HJAR Sep/Oct 2020

HEALTHCARE JOURNAL OF ARKANSAS  I  SEP / OCT 2020 47 Clark Center for Safe and Healthy Children increased by 25 percent, compared to the same quarter the previous year (Farst, 2020). While decreasing reports of abuse and neglect would normally be welcome news, in the context of school closures, increased stress, increased clinic visits for abuse, and increased numbers of children in foster care, a decrease in hotline reports is not encouraging; it is alarming. With limited capacity for children to be seen in public spaces, lower reports of abuse and neglect does not mean that abuse is decreasing; it may simply indicate that it isn’t being seen. In Arkansas in 2019, child protective services responded to 34,226 reports for child maltreatment. Abuse and neglect of children is an ongoing and widespread problem, with effects that are both immediate and long-lasting. Experiencing multiple adverse childhood experiences is known to put individuals at risk for long-term poor mental health, substance abuse, chronic medical conditions, and overall shortened lifespans (Centers for Disease Control and Prevention, 2020). The experiences of our children shape who they become. Considering the impact of trauma to children, investing inprevention, recognition, and response to child abuse and neglect is crucial for the safety of children now, and for the long-term health of our population. The wide-ranging effects of this pandemic are yet to be fully known, but we do know that stressed families, isolated families, and financially insecure families are at increased risk for child maltreatment. As we consider the health impacts of COVID-19, child abuse and neglect must not be overlooked. n Liza Murray, MD Assistant Professor of Pediatrics University of Arkansas for Medical Sciences induced economic stressors, we are also facing school closures and social distancing, which can be significant sources of stress, and may limit a child’s access to safe and trusted adults outside of their home. In the month of April, RAINN (Rape, Abuse, & Incest National Network) reported that, for the first time since the establishment of the national sexual abuse hotline, half of the victims calling for help were minors. Of those reaching out for help, 79 percent were living with their perpetrator (RAINN, 2020). Educational personnel consistently make up the largest group submitting reports for child abuse and neglect, providing 20.5 percent of investigated reports nationally in 2018 (Children’s Bureau of the U.S. Dept of Health and Human Services, 2020). Without students in school, there is substantial concern that abused children may go unseen and unreported. And given the increase in minors seeking their own help for sexual abuse, it is hard not to wonder if children who don’t have the access and capability to call for help are simply going undetected. We do not know exactly how the current pandemic is affecting rates and severity of abuse, but there is reason for concern. With school closures going into effect in March of this year, reports of child abuse and neglect in Arkansas saw a decrease of approximately 18 percent from March– June, compared to the same time frame in 2019. In contrast, at the same time that reports went down, the total number of Arkansas children in foster care increased (Arkansas Department of Human Services Division of Children and Family Services, 2020), and clinic visits for abuse and neglect at the Arkansas Children’s Hospital Dr. Liza Murray is an assistant professor of pediatrics at UAMS in the division for children at risk. She attended medical school at the University of Arkansas for Medical Sciences, and completed a pediatric residency at Arkansas Children’s Hospital in 2011. After residency, Dr. Murray spent one year as a pediatric chief resident before going on to finish a three year child abuse fellowship at Children’s Mercy Hospital in Kansas City. Dr. Murray joined the UAMS Department of Pediatrics in 2018, and currently practices as a child abuse pediatrician at Arkansas Children’s Hospital (ACH), consulting for at- risk children admitted to the hospital, and evaluating children at the ACH Clark Center for Safe and Healthy Children, a facility dedicated to the multidisciplinary care and treatment of neglected and abused children and families. Dr. Murray provides regular education to medical and non-medical professionals regarding the evaluation of child abuse, has published research in the field of abuse and neglect, and is actively involved in ongoing efforts related to the prevention, recognition, and treatment of child abuse. REFERENCES Arkansas Department of Human Services Di- vision of Children and Family Services. (2020, April). State, Area and County Profiles April 2020. NCCD Children’s Research Center. Re- trieved from humanservices.arkansas.gov. Berger R, F. J. (2011). Abusive Head Trauma During a Time of Increased Unemployment: A Multicenter Analysis. Pediatrics, 637-643. Brooks-Gunn J, S. W. (2013). The Great Reces- sion and the risk for child maltreatment. Child Abuse & Neglect, 721-9. Centers for Disease Control and Prevention. (2020, April 3). Violence Prevention. Re- trieved from Adverse Childhood Experiences (ACEs): https://www.cdc.gov/violencepre- vention/acestudy/index.html Children’s Bureau of the U.S. Dept of Health and Human Services. (2020). Child Maltreat- ment 2018. Washington, DC: U.S. Department of Health and Human Services. Farst, K. (2020, July 29). Associate Professor of Pediatrics, Division Director for Children at Risk, Department of Pediatrics. (L. Murray, In- terviewer) RAINN. (2020, April 16). RAINN: For the First Time Ever, Minors Make Up Half of Visitors to National Sexual Assault Hotline. Retrieved from RAINN.org: https://www.rainn.org/ news/first-time-ever-minors-make-half-visi- tors-national-sexual-assault-hotline Schneider W, W. J.-G. (2016). The Great Re- cession and risk for child abuse and neglect. Children and Youth Services Review, 71-81.