FACES OF VIOLENCE AND TRAUMA
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DOMESTIC (OR FAMILY) ABUSE: THE PROBLEM
An 18-month-old child was brought to the hospital
with a scald on his face. The nursing staff noted that it looked a
few days old and questioned the mother carefully. A thorough examination
of the child revealed other injuries, including bruises on his back
and, abdomen. He was also found to be failing to thrive. A skeletal
X-ray revealed a number of healing rib fractures. The child was placed
in foster care where his growth and development showed excellent catch-up.–Case
study in First Meeting on Strategies for Child Protection, Report
on WHO meeting, Padua, Italy.
No child should have to suffer violence in his or her home. A childs
first line of protection should be the family. As the World Summit
Plan of Action states – For the full and harmonious development
of their personality, children should grow up in a family environment,
in an atmosphere of happiness, love and understanding. Accordingly,
all institutions of society should respect and support the efforts
of parents and other caregivers to nurture and care for children in
a family environment. Despite their key role in nurturing, supporting
and protecting children, families all too often fail to offer this
ideal environment.
The World Health Organization (WHO) breaks domestic abuse down into
four primary forms:
1. Physical abuse: That which results in actual or potential
physical harm from an interaction or lack of interaction, which is
reasonably within the control of a parent or person in a position
of responsibility, power, or trust. There may be single or repeated
incidents.
2. Sexual abuse: The involvement of a child in sexual activity
that he or she does not fully comprehend, is unable to give informed
consent to, or for which the child is not developmentally prepared,
or that violates the laws or social taboos of society. Child sexual
abuse is evidenced by an activity between a child and an adult or
another child who by age or development is in a relationship of responsibility,
trust or power, the activity being intended to gratify or satisfy
the needs of the other person.
This may include, but not is limited to:
COMMUNITY VIOLENCE: THE PROBLEM
I worry about my kids being molested, my house
being burglarized, my oldest boy being shot, said one U.S. inner city
mother. Theres fighting, shooting or cutting someone up outside the
house all the time, said another mother. Their children have the
same fears: If someone is shooting, you might get the bullet even
if it wasnt meant for you. Im afraid of being mistaken for someone
else and shot at. Ill be a victim just by being there. (About Our
Kids)
Community violence refers to exposure, as a witness or through actual
experience, to acts of interpersonal violence perpetrated by individuals
who are not intimately related to the victim. (About Our Kids)
Results of a UNICEF survey in Europe and Central Asia stated that
twice as many children feel unsafe in urban (21%) than rural areas
(11%). Girls (19%) are more likely to feel unsafe than boys (15%).
And 20% of children have a friend or family member who has been the
victim of violence. Children who feel unsafe walking around in their
neighborhoods say it is because they have seen fighting, threatening,
or suspicious-looking persons loitering (50%); have witnessed violence
such as fights, acts of aggression, quarrels or street crime (40%);
or because of neighborhood problems such as poor street lighting,
heavy traffic and dangerous dogs (20%).
Sadly, most urban American children, by the time they enter high
school, have seen the use of weapons, guns or other acts of violence
against people in their neighborhoods or schools.
In fact, some studies cited by Future of the Children
even draw parallels between children growing up in inner-city neighborhoods
and those living in war zones. The statistics are quite alarming.
Homicide is the fourth-leading cause of death for children ages 1
through 4, third for youth ages 5 through 14, and second for persons
ages 15 through 24.
In addition, about 4 million adolescents have been victims of serious
physical assault, and 9 million have witnessed serious violence during
their lifetimes. In Miami, Florida, more than 90 percent of high school
students have witnessed community violence and 44 percent have been
a victim of a violent crime. In Richmond, Virginia, 88 percent of
children in one neighborhood had heard gunfire near home and 25 percent
had seen someone killed.
A UNICEF survey in the Western Pacific region stated that about 1,000
children reported having been the victim of either robbery or assault
(10% for each). The highest incidence of robbery is in Mongolia (39%),
Philippines and Cambodia (27%), commonly reported in urban areas.
Reported assault is very high in Cambodia (56%), experienced predominantly
by boys.
DEVELOPMENTAL IMPACT OF DOMESTIC ABUSE AND COMMUNITY VIOLENCE
The spectrum of abuses faced by children in the family or community
ranges from ill treatment in institutions to violence in the family,
from child trafficking to child bonded labor. The vulnerability of
children to such abuses often depends on other aspects of their identity,
such as gender, ethnicity or economic status. This is a powerful
reminder of the indivisibility of human rights. The denial of one
set of rights leads to the abuse of others.
Research has demonstrated repeatedly that the impact of domestic
and community violence on child development is devastating. Some
key findings:
Even infants and toddlers are gravely affected. Studies
show that infants and toddlers who witness either violence in the
community or in the home show excessive irritability, immature behavior,
sleep disturbances, emotional distress, fear of being alone and regression
in toileting and language. Exposure also interferes with the normal
tendency toddlers have to explore their environment. Some studies
even have noticed symptoms in toddlers that may indicate post-traumatic
stress disorder. (Future of the Children)
Witnessing violence has a detrimental effect on a childs perspective
on the world. Research has shown that children who witness
community violence are likely to develop a view of the world as hostile
and dangerous. Those who are exposed to multiple forms of violence
are more at risk of developing psychological difficulties than those
exposed to only one violent event.
Children who are victims of domestic violence are more likely
to become delinquent. A comparison of delinquent and non-delinquent
youth in the United States found that the biggest difference between
the two groups was that the delinquent youth had a history of exposure
to family violence. A Ukrainian study showed that more than half of
rapists came from families where cruel and tough education took place,
and that about one-quarter of all rapes were committed by someone
who himself had been raped.
Sexual abuse of children places them at greater risk of later
sexual problems. A study in New Zealand indicated that adults
who were abused by someone close to them as children also tended to
be more insecure about relationships and were more likely to be divorced.
A clear pattern of studies also links a history of child sexual abuse
with higher rates in adult life of depressive symptoms, anxiety symptoms,
substance abuse disorders, eating disorders, unwanted pregnancy, promiscuity
and post-traumatic stress disorders. (U.S. National Clearinghouse
on Child Abuse and Neglect)
Abuse and violence produce aggressive children and eventually
aggressive adults. Children learn what they
see. Those who grow up in violent homes often see aggression as the
only way to solve disputes. They also learn that the person who loves
you the most hits you the most. (National Network for Child Care)
Growing up in a violent home can increase the odds that the child
will suffer and/or commit violence as adults. Boys who witness domestic
violence are more likely to batter their female partners as adults
than are boys raised in nonviolent homes. Adolescents exposed to
violence, especially chronic community violence, tend to be highly
aggressive and act out and show high levels of anxiety, behavioral
problems, school problems, truancy and revenge seeking. In some cases,
these teens show symptoms of post-traumatic stress disorder similar
to those of soldiers returning from war. (Future of the Children.)
Victims of domestic and community violence are more likely
to suffer from mental illness and substance abuse. Child
abuse is widely regarded as a cause of mental health problems and
lessened ability to function successfully in adulthood. In school-age
children, studies show a link between exposure to violence and depression.
Research also shows that children exposed to violence tend to have
trouble concentrating and sleeping and may be slow to learn how to
master their environment. Studies of children ages 6 to 10 in Washington,
D.C., and ages 9 to 12 in New Orleans, La., showed a strong link between
witnessing violence and nightmares, fear of leaving the home, and
a numbing of affect. Other studies show that as children age, those
who have been abused are more likely to have academic problems in
schools, commit crimes, experience emotional problems and abuse alcohol
or drugs. (Future of the Children) Finally, children who witness abuse
in their homes may suffer from anxiety, guilt, language problems,
developmental delays, hearing and speech problems, withdrawal and
stress-related physical ailments, such as headaches, ulcers and rashes.
DOMESTIC ABUSE AND COMMUNITY VIOLENCE: STRATEGIES
FOR SUCCESSFUL INTERVENTIONS
Many now are recognizing that a supportive and confiding relationship
with parents and parental figures, especially mothers, may modify
the individuals experience after the abuse and can lessen its long-term
effects, as may academic, social or athletic successes at school.
Research strongly suggests that domestic abuse
and community violence have an intergenerational cycle; those who
witnessed or were victims as children are more likely to perpetrate
it as adults. As a result, prevention and early intervention are
essential, and a wide range of programs have been implemented at the
level of the individual child, the parents or and the full community.
Some programs focus on children who already have been traumatized
or victimized by violence, others on high-risk youths and others on
all children. The goals of any program should be to help children
learn social ways to deal with their frustrations, improve their self-esteem,
and negotiate conflicts nonviolently.
Some research, pilots programs and models are described
below so that the successful strategies may be more widely replicated:
A National (Australian) Audit of Child Abuse
Prevention Activity: This audit reported that many programs
aimed at preventing family violence were adopting a system reform
approach, focusing on improving communications between agencies. Findings
from some other studies, however, did indicate that poor inter-agency
communication results to some children still being left in homes that
were unsafe. The Australian Institute for Family Studies strongly
recommends better education for workers, with an emphasis on cross
service sector communication.
The Institute also is urging a change of focus
in interventions where the man abuses the wife, the children or both.
In some of these interventions, support systems have failed to ensure
the mother and childrens safety. The Institute suggests several approaches
that might help change this, including a hierarchy of priorities:
1. Safety and protection
of the children;
2. Empowerment and
safety of women; and
3. Responsibility
and accountability of the violent adult.
The Institute further suggests those child protective
agencies, rather than the mother, apply for intervention orders to
remove the violent adult from the home. Such a method would make retaliation
against the mother less likely. In addition to removing the batterer,
child protective services should provide adequate support and protection
to the woman and children afterward.
The Child Witness to Violence Project at
Boston Medical Center: This program for young children adapted
from models for treating PTSD. It encourages children to discuss the
traumatic events they have experienced, identify feelings and learn
to manage symptoms. The program also involves teachers and other caregivers
in the treatment process at both assessment and intervention phases.
The positive treatment outcomes generated have resulted in the funding
of replication programs in Massachusetts.
The Child Trauma Research Project at San
Francisco General Hospital: This program employs a psychodynamic
approach in treating preschooler-mother pairs affected by domestic
violence. It provides a forum to help the pair deal with the effects
of the violence while strengthening their ability to function as a
healthy unit. Early results of an evaluation of the program indicate
that mother-child relationships improved, individual child functioning
improved and childrens symptoms decreased.
Partnerships Against Domestic Violence: Endorsed
by the Australian Heads of Government in 1997, this strategy supports
piloting new approaches to violence prevention, enhancing existing
projects, sharing knowledge across service sectors, and developing
and replicating best practice initiatives. It identified six priority
areas including:
