“His bottom was ripped apart. You don’t expect to see that when they go to the bathroom. Working here you’d think you’d get used to it, but sometimes it takes your breath away.”
Stacy Kostevicki, GCKH executive director
Too many children in our community face violent death and abuse
By Kimberly Blair
Bryson was just 2 years old when he died in July from burns to over 41 percent of his body.
Dariyana was only 14 months old when she died in September of blunt force trauma to the back of her head.
In October, Brodie died at 15 months from injuries consistent with violent shaking.
All three of these promising toddlers died violently while in the hands of parents or caregivers, all of whom are now facing murder charges, right here in Escambia and Santa Rosa counties.
All three cases are disturbing, to say the least.
The case of Bryson is especially heinous — one can only imagine the suffering he must have endured before dying two weeks after investigators say his parents did not seek medical attention for his second- and third-degree burns. Bryson’s parents, Christopher Redd and Gail Perry, say Bryson scalded himself with hot water from a stove. They are facing the death penalty, if convicted.
A physician contracted to provide medical services for Gulf Coast Kid’s House, who wished to remain anonymous because of the sensitive nature of her work, says these are just examples of the types of child abuse cases often seen in our two-county area. (Editor’s note: The PNJ is using the pronoun “she” when referring to the physician for ease of reading and it should not be taken as an indication of the physician’s gender.)
At times it seems the violence is increasing and getting worse, especially when the cases are fresh in everyone’s minds, she said.
“It surprises me, sometimes, the ones who make the headlines and the ones who don’t,” she said of the cases she knows of in the community through her work. “I have no idea how the media learns of these cases and when they haven’t, why they didn’t. We had a bad month in January with some very egregious forms of child abuse seen in not just one or two, but in six cases.”
Those cases are still under investigation and therefore information hasn’t yet been made public.
There’s no data to prove there is a new epidemic of more egregious violence toward children, the physician said. Confounding the ability to capture concrete data on child abuse is the general under-reporting of abuse, she said. That, and the fact there is no universal definition of child abuse and neglect, so the definitions of maltreatment of children vary between social service, legal and medical professionals. “And I’m not just talking locally but nationally,” she said.
Physicians who treat abused children and professionals who provide services to abused children at Gulf Coast Kid’s House and Santa Rosa Kids’ House say the more atrocious abuse cases seem to come in clusters, and then there’s a lull.
What precipitates the clusters of abuse is not clear.
When there’s an uptick in economic stress, drug abuse and other known risk factors in a family, “the trickle-down effect of that, we know, is more children will be physically abused, sexually abused and neglected,” the physician said.
Age at Kids House
A breakdown of Gulf Coast Kids House demographics by age.
- 1-6 – 52%
- 7-12 – 31%
- 13-18 – 17%
Gulf Coast Kid’s House has seen an uptick in medical exams at its facility, 70 exams in February compared to the average number of 50 monthly, said Executive Director Stacey Kostevicki.
“In the four years I’ve been here, I’m surprised every time I hear about a case you just don’t think can get worse. Then you hear of one that’s worse. To me, it feels like it’s getting worse, but we have nothing concrete to back that up. I didn’t use to hear about going to the hospital to look at kids as much as we do now.”
Most of the children she knows of who are hospitalized are under 2 years old.
“The thing I hear of most often is shaken baby and blunt force trauma… vaginal and rectal tears that require repairs,” the physician said.
Kostevicki doesn’t often see the injuries on children firsthand who come to the Gulf Coast Kid’s House. One day, however, she was asked to help a toddler go to the bathroom.
“His bottom was ripped apart,” she said. “You don’t expect to see that when they go to the bathroom. Working here you’d think you’d get used to it, but sometimes it takes your breath away.”
While her job is tough, she says she hears enough about the cases to know how important her job is.
“I don’t have to live this on a daily basis,” Kostevicki said. “I try to make sure the people who do this on a daily basis here are supported. It’s stuff no one should have to see.”
Signs of abuse
Medical professionals at Gulf Coast Kid’s House have the hard task of diagnosing abuse so the courts or social services can intervene on behalf of the child before they end up on the obituary page or in a newspaper headline.
“The cornerstone of what makes child abuse and neglect difficult at times to diagnose is because the very nature of it is that people don’t run out and say, ‘Hey, I abused my child,'” the physician said. “And, certainly, the mechanisms of injury are explained away by fabricated stories. Our job is to try to piece together the mechanism described to the injury we see and determine if it makes sense and that can be very difficult.”
What troubles these professionals, by the time they see the outward symptoms of abuse, they know opportunities to help these children have been missed.
“Abuse starts, usually, with neglect and poor bonding,” the physician said. “Children who are coming to school dirty and their backpacks empty all school year and you’ve not had contact with the parent. These are warning signs that these parents on some level are detached and unable to meet their child’s needs.”
Preventing the next Brodie, Dariyana or Bryson from facing horrific deaths hinges greatly on raising public awareness of the violence children face and on people speaking up when they see signs of abuse or neglect.
Knowing the signs of abuse is the first line of defense for children.
Gulf Coast Kid’s House team members and advocates provide “Stewards of Children” training and speak publicly about what child abuse is, how to respond and how to identify the tell-tale signs through outreach programs and educational sessions for community providers, such as teachers, church workers and other caregivers who work with children.
Darkness to Light, a national organization that champions the movement to end child sexual abuse, developed the “Stewards” training.
The physician in this story provides educational sessions for the medical community.
“I show slides of what abuse looks like,” she said. “Sometimes you don’t know until you know what this looks like that it could signify abuse.”
She said a tell-tale sign of abuse is bruising on an ear.
“Children typically don’t bruise themselves on the ear through normal interaction or through normal play,” she said. “So ear bruising is a very concerning sign that the child has been psychically abused either through pinching or twisting of the ears or slapped on the side of the head.”
Bruising on the back is unusual because when children play in their normal environment they usually fall forward and not backward over the boney prominences — knees and elbows, she said.
“There are exceptions to that rule,” she said. “But when children are covered in bruises, particularly on their back, that is an unusual place to fall and injure oneself.”
Any type of pattern loop-type bruising or line-type bruising is a concern because that could often be from something like a belt or stick that struck the skin.
Other types of abuse include burns from cigarettes and lighters, torture in the form of starvation, forcing a child to do an “ungodly” amount of sit ups or pushups, sitting or standing in cold water and scald injuries, she said.
Any kind of unexplained head or neck injuries should be considered suspect, she said.
“These are things we look for,” she said. “It does not always mean they were abused but certainly something you should look further into and ask the kids what happened. Kids are forthcoming if they have the language abilities.”
Youngest at highest risk
“The bulk of the life-threatening egregious abuse is in children aged 5 and under,” she said.
As a child becomes older and becomes more able to defend themselves, physical abuse shifts to emotional abuse and the risk of death goes down, she said.
“The vast majority of scald injuries or immersion burns are when children are potty training,” she said. “The parents get angry when they have failed in their abilities to toilet the way they feel they should, so they ‘teach them’ by putting them in hot water or something like that. It’s the escalation of the cause and effect. In a normal circumstance, if your child has a toileting accident you still bathe them, but when you’re angry and abusive, you turn that into a form of punishment.”
Older children are likely to get lashings with belts or other objects.
“Infants are thrown or slammed against something,” she said.
Witnessing someone berating their child in public should be cause of alarm, she said.
Allegations of Abuse
Breakdown of Gulf Coast Kids House demographics by primary allegations of abuse
- Other – 38%
- Physical – 20%
- Neglect – 23%
- Sexual – 19%
Gulf Coast Kids House – Other abuse allegations include “family violence threatens child” and “drug endangerment”
It should make you think: “What are they doing behind closed doors?,” she said.
“I had a parent once using every expletive word known to mankind in front of me to the child,” she said. “Wow. If this is what she’s saying when I’m in the room, what’s happening at home? My level of concern skyrocketed because people don’t advertise ‘this is what I do to my child.'”
Surprisingly, the road to intervening on behalf of the child is peppered with people who still don’t believe child abuse exists.
“So there’s a long way to go,” the physician said.
But she and others who see the results of abuse firsthand can’t ignore it.
“I’ve gone way past turning off the lights as to whether or not this happens,” she said about the child abuse. “I know it’s out there. I can’t turn my back on it. And to not have involvement in it bothers me more than having involvement and dealing with the associated emotional upset one goes through witnessing firsthand what these children are going through. We call it secondary trauma.”
“Turning a blind’s eye to it helps no one,” the physician said.
Child welfare workers know it’s uncomfortable to intervene or report suspected child abuse because most of the people who would be close enough to the child to recognize the abuse are also closely knitted to the perpetrator or abuser.
But the child’s life and long-term health depends on someone speaking up on their behalf, they said.
“In abuse we know in each episode of physical abuse there’s a pattern of escalation,” she said. “One day the child shows up with a slap to the face. Our concern is if appropriate services are not put into place and intervention, that the next time the child comes in they may have permanent damage, and the next time they may not make it.”
PENSACOLA News Journal