Child abuse on the rise; social environment affects kids’ IQs; dying without fear and anxiety

Infant’s broken ribs (Natl. Institutes of Health)

In light of former Pennsylvania State University football coach Jerry Sandusky being sentenced today to spend at least 30 years in prison for the sexual abuse of children, this story out of Yale School of Medicine is noteworthy. Despite many social service agencies experiencing the contrary, until today the expert understanding was that physical abuse of children was decreasing. But Yale School of Medicine professor of pediatrics John Leventhal, Dr. Kimberly Martin of the Johns Hopkins School of Medicine, and Julie Gaither, a graduate student in the Yale School of Public Health, found that physical child abuse has increased nearly 5 percent from 1997 to 2009, according to this story by Kathryn Crandall in the Yale Daily News.

The studies completed by Leventhal and [New Hampshire sociology professor David] Finkelhor differ in several ways, most notably in their data collection techniques. Finkelhor considered “substantiated cases of physical abuse” ­— cases which have undergone legal review by a child protective services commissioner and are registered in the National Center on Child Abuse and Neglect data system — while Leventhal scrutinized reports from the Kids’ Inpatient Database.

Leventhal said he considered all cases of children hospitalized for severe injuries caused by physical abuse and did not limit himself solely to cases that had gone through an official legal process. Leventhal said he chose this method because he and his colleagues nationwide “were seeing the contrary” of Finkelhor’s earlier results.

Finklehor had determined that physical child abuse had decreased 55 percent between 1992 and 2009.

The research will appear in the November issue of Pediatrics, but is available online now. There’s also good coverage of the research in this story by Lois Collins at the Deseret News.

THE SOCIAL FORCES ON ACADEMIC ACHIEVEMENT are revealing that being smart can easily be squelched, says Annie Murphy Paul in the New York Times.

If the threat of social exclusion can decrease the expression of intelligence, so can a perceived threat to physical safety. It’s common to blame disadvantaged children’s poor academic performance on their “environment.” By this we usually mean longstanding characteristics of their homes and neighborhoods. But research on the social aspects of intelligence suggests that much more immediate aspects of kids’ surroundings can also affect their I.Q.’s.

In a study conducted on the troubled South Side of Chicago, for example, students whose neighborhoods had been the site of a homicide within the previous two weeks scored half a standard deviation lower on a test of intelligence.

Paul, whose book “Brilliant: The New Science of Smart” will come out next year, says this research means that one-shot tests should be replaced with ongoing assessment, and schools should be safe, supportive places. In other words trauma-sensitive schools, as is Lincoln High School in Walla Walla, WA, and many schools in the Brockton, MA, school district.

DYING WITHOUT TRAUMA is what New York Times columnist Bill Keller described in most personal terms with the peaceful death of his father-in-law, a type of death many elderly in the U.S. don’t have a chance at. Keller’s father-in-law was lucky to be in a hospital that uses the the Liverpool Care Pathway for the Dying Patient.

When they told my father-in-law the hospital had done all it could, that was not, in the strictest sense, true. There was nothing the doctors could do about the large, inoperable tumor colonizing his insides. But they could have maintained his failing kidneys by putting him on dialysis. They could have continued pumping insulin to control his diabetes. He wore a pacemaker that kept his heart beating regardless of what else was happening to him, so with aggressive treatment they could — and many hospitals would — have sustained a kind of life for a while.

But the hospital that treated him offers a protocol called the Liverpool Care Pathway for the Dying Patient, which was conceived in the 90s at a Liverpool cancer facility as a more humane alternative to the frantic end-of-life assault of desperate measures. “The Hippocratic oath just drives clinicians toward constantly treating the patient, right until the moment they die,” said Sir Thomas Hughes-Hallett, who was until recently the chief executive of the center where the protocol was designed. English doctors, he said, tell a joke about this imperative: “Why in Ireland do they put screws in coffins? To keep the doctors out.”

This is a poignant, fascinating and, for those of us in the U.S., a terrifying read.

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