Sometimes it’s an overwhelming sense of stress on the parents’ part.  Sometimes it’s the overwhelming press of poverty.  And sometimes it’s the overwhelming sense of hopelessness compounded by the absence of humility enough to ask for help.  It doesn’t really matter what the overwhelming emotion, medical records are proving that, as adults are becoming more deeply engulfed by the ravages of the economic recession, the very youngest members of the family are paying dearly.

As the nation’s economy has plummeted, child abuse has escalated.

In Ohio, child abuse cases topped the 100,000 mark in 2007 and the numbers continue to rise.  This localized Ohio rise bucks the national trend, which reveals a decline for that year.  In 2006, 12.1% of all children in the United States were the victims of child abuse.  On a national scale, that number dropped in 2007 to 10.6%, a ratio that seems small until the 71 million little lives it represents are considered.  Unfortunately, as the recession lingers, the numbers are increasing everywhere.

At Boston’s Children’s Hospital, which typically treats 1,500 child abuse cases a year, 1,800 were treated in 2008, including:

• A baby, only four months old, shaken so violently she needed brain surgery.  Her mother worked but her father had been laid off.  Some of the family’s utility services had been disconnected.  When admitted to the children’s center for the second time in a month, she was unable to do little more than stare.  Doctors performed surgery to remove the fluid that had built up dangerously around her brain.  A few weeks earlier, she’d been treated for vomiting and similar neurological symptoms but doctors had no reason to suspect abuse at that time.
• Another baby, just three weeks old, was treated for fractured ribs.
• Poverty led the single mother of a 9-year diabetic boy to stop treatment when she could no longer afford the copayments for it.

According to Allison Scobie, program director for the hospital’s Child Protection Team, twice as many children have been treated so far this year for severe injuries inflicted by others than were treated in the first three months of last year.  She reports similar situations in the metropolitan area, with many hospitals saying they’ve experienced a 20% to 30% rise in cases of suspected mistreatment of children.

The growing problem of child abuse isn’t limited to Boston and Ohio.  In Illinois, child abuse cases rose by 5.8%, with a concentration in the Chicago area, where the increase in child abuse cases topped 9%.

Children’s Hospital and the Harborview Medical Center, both in Seattle, say they treated three times as many children in 2008 with subdural bleeding than the previous year.  Subdural bleeding is caused by blows to the head or by excessive shaking, a condition frequently referred to as shaken baby syndrome.  Dr. Kenneth Feldman says the “vast majority” of these abused children are members of families that are experiencing financial crisis.  Feldman is medical director of the Seattle Children’s Hospital Children’s Protection Program.

In 2008, the medical university at Syracuse, New York, treated 19 children shaken or beaten so badly they required medical treatment; four of them died.  Their average age was 7 months.  Dr. Ann Botash, head of the Child Abuse Referral and Evaluation Program at the State University of New York-Syracuse, describes “a lot more stress” in society right now and it’s being passed along to the children in the form of physical violence or neglect.

The National Institute of Neurological Disorders and Stroke says it’s a baby’s head, large in relative size to its body, and its weak neck that makes him so vulnerable to shaken-baby syndrome.  When shaken excessively, the child’s developmentally fragile brain bounces violently back and forth, where hitting the skull repeatedly causes bleeding, bruising, and swelling.  Some symptoms of shaken-baby syndrome include hemorrhaging of the brain and retina and injuries to the neck, spine, and ribs.  These injuries can lead to brain damage that is severe and permanent when the child lives but many babies die from such treatment.

It’s not just hospitals noticing this heartbreaking trend; of 607 sheriffs, chiefs of police, and district attorneys responding to a nationwide poll, 88% of them acknowledged an expectation of increased child abuse cases in their jurisdictions.  This expectation is based on historical data from previous economic recessions.

Where child abuse is suspected, hospital authorities are almost always required to report the case to the local county’s district attorney’s office.  In Suffolk County, Massachusetts, serving the city of Boston, 500 children were treated for injuries suggesting abuse last year.  So far, that rate has risen 30% for 2009.

In cases of suspected child abuse, parents can be arrested and prosecuted for their violence or neglect.  When parents are arrested, the children are frequently placed in foster care or in the care of relatives but, as public funds for such programs is dwindling as the economy does, the agencies overseeing these protective measures are becoming underfunded even as their case load is skyrocketing.

In Massachusetts alone, the Department of Children and Families is expecting a budget cut of $25 million for the 2010 fiscal year even as the number of children needing their services is on the rise.