April is Child Abuse Awareness Month Published April 3, 2017 By Ruth Sunde 92nd Medical Operations Squadron The British sculptor and writer, Herbert Ward once said, “child abuse casts a shadow the length of a lifetime.”For more than 30 years, America has acknowledged April as Child Abuse Awareness Month. Sweeping legislation throughout the 70s and 80s gave rise to the needed public awareness campaign. Despite these efforts, in 2014, the Center for Disease Control estimated over 1,500 children died from abuse and neglect in the United States.Just like the shadow Ward alludes to, the effects of child abuse and neglect go way beyond those fatalities. In 1995, Kaiser Permanente’s Department of Prevention Medicine in San Diego and the Center for Disease Control conducted a decade-long study involving over 17,000 individuals that looked at the effects of certain conditions within a child’s environment and how they shaped that child’s future.Their conclusion? Adverse childhood experiences such as emotional, physical or sexual abuse and neglect through abandonment or deprivation of basic physical or emotional needs increases the child’s likelihood of severe and persistent emotional problems, adult diseases, high health care costs and lowered life expectancy. Other contributing factors include parental substance use, domestic violence within the home, an incarcerated parent, a caregiver’s chronic mental health issues and the loss of a parent by divorce or death. These factors are what is known as Adverse Childhood Experiences.The study found that adverse childhood experiences are powerful determinants of who we become as adults, pointing specifically to neurobiological changes that create vulnerability to developmental delays, depression, anxiety, flashbacks and difficulty channeling anger and rage.The study found that certain health risk behaviors were also present with those who scored high on the ACEs quiz, such as a propensity for smoking, alcoholism, drug use, severe obesity, self-injury and a tendency towards interpersonal violence. Social problems associated with a high ACEs score include a compromised ability to parent, homelessness, teenage involvement in the criminal justice system, employment instability and engaging in or being a victim of interpersonal violence.What are the signs to look for? Aside from obvious physical injuries or a child reporting abuse, one of the signs can be a home that presents physical hazards to the child such as medication, cleaning agents, knives or other sharp objects that are accessible to small children. Clutter, such as laundry and clothing items, blocking exit doors or areas leading to stairwells is another hazard that can lead to negative outcomes. Inadequate clean-up after pets is another indicator of neglect within the home.It would be illogical to expect everyone to keep a home “white glove inspection clean,” however, the previously mentioned problems are examples that elevate the concern of the living conditions of a home from “unkempt” to “safety hazard.” Additionally, a neglected or unsafe home is oftentimes a sign of deeper problems such as an addiction to video games or social media, parental depression or substance abuse. When any of these circumstances leads to physical or emotional neglect, the child is the one who ultimately suffers.There are a multitude of base resources for parents to help raise healthy children, free from harm and neglect. The 92nd Medical Group Family Advocacy’s mission is to promote safe and healthy individuals, children and families. They provide a variety of services including individual and family counseling and parenting classes.If you suspect child abuse or neglect you may call the base Family Advocacy Office anonymously at 247-2687 during duty hours or Spokane’s Child Protective Services at 363-3333, 24 hours a day, seven days a week. If a child is in immediate danger, call 9-1-1 or local law enforcement.