AUGUSTA, Ga. (WJBF) – The Means Report turns its focus to child abuse. It is a tough subject, but there is a good reason for the discussion. The pandemic has caused cases to go up, but, at the same time, there has been a lack of reporting. Dr. Kevin Allen is an emergency medical physician at the Children’s Hospital of Georgia as well as the Medical Director of their Child Protection Team. He helps us understand the types of abuse and how we can protect our children.
Brad Means: Dr. Allen, first and foremost. Thank you for what you do for our children.
Dr. Kevin Allen: No worries. Thank you for having me on today. And it’s I take a good pleasure of doing this job.
Brad Means: I want to just ask you about the pandemic. You know, we’ve reported on the news, that cases of child abuse would be and have been under reported. Or not reported at all because everybody’s at home and the teachers aren’t watching our children anymore. They’re in so many ways, our eyes and our ears. Did you see this coming when the pandemic started? And if not, how long did it take you to realize that the abuse was happening and nobody was finding out about it?
Dr. Kevin Allen: We did see it coming. It’s been demonstrated before in history and in literature that anytime there’s a pandemic or environmental emergency. So with the Spanish flu in 1913 and even hurricane Katrina. And anytime there’s a situation that removes children from the public eye, we know that initially reports will go down because like you said, the normal people who report, the teachers, the doctors, the clergy members who see children, aren’t seeing those children in the public eye. And then we also expect is once the world opens back up, the cases go back up because all the cases that were not reported are now getting caught again and being reported.
Brad Means: It’s so unsettling to hear. And it’s so scary, but it is a reality. You deal with it, you face it, you try to fix it every day. What kinds of abuse do you see when it’s time for somebody to finally get your help at the hospital? What are you, what kind of injuries are you noticing?
Dr. Kevin Allen: Sadly, a lot of times, because of just the nature of abuse, we tend to see them when they’re towards, you know, the more serious ends of the injury. So with the physical abuse patients, we see them once they come in with either a broken bone, or an extensive bruising or a head injury for a young baby. Sometimes we even see them when they come in, in CPR because they’ve been abused for so long, and tragically they’re in a severe critical situation. Similarly, with sexual abuse, we don’t typically see them the first instance of the abuse, it’s usually a process that happens. And we see them after months, if not years of emotional and sexual abuse underneath their caregiver. And also similarly with neglect, which is another type of abuse. We don’t tend to see them until they actually present with a serious issue, secondary to their neglect that makes them present for help.
Brad Means: Yeah I was gonna ask you about that. And also will ask you about the sexual abuse, as our time together goes on. What do you mean when you say secondary conditions or issues as it relates to neglect? Because neglect isn’t going to make a mark on your body.
Dr. Kevin Allen: Right, it may not make a mark on your body right away. Typically what we see for neglect in children, a lot of it has to do with their growth and development. So, you know, children are designed to grow and they normally putting on weight and getting taller. So what we see in neglect, where we can see sometimes is that you notice a child who’s not getting taller and not putting on weight. They’re, you know, they’re way too small for their their age. And that concludes saying that that child is being you know, nutritionally neglected. They’re not getting the resources into their body to help them grow. With medical neglect, you have children who have chronic medical problems. A common, easy one to discuss is asthma. And they normally have medicines that they’re supposed to take to control their asthma. If they’re not taking those medications, they can present routinely to the hospital with their asthma flaring up. And we can kind of get a clue that this kid is not being taken care of appropriately.
Brad Means: Take me to that moment. Take me to that moment when you know that the care is inappropriate or worse. Do you call the authorities after you race to go get the asthma medicine? Do you intervene right then and there to try to separate the victim from the abuser?
Dr. Kevin Allen: Yeah so, the first thing we do, focus in on, is that we will take care of the medical emergency first. So with the exact example of asthma, we will get the asthma medications to them, get the breathing treatments and the medicines to help control their asthma. But then, you know, our second job is we will make sure that this child has access to all the resources that they need to be taken care of at home. And if we noticed that there is something lacking, then we will get the appropriate resources involved. Sometimes it could just be a simple social work consult and getting the family some education or helping them figure out how to get access to the medications. But if it reaches more serious levels, then we are mandated reporters, so we will report to defax. If we need to, if we feel like the child is purposely being neglected.
Brad Means: I’m trying to picture the victims while you’re talking about them. I’m trying to picture the people who come into your world each day. Is there an age range that is the typical victim? Is there a socioeconomic background that is the typical victim? What do you see?
Dr. Kevin Allen: So it’s kind of an interesting phenomenon. We tell people that certain risk factors make children more likely to be abused, but then we also encourage them to realize that even in a quote-unquote, perfect home, a child could still be being abused. So the literature and data does show that younger parents, so they’re usually going to be lower in education, lower in resources to be able to support a family unit. They tend to be an increased risk factor for abuse in the home. And so by younger, we really mean like teenage parents. And then also, you know, low socioeconomic status. Anyone who has children know that children are for lack of a better word, expensive to raise. And so if you have tight, you know, resources financially, sometimes it can be hard to take care of the children. So we do note that we have increased rates of abuse in people who have low socioeconomic status, you know, below the poverty line, near the poverty line, don’t have access to good resources. But we say that with the caveat that even in a home that has good paying jobs, can have multiple parents, it can be grown parents who’ve had children before. Children could still be at risk for abuse in those, in those homes. So don’t ignore it. If you still see the signs.
Brad Means: I know you mentioned that they’re lower on the socioeconomic scale. So perhaps in many cases, they’re not employed. But if you did work at a job where there was an abuser, who was your coworker. Would you be able to tell? Is there anything about their character or personality that jumps out?
Dr. Kevin Allen: Yeah, that’s kind of a touchy subject. It’s a little hard to just judge character traits because there are some people that you work with that might have a kind of abrasive personality. But you know, when they’re dealing with their children, they’re, you know, sweet delicate and gentle as need be. I focus more on the child than the caregiver. Obviously, if you have an adult who has like a drug problem or alcohol problem, or anger management problems at work, then yes. If they have children at home, it’s reasonable to be concerned that their children might suffer from that. But paying attention more to, does the child show signs of abuse? Or does the child show signs of emotional neglect or damage? Is a little bit better way of wondering when you need to pull the trigger to get some eyes on that child.
Brad Means: Here’s the problem though, kids are rough. Kids are kids. And so if I see a child with a scraper or a bruise I might just blow it off and think they were probably just rough housing. How do you know the difference between that and real abuse related injuries?
Dr. Kevin Allen: So our pediatricians, and I was trained pediatrician first before I went into pediatric emergency medicine. We are taught to know how children grow and develop. So we know how children move. We know how children play. And so we kind of know what parts of their body, they will get quote-unquote, accidental injuries. So, children run, play, jump as far as how they put their clothes on. We know that they’re very likely to have accidental injuries on their arms and on their legs just from playing. But we do know is how they’re designed to walk and how they’re learning to walk and develop and play. They don’t typically fall and hit certain parts of their body. So we rarely see accidental bruising on their ears. We rarely see accidental bruising on their neck, or their chest and torso. Cause those are usually, one, covered areas. And or two, when they fall accidentally they’re not designed to fall and hit those areas first. They hit the more protective areas, which are the front of the skull. And they’re big butts that they fall down on their bottom and hit.
Brad Means: Yeah, that’s a good point. There are so many parts of the body that typically aren’t injured but would be in cases of abuse. We are talking to Dr. Kevin Allen with the Children’s Hospital of Georgia, a true hero and advocate for our children, when it comes to child abuse. We’re going to look at sexual abuse. We mentioned that briefly in this segment. We want to tackle it further in our second segment. When The Means Report comes back.
Brad Means: Welcome back to The Means report. We are talking about child abuse today. Something that has risen during the pandemic because few people were watching our children. They like many of us were hidden for the past 14 months or so. Dr. Kevin Allen with the Children’s Hospital of Georgia is our special guest today. You were talking Dr. Allen in our last segment about the difference between regular childhood injuries and abuse related injuries. I think you did an exceptional job of that. But what about when it’s sexual abuse? Wouldn’t it be tougher to spot those signs and symptoms?
Dr. Kevin Allen: Sexual abuse is one of the harder, one of the more harder ones to not only recognize, but then also definitively say that this child has been sexually abused. Which would give us the power to remove that child from that environment and protect them because they typically do not show any outward physical signs, for sure. There typically aren’t any bruises or obvious injuries and they usually won’t present until there’s some secondary issue going on, either a pregnancy that was not wanted, or if they have psychological sequela from it, they’ve developed depression or suicide attempts. And then in our workup, we find out that they had been abused. A lot of times, that’s how we end up picking up on those cases.
Brad Means: You mentioned how other agencies can come in and help or how you all, as physicians can refer these children and their families, if need be, to the right places and people. Is the system overwhelmed right now? Are people in places like defax and social services just slammed?
Dr. Kevin Allen: Most certainly in defax, definitely is overrun, is you know, funding issues with the pandemic. You know, a lot of these things are government funded and the government suffered from the pandemic with people not being able to work. So I know some of those funding issues are affecting us but we, I just had a meeting today with some of our different services. We’re still running strong. We’re still doing all the different things that we need to do to get those children’s interviews and get them referred to counseling services. So we’re, they’re still functioning but they are definitely stressed with the increased number of cases, for sure.
Brad Means: How do we report it? How do we perhaps have the courage to take a child to see you, to get treatment? How do we perhaps get the courage to go to an agency to report suspected abuse? Because if you’re wrong, it could get really awkward, especially if you know the parent or the abuser or the, and they’re not one.
Dr. Kevin Allen: Right. The beauty for everyday people is that the reporting system is one, anonymous. So you can make a report without your name being attached to it in someone being able to discover who you were and made the report and come back and harm you in anyway. Two, it’s also is centralized throughout the state. And it’s actually a phone number. It’s a hotline number that you can call and make the report. You would just have to be able to provide like the child’s name, possibly date of birth and address. A way for them to be able to find the child, obviously. So it, that makes it easier for an everyday citizen person to be able to report without any risk or worry about getting retribution. Sometimes that makes it harder for pediatricians who have been taking care of that family for a long period of time to make that report because the family might be able to kind of figure out that it was them. Same thing with clergy members. Obviously with us, specific like, if the child comes to the ER and all of a sudden defax shows up, or police shows up, they’re gonna clearly know that the ER team made a phone call and got people there. So it, it affects us a little bit more as far as worrying about retribution, but we also know that our law enforcement in our judicial system, they do everything they can to protect the reporters because they don’t want to scare people away from reporting. So they do everything they can to protect us as far as, an enemy. But then they also have it set up to where it’s very, very, very hard to like, sue or get somebody in trouble for making report, even if they were wrong.
Brad Means: What’s it like for you when you’re in the exam room and you kind of glance over at the mom or the dad, or the caregiver and you suspect something and they know that you suspect something? How do you get through that moment?
Dr. Kevin Allen: Yeah, it’s just, you know, part of it is kind of personally my upbringing and my personality, I’m able to, you know, be calm in chaotic situations and kind of still deliver messages. So that kind of was one of the things that helped me get into this career and be able to function in it. There’s a couple of things that I remember typically, the person who is abusing the child knows when they’re doing wrong. And they’re not usually the ones that bring the child to the medical facility. So majority of the times when they were seeing the child the person who’s there with them is not necessarily the abuser and is someone looking out for the child and they don’t typically take it personally that you’re telling them, your working their child up for abuse. Two, the second thing I do is I always focus back in on the child. Even if the parent is the one that I think is doing it, it’s the person I talked to. You know, I just remind them, I’m a children’s doctor. The patient is actually your child, not necessarily you. So I’m going to do everything I can within my power to take care of this child and protect them. And in third, a lot of times, since they’re not the abuser, I get the opportunity to have the conversation with them. That me making this report is not something about me trying to get you punished. I’m actually trying to get you access to all the resources that you and your child need to be able to help this child grow and develop in a safe environment. And a lot of times when you can kind of shift it from a punitive situation to a, “we’re getting you help” situation. A lot of times that opens up their eyes a little bit more.
Brad Means: Depending on where you do your web search, you can find all sorts of stats about the child abuse. One said that one out of every six girls and one out of eight boys will be assaulted by the time they’re eight years old. My question is if we are more diligent, if we heed your advice today and we’re better reporters and observers of child abuse and we let the proper people know. Can we really make a dent in this? Because so much of it takes place in the shadows. Can the general public help?
Yes. And that number specifically, is for sexual abuse.
Brad Means: Yeah.
Dr. Kevin Allen: And so we can, the more we recognize that it’s going on and the more that we try and keep a keen eye to it, we can help save these children sooner than later. I think I mentioned it a little bit earlier. With the sexual abuse, it’s kind of a continuum and they actually start at low levels and build up to the more traumatic things. And if we can catch it earlier on and get them referred and get their services going, we can kind of stop it before it gets to the actual assault part. We can stop them in just the kind of quote-unquote grooming phase. So yes, it’s daunting and it does happen in the shadows. It’s going to be almost impossible to eradicate it. But we do need to focus on recognizing it and getting involved sooner than later. Because the sooner we get involved, the less likely that child is to have the emotional and psychological damages from the continued abuse.
Brad Means: And what’s that damage look like when they’re older? What kind of grownups do the victims become if they’re able to survive to that stage of life?
Dr. Kevin Allen: So these are kind of the, you know, the quote-unquote horror stories you see in the in the news. And these can be people who grow up and have issues as adults, as far as, you know, drug abuse, or alcohol abuse, or in inappropriate sexual behaviors, being victims of trafficking, or, you know, selling their bodies or they learn an inappropriate way of using their bodies to love. And because they were grown that way or they were traumatized that way. And so that can affect them. For the physical abuse ones, in even the sexual abuse ones, they can then grow up to become an abuser themselves because they learned that, that behavior, they assume that that behavior is normal because it happened to them. And this is something that we actually, you’ve probably seen in the news a lot, if you’ve seen anything about called ACEs, which are Adverse Childhood Experiences. They’re speaking directly to this. Is people who were had some type of trauma or abuse as a child that are now showing those signs as an adult, difficulty learning, difficulty getting education, difficulty keeping jobs, or meaningful relationships, you know. Increased risks of depression, suicide, drug abuse, alcohol abuse, all those different things.
Brad Means: You know, you mentioned that you anticipated a surge in child abuse cases being reported when school is back in session. So let’s fast forward to August when so many of those kids are back on campus. So many of those teachers are back doing the great job they do of letting you know when they see something suspicious. How is the children’s hospital, how are you and your team preparing for that? More doctors, more nurses, more beds? How are you getting ready for the fall?
Dr. Kevin Allen: Also, even though I’m the local child abuse physician, all of our pediatric and pediatric emergency medicine physicians are trying to take care of kids. So our whole staff actually gets training on you know, mandated reporting, how to recognize abuse. They all know the initial steps of what needs to take place and how to contact the appropriate resources. I kind of serve as an expert for them to kind of go through the, you know, the critical cases or the minute new details and offer like specific tests and different things that we need to do. But our hospital, since we are a children’s hospital, we are trained to recognize this. And all of our staff know the different things that we do. We have protocols in place. We have working relationships with defax and law enforcement and the people that we need to get involved when we do. So we’re, we’re prepared. We don’t want to see them but we’re gonna definitely be prepared when they come.
Brad Means: Once you intervene, do you start to make a difference immediately? I mean, there’s not, I wouldn’t imagine there’s a real long turnaround from the time of victim sees you to the time that victim is safe.
Dr. Kevin Allen: Yeah. We, I mean, I get to see the good story endings. There’s plenty times where we saw a kid the first time and got them to a safer home and we see them for followup. And the child looks like a brand new child. Is you know, smiling and playing, looks like what they should do at point in time. I’ve seen with some of the sexual abuse patients, when they finally are able to tell their story and name their accuser and getting them away from them. You can see that they have a different outlook. They’re more joyous, and they have a different look in their eyes as well. And even the parents, when they know that you guys stepped in and what you did is saved their family. They’re so appreciative and they come back and let us know. So we do get to see it. It’s also though a long process. They’ll continue doing the healing in recovery for years to come. And so we’ll see some of these kids as adults, you know, being champions for abuse and telling their stories and saying, I was glad that the doctors were able to help me and my family.
Brad Means: I probably have about 45 seconds left and it’s just to give me a chance to ask you, why you got into this business? Who gave you such a heart for children?
Dr. Kevin Allen: Good Lord above. I always wanted to go into medicine at a young age. And as I continued to grow, I knew I wanted to work with children. So I knew I was going to end up in pediatrics. And there was a need for this physician here in our area. We have a high stats of abuse, physical and sexual abuse. And we needed a physician who was able to do it. And I had the love and passion for children and the personality to do it. So I stepped in where I could.
Brad Means: Well, I thank the good Lord that you’re doing, what you do. Dr. Kevin Allen, Children’s Hospital of Georgia leads the child protection team. From the bottom of our hearts, thank you for what you do for our little ones.
Dr. Kevin Allen: Yeah. Thank you guys for your support and having me on, and I will continue to serve the children as best as I can.
Brad Means: Thank you so much.