Children Exposed to Violence

1. Children Exposed to Violence Caryn Brauweiler, LCSW Debbie Conley, LCSW

2. Presentation Objectives • Define Children’s Exposure to Violence • Identify symptoms of exposure to violence • Understand the impact of exposure to violence on children • How to respond to children • Recommendations and Resources

3. Violence is… …anything that hurts or destroys any person, place or thing. Violence can be experienced in a variety of forms that can include, but is not limited to physical, sexual, and emotional abuse.

4. What exactly is CEV?

5. What does CEV stand for? Children’s Exposure Violence

6. Exposure to Violence… means being a victim of abuse, neglect, or maltreatment; or witnessing domestic violence, community, and/or media violence or other violent crimes/events. 1C2

7. Children’s Exposure to Violence Infants, toddlers, and young children are exposed to violence when they are abused or maltreated, or if they see, hear, and know others who are victimized by crimes that take place within their family, their community, or through the media.

8. What does the child SEE? What does the child HEAR? What does the child KNOW? ASK YOURSELF…

9. Get the Facts! Estimates show that 3-5 children in every classroom have witnessed a woman being abused In Chicago, studies have shown that among 500 elementary school students one in fourhad witnessed a shooting andone-third had seen a stabbing 3 in 5 of those childrenwhowitnessed a shooting or stabbing, indicated that the incident resulted in death. More than 25% of these children had been victims of severe violence themselves-that is, they had been shot at, suffered a knife attack, or had been beaten or mugged. Data from “Exposure and Response to Community Violence among Children and Adolescents,” Esther J. Jenkins and Carl C. Bell, 1997

10. Prevalence of Violence • Intentional injury to young children (0-4) is most likely to occur as a result of child abuse (and neglect) • Nationally in 2002, there were over 900,000 estimated maltreated children, with more than 1,300 child fatalities • 80% of these children were under the age of five • Children witness 68-80% of domestic assaults • According to the NYU Child Study Center, 3 million children are diagnosed as having PTSD

11. More Facts…! 38,985 (97% Women) sought shelter, 16,570 were turned away (IDHS, 1997). In 2001, state funding supported 67 domestic violence programs, serving 113,700 clients. This includes 25,700 children. Chicago Police Department receives 655 domestic calls per day (Mayors Office on Domestic Violence).

12. Types of Violence • Child Abuse • Physical • Sexual • Emotional • Neglect • Domestic Violence

13. Child Abuse & Neglect

14. Who Does Child Abuse & Neglect Affect? • Child Abuse affects children from all: • Ethnicities • Socioeconomic levels • Religious affiliations • Cultures

15. Factors which contribute to child abuse and neglect • Lack of parenting skills • Parental stress • Family Hardship • Alcohol and substance abuse • Economic difficulties or poverty • Domestic Violence • Previous Victimization • Depression

16. Physical Abuse • Characterized by the infliction of physical injury as a result of: • Punching • Beating • Kicking • Biting • Shaking • Burning • Or otherwise harminga child

17. Indicators of Physical Abuse • Unexplained injuries • Repeated injuries such as bruises, welts or burns • Unexplained abrasions or lacerations • Injuries in various stages of healing • Small circular burns • Burns with a “doughnut” shape • Delays in obtaining medical care

18. Child Neglect • When a caregiver fails to provide a child with adequate: • Food • Clothing • Shelter • Supervision • Needed medical treatment

19. Indicators of Child Neglect • Appears poorly nourished or inadequately clothed • Appears consistently tired or listless • Inconsistent attendance at school • Poor hygiene • Unable to relate well to others

20. Acts that damage immediately or ultimately the behavioral, cognitive, affective or physical functioning of a child, such as: Criticizing Name calling Ridiculing Blaming Screaming Withholding love and affection Unpredictable responses Double-message communication Emotional Abuse

21. Indicators of Emotional Abuse • Clingy and forms indiscriminate attachments • “Acts out” and considered a behavior problem • Withdrawn, depressed, apathetic • Exhibits exaggerated fearfulness • Bedwetting or soiling

22. Child Sexual Abuse • Using a child for the purpose of sexual needs or desires, may include: • Touching • Fondling • Oral stimulation • Penetration of genital or anal opening • Often includes the use of: • Secrecy • Bribes • Tricks • Threats • Or other forms of coercion

23. Indicators of Sexual Abuse • Sexual Behaviors of Children: • Detailed and age-inappropriate understanding of sexual behavior • Inappropriate, unusual, or aggressive sexual behavior with peers or toys • Compulsive indiscreet masturbation • Excessive curiosity about sexual matters or genitals • Seductive behavior with peers or adults • Physical Indicators: • Sexually transmitted diseases • Genital discharge or infection • Trauma or irritation to anal/genital area • Pain upon urination/defecation • Difficulty walking or sitting due to pain • Psychosomatic symptoms

24. Indicators of Sexual Abuse • Behavioral Indicators in Young Children: • Bedwetting • Fecal soiling • Eating disturbances • Fears or phobias • Change in school performance • Regressive behavior • Difficulty concentrating • Sleep disturbances

25. Domestic Violence

26. What is the Connection Between Domestic Violence and Child Abuse? • Significant overlap- 40-60% of families who present with partner violence also present with child abuse • 32% of caseloads for protective service workers involve DV • 50% of children who are physically abused were in the middle of an inter-parental attack • When there is DV, look for child abuse

27. What is Domestic Violence? • A pattern of coercive control that one person exercises over another. • Domestic Violence is not limited to physical abuse, but also includes verbal abuse, sexual abuse, emotional abuse, and economic abuse. (Domestic Violence Against Older Women: brochure from the Illinois Department On Aging.)

28. Types of Violence • Physical Abuse • pushing, punching, choking, burning, shooting, dragging, restraining, locking in the house, throwing down stairs, kicking, poking, slapping, cutting, tripping, raping, holding down, hair pulling, squeezing, suffocating, and kidnapping. (Illinois Coalition Against Domestic Violence – 40 Hour Training Manual)

29. Types of Violence (cont.) • Sexual abuse • Making degrading sexual comments, forcing sex, assaulting breasts or genitals, forcing a partner to have sex with a third person, criticizing appearance, bragging about infidelity, forced cohabitation. (Illinois coalition Against Domestic Violence – 40 Hour training manual)

30. Types of Violence (cont.) • Verbal Abuse • name calling, yelling, making demeaning comments, threatening, belittling, constant phone calls, actively undermining her authority with children, setting her up so that he can humiliate her in public or in front of family and friends. (Illinois Coalition Against Domestic Violence – 40 Hour Training Manual)

31. Types of violence (cont.) • Emotional Abuse • Making threats of violence, forcing a woman to do degrading things, controlling her activities, frightening her, or using her children as leverage against her, killing a family pet, creating crisis, embarrassment, threatening to tell others about sexuality in the case of gays/lesbians. (Illinois Coalition Against Domestic Violence – 40 Hour Training Manual)

32. Types of Violence (Cont.) • Economic Abuse • destroying property, prized possessions, relatives’ property,taking her money, restricting access to household finances, withholding medical treatment, not allowing her to work or attend school, forcing her to work. (Illinois coalition Against Domestic Violence – 40 Hour Training Manual)

33. Effects of Violence on Children What Does This Mean?

34. Myths about Children Who Witness Domestic Violence • Children are too young to understand • They won’t remember what happened • You can’t help kids anyway, especially young kids • We should just move on • Kids should just forget about it

35. Facts about Children Who Witness Domestic Violence • All children are affected by witnessing violence • The younger the child, the more likely they will show signs of distress • Children have more trouble under-standing and coping with violence

36. Factors Affecting Children’s Reactions to Violence • Intensity • Proximity • Familiarity • Developmental Level • Chronicity

37. Sleep Disturbances Somatic Complaints Increased Aggressive Behavior Angry Outbursts Increased Activity Level Hypervigilance Numbing Increased Separation Anxiety Distractibility Changes in Play Withdrawal Regression Behavioral Changes Warning Signs of Witnessing Violence

38. Effects on Infants and Toddlers • Eating Disturbances • Developmental Regression • Language Delay • Attachment Disorder • Attachment Difficulties • Failure To Thrive

39. Effects on School-Aged Children • Psychosomatic Complaints • Enuresis • School Problems/Absenteeism • Behavioral Problems • Parentification • Violence • Depression • Attachment Difficulties • Changes in Play • May Talk About Death/Dying

40. Effects on Teenagers • Antisocial Behavior • Dating Violence • School Problems/Absenteeism • Substance Abuse • Parentification • Running Away from Home • Depression • Suicidal Gestures/Talk • Relationship Problems

41. Witnessing Violence Makes it Hard for Children to Feel Safe • Children need to feel safe to: • Grow • Be Healthy • Succeed • When children see or hear violence, they worry they will not be safe

42. Impact for future functioning • Lack of trust – adults can’t protect them • Feeling of powerlessness – can’t impact environment • Turning to aggression • Risk for violence in later life

43. Children’s Exposure to Violence Impact on Brain Development

44. Overview of Brain Development • Infants are born with only primitive brain function • Brain development rapidly moves from less to more complex

45. Overview of Brain Development • Major working unit of the brain is neurons • Neurons form into networks • Networks become systems which mediate various functions

46. Overview of Brain Development • The brain system is designed to sense, perceive, process, store and act on information received from external and internalenvironments

47. CEV and Brain Development • Threatening environments in early infancy can trigger imbalances of brain chemicals • This can affect how genes are expressed • Early experiences + genes = biochemical foundation for a life time of intellectual, emotional, social functioning

48. Impact on Brain Development • Excessive stresses caused by experiences such as abuse, neglect, or witnessing violence, can actually affect genes: they can switch them on or off at the wrong times, forcing them to build abnormal networks of brain cell connections.

49. Impacts of CEV • Stress and trauma can interfere with healthy brain development for very young children • Children may manifest symptoms related to anxiety, post-traumatic stress and attention deficit disorders

50. How to Respond to Children Exposed to Violence • Address a child at eye level • Use simple, direct, age-appropriate language • Help the child understand your role in the child’s life • Address confidentiality and its limits • Respect the child’s right not to talk • Validate the child’s feelings • Reassure the child he/she is not to blame for the violence