Abused Children Are Exceptional Children MARYLANE SOEFFING
Child abuse and neglect defined by Public Law 93-247 is "physical or mental injury, sexual abuse, negligent treatment, or maltreatment of a child under the age of 18 by a person who is responsible for the child's welfare under circumstances which indicate that the child's health or welfare is harmed or threatened." The Council for Exceptional Children adopted a resolution in April 1974 recognizing abused and neglected children as exceptional children. MARYLANE SOEFFING is Staff Writer, The Council for Exceptional Children, Reston, Virginia. This article, a selected bibliography, and a list of information resources is available through the ERIC Clearinghouse on Handicapped and Gifted Children, 1920 Association Drive, Reston, Virginia 22091. This material was prepared through the ERIC Clearing House on Handicapped and the Gifted Children, A CEC project funded by the National Institute of Education, Department of Health Education and Welfare. However, the opinions expressed here do not necessarily reflect the position of policy of the National Institute of Education, and no official endorsement by the National Institute of Education should be inferred.
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The abuse and neglect of children in the United States is a serious na tional problem, a societal disgrace, and a personal nigh tmare. Conservative estimates indicate that there are between 60,000 and 500,000 cases of child abuse each year. Two to 15 children die each day from abuse, and many more are permanently handicapped either emotionally, physically, and/or men tally. According to the Chairman of New York's Mayor Task Force on Child Abuse and Neglect, Vincent J. Fontana (cited in Martin, 1973), "Statistics strongly suggest that child battering is probably the most common cause of death in children today, outnumbering those caused by any of the infectious diseases, leukemia, and auto accidents" [p. 52). Helfer, (cited in Shanas, 1975) predicts, "Unless changes are made in prevention and treatment, there will be 1.5 million reported cases of child abuse in the next 10 years (including) 50,000 deaths and 300,000 permanently injured children-most of whom will be brain damaged" (p. 482). The problem of child abuse and neglect has been studied and discussed from many perspectives and by many disciplines-law, medicine, social work. psychiatry, education, and psychology. Causative factors have been identified, referral systems have been established, legislation requiring the reporting of suspected cases has been enacted, and prevention and treatmen t programs for children and parents have been implemented. However, little attention has been given and even less recording in the literature has been done regarding the relationship between abuse and handicap. For teachers, administrators, clinicians, teacher educators, and others who work with handicapped children, a number of questions arise and need to be answered.
November 1975
In discussi ng the charac teris tics of a n ab used ch ild. S andg rund , Ga ines, a nd Green (197 4) s ta te th a t a ch ild with cog nitive or neurol ogi cal defic its w hic h mak e his beh avior pr ovocati ve a nd unman a geable ha s a grea tly inc reased pro ba bilit y of ab use whe n a st ressful s it ua tio n occ u rs with an a buse pron e paren t. By th eir definit ion , "the 'abu s e pron e' parent is one wh os e negat ive se lf image frequ entl y for ces him or h er int o unreali sti call y loft y ex pec ta tio ns of th e ch ild which wo uld be vir tua lly imp os sibl e for eve n an intellec tua lly normal yo u ngs ter to fu lfi ll" (p . 32 9 ). T hey beli eve mentall tarde r neurologicall y handicapp ed i1dren reinforc th e negati ve se lf image of l h is type of parent Morse, S a ler, and Friedman (197 0 ) in a s tudy of 25 a used children fou d th at 15 of th e ch ild re n were considered different b y th eir p arent s. ine of the chi dren wer e retaroe . th e d w ere thoug ht by th ei r arents to be SIC I . S ix others were vie we d arents as bad, selfish, spoiled rotten, by a red to siblings. or defi ant c This a rticle will rep ort data a nd inf orma Fri edm an 1972) postulates that so me ti on on chi ld a buse as it rel at es to hand ichildren are hyperactive or intellec t u"......'!!"'"'_ a b u ca p pe d ch ild re n. di scu s s th e role of e ally precocious s found that in so me teach er a nd sc hoo l. id ent ify as pec ts of c . ·~:: :;-- Ga is es,.1 rt e' mquisitiv e b avior of a child who abus e tha t n eed fur the r in vest igati on , a nd is intell ectu all y mor e ca ble than his parents ca uses him to be mor e v u erable to abuse . ou tli ne curre n t prog ram s, projects , a nd reso urces . Dis tr essing ca se s tudie s of ch ild ab use and negl ect will not be det ail ed her e. It In hi s 1967 nati onwid e study of 5.99 ph ys icall y ab use d ch ildre n. Gr ms is eno ug h to say th at ch ild re n ha ve su ffe re d in ed th e fun ction ing du ring th e yea r precedre ject ion , aba ndo nme n t, sex ua l a buse. verba l ing th e ab use of a sa mp le of 1.380 ch ild re n. Of a t tac ks, a nd ph y si cal in ju ry w ith every pos si th ese ch ild ren, 29% sho we d deviati ons in bl e ob jec t to eve ry part of th eir bodies. Man y soc ia l interac tio n and ge nera l fun ction ing , ab us ive ac ts ca use th e death of th e ch ild. Exampl es of rep ort ed ph ysi cal a nd psych o14 % sho wed devi ati on s in ph ysical fun cti oning . and 8% sho we d dev iation s in in te llec tua l logical ab use and negl ect in clud e eve ry cr ue l fun ction in g. Of th e ch ildren of sc hoo l age. 13% ac t imag ina ble and so me b eyond imagina tion. we re in grades below age level or in speci a l classes for th e ret ard ed . Nearl y 25 % of th e chi ldren had been cha rac te r ized on th e rep ortSusceptibility of Handicapped ing for m a s ex h ibi ti ng "pe rsis ten t b eh a vi oral Children to Abuse a ty pica li ty ." Studi es of th e nature and cau se of child a buse Mor e recently , Lebs ack (1975 ) r epo rts preha ve exa mine d a numb er of va ria bles, incl ud lim in ary inci de nce d at a from 22 st at es and in g parent personalit y cha ra cte ris tics, famil y ter rit ori es usin g a s ta nda rd a buse a nd negl ect int er a ction patt ern s. s tress situation s , a nd re po rt ing for m d evelop ed by th e National cha rac te ris tics of th e a buse d ch ild. Alth ough Clearingh ouse on Child Abuse a nd Negl ect a t th e Am eri can Hum an e Association , Den ver. no ma jor co mprehe ns ive res earch has exa mColor ad o. Pr elim in ary a na lysis of th e 19 74 in ed th e ex is te nce of a h andicap as a ca usa t ive dat a reveal ed a tot al of 14. 083 a buse d a nd fa ct or of abuse and n egl ect , severa l renegl ected ch ild r en of w ho m 1 .680 ha d one or sea rc he rs ha ve rep orted findin gs w hic h re more dis ti ng uis hi ng charac te ris tics. vea l a poss ibl e rel a tion ship. Other s t ud ies Mor e speci fica lly. 195 chil d re n we re bo rn ha ve ind icat ed tha t ab use d ch ildre n a re see n prem a turely , 288 we re men tall y ret arded . 234 as d ifferen t or difficult to rais e by th eir wer e ph ys icall y hand icapp ed , 25 0 had a pa rent s .
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chronic illness such as diabetes or multiple sclerosis. 130 were from a multiple birth. 180 had a congenital handicap or birth defect. 669 were emotionally disturbed and 267 were reported as having "other special characteristics ." The data was supplied by social workers conducting home interviews . A revised reporting form will help social workers to obtain professional judgment before reporting a handicapping condition. Lebsack noted that the percentage of handicaps could be expected to increase if social workers received special training in how to diagnose a handicap. In an extensive revie w of the literature in the areas of education . medicine. psychology. social work, and law, Kline (1975) and Kline and Hopper (1975) found no study establishing a definite cause effect relationship between handicap and abuse. However, some studies do indicate a correlation, and professional opinion suggests such a relationship. Helfer (1975) contends that it is difficult to determine whether the abuse or the handicap came first. Did the abuse cause the handicap or was the handicap responsible for the abuse? However. he feels that a child who is handicapped, different. orpe rce ived as different is at risk and more likely to be abused by a family that is abuse prone than a nonhandicapped child in the same family .
Consequences of Abuse to Children The research literature is more ext ensive and definitive on another aspect of th e relationship between abuse and handicap-abuse as a cause of handicap. Studies of abused children have reported high incidences of retardation, emotional disturbance, physical defects, neurologic problems, and growth failure. Sandgrund, Gaines, and Green (1974) in a study of 60 abused, 30 neglected, and 30 nonabused control children aged 5 to 12.9 years found a significant difference between abused, neglected. and nonabused subjects on both verbal and performance IQ measures. On the full scale. 25 % of the abused group, 20 % of the neglected group, and 3% of the con trol group scored below 70 . The proportion of abused and neglected children w it h IQs below 70 was nearly 10 times that of the con trols . The resea rchers concluded that cognitive imp airment appears to be closely related to both child abuse and child neglect. However
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they also stated, "It remains to be shown conclusively whether cognitive impairment antedates abuse or is one of its effects" (p. 329J .
Martin (1972) reports a three year followup stud y of 42 abused children. Of these chil dren, 18 were neurologically handicapped , 14 scored below 80 on an IQ test, 14 demon strated failure to thrive on admission (hei ght and /or weight below third percentile] , and 16 were language delayed even after intervention. In another followup study of 58 abused children, an average of 4.5 years after the ph ysical injury , Martin, Beasley, Conwa y, and Kent (1974) report 31 children hadneurological handicaps ranging from serious to mild . Of these 31, 18 were severely handicapped. One third of the children had growth failure when the abuse was originally identified; half of this group was still described as exhibiting growth failure at the lime of followup . Children with a history of head trauma and/ or present neurological impairment scored significantly lower on tests of intell ectual performance than the rest of th e group. The parents of these 58 children had received th erapeutic intervention, Martin et a1. [1974) conclude that, While the am ount of data is small, it is clea r that th e ab used chil d is at high risk for dam age to his ner vous syst em and maldevelopment of ego func tions . Actual loss of centra l ner vou s s yst em tissue by ph ysical trauma accounts for the mortalit y a nd mu ch morbidit y in the se child ren. How ever , mor e s ub tle effects of the en vircnment that may be assoc ia ted with the abusi ve home a re beginn ing to be recognized. The a busi ve envi ronment, apart from the actual ph ysical trauma , imp a irs the dev elopment of the child neurologically . cogn it ive ly, and emotionally . [p, 43)
A similar interpretation of the relat ionship between handicap and abuse is offered by McRae , Ferguson, and Lederman (1973), who s ta te, S ev er e ph ysical abu se is pred ict ive of unu sual difficulties in development. Onl y on e cond itio n app ears to result from abuse alon e a nd that is ph ysi cal in jury, in particular brain dama ge, whi ch can be fat al. What is de va st a tin g is the as socia tion of ma tern al depriv ation or dist ort ed par ent-child in tera ction which pr ecludes normal ment al de vel opm ent in th e ch ild ren who ex perience tr auma at a vu lner able age. [ p, 864)
The followup study of abused children conducted by these research ers located 46 November 1975
children. Of this group 8 had died, 4 were institutionalized, 12 were mentally retarded, 3 were disturbed, 3 showed evidence of brain damage. and 16 were normal. In an earlier followup study Elmer and Gregg (1967) reevaluated 20 children who some years earlier had been treated for child abuse in a hospital. At the time of Iollowup, 8 of the 20 children were emotionally disturbed. 10 had IQ scores below 80, and only 2 were considered normal in all areas evaluated. Of 10 children who were in an improved environment (such as a substitute home). 7 scored in the normal range on intelligence measures. Of the 10 still living in their original homes, only three were of normal intelligence. Later information obtained by the researchers indica ted five of the children would probably become public charges because of mental retardation or serious emotional problems and several would need a sheltered environment to remain in the community. Elmer (1963) also conducted a followup of 42 children who had received hospital treatment for multiple bone injuries from suspected abuse, Over half of the group had either died. been institutionalized or rehospitalized. or were handicapped. Seven had serious physical defects and four were seriously mentally retarded. A nationwide survey of hospitals by Kempe, Silverman, Steele, Droegemuellerand Silver (1962) received replies from 71 hospitals reporting 302 cases of battered children over a one year period. Of this group, 33 children died and 85 suffered permanent brain injury. Fitch (1975) reports that Denver Department of Health and Hospital researchers in a longitudinal study of abused children found that developmental scores of abused children were significantly lower than those of nonabused children. In studying the scores of children diagnosed as neglected, the researchers found a drop in developmental test scores between hospitalization and retesting after six months. Fitch holds the position that neglected children can suffer a greater intellectual handicap due to lack of stimulation than abused children who often have love, stimulation. and a positive relationship with parents even though at times the parents cannot control certain impulses. In a far reaching recent report Caffey (1974) says, "Casual. habitual, manual whiplash shaking of infants is a substantial primary frequent cause oflater men tal retardation and
Exceptional Children
permanent brain damage" (p. 396). The manual whiplash shaking of infants leaves no external signs of injury to the head, face, or neck. But it does cause massive intracranial and intraocular bleeding. This damage is often unnoticed by parents and physicians. Caffey states that habitual and prolonged whiplash shaking of an infant may produce a syndrome which is first noticed "at school age when minor idiopathic cerebral motor defects are first detected along with mild idiopathic mental retardation. Permanent impairments of vision and hearing may also be identified at this time for the first time when the children are five to six years of age" (p. 402).
Responsibilities of Educators Educ a tors and others who work directly with children have an excellent opportunity and a grave responsibility to identify and properly report suspected cases of child abuse or neglect. Proper identification and reporting to the appropriate local child protection agency enables the child to receive treatment for injury and protection from additional abuse or neglect. Gil (1969). an early researcher into incidence of child abuse, saw the important role of classroom teachers. He states "The classroom teacher should become the most important link in the preventive and protective chain. since his daily contacts put him in a strategic position to observe early indications of abuse" (p. 2). Teachers, principals. and other school system personnel must educate themselves about the problem of child abuse. about their state legislative requirements and provisions, about their school policy and local reporting procedure, about the symptoms that indicate a child may suffer abuse or neglect, and about how they can assist the abusing parent. Drews (1972) states, Children will continue to be abused and, in turn, become the abusers themselves unless the schools recognize their role and responsibility in the reporting of their suspicions and developing a close working relationship with the agency that receives their report. (p. 123)
Signs and Symptoms of Possible Abuse and Neglect
Indicators of a child's need for protection listed by the American Humane Association
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(1971) pr ovid e helpful information on id entificat ion of ch ild re n suffering a buse . Tea ch er s a re ad vised to be a lert to th e ch ild's beh a vi or a nd a ppeara nce a nd th e a t tit udes of parents . Sp ecifi call y , is th e ch ild agg ress ive, d is ru p tive, de s truc tive. shy. w ithdra wn . pa ssi ve, or ov erl y comp lia n t? Is he frequ entl y abse n t or lat e, or d oes he a rr ive ea r ly an d stay lat e? Regarding hi s appearance. is he ina dequ a tel y dress ed for th e wea ther. unk empt , dirt y. un dernour ish ed . tired , in need of med ical a tte n ti on or fre q ue n tly inj ure d? Does he ha ve bru ises , w elt s . a nd cont usio ns? Does he co mpl ain of beat ings or malt reatment ? Par ent al a t tit udes ca n be sy mp toma tic of ch ild abuse or negl ect. Ar e pa rent s aggressive or abus ive w he n as ked abo ut pr oblem s co nce rni ng th e child? A re th ey a pa the tic or unresp on si ve? Is pa rental be havio r bi zarre or s tra nge? Do parent s sho w little conce rn abo u t th eir ch ild or littl e int er es t a bo ut his ac tiv iti es ? Do th ey fai l to pa rti cip a te in sc hoo I ac ti v ities or a llo w th e ch ild to pa rti cip at e?
School Services to the Family
Helfer (1975) beli eves tea ch er s co u ld obse rve a nd ide n tif y cases of pot en ti al a buse, a nd the n wo rk with th e fam ily to prevent the occ urren ce. Ideall y , an ind epth hi st or y wo u ld reo vea l how parent s were tr eat ed as ch ild re n and wh eth er th ey we re a buse d . negl ect ed , or ha d a negati ve re la t ions h ip w ith their pa rent s . S uc h a fa mil y wo uld be conside red hi gh ris k . He sta tes, Most people w ho were reared poorly have ver y unrealisti c expectations of what their ch ild ren are supposed to do for them. If th ey superimpo s e on thes e unrealistic expectations a handi capped child . who ca n't anywhere near meet th em . then th e ch ild is in tro ub le.
Ideally , th e s pecial education s taff wou ld prov id e ex tra su pportive help to such a family . inc ludi ng assis ta nce in deve lop ing reaso nab le expec ta tions for th e child. How ever. Helfer con te nds the ta sk is made more diffi cu lt by th e fac t tha t these parent s a re ge ne r's activities . Iy not involved w it h th e sc P.a non y r (197 5), cofo und a nation al sel a pparents w t s th a t tea ch e re ca pa ble of making a so s hou ld b orne more i
School Policy on Abuse Reporting
All sta tes ha ve child a buse rep orti so me s ta tes suc h rep or tin g is mand fin es or imp ris on men t is pr ov ided fo nat ed ind ivi d ua ls w ho fail to rep ort. S pr ovi de for immunity fro m cr iminal or ci ac tion for peopl e rep or tin g a buse case s. T he abuse re po rti ng po licy of the Wa y Westlan d sc hoo l di st ri ct in Michi gan (Marti n, 19 73 ) incl udes provi si on of in forma ti on to sch ool personn el on how to recog nize a buse and neglect . rem ind ers to sc hoo l personnel a bo u t th e s ta te law requ iring child abus rep orting, a nd ex pla na tion s of the details r. ~ rep orting, su ch a s n otification of paren ts . sch ool admini strati on . and hospital. P.r sions of in forma tio n on how to transpo'lmtute--' ch ild to the hospit al for exa mina tion, and ho w to write re po rts. a re a lso include d . Montgom er y Count y , Ma ryl an sc hoo ls (Poli cy St at em ent. 1974) provide teach ers with a print ed policy sta te me n t whi ch gives in form at ion on relevant sta te ' legi sl at ion , de tai ls th e exac t ab use re po rting ' pr oced ure. s pecifies the con te nts of ora l a nd written re po r ts, and desc r ibes wha t co ns titut es a buse and negl ect. Per iodi c staff deve lop men t on th e subject is pro vi ded.
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•
November 19 75
types of abuse and symptoms . The reporting pro cedure and the responsibility for reporting are described. Suggestions for relating with the child and the family are provided. Although the training packages are tailored to legislation and procedures in Texas, they can easily be adapted to the needs of other states. As part of a comprehensive program of public and professional education, Community School District 18 in Brooklyn, New York (Gross, 1975] has provided orientation about child abuse for teachers, guidance counselors, and pupil nersonnel workers in district, private, and parochial schools, as well as an open school board meeting on child abuse . When children are identified as abused, resource personnel act as a liaison between the school and home, interpreting problems and assisting the teacher. Individual counseling is provided for the child. Project Protection (Learning, 1974] in Montgomery County, Maryland , is revising school policy, developing new curriculum for high school students and parent education programs , and training staff to identify child abuse or neglect. Training activities include conferences and staff development in each school. Guidelines and procedural manuals are being developed.
Federal Programs on Child Abuse and Neglect In 1974 Congress passed the Child Abuse Prevention and Treatment Act (PL 93-247] which established a National Center on Child Abuse and Neglect and authorized grants for child abuse programs. Six months prior to passage of the act, HEW had established an Interdepartmental Committee on Child Abuse and Neglect which provided funds for new projects on child abuse. The federal assistance helps states and local communities in the identification and prevention of abuse and in the provision of services to abused children and th eir families. A number of projects funded through the Interdepartmental Commit tee deal with characteristics of abused children , conseqences of abuse to children , incidence rates , the role of the teacher and other aspects of abuse and neglect that are of particular in terest to special educators. Brief descriptions of several of these projects follow [HEW, 1975] :
Exceptional Children
• The US Office of Education is developing models to train teachers to identify and work with abused children and to work effectively with community agen cies treating abuse. • The National Institute of Child Health and Human Development is designing a biomedical and behavioral research program on the effects of abuse and neglect on the developing child. • The Bureau of Community Health Services is funding research projects to study treatment of child abuse in health ca re settings, including the study of child abuse in ins tit u ti ons and the development of high risk infants. • The National Institute of Mental Health is conducting a project to develop and test tra ining models for medical, mental health, welfare, school, and law enforcement personnel. Training focuses on the identification, treatment, and prevention of child abuse. The National Center on Child Abuse and Neglect located in the Children's Bureau, Office of Child Development (OCD) will implement the Child Abuse Prevention and Treatment Act by conducting research about incidence, causes, prevention, and treatment; publishing annual research summaries ;establishing an information clearinghouse ; publishing training materials; providing technical assistance; providing for training activities; establishing regional centers for services ; and funding states for prevention and treatment programs. Several specific projects and activit ies of the National Center (HEW, 1975] are ofparticular interes t to educators working with handicapped children: • Herner and Company in Washington, DC is setting up a computerized clearinghouse on child abuse and neglect programs and producing a research summary. • Burt Associates , Inc., in Bethesda, Maryland, is conducting an incidence feasibility study to examine alternative ways to collect national incidence data . • Urban and Rural Systems Associates in San Francisco is de veloping cur ricu la about identification, reporting, and referral to train medical, education, social service, and law enforcement personnel. • Twelve demonstration centers were funded in December 1974 to manage cases
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of child abuse and neglect through treatment, public education, 24 hour hot lines, agency coordination, and other activities. • Eleven resource projects to promote effective use of community resources and initiation of services in dealing wi th child abuse and neglect were funded in December 1974. The resource project (HEW, 1974) at the National Center for the Prevention of Child Abuse and Neglect (University of Colorado Medical Center) will offer direct services including play therapy, a therapeutic playschool. and a crisis nursery. A resource project (HEW, 1974) at the Education Commission of the States in Denver is studying the role of the educational system and will make surveys of teacher preparation and state and local educational policies and codes concerning child abuse and neglect. This project will also develop a data base on child abuse and the public schools. A National Advisory Committee will be established to find alternative ways the public schools can identify and prevent child abuse and neglect. Regional conferences for educators and others will be conducted. Additional federally funded projects announced in Jury 1975 include 15 research grants to study factors contributing to child abuse and neglect. the relationship of drug and alcohol use to child abuse and neglect. factors causing parents to stop or resume abuse. and measures for cost effectiveness of services to abused children and their families. Ten new innovative demonstration projects were funded to provide services to target populations not within the normal service delivery systems-native American communities, rural areas, and military communities. Six resource projects to develop community services also received grants.
cause of abuse. Helfer (1975) suggests research to determine if handicapped children are at higher risk for abuse than nonhandicapped children, and why schools for the handicapped do not become more involved in possible child abuse cases. Kline (1975) recommends research into the educational correlates of child abuse such as the relation between central nervous system damage and specific learning disabilities and the relation between abuse and later educational placement. Lieber (1975) encourages research into effective ways schools can seek positive and practical involvement with families who have problems. Communities must provide accessible and effective counseling and support to abusive parents. Individuals who work with children must be alert to the problem and report suspected cases. Preservice teacher education programs must make prospective teachers aware of the problem and their responsibilities. Educa tion for parenthood programs at the secondary school level must provide more information about emotional and behavioral requirements of child rearing, reasonable expectations of children, and community services. Schools need to develop detailed policies, procedures. and inservice teacher education for identifying and reporting suspected cases of child abuse and neglect. School programs should work cooperatively with appropriate community agencies to meet the therapeutic needs of these children. As Martin (1972) states, It must be recognized that subsequent growth and development of these children-physical, neurologic, cognitive, emotional-are dependent in large part upon our ability to develop effective therapy for these children ... Methods of intervention can and must be developed to maximize the chances for the children to grow and develop into adequate healthy adults without the legacy of retardation, inadequacy, dependency, and loneliness. (p. 112)
Recommended Research and Services Research into several aspects of child abuse and neglect is needed for effective design of resources. Fitch (1975) cites the need for exploring qualities in a child that lead to abuse, studying the type of input a child adds to the situa tion, and examining possible mismatches between parental expectations of the child and actual child behavior as a possible
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References American Humane Association, Children's Division, Guidelines for schools. Denver: Author, 1971. [Pamphlet) Caffey, J. The whiplash shaken infant syndrome: Manual shaking by the extremities with whiplash-induced intracranial and intraocular bleedings, linked with residual permanent brain
November 1975
damage and mental retardation. Pediatrics, 1974,54,396-403. Drews, K. The child and his school. In H. C. Kempe & R. E. Helfer (Eds), Helping th~ bottered child and his family. Philadelphia: J. B. Lippincott Co. 1972. Elmer, E. Identification of abused children. Children, 1963,10(5),180-184. Elmer, E., & Gregg, G. S. Developmental characteristics of abused children. Pediatrics, 1967, 40, 596-602. Fitch, M. Telephone communication. Denver Department of Health and Hospitals, Denver, Colorado, May 1975. Friedman, S. B. The need for intensive follow-up of abused children. In H. C. Kempe, & R. E. Helfer, [Eds.], Helping the battered child and his family. Philadelphia: J. B. Lippincott Co., 1972. Gil, D. G. What schools can do about child abuse. American Education, 1969, 5(4], 2-5. Gil, D. G. Violence against children: Physical child abuse in the United States. Cambridge MA: Harvard University Press, 1970. Grass, N. Telephone communication. Community School District 18, Brooklyn NY, May, 1975. Helfer, R. E. Telephone communication. Department of Human Development, College of Human Medicine, Michigan State University, East Lansing MI, May, 1975. Kempe, C. H., Silverman, F. N., Steele, B. S., Droegemueller, W., and Silver, H. K. The batteredchild syndrome. Journal of the American Medical Association, 1962, Vol. 181, 17-24. Kline, D. F., & Hopper, M. A. An integration of the research related to education of children handicapped as a result of child abuse (Final report). Logan UT: Utah State University, 1975. Kline, D. F. Telephone communication. Department of Special Education, Utah State University, Logan, UT, April, 1975. Learning (Newsletter of the Montgomery County Public Schools, Rockville MD). September, 1974. Lebsack, J. R. Telephone communication. National Clearinghouse on Child Abuse and Neglect, American Humane Association, Denver CO, June, 1975. Lieber, L. Telephone communication. Parents Anonymous, Inglewood CA, May, 1975. Martin, D. L. The growing horror of child abuse and the undeniable role of the schools in putting an end to it. American School Board Journal, 1973, 160. 51-55. Martin, H. P., Beezley, P., Conway, E. F., & Kempe, C. H. The development of abused children. Advances in Pediatrics, 1974, 21, 25-73. Martin, H. The child and his development. In H. C. Kempe & R. E. Helfer [Eds.], Helping the battered child and his family. Philadelphia: J. B. Lippincott ce.. 1972. McKenty, S. B. Telephone communication. Education Consortium C, Houston TX, May, 1975.
Exceptional Children
McRae, K. N., Ferguson, C. A., & Lederman, R. S. The battered child syndrome. Canadian Medical Association Journal, 1973, 108,859-866. Morse, C. W., Sahler, O. Z., & Friedman, S. B. A three-year follow-up study of abused and neglected children. American Journal of Diseases of Children, 1970, 120,439-446. Montgomery County Public Schools. A policy statement on child abuse and child neglect. Rockville MD: Author, August 26, 1974. (Pamphlet] Sandgrund, A., Gaines, R. W., & Green, A. H. Child abuse and mental retardation: A problem of cause and effect.' American Journal of Mental Deficiency, 1974, 79,327-330. Shanas, B. Child abuse: A killer teachers can help control Phi Delta Kappan, 1975, 479-482. US Department of Health Education and Welfare, Office of Human Development, Office of Child Development, Division of Public Education. Child abuse and neglect activities. Washington DC: US Department of Health, Education, and Welfare, 1975. US Department of Health, Education and Welfare, Office of Human Development, Office of Child Development, National Center on Child Abuse and Neglect. Child abuse projects funded, December, 1974. (Pamphlet) Washington DC: US Department of Health, Education, and Welfare, December, 1974.
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Child abuse and neglect defined by Public Law 93-247 is "physical or mental injury, sexual abuse, negligent treatment, or maltreatment of a child under the age of 18 by a person who is responsible for the child's welfare under circumstances which indicate that the child's health or welfare is harmed or threatened." The Council for Exceptional Children adopted a resolution in April 1974 recognizing abused and neglected children as exceptional children. MARYLANE SOEFFING is Staff Writer, The Council for Exceptional Children, Reston, Virginia. This article, a selected bibliography, and a list of information resources is available through the ERIC Clearinghouse on Handicapped and Gifted Children, 1920 Association Drive, Reston, Virginia 22091. This material was prepared through the ERIC Clearing House on Handicapped and the Gifted Children, A CEC project funded by the National Institute of Education, Department of Health Education and Welfare. However, the opinions expressed here do not necessarily reflect the position of policy of the National Institute of Education, and no official endorsement by the National Institute of Education should be inferred.
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The abuse and neglect of children in the United States is a serious na tional problem, a societal disgrace, and a personal nigh tmare. Conservative estimates indicate that there are between 60,000 and 500,000 cases of child abuse each year. Two to 15 children die each day from abuse, and many more are permanently handicapped either emotionally, physically, and/or men tally. According to the Chairman of New York's Mayor Task Force on Child Abuse and Neglect, Vincent J. Fontana (cited in Martin, 1973), "Statistics strongly suggest that child battering is probably the most common cause of death in children today, outnumbering those caused by any of the infectious diseases, leukemia, and auto accidents" [p. 52). Helfer, (cited in Shanas, 1975) predicts, "Unless changes are made in prevention and treatment, there will be 1.5 million reported cases of child abuse in the next 10 years (including) 50,000 deaths and 300,000 permanently injured children-most of whom will be brain damaged" (p. 482). The problem of child abuse and neglect has been studied and discussed from many perspectives and by many disciplines-law, medicine, social work. psychiatry, education, and psychology. Causative factors have been identified, referral systems have been established, legislation requiring the reporting of suspected cases has been enacted, and prevention and treatmen t programs for children and parents have been implemented. However, little attention has been given and even less recording in the literature has been done regarding the relationship between abuse and handicap. For teachers, administrators, clinicians, teacher educators, and others who work with handicapped children, a number of questions arise and need to be answered.
November 1975
In discussi ng the charac teris tics of a n ab used ch ild. S andg rund , Ga ines, a nd Green (197 4) s ta te th a t a ch ild with cog nitive or neurol ogi cal defic its w hic h mak e his beh avior pr ovocati ve a nd unman a geable ha s a grea tly inc reased pro ba bilit y of ab use whe n a st ressful s it ua tio n occ u rs with an a buse pron e paren t. By th eir definit ion , "the 'abu s e pron e' parent is one wh os e negat ive se lf image frequ entl y for ces him or h er int o unreali sti call y loft y ex pec ta tio ns of th e ch ild which wo uld be vir tua lly imp os sibl e for eve n an intellec tua lly normal yo u ngs ter to fu lfi ll" (p . 32 9 ). T hey beli eve mentall tarde r neurologicall y handicapp ed i1dren reinforc th e negati ve se lf image of l h is type of parent Morse, S a ler, and Friedman (197 0 ) in a s tudy of 25 a used children fou d th at 15 of th e ch ild re n were considered different b y th eir p arent s. ine of the chi dren wer e retaroe . th e d w ere thoug ht by th ei r arents to be SIC I . S ix others were vie we d arents as bad, selfish, spoiled rotten, by a red to siblings. or defi ant c This a rticle will rep ort data a nd inf orma Fri edm an 1972) postulates that so me ti on on chi ld a buse as it rel at es to hand ichildren are hyperactive or intellec t u"......'!!"'"'_ a b u ca p pe d ch ild re n. di scu s s th e role of e ally precocious s found that in so me teach er a nd sc hoo l. id ent ify as pec ts of c . ·~:: :;-- Ga is es,.1 rt e' mquisitiv e b avior of a child who abus e tha t n eed fur the r in vest igati on , a nd is intell ectu all y mor e ca ble than his parents ca uses him to be mor e v u erable to abuse . ou tli ne curre n t prog ram s, projects , a nd reso urces . Dis tr essing ca se s tudie s of ch ild ab use and negl ect will not be det ail ed her e. It In hi s 1967 nati onwid e study of 5.99 ph ys icall y ab use d ch ildre n. Gr ms is eno ug h to say th at ch ild re n ha ve su ffe re d in ed th e fun ction ing du ring th e yea r precedre ject ion , aba ndo nme n t, sex ua l a buse. verba l ing th e ab use of a sa mp le of 1.380 ch ild re n. Of a t tac ks, a nd ph y si cal in ju ry w ith every pos si th ese ch ild ren, 29% sho we d deviati ons in bl e ob jec t to eve ry part of th eir bodies. Man y soc ia l interac tio n and ge nera l fun ction ing , ab us ive ac ts ca use th e death of th e ch ild. Exampl es of rep ort ed ph ysi cal a nd psych o14 % sho wed devi ati on s in ph ysical fun cti oning . and 8% sho we d dev iation s in in te llec tua l logical ab use and negl ect in clud e eve ry cr ue l fun ction in g. Of th e ch ildren of sc hoo l age. 13% ac t imag ina ble and so me b eyond imagina tion. we re in grades below age level or in speci a l classes for th e ret ard ed . Nearl y 25 % of th e chi ldren had been cha rac te r ized on th e rep ortSusceptibility of Handicapped ing for m a s ex h ibi ti ng "pe rsis ten t b eh a vi oral Children to Abuse a ty pica li ty ." Studi es of th e nature and cau se of child a buse Mor e recently , Lebs ack (1975 ) r epo rts preha ve exa mine d a numb er of va ria bles, incl ud lim in ary inci de nce d at a from 22 st at es and in g parent personalit y cha ra cte ris tics, famil y ter rit ori es usin g a s ta nda rd a buse a nd negl ect int er a ction patt ern s. s tress situation s , a nd re po rt ing for m d evelop ed by th e National cha rac te ris tics of th e a buse d ch ild. Alth ough Clearingh ouse on Child Abuse a nd Negl ect a t th e Am eri can Hum an e Association , Den ver. no ma jor co mprehe ns ive res earch has exa mColor ad o. Pr elim in ary a na lysis of th e 19 74 in ed th e ex is te nce of a h andicap as a ca usa t ive dat a reveal ed a tot al of 14. 083 a buse d a nd fa ct or of abuse and n egl ect , severa l renegl ected ch ild r en of w ho m 1 .680 ha d one or sea rc he rs ha ve rep orted findin gs w hic h re more dis ti ng uis hi ng charac te ris tics. vea l a poss ibl e rel a tion ship. Other s t ud ies Mor e speci fica lly. 195 chil d re n we re bo rn ha ve ind icat ed tha t ab use d ch ildre n a re see n prem a turely , 288 we re men tall y ret arded . 234 as d ifferen t or difficult to rais e by th eir wer e ph ys icall y hand icapp ed , 25 0 had a pa rent s .
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chronic illness such as diabetes or multiple sclerosis. 130 were from a multiple birth. 180 had a congenital handicap or birth defect. 669 were emotionally disturbed and 267 were reported as having "other special characteristics ." The data was supplied by social workers conducting home interviews . A revised reporting form will help social workers to obtain professional judgment before reporting a handicapping condition. Lebsack noted that the percentage of handicaps could be expected to increase if social workers received special training in how to diagnose a handicap. In an extensive revie w of the literature in the areas of education . medicine. psychology. social work, and law, Kline (1975) and Kline and Hopper (1975) found no study establishing a definite cause effect relationship between handicap and abuse. However, some studies do indicate a correlation, and professional opinion suggests such a relationship. Helfer (1975) contends that it is difficult to determine whether the abuse or the handicap came first. Did the abuse cause the handicap or was the handicap responsible for the abuse? However. he feels that a child who is handicapped, different. orpe rce ived as different is at risk and more likely to be abused by a family that is abuse prone than a nonhandicapped child in the same family .
Consequences of Abuse to Children The research literature is more ext ensive and definitive on another aspect of th e relationship between abuse and handicap-abuse as a cause of handicap. Studies of abused children have reported high incidences of retardation, emotional disturbance, physical defects, neurologic problems, and growth failure. Sandgrund, Gaines, and Green (1974) in a study of 60 abused, 30 neglected, and 30 nonabused control children aged 5 to 12.9 years found a significant difference between abused, neglected. and nonabused subjects on both verbal and performance IQ measures. On the full scale. 25 % of the abused group, 20 % of the neglected group, and 3% of the con trol group scored below 70 . The proportion of abused and neglected children w it h IQs below 70 was nearly 10 times that of the con trols . The resea rchers concluded that cognitive imp airment appears to be closely related to both child abuse and child neglect. However
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they also stated, "It remains to be shown conclusively whether cognitive impairment antedates abuse or is one of its effects" (p. 329J .
Martin (1972) reports a three year followup stud y of 42 abused children. Of these chil dren, 18 were neurologically handicapped , 14 scored below 80 on an IQ test, 14 demon strated failure to thrive on admission (hei ght and /or weight below third percentile] , and 16 were language delayed even after intervention. In another followup study of 58 abused children, an average of 4.5 years after the ph ysical injury , Martin, Beasley, Conwa y, and Kent (1974) report 31 children hadneurological handicaps ranging from serious to mild . Of these 31, 18 were severely handicapped. One third of the children had growth failure when the abuse was originally identified; half of this group was still described as exhibiting growth failure at the lime of followup . Children with a history of head trauma and/ or present neurological impairment scored significantly lower on tests of intell ectual performance than the rest of th e group. The parents of these 58 children had received th erapeutic intervention, Martin et a1. [1974) conclude that, While the am ount of data is small, it is clea r that th e ab used chil d is at high risk for dam age to his ner vous syst em and maldevelopment of ego func tions . Actual loss of centra l ner vou s s yst em tissue by ph ysical trauma accounts for the mortalit y a nd mu ch morbidit y in the se child ren. How ever , mor e s ub tle effects of the en vircnment that may be assoc ia ted with the abusi ve home a re beginn ing to be recognized. The a busi ve envi ronment, apart from the actual ph ysical trauma , imp a irs the dev elopment of the child neurologically . cogn it ive ly, and emotionally . [p, 43)
A similar interpretation of the relat ionship between handicap and abuse is offered by McRae , Ferguson, and Lederman (1973), who s ta te, S ev er e ph ysical abu se is pred ict ive of unu sual difficulties in development. Onl y on e cond itio n app ears to result from abuse alon e a nd that is ph ysi cal in jury, in particular brain dama ge, whi ch can be fat al. What is de va st a tin g is the as socia tion of ma tern al depriv ation or dist ort ed par ent-child in tera ction which pr ecludes normal ment al de vel opm ent in th e ch ild ren who ex perience tr auma at a vu lner able age. [ p, 864)
The followup study of abused children conducted by these research ers located 46 November 1975
children. Of this group 8 had died, 4 were institutionalized, 12 were mentally retarded, 3 were disturbed, 3 showed evidence of brain damage. and 16 were normal. In an earlier followup study Elmer and Gregg (1967) reevaluated 20 children who some years earlier had been treated for child abuse in a hospital. At the time of Iollowup, 8 of the 20 children were emotionally disturbed. 10 had IQ scores below 80, and only 2 were considered normal in all areas evaluated. Of 10 children who were in an improved environment (such as a substitute home). 7 scored in the normal range on intelligence measures. Of the 10 still living in their original homes, only three were of normal intelligence. Later information obtained by the researchers indica ted five of the children would probably become public charges because of mental retardation or serious emotional problems and several would need a sheltered environment to remain in the community. Elmer (1963) also conducted a followup of 42 children who had received hospital treatment for multiple bone injuries from suspected abuse, Over half of the group had either died. been institutionalized or rehospitalized. or were handicapped. Seven had serious physical defects and four were seriously mentally retarded. A nationwide survey of hospitals by Kempe, Silverman, Steele, Droegemuellerand Silver (1962) received replies from 71 hospitals reporting 302 cases of battered children over a one year period. Of this group, 33 children died and 85 suffered permanent brain injury. Fitch (1975) reports that Denver Department of Health and Hospital researchers in a longitudinal study of abused children found that developmental scores of abused children were significantly lower than those of nonabused children. In studying the scores of children diagnosed as neglected, the researchers found a drop in developmental test scores between hospitalization and retesting after six months. Fitch holds the position that neglected children can suffer a greater intellectual handicap due to lack of stimulation than abused children who often have love, stimulation. and a positive relationship with parents even though at times the parents cannot control certain impulses. In a far reaching recent report Caffey (1974) says, "Casual. habitual, manual whiplash shaking of infants is a substantial primary frequent cause oflater men tal retardation and
Exceptional Children
permanent brain damage" (p. 396). The manual whiplash shaking of infants leaves no external signs of injury to the head, face, or neck. But it does cause massive intracranial and intraocular bleeding. This damage is often unnoticed by parents and physicians. Caffey states that habitual and prolonged whiplash shaking of an infant may produce a syndrome which is first noticed "at school age when minor idiopathic cerebral motor defects are first detected along with mild idiopathic mental retardation. Permanent impairments of vision and hearing may also be identified at this time for the first time when the children are five to six years of age" (p. 402).
Responsibilities of Educators Educ a tors and others who work directly with children have an excellent opportunity and a grave responsibility to identify and properly report suspected cases of child abuse or neglect. Proper identification and reporting to the appropriate local child protection agency enables the child to receive treatment for injury and protection from additional abuse or neglect. Gil (1969). an early researcher into incidence of child abuse, saw the important role of classroom teachers. He states "The classroom teacher should become the most important link in the preventive and protective chain. since his daily contacts put him in a strategic position to observe early indications of abuse" (p. 2). Teachers, principals. and other school system personnel must educate themselves about the problem of child abuse. about their state legislative requirements and provisions, about their school policy and local reporting procedure, about the symptoms that indicate a child may suffer abuse or neglect, and about how they can assist the abusing parent. Drews (1972) states, Children will continue to be abused and, in turn, become the abusers themselves unless the schools recognize their role and responsibility in the reporting of their suspicions and developing a close working relationship with the agency that receives their report. (p. 123)
Signs and Symptoms of Possible Abuse and Neglect
Indicators of a child's need for protection listed by the American Humane Association
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(1971) pr ovid e helpful information on id entificat ion of ch ild re n suffering a buse . Tea ch er s a re ad vised to be a lert to th e ch ild's beh a vi or a nd a ppeara nce a nd th e a t tit udes of parents . Sp ecifi call y , is th e ch ild agg ress ive, d is ru p tive, de s truc tive. shy. w ithdra wn . pa ssi ve, or ov erl y comp lia n t? Is he frequ entl y abse n t or lat e, or d oes he a rr ive ea r ly an d stay lat e? Regarding hi s appearance. is he ina dequ a tel y dress ed for th e wea ther. unk empt , dirt y. un dernour ish ed . tired , in need of med ical a tte n ti on or fre q ue n tly inj ure d? Does he ha ve bru ises , w elt s . a nd cont usio ns? Does he co mpl ain of beat ings or malt reatment ? Par ent al a t tit udes ca n be sy mp toma tic of ch ild abuse or negl ect. Ar e pa rent s aggressive or abus ive w he n as ked abo ut pr oblem s co nce rni ng th e child? A re th ey a pa the tic or unresp on si ve? Is pa rental be havio r bi zarre or s tra nge? Do parent s sho w little conce rn abo u t th eir ch ild or littl e int er es t a bo ut his ac tiv iti es ? Do th ey fai l to pa rti cip a te in sc hoo I ac ti v ities or a llo w th e ch ild to pa rti cip at e?
School Services to the Family
Helfer (1975) beli eves tea ch er s co u ld obse rve a nd ide n tif y cases of pot en ti al a buse, a nd the n wo rk with th e fam ily to prevent the occ urren ce. Ideall y , an ind epth hi st or y wo u ld reo vea l how parent s were tr eat ed as ch ild re n and wh eth er th ey we re a buse d . negl ect ed , or ha d a negati ve re la t ions h ip w ith their pa rent s . S uc h a fa mil y wo uld be conside red hi gh ris k . He sta tes, Most people w ho were reared poorly have ver y unrealisti c expectations of what their ch ild ren are supposed to do for them. If th ey superimpo s e on thes e unrealistic expectations a handi capped child . who ca n't anywhere near meet th em . then th e ch ild is in tro ub le.
Ideally , th e s pecial education s taff wou ld prov id e ex tra su pportive help to such a family . inc ludi ng assis ta nce in deve lop ing reaso nab le expec ta tions for th e child. How ever. Helfer con te nds the ta sk is made more diffi cu lt by th e fac t tha t these parent s a re ge ne r's activities . Iy not involved w it h th e sc P.a non y r (197 5), cofo und a nation al sel a pparents w t s th a t tea ch e re ca pa ble of making a so s hou ld b orne more i
School Policy on Abuse Reporting
All sta tes ha ve child a buse rep orti so me s ta tes suc h rep or tin g is mand fin es or imp ris on men t is pr ov ided fo nat ed ind ivi d ua ls w ho fail to rep ort. S pr ovi de for immunity fro m cr iminal or ci ac tion for peopl e rep or tin g a buse case s. T he abuse re po rti ng po licy of the Wa y Westlan d sc hoo l di st ri ct in Michi gan (Marti n, 19 73 ) incl udes provi si on of in forma ti on to sch ool personn el on how to recog nize a buse and neglect . rem ind ers to sc hoo l personnel a bo u t th e s ta te law requ iring child abus rep orting, a nd ex pla na tion s of the details r. ~ rep orting, su ch a s n otification of paren ts . sch ool admini strati on . and hospital. P.r sions of in forma tio n on how to transpo'lmtute--' ch ild to the hospit al for exa mina tion, and ho w to write re po rts. a re a lso include d . Montgom er y Count y , Ma ryl an sc hoo ls (Poli cy St at em ent. 1974) provide teach ers with a print ed policy sta te me n t whi ch gives in form at ion on relevant sta te ' legi sl at ion , de tai ls th e exac t ab use re po rting ' pr oced ure. s pecifies the con te nts of ora l a nd written re po r ts, and desc r ibes wha t co ns titut es a buse and negl ect. Per iodi c staff deve lop men t on th e subject is pro vi ded.
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November 19 75
types of abuse and symptoms . The reporting pro cedure and the responsibility for reporting are described. Suggestions for relating with the child and the family are provided. Although the training packages are tailored to legislation and procedures in Texas, they can easily be adapted to the needs of other states. As part of a comprehensive program of public and professional education, Community School District 18 in Brooklyn, New York (Gross, 1975] has provided orientation about child abuse for teachers, guidance counselors, and pupil nersonnel workers in district, private, and parochial schools, as well as an open school board meeting on child abuse . When children are identified as abused, resource personnel act as a liaison between the school and home, interpreting problems and assisting the teacher. Individual counseling is provided for the child. Project Protection (Learning, 1974] in Montgomery County, Maryland , is revising school policy, developing new curriculum for high school students and parent education programs , and training staff to identify child abuse or neglect. Training activities include conferences and staff development in each school. Guidelines and procedural manuals are being developed.
Federal Programs on Child Abuse and Neglect In 1974 Congress passed the Child Abuse Prevention and Treatment Act (PL 93-247] which established a National Center on Child Abuse and Neglect and authorized grants for child abuse programs. Six months prior to passage of the act, HEW had established an Interdepartmental Committee on Child Abuse and Neglect which provided funds for new projects on child abuse. The federal assistance helps states and local communities in the identification and prevention of abuse and in the provision of services to abused children and th eir families. A number of projects funded through the Interdepartmental Commit tee deal with characteristics of abused children , conseqences of abuse to children , incidence rates , the role of the teacher and other aspects of abuse and neglect that are of particular in terest to special educators. Brief descriptions of several of these projects follow [HEW, 1975] :
Exceptional Children
• The US Office of Education is developing models to train teachers to identify and work with abused children and to work effectively with community agen cies treating abuse. • The National Institute of Child Health and Human Development is designing a biomedical and behavioral research program on the effects of abuse and neglect on the developing child. • The Bureau of Community Health Services is funding research projects to study treatment of child abuse in health ca re settings, including the study of child abuse in ins tit u ti ons and the development of high risk infants. • The National Institute of Mental Health is conducting a project to develop and test tra ining models for medical, mental health, welfare, school, and law enforcement personnel. Training focuses on the identification, treatment, and prevention of child abuse. The National Center on Child Abuse and Neglect located in the Children's Bureau, Office of Child Development (OCD) will implement the Child Abuse Prevention and Treatment Act by conducting research about incidence, causes, prevention, and treatment; publishing annual research summaries ;establishing an information clearinghouse ; publishing training materials; providing technical assistance; providing for training activities; establishing regional centers for services ; and funding states for prevention and treatment programs. Several specific projects and activit ies of the National Center (HEW, 1975] are ofparticular interes t to educators working with handicapped children: • Herner and Company in Washington, DC is setting up a computerized clearinghouse on child abuse and neglect programs and producing a research summary. • Burt Associates , Inc., in Bethesda, Maryland, is conducting an incidence feasibility study to examine alternative ways to collect national incidence data . • Urban and Rural Systems Associates in San Francisco is de veloping cur ricu la about identification, reporting, and referral to train medical, education, social service, and law enforcement personnel. • Twelve demonstration centers were funded in December 1974 to manage cases
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of child abuse and neglect through treatment, public education, 24 hour hot lines, agency coordination, and other activities. • Eleven resource projects to promote effective use of community resources and initiation of services in dealing wi th child abuse and neglect were funded in December 1974. The resource project (HEW, 1974) at the National Center for the Prevention of Child Abuse and Neglect (University of Colorado Medical Center) will offer direct services including play therapy, a therapeutic playschool. and a crisis nursery. A resource project (HEW, 1974) at the Education Commission of the States in Denver is studying the role of the educational system and will make surveys of teacher preparation and state and local educational policies and codes concerning child abuse and neglect. This project will also develop a data base on child abuse and the public schools. A National Advisory Committee will be established to find alternative ways the public schools can identify and prevent child abuse and neglect. Regional conferences for educators and others will be conducted. Additional federally funded projects announced in Jury 1975 include 15 research grants to study factors contributing to child abuse and neglect. the relationship of drug and alcohol use to child abuse and neglect. factors causing parents to stop or resume abuse. and measures for cost effectiveness of services to abused children and their families. Ten new innovative demonstration projects were funded to provide services to target populations not within the normal service delivery systems-native American communities, rural areas, and military communities. Six resource projects to develop community services also received grants.
cause of abuse. Helfer (1975) suggests research to determine if handicapped children are at higher risk for abuse than nonhandicapped children, and why schools for the handicapped do not become more involved in possible child abuse cases. Kline (1975) recommends research into the educational correlates of child abuse such as the relation between central nervous system damage and specific learning disabilities and the relation between abuse and later educational placement. Lieber (1975) encourages research into effective ways schools can seek positive and practical involvement with families who have problems. Communities must provide accessible and effective counseling and support to abusive parents. Individuals who work with children must be alert to the problem and report suspected cases. Preservice teacher education programs must make prospective teachers aware of the problem and their responsibilities. Educa tion for parenthood programs at the secondary school level must provide more information about emotional and behavioral requirements of child rearing, reasonable expectations of children, and community services. Schools need to develop detailed policies, procedures. and inservice teacher education for identifying and reporting suspected cases of child abuse and neglect. School programs should work cooperatively with appropriate community agencies to meet the therapeutic needs of these children. As Martin (1972) states, It must be recognized that subsequent growth and development of these children-physical, neurologic, cognitive, emotional-are dependent in large part upon our ability to develop effective therapy for these children ... Methods of intervention can and must be developed to maximize the chances for the children to grow and develop into adequate healthy adults without the legacy of retardation, inadequacy, dependency, and loneliness. (p. 112)
Recommended Research and Services Research into several aspects of child abuse and neglect is needed for effective design of resources. Fitch (1975) cites the need for exploring qualities in a child that lead to abuse, studying the type of input a child adds to the situa tion, and examining possible mismatches between parental expectations of the child and actual child behavior as a possible
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References American Humane Association, Children's Division, Guidelines for schools. Denver: Author, 1971. [Pamphlet) Caffey, J. The whiplash shaken infant syndrome: Manual shaking by the extremities with whiplash-induced intracranial and intraocular bleedings, linked with residual permanent brain
November 1975
damage and mental retardation. Pediatrics, 1974,54,396-403. Drews, K. The child and his school. In H. C. Kempe & R. E. Helfer (Eds), Helping th~ bottered child and his family. Philadelphia: J. B. Lippincott Co. 1972. Elmer, E. Identification of abused children. Children, 1963,10(5),180-184. Elmer, E., & Gregg, G. S. Developmental characteristics of abused children. Pediatrics, 1967, 40, 596-602. Fitch, M. Telephone communication. Denver Department of Health and Hospitals, Denver, Colorado, May 1975. Friedman, S. B. The need for intensive follow-up of abused children. In H. C. Kempe, & R. E. Helfer, [Eds.], Helping the battered child and his family. Philadelphia: J. B. Lippincott Co., 1972. Gil, D. G. What schools can do about child abuse. American Education, 1969, 5(4], 2-5. Gil, D. G. Violence against children: Physical child abuse in the United States. Cambridge MA: Harvard University Press, 1970. Grass, N. Telephone communication. Community School District 18, Brooklyn NY, May, 1975. Helfer, R. E. Telephone communication. Department of Human Development, College of Human Medicine, Michigan State University, East Lansing MI, May, 1975. Kempe, C. H., Silverman, F. N., Steele, B. S., Droegemueller, W., and Silver, H. K. The batteredchild syndrome. Journal of the American Medical Association, 1962, Vol. 181, 17-24. Kline, D. F., & Hopper, M. A. An integration of the research related to education of children handicapped as a result of child abuse (Final report). Logan UT: Utah State University, 1975. Kline, D. F. Telephone communication. Department of Special Education, Utah State University, Logan, UT, April, 1975. Learning (Newsletter of the Montgomery County Public Schools, Rockville MD). September, 1974. Lebsack, J. R. Telephone communication. National Clearinghouse on Child Abuse and Neglect, American Humane Association, Denver CO, June, 1975. Lieber, L. Telephone communication. Parents Anonymous, Inglewood CA, May, 1975. Martin, D. L. The growing horror of child abuse and the undeniable role of the schools in putting an end to it. American School Board Journal, 1973, 160. 51-55. Martin, H. P., Beezley, P., Conway, E. F., & Kempe, C. H. The development of abused children. Advances in Pediatrics, 1974, 21, 25-73. Martin, H. The child and his development. In H. C. Kempe & R. E. Helfer [Eds.], Helping the battered child and his family. Philadelphia: J. B. Lippincott ce.. 1972. McKenty, S. B. Telephone communication. Education Consortium C, Houston TX, May, 1975.
Exceptional Children
McRae, K. N., Ferguson, C. A., & Lederman, R. S. The battered child syndrome. Canadian Medical Association Journal, 1973, 108,859-866. Morse, C. W., Sahler, O. Z., & Friedman, S. B. A three-year follow-up study of abused and neglected children. American Journal of Diseases of Children, 1970, 120,439-446. Montgomery County Public Schools. A policy statement on child abuse and child neglect. Rockville MD: Author, August 26, 1974. (Pamphlet] Sandgrund, A., Gaines, R. W., & Green, A. H. Child abuse and mental retardation: A problem of cause and effect.' American Journal of Mental Deficiency, 1974, 79,327-330. Shanas, B. Child abuse: A killer teachers can help control Phi Delta Kappan, 1975, 479-482. US Department of Health Education and Welfare, Office of Human Development, Office of Child Development, Division of Public Education. Child abuse and neglect activities. Washington DC: US Department of Health, Education, and Welfare, 1975. US Department of Health, Education and Welfare, Office of Human Development, Office of Child Development, National Center on Child Abuse and Neglect. Child abuse projects funded, December, 1974. (Pamphlet) Washington DC: US Department of Health, Education, and Welfare, December, 1974.
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40 filmstrips and cassettes States Capitals Major cities and products Major U.S. regions National parks Waterways forming boundaries Major U.S. landforms Write or call: General Electric/Project LIFE Program Instructional Industries, Inc. Executive Park Ballston Lake, New York 12019 (518) 877·7466
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