, and administrative personnel are all included in this assessment.) For the more professionally undisciplined among them, the constricted approach to child abuse that has been described is very comforting. It offers concrete, uncomplicated answers that are conducive to immediate, short-term clinical and legal intervention. It is usually much less expensive and less rigorous than longer-range, in-depth explorations and therapy. (Considerations of patients’ limited insurance coverage also play a significant role.)

No matter what the state of awareness or rationalization that affects this process, the frequent outcome has been loss of, or diminished, professional objectivity. This is often accomplished by the intrusion of covert political influences, in all their ramifications, in tandem with the tendencies just mentioned. Ideology can also be quite comforting.

This analysis was reinforced in the course of the preparation of this essay. In amassing the supporting documentation, an impressive amount of confirming research by social and behavioral scientists, published over the years was uncovered. The body of their scholarship runs counter to the strong feminist orientation regnant in their disciplines and in many journals in which their work has appeared. Many other publications and articles, cited by the writers, support their theses. In the face of this discrepancy, the researcher is confronted with the hard fact that there has been no sustained professional debate on this conflicting material.

One hypothesis suggests that the absence of a debate indicates the lack of a continuous, intellectually integrated acknowledgment that some closely held ideas have been seriously challenged. This in turn is symptomatic of a pronounced group psychological phenomenon, a kind of mass denial. The problem of inadequate professional schooling and discipline must also account for much of this unresponsiveness.

Two issues of Social Work, November-December, 1987 and March-April, 1988, provide an exception to the general rule. The former contains an article, “The Truth about Domestic Violence: A Falsely Framed Issue,” by R.L. McNeely and Gloria Robinson-Simpson. The latter features a spirited exchange, a rebuttal by Daniel G. Saunders, and a counter rebuttal.

This debate affords a sense of the prevailing ambience and a glimpse into a rare, open clash on substantive issues in the pages of Social Work, the journal of the National Association of Social Workers.

McNeely and Robinson-Simpson cite four sociological studies by Suzanne K. Steinmetz, who found (in 1977 and 1980) that “women are more likely than men to physically abuse children, and that throughout history women have been the primary perpetrators of infanticide.” In addition, she found that mothers tended to abuse children 62 percent more often than fathers, and that male children were more than twice as likely to suffer physical injury. Time-at-risk factors explaining women’s (mothers’) greater involvement in child abuse are cited by McNeely and Robinson- Simpson as are unemployment, social class and environmental factors. They reject what they see as inordinate emphases on stress associated with single-parent homes in the middle class.

Women involved in high-stress, dual-career families are less likely than traditional wives to abuse their children, presumably because of children’s minimized exposure to risk during maternal working hours, but also because women in these families have more financial resources with which to deal with their stress. McNeely and Robinson-Simpson note that Saunders, in his rebuttal to their original article, ignores their citation of Steinmetz’s findings on women and infanticide, and the more frequent physical victimization of male children. Such disregard of research is also characteristic of professional agencies and publications that have asserted overwhelmingly more frequent abuse of female children by adult males. Saunders, they observe, notes that “time-at-risk largely explains women’s [and mothers’] greater involvement in child abuse.” They add that “such a finding fits with our view that gender itself does not predict abuse. Neither males nor females have a monopoly on violence...”

The authors stress social class factors. Regarding the most serious forms of child abuse, infanticide and childkilling, they cite some significant 1987 findings by L. Mitchell of the National Center on Child Abuse Prevention Research, National Committee for the Prevention of Child Abuse: “Active victims are typically males under two years of age, living in low socioeconomic status families with multiple young siblings and who die at the hands of a single mother.” Reporting further on this study, they also inform us:

They conclude that despite the claim and repeated emphasis (by Saunders and the professions under review) that men perpetrate more serious violence than women against children, the “evidence is clear that women are involved substantially in child abuse, including the most serious form. . .child killings.” The authors quote Mitchell again on the frequent attributions of negligence to mothers in child abuse cases involving death:

The authors reject what they see as the implication by Saunders that they sought to accuse and blame women, stating: “Our objective was, and is, to demonstrate that violence is a human, rather than a women’s issue.” Another example of biased professional practice in the mental health and social work fields has been the virtual silence about male (homosexual) pedophilia and pederasty.

Some dictionary definitions and differentiations are of primary importance at this point. This will help establish conceptual clarity that is often lacking in discussions of sexual perversion. Webster’s Ninth New Collegiate Dictionary defines pedophilia as a sexual perversion in which children are the preferred sexual object. A pederast is described more specifically as a male homosexual, that is, a lover of boys, one who practices anal intercourse, especially with boys.

There has been considerable equivocation throughout the mental health professions on the subject of male (homosexual); pedophilia and pederasty. After the initial massive denial from establishment figures, the Covenant House-Father Bruce Ritter scandal compelled serious attention. The sheer accumulation of facts and witnesses by the media required this.

What followed was the unearthing of increasingly damaging material about the social work priest with sexual inclinations toward the adolescent males in his New York City shelter for runaway youths. Father Ritter’s financial affairs were also viewed as rather inappropriate. Mental health professionals and social workers at Covenant House (including the Board of Directors) were embarrassed; some resigned. Father Ritter has since resigned as president and has been replaced.

In July 1990, a Covenant House internal investigation confirmed that Father Ritter had been involved in sexual misconduct with teenage boys at his shelter for over twenty years. It also revealed that senior staff members were aware of this, and that Father Ritter’s superiors at the Franciscan order received reports from them on these affairs.
The internal report added that Father Ritter’s proclivities had been such an open secret in New York social work agencies since the early 1970s, that some of them decided against referring male clients to Covenant House.

All this did not prevent an administrator from one of the oldest and most prestigious social work agencies in New York City from being on the Covenant House Board of Directors. The report severely criticized the Board for its inaction, for not exercising greater oversight over Father Ritter’s affairs, and for excessive willingness to defer to him during his tenure as president of Covenant House.

This study will not deal with the politics influencing a nationwide and church-sponsored charity, with a unique social service program in very great demand, funded by an annual budget of $88 million, almost all from private donations. (Covenant House has expanded from its original New York City base to shelters throughout the United States.) The focus will be on another aspect of the political deterioration of mental health and social services in the country.

To a significant extent, a cover was provided for Father Ritter and his accomplices, by widespread liberal tolerance of and rationalization for homosexual pedophilia and pederasty. Homophobia has incessantly and unfavorably been contrasted with tolerance of alternative lifestyles. Such benign attitudes hold sway in the mental health and social work fields. Interestingly, this deference is not extended to such phenomena as heterosexual pedophilia, or other heterosexual manifestations of the exploitation of children. (Clinical psychologists Diana Sullivan Everstine and Louis Everstine find that adult male sexual molesters of young girls are basically latent homosexuals.)

A double standard of this nature is very much de rigeur with many radical and extreme left-liberal intellectuals. Their influence in the professions under study has long been noted by various observers. Many of the latter are concerned with what they view as a politics of radical nihilism.

They note that this intellectual and ideological tendency is manifested in radical feminism, as well as in homosexual and lesbian narcissistic self-celebration. Sexual and social double standards prevail in this mode of thought. They are vividly evident in contrasting responses to pornography. Heterosexual pornography is vigorously opposed, as it stimulates passions for heterosexual consummation, considered degrading to women. Homosexual and lesbian sex are approved, as is homosexual pornography, including child pornography–for example, the case of Robert Mapplethorpe.

In line with these trends, ideologized rationalizations for child sexual exploitation often take this form: Some male children seem willing to participate in the caressing and fondling that comprise male (homosexual) pedophilia. Some adults recall that as young boys they accepted, even welcomed sex with adult males. Many gay men acknowledge that they have initiated such encounters. They argue that these types of relationships offer young boys the only real possibility for healthy acculturation into homosexuality.

It is precisely these attitudes, so pronounced and accepted in the professional culture under review, that allowed a Covenant House-Father Bruce Ritter case to develop and operate for twenty years. The prevalent culture of the larger, mainstream society remained unaccepting of such values and behavior. Upon complete disclosure, limits were set, punishment was meted out, and public images were severely damaged.

Equally important, the aforementioned benign presentation of male (homosexual) pedophilia is not supported by any clinical or research evidence. Outsiders usually do not learn of specifics about caressing and fondling of young boys by gay pedophiles. The subject of homosexual fellatio with children is rarely discussed. Pederasts and their anal dispositions are also not discussed, despite the AIDS epidemic. (It is acceptable for Robert Mapplethorpe to present photographs of nude children in suggestive poses, along with adult males engaged in sado-masochistic practices, Such a display has been adopted as a civil liberties cause celebre.)

Leonard Shengold offers a considerably different perspective on the physical and psychic traumas inflicted on children by all of this pathological behavior. He writes on the psycho-social implications:

It should be emphasized that these dynamics also operate beyond the immediate family and extended family milieu. They are evident in cases of homosexual pedophilia and heterosexual child molestation, as practiced by non-relatives. In both of these circumstances, usually unconscious parental and family surrogates are involved. (The Everstines also emphasize the strong psychopathic traits in all these variants of child molestation.)

Political and ideological agendas, with their attendant monomanias, have undermined the credibility of the mental health and social work professions, particularly in child abuse controversies. The children have not been well served, as this presentation sadly makes clear. The politics of child abuse is an issue that has been kept under wraps by the interested parties far too long. Its neglect has been pernicious. A public airing should be very therapeutic.

Readings Suggested By The Author:

Everstine, Diana Sullivan, and Louis Everstine. Sexual Trauma In Children
and Adolescents. Dynamics and Treatment.  New York: Brunner/Ma-
zel, 1989.

Gardner Richard A. Sex Abuse Hysteria, Salem Witch Trials Revisited.
Cresskill, N.J.: Creative Therapeutics, 1991.

McNeely, R.L., and Gloria Robinson-Simpson. “The Truth About Domestic
Violence: A Falsely Framed Issue.” Social Work,  32, November-
December 1987.

Saunders, Daniel G. “Other ‘Truths’ About Domestic-Violence: A Reply to
McNeely and Robinson-Simpson.” Social Work, 33, March-April,
1988. See also the co-authors rebuttal in this issue.

Schetky, Diane H., and Arthur H. Green, et al. Child Sexual Abuse. A
Handbook for Health Care and Legal Professionals.  New York:
Brunner/Mazel, 1988.

Shengold, Leonard. Soul Murder: The Effects of Childhood Abuse and
Deprivation.  New Haven, CT: Yale University Press, 1989.


From Society,  September/October 1991. Copyright 1991 Transaction Publishers. Included by permission of the publisher.

Improving Child Protective Services:
How to Expand and Implement the Consensus

by Douglas J. Besharov

Over the past twenty years, enormous progress has been made in protecting children from abuse and neglect. But major gaps in services remain. Recently, a consensus has developed among many child protective specialists about some basic reforms that need to be made. This report describes one way through which the broader child welfare and human services community can be helped to understand the goals of this consensus and how it can be mobilized to actively support the needed reforms.

Progress and Problems
Thanks to years of advocacy by concerned individuals across the country, there now exists a basic infrastructure of laws and agencies to protect children. All fifty states now have child abuse reporting laws. Specialized “child protective agencies” have been established to receive reports (usually via highly publicized hotlines) and then to investigate them. Health, social service, education and law enforcement agencies and individual professionals increasingly see themselves as jointly, not separately, responsible for protecting children and, wherever possible, preserving and strengthening their families. New resources have been identified, useful family support systems developed, and some simplistic solutions discarded. Statistics, definitions, and procedures are being standardized and upgraded. More concretely, the quality of treatment services has been greatly improved.

The result has been an enormous increase in reported cases.1 In 1987, almost 2.2 million children were reported to the authorities as suspected victims of child abuse and neglect. This is more than fourteen times the estimated 150,000 children reported in 1963.

Increased reporting and specialized child protective agencies have saved many thousands of children from death and serious injury. The best estimate is that over the past twenty years, child abuse deaths fell from over 3,000 a year (and perhaps as many as 5,000) to about 1,500 a year.

Still, in almost every community, there are serious inadequacies breakdowns and gaps in the child protective process. Reports are increasing faster than many agencies can handle them, but detection and reporting remain haphazard and incomplete. Professionals–physicians, nurses, teachers, social workers, and police–fail to report many of the maltreated children whom they see, including those with observable injuries severe enough to require hospitalization.

Although all statistics concerning what happens in the privacy of the home must be approached with great care, the scale of non-reporting can be appreciated with the help of the National Study of the Incidence and Severity of Child Abuse and Neglect (conducted for the federal government by Westat, Inc.). It estimated that, in 1986, selected professionals saw about 300,000 physically abused children, and 700,000 who were neglected or otherwise maltreated.2 According to the study, the surveyed professionals reported only about half of these children. (The study methodology did not allow Westat to estimate the number of children seen by nonprofessionals, let alone estimate their reporting rate.)

The professional did not report almost 40 percent of the sexually abused children whom they saw. They did not report nearly 30 percent of fatal or serious physical abuse cases (defined as life-threatening or requiring professional treatment to prevent long-term impairment) and almost 50 percent of moderate physical abuse cases (defined by bruises, depression, emotional distress or other symptoms lasting more than 48 hours). The situation was even worse in neglect cases: about 70 percent of fatal or serious physical neglect cases were not reported and about three quarters of the moderate physical neglect cases were not reported.3

This means that, in 1986, at least 50,000 sexually abused children went unreported, at least 60,000 children with observable physical injuries severe enough to require hospitalization were not reported, and almost at least 184,000 children with moderate physical injuries were also not reported.

Many thousands of other children suffer serious injuries after their plight becomes known to the authorities. Studies in a number of communities indicate that 25 to 45 percent of the children who die under circumstances suggestive of child maltreatment have previously been reported to child protective agencies.4 There is some reason to believe that, after many years of decline, child fatalities attributable to child maltreatment have begun to rise.

At the same time, the nation’s child protective agencies must investigate a large number of reports that are not substantiated. Nationwide, only about 45 percent of all reports are “substantiated” (or a similar term) after investigation. This is in sharp contrast to 1975, when about 65 percent of all reports were “substantiated.” Each year over 500,000 families are investigated for reports that are not substantiated.

In 1988, responding to these problems, three major reports were published by leading child protective and child welfare organizations. Each document proposes substantial changes in reporting, intake and screening, investigations, and case determination practices. Despite their varied origins, remarkable agreement exists among these three documents about what needs to be done to improve services to abused children and their families. In essence, each recommends that a much greater effort be made to ensure that only appropriate cases are accepted for investigation and that suitable services are provided to families needing them.

Expanding the Consensus
Issuing a report and achieving the recommended changes, however, are two very different things, as we all know. The three reports were developed by groups largely composed of child protective and child welfare specialists. For their recommendations to be implemented, much broader understanding and support will be necessary.
(Even among specialists, many of the recommendations in the three reports remain controversial.)

This report describes one way in which this consensus can be expanded and implemented. It is based on the experience of a national meeting sponsored by the American Bar Association’s National Center on Children and the Law, in association with the American Enterprise Institute, the American Public Welfare Association, and the Child Welfare League of America. (The meeting was funded by the National Center on Child Abuse and Neglect.) The process has five steps.

Step 1: Involving Others: On December 15th and 16th, 1988, thirty-eight individuals from almost as many organizations met in Washington, D.C. to consider the three documents and to identify priority steps in a strategy to implement their recommendations. The participants were from a much broader array of disciplines, agencies, and advocacy groups than those who had drafted the original documents.

To open the conference, each of the three reform documents was summarized by a designated presenter. Then, the various themes and recommendations common to each of the documents were discussed by the whole group. This initial discussion provided an opportunity for participants to voice their concerns about and disagree with some of the recommendations. In this orientation process, the group as a whole worked through the most controversial issues in the documents. Although some participants would have preferred to rewrite certain recommendations in the documents (such as the need to screen reports), they were reminded that, for the purpose of the process, they had to work within the context of the documents.

There were times when it seemed as if the group would fracture in disagreement and not be able to come together again, but the participants overriding desire to improve programs for these vulnerable children brought the discussion back to how service needs could be identified and met. The group decided that it could proceed with planning how best to seek the needed reforms even though not all participants agreed with each and every recommendation in the documents. The spirit that developed was: “Rather than getting mired down in what we disagree about, let’s see what we can agree to do to improve services.”

We think that this open, no-holds barred discussion was essential for the later success of the process. Indeed, it served to focus attention on the severe shortage of long-term, family oriented treatment programs–and what to do about it.

Step 2: Identifying Needs: To allow issues to be discussed in greater detail and to encourage a more informal and collaborative atmosphere, the participants were divided into small workgroups on (1) “reporting”; (2) “intake and screening”; (3) “investigation”; and (4) “case determination.” These are, of course, somewhat overlapping categories, so that group discussions tended to cross categories. In fact, this report adds new sections on “recruitment, staffing, and training” and on “child and family services” to cover those issues that emerged across the groups. Nevertheless, the division of the entire conference into these smaller groups and the assignment of these particular topics to each group helped move the discussion forward.

Michael Weber, President of the National Association of Public Child Welfare Administrators (an affiliate of the APWA) and Director of the Hennepin County Department of Community Services, gave the charge to the conference. Each group was asked to identify up to ten priorities or actions in its specific topic area. They were also encouraged to identify the organizations that might perform these actions. (Group leaders were asked to keep the discussion on the assigned topic but to allow the group some flexibility in working things out and in identifying needs.)

Step 3: Establishing Priorities: The workgroups met for about two and a half hours after which the full conference reconvened. Each workgroup leader presented–and explained–his or her group’s recommendations. The recommendations were also written on flip charts and the sheets were later posted around the room. An unstructured discussion helped the other participants to understand their colleagues’ proposals.
Each participant was then asked to select the ten most important recommendations. Each participant was given ten round stickers and told to put one or more next to the recommendations that he or she deemed most important.

Step 4: Planning Strategy: The next step was to determine how best to pursue the priorities that had been established. Participants were asked to suggest how their particular organization, either alone or in cooperation with others, could help. Mike Weber led the discussion, working down from the recommendation that received the most votes.

Step 5: Encouraging Implementation: We did not have funds for a second meeting, so that follow-up was limited. There was a general feeling that this hampered efforts to work together toward common goals and that more formal monitoring of the plans described at the meeting would have encouraged implementation.

Lessons Learned
We believe that the conference successfully helped to identify important objectives for reform in a way that engaged and invested the participants in the outcome. We believe that our experience can serve as a model for similar efforts at the local, state, and regional level, but we did learn some practical lessons about the process that should be shared with those contemplating a similar conference.

Choose the workgroup leaders carefully and make sure that they understand their crucial role in the process. Group leaders need to be both firm and flexible–firm enough to keep the group on its task and flexible enough to recognize when the group needs to work through an unexpected issue. Ours were, and that made all the difference.

Carefully review the workgroup recommendations before they are presented to the group as a whole, combining those that are essentially the same. We had a number of overlapping recommendations, and there was a clear tendency for participants to split their votes among similar priorities. With respect to participants, it was decided that (1) they should come from organizations whose efforts could be relevant to improving child protective and child welfare services, and (2) although it is not necessary that they have authority to commit their agency, at the meeting, to a specific project or activity, they should have a reasonable voice in setting their organization’s priorities.

During the session on planning strategy, be alert to the possibility that some priority areas–even though they receive a large number of votes–will not have action items suggested for them. It was only after the meeting that we realized that there were no implementation ideas for two priority areas.
Finally, keep your expectations for the process reasonable. Realize that many of your pet ideas will not be recommended and be prepared for many action items to go unimplemented. If even one in ten comes to pass, the process will have been worthwhile.

Douglas J. Besharov is a Resident Scholar at the American Enterprise Institute for Public Policy Research in Washington, D.C. He was the first director of the National Center on Child Abuse and Neglect, Administration for Children, Youth and Families.

Footnotes
1Much of the following material concerning reported cases is derived from Child Abuse and Neglect Reporting and Investigation: Policy Guidelines For Decision Making  (ABA/APWA/AEI, 1988), reprinted in D. Besharov, Protecting Children From Abuse and Neglect (Charles C. Thomas, 1988), Chap. 13.

²A. Sedlak, Study of National Incidence and Prevalence of Child Abuse and Neglect  (Westat, Inc., Bethesda, Md., December 1987).

³Supplementary Analyses of Data on the National Incidence of Child Abuse and Neglect,  supra n. 4, at pp. 3-19.

⁴J. Alfaro, “What Can We Learn From Child Abuse Fatalities: A Synthesis of Nine Studies,” found in: D. Besharov, Protecting Children From Abuse and Neglect  (Charles C. Thomas, 1988), Chap. 9.


First appeared in Children Today Vol. 21, No. 2, 1992.
Reprinted with permission.


The Secretary’s Initiative on Child Abuse and Neglect

by Lynne Heneson

In the summer of 1990, the Secretary of Health and Human Services, Louis W. Sullivan, M.D., created an initiative to call attention to the need for broad nationwide participation in preventing and treating child abuse and neglect. The cornerstones of the initiative were the encouragement of personal responsibility and coordinated governmental and community involvement.

In 1990, States received and referred for investigation an estimated 1.7 million reports on approximately 2.7 million children who were the alleged subjects of child abuse and neglect.1 The Secretary realized that changing this grim picture would require American citizens to build coalitions of concern, cooperative alliances that include government as a partner, but would also involve community associations, the corporate sector, the educational establishment, religious organization, parent groups–everyone who has a stake in the future of children. Collaboration between government and the people through partnerships would be key to achieving a decline in child maltreatment.

With this philosophical underpinning, the Initiative took form around three key components: 1) increasing public awareness of the problem of child maltreatment; 2) promoting intra- and inter-agency coordination of child abuse and neglect activities; and 3) encouraging all sectors of society to cooperate in combatting child maltreatment. A strategy team was formed, consisting of representatives of the Administration for Children and Families (ACF), the Offices of the Assistant Secretaries for Planning and Evaluation (OASPE) and Public Affairs (OASPA), the Public Health Service (PHS) and the Deputy Under-secretary for Intergovernmental Affairs (DUSIGA). This team worked intensively for nearly two years to carry out the Secretary’s charge. This paper will document the realization of this initiative.

1. Increasing public awareness of the problem of child maltreatment
While the public has become increasingly aware that child maltreatment is an unfortunate feature of American life today, people still need to know, in concrete terms, what to do to combat the problem. Therefore, the focus of public awareness activities in the initiative was to present positive messages regarding how each individual and community can make a difference in stemming the tide of child maltreatment.

The theme of the public awareness campaign was “Show You Care”– a reference to Secretary Sullivan’s culture of character, a place where individual and community responsibility for self and others is the norm, an atmosphere in which families and children can flourish. Materials were timed to appear during April, 1992 Child Abuse and Neglect Prevention Month. The theme was carried out in a variety of ways.

The highly successful centerpieces of the public awareness campaign were two packets developed for use by the media and by community groups. These kits, professionally designed with bold and eye-catching graphics, contained a selection of materials crafted to provide useful information for raising awareness of the problem of child maltreatment and taking steps to defeat it. Among the contents of each kit was a lively poster titled “Show You Care Everywhere!” which is meant to portray the central idea of the campaign. The poster depicts iconic vignettes of American urban and rural life–the police officer directing traffic; the farmer by his field; the firefighter in a truck; the kid shooting a basket; the family barbecuing burgers, walking down a street shopping, eating at a sidewalk cafe, leaving church, entering a hospital. These scenes are emblematic of the notion that every sector of society has a role to play in preventing child maltreatment, that no matter what one’s walk of life or style of living, everyone can contribute to the solution by being a responsible participant in community and family life.

The packets also contained a letter from Secretary Sullivan, a fact sheet on child abuse and neglect, a detachable Rolodex card with telephone numbers of national organizations and hotlines, press releases useful for media outlets and community organizations, ideas for activities communities can undertake to fight child abuse, and a booklet describing community prevention programs across the nation. Some seventeen thousand of these kits were distributed through mailing lists and by request. The public and professional response to the “Show You Care” campaign was highly favorable.

2. Promoting intra-and-inter-agency coordination of child abuse and neglect activities
The strategy team was sensitive to the variety of child abuse and neglect activities underway in different organizational locations born within and outside of the Department of Health and Human Services. Thus, a key component of the initiative was to strive to bring about a degree of coordination and reduce duplication of effort among the many agencies whose mission includes attention to the problem of child maltreatment. A two-pronged strategy was developed. First, the agencies in the Department of Health and Human Services involved in child abuse activities–ACF, ASPE, PHS, OASPA, including the Centers for Disease Control (CDC), the Inspector General (IG), the Health Care Financing Administration (HCFA)–developed a comprehensive plan designed to identify Departmental objectives for the Initiative. Planned and ongoing child maltreatment activities which would carry out these objectives were also identified, along with the responsible agency. Quarterly meetings were held to monitor progress against the objectives. As a result, not only was a coordinated Departmental approach pursued, but the participants also found many new ways to work together in order to coordinate research, enhance data collection efforts, improve information, utilization and dissemination, and close gaps in service delivery.

The team also was cognizant of the need to reach out to other Federal agencies. While legislatively mandated vehicle is already in place to coordinate Federal Child abuse activities (the Interagency Task Force on Child Abuse and Neglect), the team decided to use the opportunity presented by the initiative to reinforce each Department’s commitment to coordination at the highest level. Therefore, in December, 1992, the Secretaries of eight Cabinet agencies (the Departments of Education, Justice, Housing and Urban Development, Labor, Agriculture, Defense, Interior and HHS) signed a Memorandum of Agreement which reaffirmed his or her agency’s role in the fight against child maltreatment, and made commitments to improve the coordination of research and demonstration, increase the dissemination of knowledge about the prevention of child abuse and neglect and strengthen the agency’s participation in the Interagency Task Force. The process of developing the Memorandum of Understanding led each agency to perform an inventory of its current child maltreatment activities and to think creatively about how these activities could be strengthened by working with counterpart agencies.

As a further reinforcement to the Memorandum of Understanding, each Department prepared specific objectives that they will pursue during the coming year. The Inter-agency Task Force meetings are now being used as the logical setting for monitoring progress on these objectives, thus incorporating this aspect of the Initiative into an existing body.

3. Encouraging all sectors of society to cooperate in combatting child maltreatment
The final aspect of the initiative was perhaps the most challenging: to encourage people from many disciplines and walks of life to join together in the fight against child abuse. The goal was to convince representatives of organizations from all sectors of society to use their influence on behalf of children at risk of abuse and to initiate prevention-oriented activities among their membership.

The ultimate hope was to achieve an increased degree of individual and collective responsibility-taking for the fight against child maltreatment.

In order to do this, the strategy team organized a conference in Washington, D.C. in December, 1991. Some 100 national leaders from business, social services, professional associations, criminal justice, education, the public sector and religion were invited for a one-day meeting called, “We Can Make A Difference: Strategies for Combatting Child Maltreatment.” Attendance was impressive due not only to the relevance of the issue, but also to the persistence of the strategy team which made follow-up calls to each invited guest to reinforce the importance of their participation.

The conference was designed to provide both information and inspiration. Secretary Sullivan and other HHS officials addressed the group, providing the Federal position and the challenge; prominent experts in the field gave an overview of what can be done when interested groups work together to combat child maltreatment; and Marilyn van Derbur Atler, mentioned above as an outspoken advocate on behalf of people who have been abused, told her personal story in words that touched the audience deeply. With that preparation, the participants divided into sector-specific groups to develop action plans that they would implement within their organizations. A sampling of the ideas that emerged follows:

Religious leaders:

Business:

Law and Criminal Justice:

Education:

Professional Associations

Youth Serving Organizations:

Building on the energy created by the national meeting, the strategy team decided to guide the HHS Regional Offices in their sponsorship of similar conferences in each of the 10 Regional Office cities. The Regional conferences were an integral part of this facet of the initiative, since they were to involve the State and locally-based representatives who would actually implement plans to address the problem of child maltreatment.

Assisting in the planning of the Regional office meetings was an interesting exercise for the strategy team. In general, the role of the central office was to provide guidance and technical assistance. To do so, the team developed a “turnkey” package sent to every Region, containing information gleaned from their experience planning and implementing the national meeting. This included material on the objectives on which the meeting was based, “how-to” information on planning the meeting, issuing invitations, enlisting speakers, recruiting resource people, making logistical arrangements, developing handouts, and evaluating the meeting. Frequent conference calls were held with the Regions to help them with their planning and development of agendas, securing of speakers, etc. A high-level Central Office official spoke at each of the Regional conferences. The letters of invitation were signed by Secretary Sullivan and mailed from Washington, D.C. in order to show the Secretary’s personal support of the effort. Since nine out of ten of the Regional meetings took place in April, 1992, Child Abuse and Neglect Prevention Month, they were able to use the “Show You Care” packages provided by Central Office. Finally, each Regional Director was given a small amount of seed money for the planning and implementation of the conference.

Predictably, each Regional meeting diverged slightly from the pattern recommended by the strategy team, as was appropriate to the local environment. While each agenda was unique, they were nevertheless in keeping with the overall objectives of the initiative. The Regional offices were especially successful in generating enthusiasm among participants and obtaining commitments to pursue activities at home.

A serendipitous effect of the Regional-Central Office collaboration was the promotion of an intra-agency esprit de corps. The strategy team’s primary contact for planning the Regional meetings was the HHS Regional Director. In turn, the Regional Director worked with staff from various HHS OPDIVS to implement the meeting. In the process, then, staff who had never collaborated before had the opportunity to work together on what was seen as an exciting and interesting project. This experience was especially significant for staff of the recently formed ACF, who, in many cases, had not had the chance to interact with their new colleagues in a jointly-planned project. Thus, the initiative provided bonding and learning opportunities for ACF and other HHS staff.

The strategy team continues to assist the Regional Offices in carrying out follow-up activities from the Regional meetings. Such activities include planning similar meetings in the State, disseminating information and doing hands-on collaboration with various sector-specific groups.

The experience of planning the Secretary’s Initiative on Child Abuse and Neglect provides lessons for future endeavors. The members of the strategy team agreed that concentrated attention to every detail of the initiative was a key ingredient of its success. The team met twice weekly during the most intense months of planning and implementation, and each meeting concluded with specific assignments for members of the team. Cooperation among the operating divisions, without regard to issues of organizational territoriality, set an example of teamwork in the service of a larger goal. In this way, the strategy team was able to move the initiative forward, maintain high visibility and ensure its ultimate success.

As a result of the initiative, not only has the Department of Health and Human Services come together to demonstrate its concern and commitment, but also as a direct by-product, other Cabinet level agencies, and, indeed, the citizens of America’s communities, have become engaged in this effort. The final goal, an improvement in the lives of vulnerable children and families, is therefore, nearer our grasp.

For further information and background materials on the Secretary's Initiative on Child Abuse and Neglect, contact Donna N. Givens, Deputy Assistant Secretary for Children and Families, Administration for Children and Families.

Lynne Heneson is a Special Assistant in the National Center on Child Abuse and Neglect in the Administration for Children, Youth and Families. She was closely involved in the planning and implementation of the Secretary's Initiative on Child Abuse and Neglect.

References
¹National Child Abuse and Neglect Data System Working Paper 1 1990 Summary Data Component,  DHHS Publication No. (ACF) 92-30361, April, 1992, page 23.


First appeared in Children Today, Vol. 21, No. 2, 1992
Reprinted with permission.