Child Abuse Report Not News to Experts : Hospitals: Practitioners who handle cases on a daily basis are not surprised by county figures on violence. They hope the study spurs action to counter the ‘overwhelming’ problem.

Dr. Nancy Schonfeld is in charge of the emergency room at Childrens Hospital in Los Angeles. Every day, she sees children who make her take a deep breath and wonder what has become of society.

So Schonfeld, whose staff handled more than 900 cases of physical and sexual abuse last year, was not surprised by the grim findings of a task force report that found widespread violence against children in Los Angeles County. The report was made public Wednesday by the Inter-Agency Council on Child Abuse and Neglect.

If anything, Schonfeld was encouraged that somebody might finally be trying to do something about a problem that she has found “almost totally overwhelming.”

Her work often leaves her exhausted and depressed. She has seen so much violence that the examples come tumbling forth--a 3-year-old who can talk in hauntingly explicit detail about sexual intercourse; a 2-year-old boy who arrived at the hospital blue in the face because his baby-sitter stuffed paper towels down his throat to stop his crying; a 5-year-old girl whose body was scarred from head to toe by a belt buckle.

“It’s not just each individual case,” says Schonfeld, who has supervised the emergency room’s 10 physicians for the past two years. “It’s the volume and the repetition. It is totally devastating to be a practitioner and to keep seeing these children. The way I grew up, you kept your children safe. . . . Now, it just seems like our kids are not safe in the street and they’re not safe in their own homes.”

Within the pale pink-and-blue walls of the Childrens Hospital emergency room, signs of the crisis abound. One examination room houses child-sized gynecological equipment for examining victims of sexual abuse. Another contains a one-way mirror, so that physicians and social workers can gather surreptitious impressions of how an abused child relates to his parents.

In Schonfeld’s office, a shelf is lined with case records of abused children who have been treated at the hospital. Recently, Schonfeld hired the emergency room’s first full-time social worker, specifically to assess cases of suspected child abuse. Now, she said, she is looking for another social worker for the night shift.

Across Los Angeles County, there are doctors, social workers, child psychologists and police officers who are equally deluged. These are the people on the front lines of the county’s child abuse problem, and their day-to-day impressions of its broad scope have now been confirmed by the council’s study.

The two-volume report, the most comprehensive study ever conducted on child abuse in Los Angeles, found that the county’s social services system is being overwhelmed with seriously abused children.

It concluded that the very young are the most at risk and that the most serious threat to the future of children in the county is drug and alcohol abuse. By the year 2000, the report predicted, public schools will have at least 24,000 students who suffer the damaging effects of having been exposed to drugs in the womb.

The council gathered statistics from 25 local, state and federal agencies. These figures showed that last year an average of nearly one child was murdered each week by his parent or caretaker, more than 2,400 babies were born addicted to drugs, and school officials found at least 1,800 children who had been sexually abused.

At a press conference Wednesday to unveil the report, Sheriff Sherman Block, who chairs the council, said the findings point to a “critical need” for new programs to prevent child abuse.

“Most of the children we’re talking about today are really too young to speak,” Block said. “They are today’s innocent victims and very probably tomorrow’s criminals. . . . We can no longer wait until we are faced with the crisis of damaged and dying children before we take definitive steps to provide safe and healthy home environments.”

Schonfeld agrees. She says most experts--herself included--believe emergency rooms are not the best places to examine seriously abused children. They are often too hectic to allow doctors and social workers and police officers time to gather in-depth evidence needed for prosecution. But in Los Angeles County, there is no place else for young victims to receive emergency treatment.

The county does have several specialized centers where abused children can be examined and interviewed by experts. But these centers are overloaded, says Dr. Astrid Heger, who runs one at Los Angeles County-USC Medical Center.

“We have a three-month waiting list to get into our clinic, and that’s pretty much the same pattern everywhere in the county,” said Heger, who serves on the inter-agency council and has recommended that additional clinics like hers be created.

Such a move, Schonfeld said, would help ease the burden at Childrens Hospital. It would not, however, spare emergency room doctors the pain of confronting the human side of the county’s child abuse statistics.

Says Schonfeld: “I really am terribly troubled by what it is going to be like when these kids grow up. . . . Somewhere along the line I feel like adults have failed their own children and that we are wasting a whole generation.”