DKent: Thanks and welcome to everyone who has joined us and to those who come later. I will start by talking about some of the relevant factors that affect children who are abused. The usual four kinds of abuse will be included; these are--physical abuse, neglect, sexual abuse, and emotional abuse. As we go along after every few sentences I will stop and see if anyone has comments or questions.

  Judy: Dr. Kent would you like to give us some general information on the nature of abuse and neglect

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  DKent: I want to begin by focusing on two primary areas, the age of the child affected and hte child's personal characteristics. A child can be abused or neglected at any age and the immediate and long-term effects will differ. Sexual molestation will affect a girl different depending on whether she is 6 or 14 years old just like a boy who is regularly beaten at age 2 or 10 years may show different effects.

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  DKent: I want to introduce the concept of adaptive functioning. How well a child copes is likely to depend on the nature of the abuse, how often it occurs, and how effects develop over time. Psychologists use measures to assess such areas as language and communication, daily living skills, social behavior, motor skills, and academic performance--all of these can be affected by abuse.

  DKent: Input from parents, teachers, social workers, and other interested parties, including the child when he or she is able, can be used to assess such coping strategies of the child.

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  DKent: The personality and temperament of the child will also determine the effects of abuse. I will give some examples of what I mean. How outgoing or withdrawn is the child? How impulsive or reflective (thoughtful) is the child in approaching tasks? How does the child express feelings--being quick to cry or complain or by holding feelings inside? How moody is the child? What is the activity level? Does he or she tend to approach or withdraw from new situations? How attentive or distractible is the child.

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  DKent: Children thus vary tremendously in how vulnerable and how resilient (able to bounce back) they are with stresses. In any case, if an observer notices a change in any of these characteristics, it may be due to the child's reaction to stresses or traumas. Such stresses may include abuse and neglect.

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  Judy: Is there an understanding as to why some children can bounce back from abuse and others seem to carry a lot of "baggage" throughout their lives.

  DKent: Those points summarize the background conditions that may affect a child's response to being abused or neglected. Now, I will move on to a discussion of the effects of abuse on child development. Remember that there is no single sign that a child has been abused or neglected. Every child is different and is likely to respond in his or her individual manner based on such factors as those reviewed. Most children who are abused or neglected do show some changes in behavior, mood, thinking, use of language, and/or self-confidence. This is one reason why it is so important for a child to tell a trusted adult if she or he notices significant changes in a friend or classmate.

  DKent: In response to your question, a child's coping strategies and temperament become very important. Finding someone whom they can trust with their "story" and who will help them is critical. It is lilkely that some bit of baggage will be retained into adult years but temperament and therapy may ultimately determine the child's course.

  DKent: A further thought, the less frequent abuse or neglect is and the shorter time period over which it occurs will help a child learn to adjust more easily and sometimes quickly.

  DKent: Here are some typical effects of abuse. The first few are especially common in the first few years of life. Hypervigilance or what one writer called "frozen watchfulness"--such a child is always on guard with their eyes scanning the environment, often for something dangerous. Such a child is less likely to learn needed social skills and academic skills when they start school.

  DKent: The compliant child--some children seem to accept whatever happens. They become passive and obedient, at least until they are removed to a different environment where they can show that they can be more assertive and resistant. It may take a while for this to happen, even in a more permissive and accepting situation.

  DKent: A third common consequence on early childhood development, and often extending on into the school years, is the child who becomes negative, aggressive, and hyperactive; some writers have described such children as "demons." such children cannot play in an acceptable way with other children and end up being rejected by their peers. The only way they express feelings is with anger and they view themselves as bad, unlovable, and stupid.

  DKent: If they have been abused or seriously neglected for a period of time, it will take these children a while to regain a sense of self-confidence and can be expected to show the same behaviors just described for a while in new, more positive homes. So foster parents can expect to see some of these same characteristics. I'm interested in whether any of you have seen such things in children and how they are able to recover in new foster or adoptive homes.

  brianna: I have seen the hyperactive and the anger in the kids even something as so small as take a bath and he explodes what can I do different

  DKent: Once a child starts school, the signs of physical abuse may be less visible to others and such children may be especially reluctant to report who they have been abused or neglected. Thus it remains important for any trusted adults in their lives to be tuned into any changes in mood, behavior, learning that may be a consequence of such events. A referral to a school counselor or school social worker may help determine whether such changes are due to abuse or to more of the ordinary stresses and strains of growing up. As to simple tasks in the home that a child resists or overreacts to--be calm; try not to explode yourself; stop requiring the behavior if that will help to settle the child down. Later, try to determine why the child has come to resist a bath or other activity so strongly--this may or may not be in their records but a good guess is that such activities have been associated with abuse in the past.

  brianna: Is always hugging and kissing for a 4yr old a sign of sexual abuse he wants to hug and kiss always

  DKent: Take it slow and be aware that your behavior did not cause the child to explode. Help prepare the child for the activity (if they are old enough to communicate with you) and take things one step at a time. For example, wash face at sink before trying tub again.

  DKent: With regard to hugging and kissing, it can become excessive. the child may have learned that one way to get positive attention from mother or father (or mother's boy friend) is to hug and kiss. this could have preceded or followed physical, or more likely, sexual abuse. Still, one must try to slowly help the child to learn other responses when a hug or one kiss on the cheeks may be appropriate.

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  DKent: A few other consequences of abuse in the school age child. Depression--such children are likely to consider themselves a burden to their parents and others. There can be a risk of suicide which always needs to be assessed. Another consequence, alluded to in many ways in what we have discussed, is becoming secretive. Abused children are not likely to believe that positive change is likely in their lives. such children may be lonely and have few or no friends. They may accept their parent's behavior as normal, as the right way to bring up children. This is the child who has the ability to do work but often says "I don't know." In adolescence, anger and aggressiveness may lead some to join a gang. In such a group a child may feel wanted and accepted in a way that he or she could not at home. Unfortunately this can lead to delinquent behavior and running away.

  DKent: Have you seen these effects in older children or what else have you noticed?

  Judy: Dr. Kent, Why is it that when a child reaches his teens often negativve behaviors and attitudes seem to resurface?

  brianna: No I not these kids are all under the age of 7 they easily get upset when someone is bothering them and just react very strongly.

  DKent: That is a good question and an observation that many parents and teachers have made. It is a common experience for teens to show some rebellion and resistance. Teens are becoming more involved with peers and peers are more likely to support rebellious and resistant behavior.

  Judy: We have only a few minutes left.

  Judy: Does anyone have final questions for Dr. Kent?

  DKent: A few quick comments on effects of sexual abuse. In young children, fear states, night terrors, clinging behavior, and regressive behavior. In school-age children, sudden onset of anxiety, depression, insomnia, hysteria, massive weight loss or gain, school failure when there has been none, truancy, or running away.

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  Judy: Dr. Kent, Thank you for joining us tonight. You have shared a wealth of information that I am sure we can all use.