Child Abuse Prevention Blue Ribbon Campaign National Exchange Club April 29, 2009 David L' Corwin, M

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Child Abuse PreventionBlue Ribbon Campaign
National Exchange ClubApril 29, 2009David L.
Corwin, MDProfessor and Chief Child Protection
and Family Health DivisionPediatrics Department
University of Utah School of Medicine
TIP For TrainingPresentation Guidelines.
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Invest in the FuturePreventionBuilds Success
Prevent Child Abuse Utah and Utahs Child Abuse
Prevention Task Force
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Child Abuse in Utah
Utah is the 8th highest state in substantiated
cases of child abuse with 18.3 per 1,000
children, versus the national average of 11.9 per
1,000.
Prevent Child Abuse America 2004 study, Child
Maltreatment Reports, Victims and Fatalities
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The Cost of Child Abuse in America
The nation spends conservatively 103.8 billion
each year, or 284 million each day, as a direct,
or indirect result of child abuse.
Prevent Child Abuse America 2008 Report, Total
Estimated Cost of Child Abuse in the United States
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The Cost of Child Abuse in Utah
Utah has about 1 of the US population age 0
17. Hence, Utahs share of this cost is around
one billion dollars per year or 2.84 million
each day as a direct, or indirect result of child
abuse.
Prevent Child Abuse America 2008 Report, Total
Estimated Cost of Child Abuse in the United
States
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Normal vs. Deprived Brain of a Three Year Old
Child
Normal
Sensory Deprived
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Cycle of Safety and Success
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Healthy Brain DevelopmentResults From

• Nurturing, stable and consistent relationships
  with supportive and responsive adults
• Sense of safety and security
• Absence of stress (no family violence or
  substance abuse)
• Positive stimulation (visual, auditory, emotional)

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Cycle of Violence and Abuse
Estimated Total Annual Cost in Utah 1 billion
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Negative Impacts to Brain Development

• Exposure to domestic abuse or substance abuse
  may prevent a child from being able to maintain
  healthy emotional relationships.
• The result is often impulsive behavior and
  aggression and the inability to empathize with
  others.

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Brain Development Opportunity and Investment
Brains Capacity for Change
Spending on Health, Education, Income Support,
Social Services And Crime
Intensity of Brains Development
A. Akers, Early Intervention Research Institute,
USU
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The Adverse Childhood Experiences (ACE) Study
Vincent J. Felitti, M.D. Robert F. Anda, M.D.

• The largest study of its kind ever done to
  examine the health and social effects of adverse
  childhood experiences over the lifespan. (18,000
  participants)

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What are Adverse Childhood Experiences?

• Experiences that represent medical and social
  problems of national importance.
• childhood abuse and neglect
• growing up with domestic violence, substance
  abuse or mental illness in the home, parental
  loss, or crime

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Adverse Childhood Experiences (ACEs)
Growing up (prior to 18) in a household with

• Recurrent physical abuse
• Recurrent emotional abuse
• Sexual abuse
• An alcohol or drug abuser
• An incarcerated household member
• Someone chronically depressed, suicidal,
  institutionalized or mentally ill
• Mother being treated violently
• One or no parents
• Emotional or physical neglect

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Many chronic diseasesin adults are associated
with adverse experiences in childhood.
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The Influence of Adverse Childhood Experiences
Throughout Life
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Smoking, severe obesity, physical inactivity,
depression, suicide attempt, alcoholism, illicit
drug use, injected drug use, 50 sexual partners,
STDs
ACEs are strongly associated with the top 10 risk
factors of death in the U.S
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The majority of adultswho experiencedlittle
adversity in childhood have few, if any,health
risk factors.
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However, the majority of adults with an ACE Score
of four or more,have multiple health
riskfactors.
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Adverse childhood experiences are related to
health risk behaviors, morbidity, disability,
mortality, and healthcare costs.
Evidence from ACE Study Suggests
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• What is Working?

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Early, consistent, home-based education and
support for parents at risk for child abuse and
other outcomes.
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Healthy Families Arizona
Program 1
A voluntary home visiting program for at-risk
families of newborns, following through until the
age of 5 years old.
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Healthy Families Arizona Outcomes
Program 1

• 99.24 of families had no confirmed child abuse
  or neglect in 2006
• Children are safer
• 99 travel in car seats
• 93 of parents lock up
• household poisons
• 88 have smoke alarms
• 84 of children were immunized(Az rate for 2
  year olds was 79)

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Healthy Families Arizona Outcomes
Program 1

• Mothers stress significantly reduced
• Increased sense of competence as a parent
• Increased parental attachment to infant
• Reduced levels of depression
• Social isolation overcome
• Mothers life course improved
• After 1 year 40 employed
  11.6 enrolled in school
• 95 of families rated services excellent

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Program 2
Nurse-Family Partnership Helping First-Time
Parents Succeed

• Serves low-income, first-time parents and their
  children
• Nurse Home Visitors are highly educated
  registered nurses
• Visits begin no later than the 28th week of
  pregnancy and continue through first two years of
  life

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Program 2
Program Outcomes

• Reduced child maltreatment
• Improved prenatal care
• Reduced prenatal smoking
• Improve child health and development
• Improved parents economic self-sufficiency

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Program 3
School-Based Prevention Programs

• Instructs school-aged children on child abuse
• Usually delivered in school setting

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Program 3
Program Outcomes

• Children learn, remember and can use concepts
  learned in prevention programs
• Increased parent-child communication
• Prevention programs promote disclosure
• Abused children feel less personal blame

David Finkelhor, PhD, Prevention of Sexual Abuse
Through Educational Programs Directed Toward
Children, 2007, American Academy of Pediatrics
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Program 4
Crisis/Respite Nurseries
A safe haven for children under the age of 11
whose parents are in a crisis or who need a break
in order to prevent abuse.
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Program 4
Program Outcomes

• Prevent child abuse
• Preserve families
• Empower parents to handle crisis situations
• Teach positive parenting skills
• Provide a nurturing experience for children

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Program 5
Parents as Teachers Four-part intervention model

• Personal visits - Parent educator shares child
  development and parenting information.
• Parent group meetings - Parents support each
  other and practice parenting skills.
• Screenings - Assess child's overall health,
  hearing and vision.
• Resource network - Links family to other
  community services.

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Program 5
Program Outcomes

• Prevent child abuse and neglect
• Increase parent knowledge of early childhood
  development and improve parenting practices
• Provide early detection of developmental delays
  and health issues
• Increase children's school readiness and school
  success.

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Children Experiencing High-Quality Early Care and
Education Are

• MORE likely to
• Have good physical, emotional and mental health
• Have better jobs and higher earnings as adults
• Own their own homes
• Contribute to tax base

• LESS likely to
• Become teen parents
• Engage in criminal behavior as teens and
  adults/become incarcerated
• Abuse drugs
• Be dependent on welfare

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What Does Prevention Mean to Us?
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What Challenges Do We Face?
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How Can We HelpEach Other?
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What Are OurNext Steps?
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Invest in the Future This presentation was made
possible by generous funding from the
following Utah Childrens Trust Account United
Way of Salt Lake Freestyle Marketing LDS
Foundation
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Utah Child Abuse Prevention Task Force
Recommendations

• Most promising approaches for improving child
  abuse prevention in Utah
• Improved integration and coordination of
  prevention programs
• Attention to cultural issues and competence
• Improve Utahs Childrens Trust Fund to better
  assist child abuse prevention in Utah

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The Utah Child Abuse Prevention Task Force
Recommendations

• January 6, 2005

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Vision

• We envision that throughout Utah
• All children are protected from preventable
  harmful experiences that result from child abuse
  or neglect.
• All parents, especially new parents, are informed
  on how to provide safe and healthy formative
  years for their children.
• All communities are responding with early
  supportive services for successful parenting and
  healthy childhood development.
• Increased means are available to provide healthy
  environments for children from resources once
  spent on the results of child abuse and neglect.
• For all children, it is great to be a child!

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The Utah Healthy Families-Safe Kids Action Plan

• Principles
• Preventing child abuse strengthens families
• All families want to raise safe, healthy,
  successful children.
• Helping parents succeed prevents child abuse.
• Prevention must be universal and voluntary.
• Prevention efforts must be effective and
• adapted to diverse cultural needs of Utah.

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The Utah Healthy Families-Safe Kids Action Plan

• Principles
• Prevention efforts must be collaborative all
  community agencies and partners must be involved
  in planning and implementation.
• Prevention efforts must be public/private
  partnerships.

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The Utah Healthy Families-Safe Kids Action Plan

• Findings
• Child abuse is a major public health problem.
• 7,829 case/ 10,932 child/adolescent victims in
  2003
• 33.8 increase in cases from 2000 to 2003
• In 2002, 14.2 cases per 1,000 children (12.3
  nationally)

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The Utah Healthy Families-Safe Kids Action Plan

• Findings
• Child Abuse is a major public health problem.
• Acute injury
• Chronic illness
• Disability
• Death

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The Utah Healthy Families-Safe Kids Action Plan

• Findings
• Child abuse is a major moral issue. Child abuse
  is wrong. Prevention is right.
• Children are precious, vulnerable and dependent
  on adults. They deserve our best.
• Our society is not safe until every child is
  safe.
• The safety and well being of children is
  everyones moral responsibility.

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The Utah Healthy Families-Safe Kids Action Plan

• Findings
• Child abuse is a major social issue.
• Violence and criminality
• Social dysfunction
• Relationship problems
• Addiction
• Lost productivity
• Pain and suffering
• Intergenerational cycle of abuse

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The Utah Healthy Families-Safe Kids Action Plan

• Findings
• Child abuse is very expensive. We pay for its
  harms with our tax dollars, insurance premiums,
  lost productivity and reduced resources for other
  important services like education.
• 94 billion per year
• Preventing half of its child abuse cases could
  save Utah hundreds of millions of dollars that
  could help support education, health care and
  transportation

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The Utah Healthy Families-Safe Kids Action Plan

• Findings
• Child abuse is preventable.
• Effective programs include
• Early childhood home visiting
• Parent education, family resource centers, the
  Nurturing Program
• Parenting older children and adolescents, e.g.
• Strengthening Families

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The Utah Healthy Families-Safe Kids Action Plan

• Findings
• Utah has many promising prevention programs
• Unfortunately, they have insufficient resources
  to reach enough families to significantly reduce
  child abuse in Utah.
• Utah needs enhanced coordination across funding
  streams and disciplines to reduce child abuse as
  much as possible.

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The Utah Healthy Families-Safe Kids Action Plan

• Call To Action
• Citizens of Utah support all Utah families in
  raising safe, healthy and successful children.
• Agencies, institutions and businesses of Utah are
  called upon to develop, implement and sustain
  flexible approaches for helping parents and
  families succeed.
• Proven models
• Flexible to accommodate cultural, geographic and
  socio-economic diversity of Utah

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The Utah Healthy Families-Safe Kids Action Plan

• Call To Action
• The Utah Legislature and Governor Huntsman are
  called upon to facilitate increased funding of
  child abuse prevention from public, foundation,
  corporate and private sources by restructuring
  the Utah Childrens Trust Fund to maximize it
  flexibility and productivity.

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The Utah Healthy Families-Safe Kids Action Plan

• Call To Action
• Professionals and institutions that work with
  children and families including schools, are
  called upon to increase public and policy makers
  awareness of the harms and costs of child abuse
  as well as the benefits of preventing abuse.

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The Utah Healthy Families-Safe Kids Action Plan

• Call To Action
• You are called upon to promote safe and healthy
  families, institutions and communities for all
  people of Utah.
• Inform yourself about child abuse and its
  prevention. Invite speakers from the Child Abuse
  Prevention Speakers Bureau to talk with your
  church, civic or neighborhood organization.
• Get to know and support the parents and families
  in your neighborhood. Support community programs
  and other efforts to help parents and families
  succeed.

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We are all called upon to make a better, brighter
future for all children in Utah!

• Our Children Utahs Future

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www.avahealth.org
Google The Report on Physical Punishment
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The End and hopefully a new beginning

• Thanks for listening
• Be part of the solution!