Pennsylvania has seen a sharp decline in reports of child abuse and neglect over the last year, and some advocates see that as a sign of trouble. Experts say they have no doubt child abuse is still occurring. But many children haven’t been in classrooms as often — or at all — due to the COVID-19 pandemic, so advocates suspect some abuse isn’t being seen.

Schools are the prime source of reports to ChildLine, the state-run hotline for child abuse and neglect. (ChildLine, a 24/7 hotline, can be reached at 1-800-932-0313.) The drop in reports is a concern, said Jon Rubin, deputy secretary for the Human Services Department’s Office of Children, Youth and Families.

“I never made the assumption there was less abuse,” Rubin said. “We were concerned that reports were going down.”

The state saw a 16% drop in reports of abuse and neglect in 2020 compared with the previous year, according to the Pennsylvania Human Services Department. More serious reports meeting the definition of abuse dropped 22% over the previous year. Reports of abuse plummeted dramatically when Gov. Tom Wolf ordered the closure of schools in March 2020. In January 2021, reports of abuse and neglect dropped more than 22% compared with January 2020, before the emergence of the pandemic. While many children are learning in living rooms instead of classrooms, some are also missing out on other activities where abuse could be spotted. Advocates noted many sports and extracurricular activities have been scaled back due to the pandemic.

“Kids are isolated,” Rubin said. “They are not at other activities.”

Schools, child care centers and doctors are all “mandated reporters,” who are required by law to notify authorities of suspected abuse or neglect. Many children aren’t being seen as regularly by those mandated reporters, said Angela Liddle, president and CEO of PA Family Support Alliance.

“The best way to prevent child abuse is good, strong positive parenting,” Liddle said. “For those kids who don’t have that, it’s the mandated reporters. You hope they have the chance to spot signs of abuse.”

Advocates note the pandemic has placed added stress on parents, including on those who have lost jobs and are struggling financially. Such situations can lead to abuse, experts say. Even with the drop in reports, Cathleen Palm, founder of the Center for Children’s Justice, said doctors and child abuse specialists are seeing troubling signs of serious abuse and neglect occurring in the pandemic.

“There’s a lot of ways kids have experienced harm,” Palm said. “Some of it accidental, some of it due to a lack of supervision, and some of it due to violence.”

Berks County District Attorney John Adams said reports of abuse fell around 33% in Berks in 2020, compared with the previous year.

“I don’t think that child abuse has dropped,” Adams said. “I just don’t think the children are receiving the protection that they once received.”

Challenges for doctors

Dr. Lori Frasier, a child abuse pediatrician with Penn State Health and a member of the Pennsylvania Chapter of the American Academy of Pediatrics, said the drop in reports is troubling. Doctors and child welfare agencies have discussed this topic intensely during the pandemic. Parents and children have been home more often and most abuse occurs at home, Frasier said.

In the early weeks of the pandemic last spring, Frasier said, “We saw a sudden drop of patients for abuse and neglect in the hospitals.”

But there was something more disturbing. “The children that come to the hospital are often more severely injured,” she said.

In recent months, Penn State Health has seen more people admitted and hospitalized for injuries sustained during abuse. Dr. Rachel Berger, professor of pediatrics at the University of Pittsburgh and chief of the division of Child Advocacy at UPMC Children’s Hospital of Pittsburgh, said her institution hasn’t seen a decrease in children coming to the hospital due to abuse.

If anything, she said, the number has increased.

“We’ve seen a lot of severe injuries,” Berger said. “It’s clearly not less.”

The U.S. Centers for Disease Control and Prevention reported a drop in the number of emergency department visits nationwide due to child abuse and neglect through September 2020. But there was a higher percentage of hospital admissions stemming from those visits to the E.R. UPMC doctors are seeing children being injured while being supervised by a parent who hasn’t usually been home, Berger said. In some cases, they are parents who have lost jobs and are watching children because their local child care center closed.

“We’ve seen quite a few situations where a person who was caring for kids wasn’t the prime caregiver,” Berger said.

Doctors are also facing challenges in spotting abuse when seeing children in telehealth visits. While doctors continue to see patients in person, Frasier said, there are more appointments done remotely during the pandemic. And that makes it more difficult for doctors to determine if a child is in danger.

“Most of the time when we talk about abuse, we don’t want the parents around. We want children to have the freedom to talk about what’s happening to them,” she said. And that’s more difficult in a virtual visit when a parent is right next to the child. She said doctors and experts in treating child abuse victims are exploring ways to use telehealth visits to spot signs of abuse or neglect.

In the wake of the Great Recession over a decade ago, Berger and other researchers found a sharp uptick in abuse leading to severe head injuries in children under 5. And the COVID-19 pandemic has cost many people their jobs and businesses, placing similar stresses on families. Beyond abuse, Cathleen Palm, founder of the Center for Children’s Justice, said it may take years to fully assess how much damage has been done to children in the pandemic.

Palm said part of the problem is the state doesn’t capture real-time data on cases of child abuse and neglect, even though it’s easy to check online dashboards to find new COVID-19 cases on a daily basis.

“We don’t have anything similar to that when it relates to child abuse,” Palm said. “I think if people were tuned into that dashboard on a regular basis, I think people would be alarmed.”

While concerned about the prospect of abuse being unreported, she said doctors and advocates have seen other dire consequences due to neglect.

At a summit in December, some doctors said they were more children who overdosed, in some cases finding illegal narcotics made accessible from inattentive parents. Some youngsters are overdosing on over-the-counter medications. At UPMC, more children are coming in because they’ve ingested drugs, including “marijuana gummies,” Berger said. Some parents are drinking more and doing more drugs and are lax, or some are simply exhausted and aren’t paying enough attention, Berger said. Plus, children are home more and they have more time on their hands and more opportunities to get access to drugs in the home.

There’s also concerns with online bullying.

“There’s been so many different threats to children and ways kids have been collateral damage that I don’t think we can fully measure,” Palm said.

A call to reopen schools

About one-third of Pennsylvania’s schools are still operating remotely.

“I can’t emphasize enough the need to get back in school,” Berger said. “ … At least, get them into a classroom. Get a teacher seeing these kids.”

Wolf’s administration has earmarked the first batch of the Johnson & Johnson vaccines to teachers, school staff and child care workers in order to get more students in classrooms. Last week, the Wolf administration said the effort was ahead of schedule and most teachers and staff should be vaccinated by the end of the month.

While most Pennsylvania schools are offering some in-person classes, Berger said it has taken too long. She pointed to New York City schools, which have been in session for months with low rates of COVID-19 transmission.

“At this point, we know you can open schools as long as you do it well,” she said.

Adams, the Berks County prosecutor, said it’s critical for schools that are still operating remotely to move to in-person instruction, so teachers and staff can spot children who need help.

“We are concerned that children are not seeing the people who have reported abuse in the past,” Adams said. “That is why I’m concerned. Frankly, getting our children back into school is of the utmost importance and we should not see that constrained any longer.”

From The Morning Call, March 22, 2021