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Authors: Mary Papenfuss

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Gelles has viewed such families as the “canaries in the violence mine shaft” of American society. He worried that an alarming cluster of the murder-suicides the last few years was an indication of the start of a surging domestic-violence and child-abuse problem across society that had yet to reveal itself due to the lag of statistical information behind actual occurrences, as well as the time it takes for families to fully experience and react to the impact of a faltering economy.

A 2012 study by the PolicyLab of the Children's Hospital of
Philadelphia apparently discovered that very link from the economy to violence against children in the family.
13
In the largest study to examine child abuse within the recession, researchers discovered a significant increase over the last decade in the number of sons and daughters admitted to the nation's largest children's hospitals due to serious physical abuse. While admissions for accidental injury declined, researchers found that admissions at 38 hospitals for overall physical abuse of children under the age of six increased by 0.79 percent a year, with admissions for traumatic brain injury suspected of being linked to abuse increased an astounding 3 percent each year between 2000 and 2009. The study also tracked a corresponding increase in local mortgage foreclosures as a gauge of the economic downturn and a possible marker of economic stress. Each 1 percent increase in 90-day mortgage delinquencies over a one-year period in a specific community generally corresponded to a 5 percent increase in local hospital admissions due to traumatic brain injury suspected to be a result of child abuse.

“We were concerned that health care providers and child welfare workers anecdotally reported seeing more severe child physical abuse cases, yet national Child Protective Services (CPS) data indicated a downward trend,” the study's lead author, Dr. Joanne Wood, an attending physician at the Children's Hospital of Philadelphia, said in a statement. “It's well known that economic stress has been linked to an increase in child physical abuse, so we wanted to get to the bottom of the contrasting reports by formally studying hospital data on a larger scale.”

Results suggest that “housing concerns were a significant source of stress within communities and a harbinger for community maltreatment rates,” her study concluded.
14
“This is not surprising given the magnitude of foreclosure and housing crisis that marked the recession.” The data highlighted the value of using hospital-admission statistics along with child-welfare data to “ensure a more complete picture of child abuse rates both locally and nationally,” noted Wood. The research also underscored the need to “better understand the stress that housing insecurity places on families” and its impact on violence in the home, she added.

Child abuse and fatalities in US homes are shockingly high. “We've got a problem, and it's a big one,” Michael Petit, executive director of the Every
Child Matters Education Fund, a non-profit organization that battles abuse, told me. His organization estimates some 21,000 American children have died due to neglect, abuse, or outright homicide in the home over the past decade. That's three times the total number of US soldiers killed in Iraq and Afghanistan.
15

The United States has one of the three highest rates of child-maltreatment deaths among wealthy nations, according to a 2003 study by the United Nations Children's Fund (UNICEF), the latest in a series of “report cards” on worldwide child fatalities, and that's before taking into account child homicides by parents that aren't registered as abuse deaths, such as those that occur in a William Parente kind of family annihilation.
16
The United States tallied 2.4 annual deaths per 100,000 children in 2002, compared to 1.4 for France, 1 in Japan, and 0.9 in Britain, according to the UNICEF calculations. The child-maltreatment death rate in the United States that year was triple Germany's and 11 times that of Italy. Rates in the United States, Mexico, and Portugal—the three nations with the worst records—were as much as 15 times higher than the average for the countries with the best records—Spain, Greece, Italy, Ireland, Norway, and the Netherlands.

As dispiriting as the statistics are, they under-represent the true problem because of gaps and inconsistencies in the way the figures are gathered. In the United States, child deaths are tallied very differently across the nation due to different protocols, definitions of abuse, and legal-reporting requirements in various states. The proportion of child deaths followed by autopsies to determine the exact cause of death, for example, can range from 13 percent to 82 percent, depending on different state requirements, indicating that many communities are likely missing many deaths caused by abuse, notes the UNICEF report.
17
Even when deaths are investigated, it can be difficult to determine exact cause. “Did the two-year-old fall from a window or was he dropped? Was the newborn baby a victim of Sudden Infant Death Syndrome or was she suffocated?” asks the report. “Did the month-old baby drown in a moment of inattention or was she held under? Was the broken neck the result of a trip or a push? Was the cerebral trauma caused by a fist or a fall?”

Poverty and stress, along with drug and alcohol abuse, “appear to be
the factors most closely and consistently associated with child abuse and neglect,” the report determined.
18
A pithier profile of the typical killer might be “jealous drunks with guns,” author David Adams noted at the National Institute of Justice conference on domestic violence. His book,
Why Do They Kill? Men Who Murder Their Intimate Partners
, touches on child murder in family annihilations.

Child-maltreatment fatalities in nations tend to follow rates of adult homicides, the UNICEF study noted. “The three nations with very high levels of child deaths from maltreatment—the United States, Mexico and Portugal—also have exceptionally high adult homicide rates,” while the “same small group of countries that have extremely low rates of child death from maltreatment also have very low rates of adult homicide,” it concluded.
19
“In between these two extremes lie the bulk of industrialized nations, all with fairly low rates of child maltreatment deaths and variable rates of adult homicide.”

In the most conservative estimates, nearly five children a day died from neglect or abuse in America in 2011.
20
The frightening vision of a young child snatched from a front yard or walking to school to meet his or her death at the hands of a stranger is a relatively rare occurrence, despite the fascination such situations holds for the public and for the media. The most lethal people in child victims' lives are their parents, relatives, or a parent's lover. There has been little improvement in the United States in the number of child fatalities due to abuse or neglect for years. That's a surprise, because despite the grim statistics—and the PolicyLab's findings and some other studies aside—federal data indicate that child abuse in the United States is the lowest it has been in two decades. But the statistics present problems in calculating both abuse and maltreatment deaths, and it's nearly impossible to find officials or experts who believe the national numbers represent an accurate picture, particularly in tracking child fatalities.

Abuse and abuse-fatality figures are gathered in the federal National Child Abuse and Neglect Data System (NCANDS) by the Children's Bureau of the Department of Health and Human Services, which has collated statistics voluntarily provided by state agencies since 1990. The numbers are linked to a hodgepodge of definitions of abuse that vary by state, and a
variety of reporting requirements, though they meet basic federal standards set by law. NCANDS tabulates abuse and neglect cases addressed by local Child Protective Service agencies. States unable to provide this information for whatever reason generally submit aggregate counts of indicators of child maltreatment. An estimated 3 million children were the subjects of reports of suspected maltreatment or neglect in 2011.
21
Following investigations, approximately 681,000, children (more than one a minute) were determined to be victims of at least one incident of child abuse or neglect, or an average of 9.1 of every 1,000 American children. Babies, from birth to age one, had the highest rates of abuse or neglect, with 21.2 of every 1,000 children affected. Boys were affected at about the same rate as girls.
22

Based on state reports, NCANDS estimated that 1,570 children died from abuse and neglect in 2011 (the highest estimate in the previous four years was 1,740 in 2009); that's 2.1 fatalities per 100,000 children, the same rate as the previous year (compared with 2.3 in 2009).
23
Four-fifths of the victims were under four years old, and boys had a higher fatality rate than girls. Four-fifths of the abuse and neglect deaths were caused by one or more parents. Mothers and fathers together were responsible for 22 percent of the deaths; a father alone was the perpetrator in 15.3 percent of the deaths, and a mother alone was responsible in 26.4 percent of the deaths.
24

Both abuse and fatality figures are almost universally believed to miss much of the problem. As for abuse, the number of children “officially reported to child protection systems substantially undercounts the total population of children who experience abuse or neglect,” according to a report for the national Centers for Disease Control.
25
A 2008 national survey of children's exposure to violence found that more than one in ten children surveyed suffered some form of maltreatment in the previous year,
26
which is ten times higher than the NCANDS statistics.

A statistical shortfall is also apparent in the number of maltreatment
fatalities
reported in the NCANDS stats, according to several experts and even many agencies that tally the numbers. A key issue is that a significant percentage of deaths never make it to the report because not all children killed by abuse have ever been part of a child welfare system, which in almost all cases is necessary to be included in data provided by individual
states. Even if children are part of the system, it can be challenging to make a final determination that a child's death was caused by abuse or neglect, as the UNICEF report noted. The determination of cause of death can be further complicated because it requires complex coordination and agreement among social workers, medical professionals, police, and local district attorneys and courts, the 2011 NCANDS report observed.
27

A 2011 study by the General Accounting Office (GAO) determined that NCANDS child-maltreatment fatality figures were likely significantly undercounted.
28
The GAO attributed the inaccuracy to a range of inconsistent definitions of abuse and reporting requirements across the nation, lack of training or experience in some communities dealing with or spotting abuse, and sometimes-inexplicable holes in data provided. The GAO found that three states didn't bother reporting their child abuse fatalities in 2009, and for some unknown reason 13 states didn't include statistics on children who died after they were returned home after a stint in foster care.
29

Officials must deal with a daunting array of different legal requirements and definitions. “At the local level, lack of evidence and inconsistent interpretations of maltreatment challenge investigators—such as law enforcement, medical examiners, and child welfare officials—in determining whether a child's death was caused by maltreatment,” noted the GAO in its assessment of the 1,770 fatalities in 2009 (up from 1,450 in 2005), when nearly six children a day died due to declared neglect or abuse.
30
Just as in the UNICEF report, the GAO also recognized the difficulty in determining when deaths are due to abuse or neglect. “Without medical evidence, it can be difficult to determine that a child's death was caused by abuse or neglect, such as in cases of shaken baby syndrome, when external injuries may not be readily visible,” investigators observed.
31
In addition, “at the state level, limited coordination among jurisdictions and state agencies, in part due to confidentiality or privacy constraints, poses challenges for reporting data to NCANDS.”
32
One study cited by the GAO found that maltreatment deaths in three states were undercounted by up to 75 percent.
33

Even states themselves struggle with inconsistencies among their own communities. Michigan officials told GAO investigators that when a separate agency cross-checked 2005 child-maltreatment deaths reported by the
local CPS with medical records for 186 cases, the analysis indicated that 37 child deaths labeled as natural, accidental, or undetermined should have been documented as maltreatment, noted the GAO researchers.
34
Officials from nearly half of the states told GAO investigators they needed more help to collect accurate data on child-maltreatment fatalities.
35

The GAO report emphasized that any comprehensive strategy to combat child deaths in the United States is already missing an essential piece of the puzzle: complete, reliable statistics. Lack of accurate data makes it “difficult to develop prevention strategies. We should be doing everything in our collective power to end child deaths and near-deaths from maltreatment,” the GAO concluded.
36
“The collection and reporting of comprehensive data on these tragic situations is an important step toward that goal.”

Even if NCANDS statistics were vastly improved to offer more complete statistics, they don't even pretend to present the complete picture of children killed by their parents. Nearly half of the reporting states only provided data supplied by child-welfare agencies—even though many children who die from abuse never have contact with such an agency. A sudden, inexplicable murder of a child—often in cases with no known previous instances of abuse or neglect—will not be in the abuse-fatality-tracking figures. As a homicide without prior reported abuse, William Parente's murder of his daughters, for example, would not make the NCANDS statistics. In fact, it's unlikely most of the five major homicides reported in this book made NCANDS stats, though murder at the hands of a parent is the ultimate child abuse.

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