Chapter 4
Can Child Abuse be Prevented?

Mixed Results
Differential Response
Domestic Violence and Child Abuse
Education and Awareness
Removal and Foster Care
Juvenile Court

Twenty-three-year-old Rochanda Madry of Minneapolis, Minnesota, had five children and was overwhelmed. Most of the time she raised her children by herself with no help. One day she left her youngest daughter, who was still a baby, in the care of a friend. The friend lost control with the baby, and Madry took her daughter to the hospital with a swollen, chipped elbow joint. Because babies are unlikely to injure their own elbows, Madry's family was investigated, even though she did not injure the baby herself. Madry was later charged with neglect. She lost custody of her children temporarily and was ordered to take an eight-week parenting class. After the class she regained custody of her children.

Madry felt the class helped her enormously. She says she used to yell at her children and threaten them to get them to obey her. Now she uses time-outs to give both herself and the children time to cool off. “And when I do punish them, I let them know what the punishment is for,” Madry says. Madry is also getting more help with child care now—her mother and sister stay with her children while Madry studies for the General Educational Development (GED) test to earn the equivalent of a high school diploma.

Mixed Results

Madry was not happy about being blamed for an injury that her baby received in someone else's care. She was angry when her children were removed from her care. But she was pleased with the results of the parenting class that she took. And getting extra help with child care made it possible for her to study for her

GED. The diploma would make it possible for her to get a better job and earn more money to support her family.

Child welfare experts say that Madry's case, in some ways, is typical. Parents respond much more positively to help from the community in the form of classes, child care assistance, and other resources than they do to having their children removed from their home. Research shows that when children can remain with their families, they are often safer than they are in foster care. If parents commit acts of abuse and neglect because they are overwhelmed and under too much stress, child advocates argue, it may make more sense to prevent abuse by removing parental stress and by educating parents. It costs less for the community to provide parenting classes and even financial assistance in the form of food stamps and housing subsidies than it does to go

through the process of removing a child from the home, going to court, and providing foster care. And it is easier on both the parents and the children to have the state take action to support them than it is for the state to pull the family apart.

Differential Response

For these reasons, many states are choosing to offer a gentler approach to preventing child abuse than they have in the past. This gentle approach to stopping child abuse, though, coexists with the older, more adversarial model. In theory, removing children from the home is an option that should only be resorted to in extreme cases, when children are in danger. But some critics argue that investigators are too quick to remove children and that they place children in foster homes that are less safe than the children's own homes.

Some child welfare agencies are turning to a different model for investigating child abuse. Instead of investigating every report of child abuse, they classify each report based on the amount of risk to children that is involved. If a report is classified as high risk, the investigation proceeds in the traditional way. The child, parents, and caregivers are interviewed, and social workers visit the home and review the child's history. But if a case is classified as being of low to moderate risk, social workers approach it differently. Instead of formally investigating, they do an assessment. They do not make a formal determination that the report of abuse is substantiated or unsubstantiated. But they do find out what stresses the family is experiencing and offer help. Cases that are assessed this way may never make it into the juvenile court system. If the assessment were to show that children were at high risk, however, the response could be upgraded to a formal investigation.

Learning About Life

“I've been through verbal abuse, physical abuse, sexual abuse, all the abuse you can think of. . . . I ended up in three different foster homes. . . . I had one good foster family, one that taught me about morals and values. It was a pretty good family; it taught me about life.” —Lou Della Casey.

Quoted in Children's Defense Fund, The State of America's Children 2005. www.child rensdefense.org/site/DocServer/Greenbook2005.pdf?docID=1741.

This two-tiered approach to investigating abuse is called different things in different states. Some states call it a differential response, while others call it a dual track or alternative response. The purpose of this model is to focus on keeping families together as much as possible, offering help instead of threatening to remove a child from the home. In jurisdictions where a differential response has been tried, social workers have found that parents cooperate more with child welfare agencies. An assessment does not carry the same stigma as a child abuse investigation, so parents do not feel as though their families are under

attack. Another issue is that there are so many child abuse cases that the state cannot afford to investigate every one formally. Using a differential response makes it possible to prioritize the cases in which children are in the most danger.

Domestic Violence and Child Abuse

Some of the most dangerous families for children are those in which domestic violence, as well as child abuse, is occurring regularly. Research shows that domestic violence and child abuse tend to go hand-in-hand. About half of child abuse cases occur in homes in which women are being battered by their husbands or boyfriends. And about half of men who assault their wives or girlfriends also attack their children. Even those wife batterers who do not directly attack their children frequently end up hurting them accidentally when the children try to protect their mothers.

For example, Carol Johnson's partner beat her every day for four years. He caused her to have three miscarriages. She finally carried a son, Mark, to term, because her partner was in jail during the pregnancy. When Mark's father returned home from jail, he began beating Carol again. He did not attack Mark, but Mark got hurt anyway because he tried to get between his mother and father during beatings. “I knew he was going to kill us,” Carol says, “but I didn't know how to leave or where to go.”¹⁷ She finally fled to another state when Mark's father was sent to jail again.

Carol was lucky that she did not lose custody of her son. Women whose partners assault them often lose custody of their children, because child welfare investigators argue that these mothers have failed to protect their children from their fathers. For example, S.N. was a thirty-one-year-old full-time college student and mother of two children. She opened her apartment door one day to find her ex-boyfriend and his two friends. Her ex-boyfriend attacked her, breaking her arm and fracturing her ribs and skull. Her nine-month-old baby was asleep in a nearby room, and her five-year-old son was at school. S.N. took her baby to a neighbor, asked her cousin to get her son from school, and then went to the hospital. The next day, she received a call

from her city's Department of Children's Services. Her children had been taken into custody and placed in foster care. The state filed a neglect case against her for exposing the children to domestic violence. It took her twenty-one days to get her children back and six months to get the neglect charges dropped.

Because domestic violence and child abuse are so closely connected, domestic violence agencies and child welfare organizations are beginning to work together to try to prevent both kinds of abuse. Battered women's shelters are beginning to be recognized by the states as safe places where women can take their children without fear of having their children taken from them. Child welfare investigators making a safety plan for a family may require batterers to go through counseling or take anger management classes. And domestic violence agencies and child welfare organizations are forming partnerships to educate the community about all the different kinds of violence that can affect families.

Education and Awareness

Organizations dedicated to the well-being of children often run campaigns to raise community awareness of child abuse and domestic violence. Domestic violence awareness campaigns are usually conducted in October, which is Domestic Violence Awareness Month. Child abuse awareness campaigns are run in April, in honor of Child Abuse Prevention Month. During these campaigns, agencies not only educate the public about the existence of family violence, but also try to encourage families to find peaceful alternatives to violence in everyday situations. For example, the Frederick County, Maryland, Partners for Child Abuse Prevention (PCAP) ran a campaign to reward parents who were patient with their children at local supermarkets. Patient parents were given a “patient parent award” and a sticker.

At the same time, PCAP ran a public awareness campaign. They put billboards all over Frederick County, emblazoned with the words “Parenting is a tough job. For help, call 662-2255.” The phone number listed was the number for a parent stress line operated by the Frederick County Mental Health Association. PCAP also put messages on milk cartons, pencils, and tray liners in restaurants. Most child welfare organizations throughout the United States run campaigns like this one in April.

While most organizations run their annual child abuse awareness campaigns in April, they also try to provide support to parents year-round. The parent stress line listed in the bill-

board is run year-round. So are parenting classes that parents can take during a pregnancy or while their children are still young. The classes educate parents about what kinds of behaviors are normal for young children so parents do not punish age-appropriate behavior. For example, some parents do not realize until they take a parenting class that it does not make sense to spank a six-month-old for crying.

Parenting instructors also teach parents nonviolent methods for punishment, such as time-outs, so that parents have an option they can turn to when they feel that punishment is appropriate. For some parents, this is new information. Twenty-year-old Marisa Grady took a parenting class offered by the Illinois Department of Children and Family Services. “Before I took the class, I was a usual parent,” says Grady. “If a child did something, I'd hit her. But now I talk to my kids more.”¹⁸ Marquita Brand had a similar experience. “I used to get frustrated a lot,” she explains. “But they taught me how to sit down and talk to the children, and how to give them time-out.”¹⁹

Nurse-Family Partnerships

Experts say that the most effective child abuse prevention programs are the ones that target mothers who are still pregnant or parents whose children are newborns. The most widespread of these programs is the Nurse-Family Partnership (NFP), which is used in 263 counties in 20 states. Colorado, Louisiana, Pennsylvania, and Oklahoma offer an NFP in each of their counties.

Home visits by nurses form the cornerstone of the NFP program. Nurses begin visiting mothers while they are still pregnant. They visit low-income, at-risk mothers who are pregnant with their first child. Because they come to a woman's home, the pregnant mother is less likely to miss her appointment than she would be if she had to go to a clinic. The nurses help mothers to make good choices about prenatal care and can offer advice about nutrition and exercise. Nurses continue to visit families until the new baby reaches the age of two. They provide parenting education. They also offer counseling and advice to mothers about life choices involving family planning, education, and finding a job.

Removal and Foster Care

Child welfare investigators, however, must also find ways to help children who have already been abused. The laws of most states now require that social workers make “reasonable efforts” to help families keep their children safe without removing the children from the family. This means that social workers must offer help. They may offer to enroll the parents in parenting classes, help parents apply for child care or housing subsidies (money from the state to help pay for child care or housing), or help parents go through the process of registering for unemployment benefits or food stamps. They may also direct parents to specific programs such as substance abuse treatment centers or clinics that provide low-cost health care. Any or all of these kinds of programs could be included in a family safety plan that

child welfare investigators would prepare for a family. The plan would include a time line listing each goal and when it should be completed. For many families, these plans do help.

In many cases, though, investigators are convinced that children are in danger if they stay in their homes. Child protection workers remove approximately 15 percent of abused or neglected children from their homes. They place the children in foster care. In the United States, about eight hundred thousand children enter foster care at some point during the year. They enter family foster homes, group homes, or residential treatment centers. Not all of them stay in foster care for long. The average foster care child is ten years old, lives with a nonrelative, and has been in foster care for almost three years.

Juvenile Court

In theory, no child should be removed from a home until parents have had a chance to tell their side of the story in court. Most of the time, though, if investigators think that children are in danger, they are able to get an emergency order authorizing the removal of the children from the home right away. Then the family is asked to appear at a hearing that occurs after the children have already been placed in foster care.

The initial hearing should include both parents and the child or children in question. If appearing in court is stressful for children, though, the judge can choose to meet with the children in chambers (the judge's office). According to Judge William Jones: “The initial hearing should establish a supportive atmosphere in which parents are treated with dignity and respect. It is a process that should focus on understanding the problems the case

Aging Out of Foster Care

There are several ways that children can leave foster care. They can be reunited with their original families. They can be placed with relatives or adopted by a new family. Many children, however, leave foster care by aging out of it. This means that they reach the age of eighteen while still living with a foster family. When children in foster care reach the age of eighteen, the state no longer acts as their guardian. They are expected to leave foster care and take care of themselves.

Children who age out of foster care, however, often are not prepared to care for themselves. Almost half of children who age out of foster care leave without having earned their high school diploma or General Educational Development (GED). Without a high school diploma or its equivalent, it is hard to get a job and earn a living. About one-third of these young people end up living below the poverty level and working in jobs that do not provide health insurance. It is especially unfortunate that they lack health insurance, because half of those who age out of the foster care system have mental illnesses. One-fifth have three or more mental illnesses. One-quarter have post-traumatic stress disorder from the abuse they have endured.

presents and solving them as quickly as possible so the family can be reunited safely.”²⁰

In the initial hearing, the court must make decisions about how to address the family's immediate needs. The initial hearing, however, is only the first of several. There may also be an adjudication, or fact-finding, hearing. Adjudication is the process of going to court and presenting evidence at a hearing before a judge. In an adjudication hearing, the court hears

evidence and tries to determine what the facts are. Finally, there is a disposition hearing, in which the court decides what kind of help the child needs and whether it is necessary to order services to be provided to the family. In some cases, the court might decide to keep the family's children in foster care while the parents resolve their own problems. For example, a judge might feel that children should be cared for by someone other than the parents if the parents are about to go through rehabilitation for a drug or alcohol problem. In other cases, the court may order that children be reunited with their parents immediately but also require the parents to go through counseling or rehabilitation.

Some juvenile courts across the country have begun to offer mediation services as an alternative to adjudication. Mediation is a gentler process for families. During mediation, families meet together with a court employee who helps the family to think through their problems and work together to devise solutions. If the family can come up with a reasonable plan, the court may approve it. If not, the family may still be able to agree about some issues, shortening the amount of time necessary to go through adjudication.

Domestic Violence and Child Abuse

“There are at least 100 studies documenting the negative effects for children exposed to domestic violence.” —Jeffrey Edleson, director of the Minnesota Center Against Violence and Abuse at the University of Minnesota School of Social Work.

Quoted in Stephanie Walton, “When Violence Hits Home: Responding to Domestic Violence in Families with Kids Requires a Coordinated Effort to Help the Victim and Protect the Children,” State Legislatures, June 2003, p. 31.

When families get enough help and support early in the lives of their children, abusive situations may not arise in the first place. This is the ideal outcome. But many children do experience abuse and neglect. These children need help to make their homes safe places in which to grow up. They may also

need help recovering from their experiences. With treatment for their physical and emotional injuries, children can begin to feel safe and secure again. They can leave their abuse behind them and start a new life. Many adults who were abused as children enter professions in which they help other children. These adults have come full circle. They will never be abused again, and they can help other children to regain their feelings of trust and security.