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Pam Hallman to Meet with the U.S. Congressional Brain Injury Task Force13-Oct-2017

On October 25, our own Pam Hallman has been chosen to represent domestic violence and brain injury survivors across the country in front of the U.S. Congressional Brain Injury Task Force at a brie.. Read More...

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BIA HOME : Domestic Violence & TBI

Domestic Violence & TBI

Often, domestic violence survivors are treated for the visible wounds and, possibly, their psychological ones. Survivors often have brain injuries that go undiagnosed by medical professionals and the altered behavior from the brain injury is misinterpreted for a psychological disorder or lying. While studies exploring the relationship between domestic violence and brain injury are scant, findings suggest that survivors of domestic violence-related brain injuries are more likely to have below average recoveries. We need to be vigilant, when domestic violence is suspected or if it has been confirmed, medical professionals should check for a brain injury.

Domestic Violence

What is Domestic Violence? ↓

Domestic Violence, as defined by the American Psychological Association, is a pattern of abusive behavior, which includes causing physical, sexual, and/or psychological harm.

What is Intimate Partner Violence? ↓

Intimate partner violence is a specific type of domestic violence. As defined by the Centers of Disease Control and Prevention, IPV is physical, sexual, or psychological harm by a current or former partner or spouse. It is this clarification that the abuser is or was a romantic partner or spouse that separates it from generalized domestic violence. This type of violence can occur among heterosexual or same-sex couples and does not require sexual intimacy.

What is Child Maltreatment? ↓

Child maltreatment is domestic violence in certain cases and is aimed at children. As defined by the CDC, it is any type of abuse and neglect of a child under 18 years of age by a parent, guardian, caregiver, or another adult in a custodial role, such as a teacher, coach, or clergy member.

What is Abusive Head Trauma? ↓

Abusive Head Trauma is a specific form of child maltreatment. As defined by the CDC, it is a form of of physical child abuse that causes injury to an infant's or child's brain. This includes what is commonly referred to as Shaken Baby Syndrome. It is caused by violent shaking or blunt force and can cause bleeding around the brain or inside the back layer of the eyes.

Survivors of AHT are highly likely suffer with serious long-term health issues which include:
• Developmental delays
• Physical disabilities
• Hearing and vision problems

The most likely trigger for AHT is when a parent, guardian, or caregiver becomes angry or frustrated by the child's crying. In an attempt to stop the crying, the child is shaken or hit. It is important for parents, guardians, and caregivers to remember: crying, even long bouts of inconsolable crying, is normal for infants.

What is Elder Abuse? ↓

Elder abuse is domestic violence in certain cases and is aimed at senior citizens. As defined by the CDC, it is the intentional act, or failure to act, by a caregiver or another trusted person that causes risk of harm to an older adult.

Domestic Violence and Traumatic Brain Injury

What Causes Brain Injuries in Cases of Domestic Violence ↓

• Blows to the head
• Blows to the body that cause the head to move violently and rapidly
• Shooting or stabbing, especially in the face or head
• Blood loss
• Violent shaking
• Near drowning, suffocation, strangulation, and other forms of oxygen deprivation
• Electric shocks
• Substance abuse

The Most Frequently Injured Locations
• Face
• Neck
• Head

Why TBI in Domestic Violence Survivors Goes Unnoticed ↓

• They do not or cannot seek health care because:
   – They are afraid of their abuser
   – Their abuser controls their access to health care
   – They lack transportation
   – They live in an area that lacks the expertise or resources to diagnose and treat TBI
   – They are one of multiple victims in a family and they take the majority of it to protect the others
   – They are afraid of being stigmatized
   – They are afraid no one will listen or believe
   – They are ashamed
• Medical professionals concerned with the visible injuries
• Brain injury symptoms have not surfaced yet
• Brain injury symptoms confused with mental health or substance abuse issues

How Do Brain Injuries Affect People?

Brain injuries can alter a person's cognitive abilities, have physical manifestations, and influence a person's emotional and behavioral state. Those that have suffered a brain injury may not realize they did or do not believe they suffer any negative effects from it. Please review the information on our Brain Injury Facts page for more information on how brain injuries affect people. If you see any of these in yourself or with others, please see a medical professional and get screened for brain injuries, especially if domestic violence is involved.

Domestic Violence Statistics

BIAA Study ↓

Researchers found that 67% of women surveyed had symptoms associated with traumatic brain injury and 30% reported loss of consciousness after a blow to the head. Additionally, 60% reported no loss of consciousness, but did report symptoms associated with brain injury.

Researchers suspect that women who receive a brain injury from domestic violence are more likely to experience post-concussive syndrome. The researchers behind this study are uncertain as to the women surveyed were more likely to have below average recoveries or develop post-concussive syndrome. They believe it may be the nature of sustaining a brain injury from a blow to the head that causes the brain to rotate in the skull, that female hormones may play a role in recovery, or that victims of domestic violence have multiple injuries. While they advocate for further studies into the nature and consequences of domestic violence and brain injury, researchers also recommend early brain injury screening for domestic violence survivors to ensure proper treatment and prevent further injuries.

To read the whole study in its entirety, visit the BIAA's Domestic Violence-Related Mild Traumatic Brain Injuries in Women page.

Corrigan, J.D., Wolfe, M., Mysiw, J., Jackson, R.D., & Bogner, J.A. Early identification of mild traumatic brain injury in female victims of domestic violence. American Journal of Obstetrics and Gynocology, 188, S71-S76.

CDC Statistics ↓

National Intimate Partner and Sexual Violence Survey (NISVS)
• 22% of women and 14% of men experienced severe physical violence
• 9% of women and 1% of men experienced attempted or completed rape
• 9% of women and 3% of men were stalked by a current or former intimate partner
• Before reaching age 25, 71% of women and 58% of men who experienced sexual or physical violence, or stalking
• 27% of women and nearly 12% of men have experienced contact sexual violence*, physical violence, or stalking
   – This violence was to have negatively affected their life in some way, such as:
         º Fear for their safety
         º Sustained injuries or needed services
         º Lost days from work or school
• Roughly 24 people are victims of rape, physical violence, or stalking every minute
• Over 12 million men and women reported being the victim of rape, physical violence, or stalking in 1 year
• 1 in 4 women and 1 in 7 men will experience severe physical violence in their lifetime

*Contact sexual violence includes rape, being made to penetrate, sexual coercion, and unwanted sexual contact

Child Maltreatment Statistics
• 27% of children who experience maltreatment are under 3 years old
• 1 in 4 children will experience some form of abuse or neglect in their life
• 702,000 cases of maltreatment were reported to Child Protective Services in 2014
• Nearly 1,580 children died from maltreatment in 2014
• Lifetime costs for child maltreatment is $124 billion every year

AHT Statistics
• AHT is the leading cause of death by abuse in children under the age of 5
• Children under the age of 1 are at the greatest risk
• 1 in 3 child maltreatment deaths are from AHT
• Most cases of AHT are caused by frustrated parents trying to stop inconsolable crying

Elder Abuse Statistics
• 1 in 10 people ages 60 and older will experience abuse, neglect, or exploitation at home
• For every reported or detected case of elder abuse, roughly 23 will go unreported or unnoticed
• Medical costs associated with elder abuse are over $5.3 billion every year
• The cost of financial exploitation of elders amounts to $2.6 billion every year

What Do We Do About Domestic Violence?

Preventing IPV ↓

• Helping young people develop necessary skills
   – Leadership
   – Communication
   – Problem solving
• Teaching what constitutes dating violence
• Illustrating how sexist jokes and derogatory language support violent behavior
• Teaching young people about consent
• Encouraging men to speak out against dating and domestic violence perpetrated by other men
• Encouraging victims of dating and domestic violence, both men and women, to speak up and seek help
• Teaching non-violent ways of conflict resolution
• Modeling healthy realationships
• Advocate for the funding of domestic and sexual violence primary prevention programs
• Teaching and modeling respect
• Talking openly about the issues of violence and abuse

For more information, see the MCEDSV's Prevention Plan Brochure.

Preventing Child Maltreatment ↓

• Creating supportive family environments and social networks
• Nurturing partening skillls
• Creating stable family relationships
• Establishing household rules and child monitoring
• Ensuring parents are employed
• Providing adequate housing
• Providing access to health care and social services
• Ensuring there are caring adults outside the family who can serve as role models or mentors
• Building communities that support parents and take an active role in preventing abuse

Preventing AHT ↓

• Understanding that crying is most frequent in the first few months after birth, but will decrease over time
• To calm a crying baby, try:
   – Gently rocking
   – Softly singing or talking
   – Offering their pacifier
   – Taking the baby out for a walk in their stroller
   – Taking your baby for a drive
• If crying persists, check to make sure there are no signs of illness and call the doctor if you suspect the child is sick
• If you feel yourself getting frustrated or angry, focus on calming yourself down
   – Put the baby down is a safe place and check on them every 5 - 10 minutes
   – Call a relative or friend for support
• Never leave a baby with someone who is easily irritated or has a history of violence
• Being Aware of new parents in your family or community
• Providing support
• Offering to give parent, guardian, or caregiver a break when needed
• Encouraging parents, guardians, or caregivers to take breaks to calm down if needed when the baby is safe in the crib
• Being sensitive and supportive in situations when parents, guardians, or caregivers are trying to calm a crying baby
•Supporting work policies that make it easier for working parents to stay with their infants during the period of increased infant crying
   – This period last from 4 - 20 weeks of age

For more information, see the CDC's Child Abuse and Neglect: Risk and Protective Factors, Child Abuse and Neglect: Prevention Strategies, and Preventing Abusive Head Trauma in Children pages.

Preventing Elder Abuse ↓

• Establishing numerous strong relationships with people of varying social status
• Establishing a strong support network
• Building a strong community, one that is inclusive of elders
• Establishing positive beliefs and attitudes toward elders
• Encouraging elders to speak out if they are being abused
• Providing access to health care options
• Allowing elders to make decisions regarding their health care
• Providing greater access to formal services, such as respite care
• Ensuring financial independence for elders

For more information, see the CDC's Elder Abuse: Risk and Protective Factors and Elder Abuse: Prevention Strategies pages.

HELPS Tool ↓

This is a brief screening tool that was developed to be used by professionals that are not brain injury experts to help them catch brain injury in domestic violence victims. It should be used when working with anyone seeking domestic violence services.

H. Were you HIT IN THE HEAD?
E. Did you go to the EMERGENCY DEPARTMENT for treatment?
S. Have you experienced feeling SICK OR OTHER PHYSICAL PROBLEMS after getting hurt?

*Loss of consciousness is NOT necessary to have sustained a brain injury.

If you suspect they have a brain injury or if they answer yes to any of the questions, help them get evaluated by a medical professional. Catching brain injuries early is the only way to maximize the victim's recovery. If brain injuries go unnoticed, victims have below average recoveries and increased risk of death.

The original HELPS screening tool was developed September 1991 by M. Picard, D. Scarisbrick, and R. Paluck for the International Center for the Disabled, TBI-NET, the US Department of Education, and the Rehabilitation Services Administration (Grant #H128A00022). It was recently updated by project personnel to reflect recommendations by the CDC on the diagnosing TBI's.

Resources on Domestic Violence ↓

Center for Disease Control and Prevention: Division of Violence Prevention
Michigan Department of Health and Human Services: Professional Training and Resources
Michigan Department of Health and Human Services: Education and Prevention
Michigan Domestic and Sexual Violence Prevention and Treatment Board: Teen Dating Violence
BIAA on Domestic Violence and TBI
Michigan Coalition to End Domestic and Sexual Violence

Resources for Domestic Violence Victims ↓

Michigan Department of Health and Human Services: Information for Survivors
Michigan Department of Health and Human Services: Services Search
Michigan Women's Shelters
Michigan Coalition to End Domestic and Sexual Violence: Program Search