Teddy, I've been bad again,
My Mommy told me so;
I'm not quite sure what I did wrong,
But I thought that you might know.

When I woke up this morning,
I knew that she was mad;
Cause she was crying awful hard,
And yelling at my dad.

I tried my best to be real good,
And do just what she said;
I cleaned my room all by myself,
I even made my bed.

But I spilled milk on my good shirt,
When she yelled at me to hurry;
And I guess she didn't hear me,
When I told her I was sorry.

Cause she hit me awful hard, you see,
And called me funny names;
And told me I was really bad,
And I should be ashamed!

When I said, "I love you, Mommy,"
I guess she didn't understand;
Cause she yelled at me to shut my mouth.
Or I'd get smacked again.

So I came up here to talk to you,
Please tell me what to do;
Cause I really love my Mommy,
And I know she loves me, too.

And I don't think my Mommy means,
To hit me quite so hard;
I guess sometimes, grown ups forget.
How really big they are!

So Teddy, I wish you were real,
And you weren't just a bear;
Then you could help me find a way.
To tell Mommies every where.

To please try hard to understand.
How sad it makes us feel;
Cause the outside pain soon goes a way,
But the inside never heals!

And if we could make them listen,
Maybe then they'd understand;
So other children just like me,
Wouldn't have to hurt again.

But for now, I guess I'll hold you tight,
And pretend the pain's not there;
I know you'd never hurt me,
So Goodnight, Teddy Bear!

Author unknown

How much a society values its children can be measured by how well their children are treated. The fact that more than three children a day die from physical abuse or chronic neglect in the United States calls into question America's commitment to its young, especially as many of these deaths are preventable. The fact sheet provides information on child maltreatment fatalities including: 1) national statistics regarding the scope of the problem, 2) the relationship between fatalities and child abuse reports, 3) the underlying causes of child abuse fatalities, and 4) strategies for child welfare agencies and others to prevent future deaths.

How many children died in 1995 as a result of maltreatment? According to information from 34 states representing 67.3% of the U.S. population under the age of 18, an estimated 1,215 child maltreatment deaths were confirmed by child protective service (CPS) agencies in 1995.1 This figure undercounts the actual number of maltreatment fatalities, however, as some number of accidental deaths, child homicides, SIDS cases and deaths attributed to undetermined causes should be labeled child maltreatment fatalities.2 According to a 1993 study by McClain et al., an estimated 85% of deaths due to parental maltreatment were coded as due to some other cause on the child's death certificate.3

Is the number of child fatalities increasing? Over 3 children died each day last year as a result of parental maltreatment.4 A national survey conducted by the National Committee to Prevent Child Abuse early in 1995 suggests that the number of confirmed child abuse fatalities increased 39% over the last 10 years. This trend is not surprising given the increase in poverty, substance abuse, and violence experienced by many communities.5

Is there a corresponding increase in child abuse reports? Based on reporting data collected from 37 states and the District of Columbia, a little over 3 million children were reported for child abuse in 1995, approximately 2% more than had been reported in 1994. Overall, child abuse reporting rates have risen by an average of 4% each year between 1990 and 1995. The total number of reports has increased nationwide by 49% since 1986.6

What children are most likely to die from maltreatment? Young children are at the highest risk. Research indicates that between 1993 and 1995, 85% of fatalities occurred to children under the age of five, with 45% to children under the age of one.7 Other studies have found that child abuse ranks as the second leading cause of death, after accidents, for children between one and five years old.8

How and why do these fatalities occur? It is difficult to pinpoint one main cause for all fatalities attributed to child maltreatment. Between 1993 and 1995, 37% of all fatalities were the result of neglect, 48% from abuse, and 15% as a result of both forms of maltreatment.9 As a result, a few factors related to these fatalities seem to present themselves year after year. According to a 1995 report by NCPCA, states reported that substance abuse, by the abuser, was involved in anywhere from 4% to 65% of all substantiated cases.10 Additionally, 46% of children who died between 1993 and 1995 had prior or recent contact with CPS agencies.11 This may signify that these are the only deaths that are investigated by many states. As a result, we can expect that a high percentage of reported deaths involve such children. Also, however, there is much difficulty in providing sufficient services to all victims which may also contribute to child maltreatment fatalities.

How can more child abuse fatalities be prevented? Improving the ability of child protective service agencies to assist their clients by reducing caseloads, expanding training of caseworkers, and funding more treatment services for victims will help reduce fatalities. Child protective services, however, cannot prevent all fatalities single-handedly. Other formal institutions such as schools and hospitals as well as informal, personal networks should play an active role in identifying and assessing families at risk of abusive or neglectful behavior. Finally, alcohol and drug treatment services need to be expanded and made more accessible to pregnant and parenting women.

One of the most promising prevention strategies for reducing early childhood injuries is the provision of comprehensive home health visitors to all expectant and new mothers, or at the very least, to mothers in high risk neighborhoods.12 In 1991, NCPCA introduced Healthy Families America, a comprehensive home visiting initiative. Such services offer instruction and support regarding prenatal care, parenting skills, household management, and coping with environmental dangers. As a 1996 report on Hawaii's Healthy Start home visitation program concluded, home visiting produces measurable benefits for participants in the areas of parental attitudes toward children, parent-child interaction patterns, and type and quantity of child maltreatment.13 Evaluations of other home visitation programs also are underway, specifically evaluations of Healthy Families America sites. This form of primary prevention demonstrates not only a social commitment to a child's well-being from the point of birth, but also a strong commitment to the welfare of society.

References

1Lung, C. & Daro D. (1996) Current Trends in Child Abuse Reporting and Fatalities: The Results of the 1995 Annual Fifty State Survey. Chicago: National Committee to Prevent Child Abuse. 2See Bass, M., R. Kravath, and L. Glass (1986) "Death Scene Investigation in Sudden Infant Death." New England Journal of Medicine, July: 100-105; L. Mitchel (1987), Child Abuse and Neglect Fatalities: A Review of the Problem and Strategies for Reform. Chicago: National Committee to Prevent Child Abuse; and Report of the Auditor General of California's Records on the Incidence of Child Abuse. Sacramento: Auditor General's Office, August, 1988. 3McClain, P., Sacks, J., Froehlke, R., and Ewigman, D. (1993). Estimates of fatal child abuse and neglect, United States, 1979 through 1988. Pediatrics, 91, 338-343. 4Lung & Daro, 1996. 5Ibid. 6Ibid. 7Ibid. 8See "Child Abuse Fatalities," Virginia Child Protection Newsletter, Vol. 32 (Fall, 1990), 1-16. 9Lung & Daro, 1996. 10Wiese, D. and Daro, D. (1995) Current Trends in Child Abuse Reporting and Fatalities: The Results of the 1994 Annual Fifty State Survey. Chicago: National Committee to Prevent Child Abuse. 11Lung & Daro, 1996. 12Daro, D. (1988) Intervening With New Parents: An Effective Way to Prevent Child Abuse. Chicago: National Committee to Prevent Child Abuse. February. 13Intensive Home Visitation: A Randomized Trial, Follow-up and Risk Assessment Study of Hawaii's Healthy Start Program (1996). Prepared by Center on Child Abuse Prevention Research, NCPCA for The National Center on Child Abuse and Neglect. June.

Copyright©1998 National Committee to Prevent Child Abuse. All rights reserved. This file was last modified on Saturday, 25-Oct-97 07:42:04 CDT

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