Pride in Parenting: Training Curriculum for Lay Home Visitors
Linda T. Diamond, M.S. and Marion H. Jarrett, Ed.D., editors.

Unit 20
Children in Violent Circumstances

1. List four characteristics of high violence societies.
2. List three characteristics of low violence societies.
3. List three characteristics of high violence families.
4. List three possible effects on the parenting behavior of persons living in high violence areas.
5. List 3 possible effects living in high violence societies on the personality development of children.

1. Do you feel we covered all the information in this unit that we said we were going to?
2. What did you like best about the unit?
3. What did you like least about the unit?
4. Was the information in this unit presented clearly? If not, please explain.
5. In which skill areas do you feel you need more practice or help?
6. How can we make this unit better?
7. Any additional comments?

1. Violence among youths 11 to 17 has increased 25% in the last decade (Uniform Crime Statistics, 1992).
2. Physical abuse is the leading cause of death in children less than one year of age (Waller, Baker & Szocka, 1989).
3. Thirty-three percent of all sexual abuse cases involve children under six years of age (Schmitt & Krugman, 1992).
4. Homicide is the 2nd leading cause of death among all 15-24 year olds in the United States of America (National Center for Health Statistics, 1991).
5. In 1991, the homicide rate for African-American males 15-24 years of age was 10 times greater than the rate for 15-24 year old white males (National Center for Health Statistics, 1991).
6. In 1991, 1,383 young children (50% were less than 1 year of age) died from abuse.
7. One out of ten children under age six attending a Boston Pediatric clinic had witnessed a shooting or stabbing, either in their homes or on the street.
8. In a survey of sixth, seventh, eighth and tenth grade students, 30% reported witnessing at least one crime daily.
9. In 1990, 222 children in the United States were killed by handguns. During 1990, only 68 persons of all ages were killed by handguns in Canada.
10. At least 3.3 million children witness parental abuse each year. This includes shootings and stabbings as well as beatings (Jaffe, Wilson & Wolffe, 1988).
11. The rate of penetrating injury caused by violence in the emergency room of the Children's National Medical Center increased 1,740% between the years of 1986 and 1989.
12. Forty to 50% of all American households own a firearm (National Rifle Association).
13. Alcohol is implicated as a factor in over half of all violent attacks in the home.

Unit 20 Handout #2

• The cultural or folk heroes demonstrate high levels of violence in their exploits, i.e. Bonnie and Clyde, cowboys, "bad dudes," such as James Bond, the Terminator, etc.
• There is a high level of violent crime in the society. America has the highest murder rate in the world.
• The citizens have a right to bear arms and firearms are easily accessible.
• There is a high level of violence in the entertainment, media, sports and leisure activities of the society. For example, sports such as football and LaCrosse, leisure activities such as hunting, war games. Visual and print media in American society highlight violence. News footage is much bloodier than it was 20-30 years ago. Movies and television have gotten bloodier and more violent in the last few decades to the point that there were congressional hearings last year on the amount of violence in prime time television.
• Children are seen as an economic liability.
• There is a lack of social supports, and no close by extended family. Mother and father, or single mother alone, have almost total responsibility for child rearing.
• Primacy of parent/child relationship and inability of others to interfere.
• High rate of physical discipline. Ninety percent of Americans spank their children and feel that it is called for.
• The play of the children mirrors the violence in the society. War toys and guns are frequent playthings of young children. Video games are extremely violent, prompting congressional hearings this year. Toys R Us and Kaybee Toys will no longer carry realistic looking toy guns.
• In societies where there is chronic poverty and deprivation among minorities or the lowest levels of society, violence levels will be high. One of the side effects of high levels of violence in these strata is family instability and breakdown.
• The society's attitude towards and participation with alcohol and other drugs. Drug use is expensive and drug addicts will commit crimes and violent acts to get money to support their habits. Alcohol and cocaine use, and increasingly heroin use, by parents or caretakers is a root cause of violence against children.

• Children are highly valued and often seen as an economic asset.
• The population tends to be homogeneous.
• The child care is shared by many, not just the mother and father.
• There is a low demand level on the behavior of the children. They are rarely punished before two or three years of age.
• The society provides sanctions against violent behaviors among its members.

• Living in a chronically violent environment may affect parents ability to nurture, protect and parent their children effectively.
• Certain parts of the District of Columbia can be considered a chronic, high violence community. Some of the parents that you will see may exhibit these characteristics.
• Parents may feel hopeless, overwhelmed and powerless to provide a safe environment for and protect their children from ongoing everyday violence.
• If the parent has been traumatized by violence, he or she may be unavailable to nurture and provide security for the child.
• The parents may become hyper-vigilant and overprotect the child, not allowing him or her to grow and develop normally.
• If the parent is stressed and depressed concerning violence, there may be a tendency to be irritable and hostile, particularly in intimate relationships.

• The exposure to chronic violence affects young children's view of themselves, the world and their relationships with others around them.
• Sometimes children in chronically violent environments may experience symptoms of post traumatic stress disorder such as sleeping difficulties, nightmares, eating problems, attention problems in school, re-enactment of traumatic events, fearfulness and anxious reactions.
• Older children may resort to carrying guns or other weapons out of fear of violence from their peers.
• Pre-adolescents and adolescents may join gangs for a sense of security.

Unit 20 Handout #4

• Often have health problems that impair their ability to adequately rear their children.
• Lack of knowledge concerning developmental capabilities, normal behavior patterns of young children. They may be seen as willful, "He knows what he is doing."
• Unrealistic expectations of children's behavior.
• Lack of problem solving skills, may typically resort to aggression to solve problems.
• Inability to read and take cues from baby concerning its needs, fear of "spoiling" child.
• May have mental illness.
• High levels of stress within the home due to economic difficulties, lack of adequate coping skills, family crisis.
• May have cocaine, heroin or alcohol addiction.
• Typically it was the mother who abused the children with no or passive male present. Now social workers are seeing more males as agents of child abuse, violence, and sexual abuse. Part of this increase may be due to more reporting of child abuse.

• Inadequate or harsh parenting delivered to them as children.
• Lack of exposure to role models other than the use of harsh discipline.
• Inadequate problem solving skills, feelings of powerlessness and inadequacy, low self-esteem.

• There may be biological contributions to aggressive or violent behavior in children, i.e. basic temperament and activity level. Birth trauma and other neurological trauma, both prenatally and post-natally may cause subtle brain damage.
• Early family influences may also contribute to violent behavior in children. These influences include: weak or absent nurturing by a primary caretaker; parental rejection of the child; anti-social personality of parent; frequent and harsh physical punishment; lack of parental supervision; the subtle condoning of aggression by the parents; high levels of watching television violence. There is a correlation between the amount of watched violence and acted out violence.

Unit 20 Handout #5

• Patterns of physical violence between spouses.
• More disorganized, chaotic households (those that do not stress the importance of regular predictable schedules and routines such as meal times, early bedtimes, etc.)
• The majority of the abuse of the children occurs at home.
• Frequently it was the mother that was the abuser, with the father absent or passive. Today we are seeing more of the fatal and sexual abuse of children perpetuated by males.

• Apathetic, ignore children.
• May have been inadequately parented or neglected.
• Have poor relationship with baby's father.
• May have had difficult and complicated pregnancy.
• Inability to organize a safe, warm home environment for their children.

• Tend to be fearful, anxious, depressed, angry, hostile and aggressive, suffer from low self-esteem, feel stigmatized, isolated.
• May be sexually maladjusted.

Unit 20 Handout #6

• May trigger abusive behavior of parents through no fault of his own.
• May have been an unwanted pregnancy and birth, wrong sex.
• May remind mother of hated father.
• May have been low birth weight infant with physical problems or disabilities.
• May have a temperament that is not congruent with that of the mother or of her expectations.
• 2. Early Signs of Abuse/Neglect.
• Absence of synchrony (Infant and parent may seldom make eye contact with each other).
• Failure to thrive, gain weight or grow normally and achieve developmental milestone in a timely manner.

• Delays in speech.
• Preschoolers may be less independent, more resistant to, yet dependent on their mothers.
• Tendency to be less persistent in tasks such as solving puzzles.
• More negativistic, less enthusiastic.
• Exhibit more hyperactive behavior and are more likely to be easily distracted.
• Tend to be more hostile and anxious.
• Exhibit more aggressive verbal and physical behavior towards their peers and adults.
• As teenagers, they may exhibit wide variety of physical, cognitive and emotional disorders.

• Neglected children tend to display less self-confidence and self-assertiveness.
• May lack persistence and the ability to stick to tasks.
• May exhibit apathy and frequently withdraw from situations.
• May be non-compliant and easily distracted.
• Tend to be less aggressive than children who have been physically abused.
• More likely to be victims of violence.

• Extreme changes in behavior.
• Loss of appetite.
• Sleep disturbances, fear of sleeping alone, nightmares.
• Regression to earlier forms of behavior, such as bed wetting, thumb sucking.
• Vaginal or rectal bleeding or discharge.
• Vaginal or throat infections.
• High irritability.
• Painful, itching or swollen genitals.
• Early precocity or interest in sexual matters.
• Intense fear or dislike of being left with a particular person.
• Increase in temper tantrums and other acting out behavior.
• Learning disabilities such as inability to concentrate, falling grades, lack of interest in school and school activities.

Unit 20 Handout #7

When there is some concern about a family and there are thoughts about a possible protective service referral:

• PSS should share concerns with IDS who should alert FRS and establish if there are shared concerns.**
• The same would be true if the FRS had the initial concerns.
• Concerns should also be share with site supervisors.
• IDS might make a joint visit to the family with the PSS.
• A written summary of major concerns should be sent to project coordinator with plans to help mother better the situation. This should also be placed in the permanent file.

• Team should meet, including PSS, IDS, FRS and site supervisor, and reach a consensus* as to the action to be taken.
• BEFORE ANY ACTION IS TAKEN, the IDS involved should notify project coordinator. The project coordinator will contact the principal investigator. The project coordinator will then direct the staff as to what should be done, how and by whom. Another paragraph stating lack of change and continued concerns should go to the project coordinator; this should also be placed in the permanent file.

• Since the FRS is the only staff involved, if there are concerns about a family they should be brought directly to the project coordinator.** The project coordinator will contact the principal investigator and then direct the FRS as to how to proceed.
• Written documentation should go in the permanent file as well as to the project coordinator.

* If no consensus can be reached, the project coordinator should be contacted.

** If there is a perceived threat of life, contact CPS immediately. Notify the project coordinator subsequently.