COULD THE CORONAVIRUS PANDEMIC CAUSE A CHILD ABUSE EPIDEMIC?

Following the closure of private schools and public schools moving to remote learning, the city’s nearly 2 million children are now largely confined at home. That extra time sheltered indoors could be problematic for kids who come from abusive households. And as stress from isolation, job loss and financial uncertainty mounts for parents, so does the increased risk of abuse towards their children. So  although there have been fewer reported cases in the last couple of months, experts warn it could be a dangerous foreshadowing of unseen and unreported abuse, now that children have less contact with the teachers who normally report it. Tonight, we talk to Dr. Nina Agrawal, a child abuse pediatrician who evaluates cases for Child Protective Services about her prediction that there will be a surge in cases reported when isolation and social distancing comes to an end and about how to help prevent it before it’s too late.

Aired on May 8, 2020. 

TRANSCRIPT

> GOOD EVENING AND WELCOME TO 'METROFOCUS.'

I'M JENNA FLANAGAN.

PRACTICING SOCIAL DISTANCING HAS BEEN A STRESSFUL AND TRYING TIME FOR ALL OF US.

STAYING AT HOME TO PREVENT THE SPREAD OF THE CORONAVIRUS HAS CREATED A LOT OF STRESS WHICH FOR SOME PEOPLE IS COMPOUNDED BY FINANCIAL INSECURITY IN THE FORM OF FURLOUGHS, LAY-OFFS AND IN SOME CASES BUSINESSES COMPLETELY CLOSING.

ADD TO THAT FOR FAMILIES WHO ARE TRYING TO NOW HOME SCHOOLCHILDREN, THERE IS A SIGNIFICANT AMOUNT OF PRESSURE IN SOME HOUSEHOLDS, AND THAT'S WHY PEDIATRICIANS LIKE DR. NINA AGRAWAL SAY THESE ADDITIONAL STRESSORS ARE PUTTING SOME CHILDREN IN EVEN GREATER DANGER AT HOME.

I'D LIKE TO WELCOME HER NOW TO THE PROGRAM.

WELCOME DR. NINA AGRAWAL.

THANK YOU VERY MUCH FOR HAVING ME, JENNA.

ABSOLUTELY.

FIRST UP I WANT TO TALK A LITTLE BIT ABOUT YOUR EXPERTISE.

YOU HAVE A PEDIATRIC CHILD ABUSE SPECIALIST.

WHAT EXACTLY DOES THAT MEAN?

WHAT A CHILD ABUSE PEDIATRIC SPECIALIST IS I'M A PEDIATRICIAN SPECIALIZING IN PEDIATRICS AND CHILD ABUSE PEDIATRICS.

I HAVE TRAINING IN MEDICALLY EVALUATING CHILDREN WHO MAY BE PHYSICALLY ABUSED, SEXUALLY ABUSED, NEGLECTED, EXPOSED TO DOMESTIC VIOLENCE AND I WORK WITH VARIOUS DISCIPLINES LIKE SOCIAL WORKERS.

I WORK WITH MENTAL HEALTH CLINICIANS.

I WORK AS PROSECUTORS AND DETECTIVES.

WE WORK TOGETHER IN MAKING SURE PEOPLE ARE SAFE.

OF COURSE.

I THINK NATURAL NOW THAT WE'RE SEVERAL WEEKS, IN FACT, OVER A MONTH INTO THE QUARANTINE, THE QUESTION IS NOW HAS THE STAY-AT-HOME ORDERS, HAS THIS CREATED AN INCREASE IN CHILD ABUSE CASES, AND IF SO, HOW DO WE KNOW?

WHAT ARE THE SIGNS THAT WE'RE SEEING?

THE PANDEMIC HAS CREATED INCREASED RISK OF CHILD ABUSE.

WHAT WE ARE SEEING IS WE'RE SEEING MORE VERY YOUNG CHILDREN WHO ARE VICTIMS OF SEVERE PHYSICAL ABUSE PRESENT TO HOSPITALS.

WHAT WE'RE SEEING IS INFANTS VICTIMS OF SEVERE HEAD DRAMA OR SHAKEN BABY SYNDROME.

IS THERE A REASON WHY IT'S SUCH YOUNG CHILDREN WE'RE SEEING NOW, BECAUSE FAMILIES ARE AT HOME WITH CHILDREN OF ALL AGES.

WHY IS IT THAT BABIES ARE SHOWING UP AS THE FIRST VICTIMS?

I THINK THE INFANTS ARE SHOWING UP AS VICTIMS IS INFANTS, YOUNG CHILDREN AND TODDLERS ARE AT MOST RISK FOR PHYSICAL ABUSE.

THEY PUT THE MOST DEMAND ON CAREGIVERS.

THERE'S TOILET TRAINING AND FEEDING AND TANTRUMS, ALL THE NORMAL DEVELOPMENTAL BEHAVIORS.

BUT WHEN YOU HAVE A CAREGIVER WHO IS ALREADY STRESSED AND HAVING TROUBLE COPING WITH ALL THE STRESSORS THAT GO ALONG WITH THE PANDEMIC AND THEN HAVE A CRYING TODDLER OR CRYING INFANT TO CARE FOR, THAT CAREGIVER IS EXTRA STRESSED AND AT EXTRA RISK OF TAKING THAT STRESS OUT ON THIS CHILD OR THAT BABY.

AND IS THERE ANY INDICATION AS TO IF THERE ARE CERTAIN CAREGIVERS WHO MIGHT BE MORE VULNERABLE.

I DON'T WANT TO LAY THIS ON THAT SOME PEOPLE ARE BETTER ABLE TO CARE FOR PEOPLE THAN OTHERS.

BUT QUITE FREQUENTLY WHEN YOU SEE CASES OF CHILD ABUSE, SOMETIMES THERE ARE PATTERNS THAT EMERGE?

YES, THERE ARE CERTAIN KNOWN RISK FACTORS THAT PUT BABIES, CHILDREN AT RISK FOR PHYSICAL ABUSE.

SO THERE ARE CAREGIVER RISK FACTORS AND THOSE CAREGIVER RISK FACTORS ARE DOMESTIC VIOLENCE, SUBSTANCE ABUSE, MENTAL HEALTH PROBLEMS.

THERE'S ECONOMIC STRESS AND THERE'S ALSO ISOLATION.

THAT'S A BIG PROBLEM RIGHT NOW IS THAT FAMILIES ARE ISOLATED AND NOT GETTING THE SUPPORT THAT THEY NEED IN TAKING CARE OF THEMSELVES AND THEIR CHILDREN.

WE ALSO KNOW THAT CHILD ABUSE UNFORTUNATELY COMES IN SO MANY DIFFERENT FORMS AND IT DOESN'T NECESSARILY HAVE TO BE PHYSICAL.

IS THERE ANY INDICATION OR IS IT TOO SOON TO KNOW ABOUT THE POSSIBILITY OF PSYCHOLOGICAL ABUSE OF PERHAPS A CHILD WHOSE NEEDS ARE PUTTING FURTHER STRESS ON A CAREGIVER AND THAT CAREGIVER MIGHT BE BLAMING A CHILD FOR CREATING MORE STRESS WHEN THE CHILD IS SIMPLY AT ATTEMPTING TO EXIST?

YES.

EMOTIONAL ABUSE IS WIDESPREAD.

IT'S LIKELY HAPPENING EVERY DAY RIGHT NOW.

IT'S VERY DIFFICULT FOR THAT TO COME TO THE ATTENTION OF THE AUTHORITIES.

IT MAY COME TO THE ATTENTION OF INDIVIDUALS IN THE FORM OF MENTAL HEALTH PROBLEMS.

THE CHILD MAY MANIFEST BE LAIFL CHANGES.

THEY MAY BE MORE WITHDRAWN, MORE ANGRY.

SO THE HOPE IS THAT SCHOOLS AND MENTAL HEALTH CLINICIANS AND OTHER INDIVIDUALS CAN NOTE THESE BEHAVIORAL CHANGES AND THESE WARNING SIGNS IN CHILDREN AND MAKE SURE THE CHILDREN GET ACCESS TO MENTAL HEALTH AND OTHER SUPPORT SYSTEMS SO THAT THEY ARE ABLE TO DISCUSS WHAT'S HAPPENING AT HOME, WHATEVER TYPE OF ABUSE IT IS.

I'M SPEAKING WITH DR. NINA AGRAWAL, A PEDIATRIC CHILD ABUSE SPECIALIST.

I KIND OF WANT TO ASK ABOUT LESSONS FROM HISTORY.

I SAY THAT BECAUSE RIGHT NOW THERE'S A LOT OF TALK IN AT LEAST THE BUSINESS WORLD ABOUT HOW PEOPLE ARE LOOKING TO THE LESSONS THAT WERE LEARNED FROM THE FINANCIAL COLLAPSE OF 2008 TO TRY TO DETERMINE A PATH FORWARD.

I'M WONDERING IF FOR SOMEONE WHO IS A CHILD ADVOCATE, IF THERE'S ANY LESSONS THAT WERE LEARNED IN TERMS OF ABUSE FROM 2008 AS W WELL.

THERE ARE DEFINITELY LESSONS TO BE LEARNED FROM 2008.

IN 2008 AS PEDIATRICIANS, WE SAW MORE INFANTS THAT WERE INJURED AND DIED OF ABUSIVE HEAD TRAUMA OR WHAT WE CALL SHAKEN BABY SYNDROME.

THAT INCREASED RISK LINGERED AFTER THE RECESSION.

THERE'S A LAG EFFECT IN WHICH CHILDREN ARE AT INCREASED RISK FOR ABUSE BEYOND THE ONSET OF THE RECESSION AND THE RECOVERY.

SO WHAT WE'RE EXPECTING NOW, THE RECESSION IS MOST LIKELY GOING TO BE MORE WIDESPREAD AND IT'S GOING TO AFFECT MORE CHILDREN THAN INFANTS BECAUSE SCHOOLS ARE CLOSED.

SO WE DON'T HAVE THE SCHOOLS TO ACT AS A SUPPORT SYSTEM AND A SAFETY NET FOR CHILDREN.

SO WE'RE GOING TO SEE MORE CHILDREN BEING ABUSED FROM DIFFERENT TYPES OF ABUSE AND A WIDER AGE RANGE.

OF COURSE, A WIDER AGE RANGE, THAT BRINGS ME TO THE QUESTION ABOUT THE ROLES THAT SCHOOLS AND TEACHERS PLAY.

I UNDERSTAND THAT PART OF TRAINING TO BECOME A TEACHER IS TO KNOW WHAT SOME OF THE SIGNS ARE TO LOOK FOR.

IS THERE ANY INDICATION THAT, A, TEACHERS ARE EVEN ABLE TO STILL PLAY THAT ROLE CONSIDERING THAT THEY'RE WORKING VIRTUALLY NOW?

FIRST OF ALL, IS THERE ANY INDICATION THAT TEACHERS ARE EVEN ABLE TO STILL DO THAT?

TEACHERS HAVE VARIED ABILITIES RIGHT NOW.

THE PANDEMIC CAME ON HARD AND CAME ON STRONG.

I'M IN NEW YORK CITY WHICH IS THE LARGEST PUBLIC SCHOOL SYSTEM IN THE CURRENT.

THEY HAVE TO RAMP UP TO REMOTE LEARNING, CREATE ONLINE LESSON PLANNING, SO MANY DEMANDS UPON THE SCHOOLS.

THE SCHOOLS ARE TRYING TO GET INTO GEAR ON TEACHING KIDS AND ALSO BEING ABLE TO ASSESS FOR SIGNS OF DISTRESS AND GETTING KIDS MENTAL HEALTH SUPPORT.

IT'S VARIED, THOUGH.

I WOULD HAVE TO SAY THAT SOME SCHOOLS ARE IN A BETTER POSITION MAYBE THAN OTHERS, BUT THERE ARE EFFORTS BEING MADE TO SUPPORT CHILDREN.

WELL, GOING FORWARD, AS YOU WERE SAYING, SOME OF THE THINGS WE'RE SEEING FROM 2008 IS THAT THERE WERE LINGERING EFFECTS WHERE UNFORTUNATELY ABUSE CONTINUES AFTER THE RECESSION, QUOTE, UNQUOTE, ENDED.

I'M WONDERING SINCE WE NOW KNOW AT LEAST IN NEW YORK STATE SCHOOLS ARE GOING TO BE -- SCHOOL BUILDINGS WILL BE CLOSED FOR THE REMAINDER OF THE SCHOOL YEAR, IS THERE ANYTHING THAT A LAYPERSON CAN DO TO KEEP AN EYE OUT FOR CHILD ABUSE?

THERE'S A LOT OF PEOPLE WHO MIGHT BE SEEING KIDS NOW WHO AREN'T TRAINED AS CHILD ADVOCATES BUT MIGHT BE ABLE TO NOTICE SOME OF THE SYMPTOMS OR THE SIGNS AS WE GO INTO THE SUMMER WHEN SCHOOLS WILL DEFINITELY BE CLOSED ANYWAY.

THERE ARE SIMPLE THINGS THAT PEOPLE CAN DO.

SCHOOLS WERE EYES, THE SCHOOLS WERE THE SAFETY NET.

WE CAN ALL BE THE WATCHFUL EYES.

IT'S SIMPLE.

WE CAN THINK ABOUT IT AS THE THREE LS, LOOK, LISTEN AND LOVE.

SO LOOK, STAY CONNECTED WITH KIDS VIRTUALLY.

SOCIAL DISTANCING DOES NOT MEAN EMOTIONAL DISTANCING.

LOOK FOR SIGNS OF DISTRESS IN CHILDREN.

LOOK FOR ANY UNEXPLAINED INJURIES.

DOES THE CHILD APPEAR SAD, POOR EYE CONTACT?

LISTEN.

MAKE SURE YOU TALK TO CHILDREN.

LISTEN FOR ANY BEHAVIORAL CHANGES, SIGNS OF DISTRESS.

IS THE CHILD MORE ANGRY?

IS THE CHILD MORE WITHDRAWN, EVASIVE?

AND THEN LOVE.

PARENTS MAY NOT BE ABLE TO SHOW THE LOVE AND SUPPORT THAT KIDS NEED RIGHT NOW, SO WE CAN DO THAT.

WE NEED TO LET KIDS KNOW THAT WE CARE ABOUT THEM AND THAT THEY CAN COUNT ON US AND THAT THERE IS HELP IF THEY NEED IT.

WE NEED TO MAKE SURE THAT KIDS HAVE THE CHILD'S HELP LINE NUMBER WHICH IS A NUMBER THEY CAN CALL IF THEY EVER FEEL THEY'RE IN DANGER.

SPEAKING OF NUMBERS FOR CHILDREN WHO ARE IN DANGER, I ALSO UNDERSTAND THERE'S AN INCREASE IN THE NUMBER OF CALLS GOING TO R.A.I.N., THAT'S THE RAPE INCEST NATIONAL NETWORK?

I BELIEVE THAT'S WHAT R.A.I.N.

STANDS FOR.

THE REASON I ASK, THERE'S ALSO THE ISSUE OF SEXUAL ABUSE AND YOU COULD HAVE CHILDREN WHO ARE UNFORTUNATELY NOW QUARANTINED WITH THEIR ABUSER.

RIGHT.

THE SEXUAL ASSAULT HOTLINE IS SEEING FOR THE FIRST TIME AN INCREASE IN THE NUMBER OF MINORS CALLING IN TO THE SEXUAL ASSAULT HOTLINE.

THAT'S VERY CONCERNING.

AS A CHILD ABUSE PEDIATRICIAN, EVERY DAY I SEE CHILDREN WHO TELL THEIR FRIEND, TELL THEIR TEACHER THAT THEY HAVE BEEN SEXUALLY ABUSED AND THAT CHILD IS BROUGHT TO SAFETY.

SO WITHOUT SCHOOLS OPEN RIGHT NOW, WE NEED TO MAKE SURE THAT KIDS HAVE THE ACCESS TO HEALTH AND SUPPORT IF THEY ARE BEING ABUSED AND IT CAN BE BROUGHT TO THE ATTENTION OF AUTHORITIES AND THEY CAN BE SAVED.

AGAIN, IF THERE'S A SITUATION WHERE A CHILD NEEDS TO BE REMOVED FROM A HOME, CAN THAT EVEN HAPPEN GIVEN, AGAIN, WE'RE QUARANTINING?

RIGHT.

IT CAN HAPPEN.

ACS OR CHILD PROTECTIVE SYSTEM OF NEW YORK CITY IS STILL FUNCTIONING.

THE STATES ARE STILL FUNCTIONS.

THE ISSUE IS GETTING THE REPORTS TO THE STATE.

ONCE THE STATE IS ACTIVATED, ONCE THEY KNOW ABOUT IT, THEY HAVE THEIR MANDATE TO MAKE SURE CHILDREN ARE SAFE.

ALL RIGHT.

WELL, I DO WANT TO THANK YOU FOR TAKING THE TIME TO NOT ONLY REMIND US THAT THIS IS ALSO SOMETHING TO BE AWARE OF AND TO BE VIGILANT ABOUT, BUT MORE IMPORTANTLY, TO KNOW THAT WE AS THE LAY PUBLIC CAN BE ENGAGED WITH.

I WANT TO THANK YOU DR. NINA AGRAWAL, FOR JOINING ME ON THE PROGRAM.

THANK YOU FOR HAVING ME, JENNA.

ABSOLUTELY.

AND ALSO, ONE MORE TIME, WHAT IS THE NATIONAL CHILD ABUSE HOTLINE?

IT'S 1-800-FOR-A-CHILD.

PERFECT.

THANK YOU SO MUCH FOR JOINING ME.

THANK YOU.

Funders

MetroFocus is made possible by James and Merryl Tisch, Sue and Edgar Wachenheim III, the Sylvia A. and Simon B. Poyta Programming Endowment to Fight Anti-Semitism, Bernard and Irene Schwartz, Rosalind P. Walter, Barbara Hope Zuckerberg, Jody and John Arnhold, the Cheryl and Philip Milstein Family, Janet Prindle Seidler, Judy and Josh Weston and the Dr. Robert C. and Tina Sohn Foundation.

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