Oregon child welfare advocates forced to make difficult decisions about who gets seen

And fewer disclosures of abuse are being made at a time when children are at home with nobody to tell

by Libby Dowsett | 1 Apr 2020

Urgent child abuse cases can’t wait, even in the age of COVID-19.

“We always want to be here,” said Dr. Cathy Lang, medical director at Children’s Center of Clackamas County. “You never know when a child is going to disclose something that needs immediate attention.”

But that doesn’t mean every child is getting in for an assessment.

The skeleton crew still working at the Children’s Center building in Oregon City is being forced to pick and choose which children will be seen immediately and which will have their appointments delayed.

“It feels bad to put off a child coming in to talk about their abuse,” Lang said. “It’s not something we’re used to or feel good about, but we have found that many families, where the child is safe, don’t want to come in anyway right now, due to the public health crisis.”

In an average week, Children’s Center employees conduct about 10 child maltreatment assessments. This past week, they had just one.

Despite the dramatic drop in child abuse reports, medical personnel at the Children’s Center believe the coronavirus epidemic is leading to an increase in physical child abuse, but kids are stuck at home with no one to tell.

“A lot of times when a child is being abused, they make disclosures to people outside their family, including teachers, counselors and coaches,” said Bitsy Taylor, therapy program manager at Children’s Center of Clackamas County. “There’s so much that goes into a child making a disclosure. They often want to protect their family or not upset their family. They might be being hurt by someone in their family.”

Assessment teams are accustomed to seeing the number of child abuse reports drop during the summer, but, Lang said, “we’ve never seen the numbers go down this much. Children aren’t just out of school — but all activities. They’re not even going to grandma and grandpa’s house.

“That makes us worry about the kids who may be at risk and in unsafe situations right now — those who don’t have a person they can tell or go to, or anyone who’s going to recognize this child may have an injury.”

The Children’s Center’s interim executive director is brainstorming ideas with leaders from children's advocacy centers around Oregon on how best to keep clinic doors open for urgent child maltreatment assessments while still following the World Health Organization and Centers for Disease Control and Prevention guidelines for protecting staff and clients from COVID-19. The staff has already put into place strict safety protocols and limits on who can be seen.

“We’re really stuck between wanting to be available for kids and wanting to respond appropriately to this public health crisis,” said Rebecca Nickels, Children’s Center interim executive director. “If kids can’t go to child advocacy centers, they have to go to emergency rooms, and we certainly don’t want them to go there right now.”

On Tuesday, U.S. Sen. Ron Wyden sent a letter to the Trump administration urging guidance for child welfare agencies during the COVID-19 crisis. These agencies are not designed for the CDC’s social distancing requirements, Wyden’s office said. The letter was also signed by nine other Democratic senators.

As it is now, until April 27, the Children’s Center staff is assessing only cases that meet “urgent” and “ASAP” criteria, including acute sexual assaults, genital injuries, drug exposure, witness to a crime, and Karly’s Law incidents, which are physical abuse suspicions that must be investigated within 48 hours.

During an assessment at Children’s Center, youths may be interviewed by a forensic interviewer, examined by a specially trained physician and offered counseling through the center. Caregivers are invited to participate in the therapy program, as well.

Under the new protocols, all clients are being screened over the phone for possible illness or exposure to the coronavirus before appointments are scheduled. Only five assessment team members are working in the building at one time. Supervisors are coming in, as needed, while other staff members are working from home.

Directors from Children's Advocacy Centers across the state recently discussed the idea of conducting forensic interviews with youths over the phone, but the idea fell flat.

“Our forensic interviewers thought that they might miss non-verbal cues,” Nickels said, “or they wouldn’t know if someone was in the room while the child was interviewed, influencing what they were saying or not saying.”

One service that’s working relatively well over the phone is the Children’s Center therapy program. Taylor is asking families to find a quiet place in their homes where children and their parents can talk to her privately.

“I’m sure we’ll get back to focusing on the abuse trauma that brought the kids to see me, but mostly, I’ve just been trying to support kids and parents with navigating COVID-19,” Taylor said.

“All the skills we’ve been talking about in dealing with past abuse are applicable with their experiences right now. We’ve been working hard on recognizing triggers and recognizing when you’re feeling overwhelmed and upset.”

Taylor hopes to set up secure teleconferencing, which she believes will be a better tool for her youngest clients.

“I talked to one younger kid who was not super-interested in talking to me over the phone,” she said, laughing.

Becky Jones, with the Oregon Network of Child Abuse Intervention Centers, is calling on all Oregonians to work together to keep eyes on children during this crisis. The group serves as a liaison for Children's Advocacy Centers in working with the Governor’s Office, the Department of Justice, Oregon Child Welfare and other statewide partners.

Jones wrote in an email to Street Roots, “Especially in times of crisis, isolation and fear, it’s important to remember that a generous, knowledgeable, proactive, and prepared community can still help keep kids safe.”

She also wrote, “The public must remember it’s not their job to be an expert in child abuse. They just need to know enough to make the call. It is absolutely true that one call can save a life.”

Children’s Center staff members predict that stress and social distancing may take a toll on families, and they expect a big increase in the number of referrals when Oregon’s “Stay Home, Save Lives” order is lifted.

“Parents and kids need to take it easy on themselves,” Lang said, “because it’s a really crazy time right now. Parents should make an effort to be present for their kids and not get too stressed out about whether they’re doing everything right.”

Staff members are taking that advice to heart.

“It’s a little uncomfortable due to all the health warnings which are in your head,” Taylor said. “But once I start offering support to a family, I just get into my ‘support zone,’ and that all goes away. The focus falls more on how we can support this family, and this child, in this particular moment.”

HOW TO HELP

For more information on Children’s Center and how you can help local children who have experienced abuse, visit:

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