Authored By: Kori Stephens, Project Director, Midwest Regional Children’s Advoacy Center (MRCAC)
April is National Child Abuse Prevention Month — 30 days that recognize the need to protect the most vulnerable children in our community. It is our collective responsibility to prevent abuse from occurring and to assist children and families who have suffered abuse to heal without shame and blame.
Recently, I had the opportunity to meet a tribal judge and to share the important work of Children’s Advocacy Centers (CACs) to end child sexual abuse and exploitation. At the end of our conversation, the judge responded with a look of disbelief and said, “I am so blessed that we do not have this issue in our community.”
It wasn’t the first time I had heard this statement of disbelief — child abuse is something many people prefer not to acknowledge — but it still shocked me because American Indian children are exposed to violence at greater rates than any other race.
This brief interaction was a testament to just how long the road is to reversing the plague of child abuse. It renewed my commitment to work even more diligently to advocate for our children and to break the silence by which abuse and assault are able to proliferate without consequence.
CACs close the care gap
There are two things we can prove to be true — child abuse does not discriminate, and child abuse is a community issue. About one in 10 children will experience child sexual abuse before the age of 18. In 90 percent of those cases, the abuser is a family member or someone with whom the victim has a close and trusting relationship.
In the 1980s, we realized that the child protection system frequently resulted in more harm than good for child abuse victims. Children often had to relive their story over and over as they were carted from agency to agency, each agency looking for its own slice of information to meet the well-intentioned goal of protecting the child and seeking justice. There wasn’t the necessary infrastructure, specialization and support to meet the needs of sexually abused children and their families. Our systems lacked the expert skill needed to help these children along their healing journey.
This realization sparked the Children’s Advocacy Centers grassroots movement.
Now, almost 800 CACs across the nation see hundreds of thousands of kids each year. Rooted in each CAC is a multidisciplinary approach to investigating, prosecuting and healing the trauma experienced by its community’s children.
A CAC multidisciplinary team (MDT) brings together representatives from many sources —medical and mental health, victim advocacy, child protection, law enforcement, prosecution and the CAC. With numerous professionals contributing their assistance and expertise, a major benefit of the CAC MDT approach is that children have to share their experience only once.
Note: For those familiar with sexual assault response teams (SARTs) for adolescents and adults, it will be helpful to know that CAC MDTs are a child abuse counterpart and potentially comprise the same team members.
CACs were traditionally established to intervene in child sexual abuse. However, just as with adult sexual assault, child sexual abuse rarely manifests in a silo. Many children have experienced multiple types of abuse including physical and/or verbal mistreatment, exploitation, neglect and drug endangerment. We also know that child abuse has a deep tie with domestic violence and other violence in the home.
Many CACs work hand in hand with rape crisis centers and SANE programs at the local hospital or emergency department. Children and families impacted by abuse require ongoing support; CACs have the most expert knowledge to assess their needs and connect them with the right services.
Medical exams are essential to abused children
All CACs provide or refer children for medical care. The Midwest Regional CAC, based in suburban Minneapolis, serves a 12-state region and offers training nationwide.. We believe expert medical care for victims is crucial for not only the investigation but also, and most importantly, the healing of the child.
Only five percent of child abuse medical evaluations result in findings indicative of trauma. This is because children often delay their disclosure due to the complex dynamics involved with the abuser and the expectation or demand for secrecy. In addition, children’s bodies heal incredibly fast. So why should a child undergo a medical evaluation if there is little possibility of collecting evidence to assist in a criminal case?
The reason is to provide comprehensive medical care. These exams may be the first medical care a child has received, and they can help identify other illnesses or medical needs and assess for proper mental health treatment. The majority of children seen at CACs are under the age of 12, and many are living in poverty with limited access to and utilization of a primary care provider. For adolescents, these medical evaluations provide an opportunity for educating them about pregnancy prevention and sexually transmitted infections. Every medical provider I have worked with in this field can tell story after story about the relief a child exhibits after being reassured his or her body is normal. It is truly an essential part of the healing process.
Exams must be appropriate for abused children
Medical evaluations of children are very different from evaluations of adolescents and adults, and they require appropriate training and experience. A common myth is that medical evaluations for child abuse victims are painful and traumatic, with the experience being much like a normal gynecological exam. However, this is absolutely not the case. For prepubertal children, a proper exam is not invasive and never involves the use of a speculum. It does involve a head-to-toe well child check-up that allows the provider to examine for other marks on the body or medical conditions.
Many times the children referred to CACs present at primary care clinics or in the emergency department. If you work in either of these settings, it is important that you and others in the facility gain education around the signs and symptoms of abuse. If this is not possible, contact us at the Midwest Regional CAC to learn where to refer possible abuse victims for proper medical attention
I can’t stress enough the importance of a collective response to protect our children from abuse and neglect. We all have the opportunity to transform the systems within which we operate to be more welcoming and safe for children and their families. We have a responsibility to protect our nation’s future and to do what we can to ensure every child a safe and healthy childhood, free from abuse and violence.
For more information about CACs and our mission, services and resources, please visit the Midwest Regional CAC website.