One effect of social isolation is that child protective services workers are receiving fewer cases of suspected child abuse and neglect nationwide. Most instances of maltreatment are reported by people who, in non-pandemic times, worked with the same groups of children every day, like teachers and child care workers. Before the pandemic, about a quarter of the reports in Washington state that the Department of Children, Youth and Families investigated further came from educators. After schools closed, that dropped to less than three percent.
Adding to that shift away from the presence of mandated reporters in kids’ lives, periods of high stress in a family, such as when there’s financial stress, can lead to maltreatment, according to the Centers for Disease Control and Prevention and the American Psychological Association.
Dr. Robert Kregenow, the director of the emergency department at Mary Bridge Children’s Hospital in Tacoma, said this is a major concern. During Ed Lab Live, a Seattle Times virtual event series, he spoke to Education Lab engagement editor Anne Hillman about ways to prevent and detect child abuse and neglect even with stay-at-home orders in place. This transcript has been edited for clarity and length and some additional references have been added. You can listen to the full audio version below.
Q: [Because children aren’t interacting with educators and others outside of the home as much,] is there any way, then, for people to notice what’s happening? What kind of advice would you give folks who would normally be reporting?
A: I think there’s sort of multiple ways to approach this. One is, you know, families are going through a lot of stress — the job loss, economic strain, change in parenting function. The normal outlets parents and kids take to relieve stress are removed. So, first and foremost is just trying to prevent abuse from happening by getting information to families to help them use these tools for — and there’s lots of them online — de-stressing or sort of coping with the situation. Also helping the children understand and deal with it because they’re also having to adjust to a new schedule, new dynamics, also isolation from their friends. So first this is trying to prevent it.
I think the second big part is to recognize that CPS and institutions like that are often seen as a negative, but in many situations, they are there to support families. Not to remove a child but to mainly protect the child. And [families need to] recognize that most of the time, their interventions are supporting the family in their coping skills and providing resources and options for the family to help them. And that is their ultimate goal, to keep the family intact and the child in the household, unless they feel that is, at that point, not safe.
[Note: According to data from Washington’s Department of Children, Youth and Families, in 2018 Child Protective Services responded to 126,195 requests for interventions. They screened in 44,670 reports of abuse and neglect happening in homes, meaning those reports required further response. Of those, half went through a traditional investigation process. The other went through the Family Assessment Response program, which aims to connect families to resources and other support systems. You can learn more about that program here. Of the reports that were screened in, 6,131 cases led to children being removed from their homes, or just under 14 percent.]
So, in thinking about how best to identify these children [who might be experiencing abuse when] not having direct access to them, for educators, is really a challenge. But I think many may already be aware of some of the social dynamics at home and sort of have an idea that they may be at increased risk for either domestic violence and/or neglect/abuse. And so just being very attuned to those kids in particular.
But it’s hard. During an online setting, you’re seeing a kid’s changed behavior and to identify whether that is associated with their stressors and just the coping of this whole change, or whether it truly represents increased stress for the household and concerns of neglect or abuse. It’s hard to tease out. The obvious physical findings would still be there, but you’re unlikely to see them in an online setting. But, same things as before [the pandemic], if a child’s not showing up online for classwork and attendance is not its norm, that’s another flag that would probably raise concerns.
[Some teachers are] handing out homework assignments with a question or a sliding bar on how the child’s feeling that day. From 10 (happy) to zero (life is not good right now). It’s just an indication to get a sense for how the child was doing at that time. Try to get them in an isolated one-on-one conversation, or through an email. Give reminders that the children do have options to reach out to educators and talk to them about their concerns. Giving them a safe environment to communicate like that are all good options as well, given the setting that we’re in.
Q: Earlier, you touched on prevention, you said that there are things that people can look up online or different ways to defuse the stress at home. Can you talk a little bit more about that specifically, what could happen to defuse the stress or even to get resources to homes because that’s also a cause of stress?
A: [Educators and others can] offer to the families some, some links to these tip sheets like family time going for walks, giving one parent a respite from the environment and allowing them to kind of go de-stress. Get some fresh air for an hour before coming back. Another concept [for two parent households] was giving each parent one-on-one time with a child. The other parent handles the rest of the household just to give some good quality time the child, if that’s the right decision or right option for that family. So there’s lots of ways to manage this situation, to help the parents and the children. It’s an opportunity for the families to really bond and have quality time with their kids, if they look at it in that perspective.
Q: You are in the emergency department. What are you seeing these days? What’s different now?
A: Nationally, we are all seeing a dramatic decrease in emergency department volumes across the country. Part of that is that social isolation has really prevented not only the spread of COVID, but the spread of all the other normal infections that get passed around during the wintertime.
We are now getting into the season of more injuries and trauma in the pediatric world. So those things are starting to climb, but they normally do this time of year. But we’re anticipating that our volumes are not going to increase, at least for a while still. Again, that’s a national perspective.
We’re trying to communicate to families that we are a safe environment. We do everything we can to prevent anybody from being exposed to [COVID] and identifying that hospitals are safe to come to when you need care is important. What I have been hearing is that, although the abuse cases that we normally see have dropped in volume, we’re seeing sort of—and with no clear data to support this but just sort of anecdotally–an increase in more severe injuries coming in with children. So, again, these situations where things aren’t identified, and they escalate to the point where the child gets more injured than we would normally see than before. So that’s a big concern for us because, you know, the children can get significantly injured in a significant abuse situation. We want to try and prevent that as best as we can.
Q: Is there any other advice or information that you feel like people should have at this point? Things that would make children and families safer?
A: I think one other thing that I wanted to just point out was that we are still seeing an increased risk of children being exposed to inappropriate online material and predator situations. So parents really need to be attuned to the access the children have [to the internet], because if they’re at home with less supervision as parents are trying to deal with work and lack of child care, there’s an increased risk for becoming exposed to that situation. But also, just remember that CPS is not the enemy. They’re here to try and help and support families and identify and give tools to help the families get to a better state.