[Music] thank you it’s a pleasure to be here
thank you it’s a pleasure to be here
thank you it’s a pleasure to be here today thank you for having me speak
today thank you for having me speak
today thank you for having me speak today at TEDx was what I told you
today at TEDx was what I told you
today at TEDx was what I told you that in a survey of 3000 Dutch parents
that in a survey of 3000 Dutch parents
that in a survey of 3000 Dutch parents 5% that’s five out of every 100 of those
5% that’s five out of every 100 of those
5% that’s five out of every 100 of those parents admitted to having smothered
parents admitted to having smothered
parents admitted to having smothered slapped and/or shaken their baby because
slapped and/or shaken their baby because
slapped and/or shaken their baby because it was crying too much and what if I
it was crying too much and what if I
it was crying too much and what if I also told you that a lot of children in
also told you that a lot of children in
also told you that a lot of children in the u.s. today
one out of every 100 children will
one out of every 100 children will become a confirmed case of child abuse
so here it is you can see a hundred
so here it is you can see a hundred squares up there and you can see the
squares up there and you can see the
squares up there and you can see the five children that will be smuggling for
five children that will be smuggling for
five children that will be smuggling for shaken or slapped and one of those will
shaken or slapped and one of those will
shaken or slapped and one of those will become a confirmed case of child abuse
become a confirmed case of child abuse
become a confirmed case of child abuse we don’t know what happens to the other
we don’t know what happens to the other
we don’t know what happens to the other four they might be okay
four they might be okay
four they might be okay it might have been an isolated event or
it might have been an isolated event or
it might have been an isolated event or they may also be truly cases of child
they may also be truly cases of child
they may also be truly cases of child abuse because not all child abuse is
abuse because not all child abuse is
abuse because not all child abuse is discovered so today what I would like to
discovered so today what I would like to
discovered so today what I would like to do is present three ideas I have about
do is present three ideas I have about
do is present three ideas I have about how we could prevent child abuse before
how we could prevent child abuse before
how we could prevent child abuse before it starts so there are definitely people
it starts so there are definitely people
it starts so there are definitely people working hard to prevent child abuse but
working hard to prevent child abuse but
working hard to prevent child abuse but most of the people working on that their
most of the people working on that their
most of the people working on that their goal is to help us identify children
goal is to help us identify children
goal is to help us identify children there
there
there better identify them and get them into
better identify them and get them into
better identify them and get them into treatment coming from the perspective of
treatment coming from the perspective of
treatment coming from the perspective of Public Health
Public Health
Public Health my goal is a bit different my goal is to
my goal is a bit different my goal is to
my goal is a bit different my goal is to try to prevent child abuse before it
try to prevent child abuse before it
try to prevent child abuse before it even happens
so let’s look at one example of child
so let’s look at one example of child abuse
abuse
abuse this is shaken baby syndrome so parents
this is shaken baby syndrome so parents
this is shaken baby syndrome so parents who might shake there may be a little
who might shake there may be a little
who might shake there may be a little bit
bit
bit babies crying too much and shake the
babies crying too much and shake the
babies crying too much and shake the baby a little bit they’re angry they’re
baby a little bit they’re angry they’re
baby a little bit they’re angry they’re tired some of those parents shake the
tired some of those parents shake the
tired some of those parents shake the baby too much a babies don’t hold their
baby too much a babies don’t hold their
baby too much a babies don’t hold their neck up very well and the forces of that
neck up very well and the forces of that
neck up very well and the forces of that shaking can result in bleeding in the
shaking can result in bleeding in the
shaking can result in bleeding in the brain brain damage and blindness in some
brain brain damage and blindness in some
brain brain damage and blindness in some of these babies I guess I think it’s
of these babies I guess I think it’s
of these babies I guess I think it’s kind of a good example because there
kind of a good example because there
kind of a good example because there have been people they shook their baby
have been people they shook their baby
have been people they shook their baby too far they do realize it and they
too far they do realize it and they
too far they do realize it and they really were kind of innocence in a way
really were kind of innocence in a way
really were kind of innocence in a way they just didn’t realize that something
they just didn’t realize that something
they just didn’t realize that something so terrible could happen to their baby
so terrible could happen to their baby
so terrible could happen to their baby from shaking so at public health we
from shaking so at public health we
from shaking so at public health we often go for a simple message because we
often go for a simple message because we
often go for a simple message because we have a lot of quick messages we have to
have a lot of quick messages we have to
have a lot of quick messages we have to get out there and the quickness
get out there and the quickness
get out there and the quickness shaken baby syndrome you sometimes see
shaken baby syndrome you sometimes see
shaken baby syndrome you sometimes see it around on posters never ever shake a
it around on posters never ever shake a
it around on posters never ever shake a baby so one of our our messages FAQ
baby so one of our our messages FAQ
baby so one of our our messages FAQ which is trying to get into the public
which is trying to get into the public
which is trying to get into the public brain never ever shake a baby there are
brain never ever shake a baby there are
brain never ever shake a baby there are four types of child abuse and I’m
four types of child abuse and I’m
four types of child abuse and I’m focusing on trying to prevent two of
focusing on trying to prevent two of
focusing on trying to prevent two of them the two that are kind of the most
them the two that are kind of the most
them the two that are kind of the most obvious and well not most obvious but
obvious and well not most obvious but
obvious and well not most obvious but the easiest to measure so I’m focusing
the easiest to measure so I’m focusing
the easiest to measure so I’m focusing my ideas on physical abuse and neglect
a while ago this is just a blank slide a
a while ago this is just a blank slide a while ago the difficulty of caring for a
while ago the difficulty of caring for a
while ago the difficulty of caring for a young baby was really underscored for me
young baby was really underscored for me
young baby was really underscored for me when I received a phone call picked up
when I received a phone call picked up
when I received a phone call picked up the phone and I heard salty
the phone and I heard salty
the phone and I heard salty I really didn’t know who it was at first
I really didn’t know who it was at first
I really didn’t know who it was at first but then I realized it was a friend of
but then I realized it was a friend of
but then I realized it was a friend of mine what’s wrong I’ve been having
mine what’s wrong I’ve been having
mine what’s wrong I’ve been having thoughts of taking the baby outside and
thoughts of taking the baby outside and
thoughts of taking the baby outside and putting her in the trash can and leaving
putting her in the trash can and leaving
putting her in the trash can and leaving her there but she didn’t do it right
her there but she didn’t do it right
her there but she didn’t do it right the only thought about it and so my
the only thought about it and so my
the only thought about it and so my friend and I talked and we talked about
friend and I talked and we talked about
friend and I talked and we talked about how if it got worse she could just put
how if it got worse she could just put
how if it got worse she could just put the baby in another room make sure the
the baby in another room make sure the
the baby in another room make sure the baby was safe close the door sit outside
baby was safe close the door sit outside
baby was safe close the door sit outside if she had to and I was really happy
if she had to and I was really happy
if she had to and I was really happy that she had called me that she had felt
that she had called me that she had felt
that she had called me that she had felt comfortable to call me and to ask for
comfortable to call me and to ask for
comfortable to call me and to ask for help she went on to be an excellent
help she went on to be an excellent
help she went on to be an excellent mother for a brief period of time she
mother for a brief period of time she
mother for a brief period of time she had this disturbing box so you could see
had this disturbing box so you could see
had this disturbing box so you could see from some of the material I’m going over
from some of the material I’m going over
from some of the material I’m going over that caring for a young baby can be
that caring for a young baby can be
that caring for a young baby can be really stressful what can we do about it
really stressful what can we do about it
really stressful what can we do about it so my first suggestion the first idea is
so my first suggestion the first idea is
so my first suggestion the first idea is that we need to publicize the fact that
that we need to publicize the fact that
that we need to publicize the fact that parents have thoughts of abuse and
parents have thoughts of abuse and
parents have thoughts of abuse and neglect sometimes it’s okay to have
neglect sometimes it’s okay to have
neglect sometimes it’s okay to have those thoughts and it’s okay to talk
those thoughts and it’s okay to talk
those thoughts and it’s okay to talk about it so we need to remove the stigma
about it so we need to remove the stigma
about it so we need to remove the stigma around having those thoughts if we don’t
around having those thoughts if we don’t
around having those thoughts if we don’t remove the stigma around the boss the
remove the stigma around the boss the
remove the stigma around the boss the parents will not feel free to come
parents will not feel free to come
parents will not feel free to come forward and to get help
forward and to get help
forward and to get help they will not be feel free to talk to
they will not be feel free to talk to
they will not be feel free to talk to their friends and their doctor whoever
their friends and their doctor whoever
their friends and their doctor whoever else about it so we need to remove the
else about it so we need to remove the
else about it so we need to remove the stigma and we need to stop sugarcoating
stigma and we need to stop sugarcoating
stigma and we need to stop sugarcoating the first year of parenting it’s not the
the first year of parenting it’s not the
the first year of parenting it’s not the glorious experience that it’s put out to
glorious experience that it’s put out to
glorious experience that it’s put out to be for many it’s very difficult so we
be for many it’s very difficult so we
be for many it’s very difficult so we need to prepare parents for that we can
need to prepare parents for that we can
need to prepare parents for that we can also teach parents techniques
also teach parents techniques
also teach parents techniques hi infants techniques for rebellious
hi infants techniques for rebellious
hi infants techniques for rebellious toddlers but it is very very important
toddlers but it is very very important
toddlers but it is very very important to remove the stigma
so some of you may say this is not a
so some of you may say this is not a very realistic solution for such a
very realistic solution for such a
very realistic solution for such a difficult problem
difficult problem
difficult problem stay with me let me tell you about the
stay with me let me tell you about the
stay with me let me tell you about the experience I had that convinced me that
experience I had that convinced me that
experience I had that convinced me that child abuse is preventable years ago I
child abuse is preventable years ago I
child abuse is preventable years ago I was working as a public health nurse and
was working as a public health nurse and
was working as a public health nurse and I was asked to go out and visit a young
I was asked to go out and visit a young
I was asked to go out and visit a young mother because the pediatrician thought
mother because the pediatrician thought
mother because the pediatrician thought she was disciplining her daughter too
she was disciplining her daughter too
she was disciplining her daughter too strictly I was worried about visiting
strictly I was worried about visiting
strictly I was worried about visiting many of the nurses in the agency were
many of the nurses in the agency were
many of the nurses in the agency were judgmental about our clients and how
judgmental about our clients and how
judgmental about our clients and how they bothered their children but my
they bothered their children but my
they bothered their children but my supervisor had a different attitude
supervisor had a different attitude
supervisor had a different attitude she said to me Kim when you go visit
she said to me Kim when you go visit
she said to me Kim when you go visit that young lady I don’t I only want you
that young lady I don’t I only want you
that young lady I don’t I only want you to do one thing I just want you to build
to do one thing I just want you to build
to do one thing I just want you to build a trusting relationship now this was
a trusting relationship now this was
a trusting relationship now this was surprising for me I really thought that
surprising for me I really thought that
surprising for me I really thought that somehow is gonna be more complex than
somehow is gonna be more complex than
somehow is gonna be more complex than just having one instruction but she
just having one instruction but she
just having one instruction but she stuck with it she said I just want you
stuck with it she said I just want you
stuck with it she said I just want you to build a trusting relationship you
to build a trusting relationship you
to build a trusting relationship you could visit her as many times as you
could visit her as many times as you
could visit her as many times as you want so I went out to see my client I’ll
want so I went out to see my client I’ll
want so I went out to see my client I’ll call her Jennifer and she had a newborn
call her Jennifer and she had a newborn
call her Jennifer and she had a newborn baby boy who was 6 weeks old and she had
baby boy who was 6 weeks old and she had
baby boy who was 6 weeks old and she had a two year old daughter so when I got
a two year old daughter so when I got
a two year old daughter so when I got there I’ve noticed that she held the
there I’ve noticed that she held the
there I’ve noticed that she held the baby really close of normally like you
baby really close of normally like you
baby really close of normally like you would hold the baby she was very she
would hold the baby she was very she
would hold the baby she was very she appeared to be bonding well with her
appeared to be bonding well with her
appeared to be bonding well with her newborn son her two-year-old daughter
newborn son her two-year-old daughter
newborn son her two-year-old daughter stood by her side silently
stood by her side silently
stood by her side silently [Music]
[Music]
[Music] throughout the 45-minute this
throughout the 45-minute this
throughout the 45-minute this the two-year-old never left her mother’s
the two-year-old never left her mother’s
the two-year-old never left her mother’s side and she never spoke she I didn’t
side and she never spoke she I didn’t
side and she never spoke she I didn’t see any verses so we visited with this
see any verses so we visited with this
see any verses so we visited with this woman a number of times and I came to
woman a number of times and I came to
woman a number of times and I came to find out that she was fourth daughter of
find out that she was fourth daughter of
find out that she was fourth daughter of her parents
her parents
her parents and when she was born her father was
and when she was born her father was
and when she was born her father was really hoping for a boy but she turned
really hoping for a boy but she turned
really hoping for a boy but she turned out to be a girl so she became her
out to be a girl so she became her
out to be a girl so she became her father’s substitute son and then when
father’s substitute son and then when
father’s substitute son and then when her first baby was born she was really
her first baby was born she was really
her first baby was born she was really hoping it would be a boy and she could
hoping it would be a boy and she could
hoping it would be a boy and she could give her father this grandson that had
give her father this grandson that had
give her father this grandson that had not happened but now normally with the
not happened but now normally with the
not happened but now normally with the second child she was very warmly
second child she was very warmly
second child she was very warmly attached to her son very happy to give
attached to her son very happy to give
attached to her son very happy to give her father a grandson so at one point
her father a grandson so at one point
her father a grandson so at one point she gave me a beautiful pair
she gave me a beautiful pair
she gave me a beautiful pair earrings I was a little startled and
earrings I was a little startled and
earrings I was a little startled and very happy because it meant that our
very happy because it meant that our
very happy because it meant that our visits were meaning some
visits were meaning some
visits were meaning some to her and things were only well and
to her and things were only well and
to her and things were only well and then at one of the final visits I did
then at one of the final visits I did
then at one of the final visits I did get down on the floor and attempt to
get down on the floor and attempt to
get down on the floor and attempt to play the tuba and she very tentatively
play the tuba and she very tentatively
play the tuba and she very tentatively acted as if she might engage with me a
acted as if she might engage with me a
acted as if she might engage with me a little and Jennifer the mother said to
little and Jennifer the mother said to
little and Jennifer the mother said to me I’ve never seen someone play with an
me I’ve never seen someone play with an
me I’ve never seen someone play with an infant like that before with child like
infant like that before with child like
infant like that before with child like that before and I said who have you seen
that before and I said who have you seen
that before and I said who have you seen play with children and she said only my
play with children and she said only my
play with children and she said only my family so Jennifer was parentid as she
family so Jennifer was parentid as she
family so Jennifer was parentid as she had been parented
so I what I took away from this series
so I what I took away from this series of visits with Jennifer was the power of
of visits with Jennifer was the power of
of visits with Jennifer was the power of home visits if we approach parents
home visits if we approach parents
home visits if we approach parents Nansha judgmentally it will allow us to
Nansha judgmentally it will allow us to
Nansha judgmentally it will allow us to visit them and they will benefit from a
visit them and they will benefit from a
visit them and they will benefit from a relationship with somebody outside their
relationship with somebody outside their
relationship with somebody outside their normal circle so a question though does
normal circle so a question though does
normal circle so a question though does arise
arise
arise can we really spend healthcare dollars
can we really spend healthcare dollars
can we really spend healthcare dollars on this with just these subjective
on this with just these subjective
on this with just these subjective impressions that it works don’t you need
impressions that it works don’t you need
impressions that it works don’t you need some hard evidence this is the hard
some hard evidence this is the hard
some hard evidence this is the hard evidence that was first published 20
evidence that was first published 20
evidence that was first published 20 years ago 20 years ago a randomized
years ago 20 years ago a randomized
years ago 20 years ago a randomized clinical trial is published in the JAMA
clinical trial is published in the JAMA
clinical trial is published in the JAMA showing that home visits and prevent
showing that home visits and prevent
showing that home visits and prevent child abuse so we do have the hard
child abuse so we do have the hard
child abuse so we do have the hard so my second idea is that we identify
so my second idea is that we identify
so my second idea is that we identify high-risk families at birth and we offer
high-risk families at birth and we offer
high-risk families at birth and we offer them home visits I don’t know the slope
them home visits I don’t know the slope
them home visits I don’t know the slope here that’s my second idea okay so if we
here that’s my second idea okay so if we
here that’s my second idea okay so if we offer them home visits will probably do
offer them home visits will probably do
offer them home visits will probably do home visits on about 10% of babies it’s
home visits on about 10% of babies it’s
home visits on about 10% of babies it’s casting a wider net that we need to
casting a wider net that we need to
casting a wider net that we need to that’s how screaming works I will base
that’s how screaming works I will base
that’s how screaming works I will base that screaming on risk factors
that screaming on risk factors
that screaming on risk factors especially on whether either parent has
especially on whether either parent has
especially on whether either parent has a history of themselves having been
a history of themselves having been
a history of themselves having been abused and how sensitive all the
abused and how sensitive all the
abused and how sensitive all the scrutiny be early work shows that the
scrutiny be early work shows that the
scrutiny be early work shows that the stream can be about as sensitive as our
stream can be about as sensitive as our
stream can be about as sensitive as our screening for heart disease I’m
screening for heart disease I’m
screening for heart disease I’m suggesting we put the screening in the
suggesting we put the screening in the
suggesting we put the screening in the hospital at birth because that way we
hospital at birth because that way we
hospital at birth because that way we can catch every one and we can start
can catch every one and we can start
can catch every one and we can start home visits very early because a lot of
home visits very early because a lot of
home visits very early because a lot of abuse happens quite early in in the
abuse happens quite early in in the
abuse happens quite early in in the baby’s life my third suggestion is that
baby’s life my third suggestion is that
baby’s life my third suggestion is that we eliminate
we eliminate
we eliminate for children under the age of two so
for children under the age of two so
for children under the age of two so spanking which is usually what we’re
spanking which is usually what we’re
spanking which is usually what we’re talking about does it is a deterrent for
talking about does it is a deterrent for
talking about does it is a deterrent for behavior in the short term in the long
behavior in the short term in the long
behavior in the short term in the long term it causes more aggression and
term it causes more aggression and
term it causes more aggression and that’s why the American Academy of
that’s why the American Academy of
that’s why the American Academy of pediatricians advises against it there
pediatricians advises against it there
pediatricians advises against it there are a number of countries those in green
are a number of countries those in green
are a number of countries those in green in Northern Europe that have laws
in Northern Europe that have laws
in Northern Europe that have laws against any corporal punishment in the
against any corporal punishment in the
against any corporal punishment in the whole home or in the school so although
whole home or in the school so although
whole home or in the school so although it will be controversial in the United
it will be controversial in the United
it will be controversial in the United States it will be quite controversial
States it will be quite controversial
States it will be quite controversial here because 50 percent of mothers of
here because 50 percent of mothers of
here because 50 percent of mothers of babies under the age of one spank their
babies under the age of one spank their
babies under the age of one spank their children so will be controversial here
children so will be controversial here
children so will be controversial here but I suggested we have a law make it a
but I suggested we have a law make it a
but I suggested we have a law make it a misdemeanor that we do not spend or use
misdemeanor that we do not spend or use
misdemeanor that we do not spend or use physical punishment for children under
physical punishment for children under
physical punishment for children under the age of two my time is running short
the age of two my time is running short
the age of two my time is running short here
here
here so this is my wrap-up slug so how do we
so this is my wrap-up slug so how do we
so this is my wrap-up slug so how do we stop child abuse first we allow parents
stop child abuse first we allow parents
stop child abuse first we allow parents to realize that costs of abuse and
to realize that costs of abuse and
to realize that costs of abuse and neglect are common and there are healthy
neglect are common and there are healthy
neglect are common and there are healthy responses to excessive crime and
responses to excessive crime and
responses to excessive crime and rebellious toddlers second we identify
rebellious toddlers second we identify
rebellious toddlers second we identify high-risk families at birth and offer
high-risk families at birth and offer
high-risk families at birth and offer home visits and third we make physical
home visits and third we make physical
home visits and third we make physical punishment of children under the age of
punishment of children under the age of
punishment of children under the age of two a misdemeanor and that is how we
two a misdemeanor and that is how we
two a misdemeanor and that is how we stop child abuse before it starts
stop child abuse before it starts
stop child abuse before it starts [Music]
[Music]
[Music] [Applause]
”
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