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Families are spending more time at home and dealing with stress and uncertainty, with schools and businesses closed.

Editor's note: This is the first installment of a two-part feature story.

This week, we look at the problem of child abuse in the coronavirus era and the pandemic's effects on reporting, counseling and treatment. Next week, we focus on the coronavirus pandemic's effect on domestic violence, the eventual re-start of school and the resulting impact on abuse reporting, and funding for the organizations that provide care.

COURTESY PHOTO - During Child Abuse Awareness Month, local agencies encourage stressed families to reach out for help.

School closures, mass unemployment, stay-at-home orders, and the unprecedented stress of an economic crisis and a global pandemic.

With families stuck at home and isolated from their communities, child advocates fear that children may be left in unsafe positions with no escape. Many worry that child abuse could worsen.

'The family is under such stress'

"All of us are really fearful about what that means for these kids," said Cassy Miller, executive director of St. Helens' Amani Center.

The concern isn't only for children who already suffer in abusive households.

"I think people might end up hurting kids who wouldn't normally hurt kids, but the family is under such stress," said Kevin Dowling, executive director of CARES Northwest in Portland.

"We have already both heard and experienced cases where having children home from school, with parents potentially not working, all isolated together is causing issues and causing the disruption or breakdown in some of our placements," said Kathy Finney, operations director for CASA for Children, which trains and manages court-appointed advocates for children in child welfare cases in Columbia, Washington and Multnomah counties.

Further heightening the danger to children, school closures mean that signs of abuse that would often be seen by teachers are going unnoticed.

"Schools play such a vital role in helping keep kids safe," Dowling said.

"Our CASA volunteers are unable to physically visit the children they advocate for ... so as mandatory reporters, we worry about their eyes not being on the children they serve," Finney said.

Reporting difficulties

Calls to the state child abuse hotline — 1-855-503-7233 — dropped by more than 50% after schools shut down. The number of child abuse assessments has fallen in line with the decrease in calls.

Reports of suspected child abuse or neglect come through the hotline and local law enforcement agencies. From the start of the year through mid-March when schools closed down, an average of 86 cases per week were assigned for further investigation by Child Protective Services in Washington County. In the first five weeks after schools closed, that number dropped to an average of 44 assignments per week.

For CARES Northwest and the Amani Center, which offer child abuse assessments in Washington and Columbia counties, respectively, the COVID-19 pandemic has caused a steep drop in assessments.

Medical evaluations completed by CARES each week dropped from 25 to 30 before the pandemic down to single digits but are now building back up.

CARES Northwest closed its satellite clinic in Washington County when the coronavirus outbreak started. That clinic just re-opened this week.

Dowling said CARES hopes to see four kids per week at that location going forward.

Both CARES and the Amani Center offer medical evaluations and interviews of children who have experienced abuse. Those often have to be completed quickly, before injuries heal. Both groups have had to limit in-person appointments to only urgent cases.

Staff have to determine when a case requires immediate response, and when the risks outweigh the benefits of bringing a child to the office or into a hospital setting.

CARES also offers trauma therapy, which switched to videoconferencing when the pandemic started. Though connecting in the digital realm can present new challenges, "there have been some really neat silver linings," Dowling said. One therapist who was working with an elementary school child received a tour of the child's room and home over video, Dowling said.

Caregivers adjust to virus

A large portion of the conversations staff had with families pre-COVID was over the phone, which has continued. Now, however, the subject of those conversations has frequently changed to COVID.

"For us to be physically limited, not sitting in the same room as people, going over the documents, that's very foreign for us," Miller said.

She added, "We were all really proud of how quickly we were able to transition staff. ... We're this small, little nonprofit who had to immediately get really, really creative quickly, and I think we successfully did that."

For CASA, which relies on volunteer advocates, recruitment and training has been a struggle with social distancing.

"We have done online trainings in the past, but they are not sufficient to truly vet volunteers both for their fit with the role of a CASA as well as how they interact with others in the training class," Finney said.

The organization is working to improve digital training materials for trainings this summer.

"We anticipate the need for CASA volunteers will increase dramatically once the stay-at-home (orders) are lifted and mandatory reporters, like CASA volunteers, are able to visit kids face-to-face," Finney said.

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