New Mexico News
| HEALTHBITS - We All Can Help Prevent Abuse |
| Posted by () on May 21 2008 at 6:43 PM |
YOUR CHILD'S HEALTH: Last week in the hospital I cared for a cute little child — let’s call her Lucy — almost 1 year old. She was not my sickest patient, but was one of the saddest, especially when she cried piteously whenever I approached her. Slightly less than a year old, she was beautiful, except for the bruises around her eye and below her ear. The big lump above her ear had gone down by the time I saw her as she clung to her very attentive nurse.
Neither I nor the doctor who admitted her to the hospital knew exactly what had happened to this little girl. It wasn’t a fall from a bed, as we hear so often; this was an inflicted injury, as we call those injuries that almost always occur at the hands of someone bigger and stronger: child abuse, in other words. Perhaps I looked like her abuser; perhaps she distrusted all males.
The evaluation and management of child abuse is now an established part of the training of pediatricians and others who see children. It is now almost half a century since Denver pediatrician Henry Kempe first described the “battered child syndrome” in 1962. The problem had certainly been around well before Kempe and before Charles Dickens’ descriptions in novels such as Oliver Twist in the mid-19th century.
What will happen to Lucy? In the short run, she will be discharged to a foster home through the resources of the Children, Youth and Families Department. If she is fortunate, she will receive love that helps to dissolve her learned distrust. She will be returned to her birth family, after CYFD has investigated to be sure she will be safe. If her family was found to have been involved in her abuse, they will receive services to help them be better parents. She will be safe with them, will receive all of the caring — the bedtime stories, the holding and talking, the contact with a smiling, attentive parent — that she needs. She will enter kindergarten with parents devoted to supporting her school career and will be watched through adolescence to be sure she does not develop the signs of post-traumatic stress disorder common to abused children.
When she becomes a parent — hopefully at least 20 years from now — she will have a supportive husband and supportive medical caregivers who will help to keep her on the path of positive parenthood. That’s if she’s very fortunate; I wonder how often that really happens?
Less positive outcomes veer off from this ideal scenario. Despite CYFD’s best efforts, she may be placed in a series of less-than-adequate foster homes or returned to a family less than adequately supported to be good parents. Her parents may abuse her again at a time when they themselves are under extreme stress. She may enter school with marginal preparation; 22 percent of all abused children end up in special education. She may fall prey to PTSD or another mental disorder. According to North Carolina child abuse expert Dana Hagele, between one-third and one-half of all maltreated children are diagnosed as having PTSD.
If that isn’t scary enough, adults who have been mistreated as children often become parents too early and are more than twice as likely to abuse their own children. Lucy’s own little Lucies may end up in the arms of another caring, compassionate and despairing nurse.
Researchers have estimated the annual financial cost of U.S. child abuse to be $108 billion. That sounds like a lot of money, unless we’re all so numbed by talk of billions and trillions in the budget and economy. There’s no denying the substantial additional psychological and emotional costs of child abuse, which are hard to quantify.
What can be done about this dismal story? It’s too late for Lucy, but we can try to be sure that all children are born to parents who want them and are prepared to be good parents. We must recognize that the sexual activity so blatantly promoted on TV and in other media may encourage sexual activity resulting in pregnancy. We should do something about it. Abstinence is difficult in such a milieu, but it should be promoted as the best among other possible policies.
Parenting education such as that given at the New Futures School in Albuquerque or the Teen Parent Support Center in Santa Fe is very important, even when most of those receiving it were not planning to be parents and may be ambivalent about being there. Home visiting programs such as those provided by All Faiths or by the Young Children’s Health Center in Albuquerque or the First Born Program in Grant, Rio Arriba, Taos and Santa Fe counties help to promote the best instincts of young parents. Hands-on young childhood education for parents, such as that provided at PB&J Family Services in Albuquerque, may undo some of the bad models experienced by young parents previously subjected to abuse like Lucy.
This is National Child Abuse Prevention Month. Lucy’s story is all too real and should have been prevented. As individuals, we can work with or support agencies such as those mentioned here to prevent child abuse, and to prevent the long-term consequences that can be predicted to occur all too often to children abused as Lucy was. As a health professional, I am legally obligated to report suspected child abuse; we are all morally obligated to do so. Anonymous or otherwise, the phone number to call in New Mexico is (800) 797-3260.
Lance Chilton, M.D., is a pediatrician at the Young Children’s Health Center in Albuquerque, associated with the University of New Mexico. He is happy to hear from those with questions at 272-9242 or lancekathy@yahoo.com.
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