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The greatest pleasure life has to offer is the satisfaction that flows from … participating in a difficult and constructive undertaking.
Bill Allen, Boeing1
The health of our children, in the United States and elsewhere, is in increasing jeopardy and, with it, the ability of child neurologists to provide access to proper diagnosis and treatment. Threats to the health of children are diverse and include increasing numbers of uninsured children; restriction of comprehensive care for children with chronic and disabling conditions; continuing undersupply of child neurologists and other pediatric subspecialists; inadequate numbers of qualified trainees; and inadequate funds for such training. But the biggest threat is more ominous: child abuse and neglect. I speak not only of intentional but also institutional abuse and neglect. The numbers are staggering. In 1995, 3 million reports of intentional child abuse or neglect were registered with protective service agencies in this country alone.2 Of the 1 million substantiated reports, 10% of children were taken from the home, but an astonishing 25% were provided no services of any kind. To make matters worse, an overwhelming majority of child protective service caseworkers lack formal training in social work.
Intentional trauma or neglect is not a new problem. Both medical literature and public media report an increasing incidence that is too easily dismissed as a result of improved identification and reporting, as if this should give us comfort. Such explanations give the impression that the reality of a child’s life lost or damaged has given way to collecting statistics and convey a callous disregard for the fundamental issues underlying abuse and neglect. The current approach of many public leaders to this and other problems of childhood is nothing less than institutional child abuse. Institutional child abuse results from the impact of adverse policies in …
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