Family violence is an issue that we as social workers will probably encounter during the course of our careers. While there are many forms of family violence, I view child abuse and neglect as the worst forms. Nothing bothers me more than knowing that somewhere, someone is abusing a completely helpless individual. I view it as our duty not only as social workers but also as humans to ensure that no child has to experience the pain and suffering involved with child abuse and neglect. This may seem like an impossible task, people have been trying for years to end child abuse with no success. I believe, however, that we have the ability to end the threat of child abuse.
I hope to accomplish several things with this paper. First of all, I want you to come away from this paper knowing what child abuse and neglect is. Secondly, I want you to know how often it occurs and what the effects are. Finally, I will lay out a potential plan for ending the threat of child abuse and neglect that we as social workers can adopt and advocate for. Part of the problem in dealing with child abuse and neglect is the lack of clear definitions. There are several types of abuse and neglect, all of which have their own definitions.
According to the National Child Abuse and Neglect Data System (NCANDS), five types accounted for most of the reported child abuse and neglect committed in 1996. These five types were; physical abuse, sexual abuse, neglect, emotional abuse, and medical neglect. Physical abuse is the most visible form of child maltreatment, defined as physical injury resulting from punching, kicking, beating, biting, burning, or otherwise harming a child (American Humane Association, 1999). Most states define sexual abuse as an act by a person which forces, coerces, or threatens a child to have any form of sexual contact or to engage in any type of sexual activity. NCANDS defines neglect as, a type of maltreatment that refers to th failure to provide needed, age-appropriate care. Medical neglect is the failure to provide needed medical attention to a child when financially able to do so, or offered other means by which you can obtain the needed care.
Emotional abuse is commonly defined as a pattern of behavior that can seriously interfere with a child's positive emotional development (American Humane Association, 1999). These definitions for the most part are meant to be guidelines not absolute definitions. A mother, who playfully threatens her child that she will be angry if she doesn't get a kiss on the cheek, will not be charged with sexual abuse even though it fits the legal definition. As social workers we must be prepared to allow for cultural differences in child rearing practices and not be quick to judge. What may seem like child abuse to one culture may not be considered abuse by another. "The vast majority of cases fall in a grey area between the extremes.
Within this grey area, the decision to report an incident is a function of societal standards of acceptable child rearing practices, legal definitions of abuse and neglect, and an individual's own value system" (Rubin, 1992). It is also this lack of a clear, exact, and widely accepted definition of child abuse that hampers us in our fight to end it. According to NCANDS in 1996, an estimated 3,000,000 children were reported for abuse and / or neglect to some form of a social services agency, such as, child protective services. An estimated 1 child out of every 25 children in the U.S. had reports filed on behalf of them. After the investigations, over 1,000,000 children were found to be victims of abuse, an 18% increase since 1990. Based on the 1,000,000 confirmed cases of abuse; 52% involved neglect, 24% involved physical abuse, 12% involved sexual abuse, 6% involved emotional abuse, 3% involved medical neglect, and 14% involved other types of abuse, such as, abandonment.
The victim's age distribution is as follows: Victim's age % of victims of maltreatment Infants: Less that 1 year old 6.7% Preschool: 1-4 years old 25.0% Younger School Age: 5-11 years old 41.6% Older School Age: 12-18 years old 24.9% The age of the child was unknown for 1% of victims. More than half of all victims were younger than 8 years old. Using data from 43 states, about 77% of perpetrators were parents, 11% were other relatives, 2% were other caretakers such as foster parents, and about 10% were classified as non-caretakers, (including other household members not responsible for care or supervision of the child, friends, neighbors), or strangers (American Humane Association, 1999). The NCANDS also estimates the number of children who died as a result of abuse. Based on data from 50 states it is projected that 1,077 died, 77% of these children were under the age of 3. The most alarming fact about these numbers, however, is that most researchers believe the number of child abuse cases is under-reported.
"Hampton and New berger (1985) found that the hospitals they sampled reported less than half of the cases of serious child maltreatment to CPS" (Rubin, 1992). Several factors that influence the decision as to whether to make an official report of child maltreatment have been identified. Lack of sufficient evidence that maltreatment has occurred and lack of seriousness of the possible abuse or neglect are often cited as the most important reasons for not reporting (Rubin, 1992). This clearly shows that child abuse is a severe problem, and that its scope is much wider than most people believe it to be. The effects of child abuse can be severe and long lasting.
A number of reasonably well-established sequelae of child abuse have been identified. These include: lowered IQ, external locus of control, insecure attachment, delay in acquiring internal state vocabulary, delay in expressive language, avoidance in social relationships, aggression, social information processing deficit, suicide, alcohol abuse, and anxiety disorder (Stevenson, 1999). These sequelae are often associated with certain types of abuse. Effects of physical abuse for instance are: infants and preschoolers display problems with attachment and aggressive behavior toward peers; school-age children have been reported to display academic difficulties, decreased self-esteem and social withdrawal, depression, anxiety, and aggressive behavior; adolescents often demonstrate juvenile delinquency, alcoholism, mental illness, and premature death (Becker, Alpert, BigFoot, Bonner, Geddie, Kaufman, & Walker, 1995).
Knowing what child abuse and neglect are, having some knowledge as to its scope and prevalence, and being familiar with its effects leaves us with one important question yet unanswered. What can we do about it There is no simple solution or quick fix it. The solution is going to be complex and made up of many different components. In order to understand what I have planned we must first know what is currently being done to solve this problem.
Most of what is being done today focuses on the abuser not the victim. Researchers tend to focus on ways to treat offenders and think that the victims will be served by eliminating the abuse. Eliminating the abuse is good, but the effects of previous abuse are still there. A study such as, this was conducted by Wolfe and Edwards (1988); they attempted to determine an early prevention strategy for high-risk families. Subjects were selected from a group consisting of parents and children under supervision from a child protective service agency. They started with 53 women and ended with 30 subjects left for comparative analyses due to nonparticipation.
The subjects were divided into a control group and a treatment group. To record self-report measures of risk in the parenting role the Child Abuse Potential Inventory was used. Observational measures of child-rearing methods were based on the Dyadic Parent-Child Interaction Coding System. The Home Observation and Measurement of the Environment Scale was utilized to measure the quality of the child's environment.
The child's behavior was measured using the Pyramid Scales. Subjects in the control group participated in 2-hr group sessions twice a week that included social activities and informal discussions. The program was operated by the child protection agency. Subjects in the treatment group received individual parenting training once a week, and met in weekly information groups of 8-10 people. Subjects in the treatment group at the 3-month follow up reported fewer and less-intense child behavior problems and indicated fewer adjustment problems associated with the risk of maltreatment than did mothers in the control condition. According to Fantuzzo (1990), an extensive search of over 1,500 child abuse and neglect articles from six relevant computer data bases revealed only two studies that assessed the relative efficacy of interventions for child victims, that met minimal standards of experimental design (i. e., random assignment of subjects to multiple groups), and included dependent variables derived from the child-maltreatment research literature.
Fantuzzo's findings may date back to 1990, but they still raise an alarming issue. We do not know what effective treatment programs for victims of child abuse and neglect are, so even if we do stop the abuse from continuing we cannot help them over come the damage already done. There is a question as to whether or not treatment for regular cases of depression is just as effective for those suffering from depression because of childhood abuse or neglect. We know that definitions of abuse are not very clear-cut. The number of children who are victims to child abuse or neglect each year is unacceptable. The long-term effects of child abuse or neglect are well established.
The treatment programs that have been developed by researchers mainly deal with the abusers. Knowing these things gives us as social workers a place to start when dealing with child abuse and neglect. The first step to eliminating this problem is to establish standard operational ized definitions for the different types of child abuse and neglect. Once we have all of the researchers working with the same definitions more of the characteristics of abuse and neglect will surface giving us a better understanding of it.
Standard definitions would also allow researchers to develop treatment programs for victims because they would finally be able to recognize victims of different types of abuse. Once the type of abuse is known it is easier to place a child in the appropriate treatment programs. My plan calls for a pretty major assumption. The assumption being that every child is abused or neglected. I am not saying that every child is abused or neglected, but if we operate under that assumption we can develop universal treatment programs that will reach those who normally wouldn't be identified as being abused. This does not mean that agencies like child protective services should be eliminated.
In fact, I believe that agencies such as child protective services should be expanded. Universal treatment is not going to stop an abuser from hitting his / her child, so it is important that there still be a safeguard to insure that no child has to stay in an abusive situation. Rather, the universal treatment programs would be meant to educate the young, and act as a preventative measure against child abuse and neglect. Most researchers would agree that the only way to insure that all the effects of child abuse and neglect are treated and cured is to prevent it from happening in the first place. Universal treatment programs would be implemented in schools and hospitals and everyone would participate at one point in time or another. Classes in elementary school would teach aggression control techniques, how to express your emotions in a positive way, and other social skills needed by functional adults.
In high school parenting classes would be taught. At the hospitals every person who is giving or gave birth would be required to watch a video on child development. The skills and knowledge taught in these classes would counter-act the messages of violence taught in the media and the world at large. New parents would know what to expect from their children as they develop and with the parenting sills they learned in school they would be able to handle and situations that might arise. As a result, they would be less likely to rely on coping mechanisms and parenting practices that were abusive or neglectful. The number of abusive parents would then decline.
While the universal treatment programs are implemented we must train teachers to become more competent in recognizing the signs of abuse and neglect. Teachers would also be instructed in cultural competency to insure that they would not misinterpret cultural practices as abuse. This would give us a better chance of finding victims and getting them the help that they need. Another aspect of the universal treatment program is the fostering of a trust-based relationship between the students and the teachers. During the process of teaching children how to deal with emotions a more open relationship should develop.
This open relationship would provide a person that children could confide in about stuff that is happening to them. Each school would have a number of social workers assigned to it based on its student population. Once a teacher was alerted to a possible case of abuse or neglect they would take their findings to the social worker. It would then become the social workers responsibility to alert child protective services and interview the child. Child services in cooperation with the police would act as the investigation department to determine if abuse has in fact occurred. The school social workers job would then be to do an initial assessment to determine if any special treatment is necessary for the child.
If child abuse or neglect is found to have happened the child would go to another professional for an in depth assessment. At this assessment any necessary treatment programs to counter act the effects of abuse or neglect would be implemented. While all of this is going on a investigator from child protective services would visit the home and determine if it was safe for the child to remain there. A representative of the D.A.'s office would consult with child protective services to determine what treatment program the offender should enter and then require them to do so at the risk of additional jail time. At this time if would be the prosecutor's job to determine if criminal charges should be pressed, or if enrollment in a treatment program is good enough. No matter what happens the offender would be placed on a list of people who would be subject to random home visits by child protective services to ensure that the child is safe.
The length of time that these random visits can go on for would be determined by a joint decision by the prosecutor's office and child protective services. The current system is similar to this except that I do not see a lot of communication between different agencies. This sharing of responsibilities is a key part of my plan. Everyone has to be on the same page and have the same rules or we will never eliminate child abuse and neglect. This however, does not mean that only school social workers can report abuse and neglect to child protective services. Anyone can alert the appropriate representative of any of these agencies.
It does mean, however, that once the report is in the process of dealing with the situation will begin. The social worker will do an initial assessment, the investigation will take place, and so forth. With a standardized process we can insure that every child will receive our best efforts to insure that they are safe. The last part of my plan calls for us as social workers to do a major part now. We must develop and identify methods for treating abusers and victims.
An open dialogue must be kept so that our ideas can influence those who are conducting research. We must be diligent in our application of these treatment methods to insure that they do treat what they are meant to treat. If any evidence is found that a particular treatment method isn't really effective it must be passed on to everyone else. We are the grunts in this war. Along with developing treatment methods we must make people aware of the problem and force them to act against it. Even if you decide not to adopt my plan action must be taken.
Ideas for programs, treatment, etc. must be promoted because we can no longer ignore this issue. In 1996, 1,000,000 children were the victims of child abuse and neglect. Most of these children were under the age of 3. The effects that child abuse and neglect can have on children have been identified; these effects are quite severe and long lasting. Currently most of the research being conducted is on treatment methods for abusers.
A study conducted in 1990, found that out of 1,500 articles published on child abuse and neglect only 2 dealt specifically with the treatment of victims. This has to be our wake up call. I have presented a general framework for dealing with this issue. If steps such as universal treatment are taken, we will raise children who are a lot less violent and less likely to abuse their own children. It is necessary that we develop treatment programs for the victims because their hurt does not simply go away when the abuse does.
Social workers have always taken on the social problems as their area, so it is our duty to lead the battle against child abuse and neglect. This exercise has really opened my eyes to the vast problem with child abuse and neglect that there is today. The strengths of this paper lie in the offering of a general framework that if adopted would benefit everyone even if it doesn't end up eliminating child abuse like I believe it can. Teaching children how to deal with emotions would go a long way towards solving our problem with violence. The main weakness lies in the fact that I could not go over even a quarter of the published articles on this subject. My lack of knowledge may have led me to come up with ideas that in reality just are not going to work.
This lack of knowledge also prevented me from backing up my ideas with empirical evidence. My biases lay in the fact that I cannot accept partial solutions. I must do everything that I can to solve the problem or reduce it as much as possible. For me partial solutions are just as bad as no solutions because you can never eliminate the problem if you are just addressing a part of it. The contribution that I believe I made is to open people's eyes to the necessity for a plan of action. There must be a general context in which everything takes place if we hope to be successful.
If you have everyone running around doing their own thing vital information will not reach everyone and chances for success will decline rapidly. I do not know how the victims of domestic violence would react to my ideas. I would like to believe that they would appreciate my efforts to make sure that treatments were developed for the problems that they are having. They may decide, however, that they don't like my universal treatment plan and view it as to invasive. I am pretty sure that most abusers would not like my plan at all.
They would probably complain that mandatory treatment is too harsh. I can hear them saying that random visits to the home are a violation of their rights. In the end I don't really care what they say because I am worried about their victims. I think that social workers could adopt my ideas in practice situations in a couple of ways. First of all, they should develop relationships with the prosecutor's office, the police department, and school officials so that they can utilize all of their unique talents when they have to.
They should also keep in contact with other social workers and read the relevant journal articles on child abuse and neglect so that they are aware and up to date on the current knowledge and discoveries. This informal or formal information network would insure that they could help their client with the most current and effective tools in their possession. I hope that it has also just made social workers aware that victims need more help than just removing them from the abuse or neglect. They may also require services to deal with the trauma that they have experienced so that they can go on to lead normal lives. Bibliography
American Humane Association, (1999).
Answers to common questions about child abuse and neglect. [On-line]. Available: web Becker, J.V., Alpert, J.L., BigFoot, D.S., Bonner, B.L., Geddie, L.F., Henggeler, S.W., Kaufman, K.L., & Walker, C.E. (1995).
Empirical research on child abuse treatment: report by the child abuse and neglect treatment working group, American psychological association. Journal of Clinical Child Psychology, 24 (suppl. ), 23-46. Fantuzzo, F.W. (1990).
Behavioral treatment of the victims of child abuse and neglect. Behavior Modification, 14 (3), 316-339. Rubin, G.B., (1992).
Multicultural considerations in the application of child protection laws. Journal of Social Distress and the Homeless, 1 (3-4), 249-271. Stevenson, J., (1999).
The treatment of the long-term sequelae of child abuse. Journal of Child Psychology and Psychiatry and Allied Disciplines, 40 (1), 89-111. Wolfe, D.A., & Edwards, B. (1988).