1. Effects of domestic abuse on children By: Rabia Nagda, MD Staff Physician, Urgent care center and Emergency Room Childrens Mercy Hospital

2. 911 Audio from National Center of DV Family of 4

3. Factors affecting willingness to talk Mom’s readiness for change Cultural/religious Provider’s attitude Provider’s experience with violence Communication skills

4. Frightening statistics Battering the SINGLE Largest cause of injury of woman Frequently undiagnosed Victims often conceal their abuse 30% of woman in the US suffer from domestic violence

5. Effects on children: Common Misconceptions It won’t hurt them They are young they will forget They don’t really understand They’re unaware of what’s happening

6. When children witness abuse It affects not only the victim but the children who witness it 3.3 – 10 million children witness family violence 70% of women entering shelters have children younger than 10 years of age Abusive behaviour witnessed by children include hitting, shoving, slapping, punching, and lethal assaults

7. Mothers seek care for their children but not themselves

8. Effects of domestic violence in infancy Disruptive feeding/sleep routines Developmental delay

9. Effects of domestic violence in toddlers/preschoolers Acting out/distracting behaviours Sleep disturbances Withdrawn Clinging behaviour Regressive behaviour: bed wetting, sucking of thumb, loss of bowel control

10. Effects of domestic violence in school age Sleep disturbances School problems Regressive behaviours Somatic complaints Self destructive behaviour

11. Effects of domestic violence in adolescence Running away School problems Depression Substance abuse Aggressive/self destructive behaviours

12. Effects of domestic violence….gender specific Girls have internalizing symptoms - depression- low self esteem- low self worth- higher anxiety levels

13. Effects of domestic violence….gender specific Boys have more externalizing behaviors - conduct disorders- impulsiveness- poor temper control- depression- withdrawal

14. Cognitive effects on the child witnessing abuse Concentrating difficulties Depression Posttraumatic stress Changing school/ changing homes Developmental delays

15. Child Abuse Children of battered mothers are 6 to 15 times more likely to be abused

16. Long Term Effects Depression Low self esteem Trauma related symptoms Poor social adjustment Conduct disorders Antisocial behaviours

17. Long Term effects continued… Self Injurious behaviour Child abuser as adult Potential to become a victim or perpetrator of violence towards others Substance abusers High risk sexual behaviour during adolescence

18. Conclusion