Child abuse is a frustrating maze of complexities

ASHEVILLE – There’s that stereotype of a child abuser as the rage-filled man in a stained undershirt with a sixth beer in one hand and the other clenched into a fist ready to smack his kid against the wall and teach him a lesson.

He’s part of the picture, for sure. But not the only picture. There also are the hard-working dads who lose their jobs and are frantic and angry that they can’t pay the mortgage. The moms whose nerves are shattered by the incessant crying of colicky babies. The teen father who has no understanding of what’s reasonable behavior to expect of his willful toddler.

There are many reasons adults abuse children — not one of them acceptable. The only thing certain is that abuse crosses all lines — gender, race, culture and socioeconomic — and that the young victims often suffer lifelong effects.

Even though children are being hurt behind the doors of mobile homes and mansions alike, nationally renowned Asheville pediatrician Dr. Olson Huff said he believes the causes of physical abuse are often tied directly to poverty, which in turn is tied to public policy and funding, and to changing societal norms.

“We have at least 3 percent more children living in poverty now than we did 20 years ago, and that’s a tragedy in a country like ours, where more and more families and children are sinking to the poverty level, adding to the stress, anxiety, frustration, anger and all those things that are taken out on our most vulnerable, our children,” Huff said.

“If the family is suffering, it doesn’t take rocket science to figure out all the things that go along with that can erupt in hopelessness, depression, drug abuse and marital discord, all of which are factors in child abuse,” he said.

Huff, for whom the Olson Huff Child Development Center at Mission Children’s Hospital is named, said in addition to the trickle-down effects of poverty, modern times have led to “different ways of working and playing and living, and some of that may have a backlash on us in relationships, as far as how we get along with each other.”

“We have fewer people living in smaller communities and more living in more urban environments, in bigger cities with more traffic, more hassles that produce frustrations and challenges to basic, ordinary living,” Huff said. “And we have such a fear mentality — people carry guns all the time, and we have the instant news profiles of people blowing themselves up around the world.

“People are fearful, and they react and draw themselves in rather than engaging with each other, being positive, talking more actively with each other, being outside with their kids and walking in neighborhoods with their families,” he said. “We spend too much time simply watching TV all the time, and absorbing things we can’t really interpret well.”

Bill McGuire, executive director of Child Abuse Prevention Services, said there is no single explanation for child abuse. “But physical abuse often occurs with folks under great stress, with poor impulse control, anger, frustration, lack of support systems, alcohol or substance abuse and individuals who themselves experienced abuse as children,” he said. “And often there is little knowledge of normal age-appropriate child development and parenting and unrealistic expectations of the child.”

Adults who abuse children sexually are in another league, with triggers based in more pathological and deviant behaviors, but they, too, span the spectrum of societal lines, McGuire said.

Sobering numbers

While Huff and other child advocates work to stop the root causes of abuse, nonprofits like Child Abuse Prevention Services are arming children with the tools they need to protect themselves and offering healing to those who have succumbed to abuse. And their numbers are “staggering,” McGuire said.

One in five children in America will experience abuse, half will be younger than 6 and four will die every day from abuse and neglect, he said. In 2013 in Buncombe County, 4,716 children were reported as abused or neglected, following 3,985 in 2012; nearly 4,000 in 2010; and 3,933 in 2008, McGuire said. Most cases involved neglect, followed by physical abuse, then sexual abuse.

CAPS reached 8,200 Buncombe County children in grades K-5 last year to teach them to protect themselves and recognize, resist and report abuse. Adult training was provided to 350 child care providers, including all Head Start staff, who learned to recognize and respond to abuse and how to handle disclosure.

More than 250 families received parenting education, and 500 individuals — children, siblings and families who experienced abuse — received crisis intervention and counseling, including help for nonoffending parents, McGuire said.

Mary Trigg, community educator with CAPS, said a key piece in empowering children is “opening up an honest conversation about abuse and letting kids know that they can speak up.”

“Certainly, a huge piece of the program is providing kids with information, tools, a three-step personal safety plan and strategies for keeping themselves safe and getting out of unsafe situations,” she said. “But perhaps the biggest goal of the program is to get kids comfortable even talking and thinking about safe and unsafe touches and to de-stigmatize the conversation.”

Trigg said child abuse is almost a taboo subject on community, state and national levels because “it makes people uncomfortable to talk and think about, and because it’s a heavy topic.”

“We’ve all heard plenty about ‘stranger danger’ because it’s easier to think of a big, scary, unknown bad guy; it’s a lot harder to think that abusers are actually people we know, people who we see every day,” she said.

“If we were able to have more open conversations about what abuse really looks like, where it comes from, who it comes from, it would do a lot to start making the situation better,” Trigg said. “Of course, more funding and buy-in from policy-makers and funders would be fantastic, too.”

Staggering costs, financial and emotional

McGuire said the cost of child abuse in the U.S. is $250 million a day, or $95 billion a year. “This translates to the equivalent of $1,500 a year per family, yet we only spend $1 a year per family on prevention.”

For example, he said, there are only 30 programs like CAPS covering 100 counties in North Carolina and only about 1,000 in the country.

“It’s not only the cost in dollars, but the emotional cost,” he said, referring to an Adverse Childhood Experiences study that showed a correlation between childhood trauma and adult health problems, including alcohol or drug abuse, depression, heart disease, relationship issues and suicide.

Ilene Procida, a therapist with CAPS who has worked with hundreds of families involved with abuse, said the impact on children can be lifelong, with increased incidences of depression, anxiety, early sexual behavior and higher rates of substance use and abuse. Recent studies have linked increased digestive disorders in adulthood to early abuse.

“And, perhaps most significantly, those who were abused are far more likely to become offenders, thus perpetuating generations of dysfunction and denial,” Procida said. “Even if no one else ever knows about the abuse, the child certainly does, and the effects are long term and damaging.”

Huff believes the costs incurred after abuse could be vastly altered by putting money into front-end programs that make systemic changes and are truly preventive, beginning with lawmakers charged with policy and funding.

“Many of us are fortunate that we don’t need government help to put our lives and living situations together, but many do — subsidies for day care, for example,” Huff said.

“Good day care programs enrich the lives of children and integrate them better socially, and they provide a safe place for parents to have their children while they’re working,” eliminating one huge stressor.

To cut preschool education programs is “counterproductive — it just doesn’t make sense that we would take away the kinds of things that build a better environment for everybody and a better future for children educationally, socially and emotionally,” he said.

Huff said there is “regressive thinking” on the part of many elected officials who should be “strengthening the programs that aid people rather than shrinking programs to give others tax breaks.”

“Education and health care are pivotal. I think the failure of the state to take the Medicaid expansion is totally and completely insane,” he said. “We ought to be looking at what are the most pressing problems and put the maximum amount of attention to those, and I would argue that prevention of mental, physical and sexual abuse of children is a major place to put our focus.”

Huff said he believes most parents want the best for their children, and that even those who inflict abuse “aren’t necessarily just bad people; they are sometimes overstressed and under-resourced people.”

“The more we can do to help each other, to look at the families in our communities and see what we can do to offer more care, compassion and understanding — and certainly how we can guide our policymakers to do the same thing — I think we could make some dents in this problem.”

CHILD ABUSE PREVENTION MONTH• Child Abuse Prevention Month kicks off at noon Tuesday at the United Way building at 50 S. French Broad Ave., with the tying of blue ribbons and planting of a “pinwheel garden.”• The Buncombe County Board of Commissioners will proclaim April as Child Abuse Prevention Month at its meeting Tuesday; Asheville City Council will do the same April 8.• April 18 will be Blue Ribbon Night at the Asheville Tourists game at McCormick Field, where CAPS staff and volunteers will hand out blue ribbons at the gate and will pin a ribbon on mascot “Ted. E.” on the field.• The documentary film “Searching for Angela Shelton” will be shown at 6 p.m. April 22 at the United Way building, chronicling the Asheville native’s nationwide search for other Angela Sheltons who experienced and triumphed over child sexual abuse. Free and open to the public.• Build-A-Bear events will happen throughout the month, with volunteers and staff building teddy bears for children who have experienced abuse.• A raffle for a vintage Volkswagen — The Blue Ribbon Bug — will be held during April. Tickets are $10.• Blue ribbons and literature will be available during April at libraries, businesses, pediatrician offices and churches.LEARN MORETo take part in the month’s activities or to learn more about the programs and services offered by Child Abuse Prevention Services, call 254-2000 or visit www.childabusepreventionservices.org.