April is Child Abuse Prevention Month and experts at the Monroe Carell Jr. Children's Hospital at Vanderbilt are urging all individuals to be able to recognize the signs and symptoms of child abuse, and to be aware that reporting suspected incidents of child abuse is the law in Tennessee and many other states.
Children's Hospital, along with other services such as Vanderbilt's Regional Burn Center, treats more than 500 incidents of suspected child abuse and neglect each year. In the past five years, Vanderbilt has examined more than 3,000 cases that were reported to Tennessee's Department of Children's Services (DCS) and local law enforcement agencies.
Tennessee's DCS responds to more than 37,000 reports of child abuse and neglect a year, and there are many more unknown children suffering from abuse every day.
"This is a big problem. You just can't put your head in the sand," says Deborah Lowen, M.D., associate professor of Pediatrics and director of Child Abuse Pediatrics at Children's Hospital.
Lowen performs clinical evaluations of children when there are concerns about possible abuse or neglect.
"In most cases what we see is a caregiver or parent taking out their frustrations on the child," she said.
According to the Department of Health and Human Services, children younger than 1 year die from child abuse and neglect at a rate of 17.89 per 100,000. Nearly 80 percent of child fatalities due to abuse or neglect were caused by one or more parents.
Lowen said child abuse can be present in any household. She urges citizens to contact authorities if they suspect abuse of any kind.
If a child appears in immediate danger, call 911. For all other suspected cases in Tennessee, call the abuse and neglect hotline at (877) 237-0004.
Some indicators of child abuse, compiled by the Tennessee Children's Advocacy Centers' "One with Courage" campaign, are:
· Unexplained injuries. Visible signs of physical abuse may include unexplained burns or bruises in the shape of objects. You may also hear unconvincing explanations for these injuries.
· Changes in behavior. Abuse can lead to changes in a child's behavior. Abused children often appear scared, anxious, depressed, withdrawn or more aggressive.
· Returning to earlier behaviors. Abused children may display behaviors shown at earlier ages, such as thumb-sucking, bed-wetting or fear of the dark or strangers. For some children, loss of acquired language or memory problems may be an issue.
· Fear of going home. Abused children may express apprehension or anxiety about leaving school or about going places with the person who is abusing them.
· Changes in eating. The stress, fear and anxiety caused by abuse can lead to changes in a child's eating behaviors, which may result in weight gain or weight loss.
· Changes in sleeping. Abused children may have frequent nightmares or have difficulty falling asleep. As a result, they may appear tired or fatigued.
· Changes in school performance and attendance. Abused children may have difficulty concentrating in school or have excessive absences, sometimes due to adults trying to hide the children's injuries from authorities.
· Lack of personal care or hygiene. Abused and neglected children may appear uncared for. They may present as consistently dirty and have severe body odor, or they may lack sufficient clothing for the weather.
· Risk-taking behaviors. Young people who are abused may engage in high-risk activities such as using drugs or alcohol or carrying a weapon.
· Inappropriate sexual behaviors. Children who have been abused may exhibit overly sexualized behavior or use explicit sexual language.
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