REPORTING CHILD ABUSE: You Simply Need To Pick Up the Phone

Cyndy Doherty and Paula Robertson

The trial is over. Jerry Sandusky, former assistant football coach at Penn State, has been convicted of serial child molestation. The university will be paying millions of dollars in fines. We may come away feeling vindicated, but we also kn\ow in our hearts that this horrendous behavior is continuing elsewhere. Almost nobody knows where. But as in the cases at Penn State, someone does know--and isn’t reporting.

There was evidence through the years of child abuse at the hands of Jerry Sandusky. A temporary employee notified another staff member--but that staff member didn’t report the abuse. An assistant coach notified his supervisor, but that supervisor chose the reputation of the university football program over the emotional and physical health of defenseless boys. Only through the repeated efforts of one very determined mother did the authorities finally act. She made a report that stopped the abuse.

Here in Marin County, we often hear, “Well, there’s no child abuse in Marin County.” How could there be child abuse in the shadow of beautiful Mount Tam?

Unfortunately, the statistics tell another story. In 2006, Marin County Children and Family Services received 2,122 calls of suspected child abuse. In 2011, they received 1,986 calls. At first glance, it appears that child abuse is on the decline--but the number of calls that required an immediate response went up by 9%. Child welfare professionals can’t be absolutely sure, but we believe that as the economy declines, the severity of child abuse increases.

The Marin statistics also prompt a troubling question. Could the decrease in the number of child-abuse calls indicate not that child abuse has gone down, but that those who suspect abuse are not reporting it, as in the case of Penn State?

The effects of child abuse and neglect on the developing brain are chilling. A recent study by Dr. Bruce Perry found that when infants and small children are exposed to violence and trauma, their brains don’t develop the same way as children who are being reasonably nurtured.[1] According to Perry, the results are long-lasting. Children who were born with every chance of hope and success but then are abused are no longer able to compete. Their brains develop differently simply because they are exposed to the trauma of violence and neglect. They may never have the chance to reach their full potential.

The classic Adverse Childhood Experience (ACE) study by Dr. Vincent Felitti is equally startling.[2] He found that children exposed to adverse childhood experiences (trauma, abuse, neglect, domestic violence, poor parental mental health) were more apt to suffer chronic illness in their adult years. Those with the highest exposures to adverse experiences in childhood had significantly higher rates of diabetes and heart disease than the control group. Drug and alcohol use, liver disease, domestic violence, suicide--all increased in direct proportion to the number of adverse experiences the subject had in his or her childhood.

We can do better.

The first child abuse and neglect reporting law in the United States was enacted in 1963. It applied only to physicians. The law assumed that when a physician suspected abuse, he or she would call the authorities. As time went on, the safety net for reporting abuse was enlarged to include child-care workers, teachers, nurses, therapists, firefighters, police, and many other professionals. But the law doesn’t work if we don’t report.

Making a report of child abuse is hard. People are always hesitant to make reports. Did they really see or hear what they thought they saw or heard? Is their report going to make things better or worse? People who make child-abuse reports on a regular basis still hesitate. We have all been trained since childhood not to be snitches--but you just might change the course of a child’s life if you do make a report. Making a report starts the wheels in motion to provide resources and services, not only to the child, but also to the family.

A few years ago, one Marin pediatrician chose to make a report. (Details of this and the following case have been changed.) The doctor reported serious concerns about a little girl who was dangerously below normal in both height and weight. Her mother was from another country and was struggling to understand American language and culture. Because that doctor picked up the phone and reported his concerns, Marin County Children and Family Services (CFS) intervened. The child was placed briefly with a family member while CFS gave the child’s mother support and training in her own language about parenting and nutrition. Once CFS staff were confident that the mother was capable of caring for her daughter, they returned the child to her and provided the family with a professional parenting partner, who continued to teach the mother how to parent and nourish her daughter more effectively. The child is now in the normal range and is thriving. Where would that child be if the pediatrician had not picked up the phone?

In another instance, an ER doctor made a report about a 9-month-old boy with a suspicious fracture of the femur. Full skeletal x-rays showed that the child had five fractures in various stages of healing. As often happens in these cases, it was impossible to determine exactly how these injuries occurred. CFS offered the family various services to help them understand how to handle an active and developing baby, but the family refused. The child was subsequently adopted into a home where he is now thriving. What would have happened to that baby if the doctor had not picked up the phone?

The law is clear. Physicians are legally mandated to make reports of suspected abuse. That means the doctor does not have to be sure: he or she just has to have a suspicion that a child is suffering from abuse or neglect. The penalties for not making a report including fines and jail time. But those penalties pale in comparison to the idea that a child might suffer unspeakable pain because someone hesitated to pick up the phone.

The Marin County CFS hotline is 415-473-7153. Call it if you suspect abuse, or even if you simply want to discuss your concerns with a social worker trained to handle these situations. You don’t have to be sure. You simply need to pick up the phone.

We encourage every doctor in Marin County to know the facts about child-abuse reporting. If you would like to attend a mandated-reporter training session or would like to set up a class in your clinic or hospital, please contact Cyndy Doherty at 415-507-9016 or cyndy@marinadvocates.org.

Know the facts. Make a difference in a child’s life.

 

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Ms. Doherty is executive director of Marin Advocates for Children. Ms. Robertson is a program manager at Marin County Children and Family Services.

Emails: cyndy@marinadvocates.org, probertson@marincounty.org

References

1. Perry BD, “Examining child maltreatment through a neurodevelopmental lens,” J Loss & Trauma, 14:240-255 (2009).

2.  VJ Felitti, et al, “Relationship of childhood abuse and household dysfunction to many of the leading causes of death in adults: the Adverse Childhood Experiences (ACE) Study,” Am J Preventive Med, 14:245-258 (1998).