Wearing a tattered house robe and with a cigarette dangling from her hand, the pregnant woman in a low-income neighborhood opened the door.
Would she cut down on smoking now that her first child was on the way, the expectant mother was asked by the visiting nurse?
The response: “This baby has taken everything else from me and she’s not going to take the cigarettes, too, and if you ask me to do anything else I’m going to slap you in the face.”
But then the woman confessed to having abused young children as a baby sitter and expressed fears that she would do the same to her child.
That’s where the nurse and Dr. David Olds, to whom the health-care worker reported back, saw an opening. The young woman wanted help, and thanks to a pioneering program called Nurse Family Partnership, she received it.
Olds told the story this week to about 85 child-maltreatment professionals during a two-day conference in this city that was jointly hosted by the Israel-based Haruv Institute, the University of Oklahoma-Tulsa and the Charles and Lynn Schusterman Philanthropic Network.
The Haruv Institute, founded by the Schusterman Foundation-Israel in 2007, seeks to develop knowledge and advanced training programs for the prevention and treatment of child abuse and neglect within families. With the Sept. 10-11 conference, the institute is trying to position itself as an international leader in combating the maltreatment of children.
“Hopefully, down the line Haruv will be to the teaching and training of prevention of child abuse what the Weizmann Institute is to science,” Lynn Schusterman, benefactor of the Schusterman Foundation, said.
At the heart of the effort is forging what leading academics in the field agree has been an elusive partnership of research, public policy and field practice for professionals dealing with maltreated children. The broad category covers physical and sexual abuse as well as neglect. In fact, the 13 academics who gave public talks on Tuesday gathered for a private meeting the day before to discuss how to better disseminate knowledge from their areas of research to practitioners in the field.
Between 700,000 and 900,000 reports of child maltreatment in the United States are reported each year, said Richard Gelles, dean of the School of Social Policy & Practice at the University of Pennsylvania, at the conference. Estimates including non-reported incidents can reach as high as 3 million annually, he said.
Haruv’s director, Asher Ben-Arieh, said Haruv in the coming year will initiate a mentoring program for eight Israelis and eight young American researchers, each of whom will be matched with two well-known experts.
“Our main goal was to lay the basis for future collaboration between the U.S. and Israel, and I feel we got it,” Ben-Arieh said.
The Nurse Family Partnership created by Olds, now the director of the University of Colorado at Denver’s Prevention Research Center for Family and Child Health, focuses on pre- and postnatal home visits, and is one example of what might gain more attention with the emerging collaboration between academics and practitioners. It now serves 23,000 families a day in 400 counties in 41 states.
Such initiatives are critical on numerous levels, according to Neil Guterman, dean of the University of Chicago’s School of Social Service Administration.
“Child maltreatment is a primary source of many of the deepest social problems that we face, whether it’s crime or substance abuse or mental illness,” Guterman said in an interview. “We now know that children’s maltreatment also has a significant impact on all the major medical and health outcomes, and even strongly predicts life expectancy. Given this, we should all pay attention because it’s a huge drain on our economy and broader well-being.”
Dr. Cindy Christian, director of the Safe Place program at the Children’s Hospital of Pittsburgh of UPMC, offered another indication of the impact that academic work can make. Showing graphic slides of bruises, various X-rays and CAT scans, she explored how the marks of diseases and actual physical blows can be confused.
“You need to know that there are some diseases out there that sometimes look like child abuse,” she said, showing a brain scan that revealed excess fluids. “When I look at this brain, I don’t say, ‘Oh my God, look at that abusive head trauma,’ but ‘Oh my God, look at that brain.’ You may see an abnormal CAT scan and be fooled by these metabolic diseases that look like fractures in children.”
While the conference did not have a specific Jewish component, for many of the participants and its organizers, the broader application of Jewish values was clear.
Schusterman said her passion for the topic is “totally Jewish” and goes back to when she moved to Tulsa as a newlywed nearly five decades ago and began volunteering at a police-run shelter through the National Conference of Jewish Women.
“I vowed that when we could we would put money into these efforts,” she said of herself and her late husband, Charles.
Guterman, who did post-doctoral work at the Hebrew University of Jerusalem in the 1992-93 academic year, said the reason he went into the field is “because of our own collective historical experience with traumatic victimization.”
“So it’s not a surprise that there are a number of Jews in a field dedicated to protecting the most vulnerable,” he said. “To me this work is a form of tikkun olam,” repair of the world.
When asked how he thinks the Jewish communal social services delivery system handles the issue, he said, “Within the Jewish community there seems to be a beginning and growing awareness and willingness to deal with victimization when it occurs in the family. Clearly, child maltreatment is a very sensitive issue that sometimes still remains shrouded, but keeping the problem hidden is problematic for helping our most vulnerable children.”
Child abuse in the Jewish community, particularly among the Charedim Orthodox, has gained a great deal of attention in the past year. In New York City, Charedim rabbis, Jewish groups and law enforcement officials have fought over how to enforce mandatory reporting of suspicion and knowledge of child abuse.
Prevention should be an overriding goal, Guterman said.
“The message to the general and the Jewish community is that prevention works,” he said. “We now know how to do it effectively. It saves lives. It saves public dollars. It supports rather than stigmatizes families. And it strengthens the social and economic fabric of our society. It’s completely sensible.”