School Based Prevention: From Oklahoma City, Proof of the Need...Crystian Rivera

On Sunday, I posted about a program in Missouri that gives middle-school students parenting education and coping skills, and commented that we need it because kids are taking care of siblings.

Today, this story from News9.com in Oklahoma City proves the point, but there's nothing good about a story that ends "he is too young to get the death penalty." 

(It's the sort of story that gets around: see this UK News article)

OKLAHOMA CITY -- Police say Crystian Rivera confessed to shaking his baby sister to death, now he's one of the youngest inmates at the Oklahoma County jail.


The 13-year-old is accused of first degree murder. He is being treated as an adult, but he's not allowed to stay in a jail cell with an adult.

8/23/2011 Related Story: OKC Teen Accused Of Killing Baby Sister Won't Get Death Penalty

One week ago, Crystian Rivera was your typical 13-year-old at home playing video games. But on that day, police say he was watching his 9-month-old sister, while their parents were at work.


Detectives say the baby distracted Rivera from his game, he told police he got angry and confessed to shaking his sister.  Three days later she died at the hospital from a severe brain injury, and Rivera was taken to the Oklahoma County jail.

We went behind the doors where Rivera is being held, with 26 other juveniles charged with serious offenses. He's locked up in cell number one with one other person. Jail officials say he is checked on every 30 minutes.

Rivera was arrested just days before school started. He would have been an eighth grader at Mayfield Middle School. But now, his schooling will happen behind bars.

"We have a contract with the Oklahoma City public schools," said Mark Myers, Oklahoma County Sheriff's Department spokesman. "And they provide teachers that come out and teach our juvenile inmates."

Rivera is being held without bond. The Oklahoma County District Attorney's office has not been presented with charges yet.

Under state law, Rivera will undergo a youthful offender study to determine if he can be rehabilitated. If that is the case, he would be released when he is 18 and half years old. If not, he could be sentenced to life in prison. He is too young to get the death penalty.

Tracking Child Abuse Fatalties: Congress Hears GAO Recommendations on Improving the Body Count

Once, I was aligned with the guy who wrote that if it was important, I had learned about it in kindergarten.


Now, not so much: if it's really important, I'll probably learn about it on Twitter.


Twitter brought news that the House Ways and Means Committee Subcommittee on Human Resources is holding a hearing today on child abuse fatalities. Link: http://1.usa.gov/r0ZkWB


No real surprise: the statistics are not accurate.  The AP news report is here; 

The GAO report was just released.  Judging from the GAO testimony at the hearing, GAO did keep the focus on getting the numbers right. GAO summary (note that not one "related term" on that page mentions prevention); link to GAO Child Fatalities Report. 

Reading through the testimony quickly, while there is much discussion of resources needed, there is only one brief mention so far of the cost of abuse (at p. 9 of Every Child Matters) - and that's only the dollars spent, not the dollars and human potential lost. In these time, cost and benefits are critical parts of policy.

The background of the hearing:

Focus. The hearing will review data on child deaths due to maltreatment, determine how to improve the accuracy of this data, and review how improving the accuracy of this data may help prevent future fatalities.

Background. According to State reports, over 1,700 children died nationally in FY 2009 due to maltreatment. However, research has shown that these reports may substantially understate the number of child victims each year. To gain a clearer understanding of this issue, the Government Accountability Office (GAO) has reviewed what is known about the circumstances of child deaths and near deaths due to maltreatment, State approaches to gathering and reporting this information, and what the Department of Health and Human Services (HHS) is doing to support the collection and accurate reporting of this information. GAO will testify about the findings of their review at the hearing,

Not much on prevention - one witness mentions state initiatives, including SBS public awareness campaigns (should have said new parent education) - but seems to recognize the need for incident analysis to inform prevention (just imagine if we spent the same amount of money to investigate the deaths of 50 children and recommend prevention action as NTSB spends to investigate the cause of a plane crash that caused the deaths of 50 people).

Perhaps not surprisingly, Caylee Anthony is mentioned in testimony. [Update: hearing schedule just coincidence]

While I didn't see any Tweet about the hearing before yesterday (thanks, @youngchildfacts), I was pleased to see PCAKy Tweet about prevention and home visiting (Link; Link).


For what it's worth, I plan on bringing that focus on prevention to the Committee's attention...

FYI - The Subcommittee will take testimony for the record up to two weeks (7.26.2011) after the hearing: instructions for submission are here on this page - click here to make a submission

The witness list (click on links for testimony):

Kay E. Brown
Director Education, Workforce, and Income Security, U.S. Government Accountability Office
(Testimony) - http://waysandmeans.house.gov/UploadedFiles/Kay_E_Brown_Testimony.pdf


Tamara Tunie
Actor, Law and Order: SVU and Spokesperson, National Coalition to End Child Abuse Deaths
(Testimony)

Theresa Covington
M.P.H., Director, The National Center for Child Death Review
(Testimony)

Michael Petit
President and Founder, Every Child Matters Education Fund
(Testimony)

Carole Jenny, M.D.
Director, Child Protection Program, Hasbro Children’s Hospital
(Testimony)


Jane McClure Burstain, Ph.D.
Senior Policy Analyst, Center for Public Policy Priorities
(Testimony)

Twitters

PCAKY PreventChildAbuseKY
Is home visitation an effective way of preventing child abuse and neglect? Learn the answer to this question and more http://ow.ly/5rSVs

youngchildfacts Young Child Facts
7/12 Congressional Hearing on Child Maltreatment http://1.usa.gov/r0ZkWB Read more on maltreatment under age 5 http://bit.ly/pQfQvX

Resources: Gender Differences in AHT/SBS - Pediatrics

A study in the current issue of Pediatrics examines the outcomes of AHT/SBS cases involving males and female perpetrators. Link to Pediatrics.

Abusive Head Trauma in Children: A Comparison of Male and Female Perpetrators:

Several studies have examined the relationship between perpetrators of abusive head trauma and their victims. However, no study has evaluated the effect of perpetrator gender on victim presentation, victim clinical outcomes, and perpetrator egal outcomes.

This study reports significant gender differences in perpetrators of abusive head trauma in children. Male perpetrators were younger and more likely to confess and be convicted. Victims of male perpetrators had more serious acute presentations and neurosurgical intervention and suffered worse clinical outcomes.

US News and World Report HealthDay summarizes the study's findings:

The tiny victims of shaken baby syndrome are equally likely to be injured by a man or a woman, although women are less likely to be convicted of the crime, according to a new study.

Perhaps because of men's sheer strength, the babies are also more likely to suffer graver harm if their abuser is male, and male perpetrators are more likely to confess to the crime and be convicted, the researchers found.

In data collected over 10 years on 34 cases of abusive head trauma (AHT) in infants, researchers found that abusers' gender was evenly split and that female abusers were typically significantly older than males.

And, as the MSNBC coverage notes:

... the researchers expressed concern that many cases of child abuse may go unreported. They cited research from the University of North Carolina showing that more than 2 percent of mothers admit to shaking children as a form of discipline on surveys -- likely a low estimate. [Link to UNC article]

Child Abuse: The Persistence of Consequences

Not Exactly Rocket Science blogged on a study showing the persistent effects child abuse can have on the brain of survivors. It's a cogent explanation of the science, and worth reading....

Together, McGowan's results paint a very suggestive picture that links child abuse to later illness and death. Abuse leads to epigenetic changes that modify genes including NR3C1. These changes, especially those involving methyl groups, are very stable and they could slash the gene's activity for a very long time, potentially even for life. With the gene not working properly in many cells, the body can't produce enough glucocorticoid receptor.

As a result, the HPA trinity can't turn itself down properly and is constantly on high-alert. The body behaves as if it were stressed, even when nothing stressful is happening. The result is a higher risk of anxiety, depression and suicide. McGowan admits that this the whole picture is still speculative, but the individual steps make sense in the light of his results.

And a study reported in Pedatrics found that when we don't deal with neglect in the early years of life, it comes back to haunt us. Researchers at the Univ. of Maryland School of Medicine (MD MDs) found that failure to care properly for a young child can be as damaging as physically or sexually abusing them, when it comes triggering aggression in later childhood.