Record: Barbara L. Knox, Suzanne P. Starling, Kenneth W. Feldman, Nancy D. Kellogg, Lori D. Frasier, and Suzanna L. Tiapula, “Child Torture as a Form of Child Abuse” in Journal of Child and Adolescent Trauma 7, (2014): 37-49.
Summary: The authors, affiliated with a range of medical and educational institutions across the country, here come together to report on 28 cases of extreme child abuse, finding that the term “torture” aptly summarizes what these children experienced.
The authors contend that thus far the literature on torture has tended to limit it to the political context. Yet what these children experience fits very will with the current definition of torture. Torture is defined as the intentional infliction of severe pain and suffering for the purpose of obtaining submission or dehumanization. The goal is to “break” an individual by systematically dominating her or him.
To test the assertion that what severely abused children experience is tantamount to torture the authors corral 28 cases from their respective medical institutions in Virginia, Texas, Wisconsin, Utah, and Washington State. They deliberately exclude cases of sexual abuse because they believe there to be different motivations going on there. They acknowledge that their sample is a convenience sample–they cherry picked the subjects they wanted from their institutions rather than studying all potential cases. Cases included children between the ages of 9 months and 15 years old, with the median age being 7.5 years. Abuse duration ranged from 3.5 months to 8 years (median of 3 years). 61% were female, 43% caucasian, 36% African American, and 21% Hispanic. Ninety-three percent of subjects had cutaneous evidence of abuse on their bodies at time of discovery. The fatality rate of this sample was 36%.
Types of abuse ranged from food and fluid deprivation, restriction of toilet access, severe isolation (75% placed in solitary confinement. For over half, nobody but the abuser even knew they existed), to all sorts of brutal physical and emotional abuse. Twenty-nine percent of the school-aged children were not allowed to attend school. Two of the kids had been taken out of school with no explanation given. An additional 47% were removed from school under the auspice of “homeschooling.” The authors note,
This ‘homeschooling’ appears to have been designed to further isolate the child and typically occurred after closure of a previously opened CPS [child protective services] case. Review of these cases found no true educational efforts were provided to the homeschooled children. Their isolation was accompanied by an escalation of physically abusive events. (p. 39)
In every case reported on here, a female adult was involved in the abuse. In 20 cases a male was also involved. For all cases all adults in the home knew what was going on, and most partially confessed their crimes, though they usually minimalized or rationalized their involvement. The authors provide a table detailing the abusive treatment for every child in the sample that makes for horrifying reading. They also provide some very disturbing photographs with descriptions in a couple of the cases. Finally, they provide a detailed description of one representative case. As it deals with an issue commonly raised among homeschoolers, I will briefly summarize it.
A 14-year-old girl came to the attention of a social worker who had been notified that she and her siblings had not been attending school. Upon visiting the home the social worker found the girl and her 8 and 5 year-old siblings hiding in the closet. The 14-year-old had horrible injuries and was extremely malnourished. The social worker called law enforcement and the child was transported to a medical facility, where several internal and external injuries were discovered. The authors provide vivid description of some of the atrocious abuse this girl endured at the hands of her parents. Her case had been reported to social services three prior times that year. The first was not accepted for investigation and in the second and third no abuse was found because of the child’s testimony that her injuries had occurred during fights with other teens.
The commonalities uncovered in all 28 of these examples lead the authors to conclude that child torture can be defined as “a longitudinal period of abuse characterized by at least two physical assaults, and two or more forms of psychological maltreatment (e.g. terrorizing, isolating), resulting in prolonged suffering, permanent disfigurement/dysfunction, or death.” (p. 44) The adult involved typically makes concerted efforts to isolate the child from outside contact or observation. The child is typically scapegoated and becomes the object of derision for the entire family, including other siblings, who are often coerced to participate in the abuse. Perpetrators typically blame the victim for the abusive behavior and create rationalizations for their actions. The authors note that “in these and other cases we have subsequently evaluated, some perpetrators saw it as a religious duty to discipline their children harshly.” (p. 45)
The authors note that in many of the cases physicians failed to diagnose the torture when presented with a malnourished child with bruises and broken bones. Some of these children were even visited by protective service agents at home, who missed these signs. To rectify this the authors call for “a comprehensive, multidisciplinary approach” that would have CPS regularly chart child growth data, question all members of the household in private, share data between law enforcement, medical staff, and school and social service agencies, and question faith community leaders to ensure that extreme doctrines are not being propounded. In interviews with the children, the authors suggest that open-ended questions like “tell me about meal time” or “what are the rules about sleep or potty” are best, because the children will likely not recognize their treatment as abusive since it’s all they know. Most basically, social service agents and family physicians need to be made aware of the medical definition of torture the authors have provided here so that they can recognize it when they see it. Over half of the cases reported on in this article had been previously reported to child protective services but exonerated.
The authors conclude with another reminder that their sample is not representative of any population, but that the commonalities in it nevertheless suggest that there is a documentable medical condition called child torture that needs to be understood by all who work with children so that the children who suffer in such situations can be helped immediately rather than be sent back into their nightmarish conditions.
Appraisal: As the authors pointed out numerous times, the data here is essentially 28 anecdotes. They are powerful and horrible, but we cannot generalize from them anything about the percentage of children who endure such conditions or anything else. I find their basic argument convincing, however. The treatment these children receive at the hands of their caretakers is certainly torture, and it would be a good thing if more doctors and social workers were trained to think of this possibility when they encounter a child who is woefully malnourished, sleep deprived, and badly bruised, burned, or broken.
It also seems highly likely that the homeschooling excuse so many of these families offered would be a common ruse used by many such perpetrators. In earlier posts on this issue I have noted how abuse situations are not likely to lead to increased homeschooling regulations. The authors of this piece are not calling for that. They just want doctors and child service workers to be more effective in their diagnosis of problems. To me this article is important not only for hopefully furthering that goal but also because it offers heart-breaking evidence, rather like that being amassed by Heather Doney and Rachel Coleman at their site Homeschooling’s Invisible Children, that homeschooling IS being used as a front to mask abuse in some circumstances. This realization will hopefully continue to lead to a thaw in the relationship between homeschool advocacy organizations, which historically have been extremely, even hysterically opposed to home visits by social workers, and child protection service personnel, who, if this article is accurate, need to be more, not less vigilant about protecting children from abusive situations.
Milton Gaither, Messiah College, author of Homeschool: An American History
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