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Massachusetts Medical Society's Physician Focus

March 2013

Youth Violence and Child Abuse


  • Homicide and suicide are the second and third leading causes of death of American children.

  • In 2011, more than 707,000 youth ages 10-24 were treated in emergency departments for injuries from physical assaults, according to the Centers for Disease Control and Prevention.

  • More than three million reports of child abuse are received by state and local agencies each year – an average of nearly six every minute.

  • The total lifetime cost of child abuse is $125 billion every year.

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Be it bullying, dating or street violence, child sexual abuse, assaults, or murders, the numbers show how big a problem it is. The news reports show how tragic it can be.

Violence and abuse take a huge toll on our nation’s youth, physically, mentally, and emotionally, as spectators, perpetrators, or victims.

A key aspect of youth violence, experts say, is that children and adolescents learn from their experiences. “Children think that what they see and experience is normal,” said Robert Sege, M.D., Director of the Division of Family and Child Advocacy at Boston Medical Center, “so if their experience at home has a lot of violence in it, they’re more likely to be violent in the future, whether the home be with their family or within their community.”

Elliot Pittel, M.D., a child and adolescent psychiatrist with The Home for Little Wanderers in Boston, underscores the point. “One of the biggest causes of violence is violence,” says Dr. Pittel. “A history of being exposed to violence contributes to violent behavior.”

The two physicians shared their knowledge of the topic of youth violence and child abuse and their effects on young people as guests on the March edition of Physician Focus with the Massachusetts Medical Society. Hosting this edition is Bruce Karlin, M.D., a primary care physician in Worcester.

The exposure to violence, the physicians say, can come from different sources: the home, the community, and media, such as television, movies, and video games.

“Children think that what they experience by watching television is part of the way the world works,” notes Dr. Sege, who is also a member of the American Academy of Pediatrics Committee on Child Abuse and Neglect. “For some children, taking it from television or video games to the real world becomes quite problematic.”

So, with frequent reports about youth violence and child abuse appearing in the media, raising concern and alarm among parents, what do the physicians recommend?

A home without guns is one of the first steps to take, says Dr. Sege. “The safest home for a child is a home without a firearm,” he says, “and if there is a firearm at home, it should be kept locked with the ammunition locked separately.” But beyond the single act of guarding against firearms, he urges a wider approach to strengthening families: providing basic support services to parents as well as children and encouraging parents and children to make social connections with neighbors, friends, and family.

Such connections can be formed in many ways, through associations provided by youth agencies or school or church groups. “The feeling of belonging and learning how to do something really well is absolutely irreplaceable,” says Dr. Sege.

Dr. Pittel, who also serves as chair of the Massachusetts Medical Society’s Committee on Violence Intervention and Prevention, stresses the critical nature of making those connections.

“It’s important for kids to form connections,” he says, “not only with their peers but with adults whom they trust. Kids who feel connected have meaning and purpose to their lives. They learn how to trust and learn how to manage their moods and relationships better. The more success a child has, the less likely they are to be violent. Kids who become violent don’t seem to care about themselves or others. They feel hopeless. Part of the answer is to give kids hope.”

Watch the accompany program for the full discussion, including conversation on the role physicians can play with families on the brink of violence, the danger of amplifying bad news reports, and steps to take when a child may be headed for trouble. View the public service announcement or visit the Massachusetts Medical Society website below to learn how to get free brochures on various aspects of youth violence and child abuse, part of the Society’s Campaign Against Violence.

MMS/Richard Gulla

American Academy of Pediatrics

Centers for Disease Control

U.S. Department of Health and Human Services

American Academy of Child and Adolescent Psychiatry

Massachusetts Medical Society

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"Youth Violence and Child Abuse" PSA

From left, Bruce Karlin, M.D., Robert Sege, M.D.,
Elliot Pittel, M.D.
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