CNN -Calls to a major child abuse hotline increased in the early months of the pandemic, new research has revealed. The findings add fuel to worries that hidden child abuse may have been a consequence of school closings and lockdown measures due to the novel coronavirus.
Researchers assessed calls and texts to the national child abuse hotline Childhelp;from March to May 2020 and compared them to the same period in 2019. The team found a 13.75% increase in total inquiries to the hotline from 2019 to 2020, according to the studypublished in the journal JAMA Pediatrics Monday.
"We hypothesize that there was an increase in calls and texts to the hotline overall due to an increase in child and caregiver distress and potential child malreatment amid the stressors of the pandemic," said study author Dr. Robin Ortiz, national clinician scholar at the University of Pennsylvania and the Children's Hospital of Philadelphia.
The research team reported 16,299 calls and 300 texts from March to May 2019 and 17,618 calls and 1,263 texts during the same period in 2020, which is an 8% and 321% increase, respectively.
Callers differed between 2019 and 2020 as well, the team noted. There was a decrease in calls between 2019 and 2020 from people mandated by law to report signs of abuse, such as teachers, day-care personnel, child protective services workers and counselors.
The team noted that calls increased after US Health and Human Services declared a public health emergency at the end of January 2020. Calls decreased after schools began closing in March 2020 -- though text inquiries rose after school closures.
"Decreased exposure to school-based mandated reporters may have contributed to the initial call decrease," the researchers wrote. "Text messaging, a child- and teenager-friendly modality, expanded during the postclosure period, pointing to potential self-advocacy".
The team said their findings suggested text-based access to these kinds of hotlines can be a helpful tool for children dealing with abuse during the pandemic, while exposure to mandated reporters is limited.
Concerns about hidden child abuse
Child abuse escalates when families are overwhelmed, experts say. The pandemic's perfect storm of school closures, social isolation, separation from loved ones, interrupted income, and job loss has worried child abuse experts, who fear a hidden epidemic of abuse that has mostly gone undetected.
"I believe that it will take us many years to sort out the true effects of the pandemic on our children and this study is one step in that process," said Dr. Suzanne Haney, chair of the American Academy of Pediatrics Council on Child Abuse and Neglect, in an email. She was not involved in the study.
To complicate matters, data from 2020 has been difficult to obtain and analyze. Early in the pandemic, for instance, child abuse hotlines in Connecticut, California, Michigan, Kentucky, New Hampshire and Louisiana reported double-digit declines in calls about abuse.
"These reductions do not reflect decreased incidences of child maltreatment, but unfortunately are a direct result of the precipitous decrease in contact between children, educational personnel, and other community youth programmes," wrote researchers in an article published in July 2020 in the journal The Lancet.
Another example: report from the US Centers for Disease Control and Prevention found that emergency visits for child abuse and neglect for children under 18 dropped by 53% in mid-March 2020 compared to the same time in 2019.
Despite the drop, the study found the number of abused children who required hospitalization remained the same as last year, "suggesting that injury severity did not decrease during the pandemic," the CDC researchers said.
In fact, the study found the severity of the injuries worsened or stayed the same compared to a year ago. Did this mean that child abuse declined except for the most severe cases? Unclear, experts said. It could be that there were fewer cases of child abuse, Haney said, or just that less severe cases were not reported.
Perhaps families were choosing to keep their children at home when they have less severe injuries, child abuse pediatrician Dr. Robert Sege, who directs the Center for Community-Engaged Medicine at Tufts Children's Hospital in Boston told CNN in a prior interview.
"Most child abuse is caused by neglect, and physical abuse doesn't always cause a kind of serious injury that requires hospitalization," said Sege, who is also a member of the child protection program at Tufts Children's Hospital.
Interestingly, the American Academy of Pediatrics conducted a study last November and found about 60% of families reported they grew closer together during the pandemic.
While most children's lives were upended during the pandemic, some parents "set out to create safe and loving homes for their children -- which led to closer positive relationships," AAP President Dr. Lee Savio Beers said in a written statement.
Despite unclear data, the US House of Representatives passed The Stronger Child Abuse Prevention and Treatment Act in mid-March.
The bill introduced a variety of increased safety measures for children, such as requiring the US Department of Health and Human Services to create a national tracking system for child abuse that allows states to share information with each other.
How to spot child abuse
Everyone should be on the lookout for signs of child abuse, experts say, not just mandated reporters. It's important to report abuse as soon as it is spotted because it can cause "permanent, significant damage to the developing brain and contributes to life-long mental health and physical health issues," Haney said via email.
"The sooner that abuse is recognized and treated, the better off the child will be," she said.Neglect, such as children not having enough food or adequate clothing, is one of the most common forms of abuse, Haney said.
People should also be on the lookout for physical abuse, particularly if there are bruises on the ears or mouth injuries, she added.