April is Child Abuse Prevention Month. As a pediatrician and member and former board chairman of the Massachusetts Children's Trust Fund, I feel compelled to focus on child abuse and neglect this month.
Most individuals monitoring the intense media coverage of abuse and neglect over the past few months, both here in Massachusetts and more recently in Texas, seem quite detached from the stories they report. Perhaps this seeming apathy is related to misconceptions about abuse and neglect.
Here are some false assumptions about child abuse:
r The problem is rare and far removed from us, our friends and neighbors.
r Abuse is an intentional malevolent act committed by a disturbed and violent individual.
r Abuse is a problem related to poverty.
r There is little we can do to prevent abuse.
Child abuse and neglect is a frequent, but eminently preventable disease. Centers for Disease Control statistics reveal that every year in the United States, at least 900,000 children are abused and more than 300,000 end up in foster care. Each day in Massachusetts, nearly 100 children suffer some form of physical abuse, neglect or sexual abuse — a number equivalent to filling Fenway Park annually.
In monetary terms alone, the annual national cost of child abuse to taxpayers runs in excess of $104 billion in direct and indirect charges. Isn't it better to invest in prevention, rather than to pay for decades of treatment and lost productivity?
Child abuse occurs throughout society, across all socioeconomic and cultural planes. Having personal time and the ability to hire a sitter to go shopping or to a movie may reduce parental stress and provide some protection against child abuse. But the fact remains that abuse also occurs in the wealthiest of families.
Abuse is rarely an intentional act. Too frequently, a well-intentioned, loving, acutely stressed parent loses control and strikes out or shakes the baby he or she adores. Anyone, under extreme circumstances, has the potential to abuse. Most parents will acknowledge that at times of stress, an infant who is continuously crying causes them to tense up. The significant difference between an abuser and a nonabuser, however, is the ability and good sense to walk away, take a deep breath and, when needed, ask for help.
Effective intervention exists to prevent one of the most common and devastating kinds of abuse, shaken baby syndrome. Young infants aren't fragile, but they are vulnerable to brain injury when shaken forcefully. Their developing brains are soft, their heads disproportionately large, and their neck muscles are weak. Shaking for even a few cycles can cause the brain to bleed and swell, and subsequently lead to permanent injury or death. Studies have shown that shaken baby syndrome can be prevented by educating new parents to the potential danger of shaking and providing them with strategies to cope with stress.
The Children's Trust Fund (www.mctf.org) is a public-private partnership created by the state Legislature almost 20 years ago to prevent child abuse by strengthening families. It is a catalyst for the development of abuse prevention programs.
Healthy Families Massachusetts, which is funded by the state and managed by CTF, provides intensive, strength-based home visiting services to first-time parents under age 20. Program participants have a lower rate of abuse, tend to stay in school and graduate, and delay subsequent pregnancies. Multiple other programs are available, including The Fatherhood Initiative, Massachusetts Family Centers and the One Tough Job Web site (www.onetoughjob.org).
Abuse damages children's lives and society as a whole. We all thrive from the Clean Air initiative created by the anti-smoking campaign, and are safer since an army of volunteers decided to get drunken drivers off the road. Isn't it time we made the same commitment to protect society's most important and vulnerable assets, our children?
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Dr. Edward Bailey is chief of pediatrics at NSMC North Shore Children's Hospital and is on staff at Massachusetts General Hospital for Children. He is married and the father of three. You can contact him at ebailey@aap.org.
