Carina Franca posted on April 09, 2012 16:47
...Do not provoke your children, lest they become discouraged. Colossians 3:21“Adverse childhood experiences are clearly a major determinant of the health and social well being of the nation” –Felitti
Ethan is 36 months old. He was removed from the care of his biological mother two months ago following the discovery of his dead infant sibling. Ethan had scabs and bruises over much of his body and spoke no words but did grunt to try to make his needs known…
Joseph is 5 years old. He was found locked in a closet, starved, neglected and having experienced all types of abuse. He is bright and manipulative. Cute and rude/crude…
April is Child Abuse Prevention month. Those of us who work daily with abused children see this as an ‘opportunity’ to bring awareness to our community (personal and professional) of the tragic and extremely high number of abused and/or neglected children there are in our world, nation, communities, churches, and families.The short descriptions of Ethan and Joseph are just a couple of the children my colleagues and I tried to serve this past week. Unfortunately, these represent child experiences all too common and prevalent in all communities. Annually, over three million child abuse reports are made in the United States alone. It is imperative that each of us do not naïvely think that child abuse is not prevalent with our clients/patients and with those whom we come in contact with socially.
Sadly, much of society, including health professionals, does not want to hear about child abuse and neglect. It is too hard to hear about children being abused/neglected. Even though more than 98 percent of Americans view child abuse as a serious social problem, our society has not yet seen an effective advocacy effort resulting in resources to protect children from abuse and neglect and strengthen family functioning. In fact we spend billions of dollars each year for health care and shelter for children who have been harmed by their parents. Some argue that we are better at identifying and reporting abuse (a child is reported for abuse every five seconds in the U.S.), however, this has not been effective in reducing our child abuse mortality rate in the United States. Since 1998 death from child abuse have seen a fairly increase.
National Child Abuse Statistics
Currently, the rate of child mortality due to abuse is five deaths per day. What happens to children ought to concern each of us as a professional in health care and as private individuals and members of society. While I believe every adult has a responsibility to advocate for children (God has entrusted them to us) some of us may be more likely to spark into action. One factor for causing a move to action could be the economic cost of child abuse, particularly in health care.
In addition to the billions spent in the childhood years, more and more information related to long-term health consequences due to child abuse has been evidenced. The literature in the past decade is replete with studies that document the deleterious long-term effects of adverse experiences in childhood. This timely and vital spotlight on the consequences of childhood experiences is due in large part to the results of the Adverse Childhood Experiences (ACE) study. This is one of the largest scientific research studies addressing the relationship between multiple categories of childhood trauma with mental and physical health outcomes later in life. The ACE study has demonstrated the broad and profound long-term impact of childhood experiences on adult mental health, disease, obesity, risk behaviors, and addiction.
Felletti, the principal investigator of the ACE study, offers that the prevalence of adverse childhood experiences are clearly a major determinant of the health and social well-being of the nation. One of the major conclusions of this study is that major diseases in adulthood are determined in childhood, not by disease but by the number of adverse experiences the adult had in childhood. In fact the Centers for Disease Control (CDC) wanted to study the elderly population of persons with significant adverse childhood experiences and found it was not possible because this segment of adults died, on average, twenty years earlier than those who did not experience this level of adversity.
This more than underscores the importance of understanding and preventing/addressing adverse childhood experiences in childhood. Further, as emphasized by Edwards, et. al., to ignore the presence of such indicators would constitute a serious deficiency in medical care. Is much more evidence necessary to compel us to make a commitment to identify children at risk and advocate and intervene on their behalf?
Those of us who work in the health profession are, I believe, uniquely called to this mission. We are on the frontlines. No matter what you do or where it is you are working, you may be the first to identify risk for neglect or maltreatment. Do not miss this opportunity. Too many children are a part of the mortality rate indicated above because professional caregivers have turned a ‘blind’ eye or have chosen ‘not to get involved’. Please be your brother’s keeper, or, in this case, a keeper of safety for our children.
The following poem was written for me to use in my work on behalf of children by my dear friend, Lori R. Wilson.
ACT QUALIFIED
Kiti Freier Randall, PhD, Pediatric Neurodevelopmental Psychologist, Consultant & Director of Pediatric Psychology Services, LLUHC, Department of Pediatrics.
REFERENCES Anda, R.F., Felitti, V.J., Bremner, J. D., et.al. The enduring effects of abuse and related adverse experiences in childhood: A convergence of evidence from neurobiology and epidemiology. European Archives of Psychiatry and Clinical Neuroscience. 2006; 256(3):174-186. Retrieved September 26, 2010, from ProQuest Psychology Journals. (Document ID: 1028568701). Cannon, E., Bonomi, A., Anderson, M., et.al. Adult health and relationship outcomes among women with abuse experiences during childhood. Violence and Victims. 2010; 25:291-305. Retrieved September 25, 2010, from ProQuest Psychology Journals. (Document ID: 2033974351)Dube, S.R., Miller, J.W., Brown, D.W., et. al. Adverse Childhood Experiences and the Association with Ever Using Alcohol and Initiating Alcohol Use During Adolescence. Journal of Adolescent Health. 2006;38(4):444.el-444.c10.Dube, S., Anda, R., Felitti, V., Edwards, V., & Williamson, D.. (2002). Exposure to Abuse, Neglect, and Household Dysfunction Among Adults Who Witnessed Intimate Partner Violence as Children: Implications for Health and Social Services. Violence and Victims, 17(1), 3-17. Retrieved September 26, 2010, from ProQuest Psychology Journals. (Document ID: 1667641171). Edwards, V.J., Anda, R.F., Dube, S.R., et. al. The Wide-Ranging Health Outcomes of Adverse Childhood Experiences. In: Kendall-Tackett, K. & Giacomoni, S. eds. Child Victimization: Maltreatment, Bullying and Dating Violence, Prevention and Intervention. Kingston, NJ: Civic Research Institute, 2005: 8-1 – 8-13.Edwards, V.J., Holden, G.W., Anda, R.F., & Felitti, V.J. Experiencing multiple forms of childhood maltreatment and adult mental health: results from the adverse childhood experiences (ACE) study. American Journal of Psychiatry. 2003; 160(8):1453-60. Retrieved September 26, 2010, from ProQuest Psychology Journals. (Document ID: 388703521). Felitti, V.J. (2003). Ursprünge des Suchtverhaltens – Evidenzen aus einer Studie zu belastenden Kindheitserfahrungen. Praxis der Kinderpsychologie und Kinderpsychiatrie, 52, 547-559. Felitti, V.J., Anda, R.F., Nordenberg, D., et. al. Relationship of childhood abuse and household dysfunction to many of the leading causes of death in adults: The Adverse Childhood Experiences (ACE) Study. American Journal of Preventive Medicine. 1998; 14:245-258 Holy Bible, New King James Version. (1982). Thomas Nelson Inc.Westman, J.C. (Ed.). (1991). Who Speaks for the Children? Sarasota, FL: Professional Resource Exchange, Inc.Williamson, D.F., Thompson, T.J. Anda, R.F. et. al. Body weight and obesity in adults and self-reported abuse in childhood. International Journal of Obesity and Related Disorders. 2002; 26(8):1075-1082. Retrieved September 26, 2010, from ProQuest Psychology Journals. (Document ID: 1011901561).
Ethan is 36 months old. He was removed from the care of his biological mother two months ago following the discovery of his dead infant sibling. Ethan had scabs and bruises over much of his body and spoke no words but did grunt to try to make his needs known…
Joseph is 5 years old. He was found locked in a closet, starved, neglected and having experienced all types of abuse. He is bright and manipulative. Cute and rude/crude…
April is Child Abuse Prevention month. Those of us who work daily with abused children see this as an ‘opportunity’ to bring awareness to our community (personal and professional) of the tragic and extremely high number of abused and/or neglected children there are in our world, nation, communities, churches, and families.The short descriptions of Ethan and Joseph are just a couple of the children my colleagues and I tried to serve this past week. Unfortunately, these represent child experiences all too common and prevalent in all communities. Annually, over three million child abuse reports are made in the United States alone. It is imperative that each of us do not naïvely think that child abuse is not prevalent with our clients/patients and with those whom we come in contact with socially.
Sadly, much of society, including health professionals, does not want to hear about child abuse and neglect. It is too hard to hear about children being abused/neglected. Even though more than 98 percent of Americans view child abuse as a serious social problem, our society has not yet seen an effective advocacy effort resulting in resources to protect children from abuse and neglect and strengthen family functioning. In fact we spend billions of dollars each year for health care and shelter for children who have been harmed by their parents. Some argue that we are better at identifying and reporting abuse (a child is reported for abuse every five seconds in the U.S.), however, this has not been effective in reducing our child abuse mortality rate in the United States. Since 1998 death from child abuse have seen a fairly increase.
National Child Abuse StatisticsCurrently, the rate of child mortality due to abuse is five deaths per day. What happens to children ought to concern each of us as a professional in health care and as private individuals and members of society. While I believe every adult has a responsibility to advocate for children (God has entrusted them to us) some of us may be more likely to spark into action. One factor for causing a move to action could be the economic cost of child abuse, particularly in health care.
In addition to the billions spent in the childhood years, more and more information related to long-term health consequences due to child abuse has been evidenced. The literature in the past decade is replete with studies that document the deleterious long-term effects of adverse experiences in childhood. This timely and vital spotlight on the consequences of childhood experiences is due in large part to the results of the Adverse Childhood Experiences (ACE) study. This is one of the largest scientific research studies addressing the relationship between multiple categories of childhood trauma with mental and physical health outcomes later in life. The ACE study has demonstrated the broad and profound long-term impact of childhood experiences on adult mental health, disease, obesity, risk behaviors, and addiction.
Felletti, the principal investigator of the ACE study, offers that the prevalence of adverse childhood experiences are clearly a major determinant of the health and social well-being of the nation. One of the major conclusions of this study is that major diseases in adulthood are determined in childhood, not by disease but by the number of adverse experiences the adult had in childhood. In fact the Centers for Disease Control (CDC) wanted to study the elderly population of persons with significant adverse childhood experiences and found it was not possible because this segment of adults died, on average, twenty years earlier than those who did not experience this level of adversity.
This more than underscores the importance of understanding and preventing/addressing adverse childhood experiences in childhood. Further, as emphasized by Edwards, et. al., to ignore the presence of such indicators would constitute a serious deficiency in medical care. Is much more evidence necessary to compel us to make a commitment to identify children at risk and advocate and intervene on their behalf?
Those of us who work in the health profession are, I believe, uniquely called to this mission. We are on the frontlines. No matter what you do or where it is you are working, you may be the first to identify risk for neglect or maltreatment. Do not miss this opportunity. Too many children are a part of the mortality rate indicated above because professional caregivers have turned a ‘blind’ eye or have chosen ‘not to get involved’. Please be your brother’s keeper, or, in this case, a keeper of safety for our children.
The following poem was written for me to use in my work on behalf of children by my dear friend, Lori R. Wilson.
ACT QUALIFIED
Not “What can be done?”
–“What can I do?”
For the child that’s courted by gangs
Not “What will she eat?”
–“Let me feed her.”
The little girl with hunger pangs.
Not “That boy needs guidance.”
–“I’ll mentor”
The one headed toward guns and drug use.
Not “Her mother’s like that.”
–“Can I step in,”
And break the cycle of child abuse.
Don’t say that you care then do nothing
But defer to those “more qualified”.
For each time you put off your duty
A child who needs saving has died.
You see action is all that is needed
And love’s the best qualification.
Don’t ask, “Who will save today’s children?”
Act now – be a child’s salvation.
Kiti Freier Randall, PhD, Pediatric Neurodevelopmental Psychologist, Consultant & Director of Pediatric Psychology Services, LLUHC, Department of Pediatrics.
REFERENCES Anda, R.F., Felitti, V.J., Bremner, J. D., et.al. The enduring effects of abuse and related adverse experiences in childhood: A convergence of evidence from neurobiology and epidemiology. European Archives of Psychiatry and Clinical Neuroscience. 2006; 256(3):174-186. Retrieved September 26, 2010, from ProQuest Psychology Journals. (Document ID: 1028568701). Cannon, E., Bonomi, A., Anderson, M., et.al. Adult health and relationship outcomes among women with abuse experiences during childhood. Violence and Victims. 2010; 25:291-305. Retrieved September 25, 2010, from ProQuest Psychology Journals. (Document ID: 2033974351)Dube, S.R., Miller, J.W., Brown, D.W., et. al. Adverse Childhood Experiences and the Association with Ever Using Alcohol and Initiating Alcohol Use During Adolescence. Journal of Adolescent Health. 2006;38(4):444.el-444.c10.Dube, S., Anda, R., Felitti, V., Edwards, V., & Williamson, D.. (2002). Exposure to Abuse, Neglect, and Household Dysfunction Among Adults Who Witnessed Intimate Partner Violence as Children: Implications for Health and Social Services. Violence and Victims, 17(1), 3-17. Retrieved September 26, 2010, from ProQuest Psychology Journals. (Document ID: 1667641171). Edwards, V.J., Anda, R.F., Dube, S.R., et. al. The Wide-Ranging Health Outcomes of Adverse Childhood Experiences. In: Kendall-Tackett, K. & Giacomoni, S. eds. Child Victimization: Maltreatment, Bullying and Dating Violence, Prevention and Intervention. Kingston, NJ: Civic Research Institute, 2005: 8-1 – 8-13.Edwards, V.J., Holden, G.W., Anda, R.F., & Felitti, V.J. Experiencing multiple forms of childhood maltreatment and adult mental health: results from the adverse childhood experiences (ACE) study. American Journal of Psychiatry. 2003; 160(8):1453-60. Retrieved September 26, 2010, from ProQuest Psychology Journals. (Document ID: 388703521). Felitti, V.J. (2003). Ursprünge des Suchtverhaltens – Evidenzen aus einer Studie zu belastenden Kindheitserfahrungen. Praxis der Kinderpsychologie und Kinderpsychiatrie, 52, 547-559. Felitti, V.J., Anda, R.F., Nordenberg, D., et. al. Relationship of childhood abuse and household dysfunction to many of the leading causes of death in adults: The Adverse Childhood Experiences (ACE) Study. American Journal of Preventive Medicine. 1998; 14:245-258 Holy Bible, New King James Version. (1982). Thomas Nelson Inc.Westman, J.C. (Ed.). (1991). Who Speaks for the Children? Sarasota, FL: Professional Resource Exchange, Inc.Williamson, D.F., Thompson, T.J. Anda, R.F. et. al. Body weight and obesity in adults and self-reported abuse in childhood. International Journal of Obesity and Related Disorders. 2002; 26(8):1075-1082. Retrieved September 26, 2010, from ProQuest Psychology Journals. (Document ID: 1011901561).
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