Child Abuse in U.S. at Crisis Level, Panel Says

The level of violence aimed at young children in America has reached public health crisis proportions, claiming the lives of at least 2,000 children annually and seriously injuring more than 140,000 others, a federal advisory panel said in a report scheduled to be released today to Congress.

The U.S. Advisory Board on Child Abuse and Neglect, concluding a 2 1/2-year nationwide study that included public hearings in 10 states, found a level of fatal abuse and neglect that is far greater than even experts in the field had realized.

Abuse and neglect in the home is a leading cause of death for young children in this country, outstripping deaths caused by accidental falls, choking on food, suffocation, drowning or residential fires, the report found.

The vast majority of abused and neglected children are under 4 years old. In fact, the homicide rate among children in this age group has hit a 40-year high, a chilling trend that is similar in scope to the violence directed at teen-agers from street gunfire, according to the report.

But equally grim is the report’s finding that the child protective system has largely failed to shelter the nation’s children.

The report describes an alarming national environment of underreported child abuse fatalities; inadequately trained investigators, prosecutors and medical professionals; inconsistent autopsy practices, and an American public that continues to regard child deaths as “rare curiosities.”

“When it comes to deaths of infants and small children . . . at the hands of parents or caretakers, society has responded in a strangely muffled, seemingly disinterested way,” stated the panel, consisting of experts on child abuse and chaired by Deanne Tilton Durfee, executive director of the Los Angeles County Interagency Task Force on Child Abuse and Neglect.

“Little money has been spent to understand this tragic phenomenon. The true numbers and exact nature of the problem remain unknown and the troubling fact of abuse or neglect often remains a terrible secret that is buried with the child.”

The 15-member panel was established by Congress in 1988 to evaluate the scope of child abuse in the United States and recommend ways to improve the child protective system.

This year’s report, titled “A Nation’s Shame: Fatal Child Abuse and Neglect in the United States,” represents the most comprehensive study yet undertaken of children’s deaths at the hands of parents or caretakers in America.

Although it emphasizes that no single profile fits every case, the report attempts for the first time to fill in some of the who, how and why of children’s deaths.

It found, for example, that most physical abuse fatalities are caused by angry, extremely stressed-out fathers, stepfathers or boyfriends who unleash a torrent of rage on infants over such “triggers” as a baby’s crying, feeding difficulties or failed toilet training.

Likewise, studies suggest that mothers are most often held responsible for deaths resulting from bathtub drownings, starvation or other neglect.

Among other major findings:

* Head trauma is the leading cause of child abuse deaths. So-called Shaken Baby Syndrome is so lethal that up to 25% of its victims die and most survivors suffer brain damage.

* Domestic violence is strongly linked to child abuse deaths. An estimated 50% of homes with adult violence also involve child abuse or neglect.

* Many states lack adequate legal sanctions. Only 21 states have statues that allow parents to be prosecuted for killing their children under ‘felony murder” or “homicide by child abuse” laws.

In Orange County, the number of reported cases of child sexual, physical or emotional abuse and neglect reached 45,000 in 1994, a 22% increase from the 36,000 reported in 1993, according to the county’s Child Abuse Registry. The 1993 statistic reflected a 28% increase over 1989.

“Most people don’t think Orange County would be the place to have child abuse. They attribute this to the affluence of the county,” said Barbara Oliver, director of the Child Abuse and Prevention Council, based in Laguna Hills. “But we know 25% of all the cases we received were in the coastal and southern region of the county, which are usually considered to be the more affluent parts of the county. So child abuse happens everywhere.”

The national report is dedicated to the memory of the thousands of young victims and seeks to raise their cause beyond the level of statistics by including the names of more than 100 children who have suffered fatal abuse or neglect in recent years.

The victims range from a 10-day-old Illinois girl who was dropped two stories to her death to a 10-year-old Florida boy found battered and floating in the family pool.

“I think until the children become real the nation will not be convinced this is a problem,” Durfee said.

“There is no disease or natural disaster or trauma that is killing more children under 4 than abuse and neglect,” she said. “The natural reaction . . . is denial. We’re hoping with this report to change that.”

In describing the scope and patterns of the problem, the report details the particular susceptibility of very young children to fatal abuse. These victims are deemed the “invisible kids” because their youth leaves them largely out of sight of the community at large and the public welfare system.

The report offers a scathing assessment of a child protective system where it is easier, on the national level, to gather information on deaths involving soccer goal posts than fatal abuse.

“You can call the Centers for Disease Control and Prevention and find the number of children who had a brown recluse spider bite last year, but you certainly can’t get correct information on child abuse and neglect,” Barbara Bonner, a child abuse authority at the University of Oklahoma, testified at one of the panel’s public hearings and recounted in the report.

The panel refers to research that concludes that 85% of childhood deaths from abuse or neglect are systematically misidentified as accidents or natural causes because police, physicians and coroners are largely untrained in identifying evidence of intentional trauma and severe neglect in children.

In addition, 69% of professionals--doctors, teachers, social workers--who suspect child abuse did not report it to the proper authorities, the report found, and there are even cases where professionals have sought to protect child abusers.

But the report found that prosecution of perpetrators presents its own set of problems in cases where typically “witnesses are rare . . . and some juries simply cannot believe that any parent or caretaker would commit such acts upon a child.”

During public hearings, many prosecutors conceded that child homicides are routinely reduced to lesser crimes and the report found that most prosecutors have little or no experience with abuse and neglect cases.

The report also documents the emergence and success of child death review teams, composed of members of local law enforcement and social welfare agencies which review cases of child death and offer appropriate follow-up.

The report’s 25 other recommendations include state legislation establishing regulations for child autopsies, a national effort to increase research on and reporting of child abuse fatalities, multidisciplinary training on child deaths, ensuring that children’s safety is a priority in all family and child service programs and increased funding for family support services.