Child abuse in the time of COVID

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“I used to only have to deal with him touching me after school — now it’s all the time.” “She’s doing drugs more because she lost her job last week; she started hitting me again.” As a pediatrician-in-training, I’ve been concerned about my patients’ safety with schools closed, jobs lost, and family stress at all-time highs. As a Crisis Counselor, receiving these messages on recent shifts confirmed my fears that coronavirus is making way for a second pandemic: an outbreak of child abuse.

Roughly 700,000 children are abused in the U.S. annually. Child abuse is overwhelmingly perpetrated by a relative (90%), and 4 out of 5 instances of child abuse are perpetrated by parents. We know the numbers of reported cases and substantiated child abuse cases increase in the months following natural disasters. We also know financial hardship, unemployment, and family stress increase risk of child abuse, such as during the Great Recession.

Coronavirus is creating dangerous circumstances. Regional employers reported over 15 times as many layoffs last month than in March 2019. Many cities had high rates of family poverty, food insecurity, and homelessness before coronavirus; these vulnerable families are now struggling even more. School closures are forcing families to teach and care for their children full-time while trying to stay afloat. Caregivers battling mental health conditions or recovering from substance use disorders must accomplish this with decreased access to needed support services. Children experiencing disasters require more support than usual, and are more likely to act out. Finally, children are spending more unsupervised time online, heightening their risk of sexual exploitation.

Child abuse reporting often decreases acutely during disasters. We’re already seeing this — for instance, PA ChildLine, Pennsylvania’s reporting line for suspected child abuse, received about half as many calls in March as it did in February. Many PA ChildLine calls are made by educators (28%) and medical professionals (10%); with schools closed and many routine health visits on hold, kids have less contact with adults likely to intervene.

We can all help support our city’s children and families during coronavirus. As families, we can create daily routines to provide needed structure for our children. We can anticipate that children and teens will need extra flexibility and support, and use already existing resources from the American Academy of Pediatrics and PBS to help us talk about coronavrius. We can create quality time together by cooking, exercising, doing chores, and playing games. We can clearly communicate behaviors we want to see and praise our children for them; and take quick breaks to collect ourselves before calmly providing time-outs, re-directions, and consequences for poor behavior. And we can teach our children to stay safe online by avoiding sharing personal information or sexting, and agreeing upon safe boundaries for websites, apps, and chat rooms.

We must make our distancing physical rather than social. We can check in with our neighbors, share resources, and make grocery runs for each other. We can share free, 24/7, confidential, and professional resources like Crisis Text Line (Text 741741) with the adults and children in our lives that can provide accessible support. We must call ChildLine to report suspected abuse (1-800-932-0313). We can encourage each other to reach out for help- none of us were made to survive a pandemic alone.

Local organizations addressing food insecurity, poverty, and homelessness need our financial support and volunteer efforts so they can keep supporting our most vulnerable families — we can do this even while distancing. As health care providers, we must proactively pursue telemedicine and collaborate with our colleagues in social work and with community health workers to provide virtual forums to support our patients’ families. And we all must contact our legislators and urge them to provide the funding schools, and child welfare organizations need to support children and families well.

Coronavirus is scary, and the risks of child abuse are real — but as a community, we can emerge from this pandemic victorious.

Rebecca C. Whitmire is a pediatric resident.

Image credit: Shutterstock.com

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