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PBS News
Why child welfare experts fear a spike of abuse during COVID-19
By Laura Santhanam
Apr 6, 2020
Over the course of five consecutive days last month, Dr. Jamye Coffman
saw seven children and infants who had been abused so severely that
they required hospitalization at Cook Children’s Medical Center in Fort
Worth, Texas. At the time, the city, along with the rest of Texas, had
recently declared an emergency over the rapid spread of novel
coronavirus. Typically, the hospital sees fewer than 10 cases of fatal
child abuse in a year, but that week, two died from their injuries.
It is too early to link this single — and anecdotal — spike in severe
child abuse to the COVID-19 pandemic and the stress it’s causing, said
Coffman, who serves as medical director of the Cook Children’s Center
for Prevention and Child Abuse and Neglect. In fact, it will take more
than a year to get a clearer picture of what’s happening nationwide,
due to the lag in collecting and sharing child welfare data.
But Coffman said she is concerned that a trend she has seen before will
play out again as the nation reels from the profound effects of the
virus and the stresses brought on by mass unemployment, food insecurity
and illness. During the last financial recession, which rolled out much
more slowly than the current crisis, the rate of physical abuse and
child deaths linked to abuse both increased at her hospital, she said.
“Any time there’s increased stress increases the risk of abuse on children.”
“It all just adds stress on top of stress,” she said. “Any time there’s
increased stress increases the risk of abuse on children.”
So she said she alerted the Fort Worth community through the local news
to raise awareness of a possible rise in child maltreatment and prevent
more children from dying, if the trend bears out. “It is hard to know
if the numbers have gone up in the last few days or if medical
providers are looking carefully and reaching out,” she said. “It’s too
soon to tell if what we’re doing is making a difference.”
But even when federal data is available for this period, it may not
show the full extent of abuse because of the ways crises also inhibit
reporting.
Why the pandemic could play a role
No one knows how long this pandemic will last, and that uncertainty can
cause anxiety, tension and irritability for children and caregivers.
The United Nations has already raised the alarm that reports of
domestic violence have soared around the world, underscoring how unsafe
homes can be during a pandemic.
Child welfare experts fear children may suffer a wave of abuse and
neglect as COVID-19 disrupts households and stresses caregivers. Photo
by Nora Savosnick/Reuters
How caregivers can help themselves and their kids
Routine goes a long way to superimpose stability over a world that
feels chaotic amid a pandemic, said Dr. Steven Berkowitz, a child
psychiatrist at the University of Colorado School of Medicine.
Structure “helps organize us and feel emotionally safe,” he added.
For adults spending days at home:
Wake up on time.
Shower, shave, dress (“don’t stay in your pajamas”).
Plan to do yoga, move or do exercise.
Eat as healthily as possible at regular meal times each day.
Go to bed on time and sleep for eight hours.
Repeat.
Robert Sege, director of the Center for Community-Engaged Medicine at
Tufts University, and Berkowitz both shared advice on how to prevent
ragged nerves and feelings of isolation: Maintain social connections
while physically distancing yourself and your family. Reach out to
family, friends, faith community, coworkers and neighbors. Call or text
your loved ones and people in your life.
If your child is acting out, it may be their outlet for stress if they
miss their classmates or friends or are scared about what is happening
around them, according to the Centers for Disease Control and
Prevention. They may also have trouble sleeping, staying focused or
complaining of tummy aches, the CDC says. Parents should get the
conversation going with children about their worries, let them take the
lead, and listen.
In the extreme, child abuse may happen when a caregiver is “pushed over
the edge” by circumstances often outside their control, said Dr. Robert
Sege, who directs the new Center for Community-Engaged Medicine at
Tufts University.
Child welfare experts are most concerned about three conditions happening right now.
Routines are being disrupted. With businesses, schools and daycares
shuttered, parents and children are in each other’s constant company,
sometimes in close quarters. That may be welcome time spent together,
but it can also be incredibly stressful when coupled with the demands
of work, bills and other anxieties. Children, too, may act out when
they are under stress.
Jobs have evaporated. By March 28, 6.6 million Americans had filed
first-time jobless claims in a single week. Before that, nearly a fifth
of Americans said they’d lost wages or jobs due to COVID-19, in a PBS
NewsHour/NPR/Marist poll conducted March 13-14. That means more
households are straining under the weight of debt and economic
insecurity.
Children are isolated from others who care. Before the COVID-19
pandemic, the act of going to school and being seen by teachers, staff
and fellow students stretched a modest net to help catch children who
might be mistreated. Before, someone outside the home might spot a
bruise and ask how things were going. Amid social distancing, that
oversight is gone.
“These are all conditions that set up what might lead to child abuse
and neglect,” said Sege, who served on the American Academy of
Pediatrics’ Committee on Child Abuse and Neglect.
Under normal circumstances, the highest risk period for a child to die
after being abused or neglected is during the first year of life, he
said. Given the stress summoned by a pandemic, Sege said that risk for
the youngest children only rises.
“It’s that additional toll on vulnerable families that we’re worried
about,” said Jessica Bartlett, who directs early childhood research for
Child Trends, a nonpartisan organization that studies children’s
well-being. “It can be the straw that broke the camel’s back.”
What the data says (and what it may miss)
For care professionals, a 15-month lag in data can hinder their ability
to combat maltreatment. Bartlett said that the more real-time data they
have about abuse, the better they can “respond appropriately.” But
getting national data more quickly is tricky, said Sharon Vandivere,
senior research scientist at Child Trends.
Twice a year, states and localities submit data that tracks child abuse
and neglect to the federal government, she said, where it is then
compiled, cleaned, analyzed and published. The most recent data
available is from 2018. For years, child advocates and researchers have
explored new ways to update child welfare data systems, but haven’t
made substantial progress.
Need help?
If you are in distress, need help and don’t know where to go, experts suggest you consider calling these numbers:
Childhelp National Child Abuse Hotline – 1800-4ACHILD
SAMHSA distress helpline — 800-985-5990 or text “talk with us” to 66746
211 — National Suicide Hotline
Crisis Textline — Text Connect to 741741
National Alliance of Mental Illness — 1-800-950-6264 (Monday-Friday, 10 a.m. to 6 p.m. ET)
National Suicide Prevention Lifeline – 1-800-273-TALK (8255)
When life is disrupted by a natural disaster, research has shown that
incidents of abuse have increased, and children in dangerous situations
can fall through the cracks in the system. That may be happening now,
since teachers, early childhood education providers and home health
clinicians are obligated to file reports of suspected child
maltreatment, Bartlett said, but the COVID-19 pandemic has interrupted
or suspended those services.
When it comes to the Great Recession, the official government data do
not reflect an increase of abuse. In 2007, at the outset of the
financial crisis, 794,000 children in the U.S. were abused or
neglected, according to the federal Administration for Children and
Families. Amid the throes of the banking crisis in 2008, that estimate
appeared to dip to 772,000 children and in 2009, official estimates
said 702,000 children were maltreated. But a 2015 report by a
children’s advocacy group found that hospital admissions for serious
child abuse and traumatic brain injuries did increase during the time
period, and found that these upticks were geographically aligned in
areas with higher home foreclosure rates and unemployment rates.
There has been a push to explore ways social media or online searches
can fill in gaps and offer more immediate insights about how and where
children might be suffering, but questions must be weighed, about how
reliable and accurate those data points might be, Vandivere said.
What to do when stress takes over
The daily stress of the current pandemic, and the isolating measures
taken to combat it, make impulse control increasingly difficult, said
Dr. Steven Berkowitz, a child psychiatrist at the University of
Colorado School of Medicine.
To those who feel at risk of causing harm to their children, Sege suggests:
Call a friend.
Call a pediatrician.
Send your child to a quiet corner.
Take a walk outside (while maintaining a safe social distance of at
least six feet from anyone who doesn’t live in your household).
For infants, place them in a crib, step away and draw deep breaths to cool off.
Call or text a helpline.
There is no shame in asking for help during times of unprecedented
stress, Coffman said, adding that community members need to watch out
for their friends and step in if they think someone needs help.
“Social distancing doesn’t have to be social isolation,” she said.
“Social distancing doesn’t have to be social isolation.”
It is more important that people support families who may already have
been struggling with child maltreatment, domestic violence, substance
use or other issues to prevent trauma from happening in the first
place, Bartlett said, rather than simply identifying families where a
child has been hurt or overlooked.
For those who identify a family who may be struggling and want to help,
Sege suggests calling, texting or video-conferencing with them to ask
how they’re doing, or offering to pick up groceries, diapers or other
essential supplies.
“Sooner or later, the viral infection will pass,” Sege said. “We want
to make sure our children are physically and psychologically safe
through all this.”
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