Chapter 2
When Does Child Abuse Happen?

Every Kind of Home
The Typical Perpetrator
The Atypical Perpetrator
Typical Victims of Neglect
A Typical Victim of Physical Abuse
Homicides
A Safe Haven

“My mother drank heavily,” remembers Denise (not her real name), a child abuse survivor who grew up to be an attorney. “I've never been sure whether it was deliberate, or whether she was just so blind drunk she didn't realize what she was doing, but she burned me with a lit cigarette. And I can still remember that pain.”⁹

Denise's mother was an alcoholic. Two-year-old Benjamin Metz-Johnson's mother, Carrie Metz, was addicted to a different substance: heroin. She was taking methadone, a prescription drug used to wean addicts off heroin. Metz chose to keep her methadone in a toddler-sized sippy cup on the counter of her kitchen. In January 2007 Benjamin grabbed a bottle of methadone, which is extremely toxic for young children, off Metz's counter. Metz later testified that she did not believe Benjamin had ingested any of the methadone, so she did not take him to a doctor. A few hours later, he turned blue and stopped breathing. Then he died. Metz was charged and convicted of child neglect and sentenced to six years in prison.

Every Kind of Home

Denise and Benjamin's stories could have come from any family in any home in America. In fact, though, Denise grew up in an affluent, two-parent family in a suburb of Boston. Benjamin was the son of a struggling single mother in Kenosha, Wisconsin. Child abuse can occur in any kind of home. It occurs in wealthy families, middle-class families, and poor families. Abuse is committed by people of every race, gender, ethnicity, religion, and sexual orientation.

Alcoholics and drug addicts, like Denise's and Benjamin's mothers, are more likely than the average person to abuse a child. Children of drug- or alcohol-addicted parents are three times more likely to be abused and four times more likely to be neglected than children of nonaddicted parents. But many children are also abused by adults who do not drink or take drugs. And there are many alcoholics who do not abuse their children.

Similarly, many child abusers were abused themselves as children. A history that includes being the victim of abuse puts

a person at a very slightly increased chance of abusing children himself or herself. But most survivors of child abuse do not grow up to become child abusers themselves. Most cannot imagine subjecting other children to the experiences that they themselves endured.

The Typical Perpetrator

Perpetrator is a term used by law enforcement agencies to describe the person who committed a crime or an act of wrongdoing. In some ways, it is correct to say that there is no typical

case of child abuse. Each family is different, each child is different, and each caregiver is different. However, even though child abuse occurs in all kinds of families, child welfare authorities see certain trends in the cases in which they are asked to intervene.

A Horrific Outcome

“Perhaps each person present has his or her own private opinion about what occurred across the street. . . . To some it was a flagrant example of abuse, to others a very unfortunate accident. To some it was the result of parents who were overstressed, without resources and respite. To others it was the horrific outcome of a frightening need for power and control. But no matter where you are on this issue, the bottom line is this: No one, no one should die the way Calista Springer did.” —Karin Orr, pastor, Centreville United Methodist Church.

Quoted in Kathy Jessup, “‘God Was There with Calista’: St. Joseph County Residents Attend Vigil to Remember 16-Year-Old Who Died in Fire,” Kalamazoo Gazette, August 28, 2008. http://blog.mlive.com/kzgazette_impact/2008/08/god_was_there_with_calista_st/print.html.

Most perpetrators of child abuse and neglect are young adults. They are typically in their mid-twenties but had their first child before the age of eighteen. Most do not have a high school diploma and have not completed any higher education such as college or vocational school. Most are living at or below the poverty level. Frequently, perpetrators of abuse and neglect are depressed and have difficulty coping with stress in their lives. Many have been the victims of violence themselves.

Almost all perpetrators of child abuse and neglect have one thing in common. They are people who are responsible for caring for and supervising children. In 2006 more than 75 percent of perpetrators of child abuse and neglect were the parents of the victims. About 15 percent were nonparent caretakers, such as day care providers, babysitters, and relatives. Another 10 percent were abused by unknown perpetrators. In those cases, children were unable or unwilling to identify their abusers, and investigators were not able to identify the perpetrators.

Men and women are equally likely to commit acts of child abuse and neglect. But the type of abuse they commit varies by gender. The most common type of abuse, neglect, is usually committed by mothers. Violence and physical abuse are most commonly committed by fathers or by male caretakers.

The Atypical Perpetrator

A parent or caregiver does not have to be mentally ill to commit an act of child abuse. Most commonly, a child abuser is angry, frustrated, overwhelmed, or otherwise overcome with negative emotions. But in some cases, parents are mentally ill. These parents may commit acts of abuse without fully realizing what they are doing. For example, in New York City, social worker Marc Parent received a report about a mother who had thrown two of her children out a twenty-third story window. The mother said she was trying to send her children to God, to save them “from the sins of this world.”¹⁰

Most parents who have mental disorders do not abuse their children. But mental illness increases a parent's risk of committing abuse or neglect. The risk is highest in parents who have been diagnosed with a severe mental illness, such as schizophrenia or major depression. Schizophrenia, for example, can cause a person to have hallucinations and delusions and to hear voices. It can make parents confused about their surroundings or about how best to keep their children safe, even if they genuinely love and care for their children. Depression, by contrast, may make parents more likely to neglect their children, simply by making it harder for parents to function normally. Some depressed parents find it difficult even to get out of bed in the morning. It is hard for them, therefore, to deal with feeding and caring for a young child.

Researchers believe that people with mental disorders can still be good parents to their children. But they also believe these parents may need extra support. For example, they may need parenting classes or counseling. Many need financial support, especially to pay for health care. And they may have an even greater need than many other parents do for financial assistance to help them pay for child care and housing.

Typical Victims of Neglect

Perpetrators of neglect may believe that they are very different from people who physically abuse children. However, neglect can be just as hard on a child as physical abuse. For example, on August 13, 2008, a neighbor reported hearing screaming coming from the home of Jon Pomeroy and Rebecca Long in

Carnation, Washington. A sheriff's deputy visited and found Pomeroy's fourteen-year-old daughter near death from malnutrition. Pomeroy and Long had restricted her to half a Dixie cup of water per day. At night, they made her sleep in their bedroom and slid a heavy dresser in front of the door to keep her from sneaking out. Pomeroy's daughter had a history of sneaking out of her bedroom at night to drink out of the toilet bowl, because she was afraid her parents would hear the water running if she used the faucet.

Removing Children

“As the system is now, we end up removing children when they could remain safely at home if we had the appropriate services to offer them. We often intervene with a sword when a scalpel would do.” —Helen Jones-Kelley, executive director, Montgomery County, Ohio, Children's Services.

Quoted in Pew Commission on Children in Foster Care, “Fostering the Future: Safety, Permanence and Well-Being for Children in Foster Care,” May 18, 2004. http://pewfostercare.org/press/files/transcript051804.pdf.

When she was found, Pomeroy's daughter was badly dehydrated and emaciated. She was 4 feet 7 inches tall (140cm) and weighed 48 pounds (22kg). Her teeth were beginning to fall out from malnutrition. The sheriff's deputy who found her rushed her to Seattle Children's Hospital, where she remained for two weeks.

Gregory Jones and Jessica Lee Lovell of Jackson, Mississippi, had two children, a five-month-old and a sixteen-month-old. Both had been born prematurely and needed to see a doctor regularly. When Jones and Lovell stopped taking their children to their doctor, he feared for the children's lives. He phoned the police and reported that the children might be in danger. When child protective investigators arrived at their home, they discovered that the children were badly malnourished and dehydrated. Investigators called an ambulance and took the children to the hospital. Jones and Lovell were

charged with child endangerment for neglecting to feed their children.

Cases of neglect, like those of Pomeroy and Long or Jones and Lovell, are the most common type of child abuse in the United States. Neglect is three times more common than physical abuse. Children are much more likely to be neglected if they are living in poverty. According to researchers at the Children's Defense Fund, nearly 13 million American children were living in poverty in 2005. In families with a total yearly income of less than fifteen thousand dollars, the children are twenty-two times more likely to be abused or neglected than the children in families with total yearly incomes of thirty thousand dollars or more.

Why are children living in poverty more likely to be neglected? Sometimes parents do not have the resources they need to take adequate care of their children. A common example is a single mother of a four-year-old and a six-year-old who works the night shift. Having no child care, she may tuck her children into bed at night and go to work, hoping for the best. But leaving young children without adequate supervision is a form of neglect.

Even though poverty increases a child's chances of being abused, most poor parents and caregivers do not neglect the children in their care. Out of the nearly 13 million children living in poverty in the United States in 2005, fewer than 1 million were abused or neglected. And not all of those 1 million abuse and neglect victims came from poor families.

A Typical Victim of Physical Abuse

At about 9:20 P.M. on a Sunday evening in August 2008, Michael Below, a new father in West Bend, Wisconsin, became frustrated with his two-month-old daughter. She would not stop crying. Her mother was at work. Later, Below told investigators that he picked the baby up by her feet and began banging her head against her diaper-changing table. Investigators noted, “On a scale of one to 10, 10 being the hardest, defendant hit [the baby's] head on the changing table about eight or nine.”¹¹ Pretending that nothing was wrong, Below took the baby with him when he went to pick up her mother from work at 10 P.M.

But the baby was breathing strangely, and her mother became frightened. She called an ambulance. On admission at Children's Hospital of Wisconsin, the baby was found to have severe brain injuries, bleeding in her eyes, a skull fracture, and brain swelling. Those injuries had occurred that evening. But doctors also found older injuries: broken ribs and an older area of bleeding in her brain.

Runaways and Throwaways

Child abuse is one of the most common reasons why children end up living on the street, homeless. Around 20 percent of children who run away from home say that they have run away in order to escape physical abuse at home. According to the National Runaway Switchboard, one-seventh of U.S. children run away from home at least once before they reach the age of eighteen.

“Throwaway” children are children whose families have thrown them out. Among throwaway children, the incidence of abuse and neglect is even higher than it is among runaways. Researchers who sifted through runaway hotline calls from 2000 to 2005 found that about 25 percent of throwaway children who phoned a hotline had been neglected. About 14 percent had been physically abused.

When investigators asked Below what had happened, he told them that he was under a lot of stress. He was worried about his finances. Investigators noted in their report that “he does not know what got over him, that he just lost control and was frustrated.”¹²

Below's story is an example of the next most common type of child abuse—physical abuse. Unlike neglect, which is associated more with families living in poverty, physical abuse is just as likely to occur in wealthy families as it is in poor families. It is a little more common in families that have experienced a divorce, separation, and/or remarriage, however. The children who are most at risk for physical abuse are the very young, especially children who are under age three. Teens are the next most commonly abused age group. But children ages four to twelve are also frequently abused. Boys are more likely to be beaten, while girls are more likely to be sexually assaulted.

The most at-risk children are those who are especially hard to care for. This group includes, for example, children who had low birth weights or who were premature, like Jones and Lovell's children. It also includes children who are physically disabled or developmentally delayed. It is especially easy for an abuser to

overpower a child who is unusually small, weak, or disabled. When these children grow older and stronger, sometimes the abuse decreases because the abuser is afraid of being hit back. As babies, though, children do not hit back. What they can do is cry. But crying may trigger some caregivers to become angry and violent.

Some child welfare advocates find that children in families that have only one or two children are more at risk than children in larger families. This may be because when older children are present, they may step in to try to protect younger children from abuse. In some cases older children will stand between a caregiver and a younger sibling, trying to protect the younger sibling. But more often, older children simply step in and help with child care. As a result, the younger children in the family spend less time with a parent who might abuse them. This helps to keep the younger children in the family safe. But it also forces older children to grow up much more quickly. In these families, older children may feel like little adults, caring for children before they have become adults themselves.

Homicides

In most cases child abuse is not fatal. Unfortunately, though, sometimes children do die from abuse. Sometimes they die of injuries caused by physical abuse. They may also die of neglect if they are extremely malnourished or have been denied medical care. In rare cases, they can die from what would normally be considered a kind of emotional abuse—being confined to a small area. In 2008 sixteen-year-old Calista Springer, of Centreville, Michigan, died in a house fire. Her parents had chained her to her bed—a form of emotional abuse. But then the house caught fire, and she was unable to escape. She died in the blaze. Springer's mother later pleaded no contest to charges of child neglect, and Springer's sisters were taken from the family and placed in the care of relatives.

In 2005 authorities were aware of 1,460 children in the United States who died as a result of injuries caused by abuse. Experts believe, though, that more than half of fatalities caused by child abuse are not classified as abuse. Instead, they may be recorded as accidents. In the United States, almost 2 children out of every 100,000 die each year from physical abuse.

Homicide cases are not particularly different from other child abuse cases, except that they involve a death. The perpetrators of homicide cases share the same characteristics as the perpetrators of nonfatal abuse. As in other child abuse cases, the perpetrators of child homicides are usually the parent or care-giver. Parents and caregivers perpetrate more than 76 percent of child homicides. In another 13 percent of cases, the perpetrator is someone else the child knew, such as a nonparent caretaker (like a day care provider or a nanny).

Sometimes the perpetrator in a homicide is someone that most people would not think of, like a sibling. For example, New York City social worker Marc Parent was called to investigate a case that was expected to end in a fatality. A five-year-

Shaken Babies

Every year about fourteen hundred babies in the United States are killed or injured by caregivers who become frustrated with the demands of baby care and shake their babies. About a quarter of these babies die of their injuries. Eighty percent of babies who survive shaking are permanently disabled. They may have severe brain damage and may develop cerebral palsy or become mentally retarded. Some babies are so seriously injured that they are never able to breathe on their own. They must depend on a respirator. Some babies are left blind or unable to feel touch. These children need constant medical attention.

Some babies do survive shaking and go on to recover. These children are able to lead a relatively normal life. Even in these cases, though, children often have behavior problems. They have a hard time controlling sudden impulses and may find it difficult to organize their work or to concentrate in school.

old boy was in a coma, and his four-year-old brother had been hospitalized as well. At first, the social workers believed that the children's mother or aunt was responsible for the injuries. But as they investigated, they realized that the children's nine-year-old babysitter, their cousin, had beaten them.

Although the perpetrators of child abuse homicides match the perpetrators of other forms of child abuse, the victims are slightly different. Nonfatal child abuse tends to target very young children and teenagers. But fatal child abuse predominantly affects very young children. Young children are more vulnerable to violence than older children, and they may die from acts that would not kill an older child.

Babies and preschoolers are at the highest risk for being killed by their parents or caretakers. When that happens, it often happens in the first few weeks of the child's life. Sometimes unwanted newborns are killed by their mothers. At other times, mothers abandon babies in public places, where they may be rescued or may freeze or starve to death before a rescue occurs.

Preschool children, on the other hand, are often killed when their parents or caretakers try to control their behavior. They are also killed when parents or caregivers become angry in response to normal preschool behavior, such as crying, hitting, not using the bathroom, or getting dirty. Parents may react to such behavior by throwing the child against a hard surface or by hitting or smothering the child. They may not intend to kill the child but may not realize how fragile a very young child can be.

A Safe Haven

To children and adults who have not had to live with abuse or neglect, stories of abused children sound horrific. But children who live through abuse may not realize that there is anything unusual about their family lives. To them, abuse and neglect are not an aberration but are a normal condition of everyday life. They may not mention the abuse to friends or to caring adults. They may feel afraid that they will not be believed, or they may have been wrongly told by their abusers that the abuse is their own fault.

For children to recover from this kind of life, they need something more than a safe place to live and grow. They need an environment in which they are encouraged to develop their own interests and in which they can begin to believe that they deserve to be happy. Frequently, child welfare workers are able to work with a child's family to help the family become a place where children can thrive and be happy. At other times, the original family is so unsafe that children must be placed in another family. Either way, the state monitors the children to make sure that they are well cared for and remain safe.