COVID-19 Fallout: More Severe Child Abuse Injuries During Pandemic

Golisano Children’s Hospital of Southwest Florida has experienced an increase in the severity of injuries due to child abuse over the last few months.

Although the number of cases of suspected abuse at the hospital has gone down, the injuries have been more severe, requiring prolonged patient hospitalization.

"Overall, the number of abuse cases are down, but the injuries we’re treating are more severe," says Dr. Carmen Garcia, medical director of the Pediatric Emergency Department at the children’s hospital. "We’re seeing more children coming into the ED with injuries that require hospitalization. The risk of children being abused or neglected has increased as shelter-in-place orders continue."

Reports to the National Center for Missing and Exploited Children more than doubled during the first month of stay-at-home orders across the country, climbing from nearly 984,000 reports in March 2019 to more than 2 million reports in March this year.

Stressors and fewer eyes on our children

Dr. Garcia blames the pandemic for the troubling trend.

“Families are dealing with tremendous stressors right now,” Dr. Garcia says. “There’s the threat of looming unemployment due to economic woes, financial worries, and, of course, healthcare concerns about keeping one’s family safe from COVID-19.”

Stay-at-home orders and the closures of schools, physician offices and other venues where adults are lawfully mandated to report abuse have yielded more cases, says Richard Keelan, Kids' Minds Matter Program Supervisor in the Child Advocacy department of Golisano Children's Hospital of Southwest Florida.

“Kids are having less contact with adults outside their homes,” Keelan says. “They’ve lost exposure to the normal safety net provided by having regular contact with teachers, clergy people, camp counselors and other mandated reporters. COVID-19 has created a situation where kids are not in school, so they’re not around teachers and other caring adults who would typically notice signs of maltreatment and report it.”

Then, because schools and day care centers were closed, when financially strapped parents who returned to work as the state reopened business, had few childcare options. Older children were left to supervise younger siblings, leading to some unintentional instances of child endangerment. 

“Some injuries were not necessarily abusive in nature from another person but happened from lack of adequate oversight,” Keelan says.

The number of child abuse cases are lower because fewer children are having contact with reporters, but the severity of injuries are higher. Dr. Garcia says one reason is parents are avoiding routine appointments with doctors to avoid COVID-19 exposure.

“Part of the issue is that parents are so afraid of bringing kids to the emergency department when a child becomes ill or is injured,” Dr. Garcia says. “They’re also avoiding visits with their primary care doctors for vaccinations or check-ups for the same reason. As a result, healthcare providers are unable to detect a possible red flag like a big bruise on a child or other marks on a child. We’re missing the opportunity to be vigilant about possible cases of maltreatment.”

Ways to cope better with stress and reduce possible harm

Jason Sabo, Ph.D. and lead psychologist of Golisano Children’s Hospital’s Pediatric Behavioral Health Team, agrees that the pressures brought by the pandemic has in many situations “pushed parents and children over the edge.”

“There is a breaking point for all of us, and unfortunately, not all people use healthy coping skills,” Sabo says. “Few people in this world are able to act more calmly and rationally under stress. Many of their normal coping skills and resources have been taken away by the pandemic. As a result, many parents are reacting rather than responding.”

Sabo says that most people haven’t learned or been trained to identify or handle stress as it increases. He suggests parents should try to rely on the following anchors to stability.

1. Establish a routine, and stick with it. For families struggling to keep things calm and ordered at home, getting consistent with routines goes a long way toward avoiding chaos in the home, Sabo says. Sabo recommends that families stick to regular times for waking up and going to bed, as well as having regular meals, snacks, and playtime.

2. Work together as a team. When brainstorming ideas for managing chores and planning activities, include the whole family. Make it positive, too, Sabo advises, because kids are more likely to follow through on ideas they helped create. Make a list of fun things to do, post it where everyone can add to it, and decide what to add to your daily schedules.

3. Be flexible. Remember that your children’s lives have changed significantly. Many sports and clubs have been canceled or modified, leading to less peer-to-peer interactions. As a result, children are not engaging in as many activities. “This takes a toll on everyone,” Sabo notes. “As parents, it is important to recognize and give grace when necessary.”

4. Model appropriate behaviors. Children often emulate their parents; both in behaviors and emotions. Sabo encourages parents to reflect on how they personally handle situations. Be accountable for improving the way you react to disappointment, stress and frustration. “When we use positive techniques, our children will pick-up on them, and use them as well.”

5. Know when to seek help. No parent is perfect. Identify the areas that are causing stress/frustration and find ways to handle them. Talk to friends about their experiences and ways that they handle high conflict times. If parents find they are using corporal discipline or leaning towards it, that’s the time to seek help.

If you witness something, say something!

If you suspect or know of a child or vulnerable adult in immediate danger, call 911.

“Any person who knows, or has reasonable cause to suspect, that a child is abused, abandoned, or neglected by a parent, legal custodian, caregiver, or other person responsible for the child's welfare is a mandatory reporter,” Sabo says. “It’s based on Florida Statutes, so it’s on all of us to report any suspicions.”

How to report suspected abuse, neglect or abandonment of a child:

• Call the Florida Department of Children and Families at 800-962-2873.
• You can also report your concerns to the Florida Abuse Hotline, which accepts reports 24/7 of known or suspected child abuse, neglect, or abandonment. Visit here.

How to report suspected online enticement or sexual exploitation of a child:

• Calling 911
• Contacting the FBI at www.tips.fbi.gov
• Filing a report with the National Center for Missing & Exploited Children at 1-800-843-5678
• Filing a report at report www.cybertip.org (Department of Justice)

Supportive resources for you and your children

Keelan says, “Supporting kids and families is the best prevention for child abuse. Everyone can help prevent child abuse and neglect and promote positive childhood experiences by supporting children and families where you live and work.”

For parents and children, Keelan recommends the following online classes, which are being offered virtually due to COVID-19.

Partners in Parenting Course (Collier County residents only). This FREE specialized group parenting classes teaches parents how to focus on their strengths and set appropriate expectations for their children, Keelan says. For more information and how to register for this FREE series, visit here.

Partners In Parenting: The Exceptional Child. A FREE evidence-based parenting course. “In this course, participants will connect with other parents of children with developmental disabilities, mental health issues, or special health care needs.”

Parent Workshop: Dignified Discipline (Online). This workshop helps participants learn to manage their children’s behavior in a way that both maintains healthy relationships and changes inappropriate behaviors. “We want you to learn to look at behaviors in a new way and decrease stress,” Keelan says. “The goal is to bring the joy back into parenting.”

Safe Sitter Classes (Grades 6-8), an online series offered by the Child Advocacy Department at Golisano Children’s Hospital. “Safe Sitter prepares students in grades 6-8 to be safe when they’re home alone, watching younger siblings, or babysitting,” Keelan explains. “Participants will learn about safety skills, childcare skills, first aid and rescue skills, among others. The classes are filled with fun games and role-playing exercises.” For more information and how to register for this FREE series, visit here.

Safe@Home (Grades 4-6), a 90-minute program for students in grades 4-6. “The program provides students with important safety training that will help the be prepared to stay home alone,” Keelan says. “Completing this program doesn’t mean a child is ready to stay home alone. Only the student’s parents can make that decision. But it will help students learn about how to practice safe habits, how to handle common household emergencies, and how to address illness or injury.

For more information and how to register for this FREE series, visit here.