ER Doctors Are Seeing An Increase In Severe Cases Of Child Abuse

Child abuse isn’t new. Its devastating effects have been felt for generations.

Let’s look at some sobering facts. According to the National Children’s Alliance, almost 700,000 kids are abused in America each year. 1,670 kids died from abuse and neglect in the U.S. in 2015.

1,670 deaths. In one year.

The most horrific part: in approximately 4 out of 5 cases, the abuser is the child’s parent. This is something that is almost impossible to comprehend or process. It breaks your heart into a million pieces and makes you feel physically ill.

Now let’s talk about something else — something that isn’t really on anyone’s radar right now, as we battle a pandemic that is turning our world upside down. Since the pandemic began, cases of child abuse around the country have skyrocketed, and officials believe this issue may only get worse as time goes on.

Here’s why. With schools shut down for the foreseeable future, children who are victims of abuse don’t have a way to escape or get a break from their abusers. For them, the walls of their school are a sanctuary. It’s a place they can go to for eight hours a day free of physical and sexual violence, conditions that present as a health-hazard, mental hurt, and neglect.

In every single way, these kids are trapped and without a voice in a horrendous situation that is not yet visible to us. When they’re kept at home, we don’t readily see the signs.

Since the pandemic, ER doctors have already seen a staggering increase in severe child abuse injuries and deaths at hospitals across the nation, seeing roughly the same amount of cases a week as they would usually see in a month. And although the number of reported or referred child abuse cases are substantially lower than usual, with some states claiming more than a 60% reduction, that doesn’t reassure child abuse experts — it alarms them.

It should alarm us all.

In some states, like Kentucky (the state that leads the nation with the most child abuse and neglect cases), in-person child abuse investigations will now be limited due to the coronavirus.

“It’s a step that we have to take,” Governor Andy Beshear said in a news conference. “We are going to do our very best to make sure that we are there when those kids need us.”

For the state of Kentucky, CPS workers have been instructed to access the risk-factors of abuse through a questionnaire and avoid entering a parent’s house unless a child is at high-risk of danger. As for those who don’t fall into this category and are already in the system, monthly visits have been suspended for these cases, raising worry among foster parents who have to send their foster children to overnight visits with their biological parents per the court’s order.

As one foster parent, who wished to remain anonymous, explained to Courier Journal, “You just don’t know what the kids are being exposed to.”

And she’s right. Because without CPS workers going into a home, or even visiting the home, they are getting but a glimpse of the whole situation. This is worrisome, and you can’t help but wonder how many kids will slip through the cracks as a direct result.

Recently, Texas reported an uptick of abuse cases. In just one week, Cook Children’s Hospital in Fort Worth claims to have seen at least six cases of evident physical abuse on children, with one of them resulting in death; on average, they see around eight a month.

“Thursday night, we had one child admitted with unfortunately, life-threatening injuries, which they succumbed to, as well as four other children in the emergency department at the same time who were treated and released,” Dr. Jamye Coffman, medical director of the CARE team at the Cook’s Children Hospital told NBC 5 Dallas-Fort Worth.

According to Coffman, all of the children treated at the hospital were under six years old, which leads us to another issue: small children are the most targeted age group for child abuse among us. This is thought to be partially due to the development associated with their age (i.e. not being able to speak for themselves), but it also stems from a lack of outward advocacy and intervention that places like schools, churches, and extracurricular activities provide.

These young, vulnerable kids need the support of their schools and teachers now more than ever, and it’s just not possible for them to get it. This is awful.

Gathered from data provided by the U.S. Department of Health and Human Services, professionals submitted over half of the cases referred to CPS, with educators and school faculty members being the most frequent source. But now that children are without these people who would normally stand up and report their abuse for them, they are crying out for help themselves. As records show, for the first time ever, over 50% of visitors to the National Sexual Assault Hotline in March were minors, and 79% of them were living with their perpetrator(s).

In all honesty, it doesn’t matter the age of the victim at this point anymore — we are past that in this pandemic. Because as research is proving, kids of all ages are at a heightened risk of abuse within their homes, and experts are just hoping that someone notices and takes action before the situation escalates and becomes dire.

“People are waiting until these children have stopped breathing or something extremely serious before they’re coming into the emergency departments,” Leigh Vinocur, a spokeswoman for the American College of Emergency Physicians, tells The Washington Post. “When there’s more reporting, we can pick up injuries that are more minor. Now we’re relying on parents who have injured their child to bring them in.”

This is why we can’t even begin to guess how many children are subject to abuse in our country right now. Without outsiders speaking on behalf of these victims when abuse becomes apparent, child abuse cases are likely to go unreported unless the situation is emergent enough to require outside medical help.

“As a child abuse pediatrician, I typically see more cases in the fall because abuse that occurs during the summer often goes undetected,” Nina Agrawal, a child abuse pediatrician and assistant professor of pediatrics at Columbia University Medical Center writes in The New York Times. “I expect that when this period of social distancing comes to an end, I’ll see a similar surge.”

This is expected with all forms of abuse, but sexual abuse is thought to be one of the more inescapable forms for children during this pandemic. With roughly one in four females and one in six males being sexually abused before the age of 18, and most of their abusers being someone in the family or close to the family, we could see an increase in sexual abuse cases later on, particularly if the abuser is the breadwinner of the family and currently without a job.

And it’s likely that we won’t find out about the magnitude of it all until school — and life in general — starts back up again.

Even still, there are ways that friends, neighbors, churches and pediatricians can help when child abuse is suspected. Anyone can call the Child Protective Services hotline to report abuse. You can call the police, who have the power to remove a child from their home if there is an imminent risk of danger. If your kids are on a Zoom chat with one of their friends and you have your suspicions, try to hop in on their conversation and kindly inquire about their home life in a safe way, or message their teacher so they can offer their judgment in addition to yours.

In order to help the most children who are being abused, we have to recognize that abuse doesn’t always just happen to one person in the household. Sometimes, it’s one parent abusing another parent, which affects the children as well. Following the start of this pandemic, some areas have seen as much as a 25% rise in domestic violence reports. In these instances, some may find it difficult, even life-threatening, to leave their partner without a solid escape plan or a steady flow of financial revenue.

We need to find ways for victims of abuse to report their situation that meshes with this digital day of age — that includes raising awareness about mobile apps which offer inconspicuous ways for survivors to receive help from abuse. With no need to “cover your tracks,” the Wickr mobile app is a top-secret messenger which sends encrypted messages with a self-destruct timer. For someone needing something that allows them to hide their escape plan in plain sight, the Aspire News app allows victims of abuse to report and find support from abuse with their pages that resembles ordinary news sites.

It would be a huge leap for a victim of abuse to speak up. So when and if they do, listen to them. Stay informed on the ways you can help them. Use code words to help get them out of their situation safely, and get the authorities involved if the situation is dire enough to call for it.

Above all, keep your eyes and ears open for subtle signs. Be an advocate for the voiceless. Because for some, quarantine isn’t a time filled with board games, too much screen time, and even more food — it’s a state of constant fear.