Pilot CWS-R-SAP – v. 1 Current CWS, 11.8. Types of Child Abuse Incidences

 

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11.8. Types of Child Abuse Incidences

 

The following chart has been created from data in the annual Oregon Child Welfare Data Books for the years 2009 through 2019.

Types of Child Abuse Incidences Chart
Types of Child Abuse Incidences Chart

The chart above illustrates the frequency of the various types of child abuse incidences. One child abuse or neglect victim can endure several child abuse incidents as well as several types of child abuse incidences.

 

Mental Injury Incidences

The bright blue bar at the bottom of each year’s set of bars represents incidences of Mental Injury to the victim of child abuse or neglect. Notice the short length of the blue lines for every year. There is a maximum of 277 incidences of Mental Injury in a year throughout the full range from 2009 through 2019. A definition of Mental Injury:

“what is sometimes called emotional abuse, exposure to family violence, and/or psychological maltreatment falls under the category of mental injury. Mental injury (or psychological/emotional abuse) is a pattern of behavior that impairs a child’s emotional development or sense of self-worth. This may include constant criticism, threats, or rejection, as well as withholding love, support, or guidance. Mental injury is often difficult to prove, and therefore, child protective services may not be able to intervene without evidence of harm or mental injury to the child. Emotional abuse is almost always present when other types of maltreatment are identified. (Child Welfare Information Gateway, 2015). The term mental injury is associated with parental behavior that is so frightening, overwhelming, or threatening that it can damage a child’s developing brain.[1] [bolding added for emphasis]

Using the above definition of Mental Injury, some additional examples include:

  • Lack of Trust
  • Believing they are bad
  • Believing they need to be punished
  • Have a violent worldview
  • Feel they must fight to survive
  • Depression
  • Anxiety
  • Hypervigilance
  • Fear
  • Imprinted bad parent behavior
  • Physical changes in the brain
  • Anger
  • Lack of feelings
  • Call themselves by a different name
  • Lethargy/listlessness
  • Apprehension

The above, plus other Mental Injuries, remain for the child’s lifetime unless they are addressed quickly, and their brains are trained to return to normal functioning. To ignore or limit the assessment without noting the Mental Injury is missing many of the most tragic results of child abuse.

One reason for the low counts for Mental Injuries is provided in the 2011 Data Book:

“All types of abuse decreased with the exception of neglect. The increase in neglect is due in part to several types of maltreatment for mental Injury being re-defined as part of Oregon’s data conversion, to now be included under neglect.” [Bolding added for emphasis]

What is not clear from the above statement is whether the change was initiated by Oregon’s Child Welfare System staff to correspond with the timing of the SACWIS automated system installation or whether the SACWIS automated system required Oregon’s CWS staff to change their practices.

What is the intent or benefit of redefining several types of Mental Injury maltreatment as Neglect, which itself is a large bucket? Also, “Emotional abuse is almost always present when other types of maltreatment are identified.” Thus, Mental Injury is significantly underassessed and underreported as a type of child abuse incidence that needs treatment.

 

Physical Abuse Incidents

The orange bar, just above the bright blue bar for each year, represents incidences of Physical Abuse to the victim of child abuse or neglect. As expected, due to the visible bruising and broken bones, most types of Physical Abuse incidents are readily apparent and included in the assessment.

 

Neglect Incidences

The light gray bar, just above the orange bar for each year, represents incidences of Neglect of the victim of child abuse or neglect. Over the years, Neglect has gradually risen from a distant second place to a significant first place as the most frequent type of incident involving a victim of child abuse or neglect. There has never been a drop in Neglect, although there are a few instances where there was no significant change in Neglect.

The pattern of increased Neglect is obvious; the attempts to address and eliminate Neglect, if any, are ineffective and, perhaps, detrimental to the child.

 

Sexual Abuse Incidences

The yellow bar, just above the light gray bar for each year, represents incidences of Sexual Abuse to the victim of child abuse or neglect. The instances of Sexual Abuse vary across the years, as would be expected in a random occurrence of this type of incidence. However, the number of Sexual Abuse incidences are significantly high enough to warrant programs and services for families to reduce or eliminate Sexual Abuse within the family. In addition, treatment programs for sex offenders in the family should be mandatory.

 

Threat of Harm Incidences

The light blue bar, just above the yellow bar for each year, represents instances of Threat of Harm to the victim of child abuse or neglect. Threat of Harm has been defined as:

“Threat of harm is subjecting a child to a substantial risk of harm to his or her health or welfare. Severe harm is defined as significant or acute injury to a child’s physical, sexual, psychological, cognitive, or behavioral development or functioning; immobilizing impairment; or life threatening damage.”[2] [bolding added for emphasis]

Threat of Harm was the consistent, significantly highest type of incidence from 2009 through 2011. Then, perhaps with the introduction of the SACWIS automated system and its changes in data elements, Threat of Harm Incidences demonstrated a major drop in 2012, and has remained lower until about 2018, where the trend is increasing again. It was the drop of Threat of Harm that allowed the Neglect Incidences to overtake Threat of Harm in the number one spot.

 

Domestic Violence as a Subset of Threat of Harm Incidences

The green bar, just above the light blue bar for each year, represents instances of Domestic Violence as a type of Threat of Harm to the victim of child abuse or neglect. Domestic Violence’s role in Child Abuse and Neglect has changed throughout the years, not only within the Child Welfare System, but also within the medical and therapeutic community. One example, citing Intimate Partner Violence as one type of Domestic Violence states:

If we’re not assessing the risk of Intimate Partner Violence for our pediatric patients, then we’re keeping our eyes closed to a strong and potent risk factor for child maltreatment. … Although IPV has obvious negative effects on the parents/caregivers involved, there are also serious consequences for children exposed to IPV in their homes. These can include physical outcomes such as poor physical health and substance use, as well as adverse mental health outcomes like anxiety, depression, and post-traumatic stress symptoms. Children may act out and be aggressive, and their parents may not connect the behavior to the IPV exposure in the home. The family unit itself can become isolated from other family members or friends in an attempt to hide the violence in the home.”[3] [bolding added for emphasis]

Another example:

“Many children exposed to violence in the home are also victims of physical abuse. Children who witness domestic violence or are victims of abuse themselves are at serious risk for long-term physical and mental health problems. Children who witness violence between parents may also be at greater risk of being violent in their future relationships. If you are a parent who is experiencing abuse, it can be difficult to know how to protect your child.”[4][bolding added for emphasis]

Regardless of whether Domestic Violence is a Threat of Harm or Child Abuse, Domestic Violence has remained a consistent significant incidence to the victim of child abuse or neglect, and the trend is demonstrating an increase in Domestic Violence during the last 3 years. Earlier years of the Data Books had Domestic Violence as its own Type of Incidence; however, the current practice of declaring Domestic Violence as a type of Threat of Harm has been used throughout the chart to be able to compare the data.

 

Neglect as a Subset of Threat of Harm Incidences

The dark blue bar, just above the green bar for each year, represents instances of Neglect as a type of Threat of Harm to the victim of child abuse or neglect. Distinguishing Neglect Incidences from Neglect as a type of Threat of Harm Incidence is difficult. For example, Sexual Abuse Incidences are clearly distinguishable from Sexual Abuse as a type of Threat of Harm Incidences because in the case of Sexual Abuse Incidences, the sexual abuse has actually occurred, while in the case of Sexual Abuse as a type of Threat of Harm Incidences, there is a threat that sexual abuse could occur (e.g., a known pedophile is living in the home with the child).

However, because Neglect is the absence of action, how does that differ from the threat of the absence of action? This point is brought up because, from 2009 through 2011, Neglect Incidences were significantly lower than in 2012 through 2019, and Neglect as a type of Threat of Harm Incidences was significantly higher than in 2012 through 2019. Again, the introduction of the SACWIS automated system appears to have modified the definitions or usage of the two types, resulting in the major changes seen in 2012.

The following chart compares the Threat of Harm Incidences with the Combined Neglect Incidences Plus Neglect as a type of Threat of Harm Incidences:

Threat of Harm vs Combined Neglect
Threat of Harm vs Combined Neglect

As noted in the above chart, with the exception of 2009-2010, the combined Neglect Incidences and Neglect as a type of Threat of Harm Incidences are consistently higher than the Threat of Harm Instances. The difference is even clearer when the Neglect as a type of Threat of Harm Incidences is removed from the Threat of Harm Incidences in the comparison. Compare the following chart with the gray, light blue, and dark blue bars in the first chart in this section.

Threat of Harm Minus Neglect vs Combined Neglect
Threat of Harm Minus Neglect vs Combined Neglect

Neglect, whether recorded as its own Incidences or as a type of Threat of Harm Incidences, has ALWAYS been the highest number of Incidences to victims of child abuse or neglect. Action must be taken to reduce the number of children subjected to neglect.

“Child neglect depends on how a child and society perceives the parents’ behavior. It is not how parents believe they are behaving towards their child. Parental failure to provide for a child, when options are available, is different from failure to provide when options are not available. Poverty and lack of resources are often contributing factors and can prevent parents from meeting their children’s needs when they otherwise would. The circumstances and intentionality must be examined before defining behavior as neglectful. Child neglect is the most frequent form of child abuse, with children born to young mothers at substantial risk for neglect. In 2008, the U.S. state and local Child Protective Services (CPS) received 3.3 million reports of children being abused or neglected. Seventy-one percent of the children were classified as victims of child neglect (“Child Abuse & Neglect”). Maltreated children were about five times more likely to have a first emergency department presentation for suicide-related behavior, compared to their peers, in both boys and girls. Children permanently removed from their parental home because of substantiated child abuse, are also at an increased risk of a first presentation to the emergency department for suicide-related behavior. Neglected children are at risk of developing lifelong social, emotional and health problems, particularly if neglected before the age of two years.”[5] [some bolding in the original; other bolding added for emphasis]

 

Sexual Abuse as a Subset of Threat of Harm Incidences

The reddish-brown bar, just above the dark blue bar for each year, represents instances of Sexual Abuse as a type of Threat of Harm to the victim of child abuse or neglect. Sexual Abuse Incidences are clearly distinguishable from Sexual Abuse as a type of Threat of Harm Incidences because, in the case of Sexual Abuse Incidences, the sexual abuse has actually occurred, while in the case of Sexual Abuse as a type of Threat of Harm Incidences, there is a threat that sexual abuse could occur (e.g., a known pedophile is living in the home with the child).

Although Sexual Abuse as a type of Threat of Harm Incidences are not the highest type of child abuse or neglect, there are sufficient numbers of incidences that warrant action to reduce or eliminate the Sexual Abuse as a type of Threat of Harm from occurring in the family. This is particularly important because this type of Threat of Harm can be discovered through a background check of family members, or at least checking if the family’s address is listed on a sexual predator’s list.

 

Physical Abuse as a Subset of Threat of Harm Incidences

The dark gray bar, just above the reddish-brown bar for each year, represents instances of Physical Abuse as a type of Threat of Harm to the victim of child abuse or neglect. Physical Abuse Incidences are clearly distinguishable from Physical Abuse as a type of Threat of Harm Incidences because, in the case of Physical Abuse Incidences, the physical abuse has actually occurred, while in the case of Physical Abuse as a type of Threat of Harm Incidences, there is a threat that physical abuse could occur (e.g., a parent threatens to hit the child).

Although Physical Abuse as a type of Threat of Harm Incidences are not the highest type of child abuse or neglect, there are sufficient numbers of incidences to warrant action to reduce or eliminate the Physical Abuse as a type of Threat of Harm from occurring in the family.

This is particularly important because this type of Threat of Harm can be discovered through checking if the family’s address is linked to another child’s physical abuse.

 

Mental Injury as a Subset of Threat of Harm Incidences

The light brown bar, just above the dark gray bar for each year, represents instances of Mental Injury as a type of Threat of Harm to the victim of child abuse or neglect. Distinguishing Mental Injury Incidences from Mental Injury as a type of Threat of Harm Incidence is difficult. For example, Sexual Abuse Incidences are clearly distinguishable from Sexual Abuse as a type of Threat of Harm Incidences because in the case of Sexual Abuse Incidences, the sexual abuse has actually occurred, while in the case of Sexual Abuse as a type of Threat of Harm Incidences, there is a threat that sexual abuse could occur (e.g., a known pedophile is living in the home with the child).

However, because Mental Injury can occur without touching the child, how does that differ from the threat of the absence of action? Mental Injury Incidences were significantly low throughout the year 2009 through 2019, and Mental Injury as a type of Threat of Harm Incidences was significantly high in 2009, but much lower throughout 2010 through 2019.

 

Recommendations:

Action Step 11.8.1: Expand the definition of Mental Injury to include the list below and others from doctors who have treated adult survivors of child abuse:

  • Lack of Trust
  • Believing they are bad
  • Believing they need to be punished
  • Have a violent worldview
  • Feel they must fight to survive
  • Depression
  • Anxiety
  • Hypervigilance
  • Fear
  • Imprinted bad parent behavior
  • Physical changes in the brain
  • Anger
  • Lack of feelings
  • Call themselves by a different name
  • Lethargy/listlessness
  • Apprehension

 

Action Step 11.8.2: Remove Mental Injury from a type of Threat of Harm and combine into the Mental Injury Incidences type, with the expanded definition above.

 

Action Step 11.8.3: Find Best-Practices for programs and services for families to measurably reduce Neglect within the family, for the benefit of the child.

 

Action Step 11.8.4: The number of Sexual Abuse incidences are significantly high enough to warrant programs and services for families to reduce or eliminate Sexual Abuse within the family. In addition, treatment programs for sex offenders in the family should be mandatory

 

Action Step 11.8.5: Remove Domestic Violence from Threat of Harm to its own type, due to the current findings that Domestic Violence is actually a type of Child Abuse

 

Action Step 11.8.6: Remove Neglect from Threat of Harm and combine into the Neglect Incidences type

 

[1] Know the Signs: Mental Injury, Alaska Dept. of Health and Social Services, Office of Children’s Services, http://dhss.alaska.gov/ocs/Pages/childrensjustice/reporting/know_mi.aspx

[2] “What you can do about child abuse,” Oregon Department of Human Services, DHS 9061 (Revised 5/2017)

[3] “Domestic Violence and Child Abuse,” Children’s Hospital of Philadelphia Research Institute, Center for Injury Research and Prevention, https://injury.research.chop.edu/violence-prevention-initiative/types-violence-involving-youth/domestic-violence-and-child-abuse#.Xy8MMq-Sk2w, accessed 8/8/2020

[4] “Effects of domestic violence on children,” U.S. Dept. of Health & Human Services, Office on Women’s Health, https://www.womenshealth.gov/relationships-and-safety/domestic-violence/effects-domestic-violence-children, accessed 8/8/2020

[5]Child Neglect: Its Types, Causes and Long-Lasting Effects,” by Panos Karam, September 6, 2019, https://www.lifeadvancer.com/child-neglect-types-causes-effects/, accessed 8/8/2020

 

 

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To submit questions or comments, please email Jo@Jo-Calk.com. I welcome all input, ideas, and suggestions. Thank you for caring for children.

Blessings,

Jo Calk