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Archive for March, 2013

Taking Aim at Violence against Children—Part II Child Abuse

 [Research and National Statistics on Child Abuse]

Introduction

In Part I of this series I emphasized the need for a much broader contextual look at violence perpetrated against children in the United States.

Gun violence has certainly captured everyone’s attention since the cold blooded mass murder of 20 children and six adults at Sandy Hook Elementary School in Newtown, Connecticut. Nevertheless, there still exists a dire need to protect children beyond mass murder. We, as individuals, need to crystalize in our own mind two things: (1) Understanding the comprehensive nature of all violence toward children, and (2) What is needed in the way of recommendations, legislative proposals, and/or policy directives that would effectively address the widespread problem of violence directed against children.  During the course of this four part series both of these things will be laid out.

Child Abuse in America

Summary Statistics

In the United States children are suffering from an epidemic of child abuse and neglect. Every year 3.3 million reports of child abuse are made in the United States involving nearly 6 million children (a report can include multiple children). The United States has the worst record among industrialized nations – losing five children every day due to abuse-related deaths.

The following data were obtained from two sources: Child Help which has programs for the Prevention and Treatment of Child Abuse, and NCANDS which refers to the National Child Abuse and Neglect Data System. Child Help is a private program with a Child Abuse Hotline. NCANDS is a federally sponsored effort that collects and analyzes annual data on child abuse and neglect. The 1988 CAPTA amendments directed the U.S. Department of Health and Human Services to establish a national data collection and analysis program. The Children’s Bureau in the Administration on Children, Youth and Families, Administration for Children and Families, U.S. Department of Health and Human Services, collects and analyzes the data. In addition research findings from various studies will be presented.

The data are submitted voluntarily by the States, the District of Columbia, and the Commonwealth of Puerto Rico. The first report from NCANDS was based on data for 1990; this report for Federal fiscal year (FFY) 2011 data is the 22nd issuance of this annual publication.

 Here are crucial national facts on child abuse in America:

  • A report of child abuse is made every ten seconds.
  • More than five children die every day as a result of child abuse.
  • Approximately 80% of children that die from abuse are under the age of 4.
  • It is estimated that between 50-60% of child fatalities due to maltreatment are not recorded as such on death certificates.
  • More than 90% of juvenile sexual abuse victims know their perpetrator in some way.
  • Child abuse occurs at every socioeconomic level, across ethnic and cultural lines, within all religions and at all levels of education.
  • About 30% of abused and neglected children will later abuse their own children, continuing the horrible cycle of abuse.
  • About 80% of 21 year olds that were abused as children met criteria for at least one psychological disorder.
  • The estimated annual cost of child abuse and neglect in the United States for 2008 was $124 billion.
  • 14% of all men in prison in the USA were abused as children.
  • 36% of all women in prison were abused as children.
  • Children who experience child abuse & neglect are 59% more likely to be arrested as a juvenile, 28% more likely to be arrested as an adult, and 30% more likely to commit violent crime.  Abused children are 25% more likely to experience teen pregnancy.
  • Abused teens are less likely to practice safe sex that puts them at greater risk for STDs.
  • One-third to two-thirds of child maltreatment cases involve substance use to some degree.
  • Children whose parent’s abuse alcohol and other drugs are three times more likely to be abused and more than four times more likely to be neglected than children from non-abusing families.
  • As many as two-thirds of the people in treatment for drug abuse reported being abused or neglected as children.

Definitions of Child Abuse  

     Child Abuse is the physical, sexual or emotional mistreatment or neglect of a child or children. In the United States, the Centers for Disease Control and Prevention (CDC) and the Department for Children and Families (DCF) define child maltreatment as any act or series of acts of commission or omission by a parent or other caregiver that results in harm, potential for harm, or threat of harm to a child.

Child abuse can occur in a child’s home, or organizations, schools or communities the child interacts with. There are four major categories of child abuse:  physical abuse, sexual abuse, psychological or emotional abuse, and neglect.

Different jurisdictions have developed their own definitions of what constitutes child abuse for the purposes of removing a child from his/her family and/or prosecuting a criminal charge. According to the Journal of Child Abuse and Neglect, child abuse is “any recent act or failure to act on the part of a parent or caretaker which results in death, serious physical or emotional harm, sexual abuse or exploitation, an act or failure to act which presents an imminent risk of serious harm”.

Types of Child Abuse

     Physical abuse involves physical aggression directed at a child by an adult. Most nations with child-abuse laws consider the deliberate infliction of serious injuries, or actions that place the child at obvious risk of serious injury or death, to be illegal. Physical abuse is the intentional or non-accidental production of a physical injury. Bruises, scratches, burns, broken bones, lacerations, as well as repeated “mishaps,” and rough treatment that could cause physical injury, are the results of physical abuse. Beyond this, there is considerable variation.

Discipline and Child Abuse

The distinction between child discipline and child abuse is often poorly defined. Cultural norms about what constitutes abuse vary widely: among professionals as well as the wider public.  People do not agree on what behaviors constitute abuse. Some professionals claim that cultural norms that sanction physical punishment are one of the causes of child abuse, and have undertaken campaigns to redefine such norms. The misguided belief that physical punishment does not have consequences for children later in life is naïve. Both the physical health and psychological health of a child who is physically punished does have detrimental consequences later in that child’s life. Research has overwhelmingly proven this. Lack of knowledge about the short and long term effects of physical punishment on the child, but also knowledge how to raise a healthy and psychologically happy child, is little understood by the public at large.

It’s important here to take note of a common defense mechanism known as sublimation. What is the relationship between sublimation and child abuse? If one is really angry at a child sublimation can redirect those feelings (perhaps stress generated) into more acceptable ways of acting toward that child. By definition, Sublimation is a defense mechanism that allows us to act out unacceptable impulses by converting these behaviors into a more acceptable form. For example, a person experiencing extreme anger might take up kick-boxing as a means of venting frustration. Freud believed that sublimation was a sign of maturity that allows people to function normally in socially acceptable ways.

     Where child abuse is concerned there may not be any sublimation that prevents the unacceptable acting out of impulses. However, failure to control one’s own negative impulses may come back later to haunt the abuser.

Revenge and violence by the child directed toward the abuser might take years to be revealed. The old expression “what goes around comes around” may have real consequences for the abuser later in life. Sometimes the abused child doesn’t wait; sometimes an angry child will set fire to a home killing both his/her parents and others in the process. If revenge is delayed, it may manifest itself when the abuser is at that stage of life when they become elderly and need care, and/or medical attention. And then, those needs are left unmet by the child abuse victim. Unfortunately, child abuse victims often become abusers themselves later in life. It can become a vicious cycle for both abuser and victim. 

     Child sexual abuse (CSA) is a form of child abuse in which an adult or older adolescent abuses a child for sexual stimulation. Sexual abuse refers to the participation of a child in a sexual act aimed toward the physical gratification or the financial profit of the person committing the act.

Forms of CSA include asking or pressuring a child to engage in sexual activities (regardless of the outcome), indecent exposure of the genitals to a child, displaying pornography to a child, actual sexual contact with a child, physical contact with the child’s genitals, viewing of the child’s genitalia without physical contact, or using a child to produce child pornography. Selling the sexual services of children is also sexual child abuse.

Effects of child sexual abuse include guilt and self-blame, flashbacks, nightmares, insomnia, fear of things associated with the abuse (including objects, smells, places, doctor’s visits, etc.), self-esteem issues, sexual dysfunction, chronic pain, addiction, self-injury, suicidal ideation, somatic complaints, depression, post-traumatic stress syndrome, anxiety and other mental illnesses including borderline personality disorder and dissociative identity disorder, propensity to re-victimization in adulthood, bulimia nervosa, physical injury to the child, among other problems.

In the United States, approximately 15% to 25% of women and 5% to 15% of men were sexually abused when they were children. Most sexual abuse offenders are acquainted with their victims; approximately 30% are relatives of the child, most often brothers, fathers, mothers, uncles or cousins; around 60% are other acquaintances such as friends of the family, babysitters, or neighbors; strangers are the offenders in approximately10% of child sexual abuse cases. In over one-third of cases, the perpetrator is also a minor.

In a 1999 news story, BBC reported, “Close-knit family life in India masks an alarming amount of sexual abuse of children and teenage girls by family members, a new report suggests. Delhi organization RAHI said 76% of respondents to its survey had been abused when they were children – 40% of those by a family member.”

     Emotional abuse is defined as the production of psychological and social deficits in the growth of a child as a result of behavior such as loud yelling, coarse and rude attitude, inattention, harsh criticism, and denigration of the child’s personality. Other examples include name-calling, ridicule, degradation, destruction of personal belongings, torture or killing of a pet, excessive criticism, inappropriate or excessive demands, withholding communication, and routine labeling or humiliation.

Victims of emotional abuse may react by distancing themselves from the abuser, internalizing the abusive words, or fighting back by insulting the abuser. Emotional abuse can result in abnormal or disrupted attachment development, a tendency for victims to blame themselves (self-blame) for the abuse, learned helplessness, and overly passive behavior.

     Child neglect is the failure of a parent, or other person with responsibility for the child, to provide needed food, clothing, shelter, medical care, or supervision to the degree that the child’s health, safety, and well-being are threatened with harm. Neglect is also a lack of attention from the people surrounding a child, and the non-provision of relevant and adequate necessities for the child’s survival, which would be a lacking in attention, love, and nurture. Some of the observable signs in a neglected child include: the child is frequently absent from school, begs or steals food or money, lacks needed medical and dental care, is consistently dirty, lacks sufficient clothing for the weather.

Neglected children may experience delays in physical and psychosocial development, possibly resulting in psychopathology and impaired neurological functions such as a short attention span, mental processing speed, language development, memory and those all-important social skills.

Researchers investigating maltreated children have repeatedly found that neglected children in foster and adoptive populations manifest different emotional and behavioral reactions to regain lost or secure relationships and are frequently reported to have disorganized attachments and a need to control their environment. Such children are not likely to view caregivers as being a source of safety, and instead typically show an increase in aggressive and hyperactive behaviors which may disrupt healthy or secure attachment with their adopted parents.

These children have apparently learned to adapt to an abusive and inconsistent caregiver by becoming cautiously self-reliant, and are often described as glib, manipulative and disingenuous in their interactions with others as they move through childhood. Children who are victims of neglect have a more difficult time forming and maintaining relationships, such as romantic attachments or friendship later in life due to the lack of attachment they had in their earlier stages of life.

Prevalence

According to the (American) National Committee to Prevent Child Abuse, in 1997 neglect represented 54% of confirmed cases of child abuse, physical abuse 22%, sexual abuse 8%, emotional maltreatment 4%, and other forms of maltreatment 12%.

A UNICEP report on child wellbeing stated that the United States and the United Kingdom ranked lowest among industrial nations with respect to the wellbeing of children. It also found that child neglect and child abuse were far more common in single-parent families than in families where both parents are present.

In the USA, neglect is defined as the failure to meet the basic needs of children including housing, clothing, food and access to medical care. Researchers found over 91,000 cases of neglect in one year (from October 2005 to 30 September 2006) using information from a database of cases verified by protective services agencies.

Neglect could also take the form of financial abuse by not buying the child adequate materials for survival.

The U.S. Department of Health and Human Services reports that for each year between 2000 and 2005, “female parents acting alone” were most likely to be perpetrators of child abuse.

For FFY 2011, United States reported 676,569 victims of child abuse and neglect. Race and ethnicity of victims in 2011: 43.9% of all victims were Caucasian, 21.5% were African American, and 22.1% were Hispanic.

A child abuse fatality occurs when a child’s death is the result of abuse or neglect, or when abuse and/or neglect are contributing factors to a child’s death. In the United States, 1,730 children died in 2008 due to factors related to abuse; this is a rate of 2 per 100,000 U.S. children. Family situations which place children at risk include moving, unemployment, having non-family members living in the household. A number of policies and programs have been put in place in the U.S. to try to better understand and to prevent child abuse fatalities, including:

Safe Haven Laws

Child Fatality Review Teams

Training for Investigators

Shaken Baby Syndrome Prevention Programs

Child Abuse Death Laws Mandating Harsher Sentencing

Causes

Child abuse is a complex phenomenon with multiple causes. Understanding the causes of abuse is crucial to addressing the problem of child abuse. Parents who physically abuse their spouses are more likely than others to physically abuse their children. However, it is impossible to know whether marital strife is a cause of child abuse, or if both the marital strife and the abuse are caused by tendencies in the abuser.

Another cause is unrealistic expectations in parenting or caregiving. This commonly used term refers to the process of parents’ setting expectations for their child that are clearly beyond the child’s capability. When parents’ expectations are particularly deviant (e.g., preschool children who are expected to be totally responsible for self-care or provision of nurturance to parents) the resulting frustration caused by the child’s non-compliance is believed to function as a contributory cause of child abuse.

Children resulting from unintended pregnancies are also more likely to be abused or neglected. Neglect following an unintended pregnancy is by far the most common form of child abuse, accounting for more than 78% of all cases. In addition, unintended pregnancies are more likely than intended pregnancies to be associated with abusive relationships, and there is an increased risk of physical violence during pregnancy. They also result in poorer maternal mental health, and lower mother-child relationship quality.

Substance abuse can be a major contributing factor to child abuse. One U.S. study found that parents with documented substance abuse, most commonly alcohol, cocaine, and heroin, were much more likely to mistreat their children, and were also much more likely to reject court-ordered services and treatments. Another study found that over two-thirds of cases of child maltreatment involved parents with substance abuse problems. This study specifically found relationships between alcohol and physical abuse, and between cocaine and sexual abuse. Although the abuse survivor does not always realize the abuse is wrong, the internal confusion can lead to chaos. Inner anger turns to outer frustration. Once aged 17/18, drink and drugs are used to numb the hurt feelings, nightmares and daytime flashbacks. Acquisitive crimes to pay for the chemicals are inevitable if the survivor is unable to find employment.

Unemployment and financial difficulties are associated with increased rates of child abuse. In 2009 CBS News reported that child abuse in the United States had increased during the economic recession. It gave the example of a father who had never been the primary care-taker of the children. Now that the father was in that role, the children began to come in with injuries.

A 1988 study of child murders in the US found that children are 100 times more often killed by a “non-biological parent (e.g. step-parent, a cohabitating boyfriend or girlfriend of a biological parent)” than by a biological parent. An evolutionary explanation of this is that using resources in order to take care of another person’s biological child is likely not a good strategy for increasing reproductive success. More generally, stepchildren have a much higher risk of being abused which is sometimes referred to as the Cinderella effect.

The Cinderella Effect is often regarded as one of the great successes of Evolutionary Psychology research. It attempts to explain the observation that parents are more likely to kill their stepchildren than their biological children using evolutionary logic – as described by Daly and Wilson: “research concerning animal social behavior provide a rationale for expecting parents to be discriminative in their care and affection, and more specifically, to discriminate in favor of their own young”.

Psychologists conducted a study in the United States in 2010 which examined over 200 regular church attendees from eleven different denominations of Christianity, most of whom were educated upper-middle class Caucasian Americans. In their study they found that extrinsic religious orientation was associated with a greater risk of physical child abuse. Those with a more extrinsic religious orientation who also adhered to greater social conformity were particularly more likely to share characteristics with physically abusive subjects.

Subjects who adhered to Biblical literalism exhibited a higher potential of physical child abuse. Those who had a more intrinsic religious orientation were not found to be at a greater risk of child abuse, although they sometimes exhibited greater social conformity or a greater propensity for holding literal interpretations of the Bible. Approximately 85% of the study’s subjects were parents.

Long Term Health and Psychiatric Effects of Child Abuse

There are strong associations between exposure to child abuse in all its forms and higher rates of many chronic conditions. In the United States, the strongest evidence comes from the Adverse Childhood Experiences (ACE’s) series of studies which show correlations between exposure to abuse or neglect and higher rates in adulthood of chronic conditions, high-risk health behaviors and shortened lifespan. A recent publication, Hidden Costs in Health Care: The Economic Impact of Violence and Abuse, makes the case that such exposure represents a serious and costly public-health issue that should be addressed by the healthcare system.

A big concern with researchers is the degree to which maltreated children grow up to be maltreating adults, or if they exhibit social signs of abuse or neglect. Studies show that 90 percent of maltreating adults were maltreated as children in their life. When children were two, studies show that 16 percent of 267 high-risk mothers mistreated their own children, to different effects. The first two years of a child’s life is when parents invest the least in their children. Almost 7 million American infants go to child care services, like day care, and a majority of that care is poor.

Serious consequences occur when young children are maltreated, including developmental issues. Sixteen percent of those 267 high risk mothers mistreat their two year old children in different ways. Fifty-five percent of the children experienced physical abuse, 55 percent experienced neglect, 43 percent experienced hostile and rejecting parenting, and 43 percent experienced unavailable parenting.

Children who have a history of neglect or physical abuse are at risk of developing psychiatric problems or a disorganized attachment style. Disorganized attachment is associated with a number of developmental problems, including dissociative symptoms, as well as anxiety, depression, and acting out symptoms. A study by Dante Cicchetti found that 80% of abused and maltreated infants exhibited symptoms of disorganized attachment.

When some of these children become parents, especially if they suffer from posttraumatic stress syndrome (PTSD), dissociative symptoms, and other aspects of child abuse, they may encounter difficulty when faced with their infant and young children’s needs and normative distress, which may in turn lead to adverse consequences for their child’s social-emotional development. Despite these potential difficulties, psychosocial intervention can be effective, at least in some cases, in changing the ways maltreated parents think about their young children.

Long Term Effects of Corporal Punishment

In a study by Murray A. Straus et al titled Spanking by Parents and Subsequent Antisocial Behavior of Children (Archives Pediatric Adolescent Medicine. 1997; 151(8): 761-767) researchers studied the causal relationship between corporal punishment and antisocial behavior (ASB) by considering the level of ASB of the child at the start of the study. Data from interviews were obtained with a national sample of 807 mothers of children aged 6 to 9 years in the National Longitudinal Survey of Youth-Child Supplement.

Analysis of variance was used to test the hypothesis that when parents use corporal punishment to correct ASB, it increases subsequent ASB. The analysis controlled for the level of ASB at the start of the study, family socioeconomic status, sex of the child, and the extent to which the home provided emotional support and cognitive stimulation.

The results of their study showed that forty-four percent of the mothers reported spanking their children during the week prior to the study and they spanked them an average of 2.1 times that week. It turned out that the more spanking at the start of the period, the higher the level of ASB 2 years later. The change is unlikely to be owing to the child’s tendency toward ASB or to confounding with demographic characteristics or with parental deficiency in other key aspects of socialization because those variables were statistically controlled.

The researchers concluded that when parents use corporal punishment to reduce ASB, the long-term effect tends to be just the opposite. The findings suggest that if parents replace corporal punishment by nonviolent modes of discipline, it could reduce the risk of ASB among children and reduce the level of violence in American society.

Researchers continue to look at the long-term effect of spanking in childhood. A new report in the Journal of Pediatrics suggests it can have far reaching effects on a person’s mental health as they age. A new study by psychologist Sheyda Melkonian suggests parents think hard before using any physical form of discipline. The punishments in question include spanking, hitting and slapping. Study authors say 7 percent of adult disorders can be linked to harsh punishment in childhood. These disorders include depression, mania, anxiety disorders and alcohol and drug abuse.

“If every time you mess up, you do something wrong, the consequence is you’re physically being hit, there’s always a fear around messing up.” Melkonian also cites other studies that show spanking leads to children with a lower IQ, and that even mild hand slapping will lead to toddlers less willing to explore their world.

“Spanking is one of those experiences that I feel like once it’s done, it changes the parent-child relationship forever because that parent stops being the person that is loving and caring, and it becomes someone that they are afraid of to some degree,” Melkonian said.

Physical Health Problems Later in Life

Victims of childhood abuse, it is claimed, also suffer from different types of physical health problems later in life. Some reportedly suffer from some type of chronic head, abdominal, pelvic, or muscular pain with no identifiable reason. Even though the majority of childhood abuse victims know or believe that their abuse is, or can be, the cause of different health problems in their adult life, for the great majority their abuse was not directly associated with those problems, indicating that sufferers were most likely diagnosed with other possible causes for their health problems, instead of their childhood abuse.

One long-term study found that up to 80% of abused people had at least one psychiatric disorder at age 21, with problems including depression, anxiety, eating disorders, and suicide attempts. One Canadian hospital found that between 36% and 76% of women mental health outpatients had been abused, as had 58% of women and 23% of men schizophrenic inpatients.

Other abuse effects can come early in life or later: Significant would be: Shaking a baby is a common form of child abuse that often results in permanent neurological damage (80% of cases) or death (30% of cases). Damage results from intracranial hypertension (increased pressure in the skull) after bleeding in the brain, damage to the spinal cord and neck, and rib or bone fractures (Institute of Neurological Disorders and Stroke, 2007).

There also can be impaired brain development. Child abuse and neglect have been shown, in some cases, to cause important regions of the brain to fail to form or grow properly, resulting in impaired development (De Bellis & Thomas, 2003). These alterations in brain maturation have long-term consequences for cognitive, language, and academic abilities (Watts-English, Fortson, Gibler, Hooper, & De Bellis, 2006).

The NSCAW found more than three-quarters of foster children between 1 and 2 years of age to be at medium to high risk for problems with brain development, as opposed to less than half of children in a control sample (ACF/OPRE, 2004a).

There is also poor physical health. Several studies have shown a relationship between various forms of household dysfunction (including childhood abuse) and poor health (Flaherty et al., 2006; Felitti, 2002). Adults who experienced abuse or neglect during childhood are more likely to suffer from physical ailments such as allergies, arthritis, asthma, bronchitis, high blood pressure, and ulcers (Springer, Sheridan, Kuo, & Carnes, 2007). Children who are physically abused are likely to receive bone fractures, particularly rib fractures, and may have a higher risk of developing cancer. Children who experience child abuse & neglect are 59% more likely to be arrested as juveniles, 28% more likely to be arrested as adults, and 30% more likely to commit violent crime.

On the other hand, there are some children who are raised in child abuse, but who manage to do unexpectedly well later in life regarding the preconditions. Such children have been termed dandelion children, as inspired from the way that dandelions seem to prosper irrespective of soil, sun, drought, or rain. Such children (or currently grown-ups) are of high interest in finding factors that mitigate the effects of child abuse. In the criminal justice research world children or teens who should have become delinquent or criminals (but who subsequently did not) were called the “invulnerables .” Future research should try to find out what it is about these children or teens that makes them avoid the long term negative effects of abuse, neglect, and/or a social environment conducive to criminal behavior. This area of research has great potential.

A study reported in the American Journal of Public Health v.93(7), 2003 found that there was an association between Childhood Physical Abuse and Gastrointestinal Disorders and Migraine in Adulthood. They examined the association between childhood physical abuse and the odds of gastrointestinal disorders and migraine headache among adults in the community. They hypothesized that childhood physical abuse would be associated with increased odds of gastrointestinal disorders and migraine headache during adulthood, and that this association would be independent of comorbid mental disorders. There were limitations in this study (uncontrolled confounding of variables) but the results were reported that childhood physical abuse was reported by 381 (15.8%) of the 3032 respondents, with 74 (3.1%) reporting frequent abuse. Individuals who reported experiencing childhood abuse were significantly younger, more likely to be of minority racial status, and more likely to have current mental disorders than those who did not report abuse. Frequent abuse was associated with decreased odds of being married. A higher percentage of men than women reported any abuse, and a higher percentage of women than men reported frequent abuse.

When it came to gastrointestinal disorders and migraines they found, “Any childhood abuse was associated with a significantly increased odds ratio (OR) for recurring stomach problems (OR = 1.7; 95% confidence interval [CI] = 1.2, 2.4), and frequent childhood abuse was associated with a significantly increased likelihood of recurring stomach problems (OR = 3.5; 95% CI = 1.9, 6.4), migraine (OR = 2.7; 95% CI = 1.2, 5.8), and ulcer (OR = 4.2; 95% CI = 1.8, 10.0), which remained statistically significant after adjusting for social and demographic characteristics and mental disorders. These data provide initial evidence of an association between childhood physical abuse and increased odds of gastrointestinal problems and migraine headaches among adults in the general population.

Post Script

All behavior has consequences. When parents or strangers hit and/or hurt children it is violence that must be stopped, and carry the full brunt of the law. In the United States there is widespread ignorance in many areas of social life and interaction. Child abuse is one such area. Nevertheless, it has long been said that ignorance of the law is no excuse and neither is parental or caretaker incompetence. It is not enough for society to recognize that far too many in our adult population lack social parenting skills and may have mental disorders or drug addictions of their own. Society must act, and act now, with the same motivational effort as shown by the President and some members of Congress toward the issue of gun violence.

Cultural norms are changing all the time. Just as there’s been recognition that violence perpetrated against women is no longer acceptable under any circumstance, soon the drumbeat to no longer accept child abuse will be heard. The long term medical, psychiatric and criminal justice costs, as a result of child abuse and neglect, are staggering to our economy. These staggering economic costs are likely passed on to you—the taxpayer.

All of you concerned about unemployment, our rising national debt, the high cost of food, gasoline, and healthcare, need to understand how important it really is to prevent child abuse and neglect in this country. Why? Because, you are ultimately going to pay the huge costs for the harm that is done to children, either in its short term or long-term effects.

 

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