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The Impact of Child Abuse & What to Watch For
Dr. Raunak Khisty shares how child abuse impacts the mental, emotional, and physical health of the victim, as well as what to watch out for, and who to contact if suspect child abuse.
Featured Speaker:
Raunak Khisty, MD, MPH
Dr. Khisty completed his Bachelor of Medicine and Bachelor of Surgery at the Krishna Institute of Medical Sciences in Karad, India. He went on to receive his Masters of Public Health in Epidemiology from The University of Texas Health Science Center School of Public Health located in Houston, TX. Dr. Khisty also completed a Psychiatry Residency and a Child and Adolescent Psychiatry Fellowship at Wake Forest University in Winston-Salem, NC. Dr. Khisty is board certified in general psychiatry by the American Board of Psychiatry and Neurology. He is a member of several professional associations. As a Child and Adolescent Psychiatric Hospitalist, Dr. Khisty sees patients at Riverside Medical Center. Transcription:
The Impact of Child Abuse & What to Watch For
Liz Healy: Hello, listeners. And thank you for tuning in to Well Within Reach podcast brought to you by Riverside Healthcare. I'm your host, Liz Healy. And joining me today is Dr. Khisty, who is a child and adolescent psychiatrist at Riverside Medical Center. Thank you for joining us today, Dr. Khisty.
Dr Raunak Khisty: Thank you so much.
Liz Healy: I know that you're not a first time guest. You've been on our podcast before, but can you just remind our listeners a little bit about what you do?
Dr Raunak Khisty: Yes. I'm a child and adolescent psychiatrist at Riverside Medical Center. I'm board-certified in general psychiatry, child psychiatry and addiction. And I serve as their Director of Child and Adolescent Psychiatry and Addiction.
Liz Healy: Okay. So that makes you almost an expert on what we're going to talk about today or very knowledgeable about the fact. And we're going to kind of take a leap into the impact of child abuse and what to watch for in those types of situations.
Child abuse or neglect is obviously a very serious public health issue. And according to the CDC, the Centers for Disease Control, one in seven children have experienced some kind of abuse or neglect, but that number is likely a lot higher. What are some common forms of abuse and/or neglect that a child might experience?
Dr Raunak Khisty: I think you bring up a very valid point, Liz. I think child abuse is significantly underreported. What children may experience as far as abuse, I mean really has a huge breadth. The most common ones that we always talk about on television and social media are physical and sexual abuse. However, one of the most common forms of abuse is neglect and emotional abuse. These are very underreported.
In the age of social media, we are also seeing a lot of cyber bullying, which is also a form of abuse. And so I think those are some of the abuse and neglect forms that children can experience, especially in this day and age.
Liz Healy: So going along with that, are there certain risk factors that could cause someone to be more prone to experience abuse in their home situation or school or wherever they might experience?
Dr Raunak Khisty: Absolutely. At least 80% of children who experience abuse experience it at the hands of a caregiver. And so what we look for is risk factors in the perpetrators primarily. So some of the risk factors that we really watch out for are perpetrators or caregivers who have drug or alcohol abuse issues, or those who have some mental health problems. And one of the biggest, I guess, risk factors for this is caregivers who themselves were abused as children. We also really stress how poverty and having a low education or poor income contributes to increase levels of stress, which also contributes to ongoing levels of abuse that may happen in a child or that a child may face.
Liz Healy: So abuse usually happens at, like you said, the hand of a caregiver. Are there certain age groups that it tends to happen to, or boys versus girls? Is it pretty evenly split?
Dr Raunak Khisty: So generally, it's very evenly split amongst the genders. However, most of the child abuse, at least 80% is what we think, happens below the age of four years old. And so it's really, really startling how young these children are. So according to some of the statistics from the CDC, at least 70% of the children who died because of child abuse or neglect were two years of age or younger and at least 80% were not old enough to even be in kindergarten.
So these are really, really what statistics are showing. The younger you are, you know, children who are younger are more likely to be abused. And, like we had spoken about, at least 80% of these victims were perpetrated by a caregiver. And so that's really, really important to kind of note.
Liz Healy: Yeah. That's just like astounding. I would never consider so many so young. Do you think it has something to do with the children not being able to express what's happening to them?
Dr Raunak Khisty: Yes. I think that's a very big part of why this abuse kind of tends to be hidden is because these children really struggle to express what's going on versus a teenager.
Now, don't get me wrong. Teenagers themselves also struggle with a lot of guilt when it comes to abuse and maybe reluctant to share what's going on. But with kids as young as four or below, they really do not have the ability to express themselves verbally.
Liz Healy: Okay. Are there anything that a caregiver or teacher or healthcare workers such as yourself, is there something that you look out for in those younger age groups that will kind of trigger you to start asking questions?
Dr Raunak Khisty: Absolutely. Especially for physical abuse. Any unexplained bruises or cuts or welts or injuries that may have a specific pattern, like marks from a hand or a belt are very distinctive. And so I think those are some of the big warning signs for physical abuse. Also, children who tend to shy away or flinch at touch or at sudden movement or are constantly watchful almost as though they are on guard is really a big warning sign.
Some of the other warning signs for neglect like we'd spoken about can be children who wear ill-fitting clothes or filthy or inappropriate clothing, or have consistently bad hygiene, really concerning for neglect or who are left unsupervised or alone is a big warning sign.
The other big part that is discussed a lot is sexual abuse in children. And so children who may have trouble walking or sitting or really demonstrate knowledge of inappropriate sexual acts, which is inappropriate for their age, or even exhibit certain sexual acts that are not appropriate for your age is a big, big warning sign for sexual abuse.
Liz Healy: Okay. I know we've talked a little bit, you mentioned cyber bullying towards the beginning. is there something a parent can do to help watch and teach their children to alert someone when they feel that they're experiencing cyber bullying.
Dr Raunak Khisty: Yes. I think this is very new arena for parents and for providers altogether is this entire cyber bullying concept, right? Because a lot of us did not grow up with social media. It really exploded in the past 10, 12 years. And so what I really recommend to my parents is be in their face, right? It's perfectly okay to monitor, right? You are not there to be your child's friend. You are there to be their protector. And so I would recommend that parents monitor every single social media activity that's going on.
Previously, Facebook was all the rage. Nowadays, children use Instagram, Snapchat, Kik, TikTok. And so there are new and different forms of social media that come out really frequently. And so it is really important to know what your child is downloading on their smartphone or tablet, and that you actually keep a tab on it.
Let's not forget when you have those 20,000 terms and conditions that you agree to on social media before signing up, you have to be at least 12 years or older to actually be on Facebook or Snapchat or Instagram, right? However, we see that children who are way younger also have access to these social media platforms and that can be very concerning.
Social media provides anonymity to the abuser, and that is one of the biggest concerning parts about social media. Previously, we used to go in school in the hallways, like children would fight it out, right? Social media gives them that anonymity where it's very hard to confront their abuser.
Liz Healy: Okay. So besides watching and reporting cyber bullying, what other ways can we as a community kind of help to prevent child abuse and neglect and just bring awareness that this could be happening here?
Dr Raunak Khisty: So some of the things that we can do as a community to prevent child abuse and neglect is really addressing things on a system level. Primarily, we want to strengthen economic supports to families, right? Because studies are clear. If families are struggling socioeconomically, there is an increased risk of abuse in that household.
Also, you want to change social norms to support parents and actually encourage positive parenting. A lot of times we fail to understand what positive parenting looks like. So really development of some parenting classes or parenting techniques that are healthy would be very, very helpful.
In addition, we want to provide quality care and education early in life, so any form of abuse can be picked up really, really quickly. And improve access to primary care, which is something that we lack very frequently, because your primary care provider is truly somebody who can address these symptoms or actually recognize them before it escalates.
Liz Healy: Yes. So besides us as community members, are there organizations in the area that help bring awareness to child abuse? And if you need help, can you reach out to them?
Dr Raunak Khisty: Absolutely. I think we have a few organizations in our community, especially in Kankakee County, that can help bring awareness to child abuse.
One of the biggest ones is Casey CASA. They really advocate for and provide resources for victims of sexual assault or abuse. The other options that we have in our area are Aunt Martha's and Helen Wheeler Center, which are very good community-based resource organizations that have a strong network in our community.
The third organization that we recently had in our community is Project SUN. And so this is something that is new and taking off the ground, and really helps address child development in a holistic manner.
Liz Healy: Okay. Each April, the Child Network, which is located in Bradley, Illinois, they draw attention to children who have suffered due to child abuse or neglect by placing blue silhouettes of children throughout Kankakee County. These blue kids act as silent witnesses to child abuse happening around us. Is there any other information to draw attention to child abuse awareness and what we should be looking for?
Dr Raunak Khisty: I just want people to realize that this is so underreported, right? A report of child abuse currently is being made every 10 seconds and that is still an underestimate. To think about the magnitude, we estimate that at least to one-fourth of your kindergarten class or elementary school class was probably abused, right? So just think about the magnitude of things, one-fourth of the children who you went to school with were very, very likely abused. And so we as a community really need to band together to help our children so that our future can be more secure.
Liz Healy: Thank you for sharing all that important information with us, Dr. Khisty. And thank you, listeners, for tuning into the Well Within Reach podcast with your host, Liz Healy, and Dr. Khisty, a child and adolescent psychiatrist at Riverside Medical Center.
If you suspect a child is being abused or neglected, please call the Child Abuse and Neglect Reporting hotline at 1-800-25-ABUSE. Again, that number is 1-800-252-2873.
The Impact of Child Abuse & What to Watch For
Liz Healy: Hello, listeners. And thank you for tuning in to Well Within Reach podcast brought to you by Riverside Healthcare. I'm your host, Liz Healy. And joining me today is Dr. Khisty, who is a child and adolescent psychiatrist at Riverside Medical Center. Thank you for joining us today, Dr. Khisty.
Dr Raunak Khisty: Thank you so much.
Liz Healy: I know that you're not a first time guest. You've been on our podcast before, but can you just remind our listeners a little bit about what you do?
Dr Raunak Khisty: Yes. I'm a child and adolescent psychiatrist at Riverside Medical Center. I'm board-certified in general psychiatry, child psychiatry and addiction. And I serve as their Director of Child and Adolescent Psychiatry and Addiction.
Liz Healy: Okay. So that makes you almost an expert on what we're going to talk about today or very knowledgeable about the fact. And we're going to kind of take a leap into the impact of child abuse and what to watch for in those types of situations.
Child abuse or neglect is obviously a very serious public health issue. And according to the CDC, the Centers for Disease Control, one in seven children have experienced some kind of abuse or neglect, but that number is likely a lot higher. What are some common forms of abuse and/or neglect that a child might experience?
Dr Raunak Khisty: I think you bring up a very valid point, Liz. I think child abuse is significantly underreported. What children may experience as far as abuse, I mean really has a huge breadth. The most common ones that we always talk about on television and social media are physical and sexual abuse. However, one of the most common forms of abuse is neglect and emotional abuse. These are very underreported.
In the age of social media, we are also seeing a lot of cyber bullying, which is also a form of abuse. And so I think those are some of the abuse and neglect forms that children can experience, especially in this day and age.
Liz Healy: So going along with that, are there certain risk factors that could cause someone to be more prone to experience abuse in their home situation or school or wherever they might experience?
Dr Raunak Khisty: Absolutely. At least 80% of children who experience abuse experience it at the hands of a caregiver. And so what we look for is risk factors in the perpetrators primarily. So some of the risk factors that we really watch out for are perpetrators or caregivers who have drug or alcohol abuse issues, or those who have some mental health problems. And one of the biggest, I guess, risk factors for this is caregivers who themselves were abused as children. We also really stress how poverty and having a low education or poor income contributes to increase levels of stress, which also contributes to ongoing levels of abuse that may happen in a child or that a child may face.
Liz Healy: So abuse usually happens at, like you said, the hand of a caregiver. Are there certain age groups that it tends to happen to, or boys versus girls? Is it pretty evenly split?
Dr Raunak Khisty: So generally, it's very evenly split amongst the genders. However, most of the child abuse, at least 80% is what we think, happens below the age of four years old. And so it's really, really startling how young these children are. So according to some of the statistics from the CDC, at least 70% of the children who died because of child abuse or neglect were two years of age or younger and at least 80% were not old enough to even be in kindergarten.
So these are really, really what statistics are showing. The younger you are, you know, children who are younger are more likely to be abused. And, like we had spoken about, at least 80% of these victims were perpetrated by a caregiver. And so that's really, really important to kind of note.
Liz Healy: Yeah. That's just like astounding. I would never consider so many so young. Do you think it has something to do with the children not being able to express what's happening to them?
Dr Raunak Khisty: Yes. I think that's a very big part of why this abuse kind of tends to be hidden is because these children really struggle to express what's going on versus a teenager.
Now, don't get me wrong. Teenagers themselves also struggle with a lot of guilt when it comes to abuse and maybe reluctant to share what's going on. But with kids as young as four or below, they really do not have the ability to express themselves verbally.
Liz Healy: Okay. Are there anything that a caregiver or teacher or healthcare workers such as yourself, is there something that you look out for in those younger age groups that will kind of trigger you to start asking questions?
Dr Raunak Khisty: Absolutely. Especially for physical abuse. Any unexplained bruises or cuts or welts or injuries that may have a specific pattern, like marks from a hand or a belt are very distinctive. And so I think those are some of the big warning signs for physical abuse. Also, children who tend to shy away or flinch at touch or at sudden movement or are constantly watchful almost as though they are on guard is really a big warning sign.
Some of the other warning signs for neglect like we'd spoken about can be children who wear ill-fitting clothes or filthy or inappropriate clothing, or have consistently bad hygiene, really concerning for neglect or who are left unsupervised or alone is a big warning sign.
The other big part that is discussed a lot is sexual abuse in children. And so children who may have trouble walking or sitting or really demonstrate knowledge of inappropriate sexual acts, which is inappropriate for their age, or even exhibit certain sexual acts that are not appropriate for your age is a big, big warning sign for sexual abuse.
Liz Healy: Okay. I know we've talked a little bit, you mentioned cyber bullying towards the beginning. is there something a parent can do to help watch and teach their children to alert someone when they feel that they're experiencing cyber bullying.
Dr Raunak Khisty: Yes. I think this is very new arena for parents and for providers altogether is this entire cyber bullying concept, right? Because a lot of us did not grow up with social media. It really exploded in the past 10, 12 years. And so what I really recommend to my parents is be in their face, right? It's perfectly okay to monitor, right? You are not there to be your child's friend. You are there to be their protector. And so I would recommend that parents monitor every single social media activity that's going on.
Previously, Facebook was all the rage. Nowadays, children use Instagram, Snapchat, Kik, TikTok. And so there are new and different forms of social media that come out really frequently. And so it is really important to know what your child is downloading on their smartphone or tablet, and that you actually keep a tab on it.
Let's not forget when you have those 20,000 terms and conditions that you agree to on social media before signing up, you have to be at least 12 years or older to actually be on Facebook or Snapchat or Instagram, right? However, we see that children who are way younger also have access to these social media platforms and that can be very concerning.
Social media provides anonymity to the abuser, and that is one of the biggest concerning parts about social media. Previously, we used to go in school in the hallways, like children would fight it out, right? Social media gives them that anonymity where it's very hard to confront their abuser.
Liz Healy: Okay. So besides watching and reporting cyber bullying, what other ways can we as a community kind of help to prevent child abuse and neglect and just bring awareness that this could be happening here?
Dr Raunak Khisty: So some of the things that we can do as a community to prevent child abuse and neglect is really addressing things on a system level. Primarily, we want to strengthen economic supports to families, right? Because studies are clear. If families are struggling socioeconomically, there is an increased risk of abuse in that household.
Also, you want to change social norms to support parents and actually encourage positive parenting. A lot of times we fail to understand what positive parenting looks like. So really development of some parenting classes or parenting techniques that are healthy would be very, very helpful.
In addition, we want to provide quality care and education early in life, so any form of abuse can be picked up really, really quickly. And improve access to primary care, which is something that we lack very frequently, because your primary care provider is truly somebody who can address these symptoms or actually recognize them before it escalates.
Liz Healy: Yes. So besides us as community members, are there organizations in the area that help bring awareness to child abuse? And if you need help, can you reach out to them?
Dr Raunak Khisty: Absolutely. I think we have a few organizations in our community, especially in Kankakee County, that can help bring awareness to child abuse.
One of the biggest ones is Casey CASA. They really advocate for and provide resources for victims of sexual assault or abuse. The other options that we have in our area are Aunt Martha's and Helen Wheeler Center, which are very good community-based resource organizations that have a strong network in our community.
The third organization that we recently had in our community is Project SUN. And so this is something that is new and taking off the ground, and really helps address child development in a holistic manner.
Liz Healy: Okay. Each April, the Child Network, which is located in Bradley, Illinois, they draw attention to children who have suffered due to child abuse or neglect by placing blue silhouettes of children throughout Kankakee County. These blue kids act as silent witnesses to child abuse happening around us. Is there any other information to draw attention to child abuse awareness and what we should be looking for?
Dr Raunak Khisty: I just want people to realize that this is so underreported, right? A report of child abuse currently is being made every 10 seconds and that is still an underestimate. To think about the magnitude, we estimate that at least to one-fourth of your kindergarten class or elementary school class was probably abused, right? So just think about the magnitude of things, one-fourth of the children who you went to school with were very, very likely abused. And so we as a community really need to band together to help our children so that our future can be more secure.
Liz Healy: Thank you for sharing all that important information with us, Dr. Khisty. And thank you, listeners, for tuning into the Well Within Reach podcast with your host, Liz Healy, and Dr. Khisty, a child and adolescent psychiatrist at Riverside Medical Center.
If you suspect a child is being abused or neglected, please call the Child Abuse and Neglect Reporting hotline at 1-800-25-ABUSE. Again, that number is 1-800-252-2873.