April is Child Abuse Prevention Month

Published by Contra Costa Times

Posted on Wed, Apr. 19, 2006

By Jim Carpenter, M.D., MPH

SUPPOSE YOU HAVE a niece, grandchild or even your own child who suddenly performs poorly in school, or becomes hostile and fearful for no apparent reason.

Or becomes withdrawn and doesn't want to go home. Or perhaps seems always watchful, afraid the worst will happen.

Or you know a child who lacks adult supervision and has untreated medical problems.

What do you do in such a situation? Certainly that depends on your relationship with the child and parents - how well you know them.

Perhaps you wonder if this could be child abuse or neglect. In fact, these are common behaviors and signs of a child who is being abused or neglected.

But should you get involved? Will your intervention anger the parents? Will the parents be unfairly accused and tainted by your concerns?

Or, if you don't intervene, will the abuse persist or worsen? It's often a difficult decision.

If appropriate, your next step might be to gently talk to the child, to try to understand the situation better. Does he or she:

Seem afraid of adults, possibly his or her own parents, and resist going home?
Have unexplained cuts, bruises or burns, or even broken bones or a black eye?
Return after absences with new bruises or redness?
Say that a parent or other adult caused an injury?

If the answer is "yes" to some of the above questions, you should call the authorities. But if you still aren't sure that something is seriously wrong, you might talk to or ask about the parent.

Does the parent:

Abuse drugs or drink excessively?
Blame the child for problems, make negative comments about the child or use harsh discipline?
Dismiss concerns about the child's welfare as unimportant?
Make unrealistic demands on the child?
Seem to depend unnaturally on the child for emotional support?

These are all signs and symptoms of child abuse or neglect, though children who are not abused may, at times, also have some of the these problems, and many abused children and abusing adults don't show these behaviors.

April is Child Abuse Prevention Month, a good time to think and learn about the mistreatment of children.

Child abuse includes:

Physical abuse - inflicted bruises, burns, broken bones or brain damage from hitting or shaking.
Neglect and endangerment - not providing adequate food, clothing, shelter, supervision and medical care.
Sexual abuse and exploitation - exposing, sexual contact, and pornography.
Emotional abuse and deprivation - verbal assault, such as belittling, threatening, blaming and yelling; exposure to domestic violence and discord.

Children should feel loved, wanted, secure and worthy in their upbringing. Abuse and neglect hurt the child, and also the family and our society as a whole.

Abuse leads to increased delinquency, substance abuse, school failure and teen pregnancy. Abused children more frequently suffer from depression, anxiety, eating disorders, low self-esteem, and have difficulty making and keeping friends. And abused children may become abusive as adults.

If you see or suspect child abuse or neglect, call 925-646-1680; or 800-4-A-CHILD (800-422-2445); or local law enforcement.

The Child Abuse Prevention Council at 925-798-0546 has an extensive library about all aspects of child abuse and provides training to groups and agencies regarding identification, reporting and prevention of child abuse.

Carpenter is a pediatrician with Contra Costa Health Services, who specializes in child abuse.