Children Exposed to Violence

Caryn Brauweiler, LCSW Debbie Conley, LCSW

Presentation Objectives
Define Childrens 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

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.

What exactly is CEV?

What does CEV stand for?

Childrens Exposure Violence

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.
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Childrens 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.

ASK YOURSELF What does the child

SEE? What does the child HEAR? What does the child KNOW?

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 four had witnessed a shooting and one-third had seen a stabbing

3 in 5 of those children who witnessed 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

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

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).

Types of Violence
Child Abuse
Physical Sexual Emotional Neglect

Domestic Violence

Child Abuse & Neglect

Who Does Child Abuse & Neglect Affect?

Child Abuse affects children from all:
Ethnicities Socioeconomic levels Religious affiliations Cultures

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

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

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

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

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

Emotional Abuse
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

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

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

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

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

Domestic Violence

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

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.)

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.
Coalition Against Domestic Violence 40 Hour Training Manual)
(Illinois

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)

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)

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)

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)

Effects of Violence on Children

What Does This Mean?

Myths about Children Who Witness Domestic Violence

Children are too young to understand They wont remember what happened You cant help kids anyway, especially young kids We should just move on Kids should just forget about it

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

Factors Affecting Childrens Reactions to Violence Intensity Proximity Familiarity Developmental Level Chronicity

Warning Signs of Witnessing Violence

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

Effects on Infants and Toddlers

Eating Disturbances Developmental Regression Language Delay Attachment Disorder Attachment Difficulties Failure To Thrive

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

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

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

Impact for future functioning

Lack of trust adults cant protect them Feeling of powerlessness cant impact environment Turning to aggression Risk for violence in later life

Childrens Exposure to Violence

Impact on Brain Development

Overview of Brain Development

Infants are born with only primitive brain function
Brain development rapidly moves from less to more complex

Overview of Brain Development

Major working unit of the brain is neurons Neurons form into networks
Networks become systems which mediate various functions

Overview of Brain Development

The brain system is designed to sense, perceive, process, store and act on information received from external and internal environments

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

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.

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

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 childs life Address confidentiality and its limits Respect the childs right not to talk Validate the childs feelings Reassure the child he/she is not to blame for the violence

How to Respond to Parents or Caregivers

Be honest and direct Provide accurate information Assure them that protecting their child is your number one priority Be prepared for strong reactions Make appropriate referrals for support and treatment when appropriate

Resources and Recommendations

Guidelines for Therapeutic Services

Trauma informed services Developmentally appropriate Culturally sensitive Evidenced based practice
www.nctsn.org www.childtrauma.org

Resources
Safe from the Start funded by IVPA 12 sites in Illinois Northwest Cook County Pillars (West Suburban Cook County) Start Early, Start Right (South Cook Chicago Safe Start
Heartland Human Care Services (North) Casa Central (West) Family Focus (South) Metropolitan Safe Start (Far south side)

Additional Resources
LaRabidas Chicago Child Trauma Center Chicago Childrens Advocacy Center C-4 Counseling Centers

About Safe From The Start

SFTS is a community response dedicated to reduce the trauma of exposure to violence in children ages 0-5 in the communities of Northwest suburbs.

Safe From The Start Services

Specialized Assessment Intensive Case Management Therapeutic Services Community Education and Violence Prevention Professional Consultation

How to Contact Us

Safe From The Start (630)540-0549

Questions.Comments?
Contact Info:
Caryn Brauweiler, LCSW cbsfts@sbcglobal.net Debbie Conley, LCSW dlcsfts@sbcglobal.net

630.540.0549