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Child abuse prevention requires a multi-faceted campaign

This article firs appeared in the St. Louis Beacon, Feb. 24, 2012 - A Yale University researcher is pointing to the national campaign to prevent sudden infant death syndrome, or SIDS, as an example of what needs to be done to reduce the number of youngsters being hospitalized for abuse-related injuries ranging from fractured bones to head trauma.

Dr. John M. Leventhal found that more than 4,500 U.S. children were hospitalized due to child abuse in 2006, and that 300 of those children died. The study, published this month in the online version of the journal Pediatrics, is said to be the first to quantify the severity of abuse based on hospitalization. Leventhal is a professor of pediatrics and medical director of the Child Abuse and Child Abuse Prevention Programs at Yale-New Haven Children’s Hospital.

His study showed that babies under 12 months were the most frequent victims, at a rate of 58 cases for every 100,000 infants.

"In kids less than a year of age, the range of kids hospitalized with abusive injuries is comparable to the range of children dying of SIDS," Leventhal said. "There is a national campaign to prevent SIDS. We need a national campaign related to child abuse."

In 2010 in Missouri, eight children under the age of 1 year died from abuse, according to data from the Department of Health and Senior Services. The agency also reported that 27 children under age 18 died of child abuse in 2010, along with 33 in 2009 and 28 in 2008.

Local child advocates welcome the attention the study brings to the issue of abuse. On the other hand, they say there is big difference between SIDS and abuse and neglect. The former involves inexplicable deaths for which parents and others are not responsible; the latter involves injury and death at the hands of another person, usually an adult.

Without question, the SIDS campaign has been successful. The number of deaths attributed to SIDS in Missouri dropped from 91 in 1994 to 11 in 2010. Part of the drop is due to refinement of the definition of SIDS. Accidental deaths from suffocation in bedding, for example, are now classified as sudden unexpected infant deaths (SUID) rather than instances of SIDS.

So what might a state or national child abuse campaign look like?

Many say the issue is so complex that it would be difficult to boil it down to a single approach like the Back to Sleep educational campaign used to raise awareness of SIDS.

To begin with, there are the different forms of abuse — among them, physical, sexual, domestic, and emotional, says Kirk Schreiber, executive director of the Children's Trust Fund, a foundation dedicated to prevention of child abuse.

The foundation's primary function is education, both for the public and for at-risk populations. The group is distributing a DVD that offers pointers on preventing child abuse and unsafe sleep practices.

More focus alsoneeds to be on children who witness or experience abuse, then grow up and adopt the abusive behavior they've witnessed, Schreiber says.

Whatever form a national campaign might take, Schreiber says the message to adults should be "By not preventing these horrible things and not providing a safe haven for children, society is paying dearly for it."

That price, says the most recent Vision for Children at Risk report, included roughly 1,550 substantiated cases of child abuse and neglect in the St. Louis area in 2008. The actual number of cases, based on reputable national studies, is estimated to be anywhere from three times to 16 times what's reported. The current number of victims and reports of abuse in Missouri are comparable to the number a decade ago, the Vision report says.

The report says abuse and neglect devastate both individuals and the community. The cost of abuse includes medical and therapeutic expenses, foster care, and indirect costs stemming from lower academic achievement, adult crime and long-term mental health issues.

"Although dollar estimates on its impact vary, it is impossible to overstate the deleterious consequences of child abuse and neglect on the life of an individual or family system." the report says.

Emily van Schenkhof, deputy director of Missouri KidsFirst, mentions a combination of new laws and existing programs from which a successful campaign might grow. Programs that KidsFirst has embraced include the national Pinwheels for Prevention™ Campaign. Its website says the program uses public awareness as a tool to "put a new spin on prevention" to make sure abuse and neglect never occur.

As KidsFirst's key lobbyist, van Schenkhof believes more laws are crucial. In this legislative session, she is pressing state lawmakers to pass HB1491. Introduced by Rep. Marsha Haefner, R-Oakville, the bill would put more responsibility on mandated reporters. These include teachers, nurses, social workers, police officers, and mental health workers. The Haefner bill would require them to immediately take their suspicions to the Department of Social Services rather than reporting them to a supervisor. The proposed change is based on the concern that supervisors might not report all allegations.

Van Schenkhof says there are no easy solutions to abuse and neglect problems, but she believes "a big piece" of the answer is more funding. An encouraging example, she says, is a House proposal to add $500,000 to state child advocacy centers across Missouri. In addition to addressing sexual abuse, the money would finance more child abuse prevention work through the centers

"That is a really good example of what it takes to have a national campaign or a statewide campaign," she says. "You have got to be willing to put the money in it."

Robert Joiner has carved a niche in providing informed reporting about a range of medical issues. He won a Dennis A. Hunt Journalism Award for the Beacon’s "Worlds Apart" series on health-care disparities. His journalism experience includes working at the St. Louis American and the St. Louis Post-Dispatch, where he was a beat reporter, wire editor, editorial writer, columnist, and member of the Washington bureau.