Transcription:

Introduction: Welcome to Inside Pediatrics, a podcast brought to you by Children's Hospital of Alabama in Birmingham.

Caitlin Whyte: I'm Caitlin Whyte and today we're discussing child abuse during the COVID-19 pandemic. Joining us for this important conversation is Dr. Melissa Peters, an Associate Professor and Pediatric Emergency Medicine Medical Director at Children's of Alabama's Chip Center. Dr. Peters, by now we've all heard stories in the news about the possibility of domestic abuse and child abuse increasing because of the pandemic and the shelter in place rules. Can you tell us how the pandemic might be affecting families in this way?

Dr. Peters: There are several ways that families are being affected currently. One of the biggest ones of course is financial with people being furloughed with people losing their jobs, have with people just not being able to work. A large percentage of our population, if they don't go to work, they don't get paid, and we certainly know that financial stresses are one of the risk factors for children being abused. Another big one that we've not seen before is everybody having to spend all this time together under one roof. That's a lot of stress on people to have to spend all that time together. Especially for kids because they're used to going to school. They're used to that type of routine, here they are cooped up inside all day long and behavior issues can come up. Sometimes those end up being triggers for abuse to start. The other thing that we also think about are families recombining in different ways. Sometimes you have folks that stay with you. When I ask folks lives with you, they will tell me who permanently lives in the house.

But asking the question who stays with you tends to be a different answer because there are a lot of people with transient housing and so there may be more folks than just that usual group of people that reside in that home. So there are a lot of concerns that we had. As soon as these shelter in place, social distancing recommendations started to come down. I think all of us had been concerned that we were going to see an increase in child abuse. Some communities had definitely seen that. Talking with colleagues across the country. One thing we're certainly seeing here in the mid central Alabama area is an increase in domestic violence and I think that's happening across the country as well and certainly domestic violence is a risk factor for child abuse. It also is incredibly difficult and stressful on children. Anyone who thinks that their children don't realize that something is going down in the house when it comes to domestic violence. I would challenge that assumption. Kids are very, very smart and they are incredible observers of their environment and it also creates a very stressful environment for that child.

Host: Another side effect of the pandemic is of course schools and daycares and places like those being closed and kids aren't in touch with teachers and other trusted adults outside of their homes. How could this be addressed?

Dr. Peters: I think that's a big topic of discussion amongst educators certainly because that was another concern we had. The kids are going to be outside of that normal network of adults that they see that are not residing in their home and I wouldn't just throw in teachers, daycare folks. I would throw in also faith communities because a lot of faith communities have had to curtail their in-person worship services. There are a lot of places that kids get seen outside of the home and that is also going to be significantly curtailed. One of the things that I do recommend folks think about is talking with the families of your patients. If you're a pediatrician, if you're seeing patients, you know kids in your practice, talk with them about keeping in touch with other families, with kids that they know, watching zooms, seeing if there is anything unusual, anything that the child seems afraid of. If it seems like the child is being coached from off camera, just keep it, keep your eyes out because things can be very subtle on a regular day. This, I think is an opportunity for us to think not just about the children that we directly care for, but the whole village really that we all create as a society for the kids that we know.

Host: As we look forward to a hopeful post pandemic time, hopefully in the near future, what do you anticipate? What do you think we will maybe even learn or take away from this time?

Dr. Peters: I am really interested to see what the numbers are in terms of report, in terms of substantiated abuse from a an investigatory perspective. I'm really interested to see that. I think that it is probably going to increase over time as these stresses increase on people. There are also a group of kids who are verbal who may be being abused right now but won't disclose until they are out of that environment where they're being abused and they feel safer. So we're anticipating a surge in our numbers of kids who are verbal. Once things start to open up and we're seeing less of the social distancing and kids getting back out into their usual communities outside of their home.

Host: For anyone who may be listening who has been impacted by the pandemic in this way, do you have any resources online, socially distant ways that people can turn to for help?

Dr. Peters: I would encourage folks to talk with their primary care doctors and pediatricians first of all because there are often local resources that you can access that can be very, very helpful and not just resources as a place to talk, but resources as far as food banks, as far as other forms of support within the community, many communities, many States have a child abuse hotline. We have one here in Alabama that you can just look up online, where caregivers can talk with somebody and talk about the difficulties they're having caring for their child or concerns that they have of abuse. I also would encourage folks to think very seriously in this time if you have a concern that a child is being abused, do consider reporting it even if you're not a mandated reporter. The only way we find out if abuse is going on is through investigation and these kids, most of them don't have a voice. Nobody else is going to speak for them and so if there is a significant concern, then you can certainly call your local child protective services. You can call your local child advocacy center. Child advocacy centers are where counseling occurs for kids with suspected abuse. Formal forensic interviews occur. Call your local medical child abuse center, if you have one at a Children's Hospital nearby, they can often refer you to resources that may be helpful.

Host: Dr. Peters, is there anything else about this issue that I didn't touch on that you want to talk about?

Dr. Peters: The one other thing that I think ties into the issue of keeping your eyes and ears open for child abuse is also domestic violence. As a profession, as physicians, we are not always so great about asking folks if they feel safe in their homes, if anyone is getting injured in their homes. I think now is an especially important time for us as medical providers to be screening. And if anyone listening is in an environment where they feel are unsafe, they feel their children are unsafe, reach out in your community to a domestic violence hotline. Very, very important.

Host: Well, we appreciate your expertise and your time to focus on this critical issue during an already unprecedented time, Dr. Peters. That was Dr. Melissa Peters, an associate professor and pediatric emergency medicine medical director at Children's of Alabama's Chip Center. I'm Caitlin Whyte. Thank you for joining us.

Conclusion: Thanks for listening to Inside Pediatrics. More podcasts like this one can be found at childrensal.org/Insidepediatrics.