Brain injury from child abuse is known as abusive head trauma, or AHT. The study, led by Rachel Berger and published in the current issue of Pediatrics, looked at the incidence of AHT from 2004 to 2009 in three portions of the country: six counties outside Seattle, 23 counties in the West of Pennsylvania, and 45 counties covering Ohio and North Kentucky. These regions were chosen because each had only a single trauma center, staffed by a trained child-abuse-prevention team throughout the years studied.
The study showed an increase in the AHT rate in all three areas, timed almost perfectly with the onset of the economic recession in December of 2007. The researchers found no change in demographics which could explain the increase.
Prior to the economic recession, about 8.9 children in every 100,000 were victims of AHT. Once the recession began, however, that rate rose to 14.7 AHT victims in every 100,000 children. Child brain injuries unrelated to abuse remained stable during that same time period.
The study did not attempt to explain the reason for the increase, and did not specifically tie the increase to the recession or economic difficulties. But the timing of the increase certainly suggests that the stresses associated with the economic downturn played a role in the increase.
This research is contradicted by two reports by the Administration on Children, Youth and Families, published in 2008 and 2009, each of which found no increase in child abuse, whether resulting in brain injury or otherwise, during the recession. This conclusion, however, was based only on confirmed abuse cases reported by child protective services agencies in each state, a much more difficult standard to meet.
But lining up with this research are several prior studies. For example a study in Child Development in 1981 found that child abuse rates went up when unemployment rates rise. A study published in Child Abuse and Neglect found the same correlation.
Interestingly, this most recent study did not find a direct correlation between unemployment rates and AHT rates. But unemployment is an imperfect measure of economic stressors – it does not include those who are underemployed, whose hours or pay has been decreased, or who have simply given up looking for work.
Also troubling was the fact that nearly seventy-five percent of the AHT cases were in infants under one year of age. Infants are particularly vulnerable, and a brain injury to a child often results in permanent disability or death.
What is not entirely clear is why, precisely, economic downturn has lead to higher AHT rates. One possible explanation is simply that adults under great stress are more likely to lash out or lose control. Another possible factor is that those who find themselves unemployed or underemployed may also suddenly find themselves spending more time in the company of their children – without the necessary experience in childcare or in dealing with the stress of caring for young children. And those who are still working, but at substantially lower pay, may be forced to accept lower-quality childcare.
Whatever the specific causes, if the increase found in the regions studied is consistent nationwide, this would mean thousands of additional children and infants victimized by brain injuries each year. We encourage anyone suffering from strain to seek help before they are close to losing control. Moreover, if you suspect that your child may have been injured – whether hit, dropped, or shaken – while in the care of another, seek medical attention immediately.
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