When the COVID-19 pandemic hit and America went into lockdown, child welfare systems across the country grew concerned. Calls to child abuse hotlines have plummeted and child protection officials have sounded the alarm, suggesting the sharp drop in reports is a sign that an invisible epidemic of child abuse spread behind locked doors. As one reporter described it: “While much of the city has remained indoors and ‘safe’, for many children from struggling homes, the coronavirus pandemic has confined them to the place. as dangerous as possible.”
The shift to virtual schooling has fueled these concerns. Education staff are responsible for 20 percent of all child abuse hotline reports during the school year. And teachers no longer had the ability to see children in person and spot the signs of abuse and neglect they are required to report.
But then something unexpected happened. Rates of child abuse and neglect have not increased in the United States. Research published by two of us in JAMA Pediatrics found that the rate of child abuse emergency room visits actually decreases in the early months of the pandemic, from an average of 1,000 per month to a low of 400 per month in March 2020. Hospital admissions for child abuse declined sharply.
Other researchers have reported a decline in infant hospitalizations for undue head trauma. Reports to child protection agencies have dropped by 40 to 60 percent, a drop far greater than any school closures could explain.
What explains this epidemic of mistreatment of missing children? It’s simple: prevention works.
The pandemic has demonstrated the positive effects of meeting family needs rather than removing children from their families after a disaster. When the pandemic started, many parents struggled to keep their families safe. Many faced job losses, health problems and disruption of routines. In March 2020 and March 2021, Congress passed COVID relief bills that provided timely and meaningful support to offload this stress and lessen the impact on families. These investments have reduced economic stress, which has had a measurable impact on protecting children from abuse and neglect.
Research has found that spending on public benefit programs such as cash assistance, housing, child care, earned income tax credit and medical assistance programs are associated with a reduction in the involvement of the child protection system and in child deaths due to maltreatment. Chapin Hall’s analysis of the relationship between economic and material supports and child maltreatment and child welfare involvement confirms this, noting: “Research suggests that poverty is a key factor in the involvement of the child welfare system. . . even modest economic supports can stabilize families and lessen the need for more intensive intervention.
Which of the COVID-era supports has made the biggest difference? A 2020-2021 survey of 9,000 American parents found that nearly half of American families received help with their basic needs. Stimulus checks and child tax credits have dramatically reduced child poverty. Unemployment insurance payments and eviction moratoria have stabilized housing for many. Communities and nonprofits have also stepped up. School bus drivers delivered food to children who had missed their school meals. Non-profits have turned offices into pantries. Teenagers helped bring food to the elderly, and adults found ways to preserve family ties.
With these supports in place, families not only survived COVID, they were able to enjoy time at home with each other. In the survey, parents said they read books, cook, tell stories, take walks, play outside, watch television or play video games with their children. Even acknowledging extraordinary stress, most families have found that the pandemic has brought them closer together.
Falling rates of abuse and neglect have also exposed flaws in our mandatory reporting system. The experience during COVID, when children have seen fewer mandated reporters such as teachers, shows that mandatory reporting is not the ultimate solution to child and family well-being. The evidence that racial disparities affect our current mandatory reporting process and our child protection system has been accumulating for years. A study shows that more than half of black children and more than a third of all children in America are investigated for child abuse or neglect before the age of 18. In contrast, another study reports that black adults are less likely to remember that they experienced child abuse than white adults. This racial disproportion could be the result of our society’s tendency to blur the lines between abuse and neglect and economic instability.
The accusation of neglect, which accounts for the majority of families involved with Child Protective Services (CPS), is driven by persistent poverty or, as was the case during the pandemic, temporary economic shocks, such as a loss of employment or health problems. Both of these conditions can lead to untreated drug addiction, mental health issues, domestic violence, and other family stressors. Rather than CPS involvement and family separation, these families need resources that could enable them to weather the storm and keep their children safe at home.
We have an opportunity to leverage the lessons of this pandemic to reduce child abuse and neglect, reform child protection and mandatory reporting, and address systemic racial inequalities.
Three federal programs are slated for reauthorization by Congress this year and can help make community prevention a priority. They include the Child Abuse Prevention and Treatment Act (CAPTA), Title IV-B of the Social Security Act, and the Maternal, Child, and Early Childhood Home Visiting Program ( MIECHV). The Temporary Assistance for Needy Families (TANF) program, whose statutory purpose is to support needy families so children can stay safely at home, must also be reauthorized, and Congress could ensure that families receive the resources they need upfront, before any intrusive intervention and costly CPS interventions. Other essential supports for families are the expanded child tax credit, paid family and medical leave, behavioral health services and quality child care.
This pandemic has taught us that child adversity, like abuse and neglect, is a public problem, a problem that can be solved, and a problem that can be prevented. We know that parents love their children and that families are our greatest asset in keeping children safe and healthy. Meaningful, cost-effective supports can help even the most overburdened parents overcome adversity and help their children thrive. A child and family welfare system that helps all families meet their needs should be our goal. This is an achievable goal, a collective responsibility, and we invite everyone, especially Congress, to join us in pursuing it.
Robert Sege, MD, Ph.D. and Allison Stephens are part of the HOPE National Resource Center at Tufts Children’s Hospital and Tufts Medical Center and co-authors of the report, “Physical Abuse Against Children Did Not Increase During the pandemic”. Sege is a senior fellow at the Center for the Study of Social Policy in Washington DC and a professor of pediatrics and medicine at Tufts University School of Medicine. Stephens is director of networks, communications and policy at Tuft’s Center for Community-Engaged Medicine. Amy Templeman is Director of Within Our Reach and Director of Practice Excellence at Social Current. Previously, she served as Executive Director of the Federal Commission to Eliminate Child Abuse and Neglect.