WebMD Health News
Daniel J. DeNoon
Louise Chang, MD
July 31, 2007 - There's a hidden cost to today's long military deployments -- a price paid by soldiers' children.
That cost: Children in single-mother military households are much more likely to suffer neglect and abuse during deployments.
Research Triangle Institute researcher Deborah A. Gibbs, MSPH, and colleagues report the findings in the Aug. 1 issue of The Journal of the American Medical Association.
"The overall rate of child maltreatment is 42% higher during soldier deployment than during other times. The increase occurred both for mild and for moderate-to-severe maltreatment," Gibbs tells WebMD. "Not surprisingly, this results from much higher rates of maltreatment by female civilian parents, because they are the ones left at home most often."
During deployments, the children of left-at-home moms were four times more likely to suffer neglect and nearly twice as likely to suffer physical abuse.
"The surprising finding was that the effect of deployment was so consistent," Gibbs says. "Just about any way we could divide the population, we found increased rates of child maltreatment during deployment. We looked at pay grade, rank, single or multiple deployments, whether the family lives on or off post -- all showed increases."
This isn't happening because the left-at-home moms are terrible mothers -- it's happening because they are mothers stressed to the breaking point, says Wendy Lane, MD, MPH, chairwoman of the child protection team at the University of Maryland School of Medicine.
"The parents who do this are not bad people. This is the case in most situations of abuse and neglect," Lane tells WebMD. "People want to do the right things for their kids, but often there are stressors that keep them from doing what they want to do."
The main stressor is the "impact of continuous deployment on our soldiers and families," says Delores Johnson, director of family programs for the U.S. Army's Family and Morale, Welfare and Recreation Command.
"Because of the continuous deployment of troops, this is much more common than it had been before," Johnson tells WebMD. "We know that neglect tends to increase during deployments, although we have not seen these high rates before. This seems to be coming from families dealing with back-to-back and extended deployments. Mothers are functioning very much alone and dealing with schedules and new babies and all the demands that go with that."
Gibbs and colleagues studied reported cases of child maltreatment in 1,771 families of enlisted U.S. Army soldiers deployed at least once between September 2001 and December 2004. During these deployments, more than 80% of the cases of maltreatment were due to child neglect. Over two-thirds of these cases were reported as moderate or severe.
"An example of a mild child neglect case would be the parent's lapse in supervision of a child that did not meet the army's criteria for leaving children alone but which did not result in any harm and was not blatantly inappropriate -- such as leaving an 8-year-old home for a short period of time," Gibbs says. "A severe case of child neglect would be more along the lines of a parent not providing supervision to a young child for an extended period of time, not meeting the child's basic needs for food, or not maintaining a livable household."
The study looked only at families with reported episodes of child maltreatment. Four times as many children likely are affected, as only about 25% of cases of child neglect or abuse actually is reported, says John Fairbank, PhD, co-director of the National Center for Child Traumatic Stress, sponsored by the U.S. Substance Abuse & Mental Health Services Administration.
"This could be the tip of an iceberg," Fairbank tells WebMD. "There are probably many more Army families out there suffering. And other members of the armed forces, such as the Army Reserve and National Guard, are much more isolated than are those on military bases. ... This really is a problem we need to be addressing thoughtfully and carefully and urgently."
The Army's Johnson disagrees with the tip-of-the-iceberg analogy, although she says maltreatment of children in military families has become "much more common than it had been before." And Johnson says the findings of the Gibbs study remain relevant today.
"I don't think a snapshot taken today would be different from the 2001-2004 period in the study. We would see same level of neglect," she says. "This is something we were able to detect in our own research analyses. It has highlighted the impact of continuous deployment on our soldiers and our families."
The problem of child maltreatment is solved not by punishing families but by helping them, says child-protection expert Lane.
"There should be an assessment of the family: Are there risks in addition to the fact the parent is deployed? Is it just increased stress -- or could there be lack of social support? Could there be substance use or abuse? Could it be financial?" Lane says. "You work with the family to find out what kind of support the family needs to avoid future neglect -- and give parents better skills so the child is safe."
The U.S. Army is doing just that, Johnson says.
"The question we are addressing is, do we have a way of picking up on these families at risk and following them as the baby develops?" Johnson says. "We have a 24/7 help line families can call to ask for in-depth counseling support. We have new-parent support programs that are especially helpful with the areas that generate most concern, such as feeding. We have a special-emphasis effort on 'do not shake babies.' And then we have a normal range of parenting classes."
Sometimes, however, a family's problems are deeper than simple lack of support or know-how.
"The deeper problem might be something more serious. For example, a parent may have depression that needs to be treated, in which case you have to make a referral to a mental health specialist," Lane says.
"The Army has put a lot of money into adding more social workers and psychologists and psychiatrists to be available to our families, particularly with the levels of depression we are beginning to see," Johnson says. "We think we have the right programs in place. The chief of staff and the secretary [of defense] with their infusion of dollars are saying we are there for families. This means we are adding more home visitors to our new-parent support, and making more of a move for child care to give parents a break, in addition to other services we have available."
The current study does not address another problem for military families -- the stress of returning veterans with physical or psychological problems.
"What we know is, if they come home with a war-related psychological disorder such as PTSD, there is a substantial increase in risk for additional family conflict such as domestic violence or emotional problems with the children," Fairbank says. "The unknown is of how this will play out in terms of the newer aspects of this war -- such as high rates of traumatic brain injury -- and what risk this will pose for child maltreatment. So it is very important for these issues to be addressed now, both by providing services and by studying what is going on so we can learn from it."
SOURCES: Gibbs, D.A. The Journal of the American Medical Association,
Aug. 1, 2007; vol 298: pp 528-535. News release, RTI International. Deborah
Gibbs, MSPH, senior health analyst, RTI International, Research Triangle Park,
N.C. Wendy Lane, MD, MPH, chairwoman, child protection team, and assistant
professor of pediatrics and of epidemiology and preventive medicine, University
of Maryland School of Medicine, Baltimore. John Fairbank, PhD, associate
professor of medical psychiatry, Duke University Medical Center, Durham, N.C.;
co-director, National Center for Child Traumatic Stress. Delores Johnson,
director of family programs, Family and Morale, Welfare and Recreation Command,
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