Building awareness of child abuse

Child abuse [defined] Federal Child Abuse Prevention and Treatment Act [CAPTA] amended by Keeping Children and Families Safe Act [2003] Any recent act or failure to act on part of parent or caretaker which results in death, serious physical or emotional harm, sexual abuse or exploitation or An act or failure to act which presents an imminent risk of serious harm [a “child” is a person under age 18 who is not an emancipated minor The U.S. Department of Health & Human Services Administration for Children and Families website at http://www.acf.hhs.gov/programs/cb/stats_reserch/index.htm#can provides a wealth of current information on the nature and frequency of child abuse and neglect. It is updated regularly. RFK Inc. 2012

Major types of abuse and neglect [Federal CAPTA definitions] Physical abuse Non-accidental physical injury [ranging from minor bruises to severe fractures or death] As a result of punching, beating, kicking, biting, shaking, throwing, stabbing, choking, hitting [with hand, stick, strap or other object], burning, or otherwise harming a child That is inflicted by a parent, caregiver, or other person who has responsibility for the child. Considered abuse regardless of whether caregiver intended harm. Although RFKC volunteers need not be experts in detecting physical abuse, it may be helpful to point out that 75% of physical abuse injuries occur in a “primary target zone” that extends from the neck to the knees on the child’s backside. Most accidental injuries are to bony protuberances such as elbows and knees. One can also assess the “goodness of fit” between the nature of an injury and the explanation offered to explain it. Detecting the abuse of an RFKC camper is an infrequent occurrence because it has usually been substantiated by social services personnel. However, one may be in a position to discover more recent abuse that has taken place. One’s local camp will have in place procedures for documenting and reporting such findings. RFK Inc. 2012

Major types of abuse and neglect [Federal CAPTA definitions] Neglect – failure of caregiver to provide for a child’s basic needs Physical [e.g. food, shelter, supervision] Medical [e.g. necessary medical or mental health treatment] Education [e.g. child’s educational or special education needs] Emotional [e.g. failure to provide psychological care, permitting child to use alcohol or other drugs] May be exceptions for cultural or religious factors RFK Inc. 2012

Major types of abuse and neglect [Federal CAPTA definitions] Sexual abuse Includes activities by a parent or caregiver such as fondling a child’s genitals, penetration, incest, rape, sodomy, indecent exposure, and exploitation through prostitution or the production of pornographic materials RFK Inc. 2012

Major types of abuse and neglect [Federal CAPTA definitions] Emotional abuse A pattern of behavior that impairs a child’s emotional development or sense of self-worth May include constant criticism, threats, or rejection, as well as withholding love, support, or guidance. RFK Inc. 2012

Other types of abuse and neglect [Federal CAPTA definitions] Abandonment [defined by many states as a form of neglect] A child is considered abandoned when: Parent’s identity or whereabouts are unknown Child left alone in circumstances where child suffers serious harm Parent has failed to maintain contact with child or provide support for a specified period of time RFK Inc. 2012

Other types of abuse and neglect [Federal CAPTA definitions] Substance abuse Parental exposure of child to harm due to mother’s use of an illegal drug or other substance Manufacture of methamphetamine in the presence of a child Selling, distributing, or giving illegal drugs or alcohol to a child Use of a controlled substance by a caregiver that impairs caregiver’s ability to adequately care for the child RFK Inc. 2012

Other types of abuse and neglect [Federal CAPTA definitions] Vicarious abuse Child exposure to the abuse or neglect of a parent, sibling, or other relative [e.g. a child who witnesses domestic violence directed at his or her parent; child who witnesses abuse of a sibling] [also…sometimes a perpetrator will injure or kill a child’s pet to frighten them into not disclosing abuse] RFK Inc. 2012

Statistics [2009 national data] 3.6 million children investigated by social service agencies for alleged maltreatment in 2009 19.5% of cases were substantiated involving 702,000 children No prior history in 75% of cases Most cases referred by school, medical, and law enforcement personnel 78% of cases involve abuse by one or both parents The U.S. Department of Health & Human Services Administration for Children and Families website at http://www.acf.hhs.gov/programs/cb/stats_reserch/index.htm#can provides the current national and statewide statistics gathered on all pertinent aspects of abuse and neglect. The most current data is usually two years behind because it takes time to gather, compile and report the information accurately. The statistic of 702,000 children abused annually is undoubtedly a conservative number. Perhaps only one-third of those who witness an instance of child abuse actually go so far as to report it to social services. Also, there may not be sufficient evidence to substantiate many genuine acts of abuse that are investigated by county social service agencies. Although some believe that “stranger danger” is the operative phrase for child abuse, it is important to know that in four-fifths of substantiated cases, the offender is one or both parents. RFK Inc. 2012

Statistics [2009 national data] 78.3% of cases are neglect 17.8 -- physical abuse 9.5% -- sexual abuse 7.6% -- psychological abuse 2.4% -- medical abuse 9.6% -- other [abandonment, congenital drug abuse, vicarious, etc.] [numbers do not add to 100 because of multiple causation] Question: Will this precise distribution of types of abuse be seen at your RFKC? Neglect Physical abuse Psychological abuse Sexual abuse RFK Inc. 2012

Will this precise distribution of types of abuse be seen at your RFK? Yes and no… Most likely the highest % of campers at any local RFKC will have substantiated cases of child neglect However, local camps may have higher percentage of physically and sexually abused children. Why? Most camps take only a small percentage of eligible children Social services may refer children who are most in need of camp [i.e. multiply abused, more severely abused or neglected] Neglect is the easiest form of maltreatment to substantiate and it is by far the most common. Most likely, the majority of campers at any RFKC will have had some history of child neglect. It is also likely that most RFKCs will have higher percentages of children with documented instances of physical or sexual abuse than one might predict based on the percentages of substantiated cases nationwide. This is because most RFKCs receive only a fraction of eligible campers from any one county social service agency. When social service workers can only refer a fraction of eligible campers they are likely to refer ones that they believe have the most need to attend camp. Therefore one might receive greater numbers of physical, sexually, or multiply abused children. RFK Inc. 2012

Racial and cultural factors In terms of sheer numbers there are more Caucasian children who are abused or neglected However, in proportion to numbers in the population… Greater % of Black, Native American, Alaska American, and children of multi-racial backgrounds Hispanic about same % as Caucasian Smaller % of Asian children The racial and ethnic composition of one’s camper population will vary depending on the geographical region and demographics of one’s referring social service agencies. For example, some suburban churches work with urban agencies that may result in higher concentrations of urban minority children attending camp. Some camps, depending on locality may have higher concentrations of African-American or Hispanic children or perhaps Native or Alaskan American children. If one’s camp typically receives children from particular racial or ethnic minorities it could be beneficial for volunteers to learn more about specific customs or practices or food preferences that would enhance one’s ability to provide positive memories. RFK Inc. 2012

Behaviors associated with types of abuse Precautions: Behaviors of children are influenced by many factors apart from abuse or neglect Two children with the same pattern of abuse or neglect may react in entirely different ways Having said this, some behaviors tend to be seen more frequently among children with certain types of abuse Behaviors stemming from abuse [i.e. hyperactivity, hostility, fear, withdrawal, clinginess, etc.] are far more evident at camp that the abuse or neglect itself. Although it is important to learn about the nature of abuse and neglect, it is even more important to gain understanding of the kinds of behaviors that stem from abuse and how best to manage these behaviors during the week of camp. RFK Inc. 2012

Behaviors associated with types of abuse Neglect Developmentally delayed due to limited attention or guidance Low self-worth Low socialization. May not know how to act in certain situations May not know proper boundaries May hoard food or possessions; may steal items May crave personal attention Eating like there's no tomorrow RFK Inc. 2012

Behaviors associated with types of abuse Physical Abuse May be inappropriately fearful of/withdrawn from authorities May be inappropriately hostile or aggressive due to modeling what one has witnessed Low self-worth Certain situations at camp may trigger fearful or aggressive reactions A child crying A “disciplinary” situation such as child breaking something, wetting the bed, doing something wrong RFK Inc. 2012

Behaviors associated with types of abuse Sexual abuse May be fearful of certain situations such as bed time, changing clothes, going to the bathroom or taking a shower, getting picture taken May sleep under the bed or sleep fully dressed May avoid physical contact Or…may be sexualized to a greater or lesser degree Act out sexual scripts Attempt sexual interactions with others Engage in or allow indiscriminate acts of touching or body contact RFK Inc. 2012

Behaviors associated with types of abuse Emotional or psychological abuse May be mistrusting of others Low self-worth May have developmental delays May sabotage one’s own chances for success or happiness in a situation for fear of being “disappointed” May not accept a birthday box May not readily believe that you love or care about them In general, it may be hard for an emotionally abused child to override negative messages that he or she has internalized over several months or years RFK Inc. 2012

Child Trauma Two key elements define trauma Witnessing something threatening or harmful to self or others Perceiving the situation to be beyond one’s coping capability [One can learn more specifics about trauma by reading Wikipedia or DSM-IV entries on Posttraumatic Stress Disorder or Acute Stress Disorder] Not all acts of abuse or neglect are traumatizing Children can be traumatized by situations that do not involve abuse or neglect Two excellent sources of additional information on child trauma are: Perry, B. D. and M. Szalavitz (2006), The boy who was raised as a dog: What traumatized children can teach us about loss, love, and healing, New York: Basic Books. Johnson, K. (1989), Trauma in the lives of children: Crisis and stress management techniques for counselors and other professionals, Alameda, CA: Hunter House. RFK Inc. 2012

Child Trauma Many RFKC children have been traumatized by their abuse or neglect Trauma typically stems from: Victimization – house fire, mugging, robbery or kidnapping, rape, exploitation, etc. Loss – death or separation from loved one Family pathology – chaotic or criminal families, absent or withdrawn parents The abuse/neglect of many RFKC children may tie in with one or more of these factors RFK Inc. 2012

Reactions to trauma Impact – immediate reaction to trauma [e.g. shock, intense fear, crying hysterically, etc.] Recoil – natural feelings and coping behaviors in the aftermath of a traumatic situation Reorganization – occurs only with the assistance of caring, loving mentors and professionals who know how to restore a child to a pre-trauma state Kendall Johnson (1989) identifies three stages or sequences in a child’s reaction to trauma. Impact is the initial response in the moments and hours immediately following the trauma. Recoil refers to a child’s natural adjustments and coping behaviors in the weeks, months, and even years following a traumatizing episode. When children have to adjust to a trauma more or less on their own, these coping behaviors are only semi-successful and may create additional problems for the child. In short, the child may never “outgrow” or fully recover from trauma without professional guidance and support. Instead, behaviors and coping styles set in that may make it difficult for a child to concentrate or trust others or certain situations. Reorganization refers to adjustment aided by caring professionals that can bring a child back to a more or less complete recovery from trauma. RFK Inc. 2012

Reactions to trauma What one will witness among some kids at RFKC are those emotions and behaviors that represent “recoiling” from past, unresolved trauma Sleep problems including night terrors, nightmares, bedwetting Startle reactions to stimuli associated with one’s trauma Hypervigalent for any sign that traumatic event may recur Difficulty paying attention or focusing on tasks at hand as a result of hypervigalence RFKC campers who have been traumatized will not be attending camp in the immediate wake of a trauma, so they will be past the “impact” stage. (Nevertheless, a child may come to camp the week after one’s home burns down or right after a change in foster placement, etc. so it is possible that some children may indeed be at an “impact” stage during camp.) Traumatized children who are at the “reorganized stage” have recovered well from past trauma and therefore are not likely to come to your attention. Therefore, the “recoil” stage is the one that merits the most attention. This might, for example, involve a traumatized child who is hyper-vigilant and therefore has difficulty concentrating on whatever is going on in chapel or breakfast club. Such a child may get very irritated if distracted from his or her ritual of hyper-vigilant behavior. Another traumatized child may show startle reactions to certain stimuli or conditions [a beeping horn, getting one’s picture taken, getting undressed for swimming or bedtime, being alone behind a closed door] because these conditions signal or symbolize the onset of the trauma. Other children may have night terrors or increased frequency of bedwetting as a result of long term reactions to trauma. RFK Inc. 2012

Triggers A “trigger” is any stimulus or condition that takes one out of a normal mode of conduct and less mature or maladaptive forms of behavior. Certain stimuli associated with past trauma can be triggers for some children A common trigger for children in general is any transition from one activity to another. RFK Inc. 2012

Implications Recognizing common “triggers” such as transition from activity time to chapel time, or the end of swim time, etc. can help volunteers to anticipate and manage camper behavior more effectively. It can also be helpful for counselors to recognize the reasons for often quirky triggers of a traumatized child. “Everyone out of the bounce house. It’s 30/30 timel!” RFK Inc. 2012

Conclusion Understanding abuse, neglect, and child trauma and resulting behaviors will assist RFKC volunteers as they plan and implement a week of positive memories for their campers. RFK Inc. 2012

Let’s have three questions 3 FOR 3 Before we move on… Let’s have three questions about this section. AND / OR three Take-a-ways If you have already had good interactive questions and engagements with the trainees, or if you are out of time, you can skip this slide. If not, this is a good way to end each training section and draw some information out of the trainees. Wait for the answers, don’t move on to fast. Draw some answers out of them. You just covered a lot of material and the trainees should be able to easily come up with three questions and / or three take-a-ways. RFK Inc. 2012