Clinical Reference Systems: Pediatric Advisor 10.0

Family violence is a major social and criminal problem in our society. Adult family violence is violence between the adults residing in the home. This violence affects children directly and indirectly. It may affect children's performance in school, their friendships and other relationships, and their emotional development. Children are hurt simply by seeing or hearing violence between trusted adults in their homes. In addition, their developmental and emotional needs often remain unmet because the abused or abusive adults are not able to properly care for them.

What is adult family violence?

It is any violent behavior between adults in the home. Behaviors of concern include the more obvious ones such as hitting, slapping, kicking, biting, grabbing, pushing, throwing things, and threatening with a weapon. However, violent behavior also includes verbal threats and name calling. Family violence often exists along with substance abuse. Most frequently the victims of violence are women (the battered woman syndrome). However, sometimes both the man and woman are both abusers and victims. In any case, family violence can have serious long-term effects on children who reside in the home.

How does family violence affect children?

Witnessing violence between trusted adults has a more profound effect on a child's development than television and movies ever could. Children often see the violence. Even if they do not see it, they may well hear it. And even if they can't hear it, they will always feel the effects of violence in their home. They may hear about the violence from adult conversation. They may see how the violence affects their parents. They may be abused themselves either by being caught in the crossfire or later as victims of violence themselves. Children in violent homes are at increased risk for serious physical and sexual abuse.

Children are never safe from family violence.

How profoundly violence affects children depends, in part, on the extent and severity of the violence, especially if verbal or psychological threats are used ("Next time you..., I'll kill you"). It also depends on the ability of the parent or parents to continue to function as loving caretaker(s). Being a loving parent is often difficult for both the adult victim and the abuser.

Though the more profound effects occur in older children, even infants can sense something is wrong and experience problems in feeding, play, and other daily activities. Infants disrupted by adult violence may become fussier. The fussiness can increase an infant's own risk of becoming a target of the violence. Child-rearing problems often precipitate violence between adults. For example, an argument over who should change the baby may lead to a fight.

Older children may imitate the violent behavior they witness. Some children externalize their behavior and become aggressive, cruel, disobedient, and destructive, other children internalize their behavior in the form of sadness, withdrawal, fear, and anxiety. Violence between siblings, as an offshoot of adult violence, can also adversely affect a child's development. Children in violent homes have poor impulse control, poor self-esteem, and poor peer relations. They perform less well in school.

Adolescents from violent homes engage in more risk-taking behavior and may themselves become violent adults.

How can children be protected from family violence?

Parents in homes where family violence exists must recognize the bad effects of such behavior on children. They must take steps to stop the violence and protect their children:

1. The perpetrator(s) of the violence may need to enter a treatment program.

2. The adult victim (usually female) and the children may have to leave the perpetrator (usually male). Community family violence shelters have staff available to assist in development of a plan to help both the adult victim and the children. See the yellow pages for referral numbers.

3. If the children show symptoms, they need to be evaluated and treated. Adult victims often need treatment as well.

There is only one way to protect children: The violence must stop. If there is violence in your home, call your child's physician's office for help in stopping it. In case of emergency, call the police or go to the hospital.