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.
In recent days the whole country was strongly impressed by the reports about violent behavior of students towards the teacher and violent response of that teacher towards students. It seems that the public is polarized in the "us and them" way and that the story of one incident in Cakovec school has taken considerably larger proportions. There are public discussions about the rights of the children and the teachers, about the needs, rules, support or lack of support, and it is not good that some teachers even labelled children as bullies, which creates lynching atmosphere against these children and their parents. Any hate speech in public space is not acceptable.
We have been coping with peer bullying for years, and yet, we seem to be utterly surprised when public attention is caught with a case of bullying, which is usual everyday life for many children. According to research conducted in Croatia, every fourth child is exposed to some form of peer bullying. Despite laws and protocols, we often react only when severe psychological or physical abuse has already taken place.
Today, October 10, we mark the World Mental Health Day and on this occasion it is important to me to share some facts, knowledge and reflection on mental health of children and young people to whom our Center is dedicated, with all the experts, parents and others who are monitoring us.