Wednesday, November 11, 2009

A story of hopeful love, turned to violence and murder

This is something I decided to share on all of the blogs because I feel that through Mildred Muhammad’s pain, society as a whole can see yet again a bit of insight into a Domestic Violence Victim.  Here is a Survivor that dealt with the “hidden” affects of DV, those that aren’t seen but leave deep scars.

“But in general this book is about domestic violence when there are no scars — the domestic abuse that strains the victims' credibility in some minds because there are no broken bones or blackened eyes, and because the perpetrator is such a smooth monster, and John Muhammad was certainly that. He once told his wife, “I'm going to fix it so that no one will ever believe you or want you.” Imagine that, after John Muhammad kidnapped his and Mildred's three children and fled with them to Antigua, where he stayed for 18 months. There were people who knew where her children were, but for whatever reason (maybe, they were afraid of John, too) wouldn't give Mildred any relief.”

This is something I feel that anyone dealing with those going through Domestic Violence should read.  I have yet to read the book myself, but from what I’ve read and heard, it sounds like there were warning signs that could have prevented this monster from removing himself from “Behind Closed Doors” into becoming a monster that thousands feared.  We’ve all “met” the monster, now I feel it’s time to meet the Survivor……

A story of hopeful love, turned to violence and murder

Betty Winston BayĆ© • October 27, 2009

One day my ex-husband and the father of my children will be executed. I am still processing this fact. … Until that day execution seems like just another word. I cannot begin to comprehend how I will feel when this day comes, but I will have to lead my children through their grief.

MILDRED MUHAMMAD,
author of ‘Scared Silent'

The man that Mildred Muhammad loved, married in 1983 and bore three children for was a charming liar and cunning manipulator. He's John Allen (Williams) Muhammad, aka “The D.C. Sniper,” who in 2002, with teenager Lee Boyd Malvo, engaged in a three-week killing spree during which 13 people were shot, 10 of them fatally. The two also are implicated in other murders in Alabama and Tacoma, Wash. Their D.C.-area victims were randomly chosen as they engaged in the most mundane things: mowing grass, pumping gasoline, walking across a mall parking lot and waiting for a school bus. Thus, the terrifying fear as people wondered who would be next.

When they met in Baton Rouge, La., John Williams cast himself as the handsome prince come to sweep Cinderella off her feet. John immediately went to work on Mildred's heart. His tears appealed to her sensitive side as did his tale of a sad childhood in New Orleans, where his mother died of breast cancer. John had big dreams and once looked Mildred in the eye and said, “I'm looking for someone to share my life.” That did it for Mildred, who said that John had her at a disadvantage because “my ideas of how a man should behave in a relationship were all romanticized and based on television, movies and hearsay.”

What Mildred didn't know was that John was already married. Buy the book to learn the rest of that story.

But in general this book is about domestic violence when there are no scars — the domestic abuse that strains the victims' credibility in some minds because there are no broken bones or blackened eyes, and because the perpetrator is such a smooth monster, and John Muhammad was certainly that. He once told his wife, “I'm going to fix it so that no one will ever believe you or want you.” Imagine that, after John Muhammad kidnapped his and Mildred's three children and fled with them to Antigua, where he stayed for 18 months. There were people who knew where her children were, but for whatever reason (maybe, they were afraid of John, too) wouldn't give Mildred any relief.

Perhaps John Muhammad suffered post-traumatic stress after serving in the Gulf War, but even before he joined the Army, there were clues that he may have been a troubled young man. When things didn't go his way — even if it was while playing tag or Monopoly with his children — John would pout and change the rules.

Mildred's story of life with an abusive man who became a notorious killer is the tale of a woman fighting desperately to save her sanity, her physical self and her children. Hers is also a story of the power of prayer and friends and strangers who intervened. At the back of the book, there are resources for domestic abuse victims, for the people who love them or who simply want to gain a better understanding of the complex issues involved. The book even includes a “safety plan” with advice on how to prepare to get away from an abusive situation and what to take when you leave.

With John Muhammad behind bars, Mildred and her children finally are free from the terror. She remarried in 2007. Her son is in college, and her two daughters plan to attend colleges of performing arts. Mildred is on the speaking circuit; she's on the board of several organizations; consults with the federal Office for Victims of Crimes; and she's created “After the Trauma” to assist victims of domestic violence.

But for all the good stuff, a fairy-tale happy ending is still elusive because, as Mildred said, there's the execution to be dealt with, and she wrote, “My brain still has difficulty coming to terms with the fact that John was going to kill me; that I am not supposed to be here. I was supposed to be a statistic. And at times, my imagination still presents me a gruesome and graphic picture of a bloody, dead me.”

Original Article

Third National Incidence Study of Child Abuse and Neglect

This report presents the results of the congressionally mandated Third National Incidence Study of Child Abuse and Neglect (NIS-3). The NIS is the single most comprehensive source of information about the current incidence of child abuse and neglect in the United States. The NIS-3 findings are based on a nationally representative sample of over 5,600 professionals in 842 agencies serving 42 counties. The study used two sets of standardized definitions of abuse and neglect. Under the Harm Standard, children identified to the study were considered to be maltreated only if they had already experienced harm from abuse or neglect. Under the Endangerment Standard, children who experienced abuse or neglect that put them at risk of harm were included in the set of those considered to be maltreated, together with the already-harmed children.

The NIS-3 provides us with important insights about the incidence and distribution of child abuse and neglect and about changes in incidence since the previous studies.

Incidence

  • There have been substantial and significant increases in the incidence of child abuse and neglect since the last national incidence study was conducted in 1986.
  • Under the Harm Standard definitions, the total number of abused and neglected children was two-thirds higher in the NIS-3 than in the NIS-2. This means that a child's risk of experiencing harm-causing abuse or neglect in 1993 was one and one-half times the child's risk in 1986.
  • Under the Endangerment Standard, the number of abused and neglected children nearly doubled from 1986 to 1993. Physical abuse nearly doubled, sexual abuse more than doubled, and emotional abuse, physical neglect, and emotional neglect were all more than two and one-half times their NIS-2 levels.
  • The total number of children seriously injured and the total number endangered both quadrupled during this time.

Child Characteristics

  • Girls were sexually abused three times more often than boys.
  • Boys had a greater risk of emotional neglect and of serious injury than girls.
  • Children are consistently vulnerable to sexual abuse from age three on.
  • There were no significant race differences in the incidence of maltreatment or maltreatment-related injuries uncovered in either the NIS-2 or the NIS-3.

Family Characteristics

  • Children of single parents had a 77% greater risk of being harmed by physical abuse, an 87% greater risk of being harmed by physical neglect, and an 80% greater risk of suffering serious injury or harm from abuse or neglect than children living with both parents.
  • Children in the largest families were physically neglected at nearly three times the rate of those who came from single-child families.
  • Children from families with annual incomes below $15,000 as compared to children from families with annual incomes above $30,000 per year were over 22 times more likely to experience some form of maltreatment that fit the Harm Standard and over 25 times more likely to suffer some form of maltreatment as defined by the Endangerment Standard.
  • Children from the lowest income families were 18 times more likely to be sexually abused, almost 56 times more likely to be educationally neglected, and over 22 times more likely to be seriously injured from maltreatment as defined under the Harm Standard than children from the higher income families.

Child Protective Services (CPS) Investigation

  • CPS investigated only 28% of the recognized children who met the Harm Standard. This was a significant decrease from the 44% investigated in 1986.
  • Although the percentage of children whose abuse or neglect was investigated declined, the actual number of children investigated remained constant.
  • CPS investigated less than one-half of all Harm Standard children recognized by any source and less than one-half of all Endangerment Standard children recognized by any source except police and sheriffs' departments (52%).
  • Schools recognized the largest number of children maltreated under the Harm Standard, but only 16% of these children were investigated by CPS.
  • CPS investigated only 26% of the seriously injured and 26% of the moderately injured children.

This study would not have been possible without the support of hundreds of agencies and individual caseworkers, teachers, police officers, social workers, probation officers, nurses, and other professionals in the study counties who contributed their enthusiastic support and much of their time in the effort to assess accurately the incidence, nature, and distribution of child abuse and neglect in the United States. I extend my appreciation to these dedicated respondents.

This report summarizes the Third National Incidence Study of Child Abuse and Neglect (NIS-3). It gives a synopsis of the study's background and objectives, its design and methods, and its key findings and implications.

Background and Objectives

The National Incidence Study (NIS) is a congressionally mandated, periodic effort of the National Center on Child Abuse and Neglect (NCCAN). The first NIS (NIS-1), mandated under P.L. 93-247 (1974), was conducted in 1979 and 1980 and published in 1981. The second NIS (NIS-2), mandated under P.L. 98-457 (1984), was conducted in 1986 and 1987 and published in 1988. The third NIS (NIS-3) was mandated under P.L. 100-294 (as amended). The NIS-3 data were collected in 1993 and 1994, analyses conducted in 1995 and 1996, and these results published in 1996. A key objective of the NIS-3 was to provide updated estimates of the incidence of child abuse and neglect in the United States and measure changes in incidence from the earlier studies.

Design and Methods

The NIS-3 offers an important perspective on the scope of child abuse and neglect. The NIS includes children who were investigated by child protective service (CPS) agencies, but it also obtains data on children seen by community professionals who were not reported to CPS or who were screened out by CPS without investigation. This means that the NIS estimates provide a more comprehensive measure of the scope of child abuse and neglect known to community professionals, including both abused and neglected children who are in the official statistics and those who are not. The NIS follows a nationally representative design, which means that the estimates represent the numbers of abused and neglected children in the United States who come to the attention of community professionals. The fact that there have been three similar national incidence studies that have used comparable methods and definitions means that one can compare NIS-3 estimates with those from the earlier studies in order to identify any changes over time in the incidence and distribution of abused and neglected children.

The NIS-3 was conducted in a nationally representative sample of 42 counties. In every county, the CPS agency was a key participant, providing basic demographic data on all the children who were reported and accepted for investigation during the 3-month study data period, September 5 through December 4, 1993. Further details about the child's maltreatment and the outcome of the CPS investigation were obtained for a representative sample of these cases.

Like the NIS-1 and NIS-2 before it, the NIS-3 employed a sentinel survey methodology, in which community professionals serving children and families in various categories of non-CPS agencies were also recruited into the study. In each county, these sentinels were a representative sample of all professional staff who were likely to come into contact with maltreated children in police and sheriffs' departments, public schools, day-care centers, hospitals, voluntary social service agencies, mental health agencies, and the county juvenile probation and public health departments. The participating sentinels in the NIS-3 were 5,612 professionals in 800 non-CPS agencies who remained on the lookout for maltreated children during the study period. They were trained in the standard NIS definitions of abuse and neglect at the outset, and they submitted data forms on any children they encountered who were maltreated during the study data period. The NIS-3 collected a total of 50,729 data forms: 4,711 from non-CPS sentinels; 3,154 on the investigation outcomes and the abuse and neglect involved in cases sampled at participating CPS agencies; and 42,864 capturing the basic demographic data on all cases reported to participating CPS agencies during the study period.

Children who were submitted to the study by non-CPS sentinels and those who were investigated in the CPS sampled cases were evaluated according to standard study definitions of abuse and neglect, and only children who fit the standards were used in generating the national estimates. The definitional standards used in the NIS-3 were identical to those used in the NIS-2. These standards imposed a number of requirements, including the restriction that the abuse or neglect be within the jurisdiction of CPS (i.e., perpetrated or permitted by a parent or caretaker), and they applied uniform classification systems to index the type of maltreatment and the severity and type of injury or harm.

Two sets of definitional standards were applied: the Harm Standard and the Endangerment Standard. The Harm Standard was developed for the NIS-1, and it has been used in all three national incidence studies. It is relatively stringent in that it generally requires that an act or omission result in demonstrable harm in order to be classified as abuse or neglect. Exceptions are made in only a few categories where the nature of the maltreatment itself is so egregious that the standard permits harm to be inferred when direct evidence of it is not available. The chief advantage of the Harm Standard is that it is strongly objective in character. Its principal disadvantage is that it is so stringent that it provides a view of abuse and neglect that is too narrow for many purposes, excluding even many children whose maltreatment is substantiated or indicated as abuse or neglect by CPS.

To meet the need to include the full set of substantiated/indicated children in the incidence statistics, the Endangerment Standard was developed as a definitional standard during the NIS-2 to supplement the perspective provided by the Harm Standard. The Endangerment Standard includes all children who meet the Harm Standard but adds others as well. The central feature of the Endangerment Standard is that it allows children who were not yet harmed by maltreatment to be counted in the abused and neglected estimates if a non-CPS sentinel considered them to be endangered by maltreatment or if their maltreatment was substantiated or indicated in a CPS investigation. In addition, the Endangerment Standard is slightly more lenient than the Harm Standard concerning the identity of allowable perpetrators in that it includes maltreatment by adult caretakers other than parents in certain categories as well as sexual abuse perpetrated by teenage caretakers. The Endangerment Standard was used in both the NIS-2 and the NIS-3.

Duplicate forms about the same child were identified and unduplicated, so that each child was included in the database only once. Finally, the data were weighted to represent the total number of children maltreated in the United States and annualized to transform the information from the 3-month data period into estimates reflecting a full year.

The National Incidence of Child Abuse and Neglect

The findings of the Third National Incidence Study of Child Abuse and Neglect (NIS-3) show a sharp increase in the scope of the problem, whether maltreatment is defined using the Harm Standard or the Endangerment Standard.

Estimated Incidence As Defined by the Harm Standard.

An estimated 1,553,800 children in the United States were abused or neglected under the Harm Standard in 1993. The NIS-3 total reflects a 67% increase since the NIS-2 estimate, which indicated that the total was 93 1,000 children in 1986, and it corresponds to a 149% increase since the NIS-1 estimate for 1980 of 625,100 children. Significant or close-to-significant increases were found in both abuse and neglect. The number of abused children who were countable under the Harm Standard rose by 46% from an estimated 507,700 in the NIS-2 to 743,200 in the NIS-3. The number of neglected children who fit the Harm Standard increased significantly from 474,800 during the NIS-2 data collection in 1986 to 879,000 at the time of the NIS-3 data period in 1993. In the estimates given here and below, children are included in all categories that apply to them (i.e., those who were both abused and neglected are included in both estimates).

Considering specific types of abuse and neglect as defined by the Harm Standard, significant increases since the NIS-2 were found in the incidence of sexual abuse, physical neglect, and emotional neglect, and a close-to-significant (i.e., statistically marginal) increase was observed in the incidence of physical abuse:

  • The estimated number of sexually abused children under the Harm Standard rose from II 9,200 in 1986 to 217,700 in 1993 (an 83% increase);
  • The number of physically neglected children under the Harm Standard increased from an estimated 167,800 at the time of the NIS-2 to an estimated 338,900 in the NIS-3 (a 102% rise in incidence);
  • There was a 333% increase in the estimated number of emotionally neglected children using the Harm Standard, from 49,200 in the NIS-2 to 212,800 in the NIS-3; and
  • The estimated number of physically abused children under the Harm Standard was 269,700 at the time of the NIS-2, but it had increased to 381,700 during the NIS-3 (a 42% increase).

When these abused and neglected children were classified according to the injury or harm they suffered from maltreatment that fit the Harm Standard, there was a substantial and significant increase in the incidence of children who were seriously harmed and a statistically marginal increase in the number for whom injury could be infeffed due to the severe nature of their maltreatment. The estimated number of seriously injured children essentially quadrupled from 141,700 to 565,000 in the intervening 7 years between the NIS-2 and the NIS-3 (a 299% increase). The number for whom injury could be infeffed increased from an estimated 105,500 children in the NIS-2 to an estimated 165,300 children in the NIS-3 (a 57% increase).

Estimated Incidence Using the Endangerment Standard.

Between 1986 and 1993, the total estimated number of abused and neglected children in the United States who fit the Endangerment Standard nearly doubled: in 1986, there were an estimated 1,424,400 abused and neglected children in the United States. The NIS-3 estimate of 2,815,600 reflects a 98% increase over the NIS-2 figure. Significant increases were found in both abuse and neglect. The number of abused children more than doubled from an estimated 590,800 to 1,221,800 (a 107% increase), while the estimated number of neglected children also more than doubled from 917,200 to 1,961,300 (a 114% increase).

  • The increases were substantial and significant in all types of abuse and neglect except educational neglect;
  • The estimated number of physically abused children rose from 311,500 to 614,100 (a 97% increase);
  • The estimated number of sexually abused children increased from an estimated 133,600 children to 300,200 (a 125% increase);
  • The more recent estimate of the number of emotionally abused children was 183% higher than the previous estimate (188,100 in 1986 versus 532,200 in 1993);
  • The estimated number of physically neglected children increased from 507,700 to 1,335, 100 (a 163% increase); and
  • The estimated number of emotionally neglected children nearly tripled in the interval between the studies, rising from 203,000 in 1986 to 585,100 in 1993 (a 188% increase).

When the children whose abuse or neglect met the Endangerment Standard were classified according to the injury or harm they suffered, significant increases were evident in two categories. First, the 1993 estimate of the number of children who were endangered by their maltreatment (but not yet harmed) was more than four times the corresponding 1986 estimate. That is, the number of endangered children rose from an estimated 254,000 in 1986 to an estimated 1,032,000 in 1993 (a 306% increase). Second, the number of children who were seriously injured or harmed by abuse or neglect that fit the Endangerment Standard in 1993 was well over one-half million, which is nearly quadruple the 1986 estimate for this category. In 1986, an estimated 143,300 children had been seriously injured by abuse or neglect; in 1993, the figure was 569,900 children (a 298% increase). Note that nearly all (99%) of the children who counted as seriously injured here were also countable under the Harm Standard, so the near-quadrupling of their numbers since 1986 essentially reiterates what was reported above in connection with the Harm Standard.

Distribution of Child Abuse and Neglect by the Child's Characteristics

The child's sex and age were related to the rate of maltreatment, but race was not.

Child's Sex.

Girls were sexually abused about three times more often than boys, under both the Harm Standard and the Endangerment Standard. This finding reiterates the NIS-2 result, so females' disproportionately greater risk of sexual abuse has been stable over time. This sex difference in incidence rates of sexual abuse leads to higher rates of abuse in general among girls. Also, because the definitional guidelines permit the inference that injury or harm occurred in connection with the more extreme forms of sexual abuse, girls' greater risk of sexual abuse also accounts for their higher incidence rates for inferred injury.

At the same time, boys had higher incidence rates than girls in some arenas, and boys' maltreatment risks also demonstrated some increases since the NIS-2. Boys were at somewhat greater risk of serious injury (24% higher than girls' risk under both definitional standards), and boys were significantly more likely to be emotionally neglected (boys' risk was 18% greater than girls'). Also, boys' rates of physical neglect defined by the Harm Standard and of emotional abuse using the Endangerment Standard increased more since the NIS-2 than girls' rates did. Moreover, trends in the incidence of fatal injuries from maltreatment moved in opposite directions for girls and boys-the incidence of fatally injured girls declined slightly since the NIS-2, while the incidence of fatally injured boys rose.

Child's Age.

A consistent feature of the age differences in incidence rates within the NIS-3 was the lower incidence of maltreatment among the younger children under both definitional standards. In most cases, the differentiation was between the 0- to 2-year-olds and older children or between the 0- to 5-year-olds and older children. It is possible that the lower rates at these younger ages reflect undercoverage of these age groups. That is, prior to attaining school age, children are less observable to community professionals.

Another recurring theme in connection with age is that of disproportionate increases in the incidence of maltreatment among the younger children (under 12 years old) and especially among children in their middle-cbildhood years (ages 6 to I 1). Note that as circumstances deteriorate and maltreatment becomes more prevalent and more severe, older children have greater opportunities for escape. Also, older children are more able to defend themselves andIor retaliate. These factors may have moderated the increases in maltreatment that were observed among the older age groups.

The disproportionate increases during the younger and middle-childhood years mean that the overall profiles of age differences in maltreatment were different in the NIS-3 than they had been in the NIS-2. During the NIS-2, the risk of maltreatment generally increased with the age of the child in a close-to-linear fashion. With the lopsided increases among the younger children and among children in their middle-childhood years, the profile has changed toward a curvilinear configuration-where the middle-years of childhood are associated with the maximum risk of maltreatment-and toward a somewhat flatter distribution-where age differences are somewhat attenuated overall compared to their NIS-2 patterns.

One of the most striking findings is the age distribution of sexual abuse, which combined the general flattening of the age differences in incidence rates with a very low age transition in the distribution of incidence rates. The rate of sexual abuse as defined under the Endangerment Standard was very low for 0- to 2-year-olds, but then relatively constant for children ages 3 and older, indicating a very broad age range of vulnerability from preschool age on.

Race.

The NIS-3 found no race differences in maltreatment incidence. The NIS-3 reiterates the findings of the earlier national incidence studies in this regard. That is, the NIS-1 and the NIS-2 also found no significant race differences in the incidence of maltreatment or maltreatment-related injuries.

Service providers may find these results somewhat surprising in view of the disproportionate representation of children of color in the child welfare population and in the clientele of other public agencies. However, it should be recognized that the NIS methodology identifies a much broader range of children than those who come to the attention of any one type of service agency or the even smaller subset who receive child protective and other child welfare services. The NIS findings suggest that the different races receive differential attention somewhere during the process of referral, investigation, and service allocation, and that the differential representation of minorities in the child welfare population does not derive from inherent differences in the rates at which they are abused or neglected. It is also important to recognize that while there are no overall race differences in the incidence of child abuse and neglect in the NIS-3 findings, subsequent analyses that simultaneously consider multiple characteristics may reveal race differences in maltreatment incidence among specific subsets of children (e.g., for children of certain ages, for one sex but not the other, etc.).

Distribution of Child Abuse and Neglect by Family Characteristics

The incidence of child maltreatment varied as a function of family income, family structure, family size, and the metropolitan status of the county.

Family Structure.

Children of single parents were at higher risk of physical abuse and of all types of neglect and were overrepresented among seriously injured, moderately injured, and endangered children. Compared with their counterparts living with both parents, children in single parent families had:

  • a 77% greater risk of being harmed by physical abuse (using the stringent Harm Standard) and a 63% greater risk of experiencing any countable physical abuse (using the Endangerment Standard);
  • an 87% greater risk of being harmed by physical neglect and a 165% greater risk of experiencing any countable physical neglect;
  • a 74% greater risk of being harmed by emotional neglect and a 64% greater risk of experiencing any countable emotional neglect;
  • a 220% (or more than three times) greater risk of being educationally neglected;
  • an approximately 80% greater risk of suffering serious injury or harm from abuse or neglect;
  • an approximately 90% greater risk of receiving moderate injury or harm as a result of child maltreatment; and
  • a 120% (or more than two times) greater risk of being endangered by some type of child abuse or neglect.

Among children in single-parent households, those living with only their fathers were approximately one and two-thirds times more likely to be physically abused than those living with only their mothers.

Although parents are not necessarily, nor even most frequently, the perpetrators of maltreatment, the relationship between parent structure and maltreatment incidence is understandable, considering the added responsibilities and stresses of single-parenting together with the likelihood that surrounding social and practical support may be inadequate.

Family Size.

The incidence of maltreatment was related to the number of dependent children in the family, especially in the categories of physical and educational neglect. For educational neglect, and for physical neglect according to the Harm Standard, the pattern was nonlinear: the incidence rates were highest for children in the largest families (those with four or more children), intermediate for "only" children, and lowest for children in families with two to three children. Children in the largest families were almost three times more likely to be educationally neglected, and nearly two and two-fifths times more likely to be physically neglected under the Harm Standard, compared to children in families with two or three children. Under the Endangerment Standard, the pattern was one of increasing incidence of physical neglect with greater numbers of children. Children in the largest families were physically neglected at nearly three times the rate of those who came from "only" child families.

Additional children in a household mean additional tasks and responsibilities, so it is understandable why incidence rates of child abuse and neglect may be higher when there are more children. Accounting for why "only" children have higher rates of educational neglect and of physical neglect under the Harm Standard than children in families with two or three children requires a different explanation. One possibility is that there may be too many expectations focused on "only" children, whereas expectations (and disappointments) are diffused over multiple children in the larger families. Another possibility is that many "only" child households represent the early stages in their families' development, since a number of these families will have additional children, in time. Thus, many "only" children are in families with relatively young and inexperienced parents and caretakers.

County Metropolitan Status.

The incidence of children who had been moderately harmed by maltreatment was significantly lower among children in large urban counties than among children who lived in other urban counties. This was interpreted as reflecting a general under-coverage of moderately injured maltreated children in the large urban counties. It was not clear whether this was because the moderately injured children are less likely to be encountered by community professionals in the large urban centers, because community professionals in these locales are less likely to identify these children as maltreated, or because the NIS information sources in these counties are less likely to submit data about these maltreated children.

Family Income.

Despite the fact that only a rather gross index of family income was available, and despite a substantial percentage of cases with missing data on this factor, family income was significantly related to incidence rates in nearly every category of maltreatment. Compared to children whose families earned $30,000 per year or more, those in families with annual incomes below $15,000 per year were:

  • more than 22 times more likely to experience some form of maltreatment under the Harm Standard and over 25 times more likely to suffer maltreatment of some type using the Endangerment Standard;
  • almost 14 times more likely to be harmed by some variety of abuse and nearly 15 times more likely to be abused using the Endangerment Standard criteria;
  • more than 44 times more likely to be neglected, by either definitional standard;
  • almost 16 times more likely to be a victim of physical abuse under the Harm Standard and nearly 12 times more likely to be a victim of physical abuse using the Endangerment Standard;
  • almost 18 times more likely to be sexually abused by either definitional standard;
  • thirteen times more likely to be emotionally abused under the Harm Standard criteria and more than 18 times more likely to be emotionally abused in a manner that fit Endangerment Standard requirements;
  • forty times more likely to experience physical neglect under the Harm Standard and over 48 times more likely to be a victim of physical neglect using the Endangerment Standard;
  • over 29 times more likely to be emotionally neglected under the Harm Standard definitions and over 27 times more likely to be emotionally neglected by Endangerment Standard criteria;
  • nearly 56 times more likely to be educationally neglected, by either definitional standard;
  • sixty times more likely to die from maltreatment of some type under the Harm Standard and over 22 times more likely to die from abuse or neglect using the Endangerment Standard;
  • over 22 times more likely to be seriously injured by maltreatment under the Harm Standard and almost 22 times more likely to be seriously injured by maltreatment that fit the Endangerment Standard requirements;
  • about 18 times more likely to be moderately injured by abuse or neglect under the Harm Standard and nearly 20 times more likely to have a moderate injury from maltreatment as defined by the Endangerment Standard;
  • fifty-seven times more likely to be classified as having an inferred injury under the Harm Standard and 39 times more likely to meet the criteria for inferred injury as defined by the Endangerment Standard; and
  • over 31 times more likely to be considered endangered, although not yet injured, by some type of abusive or neglectful treatment.

The NIS-3 findings on the correlation between family income and child maltreatment are entirely consistent with the earlier findings of the NIS-2. Moreover, they cannot be plausibly explained on the basis of the higher visibility of lower-income families to community professionals.

On the one hand, the NIS sentinels observe substantial numbers of children and families at the middle- and upper-income levels. The large majority of maltreated children were recognized by professionals likely to encounter children and fan-filies at all Income levels, such as sentinels in hospitals, schools, day-care centers, mental health agencies, voluntary social service agencies; by professionals not represented by NIS sentinel categories; and by the general public. Sentinels in schools alone recognized the majority of the maltreated children. Although the NIS design includes only public schools, approximately 89% of the U.S. population of school-age children attend public schools, so children attending the public schools represent a broad spectrum of family income levels. Moreover, the private schools not reflected in the NIS include religiously affiliated schools, which have sliding scales for poorer children, so children who attend private schools are not necessarily from better economic circumstances than children enrolled in public schools.

On the other hand, if the income finding is interpreted as an artifact of selective observation of low-income families, then it would mean that there have to be enough undetected abused and neglected children in the middle- and upper-income brackets used here to equalize the incidence rates across different income categories. That would require an astounding number of still-undetected children in the nation who experience countable maltreatment. Specifically, it would mean that an additional 2,138,700 children suffered maltreatment according to the Harm Standard yet remained hidden to the NIS. Similarly, it would mean there were an additional 4,500,700 children in 1993 who experienced maltreatment under the Endangerment Standard but who escaped observation by community professionals. To add some perspective as to what this would entail, consider that almost seven% of the total U.S. child population would be maltreated in countable ways yet entirely escape the attention of the spectrum of community professionals who serve as NIS sentinels, and all of these additional children would have to be in families with incomes of $15,000 per year or more.

Considering the implications of the alternative, it appears more plausible to assume that the income-related differences in incidence found in the NIS reflect real differences in the extent to which children in different income levels are being abused or neglected. Note that. there are a number of problems associated with poverty that may contribute to child maltreatment: more transient residence, poorer education, and higher rates of substance abuse and emotional disorders. Moreover, families at the lower socioecononu'c levels have less adequate social support systems to assist parents in their child care responsibilities.

Distribution of Child Abuse and Neglect by Perpetrator Characteristics

Children who had been maltreated as defined by the Harm Standard were categorized according to their relationship to the most closely related perpetrator and according to this perpetrator's sex, age, and employment status; these categorizations were examined in relation to the type of maltreatment and the severity of the child's injury or harm. Perpetrators' relationships to the children also were examined in relation to the children's race. The findings represent only a preliminary exploration of perpetrator characteristics in the NIS-3 data, since they lack significance tests concerning potential relationships and substantial percentages of the children were missing information concerning certain of the perpetrator characteristics.

Perpetrator's Relationship to the Child.

The majority of all children countable under the Harm Standard (78%) were maltreated by their birth parents, and this held true both for children who were abused (62% were maltreated by birth parents) and for those who were neglected (91 % experienced neglect by birth parents).

Birth parents were the most closely related perpetrators for 72% of the physically abused children and for 81% of the emotionally abused children. The pattern was dis tinctly different for sexual abuse. Nearly one-half of the sexually abused children were sexually abused by someone other than a parent or parent-substitute, while just over one-fourth were sexually abused by a birth parent, and one-fourth were sexually abused by other than a birth parent or parent-substitute. In addition, a sexually abused child was most likely to sustain a serious injury or impairment when a birth parent was the perpetrator.

Perpetrator's Sex.

Children were somewhat more likely to be maltreated by female perpetrators than by males: 65% of the maltreated children had been maltreated by a female, whereas 54% had been maltreated by a male. Of children who were maltreated by their birth parents, the majority (75%) were maltreated by their mothers and a sizable minority (46%) were maltreated by their fathers (some children were maltreated by both parents). In contrast, children who were maltreated by other parents or parent-substitutes, or by other persons, were more likely to have been maltreated by a male than by a female (80 to 85% were maltreated by males; 14 to 41 % by females).

Abused children presented a different pattern in connection with the sex of their perpetrators than did the neglected children. Children were more often neglected by female perpetrators (87% by females versus 43% by males). This finding is congruent with the fact that mothers and mother substitutes tend to be the primary caretakers and are the primary persons held accountable for any omissions and/or failings in caretaking. In contrast, children were more often abused by males (67% were abused by males versus 40% by females). The prevalence of male perpetrators was strongest in the category of sexual abuse, where 89% of the children were abused by a male compared to only 12% by a female.

Among all abused children, those abused by their birth parents were about equally likely to have been abused by mothers as by fathers (50% and 58%, respectively), but those abused by other parents, parent-substitutes, or other, nonparental perpetrators were much more likely to be abused by males (80 to 90% by males versus 14 to 15% by females). This general pattern held for emotional abuse, but was slightly different in the area of physical abuse. Children who had been physically abused by their birth parents were more likely to have suffered at the hands of their mothers than their fathers (60% versus 48%), while those who had been physically abused by other parents or parent-substitutes were much more likely to have been abused by their fathers or father-substitutes (90% by their fathers versus 19% by their mothers). For sexual abuse, the child's relationship to the perpetrator made very little difference, since males clearly predominated as perpetrators, whatever their relationship to the child. Moreover, the severity of the injury or impairment that the child experienced as a result of maltreatment did not appear to bear any relationship to the sex of the perpetrator.

Perpetrator's Age.

The perpetrator's age was entirely unknown for one-third of the children who were countable under the Harm Standard. Given the prevalence of children maltreated by perpetrators of unknown age, the findings here are tentative, since they could easily be eradicated if all perpetrators' ages were known.

Among all maltreated children, only a small percentage (13%) had been maltreated by a perpetrator in the youngest age bracket (under 26 years of age). However, younger perpetrators were slightly more predominant among children who had been sexually abused (where 22% had been sexually abused by a perpetrator under 26 years of age) and among children who had been maltreated in any way by someone who was not their parent or parent-substitute (among whom 40% had been maltreated by a perpetrator in the youngest age bracket).

A child's severity of injury or harm from maltreatment appeared not to be associated with the age of the perpetrator.

Perpetrator's Employment Status. 

Perpetrator's employment status was unknown for more than one-third of the maltreated children, limiting the value of the findings on this issue. Nearly one-half of all maltreated children were abused by a perpetrator who was employed, and this held true for both abuse and neglect. Of the children who sustained serious injury, the majority were maltreated by an employed perpetrator. In no category were the majority of children maltreated by a perpetrator who was unemployed.

Child's Race and Relationship to the Perpetrator. 

Because the perpetrator's race was not known for children submitted to the study solely through non-CPS sources, the child's race was examined in connection with the relationship to the perpetrator and with the nature and severity of the maltreatment.

For overall abuse, child's race reflected no notable connection to the relationship with the perpetrator. However, among sexually abused children, white children constituted a greater proportion of children who were sexually abused by their birth parents than of those sexually abused by other parents and parent-substitutes, and by others. Among physically abused children, white children were more prevalent among those who were physically abused by other parents and parent-substitutes than among those who were physically abused by their birth parents or among those physically abused by other types of perpetrators. Although non-white children were the minority of victims in all categories, they were more prevalent among children who were physically or sexually abused by perpetrators other than parents or parent-substitutes.

White children are a larger majority of those who suffered serious injury, whereas nonwhite children's representation was strongest among those who experienced moderate injury and among those for whom injury could be infeffed based on the severity of their maltreatment.

Sources of Recognition for Maltreated Children

School staff predominated as a source of recognition for maltreated children. School sentinels recognized 59% of the children who suffered maltreatment as defined by the Harm Standard and 54% of the Endangerment Standard total. Other important sources of abused and neglected children were hospitals, police departments, social service agencies, and the general public. For maltreatment defined under the Endangerment Standard, day-care centers also joined in the group of agency categories that encountered more than 100,000 abused and neglected children.

Since the NIS-2, hospitals more than tripled the rate at which they recognized maltreated children; mental health agencies nearly quadrupled their rate of recognition of children who met the Harm Standard and increased their recognition fivefold of children who met the Endangerment Standard; schools more than doubled their rate of recognition of children who met the Endangerment Standard, which included a 70% increase in their recognition rate for the Harm Standard sector. Endangerment Standard recognition more than doubled in law enforcement agencies. Interestingly, there were no changes in the contributions of sources that are tapped in the NIS only through their reports to CPS (e.g., private physicians and the general public). This last finding probably reflects the relatively stable level of CPS involvement with the abused and neglected children countable in the NIS over the time period, as noted below.

Official Reporting of Maltreated Children and Their Investigation by Child Protective Services

The NIS methodology provides information that speaks only to the end result of several processes, indicating whether or not a given maltreated child was or was not among the children whose maltreatment was investigated by CPS. Children who do not receive CPS investigation of their maltreatment represent an enigma to the study, as it cannot be determined whether this was because they were not reported to CPS or because CPS screened their reports out without an investigation.

Despite that limitation, the NIS-3 findings concerning the percentages of abused and neglected children whose maltreatment received CPS investigation are cause for serious concern. Only a minority of the children who were abused or neglected, by either definitional standard, received CPS attention for their maltreatment. CPS investigated the maltreatment of only 28% of children who were countable under the Harm Standard and of only 33% of those whose maltreatment fit the Endangerment Standard. Moreover, the percentages of those who received CPS investigation represented less than one-half of the maltreated children in all categories of maltreatment except fatalities, and across nearly all recognition sources. Especially remarkable was the finding that CPS investigation extended to only slightly more than one-fourth of the children who were seriously harmed or injured by abuse or neglect.

Another important finding was that the percentages of maltreated children who receive CPS investigation have decreased significantly since the NIS-2. The percentage of children receiving investigation among those who met the Harm Standard dropped from 44% to 28%, while the percentage of CPS investigation of children who met the Endangerment Standard fell from 51% to 33%. Although the decline was significant only among children recognized in law enforcement agencies and hospitals, it nevertheless cut across every type of recognition source. The decline in rates of CPS investigation affected abuse under the Harm Standard, all categories of maltreatment under the Endangerment Standard, and all levels of outcomes except fatalities.

At the same time, the actual numbers of countable children investigated by CPS remained stable (when considering Harm Standard totals) or even slightly increased (considering the Endangerment Standard totals). Thus, as the total number of maltreated children has risen, it means that a larger percentage of them have not had access to CPS investigation of their maltreatment. This picture suggests that the CPS system has reached its capacity to respond to the maltreated child population.

Implications

Are the observed increases in the incidence of child abuse and neglect, especially the quadrupling of the numbers of children who were seriously injured or endangered by maltreatment, real increases in the scope of the problem, or do they instead reflect improved recognition on the part of sentinels and other reporters to CPS? The fact that the increases occurred where they did-among children who were seriously injured and among children who were endangered-suggests that both of these dynamics contributed to the observed increases, each dynamic affecting a different sector of the abused and neglected population.

More Children Are Now Being Abused and Neglected Than in 1986, and Their Injuries Are More Serious.

The rise in the number of seriously injured children probably reflects a real increase in child abuse and neglect, because it cannot plausibly be explained on the basis of heightened sensitivity. It is unreasonable to suppose that quadruple the number of seriously injured victims of abuse and neglect existed at the time of the NIS-2 and somehow escaped notice by community professionals. The fact that the seriously injured group has quadrupled during the 7 years since the NIS-2, and now comprises more than one-half million children, appears to herald a true rise in the scope and severity of child abuse and neglect in the United States.

Although the NIS does not address the causes of abuse and neglect, it was striking how often illicit drug use was noted in the narrative descriptions on the NIS data forms. The increase in illicit drug use since the fall of 1986 when the NIS-2 data were collected may have contributed to the rise in incidence observed in the NIS-3. Economics is another factor that may have enlarged the problem. Family income is the strongest correlate of incidence in nearly all categories of abuse and neglect, with the lowest income families evidencing the highest rates of maltreatment. Increases in incidence since 1986 may partially derive from decreased economic resources among the poorer families and the increase in the number of children living in poverty.

Community Professionals Are Better at Recognizing Abused and Neglected Children, Especially Those Endangered but Not Yet Harmed by Maltreatment. The rise in the number of endangered children probably stems from improved recognition of more subtle cues-those that indicate abusive and neglectful behaviors that have not yet resulted in harm or injury. It is quite plausible to suppose that some (even sizable) portion of the endangered children escaped attention in the NIS-2, but that by the time of the NIS-3, community professionals had learned to pay better attention to information that might indicate endangering maltreatment. Note that this explanation also completes an account of consistent progression in recognition across the three national incidence studies. The NIS-2 demonstrated an increase in the number of moderately injured children. In interpreting that finding, it was considered likely to have derived from improved attentiveness to moderate-injury indicators of abuse and neglect. The NIS-3 found no statistical change in the numbers of moderately injured children, which suggests that professionals had reached close-to-maximum recognition rates for this category of children at the time of the NIS-2. The fourfold increase in the number of endangered children in the NIS-3 implies that the subsequent further improvements in recognition have now shifted toward even subtler cues:those associated with not-yet-injurious abusive actions and neglectful omissions.

Better Targeting Is Needed To Ensure CPS Investigation for the Children Who Most Need It.

The number of NIS-countable children who are investigated by CPS has remained fairly stable, or risen slightly, since the last national incidence study in 1986. As a result, CPS investigation has not kept up with the dramatic rise in the incidence of these children, so the percentages who receive CPS investigation of their maltreatment have fallen significantly. The low rates of CPS investigation of the maltreated children, especially of those already seriously injured by maltreatment, warrant immediate attention.

These findings emphasize the need for better targeting, whether by reporters in referring children to CPS, by CPS screening practices in connection with reports, or by both. One possibility is that, although reporters now demonstrate considerable perceptiveness in identifying maltreated children, they have not reliably translated this into reports to CPS, or are unclear as to how to do so. Another possibility is that CPS, which has increasingly turned to screening cases in order to keep its workload manageably within the range of its resources, has not been using effective screening criteria or has been unclear or inconsistent about the criteria to be applied. Note that these are not independent dynamics, because the response of CPS to a report provides feedback that has consequences for future reporting behaviors. Information bearing on these issues is provided by reports on two of the NIS-3 special substudies: the Sentinel Questionnaire Follow-up Study, which asked school sentinels about their decisions to report cases to CPS, and the CPS Screening Policy and Recordkeeping Study, which examined the screening policies and practices of CPS agencies that participated in the NIS-3.

The main NIS-3 data can offer some guidance in targeting. Neglect warrants more attention. It affects the greatest number of maltreated children, and their injuries are often serious. Children from the poorest families are at the greatest risk of maltreatment, so these children may warrant increased CPS attention as well. Children in single-parent families also experienced higher rates of maltreatment. A number of characteristics explored here are not unrelated to each other-for instance, single-parent families often have lower incomes. Further analyses of the NIS-3 data can address the independent contributions of different characteristics to better clarify risk factors that can guide CPS screening activities. Narratives on the NIS data forms can also be more systematically explored. The narratives often included spontaneous comments about illegal drug use, indicated whether the perpetrator had a history (sometimes a criminal record) of sexually or physically abusing/assaulting other children or adults, or noted that the incident described was not the first time the child had been abused or neglected.

As part of improving CPS targeting of the more serious cases, efforts should also focus on achieving better consensus about what types of cases should not receive CPS investigation. Very few of the educationally neglected children currently have their maltreatment investigated by CPS, and those who do may have been maltreated in multiple ways, with the CPS investigation focusing on abuse or other types of neglect. The current role of CPS in relation to educational neglect might be the centerpiece of an emerging consensus on what specific forms of abuse or neglect should not receive CPS investigation.

Forging Working Relationships Between CPS Agencies and Schools.

The NIS has consistently demonstrated that professionals in schools play a central and critical role in identifying children who are abused and neglected. As policies are developed to address the burgeoning problem of child abuse and neglect, they should capitalize on the unique role of school professionals as front-line observers.

Information provided by the DHHS.

For more information, contact the National Clearinghouse on Child Abuse and Neglect Information at nccanch@calib.com.

Updated on April 6, 2001

PTSD in Children and Adolescents

A National Center for PTSD Fact Sheet
By Jessica Hamblen, Ph.D.

The diagnosis of Posttraumatic Stress Disorder (PTSD) was formally recognized as a psychiatric diagnosis in 1980. At that time, little was known about what PTSD looked like in children and adolescents. Today, we know children and adolescents are susceptible to developing PTSD, and we know that PTSD has different age-specific features. In addition, we are beginning to develop child-focused interventions. This fact sheet provides information regarding what events cause PTSD in children, how many children develop PTSD, risk factors associated with PTSD, what PTSD looks like in children, other effects of trauma on children, treatment for PTSD, and what you can do for your child.

What events cause PTSD in children?

A diagnosis of PTSD means that an individual experienced an event that involved a threat to one's own or another's life or physical integrity and that this person responded with intense fear, helplessness, or horror. There are a number of traumatic events that have been shown to cause PTSD in children and adolescents. Children and adolescents may be diagnosed with PTSD if they have survived natural and man made disasters such as floods; violent crimes such as kidnapping, rape or murder of a parent, sniper fire, and school shootings; motor vehicle accidents such as automobile and plane crashes; severe burns; exposure to community violence; war; peer suicide; and sexual and physical abuse.

How many children develop PTSD?

A few studies of the general population have been conducted that examine rates of exposure and PTSD in children and adolescents . Results from these studies indicate that 15 to 43% of girls and 14 to 43% of boys have experienced at least one traumatic event in their lifetime. Of those children and adolescents who have experienced a trauma, 3 to 15% of girls and 1 to 6% of boys could be diagnosed with PTSD.

Rates of PTSD are much higher in children and adolescents recruited from at-risk samples. The rates of PTSD in these at-risk children and adolescents vary from 3 to 100%. For example, studies have shown that as many as 100% of children who witness a parental homicide or sexual assault develop PTSD. Similarly, 90% of sexually abused children, 77% of children exposed to a school shooting, and 35% of urban youth exposed to community violence develop PTSD.

What are the risk factors for PTSD?

There are three factors that have been shown to increase the likelihood that children will develop PTSD. These factors include the severity of the traumatic event, the parental reaction to the traumatic event, and the physical proximity to the traumatic event. In general, most studies find that children and adolescents who report experiencing the most severe traumas also report the highest levels of PTSD symptoms. Family support and parental coping have also been shown to affect PTSD symptoms in children. Studies show that children and adolescents with greater family support and less parental distress have lower levels of PTSD symptoms. Finally, children and adolescents who are farther away from the traumatic event report less distress.

There are several other factors that affect the occurrence and severity of PTSD. Research suggests that interpersonal traumas such as rape and assault are more likely to result in PTSD than other types of traumas. Additionally, if an individual has experienced a number of traumatic events in the past, those experiences increase the risk of developing PTSD. In terms of gender, several studies suggest that girls are more likely than boys to develop PTSD. A few studies have examined the connection between ethnicity and PTSD. While some studies find that minorities report higher levels of PTSD symptoms, researchers have shown that this is due to other factors such as differences in levels of exposure. It is not clear how a child's age at the time of exposure to a traumatic event impacts the occurrence or severity of PTSD. While some studies find a relationship, others do not. Differences that do occur may be due to differences in the way PTSD is expressed in children and adolescents of different ages or developmental levels (see next section).

What does PTSD look like in children?

Researchers and clinicians are beginning to recognize that PTSD may not present itself in children the same way it does in adults (see What is PTSD? below). Criteria for PTSD now include age-specific features for some symptoms.

Very young children may present with few PTSD symptoms. This may be because eight of the PTSD symptoms require a verbal description of one's feelings and experiences. Instead, young children may report more generalized fears such as stranger or separation anxiety, avoidance of situations that may or may not be related to the trauma, sleep disturbances, and a preoccupation with words or symbols that may or may not be related to the trauma. These children may also display posttraumatic play in which they repeat themes of the trauma. In addition, children may lose an acquired developmental skill (such as toilet training) as a result of experiencing a traumatic event.

Clinical reports suggest that elementary school-aged children may not experience visual flashbacks or amnesia for aspects of the trauma. However, they do experience "time skew" and "omen formation," which are not typically seen in adults. Time skew refers to a child mis-sequencing trauma related events when recalling the memory. Omen formation is a belief that there were warning signs that predicted the trauma. As a result, children often believe that if they are alert enough, they will recognize warning signs and avoid future traumas. School-aged children also reportedly exhibit posttraumatic play or reenactment of the trauma in play, drawings, or verbalizations. Posttraumatic play is different from reenactment in that posttraumatic play is a literal representation of the trauma, involves compulsively repeating some aspect of the trauma, and does not tend to relieve anxiety. An example of posttraumatic play is an increase in shooting games after exposure to a school shooting. Posttraumatic reenactment, on the other hand, is more flexible and involves behaviorally recreating aspects of the trauma (e.g., carrying a weapon after exposure to violence).

PTSD in adolescents may begin to more closely resemble PTSD in adults. However, there are a few features that have been shown to differ. As discussed above, children may engage in traumatic play following a trauma. Adolescents are more likely to engage in traumatic reenactment, in which they incorporate aspects of the trauma into their daily lives. In addition, adolescents are more likely than younger children or adults to exhibit impulsive and aggressive behaviors.

Besides PTSD, what are the other effects of trauma on children?

Besides PTSD, children and adolescents who have experienced traumatic events often exhibit other types of problems. Perhaps the best information available on the effects of traumas on children comes from a review of the literature on the effects of child sexual abuse. In this review, it was shown that sexually abused children often have problems with fear, anxiety, depression, anger and hostility, aggression, sexually inappropriate behavior, self-destructive behavior, feelings of isolation and stigma, poor self-esteem, difficulty in trusting others, and substance abuse. These problems are often seen in children and adolescents who have experienced other types of traumas as well. Children who have experienced traumas also often have relationship problems with peers and family members, problems with acting out, and problems with school performance.

Along with associated symptoms, there are a number of psychiatric disorders that are commonly found in children and adolescents who have been traumatized. One commonly co-occurring disorder is major depression. Other disorders include substance abuse; other anxiety disorders such as separation anxiety, panic disorder, and generalized anxiety disorder; and externalizing disorders such as attention-deficit/hyperactivity disorder, oppositional defiant disorder, and conduct disorder.

How is PTSD treated in children and adolescents?

Although some children show a natural remission in PTSD symptoms over a period of a few months, a significant number of children continue to exhibit symptoms for years if untreated. Few treatment studies have examined which treatments are most effective for children and adolescents. A review of the adult treatment studies of PTSD shows that Cognitive-Behavioral Therapy (CBT) is the most effective approach. CBT for children generally includes the child directly discussing the traumatic event (exposure), anxiety management techniques such as relaxation and assertiveness training, and correction of inaccurate or distorted trauma related thoughts. Although there is some controversy regarding exposing children to the events that scare them, exposure-based treatments seem to be most relevant when memories or reminders of the trauma distress the child. Children can be exposed gradually and taught relaxation so that they can learn to relax while recalling their experiences. Through this procedure, they learn that they do not have to be afraid of their memories. CBT also involves challenging children's false beliefs such as, "the world is totally unsafe." The majority of studies have found that it is safe and effective to use CBT for children with PTSD.

CBT is often accompanied by psycho-education and parental involvement. Psycho-education is education about PTSD symptoms and their effects. It is as important for parents and caregivers to understand the effects of PTSD as it is for children. Research shows that the better parents cope with the trauma, and the more they support their children, the better their children will function. Therefore, it is important for parents to seek treatment for themselves in order to develop the necessary coping skills that will help their children.

Several other types of therapy have been suggested for PTSD in children and adolescents. Play therapy can be used to treat young children with PTSD who are not able to deal with the trauma more directly. The therapist uses games, drawings, and other techniques to help the children process their traumatic memories. Psychological first aid has been prescribed for children exposed to community violence and can be used in schools and traditional settings. Psychological first aid involves clarifying trauma related facts, normalizing the children's PTSD reactions, encouraging the expression of feelings, teaching problem solving skills, and referring the most symptomatic children for additional treatment. Twelve Step approaches have been prescribed for adolescents with substance abuse problems and PTSD. Another therapy, Eye Movement Desensitization and Reprocessing (EMDR), combines cognitive therapy with directed eye movements. While EMDR has been shown to be effective in treating both children and adults with PTSD, studies indicate that it is the cognitive intervention rather than the eye movements that accounts for the change. Medications have also been prescribed for some children with PTSD. However, due to the lack of research in this area, it is too early to evaluate the effectiveness of medication therapy.

Finally, specialized interventions may be necessary for children exhibiting particularly problematic behaviors or PTSD symptoms. For example, a specialized intervention might be required for inappropriate sexual behavior or extreme behavioral problems.

What can I do to help my child?

Reading this fact sheet is a first step toward helping your child. Gather information on PTSD and pay attention to how your child is functioning. Watch for warning signs such as sleep problems, irritability, avoidance, changes in school performance, and problems with peers. It may be necessary to seek help for your child. Consider having your child evaluated by a mental-health professional who has experience treating PTSD in children and adolescents. Many therapists with this experience are members of the International Society for Traumatic Stress Studies, which has a membership directory containing a geographical listing of therapists who treat children and adolescents. Ask how the therapist typically treats PTSD, and choose a practitioner with whom you and your child feel comfortable. Consider whether you might also benefit from talking to someone individually. The most important thing you can do now is to support your child.

Based in part on the Practice Parameters for the Assessment and Treatment of Children and Adolescents with Posttraumatic Stress Disorder, Journal of the American Academy of Child and Adolescent Psychiatry, 37:10 supplement, October 1998.

Parenting - coping with stress

Being a parent brings out a range of powerful emotions from exhilaration to despair. Your feelings of love, happiness and pride may quickly turn to anger, hate or guilt, depending on the situation and the degree of support available to you. These feelings are completely normal. Most parents experience negative emotions from time to time.

It is important to manage feelings like anger and frustration so that you can enjoy parenting and maintain a safe, happy home for your child. It may be helpful to talk to other parents – you’ll soon discover that everyone is experiencing the same rollercoaster of feelings and experiences.

Build a trusting, loving and respectful relationship

The type of relationship you build with your child is what guides them throughout their life. Children learn by following the examples set by adults around them and from their experience of their own relationship with their parents.

To become a person who is able to control themselves, manage their negative feelings in a peaceful way, trust and respect others, and behave with care and compassion, your child will have to experience and see these behaviours.

Physical discipline can injure your child

Some parents believe that physical discipline, such as smacking, is for the child’s own good. Children are dependent on their parents for love and care – they never deserve to be punished by physical discipline.

Young children, such as those less than 12 months of age, don’t have the intellectual maturity to understand discipline of any kind. Hitting or smacking will only frighten a young child or cause serious and permanent injuries. By using physical discipline with your child, you are teaching them that the acceptable way to resolve conflict is by using violence.

Some parents may also lash out at their child when angry or stressed. This is particularly dangerous as parents may not recognise their own strength and can cause their child a lot of pain.

Experiencing negative feelings is normal

Parents can feel tired, ill, stressed and angry and so can children. Children often cannot tell us how they are feeling but instead ‘act out’ their feelings through their behaviours. When parents are under pressure themselves, it is more difficult to take the time to work out what your child is trying to tell you. Parents may often just react to the behaviour.

Most children experience difficult times. Try to remember that these times can be normal phases of growing up and will probably pass. Suggestions on dealing with your child’s unhappy behaviour include:

  • Ask for support. Remember that ‘it takes a village to bring up a child’, so don’t try to parent on your own.
  • Take time out from the care of your child. Leave your child with a responsible adult and have a break to catch up on some sleep, go to the hairdresser or talk to a friend.
  • Seek out like-minded people who will encourage you in your parenting and build your confidence as a person and parent.
  • Attend a parent group that has the same philosophy and values as you have.
Dealing with frustration and anger

If you feel frustrated and angry to the point where you feel you might lose control, you need to take time out to deal with these feelings.

Some short-term suggestions include:

  • Put your child in a safe place and leave the room.
  • Walk around the house or go outside.
  • Inhale deeply and exhale slowly and steadily.
  • Count your breaths to focus your concentration.
  • Be aware of your body language and try to change it so that you are more relaxed.
  • Recognise how to reduce your frustration and anger and take action:
  • Play your favourite music – you may need earplugs!
  • Make yourself a comforting warm drink.
  • Physical activity – try sprinting from one end of your backyard to the other or punch a pillow.
  • Call a friend or relative and ask for help.
Managing in the long term

It is important to take care of your own needs and feelings. No matter how loving and selfless, a parent can’t continue to give to their children while receiving little or no emotional nourishment themselves.

Some suggestions include:

  • Make the time to maintain your relationship with your partner (if you have one), even if all you can manage is dinner alone together once a week.
  • Reward yourself by scheduling at least one self-indulgent activity every day, such as sitting down in a quiet room to read a book or having coffee with a friend.
  • Find support from family members, friends or counsellors who are prepared to listen to your problems sympathetically.
  • Mix with other parents to share stories and swap parenting tips.
  • Learn about child development, so that you can better understand and anticipate your child’s behaviour.
  • Recognise and try to attend to underlying problems such as financial stresses, marital difficulties or problems at work, which can impact on your relationship with your child.
  • Investigate stress management options such as yoga, meditation or regular exercise.
  • Remember that seeking professional help is the smartest option if some problems are too complex to solve on your own.
Where to get help
  • Your doctor
  • Your partner
  • Family members and friends
  • Parentline Tel. 132 289
  • Maternal and Child Health nurse
  • Your local community health centre
  • Professionals such as counsellors.
Things to remember
  • Most parents experience negative emotions from time to time.
  • It is important to manage frustration and anger so that you can enjoy parenting and maintain a safe, happy home for your child.
  • Seek professional help if problems are too complex to solve on your own.

This page has been produced in consultation with, and approved by:
National Association for Prevention of Child Abuse & Neglect.

Original Article

Plain Talk About...Dealing With the Angry Child

Handling children's anger can be puzzling, draining, and distressing for adults. In fact, one of the major problems in dealing with anger in children is the angry feelings that are often stirred up in us. It has been said that we as parents, teachers, counselors, and administrators need to remind ourselves that we were not always taught how to deal with anger as a fact of life during our own childhood. We were led to believe that to be angry was to be bad, and we were often made to feel guilty for expressing anger.

It will be easier to deal with children's anger if we get rid of this notion. Our goal is not to repress or destroy angry feelings in children-or in ourselves-but rather to accept the feelings and to help channel and direct them to constructive ends.

Parents and teachers must allow children to feel all their feelings. Adult skills can then be directed toward showing children acceptable ways of expressing their feelings. Strong feelings cannot be denied, and angry outbursts should not always be viewed as a sign of serious problems; they should be recognized and treated with respect.

To respond effectively to overly aggressive behavior in children we need to have some ideas about what may have triggered an outburst. Anger may be a defense to avoid painful feelings; it may be associated with failure, low ' self-esteem, and feelings of isolation; or it may be related to anxiety about situations over which the child has no control.

Angry defiance may also be associated with feelings of dependency, and anger may be associated with sadness and depression. In childhood, anger and sadness are very .close to one another and it is important to remember that much of what an adult experiences as sadness is expressed by a child as anger.

Before we look at specific ways to manage aggressive and angry outbursts, several points should be highlighted:

  • We should distinguish between anger and aggression. Anger is a temporary emotional state caused by frustration; aggression is often an attempt to hurt a person or to destroy property.
  • Anger and aggression do not have to be dirty words. In other words, in looking at aggressive behavior in children, we must be careful to distinguish between behavior that indicates emotional problems and behavior that is normal.

In dealing with angry children, our actions should be motivated by the need to protect and to teach, not by a desire to punish. Parents and teachers should show a child that they accept his or her feelings, while suggesting other ways to express the feelings. An adult might say, for example, "Let me tell you what some children would do in a situation like this... It is not enough to tell children what behaviors. we find unacceptable. We must teach them acceptable ways of coping. Also, ways must be found to communicate what we expect of them. Contrary to popular opinion, punishment is not the most effective way to communicate to children what we expect of them.

Responding to the Angry Child

Some of the following suggestions for dealing with the angry child were taken from The Aggressive Child by Fritz Redl and David Wineman. They should be considered helpful ideas and not be seen as a "bag of tricks." Catch the child being good. Tell the child what behaviors please you. Respond to positive efforts and reinforce good behavior. An observing and sensitive parent will find countless opportunities during the day to make such comments as "I like the way you come in for dinner without being reminded"; "I appreciate your hanging up your clothes even though you were in a hurry to get out to play"; "You were really patient while I was on the phone"; "I'm glad you shared your snack with your sister"; "I like the way you're able to think of others"; and "Thank you for telling the truth about what really happened: Similarly, teachers can positively reinforce good behavior with statement like '1 know it was difficult for you to wait your turn, and I'm pleased that you could do it"; 'Thanks for sitting in your seat quietly"; 'You were thoughtful in offering to help Johnny with his spell ing"; 'You worked hard on that project, and I admire your effort?

Deliberately ignore inappropriate behavior that can be tolerated. This doesn't mean that you should ignore the child, just the behavior. The 'ignoring" has to be planned and consistent. Even though this behavior may be tolerated, the child must recognize that it is inappropriate.

Provide physical outlets and other alternatives. It is important for children to have opportunities for physical exer cise and movement, both at home and at school.

Manipulate the surroundings. Aggressive behavior can be encouraged by placing children in tough, tempting situations. We should try to plan the surroundings so that certain things are less apt to happen. Stop a "problem" activity and substitute, temporarily, a more desirable one. Sometimes rules and regulations, as well as physical space, may be too confining.

Use closeness and touching. Move physically closer to the child to curb his or her angry impulse. Young children are often calmed by having an adult nearby.

Express interest in the child's activities. Children naturally try to involve adults in what they are doing, and the adult is often annoyed at being bothered. Very young children (and children who are emotionally deprived) seem to need much more adult involve ment in their interests. A child about to use a toy or tool in a destructive way is sometimes easily stopped by an adult who expresses interest in having it shown to him. An outburst from an older child struggling with a difficult reading selection can be prevented by a caring adult who moves near the child to say, "Show me which words are giving you trouble?

Be ready to show affection. Some times all that is needed for any angry child to regain control is a sudden hug or other impulsive show of affection.

Children with serious emotional problems, however, may have trouble accepting affection. Ease tension through humor. Kid ding the child out of a temper tantrum or outburst offers the child an opportunity to "save face." However, it is important to distinguish between face saving humor and sarcasm or teasing ridicule.

Appeal directly to the child. Tell him or her how you feel and ask for consideration. For example, a parent or a teacher may gain a child's cooperation by saying, "I know that noise you're making doesn't usually bother me, but today I've got a headache, so could you find something else you'd enjoy doing?"

Explain situations. Help the child understand the cause of a stressful situation. We often fail to realize how easily young children can begin to react properly once they understand the cause of their frustration.

Use physical restraint. Occasionally a child may lose control so completely that he has to be physically restrained or removed from the scene to prevent him from hurting himself or others. This may also "save face" for the child. Physical restraint or removal from the scene should not be viewed by the child as punishment but as a means of saying, "You can't do that." In such situations, an adult cannot afford to lose his or her temper, and unfriendly remarks by other children should not be tolerated.

Encourage children to see their strengths as well as their weaknesses. Help them to see that they can reach their goals.

Use promises and rewards. Promises of future pleasure can be used both to start and to stop behavior. This approach should not be compared with bribery. We must know what the child likes-what brings him pleasure-and we must deliver on our promises.

Say "NO!" Limits should be clearly explained and enforced. Children should be free to function within those limits.

Tell the child that you accept his or her angry feelings, but offer other suggestions for expressing them. Teach children to put their angry feelings into words, rather than fists.

Build a positive self-image. Encourage children to see themselves as valued and valuable people.

Use punishment cautiously. There is a fine line between punishment that is hostile toward a child and punishment that is educational.

Model appropriate behavior. Parents and teachers should be aware of the powerful influence of their actions on a child's or group's behavior.

Teach children to express themselves verbally. Talking helps a child have control and thus reduces acting out behavior. Encourage the child to say, for example, 'I don't like your taking my pencil. I don't feel like sharing just now."

The Role of Discipline

Good discipline includes creating an atmosphere of quiet firmness, clarity, and conscientiousness, while using reasoning. Bad discipline involves punishment which is unduly harsh and inappropriate, and it is often associated with verbal ridicule and attacks on the child's integrity.

As one fourth-grade teacher put it: "One of the most important goals we strive for as parents, educators, and mental health professionals is to help children develop respect for themselves and others? While arriving at this goal takes years of patiem practice, it is a vital process in which parents, teachers, and all caring adults can play a crucial and exciting role. In order to accomplish this, we must see children as worthy human beings and be sincere in dealing with them.

Adapted from "The Aggressive Child" by Luleen S. Anderson, Ph.D,, which appeared in Children Today (Jan-Feb 1978) published by the Children's Bureau, ACYF, DHEW.

National Institute of Mental Health 1992

Plain Talk about Spanking

“As long as the child will be trained not by love, but by fear, so long will humanity live not by justice, but by force. As long as the child will be ruled by the educator’s threat and by the father’s rod, so long will mankind be dominated by the policeman’s club, by fear of jail, and by panic of invasion by armies and navies.”

Boris Sidis, 1919

By JORDAN RIAK

Today, one finds no support for spanking in the scientific literature. This opinion, shared by mental health and child development experts, and other professionals in related fields, has been evolving for many decades and its beginnings can be found centuries ago.

That is not to say there are no advocates for physical punishment of children, as indeed it would be false to claim there are no advocates for physical punishment of wives. Both practices are widespread and people who hit other people usually believe they have valid reasons.

The Lasting Effect on Children

Some researchers claim that every act of violence by an adult toward a child, no matter how brief or how mild, leaves an emotional scar that lasts a lifetime. To some extent we can demonstrate this from personal experience. Most of us must admit that the most vivid and most unpleasant childhood memories are those of being hurt by our parents. Some people find the memory of such events so unpleasant they pretend that they were trivial, even funny. You’ll notice that they smile when they describe what was done to them. It is shame, not pleasure, that makes them smile. As a protection against present pain, they disguise the memory of past feelings.

In an attempt to deny or minimize the dangers of spanking, many spankers have been heard to argue, “Spanking is very different from child abuse,” or “A little smack on the bottom never did anybody any harm.” But they are wrong.

A good comparison to spanking is exposure to chemical compounds containing lead. In earlier generations, most people lived in houses painted with lead based paint, and most survived with no apparent ill effects. Were they smart, or just lucky? Today, we don’t do that anymore. We know better. Likewise, informed parents recognize that spanking children is like exposing them to a dangerous toxin. No good can result and the risk is great.

But some parents will ask, “How can you claim to be a responsible parent if you don’t grab the child who is about to run out into traffic and deliver a good smack so that your warnings about the danger of the street will be remembered?”

In fact, being spanked throws children into a state of powerful emotional confusion making it difficult for them to learn the lessons adults claim they are trying to teach. Delivering a so-called "good smack" neither diminishes the adult’s anger nor improves the child’s behavior. Adults who spank tend to get angrier; spanked children tend to behave worse. And spanking's negative effect on a child can be long-lasting or permanent. It does not teach children that cars and trucks are dangerous. It teaches them that the grownups on whom they depend are dangerous.

Lost Trust

The spanked child is less able to regard the parent as a source of love, protection and comfort which are vital to every child’s healthy development. In the child’s eyes the parent now appears to be the source of danger and pain.

Fear, resentment and mistrust that result from spanking, undermine children’s feelings of attachment to the most important adults in their lives. A child who is thus betrayed, like the child who is denied adequate food, warmth or rest, suffers and fails to mature in the best possible way.

Threats

Some parents rarely spank or don’t spank at all, but are always threatening to do terrible things. “If you don’t keep quiet while I’m on the phone, I’m going to sew your mouth shut with a big needle,” or “Better watch out, or somebody is going to chop your fingers off. That’s what they do to naughty children who are always touching things they shouldn’t.” They find it easy to manage children by these means —at least temporarily.

At first, while children believe adults’ threats, they obey out of fear. But they soon learn to sneak and tell lies in order to evade the terrible punishments they believe are in store for them. Later, as they discover the threats are empty, they conclude (correctly) that the grown-ups they once trusted are in fact not trustworthy.

When trust between children and their closest caretakers is damaged in this way, the children’s ability to form trusting relationships with others is also damaged. This may render them incapable of ever achieving cooperation or intimacy with anyone. People who have been damaged in this way tend to see all relationships as negotiations, as deals to be won or lost. They see innocence, honesty and trustfulness in others as weaknesses to be exploited, exactly as it was once done to them.

Force

Spanking teaches children that human interaction is based on force, that might makes right. The more a child is spanked, the greater is the likelihood that that child will become an adult who deals with others, not by reason and good example, but by force. What kind of person are we describing? The bully is such a person. The rapist is such a person. The wife beater is such a person. The quack, the cheat, the con artist, the crook—each of these is such a person. And so are cowards and hangers-on who derive their power secondhand by clinging to such people as those we’ve just listed.

Spousal Battery and Spanking

In the overwhelming majority of cases, husbands and wives whose relationship includes violence are also violent toward their children. Such parents surely were spanked when they were little and witnessed others being spanked.

Battering and battered spouses who spank their children are raising them to be batterers and victims exactly like themselves. The children learn from their parents’ example that the way to vent frustration, express disapproval and assert authority is by hitting someone smaller and weaker than themselves. They see this principle demonstrated every time they witness their parents fighting, as well as every time they are on the receiving end of violent punishments.

They learn that once they are big enough and strong enough, they can control others by threatening or hurting them. They learn that it is okay for husbands and wives to batter each other and for adults to batter children.

When children, whose personalities have been formed in violent households, grow up and produce children of their own, they find it very difficult to break free from the behaviors they have witnessed and experienced. The skills they apply to family life will be the poor ones they learned from their parents, and they are likely to carry on the cycle of violence through their own innocent children.

As spanking disappears from family life, other forms of domestic violence will also disappear. Not before.

Escalation

Physical injuries and deaths of children caused by their caretakers often are the consequence of physical punishment carried to extremes. Perpetrators of even the most horrendous acts against children typically explain that the child's misbehavior called for punishment, and the outcome was unintended or accidental.

Many of the babies who die annually "falling out of the crib," "falling down the stairs" or because they "just stopped breathing for no reason" would be added to the statistic of non-accidental deaths if the truth were known. Sometimes the victim is blamed for his own misfortune, e.g, the child "bruises easily," "is accident prone" or "refused to stand still while being punished, and that's why the belt buckle caught his lip."

Spankers are often heard reciting the soothing catchphrase about never spanking in anger. This bogus claim belies what typically motivates people who hit children: anger. Many spankers are habituated to the act because it provides an instant outlet for feelings of frustration and anger -- not because they've found it an effective way to improve a child's behavior. Because anger, by its very nature, tends to escalate as it is indulged, there is no safe way to hit a child.

Sexual Molestation and Spanking

Spanked children don’t regard their bodies as being their own personal property. Spanking trains them to accept the idea that adults have absolute authority over their bodies, including the right to inflict pain. And being hit on the buttocks teaches them that even their sexual areas are subject to the will of adults. The child who submits to a spanking on Monday is not likely to say “No” to a molester on Tuesday. People who sexually molest or exploit children know this. They stalk potential victims among children who have been taught to “obey or else” because such children are the easiest targets.

Spanking the Buttocks and Sexual Development

Spanking of the buttocks can stimulate immature sexual feelings in some children. They have no control over those feelings, nor do they understand what is happening to them. The tragic consequence for some of these children is that they form a connection between pain, humiliation and sexual arousal that endures for the rest of their lives. Even though they may marry, raise families, hold responsible positions in the community and show no signs of emotional disturbance, they may be secretly and shamefully tormented by a need which, in some cases, compels them to hire prostitutes whom they spank or from whom they receive spankings. The pornography industry does a thriving business catering to the needs of these unfortunate individuals.

Medical science has long recognized and documented in great detail the link between buttocks-beating in childhood and the later development of unnatural sexual desires and behaviors. This should be reason enough never to spank a child.

Physical Danger of Hitting the Buttocks

Located deep in the buttocks is the sciatic nerve, the largest nerve in the body. A severe blow to the buttocks, particularly with an instrument such as a piece of wood, could cause bleeding in the muscles that surround that nerve, possibly injuring it and causing impairment to the involved leg.

The very delicate tail bone at the base of spine is also susceptible to injury when a child is hit there. And when children are required to bend over for beatings, their sex organs may be injured. Dislocation of the tail bone and bruising the sex organs as a result of violent punishments are frequently reported by hospital authorities.

Some people, in their attempt to justify battering children’s buttocks, claim that God or nature intended that part of the anatomy for spanking. That claim is nonsense. No part of the human body was made to be violated.

Physical Danger of Hitting the Hands

The child’s hand is particularly vulnerable because its ligaments, nerves, tendons and blood vessels are close to the skin which has no underlying protective tissue. Striking the hands of younger children is especially dangerous to the growth plates in the bones which, if damaged, can cause deformity or impaired function. Striking a child’s hand can also cause fractures, dislocations and lead to premature osteoarthritis.

Shaking

Being shaken can cause a child blindness, whiplash, brain damage and even death.

Spanking at Home, Performance in School

Most teachers will tell you that the children who exhibit the most serious behavior problems at school are the ones who are the most mistreated at home. Children who are spanked at home have been conditioned to expect the same kind of management by authority figures outside the home. For many of these children, the battle zone which is their home life extends to school life. This sets them up for academic failure, dropout, clashes with juvenile authorities and eventually perhaps with the criminal justice system.

In their attempt to erect a shield against what they see as a comfortless, hostile world, these children naturally seek the company of other children with similar problems. “My parents and teachers don’t understand me—my friends do,” they say. And they have good reason to believe that. This is one reason street gangs evolve and why they are especially attractive to children whose self-esteem has been ruined by spanking, whupping, paddling, switching, humiliation, insults, threats, relentless criticism, unreasonable restrictions and physical and emotional neglect.

We should not be surprised that many youngsters reject the adult world to the degree they believe it has rejected them. Nor should we be surprised that adolescents, who throughout childhood have borne the brunt of violence, will utilize violence as soon as they are able. As it often turns out, the aggressiveness that many young people cultivate, believing it is essential to their survival, propels them toward failure or catastrophe. Our crowded prisons are proof of this.

Some teachers work tirelessly to redirect the aggressiveness which violence-ridden children have far too much of and instill trust which violence-ridden children have far too little of. But that is a monumental task requiring specialized skills and a level of dedication which not all teachers possess or can maintain for extended periods. It requires extraordinary resources unavailable to the public school systems.

School dropout and juvenile delinquency would cease to be major problems wracking our nation if only it were possible to persuade parents and other caretakers to stop socializing children in ways guaranteed to make them antisocial and/or self-destructive. In other words, to stop the spanking and start the nurturing.

Spanking, Smoking, Drinking and Drugs

To be spanked is a degrading, humiliating experience. The spanked child absorbs not only the blows, but the message they convey: “You’re worthless. I reject you!” That message powerfully influences the child’s developing personality. It instills self-hatred.

Sooner or later every child is exposed to substances that promise instant relief from feelings of worthlessness and rejection. Everywhere people can be seen putting things into their bodies to make themselves feel good. It is difficult to convince a child who is suffering that such relief is an illusion, that one cannot rebuild damaged self-esteem by means of something swallowed, inhaled or injected, but can easily bury it deeper under the weight of new problems.

Spanking and Criminal Behavior

Everyone is familiar with the list of social maladies believed to be at the root of violent criminal behavior: poverty, discrimination, family breakdown, narcotics, gangs and easy access to deadly weapons. And it’s clear that every item in the above list contributes to violence and crime. However, one key ingredient is rarely acknowledged—spanking.

In 1940, researchers Sheldon and Eleanor Glueck began their famous study of delinquent and nondelinquent boys. They discovered how certain early childhood influences cause children to develop antisocial, violent behaviors. They showed that the first signs of delinquency often appear as early as three—long before children come into contact with influences outside the home. The Gluecks showed that parents who fail to manage their children calmly, gently and patiently, but instead rely on physical punishment, tend to produce aggressive, assaultive children. The more severe and the earlier the mistreatment, the worse the outcome.

The Gluecks also found that the lowest incidence of antisocial behavior is always associated with children who are reared from infancy in attentive, supportive, nonviolent, non-spanking families.

The message here for all parents who want their children never to see the inside of a jail or prison is a simple one: guide gently and patiently—never hit.

Spanking, Racism and Collective Hatreds

Spanking fills children with anger and the urge to retaliate. But this urge is almost never directly acted upon. Even the most severely spanked children, as a general rule, will not strike back at those who have hurt them. Instead, they are likely to seek relief in fantasy where they can safely vent their anger against make-believe adversaries. Sometimes younger brothers or sisters or family pets serve this purpose. Popular entertainment also caters to this need.

As children grow and come under the influence of the prejudices of their community, their anger can be easily channeled toward approved scapegoats. Hate cults and extremist political factions beckon to them with open arms, offering an opportunity to convert fantasy into reality. In every generation, more than a few seize that offer. Their behaviors constitute the worst fallout of the spanking tradition.

Spanking at School

Throughout the developed world spanking by teachers has almost disappeared. It is illegal in every European country and many developing countries. (In Austria, Croatia, Cyprus, Denmark, Finland, Germany, Israel, Italy, Latvia, Norway and Sweden no one, including a parent, may legally spank any child in any circumstance.) Among the major, developed industrial nations, the U.S. is the most resistant to reform in this regard. But gradually more states are banning school corporal punishment and in the states that allow it a growing number of school districts are wisely forbidding the practice.

Still, there remain many uninformed teachers and school administrators who, like many uninformed parents, persist in believing that it is okay to manage pupils by means of physical violence or the threat of it. What should enlightened, responsible parents do?

If you knew that a school bus had bald tires and faulty brakes, you would not let your child ride that bus and you would demand that your school authorities correct the problem immediately. If you knew that the air ducts in your school were contaminated with asbestos, you’d remove your child immediately and alert other parents to the danger.

Corporal punishment is no different. It is very dangerous and all sensible people in the community should immediately unite in opposition to it.

As a parent you have a right and an obligation to protect your child from known danger. Inform your local, regional and state education authorities that no one has your permission, nor the moral right, to endanger your child at school.

Spanking and Brain Development

In early childhood, the brain develops faster than any other organ in the body. By age 5, the brain reaches about 90 percent of its adult weight, and by 7, it is fully grown. This makes early childhood a very sensitive and critical period in brain development.

Stress associated with pain and fear caused by spanking can negatively affect the development and function of a child’s brain. It is precisely during this period of great plasticity and vulnerability that many children are subjected to physical punishment. The effect can be a derailing of natural, healthy brain growth resulting in life-long and irreversible abnormalities.

According to researcher Dr. Martin Teicher of McLean Hospital, Belmont, Massachusetts, “We know that an animal exposed to stress and neglect in early life develops a brain that is wired to experience fear, anxiety and stress. We think the same is true of people,” (“Child Abuse Changes the Developing Brain,” Yahoo! News, Dec. 29, 2000).

In Teicher’s article, “The Neurobiology of Child Abuse,” Scientific American, March 2002, he wrote, “New brain imaging surveys and other experiments have shown that child abuse can cause permanent damage to the neural structure and function of the developing brain itself. This grim result suggests that much more effort must be made to prevent childhood abuse and neglect before it does irrevocable harm to millions of young victims (p. 70)... Society reaps what it sows in the way it nurtures children (p. 75).”

No responsible parent would deliberately jeopardize a child’s normal brain development, yet that is precisely what spankers unwittingly do.

WHAT THE EXPERTS SAY

“Any form of corporal punishment or ‘spanking’ is a violent attack upon another human being’s integrity. The effect remains with the victim forever and becomes an unforgiving part of his or her personality — a massive frustration resulting in a hostility which will seek expression in later life in violent acts towards others. The sooner we understand that love and gentleness are the only kinds of called-for behavior towards children, the better. The child, especially, learns to become the kind of human being that he or she has experienced. This should be fully understood by all caregivers.”
Ashley Montagu, Anthropologist

“Corporal punishment of children actually interferes with the process of learning and with their optimal development as socially responsible adults. We feel it is important for public health workers, teachers and others concerned for the emotional and physical health of children and youth to support the adoption of alternative methods for the achievement of self-control and responsible behavior in children and adolescents.”
Dr. Daniel F. Whiteside, Assistant Surgeon General, Department of Health & Human Services (Administration of President Ronald Reagan)

“Punitive measures whether administered by police, teachers, spouses or parents have well-known standard effects: (1) escape—education has its own name for that: truancy, (2) counterattack—vandalism on schools and attacks on teachers, (3) apathy—a sullen do-nothing withdrawal. The more violent the punishment, the more serious the by-products.”
B. F. Skinner, Ph.D., author, Professor of Psychology, Harvard

“Corporal punishment trains children to accept and tolerate aggression. It always figures prominently in the roots of adolescent and adult aggressiveness, especially in those manifestations that take an antisocial form such as delinquency and criminality.”
Philip Greven, Professor of History, Rutgers University

“I have always been an advocate for the total abolition of corporal punishment and I believe the connection with pornography that is so oriented has its roots in our tradition of beating children.”
Gordon Moyes, D. D., Pastor, Uniting Church, Superintendent of the Wesley Central Mission, Sydney, Australia

“The much-touted ‘religious argument’ to support corporal punishment is built upon a few isolated quotes from the Book of Proverbs. Using the same kind of selective reading, one could just as easily cite the Bible as an authority for the practice of slavery, the rigid suppression of women, polygamy, incest and infanticide. It seems to me that the brutal and vindictive practice of corporal punishment cannot be reconciled with the major themes of the New Testament which teach love and forgiveness and a respect for the beauty and dignity of children, and which overwhelmingly reject violence and retribution as a means of solving human conflicts.”
Thomas E. Sagendorf, United Methodist Pastor, Toledo, Ohio

“The development of self-control, which we call conscience, results from the appropriate interaction of children with their caretakers. Children’s experience of love and respect promotes the development of conscience, whereas the experience of fear or pain, as results from spanking and paddling, interferes with this development. Physical punishment of children must end if our society is going to become one that is governed by conscience and self-control rather than be governed by their opposites.”
H. Patrick Stern, M.D., Asst. Prof. of Pediatrics, Psychiatry and Behavioral Pediatrics, University of Arkansas for Medical Sciences.

“Infliction of pain or discomfort, however minor, is not a desirable method of communicating with children.”
American Medical Association, House of Delegates, 1985

"Slavish discipline makes a slavish temper... Beating them, and all other sorts of slavish and corporal punishments, are not the discipline fit to be used in the education of those we would have wise, good, and ingenuous men."
John Locke, 1632-1704, "Some Thoughts Concerning Education," 1692

“Chide not the pupil hastily, for that will both dull his wit and discourage his diligence, but [ad]monish him gently, which shall make him both willing to amend and glad to go forward in love and hope of learning... Let the master say, ‘Here ye do well.’ For I assure you there is no such whetstone to sharpen a good wit and encourage a love of learning as his praise... In mine opinion, love is fitter than fear, gentleness better than beating, to bring up a child rightly in learning.”
Roger Ascham, (Tutor to Queen Elizabeth I), The Schoolmaster, England, published circa 1568

“Children ought to be led to honorable practices by means of encouragement and reasoning, and most certainly not by blows and ill treatment.”
Plutarch, circa 46-120 A.D., “The Education of Children,” Vol. I, Moralia, Ancient Greece

“It is a disgusting and slavish treatment... When children are beaten, pain or fear frequently have the result of which it is not pleasant to speak and which are likely subsequently to be a source of shame, shame which unnerves and depresses the mind and leads the child to shun the light of day and loathe the light... I will spend no longer time on this matter. We know enough about it already.”
Quintilian, circa 35-95 A.D., Institutes of Oratory, Ancient Rome

QUESTIONS AND ANSWERS

Q: What do virtually all juvenile delinquents have in common?
A: They have been raised by spankers.

Q: What was a common feature of the childhoods of Hitler, Stalin, Pol Pot, Saddam Hussein and Charles Manson?
A: Each one was relentlessly, severely, physically punished as a child.

Q: What do prisoners on death row all have in common?
A: Plenty of spankings during childhood.

Q: What do rapists, arsonists, terrorists, torturers, serial killers, mass murderers, suicide bombers, kidnappers, snipers, assassins, muggers, product tamperers, vandals, spouse batterers and stalkers have in common?
A: Violent upbringing.

Q: Which child is destined never to join the company of felons?
A: One who is raised in a nurturing, attentive, supportive, non-spanking family.

Q: To turn a friendly puppy into a vicious guard dog, what must you do to it?
A: Restrict its movement and beat it often.

HOW YOU CAN MAKE A DIFFERENCE

There are people in your community who have never heard the ideas expressed in this publication. It’s time they heard, don’t you agree?

You can help plant the seeds of a more caring, more cooperative and less violent next generation by sharing this information with others—with friends, co-professionals, neighbors, relatives, the parents of your children’s friends, community leaders, religious leaders, your children’s teachers, local and state education authorities and your representatives in government. We believe everyone should hear this message.

We know that some people in your community will reject our conclusions about the dangers of spanking. Some people will refuse to think about it or may even become annoyed or hostile because this information makes them feel extremely uncomfortable. That doesn’t discourage us. It shouldn’t discourage you. There are others who want to know why the old familiar method of socializing children works so poorly.

Also, there are those who already are raising their children without violence but who need to be reassured that they are doing the right thing. Your role is to reach out to those people and to let them know what you know about this matter. Put a copy of Plain Talk... in their hands. And tell them about our Web site, “Project NoSpank” at www.nospank.net where they can learn the 1001 reasons to refrain from spanking.

We are confident that some day soon civilized humanity will look back with astonishment and pity at the time when people believed hitting children was good for them.

RESOURCES AND FURTHER READING

Jane Bluestein. Creating Emotionally Safe Schools: A Guide for Educators and Parents. Deerfield Beach, Florida: Health Communications, Inc., 2001

Alan DeWitt Button. The Authentic Child. New York: Random House, 1969.

Susan Forward. Toxic Parents: Overcoming Their Hurtful Legacy and Reclaiming Your Life. New York: Bantam Books, 1989.

Ian Gibson. The English Vice. London: Duckworth, 1978.

James Gilligan. Violence: Reflections on a National Epidemic. New York: G.P. Putnam's Sons, 1996.

Thomas Gordon. Teaching Children Self-Discipline At Home and At School. New York: Ramdom House, 1989. [PTAVE strongly recommends Thomas Gordon’s Parent Effectiveness Training (P.E.T.) and Teacher Effectiveness Training (T.E.T.)]

Philip Greven. Spare the Child: The Religious Roots of Punishment and the Psychological Impact of Physical Abuse. New York: Random House, 1991.

Mitch Hall. The Plague of Violence: a preventable epidemic. Checkmate Press, www.CheckmateNow.org, 2002.

Irwin A. Hyman. Reading, Writing and the Hickory Stick: The Appalling Story of Physicaland Psychological Violence in American Schools. Boston: Lexington Books, 1990.

__________, Case Against Spanking: How to Stop Hitting and Start Raising Healthy Kids. San Francisco: Jossey-Bass Inc., 1997.

Irwin A. Hyman and Pamela A. Snook. Dangerous Schools: What We Can Do About the Physical and Emotional Abuse of Our Children. San Francisco: Jossey-Bass Publishers, 1999

Dorothy Otnow Lewis. Guilty by Reason of Insanity - A Psychiatrist Explores the Minds of Killers. New York: The Ballantine Publishing Group, 1998.

Mike A. Males. The Scapegoat Generation: America's War on Adolescents. Monroe, Maine: Common Courage Press, 1996.

Michael J. Marshall. Why Spanking Doesn’t Work. Springville, Utah: Bonneville Books, 2002.

Alice Miller. The Truth Will Set You Free: Overcoming Emotional Blindness and Finding Your True Adult Self. New York: Basic Books, 2001.

____________For Your Own Good: Hidden Cruelty in Child Rearing and the Roots of Violence. New York: Farrar, Straus and Giroux, 1983. [PTAVE strongly recommends all Alice Miller’s works.]

Eli H. Newberger. The Men They Will Become: The Nature and Nurture of Male Character. Cambridge: Perseus Publishing, 1999.

Jane & James Ritchie. Spare the Rod. Sydney: George Allen & Unwin, 1981.

Murray A. Straus. Beating the Devil out of Them: Corporal Punishment in American Families. New York: Free Press, 1994.

Teresa Whitehurst. How Would Jesus Raise a Child? Grand Rapids: Baker Books, 2003.

Felicity de Zulueta. From Pain to Violence: The Traumatic Roots of Destructiveness. London: Jason Aronson, Inc., 1994

Plain Talk about Spanking was published in 1992 and last revised in February 2003. Copyright is waived and it may be printed from this Web page: www.nospank.net/ptas.pdf. It is also available as a 12-page booklet from Parents and Teachers Against Violence in Education (PTAVE), P.O. Box 1033, Alamo, CA 94507. E-mail inquiries to riak@nospank.net or call (925) 831-1661.

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