Shaken Baby Syndrome (SBS):
According to the National Institute of Neurological Disorders and Stroke, SBS is “a severe form of head injury that occurs when a baby is shaken forcibly enough to cause the baby’s brain to rebound (bounce) against his or her skull. This rebounding may cause bruising, swelling, and bleeding of the brain, which may lead to permanent, severe brain damage or death” (Keep Kids Healthy, 2003).
“Many people are still not aware that shaking causes brain injuries and that the brains of babies and small children up to age five are particularly susceptible to such injury. One of four shaken infants dies. Half of the survivors suffer brain injuries that result in irrevocable neurological impairment and developmental delays. They don’t lose their life, but they do lose eyesight, their mobility and the potential for independent living. Over the first five years, the total cost of medical care for a SBS survivor may reach $1,000,000. The death of an infant is tragic, but the tragedy is compounded by the fact that SBS can be prevented” (The Skipper Initiative, n.d.).
“ . . . although likely under-reported, 3,000 children a year in the United States are thought to be victims of shaken baby syndrome. …The harm to these children can likely be prevented with more education” (Keep Kids Healthy, 2003).
Even throwing a child up in the air or swinging them around vigorously, although playfully, could possibly also cause damage to a child whose brain is still developing.
Shaken Infant Syndrome
“Shaken Infant Syndrome” or “Shaken Baby Syndrome” happens when caregivers become frustrated with children and shake them forcefully. Even mild or moderate shakings can cause serious injury. The damage that occurs usually cannot be seen. Severe injury is most common in very young children, but can happen to three and four year old children.
- 1/3 of children who are shaken will die
- 1/3 of children who are shaken will be permanently brain damaged
- 1/3 of children who are shaken will recover with minimal injury
Results from Shaken Infant Syndrome can include:
- Brain Damage
- Spinal injury/paralysis
- Blindness or other eye trauma
- Delay in normal development
- Broken bones
- Mental retardation
If you or someone else has shaken a child, accidentally or on purpose, take the child to the emergency room immediately. Bleeding inside the brain can be treated, but only if you tell the doctors you shook the child. Waiting will only cause further damage. This may save your child a lot of problems in the future… and possibly save his or her life.
Studies show that most babies are shaken when a male caregiver is left alone and becomes frustrated with a crying infant. Men often feel like they must “fix” things. This sense of frustration with a crying baby can lead to a loss of control. We can learn how to handle frustration.
Here Are Some Tips:
To calm the baby take a time out:
- To see if the baby is hungry or needs a diaper changed
- To lean over the baby without picking up the baby and talk softly
- To guide the baby’s hand to its mouth to suck on
- To gently rock the baby in your arms or walk with the child cuddled around your shoulder
- To place the baby in a stroller and go for a walk around the neighborhood
- To create some “white noise” by running the sweeper, running water, turning on the dryer or playing some music
- To give the baby a pacifier
- To whisper softly in the baby’s ear or sing softly and slowly
If the baby won’t stop crying and you feel yourself getting angry or tense, it’s ok to place the baby in its bed. Your job is to make sure the baby is in a safe place and to be available if an emergency should arise.
To calm yourself take a time out:
- To count to 10; then count to 10 again before doing anything
- To listen to music with headphones
- To watch something you enjoy on television
- To take a shower
- To exercise
If you still feel out of control, take time out:
- To call the baby’s mother and ask for help
- To call a friend, neighbor or relative and ask for help
“Child abuse is any mistreatment or neglect of a child that results in non-accidental harm or injury and which cannot be reasonably explained. Child abuse can include: physical abuse, emotional abuse, sexual abuse and neglect.
...According to a 1992 study sponsored by the National Institute of Justice (NIJ), maltreatment in childhood increases the likelihood of arrest as a juvenile by 53 percent, as an adult by 38 percent, and for a violent crime by 38 percent.
...Based on data reported by [Child Protective Services] CPS agencies in 2001…five to six children die each day as a result of child abuse or neglect. Of these fatalities, 85 percent were children younger than six years old at the time of their death, and 44 percent were under the age of one.
...Most parents want to be good parents but sometimes lose control and are unable to cope. Factors which contribute to child abuse include the immaturity of parents, lack of parenting skills, unrealistic expectations about children’s behaviors and capabilities, a parent’s own negative childhood experience, social isolation, frequent family crises and drug or alcohol problems” (National Exchange Club Foundation, 2000).
“Ironically, if you asked people if they should help if seeing a nearby car accident, most will say yes. But in the case of suspected child abuse, that thinking may be different. Why? Because of prevalent attitudes that someone else’s children are either ‘their responsibility’ or ‘their property’” (Tennyson Center for Children, 2004).
Recognizing Child Abuse: What Parents Should Know
The first step in helping abused children is learning to recognize the symptoms of child abuse. Although child abuse is divided into four types – physical abuse, neglect, sexual abuse, and emotional maltreatment – the types are more typically found in combination than alone. A physically abused child for example is often emotionally maltreated as well, and a sexually abused child may be also neglected. Any child at any age may experience any of the types of child abuse. Children over age five are more likely to be physically abused and to suffer moderate injury than are children under age five.
RECOGNIZING CHILD ABUSE
Experienced educators likely have seen all forms of child abuse at one time or another. They are alert to signs like these that may signal the presence of child abuse.
- Shows sudden changes in behavior or school performance;
- Has not received help for physical or medical problems brought to the parent’s attention;
- Has learning problems that cannot be attributed to specific physical or psychological causes;
- Is always watchful, as though preparing for something bad to happen;
- Lacks adult supervision;
- Is overly compliant, an overachiever, or too responsible; or
- Comes to school early, stays late, and does not want to go home.
- Shows little concern for the child, rarely responding to the school’s requests for information, for conferences, or for home visits;
- Denies the existence of – or blames the child for the child’s problems in school or at home;
- Asks the classroom teacher to use harsh physical discipline if the child misbehaves;
- Sees the child entirely bad, worthless, or burdensome;
- Demands perfection or a level of physical or academic performance the child cannot achieve; or
- Looks primarily to the child for care, attention, and satisfaction or emotional needs.
The Parent and Child:
- Rarely touch or look at each other;
- Consider their relationship entirely negative; or
- State they do not like each other.
None of these signs proves that child abuse is present in a family. Any of them may be found in any parent or child at one time or another. But when these signs appear repeatedly or in combination, they should cause the educator (observer) to take a closer look at the situation and to consider the possibility of child abuse. That second look may reveal further signs of abuse or signs of a particular kind of child abuse.
SIGNS OF PHYSICAL ABUSE
Consider the possibility of physical abuse when the child:
- Has unexplained burns, bites, bruises, broken bones, or black eyes;
- Has fading bruises or other marks noticeable after an absence from school;
- Seems frightened of the parents and protests or cries when it is time to go home from school;
- Shrinks at the approach of adults; or
- Reports injury by a parent or another adult caregiver.
Consider the possibility of physical abuse when the parent or other adult caregiver:
- Offers conflicting, unconvincing, or no explanation for the child’s injury;
- Describes the child as “evil,” or in some other very negative way;
- Uses harsh physical discipline with the child; or
- Has a history of abuse as a child.
SIGNS OF NEGLECT
Consider the possibility of neglect when the child:
- Is frequently absent from school;
- Begs or steals food or money from classmates;
- Lacks needed medical or dental care, immunizations, or glasses;
- Is consistently dirty and has severe body odor;
- Lacks sufficient clothing for weather;
- Abuses alcohol or other drugs; or
- States there is no one at home to provide care.
Consider the possibility of neglect when the parent or
other adult caregiver:
- Appears to be indifferent to the child;
- Seems apathetic or depressed;
- Behaves irrationally or in a bizarre manner; or
- Is abusing alcohol or other drugs.
SIGNS OF SEXUAL ABUSE
Consider the possibility of sexual abuse when the child:
- Has difficulty walking or sitting;
- Suddenly refuses to change for gym or to participate in physical activities;
- Demonstrates bizarre, sophisticated, or unusual sexual knowledge or behavior;
- Becomes pregnant or contracts venereal disease, particularly if under age fourteen;
- Runs away; or
- Reports sexual abuse by a parent or another adult caregiver.
Consider the possibility of sexual abuse when the parent or other adult caregiver;
- Is unduly protective of the child, severely limits the child’s contact with other children, especially of the opposite sex;
- Is secretive and isolated; or
- Describes marital difficulties involving family power struggles or sexual relations.
SIGNS OF EMOTIONAL MALTREATMENT
Consider the possibility of emotional maltreatment when the child:
- Shows extremes of behavior, such as overly compliant or demanding behavior, extreme passivity or aggression;
- Is either inappropriately adult (parenting other children, for example) or inappropriately infantile (frequently rocking or head-banging, for example);
- Is delayed in physical or emotional development;
- Has attempted suicide; or
- Reports a lack of attachment to the parent.
Consider the possibility of emotional maltreatment when the parent or other adult caregiver:
- Constantly blames, belittles, or berates the child;
- Is unconcerned about the child and refuses to consider offers of help for the child’s school problems; or
- Overtly rejects the child.
If you suspect child abuse of any kind, you should:
- Take the child to a quiet, private area
- Gently encourage the child to give you enough information to evaluate whether abuse may have occurred
- Remain calm so as not to upset the child
- If the child reveals the abuse, reassure him/her that you believe him/her, that he/she is right to tell you, and that he/she is not bad
- Tell the child you are going to talk to persons who can help him/her
- Return the child to the group (if appropriate)
- Record all information
- Immediately report the suspected abuse to the proper local authorities. In most states, reporting suspected abuse is required by law.
- As a child care provider, you should get training in recognizing and reporting child abuse before you are confronted with a suspected case.
Abuse of Children With Disabilities:
“A recent American study found that caregivers abused children with disabilities 1.7 times more than children without disabilities. Research in Canada suggests that the risk estimate of abuse of people with disabilities may be as high as five times greater than the risk for the general population.
...Feelings of shame and denial may be so strong in some cultures that a child’s disability will be hidden by members of his or her family. As a result, the child may be denied access to normal developmental opportunities, as well as important support or treatment.
...Some adults find it easier to empathize with the caregiver than with the child with a disability. They may hesitate to judge a caregiver’s actions as abusive, wondering what they would do if they had to deal with the stress of caring for a child with disabilities. These self-doubts must be set aside when the dignity, safety or physical integrity of a child with a disability has been violated in any way. Children with disabilities are entitled to the same protection and security as all other children” (Frazee, 2000).
ARE CHILDREN WITH DISABILITIES MORE VULNERABLE TO ABUSE?
For children with disabilities, the usual risk factors for child abuse (i.e. dependence and vulnerability) are intensified. Children who are unable to perform the same tasks as other children of their age are more vulnerable for many reasons:
- Their inability to see, hear, move, communicate, dress, toilet or bathe themselves independently makes them more vulnerable to rough, careless or intrusive personal care, or neglect of their personal needs.
- These differences also make them vulnerable to unfair and disrespectful comparisons with siblings or other children of the same age.
- Their differences make it difficult for them to participate in family and community activities without assistance, leading to social isolation from their natural peer group and adults other than their primary caregiver(s). Isolation is another major risk factor for abuse.
- Their differences make it more likely that their personal care and even their residence will be provided by people who are not related to them and/or who lack an affective relationship with them. Being cared for outside of the home is another major risk factor for abuse.
- Children with intellectual or communication differences are vulnerable to being ignored, disbelieved or misunderstood if they attempt to report abuse.
- Parents/caregivers of a disabled child may feel very much on their own. They may be stressed by ongoing health care needs, difficulties in finding suitable childcare, financial burdens and social isolation, along with related difficulties such as depression and marital discord. Although the role of stress in triggering or causing abuse of children with disabilities is still controversial, studies indicate that caregivers who perceive themselves as severely stressed are more likely to commit abuse.
- Children with disabilities are more likely to be viewed in terms of their disability. This places severe limits on a child’s sense of his or her own capabilities, interests and ability to dream and imagine future possibilities. Being depersonalized in this way makes a child vulnerable to some of the most severe forms of abuse, including homicide.
- Children with disabilities are often taught to be compliant with adults, especially at the doctor’s office or therapist’s office or clinic. Compliance for intrusive or painful procedures that a child would naturally resist may sometimes be obtained through force, coercion or bribery. As a result, it becomes very difficult for a child to distinguish between legitimate and abusive adult demands.