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The term of the Commission to Eliminate Child Abuse and Neglect Fatalities expired on March 18, 2016.

Because Every Child Counts

Filed in Commissioner’s Blog By on September 19, 2014

By David Sanders, Chairman

September 19, 2014

Dr. David SandersWe can all agree: One death from child abuse or neglect is one too many.

Yet we have spent considerable time during our last several public meetings, including our meeting in Plymouth, Mich., on August 28, trying to understand exactly how many children die from abuse and neglect in the United States each year. Why is this matter of “counting” so important?

We cannot solve a problem until we agree on its magnitude. The conversation begins with definitions. Although we may all agree that egregious cases of violence or deprivation represent child maltreatment, many cases are less clear. For example, if an infant suffocates while co-sleeping with a parent, do we call that neglect or a tragic accident? Does our answer change if the parent was under the influence of alcohol or drugs at the time? These decisions currently vary from state to state. They may even depend, we are learning, on which local office (e.g., child welfare, law enforcement, medical examiner) makes the determination, because each of these groups has a different goal in mind when making a decision about whether a death should be counted as a case of child abuse or neglect.

Commissioner Bud Cramer (center) engages with panel members at the August 28 public meeting in Plymouth, Mich. Also pictured: Commissioners Dr. Cassie Bevan (l) and Michael Petit (r).

Commissioner Bud Cramer (center) engages with panel members at the August 28 public meeting in Plymouth, Mich. Also pictured: Commissioners Dr. Cassie Bevan (l) and Michael Petit (r).

When we understand how these deaths occur, we can develop more effective strategies to prevent them. It is not enough to agree that a death occurred. Information about the circumstances around that death shows us which risk factors were present. These risk factors can then be used, in conjunction with real-time data, to identify other children who are at increased risk of harm—and to prevent future deaths by offering timely services to their families or moving the children to a safe environment.

Reliable trend data help us understand what is working and what is not. We have visited several states and localities that have reported declines in fatalities. However, in many cases, recent changes in how child abuse and neglect deaths are defined or reported call into question whether these declines truly reflect greater safety for children. To report an increase or decline in deaths as a “trend,” we must feel confident that the same types of deaths are being counted, in the same way, from place to place and year to year. Only then will we be able to determine which prevention strategies are effective and should be continued or expanded to other regions.

Dr. Amy Smith Slep (r), professor at  New York University, presents her research to Commissioners during the panel, State and Federal Strategies to Improve Data Collection for More Effective Child Maltreatment Fatality Research, Practice, and Policy. Panel member Steve Wirtz, Ph.D., Chief of Injury Surveillance and Epidemiology, California Department of Public Health, is also pictured (l).

Dr. Amy Smith Slep (r), professor at New York University, presents her research to Commissioners during the panel, State and Federal Strategies to Improve Data Collection for More Effective Child Maltreatment Fatality Research, Practice, and Policy. Panel member Steve Wirtz, Ph.D., Chief of Injury Surveillance and Epidemiology, California Department of Public Health, is also pictured (l).

What we are hearing, over and over again, is that if we are going to successfully gather accurate, complete, and useful data that will further our cause, we must work together—across systems and through broad-based community partnerships. We know, from the GAO’s 2011 report that relying on any single agency or system to provide national data is likely to fall short of providing an accurate count.

Through our current focus on counting, we are looking closely at promising practices at work in states and localities. We are asking tough questions to unearth what is working and what it will take to bring effective solutions to scale. I invite you to read about these discussions in our highlights and transcripts of each meeting; these will continue to be posted on our Past Events pages as they become available.

Why is counting so important? Because every child counts. Our ultimate goal—to reduce the number of child abuse and neglect fatalities in this country to zero—is going to require the cooperative efforts of a broad and committed group of stakeholders. Only when we agree on the scope of the problem will we be able to work together effectively to solve it.

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