Part 1: A home is no refuge for abused youngsters

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PART 1 OF THE SERIES:

The case was widely publicized in the days immediately after the children's deaths, as the grisly details unfolded of a father killing his own.

What was never publicized and what was known only to a select few was that the children were already under the "protection" of the state; that the family had been the subject of five referrals to the county Department of Family and Children Services in the previous eight months; that there had been reports of cigarette burns, a beating that had left marks on one of the boys, and an incident in which the father had threatened one of his children with a butcher knife.

The case is not unique. Last year, 51 Georgia children who were already known to child protective service workers died - an average of almost one a week.

The deaths of these children, outlined in case summaries obtained by The Atlanta Journal-Constitution, underscore a child welfare system that is shrouded in secrecy and structured to fail the children it is intended to protect.

It is a system in which overburdened caseworkers often leave children with violent parents, abused children are sometimes placed in foster homes more dangerous than their own, temporary emergency shelters end up as a child's permanent home, and judges routinely ignore laws designed to protect children in court.

It is a system in which a 7-week-old baby who died after her drug- abusing mother "rolled" her across the floor like a bowling ball was listed by a coroner as a case of sudden infant death syndrome (SIDS) - despite a physician's opinion that child abuse was the cause.

The deaths of such children, who are already under the protection of the state, represent the ultimate failures of the state's child protective system. But an examination of the cases also points to ways to prevent other child deaths.

A three-month investigation of Georgia's child fatalities revealed that:

Between 1979 and 1982, four children in the same Clayton County family died of suspicious causes. After the second child's death, the father told medical examiners he was suspicious of his wife. After the third child's death, the only survivor - an 11-year-old girl - told a child welfare worker she was afraid to stay with her mother. The girl was later found dead in her mother's home of "probable asphyxia" of "undetermined cause." The medical examiners had never heard of the girl's request for help, and the welfare worker never knew of the husband's suspicions.

The case was recently reopened as a possible homicide.

"There is strong evidence that Georgia knows little about how often, why or how people have killed children they're responsible for," said Dr. Michael Durfee, a national expert on child fatalities. "In a small but horrible way, a child may be murdered and nobody bothers to do anything."

State child welfare officials are aware of the problem, but say it is far more complex than child protective services alone can solve. Sometimes, they are discouraged from even trying.

Last summer, when the state child welfare agency took a stab at reviewing the suspicious death of a 2-year-old girl who was mysteriously burned to death, they were advised to stop.

"Our lawyers said we don't want to collect evidence to convict ourselves," said Douglas G. Greenwell, director of Georgia's Division of Family and Children Services.

More Than 39,000 Reports of Abuse in 1987 

In 1987 more than 39,000 cases of abuse or neglect were reported in Georgia - and more than half of those cases were confirmed. The figure represents a 26 percent jump from the year before.

In extreme cases of abuse and neglect, children die - mostly at the hands of their parents and mostly before they reach their first birthday.

A March report by Johns Hopkins University School of Public Health showed that for the first time in two decades, homicides had replaced motor vehicle accidents as the No. 1 cause of injury-related deaths for children under 1 in the United States.

While sexual abuse is perhaps the child abuse issue of the day, "the next issue is that people kill their kids," said Dr. Durfee, a child psychiatrist with the Los Angeles County Department of Health Services and a member of the Presidential Commission on Child and Youth Fatalities.

Georgia child welfare officials say they often don't know a lot about how children on their caseloads died, since they sometimes close cases before autopsies have been conducted or before police have concluded their investigation.

"Unlike other states, Georgia doesn't have a real system for reporting child fatalities," said Jan T. South, a child protective services specialist for the state Department of Human Resources. "Basically because no one has said we need to look at that."

In Georgia, so little attention has been paid to the problem that the best the state has is an informal list of children who died while in their custody or who were at least known to the agency. That figure ignores what is probably a larger group of victims.

"For every child that is known, there are probably a dozen that are not known," said Dr. Joseph L. Burton, medical examiner for five metro Atlanta counties and an expert on child abuse.

Cocaine, Crack Share the Blame 

The mounting number of child abuse and neglect cases is in part rooted in more aggressive reporting, but some experts believe that the actual incidence of violence against children is also on the rise.

One reason for the growing violence is drugs, experts say, primarily cocaine and its derivative, crack. Of the 51 Georgia protective services death cases last year, close to a third had parents involved in drugs or alcohol, according to the summaries obtained by the newspaper under the Georgia Open Records Act. Nationally, 60 percent of confirmed cases of child abuse and neglect involve drug or alcohol abuse, according to the National Committee for Prevention of Child Abuse.

One difficulty in checking the violence is society's reluctance to interfere with the sanctity of the family - the belief that what goes on in a family's home is no one else's business.

"I think society does not give a great deal of value to children," said Dr. Janine M. Jason, a pediatrician and immunologist at the U.S. Centers for Disease Control who did a national study on child homicides.

In the eyes of many decision-makers, Dr. Durfee said, "babies are not people."

Unfortunately, babies under 1 account for 90 percent of all child abuse homicides, according to the National Council of Juvenile and Family Court Judges.

And the younger the child, the more likely that his murderer was his parent or some other caretaker, says Dr. Durfee.

"If you graph out child abuse homicides, the single most important factor to look at is age," he says. "Babies are more fragile when they're younger, they're a whole lot more trouble, parents are more stressed."

Babies also leave no signs of struggle. As a result, an unknown number of children's deaths are mislabeled, according to the National Committee for Prevention of Child Abuse, which estimates that the 1,200 children killed in 1987 may be closer to 5,000.

"I am sure there are children's deaths that occur in the state of Georgia and elsewhere that are certified as accidents or natural that are actually homicides," said Dr. Burton.

One of the most glaring questions arising from the summaries obtained by the newspaper from the state attorney general involves the frequency with which SIDS is cited as the cause of death, particularly where there has been a clear history of abuse.

Nationally, SIDS accounts for 13.6 percent of all deaths of babies under 1, according to the National SIDS Foundation in Landover, Md. Yet of the 19 deaths of Georgia infants known to the state last year, 11 - or 58 percent - were listed as SIDS deaths, the summaries show.

"Some of those children may technically be SIDS," said Dr. Burton. "There is a preponderance of them in the lower socio-economic class." Nevertheless, he said, he suspects that many deaths are mislabeled. "I think there are many cases signed out as SIDS that aren't SIDS."

The National Committee for Prevention of Child Abuse estimates that 5 percent to 10 percent of the 8,000 SIDS deaths that occur across the nation each year are in fact homicides.

State officials agreed that a number of the summaries citing SIDS leave unanswered questions.

"SIDS is often on the death certificate, but if you look at some of the factors, you wonder," said Gerald V. Gouge, chief of the state's Child Protective Services Unit.

Vale Henson, a veteran child protective services caseworker for DeKalb County, had one neglect case in which the baby's weight when she died was 6 pounds - 2 pounds less than her weight at birth. Doctors tagged the death a natural SIDS.

"The baby died of starvation," Ms. Henson said.

The diagnosis may be overused in Georgia because coroners often label a death as SIDS without an autopsy, an essential element to making the diagnosis, medical experts say.

A review of Georgia death certificates shows that of 113 SIDS deaths outside Atlanta last year, 44 were diagnosed without autopsy.

At the root of Georgia's problem, say forensic pathologists and some child welfare experts, is this state's reliance on a system of elected coroners who have little medical training.

"Let's face it," said Dr. Joseph H. Davis, Dade County medical examiner in Miami. "Georgia is the last outpost. It's got a long way to go before it cleans up its act."

The subtle differences between SIDS and suffocation are difficult to detect even with an autopsy, forensic experts say. They're nearly impossible without. Small children also can be strangled or drowned in bathtubs with a fair amount of ease and little detection.

In Los Angeles, where a sophisticated team of professionals investigates all suspicious child deaths, bathtub drownings are the cause of death most frequently moved from the accident to homicide category after the review.

"A 2-year-old who drowns in the bathtub - that's a homicide until proven otherwise," said Dr. Davis of Miami.

That was not the case for a 4-year-old Georgia girl who died last year. According to the summary of her case, an emergency room physician, who treated her for mouth injuries, reported to the child welfare agency that he suspected she was being abused. He said the mother's behavior was not normal, and he described her as "overly critical" and "very rough" with the child.

By the time a child welfare worker got in touch with the family, the little girl was dead. "The child drowned in a bathtub," the summary says. The agency "had no further involvement after referring relatives for therapy to assist them with their grief."

A Team Approach to Investigating Deaths 

In recognition of the growing problem of child fatalities, 32 states have established child fatality review teams to look at all suspicious deaths. Georgia is not one of them.

The Los Angeles team, which Dr. Durfee helped to form in 1978, reviews the deaths of all children under 10 where one or more of a number of factors are found, including drugs, bathtub drowning, asphyxia, SIDS over 7 months, drugs or burns.

Included on the team are representatives from the medical examiner's office, police and sheriff's departments, district attorney's office, the Department of Children's Services and the Department of Health Services.

In 1986, the team reviewed 203 suspicious deaths. Of those, 52 were designated as child abuse homicides.

"We learn best from those situations where we have clearly failed," said Dr. Richard D. Krugman, director of the C. Henry Kempe National Center for the Prevention and Treatment of Child Abuse and Neglect, located in Denver. "Unless you bring all these people into one room to discuss what they know about a given child's death and the family, you're not going to make progress in understanding what's going on."

Such information automatically leads to improvements in the child welfare system, including more convictions of people who previously might have gotten away with murder.

After creation of a fatality review team, Oregon's conviction rate in child abuse homicides rose from 50 percent in 1985 to 90 percent in 1987.

"As the system ties itself together, the first thing you get is more criminal action," Dr. Durfee said. Coroners do a better evaluation, surviving siblings are protected, and potential child abusers are identified, he said.

Often, child homicide occurs when a parent under stress, with limited financial or emotional resources, lashes out unintentionally at a child.

"It's something that is avoidable if someone was there to help," Dr. Durfee said.

Tape of Abuse: 'It's Difficult to Watch' 

The notion of a parent killing his child - particularly a helpless infant - is a difficult one for the public to grasp. Most parents at some point experience the anger a child can trigger, sometimes scaring themselves with the force they use to spank their child. That common experience is one reason why the offense of child abuse may go undetected or unpunished until a child is dead.

But there is a line that is crossed, fine as it may be, that distinguishes between occasional uncontrolled anger and anger that kills.

Recently, rare footage of child abuse in action captured the nation's attention after a Tennessee couple secretly videotaped their baby sitter hitting their 6-month-old baby boy.

The parents had become suspicious of the woman after their 3-year- old daughter told them the sitter was hitting the infant. In a dramatic display of anger, the tape shows the 27-year-old sitter whacking the baby on the side of the head as she sits feeding her. The child was not seriously injured.

"It's a striking case in the sense that when you see the way this particular baby sitter slammed the head twice of this infant, the force is staggering," said Dr. Krugman, during a recent child abuse conference in Atlanta. "It's difficult to watch."

What's even more striking, he said, is that the baby had no brain injuries.

"If a blow of that nature doesn't cause injury, imagine what kind of a blow does," Dr. Krugman said. "It is substantial. The kinds of forces that are brought to bear on children by enraged adults is unbelievable."

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How Journal-Constitution carried out investigation

More than six months ago, The Atlanta Journal-Constitution began efforts to find out what had happened to 51 child abuse or neglect victims whose plight was known to Georgia social workers at the time of their deaths last year.

The Journal-Constitution filed a request for the files under the Georgia Open Records Act, suggesting that names and specific identifiers be removed to avoid any invasion of privacy.

State Attorney General Michael J. Bowers denied the request, saying the records were protected by confidentiality laws, even though the children those laws were designed to protect were dead.

Rather than turn over actual records of the cases, many of which are now closed, Mr. Bowers instructed Assistant Attorney General Carol Cosgrove to help the state Division of Family and Children Services prepare summaries of the files.

Forty-two summaries were provided. They are sketchy and often prompt more questions than they answer - such as whether an investigation into the death was ever conducted, whether anyone was ever arrested, whether an autopsy was done, and what efforts were made to protect siblings still at home.

But they do offer glimpses of lives whose tragic circumstances rival that of Oliver Twist:

A few excerpts:

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Jane Hansen researched series over 6-month period

"Suffer The Children" was researched and written by staff writer Jane O. Hansen over a period of six months. Ms. Hansen, 39, reports on children's issues for The Atlanta Journal-Constitution and has been a staff member since 1982. She graduated from the Columbia University Graduate School of Journalism that year after serving in the Carter White House, preparing issue briefings for the president's appearances away from Washington.

"Suffer The Children" was supervised by special projects editor Hyde Post and copyedited by Sharon Bailey. Staff writer Ron Taylor assisted in the editing. Photo coverage was coordinated by Rich Addicks, and layouts were designed by Paul Shea, news editor for special projects.