Child abuse and neglect. The need for Child Protection
by Ms Cecilia Kjellgren, Senior Socialworker, 1999-03-17

Speech
from the Stockholm Ministerial Meeting on Children at Risk in the Baltic Sea Region
17th March 1999

CHILD ABUSE AND NEGLECT
THE NEED FOR CHILD PROTECTION

by Cecilia Kjellgren, Senior Socialworker

Dear delegates,

I am honoured to be invited to this meeting.

I want to share with you my experience of working as a socialworker with child protection for more than 20 years, in the city of Kristianstad. The city is located in the south of Sweden.

The last seven years I've been specialised to develop better methods in the field of child sexual and physical abuse. Since three years I am responsible for running the first post- qualifying university training in Sweden for socialworkers, psychologists, medical doctors, police investigators and prosecutors, focusing on child sexual and physical abuse. At the moment I am also privileged to be part of a twinning project, to run training for professionals in Siauliai in Lithuania.

The child protection services in Sweden are organised by the local authorities in the social services department. The national law are the frame of the work that should be practiced with the same intention in the whole country.

The child protection services need well-trained socialworkers that works in co-operation with parents and key persons around the child. In many cases you need to work close to the medical health, treatment facilities and crime investigators.

Working with children in risk you need to be informed by people who have made observations about a child.

As a socialworker you need to get reports and referrals from teachers, from health care professionals and others that a child is in a risk. In Sweden the legislation state a mandatory reporting for professionals to child protection, when you are worried about a child.According to the social services act, the content could be summarised:

Anyone that gets knowledge about a child that need child protection service should report it to the social services.

Each professional who are employed by public or private agencies working with children or teenagers, professionals working in social services and medical care have the obligation to report to the social service when they get the knowledge of that a minor needs protection.

The obligation to report is not limited to situations when you know that the abuse of the child takes place within the family. But also when a child, as a result of neglect, are not cared for and abused by somebody outside the family.

My personal reflection of this approach, with mandatory reporting, is that children in risk, is not a private problem but a public issue.

The reports that have been filed are most often made by teachers, secondly by medical health staff and thirdly by relatives. The cases concern different kinds of maltreatment, as neglect, emotional abuse, physical or sexual abuse.

In child protection cases there has been expressed doubts about the parenting capability of a child/children.

It is important to approach the family members with an open mind and with respect. When we get a case referred, we have to clarify the concerns behind the report. We need further information to find out the need for a child protection act. My experience it that it is not frequent that a neighbour or a relative make false allegations by reporting to child protection.

A child protection investigation proceeds by a number of interviews with parents. Focus is the history of the child from the developmental, emotional and social aspects and the parent's way of viewing the child. Further more the reports from medical examination and police can provide the child protection work with important information.

The childhood stories of the parents are important. Interviews of key persons and relatives around the child. An important part of the work is to interview the child.It is easy as socialworker who may also be a parent to identify yourself with the parents. But as a socialworker you have a special responsibility to focus on the child. Since a year ago this is also pointed out in the Swedish social services act. Following a summary of the act:

When the action concerns a child, the attitude of the child has to be clarified. The desire of the child should be regarded, considering age and maturity.

The new legislation put the light on the child and our obligation to listen to the opinion of the child. There is need among professionals for better knowledge about interviewing children, especially about difficult events in their lives. There is an increasing interest, among child protection agencies, to get training in this area.

In the child protection investigation, we need to be aware of the siblings. From a number of studies we have got the knowledge of the impact on siblings that witnessing violence or abuse have. It could be tremendously harmful for a child to be the silent witness of abuse.

When children are sexually or physically abused the conflicts of interests are strong. It is a fact that these children even if they are abused often are dependent of and attached to their parents. Abuse often is an action on a regular base. It becomes part of normal life. The child gets confused of what is normal and not. We have to be aware of that the offender, within and outside the family, could have a ''loving'' approach.

The dilemma when working with physical/sexual abuse is to be trained and skilled to understand that the dynamics of family violence usually not appears at one occasion. We have to be aware of that the offender’s personality in many ways are that abuse are the only way out. For better understanding, it is important to point out that sexual or physical abuse are often the acts of an adult with strong inner conflicts - with a high level of frustration. The reason for the act is often feelings as anger, fear, inferiority and powerlessness. These feelings are in one way solved when you abuse because you get the feeling of relief, power, control or superiority.

The fixated paedophiles, sexually abusing children, has another drive, sexual orientation towards children, looking for sexual gratification. It is not possible for a child to report - for a child to make up his/her mind to leave parents in those cases. Child protection has to assess if there is a need for protection or if the child could live a good life, staying with the family.

Even when the offender is a person outside the family, child protection sometimes need to intervene. To make sure that the child and the family are supported.

The end of the investigation is the assessment. To summarise and value the results of the investigation. The outcome could be different kinds of support to the child and family. It could be a referral to child psychiatric clinic. Sometimes we need to make a placement out of the home, when the family environment is not good enough.

The care could be voluntarily, when the parents apply to child protection to have their child placed away from home or a court decision of care order when the parents disapprove the need for protection. The care of children, outside the family, is mostly organised through placements in fosterfamilies in our country. The foster parents are recruited and assessed by the social services. The procedure includes a number of very close interviews.

Children that have been victimised are still in risk, even when they are separated from the abusive environment. They are vulnerable and need further protection by adults in treatment centres or foster families. It takes time to recover from abusive experiences. Abused children can expose risk behaviors, like bad boundaries - no capacity to protect them self and sexualised behavior which could attract presumptive offenders.

It is a fact that a sex offender could be trained and qualified for work with children e.g. as a teacher in school, nursery school, as staff at treatment centres or as a socialworker. An adult, with a deviant sexual behavior, could apply for becoming a fosterparent. In a survey, conducted by the Swedish National Board of Health and Social Welfare (1996), it was found that a number of children have been sexually abused in fosterhomes in Sweden.

Checking the police register is a way to find out the ones that prior has been sentenced of child abuse. But we need to have in mind that not all sex offences/sex offenders get disclosed. To prevent getting the wrong person to work with children or the wrong foster parents we need to proceed a more careful recruitment. Focusing on the important question of sexuality and boundaries. My experience is that one way to improve methods is to develop the recruitment of foster parents.

Finally, I would like to end with some aspects of adolescents as actors of abuse. The abuser and the victim are both of concern for child protection. Since six years I have been working in a project concerning adolescent sex offenders, teenagers 13-18 years of age, abusing other children sexually.

From research in the US we know that the starting point for a sexual offending pattern could be at early age. In the study of Abel & Rouleau (1990) they found that of 561 adult male sex offenders, 53.6% had at least one deviant sexual interest prior to the age of 18. The English Home Office figures of all sex offences during 1989, indicate that 32% of the offenders cautioned or found guilty were under 21. We should have concern for the fact that the starting point of an abusive behavior is that early and to that extent.

The project I am part of has summarised the experiences of 70 adolescent sex offenders, 67 boys and 3 girls. Their starting point of the behavior are in average at 14.1 years of age. The average age of the victims are 9.6 years. In 91% of the cases the victims are relatives of the offender or a boy/girl that the offender knows. 21 of the 123 victims, 17%, are children placed in care, fostercare or residential care, together with the offender. The abusive acts are in 46% of the cases fondling or frottage. In 38% of the total number of cases the abuse includes penetration (anal, genital or oral).

The background factors are in some cases limited. For many of the adolescents, emotional abuse and neglect is present during childhood. 1/3 have been sexually abused and 1/3 have been physically abused.

The work with the adolescent sex offender could an important way to protect a number of children from being sexually abused in the future. It could also save young persons from the risk of growing into the pattern of sexual abuse. To protect and prevent- by working with children and adolescents, are an important issue for the child protection service.