COVID-19 is Putting More Children at Risk for Abuse Posted on March 27, 2020March 27, 2020 Yesterday, Montana governor, Steve Bullock, issued a “stay at home” order for all Montanans, only allowing us to leave home for certain necessary functions, such as buying food or medicine, going to work at essential businesses, or performing outdoor recreation, as long as everyone maintains physical distance (six feet apart) in these situations. “While this action by the state is necessary to flatten the curve of COVID-19 in our state to preserve our medical equipment and healthcare staff, it also comes a ripple effect not directly related to medical illness,” says Laurie Carter, MD, pediatric hospitalist at Community Children’s in Missoula. “Our nation is experiencing an unprecedented increase in unemployment, which will be followed by financial insecurity for most Montanans. If past experience can predict the future, this will likely be followed by an increase in child abuse.” During the last economic downturn, The Great Recession, that occurred from 2007 to 2009, the rate of abusive head trauma, formerly known as “shaken baby syndrome,” increased by 65 percent in the three years during the downturn compared to the three years before The Great Recession1. Our public schools are closed, at least through April 10, and many child care centers have similarly closed. This has led to families, who are already burdened by anxiety or unemployment, having to spend every hour, every day of the week together. Well known risk factors for child abuse are social isolation, parenting stress and family stress2 – which most likely will describe the environment of many homes where the “stay at home” order is being applied. Other parts of the country, which have more extensively been affected by COVID-19 to date, have already noted this increase in child abuse, and believe it is directly related to the stress of social distancing and unemployment. On March 20, a children’s hospital in Fort Worth, Texas reported seven cases of severe child abuse, with two deaths in one week3. Typically, their hospital would see this many cases over the course of a month, and a total of six deaths each year from abuse. Another concerning statistic is that the fewer people have been calling the child abuse hotline in Colorado since the pandemic closed school and other family services. Between March 2 and 6, they received greater than 4,800 calls. This past week4 they have only received half that number. This decrease is most likely due to fewer teachers and non-parental caregivers being in contact with children. What can we do to decrease the risk of child abuse? Check in with your friends and offer a listening ear. If you are in a position to do so, support your neighbors’ food security and financial security with donations to our food banks/pantries or charities like the United Way, which offer direct financial support to lessen the impact of unemployment. Additionally, look to make your own relationships with your children as positive and healthy as you can. The American Academy of Pediatrics has published parenting tips on their HealthyChildren.org website, including: Engage your children in constructive activities. Bored or frustrated children are more likely to act out. Many children have had their lives disrupted. They are out of school, and they can’t play with their friends. Help them with their fears. Children who are old enough to follow the news may be afraid, for example, that they or their parents are going to die. You can acknowledge the fear, and discuss all the things you are doing to stay healthy, such as washing hands and staying home to avoid germs. Call a time-out. This discipline tool works best by warning children they will get a time-out if they don’t stop, reminding them what they did wrong in as few words―and with as little emotion―as possible, and removing them from the situation for a pre-set length of time (1 minute per year of age is a good guide). Know when not to respond. As long as your child isn’t doing something dangerous and gets plenty of attention for good behavior, ignoring bad behavior can be an effective way of stopping it. Ignoring bad behavior also can teach children natural consequences of their actions. For example, if your child keeps dropping his food on purpose, he soon will have no more crackers left to eat. Catch them being good. Children need to know when they do something bad—and when they do something good. Notice good behavior and point it out, praising success and good tries. This is particularly important in these difficult times, when children are separated from their friends and usual routines. Give them your attention. The most powerful tool for effective discipline is attention—to reinforce good behaviors and discourage others. Remember, all children want their parent’s attention. When parents are trying to work at home, this can be particularly challenging. Clear communication and setting expectations can help, particularly with older children. If you are ever concerned that you, or someone you know, is at risk of harming a child, PLEASE call the Child & Family Services Division child abuse hotline: (800) 820-5437 Other resources from HealthyChildren.org Working and Learning from Home During the COVID-19 Outbreak, including how to smartly use extra screen time What’s the Best Way to Discipline My Child? Feeling Overwhelmed with Parenting Demands Tips for Coping with a New Baby during COVID-19 From the American Academy of Pediatrics website: Finding Ways to Keep Children Occupied During these Challenging Times, including online and offline activities References: 1 Berger et al. Abusive head trauma during a time of increased unemployment: a multi-center analysis. Pediatrics 2011 Oct: 128 (4): 637-43. 2 https://www.cdc.gov/violenceprevention/childabuseandneglect/riskprotectivefactors.html 3 https://www.checkupnewsroom.com/spike-in-severe-child-abuse-cases-likely-result-of-covid-19/ 4 https://kdvr.com/news/coronavirus/colorado-officials-call-reduction-in-child-abuse-hotline-calls-during-covid-19-pandemic-concerning/