April is National Child Abuse Prevention Month. The topic of child abuse is sobering and difficult to raise in conversation. It could be a long month. But this year there is hope in April.
Each year over 4 million children in the United States are identified as harmed by their parents or guardians. In New Hampshire, there are about 2,000 abused or neglected children under the protection of the state today. Those are the ones we know about. It’s a hard fact of our communities that children walk among us in pain, even in terror.
Remarkable science of the last two decades tells us those children are at heightened risk for long-term devastating effects: poor school performance, mental illness, chronic heart disease, obesity, a generally shortened life span. The toxic stress of living under constant fear and instability literally changes the architecture and chemistry of a child’s developing brain.
What does that look like? It looks like distraction and inattention: a child who cannot sit still, pay attention or complete a task. It looks like depression and obesity: a child who is isolated, will not participate, may cut himself. It looks like delinquency: a child who communicates her despair by running away, placing herself at risk for substance use and trafficking.
Children respond to toxic stress in two different ways: some internalize it with substance use, self harm or suicidality. Others externalize toxic stress with behaviors that are annoying and disruptive to school and daily routines. Children who externalize stress as a means of coping are far more likely to be suspended or expelled from school – setting off yet another set of risk factors for failure. A child who has been abused or neglected is on a trajectory of poor social and emotional control that pits her or him against all expectations of society, through no fault of their own.
On April 5, New Hampshire also acknowledges the theme of the month with “Wear Blue Day” to raise awareness of the problem of child abuse. You have to wonder: Why April and why blue? Does blue represent the color of bruising or loss of life from abuse? Is it sadness and depressed mood? Or is it the color of hope?
April marks the first full month of spring. After a long, cold New England winter, April brings blue skies and fresh starts. This is the gift we must give to children who have been, or are at risk of being, abused and neglected: the blue skies of hope.
There is good news. The same rigorous science that taught us about the harrowing effects of child maltreatment is now telling us that children can be resilient. They can recover. Their brains can regenerate the vital neurons so necessary to critical thought and emotional stability that have been damaged by the stress of maltreatment. There is hope.
The trajectory of chronic illness and dysfunction fades when children have positive experiences.
Dr. Robert Sege, professor of pediatrics and medicine at Tufts University School of Medicine lifts all children on “pillars of hope,” (health outcomes of positive experience). He spoke recently in Concord to a roomful of advocates and providers for children. In an otherwise bleak conversation about the sadness of childhood maltreatment, Dr. Sege was a spring day of optimism and, surprisingly, simplicity. The four pillars of hope include: positive supportive relationships; a safe place to live, play and learn; a sense of belonging to community; and opportunities to develop social-emotional competence. That sounds complicated, but it’s not. Dr. Sege confirms that even a single caring consistent adult can make a difference in a child’s life. Being engaged by and in the community – whether at a church supper or a town meeting – kindles a sense of connectedness that buffers adverse or negative experiences.
We can wear blue on April 5 to acknowledge the need to prevent child maltreatment. Or we can say hello to a child in the neighborhood. Ask her how school was today. Compliment him on his haircut. Know his or her name. They may be shy, they may be restless or active, but they will hear and learn the sense of being valued.
In the meantime, as we mark Child Abuse Prevention Month, we must recognize that it takes all of us and responsive public policy to prevent child abuse in the first place. Policy leaders debating paid family leave in New Hampshire should look to the studies in California that confirm paid family leave has a direct effect on lowering the incidence of child maltreatment. These are the things we know are effective in preventing child abuse or neglect: stable housing and employment, access to health care, including mobile crisis response for distressed children; substance use treatment and prevention. The federal Families First Prevention Services Act, which goes into effect shortly, supports these things with a shift of funding from child protection to prevention. That provides another pillar of hope.
New Hampshire should open up to the hopeful blue skies of childhood and healthy families. Wear blue on April 5. Smile and say hello. We all have a part to play.
(Moira O’Neill is the director of the State of New Hampshire Office of the Child Advocate.)