Gray Zone Between Children Witnessing Domestic Violence and Child Maltreatment: A Call to Establish a Threshold for Intervention, The

Medicine and Health Rhode Island, Dec 2003 by Verhoek-Oftedahl, Wendy, Devine, Alexis

Only four states define child witnessing as child maltreatment in their statutes. Rhode Island is not one.

The definition of witnessing varies, as do the events children may witness. Acts that constitute domestic violence range from property damage and low-level physical violence to homicide. Children can see such an incident, hear it (screams, crashing, thuds) and/or see the aftermath of the violence, including victim injury and emotional distress, police response and property damage. While equating "child witnessing" with "child maltreatment" is not appropriate, there is still a need to identify children who are at increased risk of physical harm and psychological maltreatment, specifically, terrorizing, due to the nature of the violence.

An estimated 3.3 to 10 million children are exposed to domestic violence each year.1 That exposure has been associated with a variety of negative emotional1,2 and physical health outcomes2,3 as well as injury,2,3 behavioral problems1,2 and poor school performance.2,4 It is estimated that physical child maltreatment and domestic violence co-occur in 30% to 60% of families.5 The most rigorous studies report concurrence rates of child abuse and domestic violence close to 50%.6 Why then, is child witnessing not considered a warning sign for child maltreatment? In the absence of physical child abuse, serious psychological maltreatment may still occur.

The American Academy of Pediatrics identifies witnessing of domestic violence as a behavior that may be considered psychological maltreatment. 2 It also identifies terrorizing, "committing life-threatening acts; making a child feel unsafe; setting unrealistic expectations with the threat of loss, harm or danger if they are not met; and threatening or perpetrating violence against a child or a child's loved ones or objects," as psychological maltreatment.

AMBIVALENCE SURROUNDING REFERRAL OF CHILD WITNESSING FOR ASSESSMENT FOR CHILD MALTREATMENT

While child witnessing has been associated with adverse outcomes, causality is difficult to establish. Not all children appear to be adversely affected.1 Unless a child is physically injured or sexually assaulted, the determination of child maltreatment is subjective. If the co-occurrence of domestic violence and child abuse in families is 30% to 60% then in 40% to 70% of families with domestic violence child abuse is not occurring. Referral of all children who witness would unnecessarily overwhelm child protective services (CPS).

Referral of children who witness domestic violence to CPS may still fail to protect the child. Recently in Chicago, a six-year-old child died of blunt trauma to the abdomen and hypothermia after being assaulted and thrown outside for going to the aid of her mother during an incident of domestic violence. A month earlier, CPS had investigated a report that the child had tried to stop a fight between the perpetrator and his brother.7 As this case sadly demonstrates, lethality is difficult to predict. Children younger than two years old have been reported to attempt to intervene to stop the violence.3 Yet removal of children who witness domestic violence from the home may increase the risk of harm to the adult victim and further victimize the child.8,9

Unfortunately, services for child abuse victims and adult victims of domestic violence have developed separately. While collaborative programs between CPS and victim services agencies exist, they are not the norm 8,9,10

CHILD WITNESSING IN RHODE ISLAND

While RI-specific data arc not available on the co-occurrence of domestic violence and child maltreatment, RI's statewide Domestic Violence/Sexual Assault (DV/SA) Database highlights what children see or hear during police-reported incidents of domestic violence occurring in RI.

In 1988 the RI Domestic Violence Prevention Act11 established a mandatory arrest policy for domestic violence and mandated police reporting of details on a standardized form. The forms and police narratives of incidents are submitted to the RI Supreme Court Domestic Violence Training and Monitoring Unit. In 1996 the form was expanded to collect data on sexual assaults including child molestations and is now known as the DV/SA form. DV/SA data formed the core data source for the RI Department of Health Violence Against Women Public Health Surveillance System (VAWPHS).

Under the Domestic Violence Prevention Act, RI State General Laws (2001) Section 12-29,11 domestic violence is defined to include a variety of criminal acts including simple and felony assault, stalking, homicide, violation of protective orders, and property damage. Domestic relationships are defined as those in which the involved parties are married, separated, or divorced; current and former intimate partners; persons who have been in a substantive dating relationships; persons related by blood or marriage; and persons with a child in common or cohabiting.

The DV/SA form collects information on incident characteristics, including the nature of the assault (physical, sexual, both); the specific acts of violence (pushing, shoving, beating, choking, stalking, etc); use of a weapon to threaten or injure; involvement of alcohol or drugs; damage to property; and threats and assaults to children and others. In addition, information is collected on victim and suspect demographics, whether or not children reside in the home, ages of the children, and whether or not children were present at the time of the incident and witnessed the incident, and the existence of protective orders.