Long-term consequences for victims of child abuse

Karen Kay Imagawa, MD, explains what the long-term consequences of child abuse are, depending on the time of abuse and shares advice on how to help a child with these challenges
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Long-term consequences for victims of child abuse

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People often wonder what the long-term consequences of child abuse are. Now if we're talking about, for example, physical abuse, the child may have sustained broken bones which may heal with no problems at all, or depending on the type of fracture and where it is, if it involves an extremity, it might actually cause difficulties with length discrepancy, as well as maybe a deformity, or for instance, if a child has traumatic brain injury, where the brain itself is actually injured. That can have long-term consequences regarding their cognitive ability, attention, even their social/emotional status. Also there is this issue of the whole neurobiology of trauma. Over the last few years, there's been an upsurge in research regarding the effects of trauma, such as child abuse and neglect on the developing brain, particularly in those critical periods of infancy and childhood where the brain is rapidly developing. What has been found is that the exposure to extreme stress, such as child abuse and neglect, can cause difficulties to the developing brain, the whole nervous system, the endocrine system and the immune system, which then in turn has consequences to the physical, emotional, cognitive, social well-being of a child. So we do know that adverse childhood experiences that happen in childhood can have long-term effects, and they actually increase the risk of having health-related problems as adults. Things, such as, diabetes, heart problems, obesity, high-risk behaviors such as alcohol and drug abuse, so there are a lot of long-term effects that can happen. Now, when we talk about stress, stress can have it's protective nature, and can have it's negative parts. As an example, as a protective, if you see a bear and you're like, "Oh my gosh! There's a bear!" Your adrenalin starts going and you have this flight/fight response, and you've got to figure out, "Okay what am I going to do? I need to get away from the bear!" Okay, then you come back down to your normal stress level. That's a good protective way of dealing with stress, however, it can be mal-adaptive in that if you are constantly having the bear, the bear is constantly coming at you - the child abuse and neglect, if you are constantly being abused, you are constantly exposed to stress, you are always in this stress level, and that can actually affect your whole development. What we have found now is, we don't want to give up on these children who have been exposed to chronic abuse and neglect, but having a supportive parent can be a mediating factor that can help them get back down to their normal stress levels. Getting early intervention, involving your mental health professionals is very important. So there certainly are some long-term consequences and outcomes that can happen from child abuse and neglect and with this whole body of research regarding the neurobiology of trauma, we need to be thinking about how we protect our children from having those adverse childhood experiences. Again, we want to make sure that they have safe, stable, nurturing relationships.

Karen Kay Imagawa, MD, explains what the long-term consequences of child abuse are, depending on the time of abuse and shares advice on how to help a child with these challenges

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Karen Kay Imagawa, MD

Director of the Audrey Hepburn CARES Center, Children's Hospital Los Angeles

Karen Kay Imagawa, MD: Director, Audrey Hepburn CARES Center, Director, Developmental-Behavioral Pediatrics Program, Division of General Pediatrics; Children's Hospital Los Angeles. Karen Kay Imagawa, MD, is also the Assistant Professor of Pediatrics at USC’s Keck School of Medicine and is a full-time attending within the Department of Pediatrics, Division of General Pediatrics, at Children’s Hospital Los Angeles (CHLA). She received her medical degree at the University of California, Los Angeles, and is board certified in General Pediatrics, Developmental-Behavioral Pediatrics, and Child Abuse Pediatrics.  Dr. Imagawa has made significant contributions to program development at CHLA: She is currently the Director of the Joint General Pediatrics – USC University Center for Excellence in Developmental Disabilities (UCEDD) Developmental-Behavioral Pediatrics Program ,expanding the program to its current position with the largest number of board-certified developmental-behavioral pediatricians (7) in a Southern California program, and was integral in establishing the ACGME accredited Developmental-Behavioral Pediatrics Fellowship program at CHLA . Dr. Imagawa is also one of the founders and the Director of the Audrey Hepburn CARES Center at CHLA, a multifaceted interdisciplinary child protection center involving evaluation, treatment, prevention, education and research in the field of child maltreatment.  Dr. Imagawa is a court appointed expert (730 paneled expert in both Criminal and Dependency Court) in the field of child abuse, and was actively involved in the development of the Foster Care Hub at CHLA, one of seven designated Hubs in Los Angeles County that were initially established to provide forensic, medical, and mental health screenings for newly detained children entering the foster care system.  She previously served on the advisory group for The California Medical Training Centers formulating standardized training in child abuse, and collaborated on a task force to develop standards at the state level for mental health care for child victims of trauma. She is a medical consultant for the Inter-agency Council on Child Abuse and Neglect (ICAN – the official county agency which coordinates the development of services for the prevention, identification and treatment of child abuse and neglect), having participated in various medical task forces establishing protocols and best practice standards for the evaluation and treatment of suspected victims of child abuse, included those with developmental disabilities. Dr. Imagawa’s strength as a clinical educator is also seen in her dedication to education and training. She has been invited to participate in numerous speaking engagements, as well as requests from the media and entertainment industry, involving a variety of topics in the fields of child abuse and/or developmental-behavioral pediatrics. 

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Transcription: 
People often wonder what the long-term consequences of child abuse are. Now if we're talking about, for example, physical abuse, the child may have sustained broken bones which may heal with no problems at all, or depending on the type of fracture and where it is, if it involves an extremity, it might actually cause difficulties with length discrepancy, as well as maybe a deformity, or for instance, if a child has traumatic brain injury, where the brain itself is actually injured. That can have long-term consequences regarding their cognitive ability, attention, even their social/emotional status. Also there is this issue of the whole neurobiology of trauma. Over the last few years, there's been an upsurge in research regarding the effects of trauma, such as child abuse and neglect on the developing brain, particularly in those critical periods of infancy and childhood where the brain is rapidly developing. What has been found is that the exposure to extreme stress, such as child abuse and neglect, can cause difficulties to the developing brain, the whole nervous system, the endocrine system and the immune system, which then in turn has consequences to the physical, emotional, cognitive, social well-being of a child. So we do know that adverse childhood experiences that happen in childhood can have long-term effects, and they actually increase the risk of having health-related problems as adults. Things, such as, diabetes, heart problems, obesity, high-risk behaviors such as alcohol and drug abuse, so there are a lot of long-term effects that can happen. Now, when we talk about stress, stress can have it's protective nature, and can have it's negative parts. As an example, as a protective, if you see a bear and you're like, "Oh my gosh! There's a bear!" Your adrenalin starts going and you have this flight/fight response, and you've got to figure out, "Okay what am I going to do? I need to get away from the bear!" Okay, then you come back down to your normal stress level. That's a good protective way of dealing with stress, however, it can be mal-adaptive in that if you are constantly having the bear, the bear is constantly coming at you - the child abuse and neglect, if you are constantly being abused, you are constantly exposed to stress, you are always in this stress level, and that can actually affect your whole development. What we have found now is, we don't want to give up on these children who have been exposed to chronic abuse and neglect, but having a supportive parent can be a mediating factor that can help them get back down to their normal stress levels. Getting early intervention, involving your mental health professionals is very important. So there certainly are some long-term consequences and outcomes that can happen from child abuse and neglect and with this whole body of research regarding the neurobiology of trauma, we need to be thinking about how we protect our children from having those adverse childhood experiences. Again, we want to make sure that they have safe, stable, nurturing relationships.