Children's Exposure to Violence

Domestic violence is the greatest public health issue confronting women and children in the United States today. Information from the American Medical Association indicates that:

• Battering is the primary cause of injury to women in the United States.
• The average victim of domestic violence will be physically abused three times per year.
• The total annual health care cost of domestic violence is estimated at over $40 million.
• 20 to 45 percent of all injuries seen in emergency rooms are the result of domestic violence.
• Two-thirds of all women who are murdered die as a result of domestic violence.

Domestic violence is defined as a pattern of behavior that may include physical and sexual violence, threats, insults, and economic deprivation aimed at gaining and maintaining power and control over the mind, body, behavior, and lifestyle of a partner. Under this definition, domestic violence is not limited to married couples or even heterogeneous relationships. Domestic violence can and often does occur within families and across generations.

One of the problems that social scientists, researchers, doctors, and advocates have in documenting the numbers of victims of domestic violence is the stigma attached to an act of violence between family members and intimate partners. One's home is considered a place of safety and refuge, so when violence occurs in that sanctuary, the perpetrators and victims are often reluctant and even fearful to report the incident to outside persons or agencies. When the violence is reported, women and children are overwhelmingly reported as the victims.

In the United States, researchers estimate that one in four women will experience domestic violence at some point in their lifetime. Women who seem most vulnerable to domestic violence are ages sixteen to twenty-four. Data from a 1998 study by the National Violence Against Women Survey indicate that 8 million women are physically, sexually, or emotionally abused every year and 1.9 percent of the women in the United States, which represents 1.9 million women, were physically assaulted in the 12 months prior to the survey.

But physical assault is only a small part of the overall cycle that constitutes domestic violence. The cycle frequently begins with forms of emotional abuse including humiliation, name calling, and making the victim feel guilty. The perpetrator may also use economic abuse, such as preventing the victim from getting a job or taking all the money away and controlling every expenditure. The perpetrator may isolate the victim, limiting the victim's contacts with other family members, friends, and social contacts. As the cycle escalates the perpetrator may use threats of violence against the victim or against children in the home or actual violence such as abusing pets, breaking things, and displaying weapons. Eventually the threats will lead to physical violence causing injury and sometimes death. Physical violence includes beatings, rape, and mutilation.

When the violence is over there may be a period of peace in which the perpetrator asks for forgiveness, apologizes, presents gifts, and blames others, including the victim, for causing the violence. Most often the victim will forgive the perpetrator due to emotional and financial dependence. Victims may also, because of past humiliations and intimidations, feel that they share the blame for causing the violence and the cycle will repeat itself. By definition, domestic violence is a pattern of behavior and not a single act of violence. This pattern or cycle repeats itself many times and it is the repetition that classifies the behavior as domestic violence.

Domestic violence cuts across all areas of culture, class, income, education, profession, race, and age. Internationally an estimated 20 to 50 percent of women have experienced physical violence from an intimate partner or family member. But the true magnitude of domestic violence is hard to assess. In some cultures sexual abuse or rape by an intimate partner is not considered a crime and many incidents of domestic violence are ultimately reported as child injury or abuse when a child is intentionally or unintentionally injured during a violent episode. Even when the situation is made known to legal or social service agencies, treatment or prosecution may be difficult because the victim will not press charges or leave the home.

The Effect of Domestic Violence on Children

Police reports indicate that children are present in the home in 40 to 50 percent of cases involving domestic violence calls. Research indicates that between 3.3 and 10 million children are exposed to domestic violence in the United States every year. Children are significantly affected by this exposure to domestic violence in a number of ways. The most common are that they observe violent acts, they incur injury to themselves, and they suffer neglect by their caretakers.

Children who observe domestic violence react in many ways. External behaviors may include aggressive behavior and conduct problems in home and in school, fighting, cursing, and name calling. Internal behaviors that may also occur include anxiety, depression, low self esteem, guilt, crying; decreased intellectual and academic functioning including inability to concentrate; difficulty with school work, school truancy and failure; and developmental delay. Domestic violence can also affect children's social development, causing them to become isolated and withdrawn from friends and family and demonstrate low levels of empathy. Children affected by domestic violence may also exhibit negative physical health, developing somatic symptoms, poor sleeping and eating habits, headaches, stomach aches, and self-destructive behaviors such as suicide attempts and self-mutilation. A 1998 study indicates that between 45 and 70 per cent of children exposed to domestic violence are also victims of physical abuse. Children in homes with domestic violence are at higher risk of sexual abuse than children in nonviolent homes.

At every stage of a child's life the impact of exposure to violence in the home is evident. Infants or very young children are vulnerable to injury when adults handle them roughly in a moment of violence, but children are also subject to injury when flying objects are thrown or smashed or when weapons are used. They also may be ripped from their caretakers' arms or hurt when the person holding them falls or is knocked down. The victim of domestic violence may neglect the child in an attempt to appease the abuser or in fear that the child might be harmed further if concern is shown. Effects of this neglect can be seen in infants or young children through eating or sleeping disturbances (particularly if the abuse routinely occurs during meal times or after the child has gone to sleep), listlessness, developmental delays (due to lack of stimulation), and failure to thrive (due to lack of nurturing). Exposure to violence interferes with children's ability to develop trust in adults charged with their care. These children commonly exhibit excessive irritability, fear of being left alone, regression in toileting and language skills, and other delays in learning.

School-age children between the ages of five and twelve may exhibit more significant behaviors as a result of observing domestic violence. These children may be aggressive toward other children, exhibit low self-esteem, feel insecure, run away, use drugs, or have problems in school. As the child enters the teen years the child may exhibit more of the behaviors associated with the abuser or the victim. The child who identifies with the victim may come to accept violence as part of an intimate relationship. The child who identifies with the perpetrator learns to use violence to control relationships. Teens may also feel compelled to intervene on behalf of the victim and be injured, or be coerced into participating in the violence. Teens commonly experience shame about what is going on in their home and seek to remove themselves from the situation by running away or attempting suicide. When a victim seeks to remove herself and her children from an abusive situation, the children are frequently separated from their communities, friends, and schools. This puts additional stress on the child.

Given the serious consequence of domestic violence on children, some professionals argue that exposure to domestic violence constitutes a form of child maltreatment. But others argue that not all children are affected in the same way and that, in fact, many children learn to cope with the violence. Thus, witnessing abuse should be viewed as a potential risk factor for child maltreatment rather than conclusive evidence.

Response to Domestic Violence and Child Maltreatment

Since the late 1980s, researchers and practitioners have recognized the relationship between domestic violence and child maltreatment, yet little has been done to coordinate the delivery of services to these populations. The typical service delivery model has different points of entry into the system for adult victims and child victims. Frequently cases are heard in different court systems and those seeking help have to repeat their stories numerous times, fill out similar types of forms at each agency, and receive counseling separately from their children. In some systems the victim is required to seek counseling to receive other services, but the abuser is not required to receive any treatment at all.

As communities have focused on making families safer, new strategies have been developed to address domestic violence treatment and prevention. These strategies focus on building collaboration among law enforcement, child welfare, health care, and domestic violence prevention advocates. Cross-training is one of the most commonly implemented strategies to ensure that police officers, child protective services workers, school personnel, and mental health and medical professionals all recognize the signs of domestic violence and child abuse and know where to refer the victim. Co-location of services to facilitate access to safe housing, counseling, financial support, and legal intervention to victims and children is another effective strategy. But there is still much about prevention, identification, reporting, and treatment of domestic violence victims and abusers that is not known.

Laws on Domestic Violence

In 1984 Congress passed the Family Violence Prevention and Services Act, designed to help states in their efforts to increase public awareness about domestic violence. Ten years later the Violence Against Women Act of 1994 (VAWA) was passed. This act includes provisions to increase the number of programs available to victims of domestic violence. In addition, VAWA directly addresses the impact of domestic violence on children through treatment programs for children who are harmed by these acts.

State laws vary in approaches to domestic violence. For example, all states have provisions for restraining orders to keep the abuser away from the victim, but how long the order lasts, who is included in the order, and how specific courts process such requests vary from state to state. More than half of the states have laws that require that domestic violence be considered when a court makes an award of child custody or visitation. And while this is an improvement over the days when domestic issues were considered irrelevant to the welfare of the child, the laws still leave much discretion to the court.

Societal costs of the effects of domestic violence are enormous. Some costs, such as the cost of mental health and medical treatment, loss of work time for victims and abusers, court proceedings, and law enforcement response, can be estimated. But society cannot begin to estimate the worth of a lost childhood, broken homes, death of a parent, and fear caused by domestic violence.