Violence and Children: Creating A Safer World For Kids

By Jan Howard

We see the headlines all the time, we have all heard the shocking stories— a 2-year-old boy killed by a gun, a 6-year-old fatally shot by his 5-year-old brother.

Debbie Henriques, RNC, of Danbury Hospital’s staff, stepped in at the Sixteenth Annual Pediatrics Update Conference to present a program prepared by Elizabeth Ahmann, ScD, RN, of Columbia University School of Nursing, who was unable to attend because of a child’s illness.

The presentation noted the following statistics.

In 1994, arrests of persons younger than 18 years of age for murder and nonnegligent manslaughter totaled 2,982. This was an increase of almost 75 percent over 1985.

The violent crime index for juveniles increased by 68 percent between 1988 and 1992.

The United States has the highest youth homicide and suicide rates among the 26 wealthiest nations in the world. From 1985 to 1995, homicides among 15- to 19-year-olds increased 113 percent.

Every six hours, a teen or preteen commits suicide with a gun. In 1997, firearms-related deaths accounted for eight percent of all injury deaths in children through 14 years and 27.9 percent in children and young adults through 24 years of age.

More United States teens die from gunshot wounds than from all natural causes combined, and permanent physical disabilities attributable to assaults are rising, including spinal cord and traumatic brain injuries.

In 1999, 36 percent of students in grades nine to twelve had been in one or more physical fights.  Thirty-eight percent from sixth through tenth grade had been involved, either as a perpetrator or recipient.

Eighty-eight percent of children injured or killed in unintentional shootings are shot in their own homes or in the homes of relatives or friends.

Twenty thousand people a year are paralyzed from gunshot wounds.

 “We have a lot of work to do,” Ms Henriques said.

According to Ms Ahmann’s program, children are exposed to violence through family, community, media violence, and bullying.

“Violence can have staggering effects on children,” Ms Henriques noted.

Some effects are physical injuries; psychological consequences; developmental, cognitive, and academic; antisocial behavior; and increased risk of violent behavior. Witnessing or experiencing violence can affect children’s views of the world, their expectations, and cause post traumatic stress disorder.

Very early exposure to violence may affect children through decreased verbalization, depression, fears, and their ability to react to stress.

Mediating family and community factors include a good relationship between a child and parent, both early on and later; good relationships with siblings, teachers, and peers; self-discipline; school success; having friends; and a good, supportive relationship with at least one adult.

Teachable protective skills include good communication, empathy, anger management, problem solving, and conflict resolution.

Potential interventions include legislative efforts, media campaigns, development of violence prevention programs for use in schools and communities, preventive guidance and interventions in the clinical setting, and specific, targeted interventions for children at high risk.

Parent-based interventions are among the most effective strategies for preventing violence by children and adolescents. Children learn behaviors at home, and parents can help children express their feelings about what they are experiencing.

Violence prevention counseling should be part of well child checkups, according to Ms Ahmann’s program. According to a sample of 220 California pediatricians, 31 percent screened children for fighting, 39 percent screened children for violence at home, and 29 percent screened children for weapon carrying. Fifty-eight percent followed up at-risk children.

Violence prevention by pediatricians should begin with infant and toddler visits and continue through school age children and adolescents. Pediatricians who included violence prevention received positive support for their efforts.

Key issues in violence prevention include early and ongoing nurturing, limit setting, safety screening for violence involvement and exposure, and referral to community resources as appropriate.

Pediatricians should help parents assess the child’s support system. They should emphasize positive parenting skills and reading to and spending time with children. Children want their parents to be parents.

Bullying is a precursor to actual violent behavior. Children and parents should be questioned about teasing and bullying. Parent-teacher meetings should be encouraged, and children should be reassured and counseled on responding to bullies.

Bullying can cause sleeping disorders, bedwetting, headaches, stomachaches, stress, anxiety disorder, increased absenteeism from school, and retaliation, and lead to adult criminal behavior.

A positive approach to discipline should start at a young age. Pediatricians should encourage parents to use appropriate, nonviolent discipline, such as time outs, so children know their actions have consequences. Regular family meetings should be encouraged.

Healthy communication patterns in families should also be encouraged, with parents actively listening to their children. Problems should be discussed, and good behavior rewarded.  

A child’s threats of violence should be taken seriously. Violence is of epidemic proportions, according to Ms Ahmann. Children see approximately 10,000 acts of violence a year through the media, and 80 percent of video games contain violence.

Children who watch more violent behavior become desensitized to violence, and cause them to have bad dreams, nightmares, and antisocial effects.

Parents should limit television viewing, participate in selection of programs, view them with their children and adolescents, discuss their content, and teach critical viewing skills.

Handgun safety should be emphasized to parents. One out of every four homes contains a handgun. Approximately 1.2 million elementary school age latch-key children have access to guns. Almost 90 percent of accidental shootings involving children are linked to an easy-to-find, loaded handgun in the house.

The chance that potentially suicidal adolescents will kill themselves doubles when a gun is kept in the home.

Some tips for firearm safety include removing guns from the home; if there is a gun in the home, keep it unloaded and locked up; lock and store bullets in a separate location; make sure children do not have access to the keys; use trigger locks; and, when handling or cleaning a gun, never leave it unattended.