NCJ Number
49035
Date Published
1972
Length
22 pages
Annotation
FINDINGS FROM A 3-YEAR FOLLOWUP OF 42 PHYSICALLY ABUSED CHILDREN SEEN AT THE JOHN F. KENNEDY CHILD DEVELOPMENT CENTER, UNIVERSITY OF COLORADO, ARE SUMMARIZED AND DISCUSSED.
Abstract
THE FOLLOWUP EVALUATION OF THE CHILDREN INCLUDED PHYSICAL MEASUREMENTS, NEUROLOGICAL EXAMINATIONS, AND DEVELOPMENTAL TESTS. CLINICAL FINDINGS AND OBSERVATIONS ARE PRESENTED RELATIVE TO THE TYPES OF CHILDREN ABUSED, CENTRAL NERVOUS SYSTEM DEVELOPMENT (NEUROLOGICAL DYSFUNCTION AND RETARDATION), AND FAILURE TO THRIVE, AND PATTERNS OF DEVELOPMENT. THE FINDINGS DO NOT SUPPORT THE NOTION THAT SOME CHILDREN ARE UNUSUALLY VULNERABLE TO ABUSE OR MAY UNWITTINGLY INVITE ABUSE. ONLY THREE OF THE STUDY CHILDREN APPEARED TO HAVE BEEN 'DIFFICULT' FROM BIRTH. THERE WERE NO SMALL PREMATURE INFANTS IN THE GROUP. IT IS POINTED OUT THAT UNUSUAL TEMPERAMENT OR PERSONALITY EXHIBITED BY AN ABUSED CHILD IS NOT NECESSARILY INHERENT IN THE CHILD BUT MORE LIKELY REFLECTS THE WAY THE CHILD HAS BEEN TREATED SINCE BIRTH. AT THE TIME OF FOLLOWUP, 43 PERCENT OF THE CHILDREN HAD NEUROLOGICAL DYSFUNCTIONS. ONLY HALF OF THESE CHILDREN HAD A HISTORY OF SKULL FRACTURE OR SUBDURAL TO LESS SEVERE TRAUMA. NEARLY HALF OF THE BRAIN-DAMAGED CHILDREN EXHIBITED NORMAL INTELLIGENCE AT FOLLOWUP, BUT SPECIAL SCHOOLING PROBABLY WILL BE REQUIRED BY ALL OF THE BRAIN-DAMAGED CHILDREN. THE FINDINGS SHOW A CLEAR RELATIONSHIP BETWEEN CENTRAL NERVOUS SYSTEM DAMAGE AND RETARDATION. FAILURE TO THRIVE (AS INDICATED BY SUBNORMAL HEIGHT AND/OR WEIGHT) WAS FOUND IN 14 (33 PERCENT) OF THE CHILDREN AND WAS PARTICULARLY COMMON IN CHILDREN WHOSE RETARDATION HAD NOT IMPROVED WITH INTERVENTION. THE FINDINGS INDICATE THAT THERE ARE AT LEAST TWO TYPES OF PHYSICALLY ABUSED CHILDREN: THOSE WHO ALSO HAVE BEEN NEGLECTED, UNDERNOURISHED, AND POORLY CARED FOR; AND THOSE WHO HAVE RECEIVED ADEQUATE CARE. THE FORMER GROUP ARE AT GREATER RISK OF SERIOUS, PERMANENT PROBLEMS AND REQUIRE MORE ACTIVE INTERVENTION. ONE STRIKING OBSERVATION AT FOLLOWUP WAS THE LARGE NUMBER OF CHILDREN WITH ABSENT, MINIMAL, OR IMPAIRED SPEECH AND LANGUAGE. THE POSSIBILITY THAT THIS DELAY IN LANGUAGE DEVELOPMENT IS RELATED TO THE ABUSED CHILD'S LACK OF TRUST IN HIS OR HER ENVIRONMENT IS RAISED. IN ADDITION TO FINDINGS FROM THE COLORADO STUDY, OTHER STUDIES OF MORBIDITY AND MORTALITY AMONG ABUSED CHILDREN, DEVELOPMENTAL PROBLEMS IN THESE CHILDREN, AND PERSONALITY DIFFERENCES BETWEEN ABUSED AND NONABUSED CHILDREN ARE CITED. CHANGES IN PERSONALITY ACHIEVED THROUGH INTERVENTION WITH SOME ABUSED CHILDREN ARE NOTED. THE PHYSICAL, NEUROLOGICAL, COGNITIVE, AND EMOTIONAL DEVELOPMENT OF ABUSED CHILDREN IS LARGELY DEPENDENT UPON SUCH INTERVENTION. IT IS SUGGESTED THAT EMPHASIS BE PLACED ON HELPING ABUSED CHILDREN AND THEIR PARENTS, RATHER THAN ON STUDYING CHILD ABUSE AS A PHENOMENON. A LIST OF REFERENCES AND ONE TABLE ARE INCLUDED. (LKM)