Linda Simkins is the executive director of the Pediatric Resource Center at the University of Illinois College of Medicine at Peoria, where she’s also a clinical associate in the Department of Pediatrics. She earned a master’s degree in social work and is licensed in Illinois as a Licensed Clinical Social Worker. She also holds a national certification in social work through the Academy of Certified Social Workers.
Active in the community, Simkins is a member of the Junior League of Peoria, where she participated in and chaired the State Political Action Committee and the Public Policy Committee. She served as chair of the Peoria Region’s Child Death Review Team, sponsored by the Illinois Department of Children and Family Services, for four years and is currently a member of all committees of the Community Advisory Board of the Pediatric Resource Center, including the Blue Ribbon Child Abuse Prevention Campaign and fund-raiser committees. She’s also a member of the Children’s Hospital of Illinois’ Community Advocacy Committee.
Simkins resides in Peoria.
Tell us about your background: schools attended, family, etc.
I grew up in Peoria in the 1950s and 1960s and was fortunate to live in an intact family: two parents, two sisters, and two brothers. This was a good time for children; parents and extended families focused on children and child-life.
Upon graduating from Peoria High School, I attended Illinois State University, where I obtained a degree in secondary education. I went onto graduate school at the University of Wisconsin at Madison, where I obtained a master’s degree in social work. My first social work position was in Milwaukee, and I stayed in Milwaukee for five years, working at three different agencies-all in the area of child welfare. I enjoyed Milwaukee but missed my family, so in 1979, I took a social work position here in Peoria and have been here ever since.
Who or what influenced your career in social work?
My grandmother, Harriett Simkins, was an elementary school teacher in District 150. During my grade school years, I listened to her talk about children’s social situations. She would describe the days they deloused every head in the classroom, children who would fall asleep at their desks, children who were hungry, and parents who would interfere in various ways with children’s abilities to learn. These situations were much more fascinating to me than the classroom education of children.
It was during my high school years at Peoria Central High School that I decided to become a social worker. Our church did a lot of community outreach projects, and I always enjoyed participating. Then I met an adult who was a social worker. She loved her work, and it sounded exciting and fulfilling. I knew right then that was what I wanted to be. It was the career that would allow me to be in the midst of helping individuals and groups of people.
My dad wanted me to be a teacher, and he was paying for college, so I followed in the footsteps of my grandmother, aunt, and sister and went to college at Illinois State University to obtain a teaching degree. But I never lost sight of my ambition to be a social worker. I wanted to work in direct service for a number of years and then help formulate federal social welfare policies. Although I received a teaching degree from ISU, I never taught. Instead, I saved money for graduate school and, in 1972, entered the University of Wisconsin at Madison as a graduate student in social work. This is when I knew I had entered my element. I loved every facet of social work. It was interesting, challenging, and rewarding. If there’s ever a dull moment in social work, you aren’t working.
Tell about the Pediatric Resource Center.
The Pediatric Resource Center is a service program that combines medical and social services in a unique way to meet the needs of abused and neglected children. We do this in three major areas: direct service to children suspected of being abused or neglected; education, training, and consultation to professionals; and prevention through community education and awareness. Since our inception, we’ve expanded our geographic service area from the tri-county area to the entire state. Our direct service component has served children in more than 40 counties, and our consultation and networking services to other professionals covers the entire state.
Our staff has also increased from me, as the only full-time employee working with six part-time volunteer physicians, to seven full-time and four part-time employees. In addition to myself and Medical Director Dr. Kay Saving, we have two full-time case coordinators, one part-time nurse practitioner, two part-time physicians, and four full-time clerical positions.
Our direct service program, which constitutes about 50 percent of our time, is a program in which we accept cases under specific guidelines and provide one or more of the following services to the child, parents, or both: information and referral, crisis counseling, education, linkage with DCFS and the police, physical examination, forensic documentation of injuries, medical and social service advocacy, long-term counseling, and court preparation for child victims/witnesses.
We also provide education and training in many ways. Various members of our staff give lectures on aspects of child abuse. We provide telephone consultation to individuals for both medical and social service issues. We train University of Illinois College of Medicine residents from the specialties of emergency medicine, pediatrics, and combined medicine/pediatrics. And we hold one large conference per year on a targeted aspect of child abuse.
How has the PRC’s mission and/or clientele changed since 1993, when you became executive director?
Our mission remains the same: Meeting the needs of abused and neglected children. We’ve expanded the ways in which we fulfill this mission. In the beginning, we provided medical examinations and social services to children who were going into foster care. Our program was devoted exclusively to direct service work.
But it wasn’t long after we began operating that we began receiving requests from professionals and community groups for education and training on the subject of child abuse. We gave lectures and worked on two conferences in the first year of operation, and our educational and training component was born.
Also in the first year of operation, we responded to many calls for information and resources. We developed lists of national, state, and local resources, and began our "lending library" of books, articles, and tapes on various specialized aspects of child maltreatment. We keep current on resources through attending and networking at national, regional, and local conferences; memberships in national and international societies for the prevention and treatment of abuse; journal subscriptions, other periodicals, book reviews, and books; and participating in Internet discussions with child abuse professionals from around the nation. We use the information we gather to respond to the many telephone inquiries we receive from professionals. Our consult services include linking professionals with resources, providing articles on various child abuse subjects, and providing information on protocols and procedures.
Who’s a typical client of the PRC? Has that changed through the years?
Today, a typical client is a five-year-old girl who reportedly has been sexually abused by her mother’s boyfriend. She was living with her mother and the mother’s boyfriend, but the boyfriend is out of the home under a DCFS protection plan. She has revealed the molestation a few days prior, but it took place three months prior, and the allegation is now being investigated by both DCFS and the police. Although this is the "typical" client, our clientele is quite diverse. We serve both boys and girls, up to age 18 for sexual abuse, physical abuse of all types, and neglect issues such as medical neglect and failure to thrive.
The typical client has changed over the years. When we began our program, we served children entering foster care by giving them a health care screen. We also documented physical injuries. Our physicians were more interested in the evaluation of children for physical evidence of abuse, so we changed our intake criteria to children who were under investigation for abuse, whether or not they were going into foster care. Because we had a colposcope and physicians trained in finding physical injuries from sexual abuse, the greatest percentage of our clients were referred for sexual abuse.
In fiscal year 1996, 90 percent of the children we served were referred for sexual abuse. By fiscal year 1999, 77 percent presented for sexual abuse, with 19 percent presenting for physical abuse, and 4 percent for neglect. The age of the clients we serve has declined considerably. The majority of children we see now are under 7 years old.
What are the most critical needs of the PRC?
One of our needs is for a full-time medical director to assist in expanding the program’s services. Our present medical director, Dr. Kay Saving, has done an outstanding job in this position since she helped open the PRC in 1993. Her other duties-as medical director of Children’s Hospital of Illinois at OSF Saint Francis Medical Center and a pediatric hematologist/oncologist at the University of Illinois College of Medicine at Peoria-don’t allow her the time needed for the expanding PRC program.
All not-for-profits wish for financial stability, and we’re no exception. Each year we count on various grants, contracts, and donations. When the economy is depressed or uncertain, funding decreases. We’ve built an endowment fund of a quarter of a million dollars over the past three years, which has helped greatly to provide security for our future, and our wish is to build it to $1 million.
Our staff also wishes for greater understanding on the part of the community about the problem of child abuse. This is a critical need because community opinion affects the odds of a child’s voice being heard and given credibility; it affects the chances that a child’s situation will be reported; it affects jurors’ opinions and votes and, therefore, the jury’s decision on criminal child abuse matters; and it affects how people treat a child who’s reported his or her abuse. We hope people will educate themselves about the problem of child abuse, take steps to monitor their own behavior, encourage others to do the same, and report any suspicions of child abuse to the DCFS hotline.
How has the Internet affected the number of child pornography and/or sexual abuse cases?
With the Internet’s rise in popularity has been a corresponding rise in the use of the Internet for posting and exchanging pornography. In the 1980s, legal changes slowed the child pornography industry. The numbers escalated in the 1990s with the widespread use of the Internet.
Victimizing children via the Internet can be done in more than one way. Children may be victimized without leaving their own home through exposure to pictorial or written pornography. They also can be lured or solicited via chat rooms and instant messaging for "cybersex" or in-person encounters. Once they’ve been used as a subject in pornography photos, they may be repeatedly victimized by the widespread use of the photos. It’s estimated that more than 1 million children per year are involved in the industry in the United States.
There’s been action among law enforcement officials throughout the nation to attack this problem. The computer is particularly friendly to pornographers, as it’s possible to digitally alter images so specific children can’t be identified. The PRC has worked with the FBI on a few child pornography Internet cases. What I found particularly frightening was learning the outrageously high number of images generally collected by a single person.
In a down economy, do the number of cases increase?
The stress of a depressed economy definitely affects people. Poverty and unemployment stress can build up and serve as a "tipping point" from good parenting to abusive parenting. Other factors, which are often present, are marital conflict; social isolation; sexual difficulties; physical illness; or child-produced stressors such as colic, developmental delays, toilet training, and delinquency. Most offenders have a body of improper attitudes and beliefs towards child rearing.
Studies have shown the following factors are the primary causes of child maltreatment: alcohol abuse; drug abuse or drug dependence; a perpetrator’s own history of abuse or family violence; deviant thoughts, feelings, and behaviors; and some forms of mental illness.
What, if any, are the misperceptions of the PRC in the community?
We find a lot of people in the community aren’t familiar with the name "Pediatric Resource Center" or, if they’ve heard of us, they aren’t aware of the nature of our work. We decided not to use the word "abuse" in our title, as not all of the children who come here are abused, and we wanted to minimize the trauma to children and their families who do come to us for services.
Some professionals who are aware of our program for abused children aren’t aware of the broad scope of services we offer. They think we only serve young girls suspected of being sexually abused. In fact, we serve both males and females referred for possible physical abuse, sexual abuse, and/or neglect. We also consult on child death cases and offer resources, referral information, and consultation on various aspects of child maltreatment.
Another misconception is that we’re a program of the Children’s Hospital of Illinois. Although we’re affiliated with CHOI, we’re a service program of the University of Illinois College of Medicine at Peoria. We accept referrals from all area hospitals and physicians.
What should parents say and/or do to help their children avoid abuse, feel comfortable reporting abuse, etc?
The pathway to help children avoid or report abuse isn’t a short one. You can’t give children a 15-minute lecture and expect a guarantee that they’ll live abuse-free. Parents need to practice good parenting skills on a constant, consistent basis. They should be knowledgeable about abuse and closely supervise and monitor their children’s activities, whereabouts, and caretakers.
Good communication between a parent and child is essential. Children who are comfortable talking to their parents and parents who are good listeners can often be a winning combination to avoid abuse. Frequent conversation allows parents to learn early on that someone may be preying on their child. Abusers often proceed on a slow, cautious course in which they initially develop rapport with a child, move to verbal abuse or innuendoes, and slowly begin abusive behaviors. If a child says an adult or older child is giving them gifts, taking them to the bathroom, singling them out, making statements that make them uncomfortable, or showing them nude or suggestive photos, listen to this, and judge whether or not your child should be alone with this person. A child’s discomfort with an adult may well be a sign that the adult is exhibiting behaviors that fall outside the norm. Perpetrators usually look for children who are unsupervised or get little attention from their parents because they count on the lack of communication between parent and child to keep the secret of the abuse.
Parents should give a clear message to their children that they can talk to them about anything. Then, parents must be prepared to listen to their child, even at inopportune times, as a child is most likely to blurt out something significant when a parent is otherwise preoccupied.
If someone suspects a child is being neglected and/or abused, how can they best help that child?
Unsettling as it is, we all must call the proper authorities if we suspect abuse or neglect. Call the DCFS hotline, at 1-877-262-2873, if you suspect a parent or caretaker is committing the abuse or neglect. Otherwise, call the police. It’s often a difficult struggle to arrive at the conclusion that a child may be abused or neglected, and the decision to intervene in someone’s personal family life should never be taken lightly, but it’s a necessity if we’re going to help children. Before calling, one should gather enough information to allow DCFS or the police to identify and find the child and alleged perpetrator and to describe the type of abuse or neglect one suspects.
You can also go the route of talking to the person you suspect, but don’t expect a straight answer or a positive outcome. A team of skilled professionals is best equipped to deal with child abuse investigations.
How likely is it that a perpetrator of sexual abuse is a family member of the child? Do you often see chains of abuse?
Surveys have reported that sexual abuse by parents and stepparents constitutes 6 to 16 percent of all cases. Child sexual abuse by any relative is shown at 25 percent. Studies on sex offenders’ past history have shown widely differing percentages of sex abuse victimization: from 0 to 70 percent.
What I’ve seen frequently are that mothers of daughters who are child sexual abuse victims were victimized themselves as children. These mothers usually have had no intervention for their abuse and no counseling. They’ve grown up and created an environment that allows their daughters to be hurt; they’re passive or ineffectual in protecting their own children. The household is sometimes chaotic and dysfunctional, communication is lacking, and the cycle repeats itself.
However, it’s also possible for a parent to do everything right for a child and have a child suffer from sexual abuse. Unfortunately, you can’t always prevent it.
Have you had to handle false claims of abuse?
Yes, we’ve handled many cases in which we didn’t find the child under investigation to be abused. The PRC is here to assist in finding the truth. We don’t operate under a foregone conclusion that everyone referred to us has been abused. False abuse cases have run the gamut from very easy to resolve to very difficult to resolve. There are two things that can be difficult: Finding the truth regarding the allegation and convincing the mandated authorities to agree with our conclusion.
A child’s case enters our system with a low or high level of suspicion, based on the background information. If we find an injury to be accidental, which is of low suspicion to begin with, that’s easy. If we find no medical evidence of abuse on a high suspicion case, then we may have to do much to educate and persuade the mandated authorities of the reasonableness of our position.
I’ve worked very hard on some cases in which we found no abuse. One family, who was under investigation for possible sexual abuse to their youngest daughter, told me they experienced so much trauma from the investigation that they were having sleep difficulties and daytime anxieties. Their daughter was almost taken away from them. Fortunately, the DCFS worker believed the child, referred the case to us within 24 hours of receiving it, and we were able to rule out child abuse through appropriate medical testing, combined with the child’s statements that no abuse occurred.
How does the State of Illinois handle abuse cases? Is there a backlog for investigations?
Illinois has set up the Department of Children & Family services to be the authority to investigate and handle child abuse investigations. Reports are taken through a toll-free, statewide phone system called the "hotline." These calls are taken 24 hours a day at the State Central Registry in Springfield. Once a case is taken as a report, the DCFS investigators have regulated, monitored time frames for responses. There’s no backlog for initiating cases that I’m aware of. No matter how many cases come into a field office, the available staff must work the necessary hours to see the children and ascertain the risk of harm.
To assist in the investigations and treatment of child abuse cases, DCFS contracts with many private agencies. The Pediatric Resource Center is one of those agencies. We’re contracted to add medical case management and case coordination to the investigative piece. Specifically, we assist the investigators by providing medical examinations and consultation on injuries, mechanisms of injuries, time frames, etc., accompanied by social services for the child and family, and case coordination with the other involved agencies.
In Peoria County, as in many other counties, there’s a Children’s Advocacy Center. The design of a Children’s Advocacy Center is to bring professionals together to work jointly on cases. This design is one of a multi-disciplinary team approach to investigating cases and setting goals.
Many social workers face burnout after a few years. What’s kept you in the field?
I’ve been burned out many times. The horrific real-life situations one encounters when working child physical and sexual abuse cases are unfathomable to most people. A lot of people simply don’t think these atrocities occur. I’ve seen the real-life injuries, listened to children describe their very real emotional pain, and seen the destruction child abuse inflicts on children. It would be abnormal not to feel for these children.
Another time I suffered from burnout I was simply bored. I’d been doing the same job for a number of years and needed a change-a challenge. I was lucky enough to be able to make some changes and encounter new social work challenges, which led me to more education and more challenging tasks.
What’s kept me in the field of social work is a passion to make a difference in children’s lives, satisfaction in contributing to positive outcomes for people through my knowledge and skills, a desire to see results in human lives rather than bottom lines on a financial sheet, the intellectual challenge of the complexities of child abuse investigations and child sexual abuse counseling, the rush of success in attaining seemingly unattainable goals, seeing the heights of happiness achieved by children who were once in the depths of sorrow, a myriad of professional challenges and growth opportunities, and a strong sense of right and wrong and a passion to correct wrongs.
What coping skills best help you detach from your work?
We’ve built a great support system at the PRC. We work as a team, so we help each other debrief from emotionally difficult cases. It helps diminish our stress and anxieties when we talk to another person who’s also directly involved. Also, I rarely work at home. I’ll stay at the office until a job is done so I don’t have to bring work materials and problems into my home. Creating this physically separate space helps me separate it mentally.
Of course sometimes I do take the difficulties and sadness of the job home. I have a great network of family and friends that will listen to me and be there for me. My mother is the absolute best listener. I also believe strongly in exercise as a stress reliever. I’ve belonged to a health club for years and enjoy heading there after work to exercise away tension. I also like to walk, bike, and swim.
Looking at the positives in life helps me cope with stress, too. I try to accentuate the small and large good things in my life to balance out the bad things I see at work. TPW
Active in the community, Simkins is a member of the Junior League of Peoria, where she participated in and chaired the State Political Action Committee and the Public Policy Committee. She served as chair of the Peoria Region’s Child Death Review Team, sponsored by the Illinois Department of Children and Family Services, for four years and is currently a member of all committees of the Community Advisory Board of the Pediatric Resource Center, including the Blue Ribbon Child Abuse Prevention Campaign and fund-raiser committees. She’s also a member of the Children’s Hospital of Illinois’ Community Advocacy Committee.
Simkins resides in Peoria.
Tell us about your background: schools attended, family, etc.
I grew up in Peoria in the 1950s and 1960s and was fortunate to live in an intact family: two parents, two sisters, and two brothers. This was a good time for children; parents and extended families focused on children and child-life.
Upon graduating from Peoria High School, I attended Illinois State University, where I obtained a degree in secondary education. I went onto graduate school at the University of Wisconsin at Madison, where I obtained a master’s degree in social work. My first social work position was in Milwaukee, and I stayed in Milwaukee for five years, working at three different agencies-all in the area of child welfare. I enjoyed Milwaukee but missed my family, so in 1979, I took a social work position here in Peoria and have been here ever since.
Who or what influenced your career in social work?
My grandmother, Harriett Simkins, was an elementary school teacher in District 150. During my grade school years, I listened to her talk about children’s social situations. She would describe the days they deloused every head in the classroom, children who would fall asleep at their desks, children who were hungry, and parents who would interfere in various ways with children’s abilities to learn. These situations were much more fascinating to me than the classroom education of children.
It was during my high school years at Peoria Central High School that I decided to become a social worker. Our church did a lot of community outreach projects, and I always enjoyed participating. Then I met an adult who was a social worker. She loved her work, and it sounded exciting and fulfilling. I knew right then that was what I wanted to be. It was the career that would allow me to be in the midst of helping individuals and groups of people.
My dad wanted me to be a teacher, and he was paying for college, so I followed in the footsteps of my grandmother, aunt, and sister and went to college at Illinois State University to obtain a teaching degree. But I never lost sight of my ambition to be a social worker. I wanted to work in direct service for a number of years and then help formulate federal social welfare policies. Although I received a teaching degree from ISU, I never taught. Instead, I saved money for graduate school and, in 1972, entered the University of Wisconsin at Madison as a graduate student in social work. This is when I knew I had entered my element. I loved every facet of social work. It was interesting, challenging, and rewarding. If there’s ever a dull moment in social work, you aren’t working.
Tell about the Pediatric Resource Center.
The Pediatric Resource Center is a service program that combines medical and social services in a unique way to meet the needs of abused and neglected children. We do this in three major areas: direct service to children suspected of being abused or neglected; education, training, and consultation to professionals; and prevention through community education and awareness. Since our inception, we’ve expanded our geographic service area from the tri-county area to the entire state. Our direct service component has served children in more than 40 counties, and our consultation and networking services to other professionals covers the entire state.
Our staff has also increased from me, as the only full-time employee working with six part-time volunteer physicians, to seven full-time and four part-time employees. In addition to myself and Medical Director Dr. Kay Saving, we have two full-time case coordinators, one part-time nurse practitioner, two part-time physicians, and four full-time clerical positions.
Our direct service program, which constitutes about 50 percent of our time, is a program in which we accept cases under specific guidelines and provide one or more of the following services to the child, parents, or both: information and referral, crisis counseling, education, linkage with DCFS and the police, physical examination, forensic documentation of injuries, medical and social service advocacy, long-term counseling, and court preparation for child victims/witnesses.
We also provide education and training in many ways. Various members of our staff give lectures on aspects of child abuse. We provide telephone consultation to individuals for both medical and social service issues. We train University of Illinois College of Medicine residents from the specialties of emergency medicine, pediatrics, and combined medicine/pediatrics. And we hold one large conference per year on a targeted aspect of child abuse.
How has the PRC’s mission and/or clientele changed since 1993, when you became executive director?
Our mission remains the same: Meeting the needs of abused and neglected children. We’ve expanded the ways in which we fulfill this mission. In the beginning, we provided medical examinations and social services to children who were going into foster care. Our program was devoted exclusively to direct service work.
But it wasn’t long after we began operating that we began receiving requests from professionals and community groups for education and training on the subject of child abuse. We gave lectures and worked on two conferences in the first year of operation, and our educational and training component was born.
Also in the first year of operation, we responded to many calls for information and resources. We developed lists of national, state, and local resources, and began our "lending library" of books, articles, and tapes on various specialized aspects of child maltreatment. We keep current on resources through attending and networking at national, regional, and local conferences; memberships in national and international societies for the prevention and treatment of abuse; journal subscriptions, other periodicals, book reviews, and books; and participating in Internet discussions with child abuse professionals from around the nation. We use the information we gather to respond to the many telephone inquiries we receive from professionals. Our consult services include linking professionals with resources, providing articles on various child abuse subjects, and providing information on protocols and procedures.
Who’s a typical client of the PRC? Has that changed through the years?
Today, a typical client is a five-year-old girl who reportedly has been sexually abused by her mother’s boyfriend. She was living with her mother and the mother’s boyfriend, but the boyfriend is out of the home under a DCFS protection plan. She has revealed the molestation a few days prior, but it took place three months prior, and the allegation is now being investigated by both DCFS and the police. Although this is the "typical" client, our clientele is quite diverse. We serve both boys and girls, up to age 18 for sexual abuse, physical abuse of all types, and neglect issues such as medical neglect and failure to thrive.
The typical client has changed over the years. When we began our program, we served children entering foster care by giving them a health care screen. We also documented physical injuries. Our physicians were more interested in the evaluation of children for physical evidence of abuse, so we changed our intake criteria to children who were under investigation for abuse, whether or not they were going into foster care. Because we had a colposcope and physicians trained in finding physical injuries from sexual abuse, the greatest percentage of our clients were referred for sexual abuse.
In fiscal year 1996, 90 percent of the children we served were referred for sexual abuse. By fiscal year 1999, 77 percent presented for sexual abuse, with 19 percent presenting for physical abuse, and 4 percent for neglect. The age of the clients we serve has declined considerably. The majority of children we see now are under 7 years old.
What are the most critical needs of the PRC?
One of our needs is for a full-time medical director to assist in expanding the program’s services. Our present medical director, Dr. Kay Saving, has done an outstanding job in this position since she helped open the PRC in 1993. Her other duties-as medical director of Children’s Hospital of Illinois at OSF Saint Francis Medical Center and a pediatric hematologist/oncologist at the University of Illinois College of Medicine at Peoria-don’t allow her the time needed for the expanding PRC program.
All not-for-profits wish for financial stability, and we’re no exception. Each year we count on various grants, contracts, and donations. When the economy is depressed or uncertain, funding decreases. We’ve built an endowment fund of a quarter of a million dollars over the past three years, which has helped greatly to provide security for our future, and our wish is to build it to $1 million.
Our staff also wishes for greater understanding on the part of the community about the problem of child abuse. This is a critical need because community opinion affects the odds of a child’s voice being heard and given credibility; it affects the chances that a child’s situation will be reported; it affects jurors’ opinions and votes and, therefore, the jury’s decision on criminal child abuse matters; and it affects how people treat a child who’s reported his or her abuse. We hope people will educate themselves about the problem of child abuse, take steps to monitor their own behavior, encourage others to do the same, and report any suspicions of child abuse to the DCFS hotline.
How has the Internet affected the number of child pornography and/or sexual abuse cases?
With the Internet’s rise in popularity has been a corresponding rise in the use of the Internet for posting and exchanging pornography. In the 1980s, legal changes slowed the child pornography industry. The numbers escalated in the 1990s with the widespread use of the Internet.
Victimizing children via the Internet can be done in more than one way. Children may be victimized without leaving their own home through exposure to pictorial or written pornography. They also can be lured or solicited via chat rooms and instant messaging for "cybersex" or in-person encounters. Once they’ve been used as a subject in pornography photos, they may be repeatedly victimized by the widespread use of the photos. It’s estimated that more than 1 million children per year are involved in the industry in the United States.
There’s been action among law enforcement officials throughout the nation to attack this problem. The computer is particularly friendly to pornographers, as it’s possible to digitally alter images so specific children can’t be identified. The PRC has worked with the FBI on a few child pornography Internet cases. What I found particularly frightening was learning the outrageously high number of images generally collected by a single person.
In a down economy, do the number of cases increase?
The stress of a depressed economy definitely affects people. Poverty and unemployment stress can build up and serve as a "tipping point" from good parenting to abusive parenting. Other factors, which are often present, are marital conflict; social isolation; sexual difficulties; physical illness; or child-produced stressors such as colic, developmental delays, toilet training, and delinquency. Most offenders have a body of improper attitudes and beliefs towards child rearing.
Studies have shown the following factors are the primary causes of child maltreatment: alcohol abuse; drug abuse or drug dependence; a perpetrator’s own history of abuse or family violence; deviant thoughts, feelings, and behaviors; and some forms of mental illness.
What, if any, are the misperceptions of the PRC in the community?
We find a lot of people in the community aren’t familiar with the name "Pediatric Resource Center" or, if they’ve heard of us, they aren’t aware of the nature of our work. We decided not to use the word "abuse" in our title, as not all of the children who come here are abused, and we wanted to minimize the trauma to children and their families who do come to us for services.
Some professionals who are aware of our program for abused children aren’t aware of the broad scope of services we offer. They think we only serve young girls suspected of being sexually abused. In fact, we serve both males and females referred for possible physical abuse, sexual abuse, and/or neglect. We also consult on child death cases and offer resources, referral information, and consultation on various aspects of child maltreatment.
Another misconception is that we’re a program of the Children’s Hospital of Illinois. Although we’re affiliated with CHOI, we’re a service program of the University of Illinois College of Medicine at Peoria. We accept referrals from all area hospitals and physicians.
What should parents say and/or do to help their children avoid abuse, feel comfortable reporting abuse, etc?
The pathway to help children avoid or report abuse isn’t a short one. You can’t give children a 15-minute lecture and expect a guarantee that they’ll live abuse-free. Parents need to practice good parenting skills on a constant, consistent basis. They should be knowledgeable about abuse and closely supervise and monitor their children’s activities, whereabouts, and caretakers.
Good communication between a parent and child is essential. Children who are comfortable talking to their parents and parents who are good listeners can often be a winning combination to avoid abuse. Frequent conversation allows parents to learn early on that someone may be preying on their child. Abusers often proceed on a slow, cautious course in which they initially develop rapport with a child, move to verbal abuse or innuendoes, and slowly begin abusive behaviors. If a child says an adult or older child is giving them gifts, taking them to the bathroom, singling them out, making statements that make them uncomfortable, or showing them nude or suggestive photos, listen to this, and judge whether or not your child should be alone with this person. A child’s discomfort with an adult may well be a sign that the adult is exhibiting behaviors that fall outside the norm. Perpetrators usually look for children who are unsupervised or get little attention from their parents because they count on the lack of communication between parent and child to keep the secret of the abuse.
Parents should give a clear message to their children that they can talk to them about anything. Then, parents must be prepared to listen to their child, even at inopportune times, as a child is most likely to blurt out something significant when a parent is otherwise preoccupied.
If someone suspects a child is being neglected and/or abused, how can they best help that child?
Unsettling as it is, we all must call the proper authorities if we suspect abuse or neglect. Call the DCFS hotline, at 1-877-262-2873, if you suspect a parent or caretaker is committing the abuse or neglect. Otherwise, call the police. It’s often a difficult struggle to arrive at the conclusion that a child may be abused or neglected, and the decision to intervene in someone’s personal family life should never be taken lightly, but it’s a necessity if we’re going to help children. Before calling, one should gather enough information to allow DCFS or the police to identify and find the child and alleged perpetrator and to describe the type of abuse or neglect one suspects.
You can also go the route of talking to the person you suspect, but don’t expect a straight answer or a positive outcome. A team of skilled professionals is best equipped to deal with child abuse investigations.
How likely is it that a perpetrator of sexual abuse is a family member of the child? Do you often see chains of abuse?
Surveys have reported that sexual abuse by parents and stepparents constitutes 6 to 16 percent of all cases. Child sexual abuse by any relative is shown at 25 percent. Studies on sex offenders’ past history have shown widely differing percentages of sex abuse victimization: from 0 to 70 percent.
What I’ve seen frequently are that mothers of daughters who are child sexual abuse victims were victimized themselves as children. These mothers usually have had no intervention for their abuse and no counseling. They’ve grown up and created an environment that allows their daughters to be hurt; they’re passive or ineffectual in protecting their own children. The household is sometimes chaotic and dysfunctional, communication is lacking, and the cycle repeats itself.
However, it’s also possible for a parent to do everything right for a child and have a child suffer from sexual abuse. Unfortunately, you can’t always prevent it.
Have you had to handle false claims of abuse?
Yes, we’ve handled many cases in which we didn’t find the child under investigation to be abused. The PRC is here to assist in finding the truth. We don’t operate under a foregone conclusion that everyone referred to us has been abused. False abuse cases have run the gamut from very easy to resolve to very difficult to resolve. There are two things that can be difficult: Finding the truth regarding the allegation and convincing the mandated authorities to agree with our conclusion.
A child’s case enters our system with a low or high level of suspicion, based on the background information. If we find an injury to be accidental, which is of low suspicion to begin with, that’s easy. If we find no medical evidence of abuse on a high suspicion case, then we may have to do much to educate and persuade the mandated authorities of the reasonableness of our position.
I’ve worked very hard on some cases in which we found no abuse. One family, who was under investigation for possible sexual abuse to their youngest daughter, told me they experienced so much trauma from the investigation that they were having sleep difficulties and daytime anxieties. Their daughter was almost taken away from them. Fortunately, the DCFS worker believed the child, referred the case to us within 24 hours of receiving it, and we were able to rule out child abuse through appropriate medical testing, combined with the child’s statements that no abuse occurred.
How does the State of Illinois handle abuse cases? Is there a backlog for investigations?
Illinois has set up the Department of Children & Family services to be the authority to investigate and handle child abuse investigations. Reports are taken through a toll-free, statewide phone system called the "hotline." These calls are taken 24 hours a day at the State Central Registry in Springfield. Once a case is taken as a report, the DCFS investigators have regulated, monitored time frames for responses. There’s no backlog for initiating cases that I’m aware of. No matter how many cases come into a field office, the available staff must work the necessary hours to see the children and ascertain the risk of harm.
To assist in the investigations and treatment of child abuse cases, DCFS contracts with many private agencies. The Pediatric Resource Center is one of those agencies. We’re contracted to add medical case management and case coordination to the investigative piece. Specifically, we assist the investigators by providing medical examinations and consultation on injuries, mechanisms of injuries, time frames, etc., accompanied by social services for the child and family, and case coordination with the other involved agencies.
In Peoria County, as in many other counties, there’s a Children’s Advocacy Center. The design of a Children’s Advocacy Center is to bring professionals together to work jointly on cases. This design is one of a multi-disciplinary team approach to investigating cases and setting goals.
Many social workers face burnout after a few years. What’s kept you in the field?
I’ve been burned out many times. The horrific real-life situations one encounters when working child physical and sexual abuse cases are unfathomable to most people. A lot of people simply don’t think these atrocities occur. I’ve seen the real-life injuries, listened to children describe their very real emotional pain, and seen the destruction child abuse inflicts on children. It would be abnormal not to feel for these children.
Another time I suffered from burnout I was simply bored. I’d been doing the same job for a number of years and needed a change-a challenge. I was lucky enough to be able to make some changes and encounter new social work challenges, which led me to more education and more challenging tasks.
What’s kept me in the field of social work is a passion to make a difference in children’s lives, satisfaction in contributing to positive outcomes for people through my knowledge and skills, a desire to see results in human lives rather than bottom lines on a financial sheet, the intellectual challenge of the complexities of child abuse investigations and child sexual abuse counseling, the rush of success in attaining seemingly unattainable goals, seeing the heights of happiness achieved by children who were once in the depths of sorrow, a myriad of professional challenges and growth opportunities, and a strong sense of right and wrong and a passion to correct wrongs.
What coping skills best help you detach from your work?
We’ve built a great support system at the PRC. We work as a team, so we help each other debrief from emotionally difficult cases. It helps diminish our stress and anxieties when we talk to another person who’s also directly involved. Also, I rarely work at home. I’ll stay at the office until a job is done so I don’t have to bring work materials and problems into my home. Creating this physically separate space helps me separate it mentally.
Of course sometimes I do take the difficulties and sadness of the job home. I have a great network of family and friends that will listen to me and be there for me. My mother is the absolute best listener. I also believe strongly in exercise as a stress reliever. I’ve belonged to a health club for years and enjoy heading there after work to exercise away tension. I also like to walk, bike, and swim.
Looking at the positives in life helps me cope with stress, too. I try to accentuate the small and large good things in my life to balance out the bad things I see at work. TPW