1. Children Exposed to Violence
Caryn Brauweiler, LCSW
Debbie Conley, LCSW

2. Presentation Objectives
Define Children’s Exposure to Violence
Identify symptoms of exposure to violence
Understand the impact of exposure to violence on children
How to respond to children
Recommendations and Resources

3. Violence is…
…anything that hurts or destroys any person, place or thing. Violence can be experienced in a variety of forms that can include, but is not limited to physical, sexual, and emotional abuse.

4. What exactly is CEV?

5. What does CEV stand for?
Children’s
Exposure
Violence

6. Exposure to Violence…
means being a victim of abuse, neglect, or maltreatment; or witnessing domestic violence, community, and/or media violence or other violent crimes/events.
1C2

7. Children’s Exposure to Violence
Infants, toddlers, and young children are exposed to violence when they are abused or maltreated, or if they see, hear, and know others who are victimized by crimes that take place within their family, their community, or through the media.

8. What does the child SEE? HEAR? KNOW?
ASK YOURSELF…
What does the child
SEE?
HEAR?
KNOW?

9. Get the Facts!
Estimates show that 3-5 children in every classroom have witnessed a woman being abused
In Chicago, studies have shown that among 500 elementary school students one in four had witnessed a shooting and one-third had seen a stabbing
3 in 5 of those children who witnessed a shooting or stabbing, indicated that the incident resulted in death.
More than 25% of these children had been victims of severe violence themselves-that is, they had been shot at, suffered a knife attack, or had been beaten or mugged.
Data from “Exposure and Response to Community Violence among Children and Adolescents,” Esther J. Jenkins and Carl C. Bell, 1997

10. Prevalence of Violence
Intentional injury to young children (0-4) is most likely to occur as a result of child abuse (and neglect)
Nationally in 2002, there were over 900,000 estimated maltreated children, with more than 1,300 child fatalities
80% of these children were under the age of five
Children witness 68-80% of domestic assaults
According to the NYU Child Study Center, 3 million children are diagnosed as having PTSD

11. More Facts…!
38,985 (97% Women) sought shelter, 16,570 were turned away (IDHS, 1997).
In 2001, state funding supported 67 domestic violence programs, serving 113,700 clients. This includes 25,700 children.
Chicago Police Department receives 655 domestic calls per day (Mayors Office on Domestic Violence).

12. Types of Violence Child Abuse Domestic Violence Physical Sexual
Emotional
Neglect
Domestic Violence

13. Child Abuse & Neglect

14. Who Does Child Abuse & Neglect Affect?
Child Abuse affects children from all:
Ethnicities
Socioeconomic levels
Religious affiliations
Cultures

15. Factors which contribute to child abuse and neglect
Lack of parenting skills
Parental stress
Family Hardship
Alcohol and substance abuse
Economic difficulties or poverty
Domestic Violence
Previous Victimization
Depression
It is important to remember that these factors do not cause child abuse and neglect, but contribute to it.
*Lack of parenting skills – parents lack understanding of child development - unrealistic expectations of child’s behaviors.

16. Physical Abuse
Characterized by the infliction of physical injury as a result of:
Punching
Beating
Kicking
Biting
Shaking
Burning
Or otherwise harming a child

17. Indicators of Physical Abuse
Unexplained injuries
Repeated injuries such as bruises, welts or burns
Unexplained abrasions or lacerations
Injuries in various stages of healing
Small circular burns
Burns with a “doughnut” shape
Delays in obtaining medical care
Especially located on parts such as eyes, mouth, back, thighs, buttocks, genital areas
Injuries appear in a regular pattern or grouped together
Circular burns found on forearms, hands, buttocks, or soles of the feet
Doughnut shaped burns- may indicate child was dipped or forced to sit in hot liquid

18. Child Neglect When a caregiver fails to provide a child with adequate:
Food
Clothing
Shelter
Supervision
Needed medical treatment

19. Indicators of Child Neglect
Appears poorly nourished or inadequately clothed
Appears consistently tired or listless
Inconsistent attendance at school
Poor hygiene
Unable to relate well to others

20. Emotional Abuse
Acts that damage immediately or ultimately the behavioral, cognitive, affective or physical functioning of a child, such as:
Criticizing
Name calling
Ridiculing
Blaming
Screaming
Withholding love and affection
Unpredictable responses
Double-message communication

21. Indicators of Emotional Abuse
Clingy and forms indiscriminate attachments
“Acts out” and considered a behavior problem
Withdrawn, depressed, apathetic
Exhibits exaggerated fearfulness
Bedwetting or soiling

22. Child Sexual Abuse
Using a child for the purpose of sexual needs or desires, may include:
Touching
Fondling
Oral stimulation
Penetration of genital or anal opening
Often includes the use of:
Secrecy
Bribes
Tricks
Threats
Or other forms of coercion

23. Indicators of Sexual Abuse
Sexual Behaviors of Children:
Detailed and age-inappropriate understanding of sexual behavior
Inappropriate, unusual, or aggressive sexual behavior with peers or toys
Compulsive indiscreet masturbation
Excessive curiosity about sexual matters or genitals
Seductive behavior with peers or adults
Physical Indicators:
Sexually transmitted diseases
Genital discharge or infection
Trauma or irritation to anal/genital area
Pain upon urination/defecation
Difficulty walking or sitting due to pain
Psychosomatic symptoms

24. Indicators of Sexual Abuse
Behavioral Indicators in Young Children:
Bedwetting
Fecal soiling
Eating disturbances
Fears or phobias
Change in school performance
Regressive behavior
Difficulty concentrating
Sleep disturbances

25. Domestic Violence

26. What is the Connection Between Domestic Violence and Child Abuse?
Significant overlap % of families who present with partner violence also present with child abuse
32% of caseloads for protective service workers involve DV
50% of children who are physically abused were in the middle of an inter-parental attack
When there is DV, look for child abuse

27. What is Domestic Violence?
A pattern of coercive control that one person exercises over another.
Domestic Violence is not limited to physical abuse, but also includes verbal abuse, sexual abuse, emotional abuse, and economic abuse.
(Domestic Violence Against Older Women: brochure from the Illinois Department On Aging.)

28. Types of Violence Physical Abuse
pushing, punching, choking, burning, shooting, dragging, restraining, locking in the house, throwing down stairs, kicking, poking, slapping, cutting, tripping, raping, holding down, hair pulling, squeezing, suffocating, and kidnapping.
(Illinois Coalition Against Domestic Violence – 40 Hour Training Manual)

29. Types of Violence (cont.)
Sexual abuse
Making degrading sexual comments, forcing sex, assaulting breasts or genitals, forcing a partner to have sex with a third person, criticizing appearance, bragging about infidelity, forced cohabitation.
(Illinois coalition Against Domestic Violence – 40 Hour training manual)

30. Types of Violence (cont.)
Verbal Abuse
name calling, yelling, making demeaning comments, threatening, belittling, constant phone calls, actively undermining her authority with children, setting her up so that he can humiliate her in public or in front of family and friends.
(Illinois Coalition Against Domestic Violence – 40 Hour Training Manual)

31. Types of violence (cont.)
Emotional Abuse
Making threats of violence, forcing a woman to do degrading things, controlling her activities, frightening her, or using her children as leverage against her, killing a family pet, creating crisis, embarrassment, threatening to tell others about sexuality in the case of gays/lesbians.
(Illinois Coalition Against Domestic Violence – 40 Hour Training Manual)

32. Types of Violence (Cont.)
Economic Abuse
destroying property, prized possessions, relatives’ property,taking her money, restricting access to household finances, withholding medical treatment, not allowing her to work or attend school, forcing her to work.
(Illinois coalition Against Domestic Violence – 40 Hour Training Manual)

33. Effects of Violence on Children
What Does This Mean?

34. Myths about Children Who Witness Domestic Violence
Children are too young to understand
They won’t remember what happened
You can’t help kids anyway, especially young kids
We should just move on
Kids should just forget about it

35. Facts about Children Who Witness Domestic Violence
All children are affected by witnessing violence
The younger the child, the more likely they will show signs of distress
Children have more trouble under-standing and coping with violence

36. Factors Affecting Children’s Reactions to Violence
Intensity
Proximity
Familiarity
Developmental Level
Chronicity

37. Warning Signs of Witnessing Violence
Sleep Disturbances
Somatic Complaints
Increased Aggressive Behavior
Angry Outbursts
Increased Activity Level
Hypervigilance
Numbing
Increased Separation Anxiety
Distractibility
Changes in Play
Withdrawal
Regression
Behavioral Changes

38. Effects on Infants and Toddlers
Eating Disturbances
Developmental Regression
Language Delay
Attachment Disorder
Attachment Difficulties
Failure To Thrive

39. Effects on School-Aged Children
Psychosomatic Complaints
Enuresis
School Problems/Absenteeism
Behavioral Problems
Parentification
Violence
Depression
Attachment Difficulties
Changes in Play
May Talk About Death/Dying

40. Effects on Teenagers Antisocial Behavior Dating Violence
School Problems/Absenteeism
Substance Abuse
Parentification
Running Away from Home
Depression
Suicidal Gestures/Talk
Relationship Problems

41. Witnessing Violence Makes it Hard for Children to Feel Safe
Children need to feel safe to:
Grow
Be Healthy
Succeed
When children see or hear violence, they worry they will not be safe

42. Impact for future functioning
Lack of trust – adults can’t protect them
Feeling of powerlessness – can’t impact environment
Turning to aggression
Risk for violence in later life

43. Children’s Exposure to Violence
Impact on Brain Development

44. Overview of Brain Development
Infants are born with only primitive brain function
Brain development rapidly moves from less to more complex

45. Overview of Brain Development
Major working unit of the brain is neurons
Neurons form into networks
Networks become systems which mediate various functions

46. Overview of Brain Development
The brain system is designed to sense, perceive, process, store and act on information received from external and internal environments

47. CEV and Brain Development
Threatening environments in early infancy can trigger imbalances of brain chemicals
This can affect how genes are expressed
Early experiences + genes = biochemical foundation for a life time of intellectual, emotional, social functioning

48. Impact on Brain Development
Excessive stresses caused by experiences such as abuse, neglect, or witnessing violence, can actually affect genes: they can switch them on or off at the wrong times, forcing them to build abnormal networks of brain cell connections.

49. Impacts of CEV
Stress and trauma can interfere with healthy brain development for very young children
Children may manifest symptoms related to anxiety, post-traumatic stress and attention deficit disorders

50. How to Respond to Children Exposed to Violence
Address a child at eye level
Use simple, direct, age-appropriate language
Help the child understand your role in the child’s life
Address confidentiality and its limits
Respect the child’s right not to talk
Validate the child’s feelings
Reassure the child he/she is not to blame for the violence

51. How to Respond to Parents or Caregivers
Be honest and direct
Provide accurate information
Assure them that protecting their child is your number one priority
Be prepared for strong reactions
Make appropriate referrals for support and treatment when appropriate

52. Resources and Recommendations

53. Guidelines for Therapeutic Services
Trauma informed services
Developmentally appropriate
Culturally sensitive
Evidenced based practice

54. Resources Safe from the Start – funded by IVPA 12 sites in Illinois
Northwest Cook County
Pillars (West Suburban Cook County)
Start Early, Start Right (South Cook
Chicago Safe Start
Heartland Human Care Services (North)
Casa Central (West)
Family Focus (South)
Metropolitan Safe Start (Far south side)

55. Additional Resources LaRabida’s Chicago Child Trauma Center
Chicago Children’s Advocacy Center
C-4 Counseling Centers

56. About Safe From The Start
SFTS is a community response dedicated to reduce the trauma of exposure to violence in children ages 0-5 in the communities of Northwest suburbs.
New program, focus = ages 0-5, IVPA/legislators realized the need to focus on this age group- earlier the intervention the better…
Not many program specifically focused on this age group-specialized in 0-5
New.. Exciting!
Coalition devel. Police, dcfs, etc….

57. Safe From The Start Services
Specialized Assessment
Intensive Case Management
Therapeutic Services
Community Education and Violence Prevention
Professional Consultation
Community education presentation topics include:
Bullying, dv, media violence, keeping kids safe, and others…

58. How to Contact Us Safe From The Start (630)540-0549
Mention brochures handed out to everyone, take lots of copies and distribute them throughout your community!!
Safe From The Start
(630)

59. Questions….Comments?
Contact Info:
Caryn Brauweiler, LCSW
Debbie Conley, LCSW