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Spokane leaders: CDC girls' trauma report part of unfolding sex abuse cases after pandemic isolation

Spokesman-Review - 3/6/2023

Mar. 5—Somewhere in Spokane, a parent who had to leave for work during pandemic shutdowns thought they could trust somebody to watch a child.

In a few cases during that COVID-19 isolation, kids ages 8-14 were sexually abused while with a temporary caregiver, said Stephanie Widhalm, Children's Advocacy Center director in Spokane.

Those types of cases and similar post-pandemic reports of sexual abuse and trauma are just starting to unfold, said Widhalm and other Spokane leaders who work with children and teens. Local leaders also describe a similar wave of reported trauma affecting children and adolescents as highlighted in a February federal report, showing increases in rape and trauma among teen girls, and record levels of feeling sad or hopeless.

"What we know about children and youth from 0 to 17 is that any disclosure specific to sexual abuse is often a delayed disclosure," said Widhalm, also a forensic interviewer. "So, you will find it more common that somebody doesn't tell right away. I would say that we don't know the true extent of the isolation due to COVID just yet. I think that is going to take a significant period of time before we truly get a glimpse."

And cases involve more than teen girls, although leaders said patterns here echo those described in the federal report.

"What we were seeing even across the country, as well, are impacts on girls — and I know the article referenced teen girls — but I'd make the argument specific to boys as well," Widhalm said.

Nearly one in three high school girls reported in 2021 that they seriously considered suicide, up nearly 60% from a decade ago, according to the recent report from the Centers for Disease Control and Prevention. It tapped data collected in fall 2021 from the Youth Risk Behavior Survey, which has been conducted since 1990 and seeks to identify behaviors linked to death, disability and social problems for young people.

The CDC reported nearly 15% of teen girls said they were forced to have sex, an increase of 27% over two years and the first increase since the agency began tracking it.

Almost three in five teenage girls reported feeling so persistently sad or hopeless almost every day for at least two weeks in a row during the previous year that they stopped regular activities. That was double the share of boys, and the highest number in a decade. LGBTQ students were significantly more likely to experience violence, the CDC said.

Kathleen Ethier, CDC's division of adolescent and school health director, said the rise of sexual violence likely contributed to a spike of depressive symptoms. The researchers also said school could be a lifeline and pointed to studies of better mental health outcomes for students who feel connected to their schools.

The CDC analysis didn't bring any surprises to Spokane professionals who support child and teen victims of sexual abuse, said Roshelle Cleland with Lutheran Community Services Northwest victim advocacy. The report's overview of subsequent anxiety and depression also wasn't new.

"It's very common when we're working with a teen that has experienced sexual violence in some form that they're also talking to us about self-harm or suicide," said Cleland, or it can be other signs of unhealthy coping with alcohol or drugs.

During COVID-19 shutdowns, mandated reports of abuse didn't happen as often because kids weren't in schools, counseling or sports, Cleland added.

"There weren't eyes on children," she said. "They didn't have that safe person to go to, to talk to about what's happening, to see bruises, to notice emotional and mood changes.

"We have absolutely seen an increase since the pandemic of specifically forensic interviews at the Child Advocacy Center we attend that involve minors, so all minors, and you hear teens and younger kiddos talk about abuse that they experienced during the pandemic. Then more and more as students got back into school, got back into counseling, you saw this," she continued.

"Those mandated reports started to come back in of those two years, and really one full year, of having no eyes on youth."

As mandatory reporters of suspected child abuse or neglect, school employees complete yearly training, said Dr. David Crump, Spokane Public Schools director of behavioral health services. Teachers, coaches and administrators take the "SafeSchools" course.

Additionally, SPS offers internal classes on trauma-informed care, mental health and hope and resiliency. Recently, Crump said, several hundred SPS employees took those courses.

But Crump also said he's grateful the CDC report came out. Since students returned to in-person instruction, reports have risen as educators suspect or see physical or emotional indications of potential abuse, he said. During virtual education, often students would turn their cameras off, or it was a limited view.

"There is a world of difference to have that interpersonal contact versus virtual," Crump said. "Yes, when our kids came back to that in-person contact, we did notice a drastic increase in the number of calls we made as mandated reporters."

The district has school counselors in every building, and often partners with agencies such as Frontier Behavioral Health and the Children's Advocacy Center. SPS has about 50 master's degree-level licensed mental health clinicians, Crump said.

"We also are the largest children's mental health provider in the city of Spokane," he said. "We have mental health therapists in almost all of the buildings, and that's a very different role than the school counselors. We provide that resource not only to the staff but also to the students."

Crump also described other post-pandemic fallout.

"We see a great deal of human trafficking here in the region and we do see a lot of victimization of females — from harassment to assault to rape," he said. There also is an increase in the number of students with anxiety, depression and suicidal thoughts, he added.

Although he said these issues also affect boys and LGBTQ students, Crump agreed with the CDC findings that there is a greater percentage increase of abuse and depression issues among females coming out of the pandemic.

"There are some reasons for that," Crump said. "Part of it is a human growth and development issue, that teen girls mature sooner and earlier and with that comes a greater desire — and we're talking in generalities — of that social connectivity and interpersonal connection, which is really important to young women.

"They needed to have that connection and the socialness. Through COVID we were saying stay away from each other, stay 6 feet apart and don't get together. I think that had a significant impact, and more severe on females than males."

Social media sometimes can have a strong impact on their definition of a friend and what's socially accepted, he said.

Among support offered

The Children's Advocacy Center, part of Partners with Families & Children, is accredited for the multidisciplinary diagnosis and treatment of child victims of sexual and physical abuse, among other roles in mental health and substance use disorder help. The center provides forensic interviews, mental evaluations and treatments.

"Our providers are specialized in diagnosing child abuse and neglect, and we coordinate the multidisciplinary team response to cases involving young people," Widhalm said.

She said specialists conducting interviews are trained to consider what's cognitively and developmentally appropriate for young victims when talking about abuse. They might be called to the hospital if a child's injuries could be caused by abuse, but most often interviews are at the center. Child Protective Services and police are typically on scene, but in another room.

Lutheran Community Services has the only accredited community sexual assault program in Spokane. It offers a 24/7 hotline at (509) 624-7273 for sexual assault victims, along with advocates and education. It has an art-focused support for teens who have experienced any kind of trauma.

Ways to improve

Cleland said local resources include Lutheran Community Services, the advocacy center, Daybreak Youth Services for substance use disorder, and Crosswalk Youth Center, if shelter is needed.

Lutheran Community Services also partners with other agencies for training in victim advocacy and support.

"We work better and stronger and serve the community better when we provide a holistic approach to families, supporting a parent where they believe they won't be alienated and have a child removed, and that teen survivor feels they won't be alienated, bullied, kicked out of school, retaliated against," Cleland said.

She's currently co-instructing officers in the Spokane County Sheriff's Office on the neurobiology of trauma and trauma-informed interviewing, and working with Lutheran Community Services to offer such training to other entities.

Widhalm also urged more awareness around supporting victims.

"For what we can do better as a community, I think it would be important to bring more education into the schools for staff and educators on the dynamics of sexual abuse and how to support students after a disclosure," she said. "As an agency who sees law enforcement and CPS reports as part of referral for services, there are clear differences in responses not only between districts, but also between schools within the same districts."

A child or teen, when disclosing abuse, can be impacted by how others respond, she said. "It is also important that there be mindfulness in how schools directly respond to the individual who is making the disclosure."

In how the community can do more, kids and teens need positive social support and connection, including outside of schools, Crump said. It helps to recognize kids don't always have words for feelings and might need help with that. Other keys are appropriately supporting victims, listening and noticing withdrawal or sadness.

"We do a really good job of helping our staff to be aware of trauma, but there is always more to learn, and we're always interested in what is out there," Crump said. "We don't want to miss any student."

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