Preventing Child Fatalities
The death of a child from abuse or neglect is a terrible,
powerful thing. Upon learning of such a tragedy, people everywhere experience fear, shame, and outrage. They hunger to know
how and why this has happened, and resolve that such a thing should never happen again.
Legislators and others in positions of authority
have responded to child fatalities and the public outcry that follows by creating a child welfare system charged with keeping
children safe and promoting their well being. In many states they have also created a complex system of local and statewide
organizations designed to help us understand, respond to, and prevent child deaths. To learn more about NC's child fatality
prevention system, see North Carolina's Response to Child Fatalities.
Child welfare workers are on the front lines in our
efforts to prevent child maltreatment deaths. Every time they respond to a report of abuse or neglect, conduct a child protective
services investigation, or assess an adoptive or foster home, child welfare workers are trying to ensure the safety of children.
In order to succeed in their efforts, they seek to follow (and refine) protocols and procedures, always keeping in mind that
the assessment of risk is an ongoing, continuous process. To help them with this process, we provide the following information
about child abuse fatalities.
Facts About Child Fatalities
It is not possible to say with complete accuracy how
many children in the United States are killed each year by their caretakers. This is due in part to differences in state laws,
in the way child deaths are investigated and classified, and in how this information is recorded. Observers also question
the accuracy of the available national data on child fatalities because they believe that many child homicides go unclassified
or unreported. Official reports probably undercount child abuse homicides by between 20% and 60% (Schlosser, 1992;
We can speak with some confidence, however, about recent
data on child fatalities in North Carolina. From 1985 through 1999, 356 children under 11 years of age are known to
have been killed by their parents or caregivers. Children above this age were much less at risk; between 1993 and
1999, only ten children between 11 and 17 years old died in this way (Herman-Giddens, 2001).
We also know that child abuse deaths are increasing
in North Carolina: between 1985 and 1994 rates of child abuse homicides rose at about 12.5% a year. Currently,
every two weeks or so, a child in North Carolina is killed by his or her caregiver (Herman-Giddens, 2001).
Most of the children killed as a result of maltreatment
in North Carolina are unknown to child protective services (CPS). Between 60% and 70% of families experiencing a child maltreatment
death have no CPS involvement in the year prior to the death (Herman-Giddens, 2001).
Child maltreatment deaths occur in the greatest numbers
among infants, followed by toddlers and preschool children. Children younger than 6 years are most vulnerable because of their
small size, incomplete verbal skills, and limited contact with adults other than their primary caregivers (Herman-Giddens,
Maltreatment fatality victims are often only children
or youngest siblings. Being born with a low birth weight and complications during pregnancy have both been identified as risk
factors for infants (Schlosser, 1992).
Depending on the age of the victim, gender appears
to be a risk factor for homicide as well. In a 1996 study, Kunz and Bahr examined records of 3,459 children killed by their
parents. They found that "in the first week of a child's life, the risk of being killed by a parent was equal for males and
females. From 1 week to 15 years, males were the victims in about 55% of all parent-child homicides; the percentage of male
victims increased to 77% in the 16—18 year-old group."
It is not clear whether race is a risk factor for child
homicide. In their review of the literature, Kunz and Bahr concluded that the research on this topic is inconclusive and in
need of further study.
Research has found that children are most
often killed by their parents or members of their families. Herman-Giddens et al. (1999) found that 63.5% of child
maltreatment fatality victims were killed by their biological parents.
Herman-Giddens and colleagues (1999) also found
that most of the time (65.5%) the killer was male—usually the father or step-father, although 18.2% of the time it was
the mother's boyfriend. Others have found that in neglect-related deaths and homicides of newborns, the mother is
usually the perpetrator (Schlosser, 1992; Kunz & Bahr, 1996).
Young children killed by their parents are most often
beaten, shaken, or suffocated to death. Older maltreatment fatality victims, especially teenagers, are more likely to be killed
with guns or other weapons (Herman-Giddens, 2001). Parents who kill their children tend to be young, often in their twenties
(Schlosser, 1992; Kunz & Bahr, 1996). Mothers who kill their children are often single, gave birth to their first child
as a teenager, have low educational attainment, did not receive adequate prenatal care for the child, and experienced complications
during pregnancy (Schlosser, 1992). In their study, Overpeck et al. (1998) found a strong association between infant homicide
and childbearing at an early age, especially if the mother had given birth previously.
Kunz and Bahr (1996) found that the age of the child
had a lot to do with the gender of the murderer. "Among infants in the first week of life," they tell us, "mothers were almost
always the ones who committed the homicide. Between the first week of life and the teenage years, mothers and fathers were
about equally likely to kill their child. During the 13 to 15 year age group, fathers committed 63% of all homicides, and
this increased to 80% among the 16 to 18 year age group" (p. 359).
The research on child maltreatment fatalities
underscores the importance of risk assessment. The risk factors found on North Carolina's risk assessment tool—especially
the high risk factors—are based on what we know about the victims of child maltreatment and their families. Social workers
should use this assessment tool as a guide as they continuously measure the relative risk and safety of every child they meet.
When there are barriers to providing effective intervention (e.g., families with multiple CPS reports, families that seem
resistent to intervention, etc.), social workers should seriously consider requesting a review of the case by their local
community child protection team (CCPT). The underlying, unaddressed conditions within these families often contribute to child
fatalities. Review by the CCPT can mobilize community resources to prevent a tragic outcome. For more on CCPTs, see North Carolina's Response.
Social workers should also continue to expand their
awareness of the factors that may increase or reduce the risk of a child fatality. A word of caution, however: even if the
people they encounter have so-called high risk traits, social workers should be careful not to judge them rashly. Instead,
they should bear in mind the fundamental social work belief that every person has innate value and is worthy of respect, regardless
of his or her actions or characteristics.
Herman-Giddens, M. E., Brown, G., Verbiest, S., Carlson, P. Hooten,
E. G., Butts, J. B. (1999). Under-ascertainment of child-abuse mortality in the United States. Journal of the American
Medical Association (JAMA), 282(5), 463-467.
Herman-Giddens, M. E. (Ed.). (2001). Not invisible, not in vain.
Raleigh, NC: North Carolina Child Advocacy Institute.
Kunz, J. & Bahr, S. J. (1996). A profile of parental homicide
against children. Journal of Family Violence, 11(4), 347-362.
McKee, G. R., & Shea, S. J. (1998). Maternal filicide: A cross-national
comparison. Journal of Clinical Psychology, 54(5).
Overpeck, M. D., Brenner, R. A., Trumble, A. C., Trifiletti, L.
B., Berendes, H. W. (1998). Risk factors for infant homicide in the United States. New England Journal of Medicine,
Schlosser, P., Pierpont, J., & Poertner, J. (1992). Active surveillance
of child abuse fatalities. Child Abuse and Neglect, 16, 3-10.