Keeping Our Girls Safe™ Keeping Our Girls Safe™ Personal Safety for Girls: Violence and Abuse Personal Safety for Girls: Violence and Abuse

Indicators, Lifelong Health Implications, & Indicators, Lifelong Health Implications, & Girl Scout Leader Response and InterventionGirl Scout Leader Response and Intervention

Dr. Martina J. Jelley MD, MSPH, FACP Sherry S. ClarkInterim Chair, Department of Internal Medicine f.a.c.e.s. Founder/PresidentOU School of Community Medicine RSVP Programs Manager

Families and Communities Empowered for Safety (918) 519-3698 :: faces.sherry@gmail.com :: www.faces.tulsa.org

Raising Awareness; Inspiring Action

INTRO“Through this multi-year initiative, GSEOK intends to take a comprehensive approach to health. Our goal is to empower girls to live healthy lives while creating positive change in families and the community. “Live Healthy, Lead Healthy” is designed to address all aspects of health and wellness, including but not limited to: nutrition, exercise, relationships, emotional and physical wellness.“

What You’ll LearnWhat You’ll Learn

1. Scourge of child abuse and violence data  

2. Types of violence and abuse children may experience or be exposed to

3. How children’s relationships can be impacted

4. Resulting life-long health vulnerabilities 

5. Sign and symptoms

6. How to help girls 

7. Agency reporting policy and guidelines recommendations

8. Oklahoma reporting statutes

Children Are At-Risk Children Are At-Risk

Of the 76 million children currently residing in the U.S, an estimated 46 million can expect to have their lives touched by violence, crime, abuse, and psychological trauma this year.” www.justice.gov/defendingchildhood/cev-rpt-full.pdf

A 2009 DOJ study showed that more than 60 percent of the children surveyed were exposed to violence within the past year either directly or indirectly.” *Finkelhor, D., Turner, H., Ormrod, R., Hamby, S., and Kracke, K. 2009. Children’s Exposure to Violence: A Comprehensive National Survey. Bulletin.

Stress can shorten telomeres in childhood Shorter telomeres are associated with a raft of diseases in adults from diabetes to dementia. http://www.nature.com/news/2011/110517/full/news.2011.298.html

The Oklahoma FactsThe Oklahoma Facts• In OklahomaIn Oklahoma:

A child is abused or neglected every 1 hour.

A child dies before his or her first birthday every 22 hours.

• In OklahomaIn Oklahoma: 922,098 children: 521,683 are White, non-Hispanic 76,600 are Black127,371 are Hispanic16,297 are Asian/Pacific Islander82,982 are American Indian/Alaska Native 121,036 are two or more races

OK Child Abuse and Neglect 2012OK Child Abuse and Neglect 2012

Adair 71Alfalfa 7Atoka 61Beaver 8Beckham 100Blaine 52Bryan 166Caddo 57Canadian 395Carter 201Cherokee 73Choctaw 73Cimarron 1Cleveland 250Coal 38Comanche 301Cotton 36

9,842 Children Substantiated to be Victims of Child Abuse or Neglect By County

Craig 38Creek 217Custer 84Delaware 78Dewey 0Ellis 7Garfield 93Garvin 66Grady 81Grant 8Greer 46Harmon 18Harper 2Haskell 40Hughes 66Jackson 72Jefferson 17Johnston 28Kay 87Kingfisher 20

Kiowa 18Latimer 21LeFlore 138Lincoln 112Logan 99Love 24Major 20Marshall 49Mayes 71McClain 73McCurtain 99McIntosh 61Murray 14Muskogee 343Noble 37Nowata 24Okfuskee 53Oklahoma 2,358Okmulgee 134Osage 137

Ottawa 39Pawnee 40Payne 157Pittsburg 177Pontotoc 99Pottawatomie 248Pushmataha 39Rogers 97Roger Mills 2Seminole 129Sequoyah 134Stephens 92Texas 52Tillman 4Tulsa 1,325Wagoner 119Washington 123Washita 13Woods 34Woodward 76

Exposure to Violence and Trauma Exposure to Violence and Trauma • 31% of 1,200 protective

orders filed the first half of 2013 included children on the protective order RSVP Family Safety Court Watch

• 4,200 Protective orders filed in Tulsa Co in 2012

• Oklahoma is 3rd in the nation for the number of women killed by men. 2013

• More than 100 2012 domestic violence-related OK fatalities

4 children are in the back seat of this car…

Effects of Exposure to Abuse Effects of Exposure to Abuse • Of the 2-4 million women battered each year, one-half

live with children under 12.

• 62% of children living in a home with domestic violence are also abused.

• Boys who witness violence against their mothers are 10X more likely to abuse their female partners as adults.

• 63% of boys aged 11-20 arrested for murder were arrested for murdering the man assaulting their mother.

BullyingBullying

TraffickingTrafficking• Human trafficking is loss of freedom to another’s control by force, fraud, or

coercion. (OATH)• Human trafficking generates $9.5 billion yearly in the United States.  (United Nations) 

• Approximately 300,000 US children are at risk of being prostituted. (US Department of Justice)

• The average age of entry into prostitution for a child victim in the United States is 13.5 years old. (US Department of Justice)

• A pimp can make $150,000-$200,000 per child each year and the average pimp has 4 to 6 girls. (U.S. Justice Department, National Center for Missing Children) 

• Vulnerable children are targeted.

www.sctnow.org Stop Child Trafficking Now

Teen Relationships: Teen Relationships: Emotional Abuse and StalkingEmotional Abuse and Stalking

• Constantly calling, texting, following• Criticizing, calling names• Controlling all actions• Manipulation• Withholding affection as punishment• Humiliation• Making all the decisions• Jealousy • Not allowing time with friends and

family• Possessiveness

Study reveals an alarmingly high number of 7th graders are not only dating, but are involved in abusive relationships.—Robert Woods Johnson Foundation 2012

Physical Violence and AbusePhysical Violence and Abuse• Pushing• Shoving• Slapping• Kicking• Throwing objects• Pinching• Strangulation / Choking• Restraining with force• Abandonment in a

dangerous place• Pulling hair• Driving erratically• Threatening and using

weapons

Teen Dating and Teen Dating and Electronic Monitoring Electronic Monitoring

• “Sexting”: sharing nude photos – Legalities

• Stalking – Serial texting/calling at all

hours, checking up on, demanding frequent “check-in’s”

• Shared passwords– To monitor online

communications with others

One in ten teens (11-18 years old) said a romantic partner had prevented them from using a cell phone,

6% said their romantic partner had posted something publicly online to make fun of, threaten, orembarrass them,

and 10.4% of boys and 9.8% of girls said they had received a threatening cell phone message from their romantic partner. – Futures Without Violence 2/2013

Teen Dating & Teen Dating & Sexual ViolenceSexual Violence

• Dating Violence• Sexual violence

– Rape• Sexual coercion

• Negative Outcomes• Sexual violence is related

to a wide range of negative health outcomes– Greater incidence and

exposure to HIV and other STDs

– Unhealthy weight, – Asthma – Diabetes – Substance abuse – Risky sexual behaviors– Miscarriage – Unplanned pregnancy

Physical

Sexual Violence

Emotional

Social isolation

Economic Abuse

POWER AND CONTROL

The objective of all violence and abuse is…

Sex trafficking

Labor trafficking

Stalking

Neglect

Rape

BullyingElectronic Monitoring

Coercion

Adverse Childhood Experience Adverse Childhood Experience (ACE) Study(ACE) Study

Summary of Major Findings• Adverse Childhood Experiences

(ACEs) are very common

• ACEs are strong predictors of later health risks and disease

• This combination makes ACEs the leading determinant of the health and social well-being of our nation

ACE Study QuestionsACE Study Questions• Emotional Abuse• Physical Abuse• Sexual Abuse• Felt unloved or unimportant• Not enough to eat, dirty

clothes, felt unprotected• Parents separated or divorced• Mother or Stepmother abused• Alcoholic or drug abuser in household• Depression or mental illness in household• Household member in prison

ACEs predict behavioral risk factors and ACEs predict behavioral risk factors and diminished physical health…diminished physical health…

Behavioral risk factors Smoking Alcohol, drug abuse Obesity, inactivity Depressed mood, suicide attempts STDs, > 50 sexual partners

Poor health outcomes Heart disease Cancer COPD (lung disease) Hepatitis Fractures Poor self-rated health

Felitti V, Anda R et al. Relationship of childhood abuse and household dysfunction to many of the leading causes of death in adults. Am J Prev Med 1998;14:245-258.

Childhood stressors increased risk of poor health

Statistically significant association between number of childhood stressors and physical health

Just one of our clinic’s patients… Just one of our clinic’s patients… • Female, age 34• Morbidly obese, BMI 60• Smoker• Oxygen-dependent COPD

(emphysema)• Poorly controlled diabetes• Married, 3 children ages 8, 13,

15.• Molested at age 8 • Raped at age 13 • Grew up in home with

alcoholism, instability, and physical abuse

The rest of the story…The rest of the story…

• Last year this patient was found dead at home, age 36

• Death thought to be due to heart attack or respiratory failure

The cycle of toxic stress and poverty…The cycle of toxic stress and poverty…

Teach Safety PlanningTeach Safety PlanningA safety plan is a list of preventive responses and actions 

children can take to protect themselves and to lessen the risk of exposure and abuse.

- Safety Rules for Younger Children

- Safety Rules for OlderChildren & Teens

- What Children Can Do At Home and School

https://www.ncjrs.gov/html/ojjdp/psc_english_02/intro.html

What Can Girl Scout Leaders Do? What Can Girl Scout Leaders Do? • Help girls feel safe and in

control – be kind and allow them to make decisions.

• Don’t force them to talk if they don’t want to.

• Give straightforward explanations for things that are worrying girls.

• Don’t downplay or minimize their feelings – the feelings and fears are very real to the child.

• Respect their words and thoughts – we all need to LISTEN to what children say

• www.safestartcenter.org/pdf/Evidence-Based=Practices-Matrix_2011.pd

What To Do To Help At-Risk GirlsWhat To Do To Help At-Risk Girls

• Don’t make commitments you can’t honor.• Look at options and

suggest concrete steps to be taken that creates safety for the girl.

• Help her think of positive ways to keep busy: sports, be with safe friends, make art or music.

• Learn when and how to make a referral to Girl Scout leadership to intervene.

www.safestartcenter.org/pdf/Evidence-Based=Practices-Matrix_2011.pd

Girls Are Hurting - Warning SignsGirls Are Hurting - Warning Signs• Physical complaints – head-

and stomach aches • Excessive worry about danger

and safety of loved ones• Signs of depression,

withdrawing from others, not enjoying play

• Attention, concentration, can’t retain new information

• Angry outbursts toward others or self

• Won’t follow rules• Uses violence to get what they

want

• Rebellion at home/school• Bullying/aggressive behaviors• Risky behaviors – driving fast,

jumping from high places• Abrupt changes in friends and

relationships• Hypervigilant• Changes in sleep

habits• Stereotypical beliefs about

males as aggressors and females as victims

• What warning signs appear will depend on the frequency and intensity of traumatic events.

I See Warning Signs – I See Warning Signs – How Do I Begin? How Do I Begin?

• Tell her you’ve noticed that she seems sad (or afraid, or is different than she has been, or is often ill – whatever the warning sign you’ve noticed), and that you want to know if she’s okay.

• If you notice a change in her personality, she is either more quiet or is acting out, ask her if there’s something she would like to tell you or talk to you about.

• If you observe signs of physical trauma – bruises, marks, difficulty walking, over-dressing, doesn’t want to be touched, as examples, ask her gently if someone is hurting her.

• Ask her if she would like your help.

Children are Safe When…Children are Safe When…

• parents and families provide safety and security so they learn to trust and feel secure;

• parent and extended families, teachers, and other significant peoplein a child’s life team up to teach children how to be safe and stay safe;

• significant people in a child’s life takeprotective action when indicated;

• violence is removed from their lives.

Reporting Child Abuse 1-2-3Reporting Child Abuse 1-2-3Oklahoma Statute Title 10 Children, Chapter 71 OK Child Abuse Reporting and

Prevention Act, Section 7103 Reporting Abuse, Neglect, or Birth of Chemically-Dependent Child

1. It is mandatory for any person to report child abuse or neglect if there is reason to believe that a child under the age of eighteen (18) years of age is a victim of abuse or neglect. A report must be made.

2. Your good faith report may be made in writing, by telephone or in person to the Department of Human Services. Failure to report is a misdemeanor offense.

3. If the child is in imminent danger, call 911 or local law enforcement.

Oklahoma Department of Social Services

Child Protective Services 1-800-522-3511

Girls Are Hurting - Warning SignsGirls Are Hurting - Warning Signs• Physical complaints – head-

and stomach aches • Excessive worry about danger

and safety of loved ones• Signs of depression,

withdrawing from others, not enjoying play

• Attention, concentration, can’t retain new information

• Angry outbursts toward others or self

• Won’t follow rules• Uses violence to get what they

want• Bruising, marks on body

• Rebellion at home/school• Bullying/aggressive behaviors• Risky behaviors – driving fast,

jumping from high places• Abrupt changes in friends and

relationships• Hypervigilant• Changes in sleep

habits• Older girls have

stereotypical beliefs about males as aggressors and females as victims

• What warning signs appear will depend on the frequency and intensity of traumatic events.

Role Play ObjectivesRole Play Objectives1. To give you practice acting on the gut feeling you

have that something is not okay. Could girl be suffering from: • Abuse?

• Emotional – withdrawn crying, depressed, surly? • Physical – bruising, marks on body, other?• Sexual – over-dressing, doesn’t want to be

touched, startles easily

• Neglect? Examples:• Teeth that need fillings and resulting pain• Allergies causing headaches, infections, loss of

sleep

2. To practice saying the words with a leader partner and getting feedback and suggestions.

Why Should I Ask? Why Should I Ask? 1. Asking is identification and prevention.

• IF the girl is being abused or neglected, taking the time to tell her you are concerned about her may make a difference for her today or another day to prevent further abuse.

• Some girls may react immediately, while for others the signs may not appear for months or even years later.

2. To help you decide if there is a problem and to document it. • Asking an open-ended question will let you hear her words, see

her expressions and other body language that will help you decide whether you need to advise management of your concern.

• Seeing her response will help you communicate your concern with management.

3. To let the girl know that you care about her. • Data tells us it takes only one person in a child’s life to make a

difference for all of the child’s life.

How to BeginHow to Begin1. Don’t ask direct questions:

• Is someone at home hitting you?Better: “Are you afraid of someone?”

• Has someone touched you in a way you do not like? Better: “Are you afraid of someone?”• Director questioning is the job of professionals who can

interpret and address real problems. Non-professionals can do damage.

2. Don’t press her to talk. • The objective is to make and keep the Girl Scout connection

for the girl.

3. Speak calmly and quietly with a neutral facial expression.

4. When in doubt and your instinct is strong, advise management AND report to DHS CPS.

What Words Should I Use?What Words Should I Use?Examples:

1. “I always feel better when I have someone to talk to. I want you to know that if there’s anything you ever want to talk about, I will hear what you tell me.”

2. “Are you feeling okay?”

3. “It is okay to ask for help when you feel afraid.”

4. “Is there something I can help you with?”

http://www.safestartcenter.org/sites/default/files/documents/publications/PDF_TipSheetFor_WorkingWithYouth.pdf

Tamicka is 7 Years Old Tamicka is 7 Years Old 1. Your have known Tamicka for 2 years.2. Her parents are married and both

work away from the home during the day; she has two teenage brothers.

3. Her friend’s mom brings her to afterschool troop meetings.

4. You can always count on Tamicka with her quiet but alert personality to do what she is expected to do and she plays happily with the other troop members.

5. During the past five weeks, you notice that Tamicka seems overly-tired, withdrawn from the other girls and while she continues to work cooperatively, she lacks spirit.

6. What words or actions do you take to determine that Tamicka is safe?

Madelyn is 9 Years Old Madelyn is 9 Years Old 1. You have known Maddie, middle, for six months. Her mom has a part time job; her father is absent in her life. She has no siblings. 2. Maddie tends to be a bit bossy but she likes the other girls and they like her, too.3. 10 weeks ago, Maddie began belittling another girl who was having a hard time understanding and following instructions. Maddie made a joke about the girl and the other girls laughed, too. Eight weeks ago, you noticed that Maddie continued to make faces at, poke, and exclude the girl when she thought you weren’t looking. 4. Six weeks ago, you also noticed that Maddie had small bruises on the back of her neck. 5. Today, you had to acknowledge that there is a definite overall change in Maddie’s personality because she was just plainly surly to everyone and cried angry tears when she wasn’t able to accomplish a task.

LOCAL: www.fsctulsa.org – Family Safety Centerwww.dvis.org - DVISwww.parentchildcentertulsa.org – Parent Child Centerwww.childabusenetwork.org – Child Abuse Network http://www.fcsok.org/ –Family & Children’s Services

STATE:www.okdhs.org/programsandservices/cps/ - OK DHS Child Protective Serviceshttp://www.ok.gov/health/Child_and_Family_Health/Family_Support_and_Prevention_Service/Office_of_Child_Abuse_Prevention/ - Office of Child Abuse Preventionhttp://www.ok.gov/health2/documents/2013%20JULY%20EBLAST.pdf - CAP

Info and Learning Resources Info and Learning Resources NATIONAL:

http://www.kidpower.org/library/articles/?gclid=CMf4pJSi3boCFaU5QgodMmMAZQ#teen-safety – Kidpower http://www.loveisrespect.org/pdf/Teen-Safety-Plan.pdf - Love is Respecthttp://promising.futureswithoutviolence.org/what-do-kids-need/supporting-parenting/protective-factors-resiliency/ - Promising Futures Without Violencehttp://www.aecf.org/ - Annie Casey Foundationhttp://www.safehorizon.org/index/child-abuse- – Safe Horizonhttp://www.americanhumane.org/children/stop-child-abuse - American Humanehttp://www.victimsofcrime.org/help-for-crime-victims/get-help-bulletins-for-crime-victims/when-a-youth-is-victimized - The National Center for Victims of Crime

f.a.c.e.s. f.a.c.e.s. DisclaimerDisclaimerThis material is provided strictly for information purposes

as a quick reference, is not and is not intended to be legal advice, is not a substitute for advice from an attorney and is not guaranteed to be free of any errors or omissions either now or in the future. For complete statutes, refer to the official Oklahoma Statutes/ Code. Legal statutes, case law and other legal mechanisms change frequently and are subject to interpretation in various jurisdictions; therefore you should strongly consider seeking the advice of an attorney of your choice at any time that questions or application of this information is required.

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Thank Thank You!You!

To request a family violence prevention presentation for your group, contact Sherry Clark: 918-519-3698 or sherry@facestulsa.org or

www.facestulsa.org. f.a.c.e.s. is an all-volunteer OK non-profit since 2006 with volunteers contributing 10,000+ community ed hours.

Promotion of family safety across thelifespan through education, collaboration,

community building, and action