This year is the 50th anniversary since American pediatrician dr. Henry Kempe and his collaborators published the paper about the battered child syndrome on 7 July 1962 in the Journal of the American Medical Association. He defined the battered child syndrome as “the clinical condition in young children who have received serious physical abuse generally from a parent or foster parent”. He also describes the condition as “unrecognized trauma” by radiologists, orthopedists, pediatricians, and social service workers and emphasizes that those battering children do not necessarily have psychopathic personalities nor do they come from borderline socio-economic groups and that there are indications that abusive parents were themselves abused in their childhood and, having identified with the aggressive parent, repeat the abuse, battering the next generation .
The first team in the world to recognize and treat abused children
Dr. Kempe indicated that physicians may have been reluctant in believing that parents were guilty of abuse, and the fact that during their study and specialization they had not received information about the role of the police and the state attorney, only added to the problem. Therefore, dr. Kempe gave examples and recommendations for professionals as to how to talk to parents in order to obtain information about the possible abuse of the child. He emphasized that physicians had duty and responsibility to tackle the problem and to prevent the repetition of trauma.
Publishing this paper in the prestigious scientific journal has been considered to have been the most significant event in the creation of awareness that abused children exist and that professionals were responsible for their protection. With this paper, Dr. Kempe helped professionals, especially physicians, to accept and understand that child abuse was happening in families and confronted them with the responsibility in the protection of abused and neglected children. Dr. Kempe warned physicians about quite frequent cases of injuries and even deaths of battered children who were not adequately diagnosed and/or treated due to professionals’ reluctance to report cases to the police. In 1958 he established one of the first teams in the world for the identification and treatment of abused children. Three decades later the number of such teams in the USA increased to over 800. Today the Kempe Center is one of the leading world centers conducting research, training professionals and developing programs of child protection. It is committed to prevention improvement, identification and treatment of abused children.
What has been done since the problem was recognized
After dr. Kempe had specified the battered child syndrome, the awareness of other forms of abuse, like domestic abuse, violence against women and child sexual abuse also increased. We have learned a lot about physical, emotional and behavioral consequences of all forms of abuse, have understood that abuse is not a problem to go away with growing up. Countless laws have been passed which protect children, countless institutions and associations like International Society for the Prevention of Child Abuse and Neglect (ISPCAN) have been established, countless conventions have been ratified, like the UN Convention on the Rights of the Child, and universities introduced courses to teach about this issue.
During the past fifteen years abuse and neglect of children has been increasingly recognized as a public health issue in Croatia. Research on the prevalence of child abuse has been conducted and results show that Croatia is in line with other countries. Institutions and associations have been established, like our Child Protection Center of Zagreb, the Brave Phone, Ombudsman for Children, Tić in Rijeka, Feniks in Dubrovnik, Mirta in Split.
The number of abused children in the USA dropping by one third, in Croatia still increasing
According to Croatian laws, child abuse is criminal offence. We have signed and ratified conventions which protect children’s rights and we are among the first countries in Europe to banish corporal punishment of children. Our low imposes that reporting suspected child abuse is obligatory, and due to the aforementioned, the number of cases is on the rise.
The importance of all these efforts is confirmed by recent studies in the USA which, for the past fifteen years, show a significant fall in the number of recorded (reported and substantiated) cases by one third, from 16 abused children in one thousand to 9. The statistics, of course, do not include the gray area of unreported cases, whose number, even in the countries with long tradition in child protection is still bigger than the number of reported cases.
We have not recorded falling trends in Croatia yet, which can be explained by the fact that we only started fifteen years ago with what dr. Kempe started in the USA fifty years ago. However, Croatia is catching up fast. This is corroborated by the fact that the Council of Europe recognized the work of the Child Protection Center of Zagreb as a good practice model and included the Center in the Council of Europe Campaign to Stop Sexual Exploitation of Children.
International No Hitting Day for Children is celebrated throughout the world with occasional educational warnings of the dangers of physical punishment on this day, April 30th. Everyday practice and research such as this latest research Brave phone show, however, that many parents still use methods of corporal punishment of children and that they do not see anything controversial, often without knowing it violates the law.
We have noticed that parents sometimes hesitate to seek professional help for their child and their family. In our culture, contacting a psychologist or a psychiatrist is sometimes seen in a negative light. Parents may be judged by others that something is wrong with them or with their child, that they are unable to solve the problem themselves, and similar. Such attitudes may cause the parents to feel shame and resistance, they may develop anger towards their child who 'causes problems' and parents may start taking their child's psychological difficulties personally.
Today, on 10 September is World Suicide Prevention Day, on the initiative of the International Association for Suicide Prevention and the World Health Organization.To many people, death is a taboo theme, something they do not like to talk or think about, something they hope will never hit them, their loved ones, family or friends, even though they know it is impossible to avoid it. If we just have to think about mortality, many will imagine peaceful death in a daunting age, without pain and suffering. However, when death is linked to aggression, or suicide, they are subjected to various unpleasant emotions.