Children Exposed to Violence
Caryn Brauweiler, LCSW
Debbie Conley, LCSW
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
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?
Children’s
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.
1C2
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.
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
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•
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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?
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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 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
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 Children’s Reactions
to Violence
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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 can’t protect them
• Feeling of powerlessness – can’t impact
environment
• Turning to aggression
• Risk for violence in later life
Children’s 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 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
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
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Trauma informed services
Developmentally appropriate
Culturally sensitive
Evidenced based practice
– www.nctsn.org
– www.childtrauma.org
Resources
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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
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Heartland Human Care Services (North)
Casa Central (West)
Family Focus (South)
Metropolitan Safe Start (Far south side)
Additional Resources
• LaRabida’s Chicago Child Trauma Center
• Chicago Children’s 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