Just days before 9-month-old Karlie Mellick was fatally battered at her Fairdale home, her mother, Kara Mellick, four day-care workers and a physician all noticed the infant’s bruises.

Yet no one reported the marks, even on her face and ear, which experts say are a key warning sign of abuse.

On June 11, Karlie died. She had suffered a severe head injury, a broken arm and leg and fractured ribs.

Her mother’s boyfriend, Matthew Vaughn, who was babysitting, told police that he shook the baby and slammed her repeatedly on the floor, according to court records. Vaughn, 21, who is charged with murder, has pleaded not guilty.

Karlie’s violent death might have been prevented if just one person had recognized the bruises as warning signs and reported them to child-protection authorities, said Dr. Melissa Currie, a University of Louisville forensic pediatric expert.

“It’s a perfect example of what we’re talking about,” said Currie, director of a UofL unit created to evaluate children for possible abuse.

Karlie’s bruises before her death were “red flag” signs of abuse — especially those on the ear, which is mostly cartilage and rarely bruises unless it has been subjected to a forceful blow, Currie and other child-abuse experts said.

“Medical studies have shown that a child with a bruise on the ear is at higher risk of becoming a fatality,” said Debbie Acker, a nurse with the Cabinet for Health and Family Services who trains workers to recognize medical evidence of child abuse and neglect. “The force that it takes to cause a bruise to the ear also can cause damage to a child’s brain.”

State officials and child abuse experts believe many deaths could be averted if people who come in contact with young children understood that bruises — especially to the face, ear and trunk —should be reported as signs of possible abuse.

Currie, who evaluated Karlie’s case for police, outlined those concerns in a letter in Vaughn’s court file.

“It is unfortunate that her previous bruising did not result in a CPS (state Child Protective Service) report and a complete medical evaluation for abuse,” Currie wrote in the letter, also signed by Kathy Recktenwald, a forensic nurse specialist at UofL. “To be clear, it is not normal for infants to have bruises.”

Matthew Vaughn, 21, is charged with murder in the death of Katie Mellick, who was 9 months old when she was killed. He has pleaded not guilty.

A 2007 study of 20 Kentucky children under age 3 — 10 who died and another 10 who suffered life-threatening injuries from abuse — found 90 percent had bruising that in many cases had been documented by a doctor or an official, such as a social worker. But in those cases no one had followed up on or questioned the cause of the bruising.

Dr. Mary Clyde Pierce, the former UofL professor who led the study, said bruising should be taken seriously, especially in very young children.

“It is the most common sign of abuse and the most likely to be overlooked,” said Pierce, who is now an associate professor of pediatrics at Northwestern University in Chicago, specializing in child-abuse research.

While more aggressive reporting might result in some unnecessary investigations, Currie said she believes many more instances of abuse would be substantiated. A report also would allow a social worker to make inquiries and investigate further if a parent or other caregiver’s explanation didn’t make sense.

A report to authorities also might help identify abuse that a parent isn’t aware of, Currie said. Sometimes, inquiries reveal that someone else — a baby sitter or relative, for example — is harming a child when the parent isn’t around and is unaware of the abuse, she said.

Currie said she once treated an infant with an abusive head injury who arrived at the Kosair Children’s Hospital emergency room still wearing a cast for a previously broken leg, an injury that should have been questioned at the time and reported as possible abuse. Broken legs, especially in children too young to walk, are always suspicious, she said.

In Karlie’s case, her mother told police that she first noticed some bruising on her daughter’s left ear on May 24, when she took her to a doctor for an ear infection. The doctor said it might be a “circulation issue” and prescribed an antibiotic for the infection, Kara Mellick told police. During the next two weeks, four workers at Karlie’s day-care center noticed, and pointed out to her mother, bruises on the infant’s face, ear and hip, the workers said in police interviews.

One of them later told police she began documenting the bruises, starting June 1, because “the bruises had continued and were becoming worse,” the police report said. “She felt the bruises were no longer ordinary, especially the bruising on the victim’s ear.”

Kara Mellick told the day-care workers she was planning to take Karlie to the doctor to find out why she was getting so many bruises, they told police. Mellick told police she had noticed bruises on her daughter’s ear, jaw, arms, side and hip in the days before her death and had wondered whether the baby might be getting injured at the day-care center.

On Sunday, June 7, the day Karlie suffered the injuries that would prove fatal, Kara Mellick left for her job at Six Flags Kentucky Kingdom about 8:30 a.m., leaving her sleeping infant with her boyfriend, she told police.

Later that day, according to court records, Vaughn e-mailed Mellick: “The baby is making me crazy b/c every time I walk out of the room she starts crying just because she don’t see me.”

Mellick e-mailed him back: “I am sorry just be patient with her.”

Around 3:30 p.m. Vaughn called Mellick and told her to come home immediately because Karlie was unconscious, the police report said. Mellick arrived just in time to ride in the ambulance with her daughter to Kosair.

Karlie died four days later.

SOURCE: http://www.courier-journal.com/article/20091213/NEWS01/912130305/Recognizing+the+warning+signs+of+abuse+can+save+some+children+s+lives

Child sexual abuse is a nation concern
by Ngoni Dzimiri
13.12.2009 7:05:01 PM

It is not easy to talk about child sexual abuse. It is even more difficult to acknowledge that sexual abuse of children and infants happens daily in our country. As a nation we turn a deaf ear to such situations and pretend that they do not occur in our world.

Child sexual abuse, especially amongst girls, should be recognized as a widespread and growing problem in Botswana that needs to be dealt with, with the utmost urgency. It is estimated that 1 in 4 girls are victims of child sexual abuse. This should be a cause for concern.

This form of abuse may include fondling a child’s genitals, masturbation, oral genital contact, digital penetration and vaginal and anal intercourse. Child sexual abuse is not solely restricted to physical contact. Such abuse may not be contractual, but might include exposure to voyeurism and child pornography.

Research has it that approximately 30% of the perpetrators are relatives of the child, most often brothers, fathers, uncles and cousins. Around 60% are other acquaintances such as friends of the family.

The current political, social and economic situation in the country has rendered the girl child more vulnerable to sexual abuse. The primary cause of sexual abuse faced by girls resides within the parent. Some parents rely on their youngest children to take care of them. These difficult circumstances have forced the little girls to be commercial sex workers so as to meet the demands of the family.

In some cases, the presence of the step parent can make a child more vulnerable. Friends or relatives may not perceive molesting the adopted daughter of a friend or relative as taboo. This perception emanates from the belief that a step parent does not have any emotional investment in the child.

The behavior that is displayed by children can alert us that the child is being sexually abused. In most cases a child who is or was sexually abused will display knowledge or interest in sexual acts. At times a child might avoid the perpetrator or display unusual behavior, either being aggressive or very passive. Older children might resort to destructive behavior such as alcohol, drug abuse and self-mutilation or suicide attempts.

Childline Programs Officer, Olabile Machete, highlighted that many children are sexually abused. He added that the impact of child sexual abuse can at times be very severe. Children who are sexually abused usually exhibit abnormal behavior, including anxiety and post traumatic stress disorder.

Child sexual abuse is very humiliating, such that the shame of the experience most often forces the victim to be reserved, keeping their abhorring experiences to themselves. Children fear that they may be laughed at if they disclose that they are sexually harassed.

What is even more frightening is that the perpetrators of sexual abuse are usually parents, trusted relatives, child care providers or family friends. Consequently, it is often difficult for the children to report them, and they are often not taken seriously even if they did.

Childline makes an appeal to everyone to participate in the fight against child sexual abuse. Parents should know that any child, whether rich or poor, can be at risk of child sexual victimization. Children are everyone’s concern and we should not turn a blind eye to incidents of child abuse.

Government should intervene to help combat this problem, especially as there are few support institutions at which abused children can seek psychotherapy.

There should be more public awareness campaigns, at which people can be informed about child sexual abuse.

Parents or members of the community who know of children who are sexually abused can contact ChildLine on the toll free number 0 800 300 900.This is a helpline where anyone can call and report such cases. Children should know that their identity will not be disclosed. Child line is there for them.

The tragic Little Ted’s nursery case has forced us to face an unfortunate truth: that women use children for sex too.

Susannah Faithfull has been haunted by her mother’s image for all of her adult life. She sees her every time she looks in the mirror, for she has inherited her mother’s startling blue eyes. But every time Susannah is reminded of her mother, she is reminded of a childhood full of trauma. She was systematically sexually abused by her mother; repeatedly hurt by the woman she looked to first for her security, care and support.

“I used to hide in the cupboard under the stairs,” she tells me, explaining that was the only place that she felt safe at home. “My nana had a chenille-type table cloth there and I used to hide underneath it. When my mum came back from work she’d be shouting for me.”

Susannah now runs the Aurora Health Foundation, a treatment centre for victims — or survivors, as some like to be known — of child sex abuse. Her testimony is part of my Radio 4 documentary, Female Sexual Abuse: Breaking the Silence available here:-

http://to-catch-a-female-predator.blogspot.com/2009/10/bbc-radio-4-broadcast-female-sexual.html

Her abuse began when Susannah was very small and her father had left the household. It continued until she herself left home at 16, and throughout all that time her mother forced her to share a bedroom with her, and a double bed. When she told her father about the abuse during a visit, he didn’t believe her.

“The more I cried, the worse it would be. We used to have this rose wallpaper and I used to just look at the roses and wish that I was dead. How can the mother that gave birth to you do those things to you?”

Last week when two women, both of them mothers, pleaded guilty to charges of serious sexual abuse in a Bristol court room, it forced us to confront the reality that Susannah has known for most of her 54 years: that women can and sometimes do sexually abuse the children in their care.

It’s a reality that has always been thought to be very rare. There are a very small number of convictions (2 per cent of all sexual crimes, according to the Ministry of Justice). But when the cases occur they upset us greatly because they challenge every comforting and accepted image we have of women and of mothers in particular.

So just how rare an occurrence is it? The statistics are hard to pin down and some think they may not tell the whole story. We do know that there are now about 50 women held in custody for sexual offences against children, a tiny fraction of the total. We also know that there are some women on the sex offenders register, although we don’t know how many because the Home Office doesn’t keep details of gender.

We also know that those working in the field believe it is an underreported crime because the stigma associated with it prevents victims coming forward.

Detective Superintendent Graham Hill works at CEOP, the Child Exploitation and Online Protection Agency. He heads the Behavioural Therapy Unit and interviews female sex offenders. He believes that as many as one in five of all cases of sexual abuse may involve female perpetrators. “I don’t think there’s a police force in the country that isn’t currently dealing with a female child sex offender,” he tells me, adding that this was just the “tip of the iceberg”.

According to Hill, ten or fifteen years ago most crimes involving accusations of child sexual abuse that the police dealt with were always examined on the premise that the man was the guilty party.

“It was always the case that the female in the family was treated as a potential witness,” he says. “One of our messages to law enforcement officers now is that, when you investigate a serious sexual offence against a child, you should always look at how complicit the female is in that kind of offending.”

And not always just complicity. Hill believes that the public’s perception that female sex offenders usually operate alongside a controlling and manipulative man is often false. He dismisses that stereotypical image as a societal cliché born out of a reluctance to believe that a woman could act so heinously alone and for her own sexual gratification.

“The public’s perception is coloured by the high-profile crimes, the sort of duos in the press. And the thought is that a bad man and a bad woman equal a perfect storm. But what I’m looking at at this centre are women who do have a sexual interest in children in their own right. We even have some examples where women have brought men into their lives just to facilitate sex with their children.”

Bill Jenkins doesn’t know whether his foster mother deliberately took him into care so that she could abuse him. But that was the tragic result and he, like other victims of female child abusers, says that, while he spoke about the abuse at the time, no one investigated it or believed him.

He now runs a company devising and selling software to protect children who are online from harm. He is clearly driven by the memory that no one was there to help and protect him as a child. His abuse consisted of inappropriate touching when his foster mother forced him to bath her. He told me he remembered that the door handles in the bathroom seemed to be quite high. “I suppose that was because I was so small. She was a harsh-looking woman — great big eyes, right in my face. I was always frightened of her.”

That his abuser was a woman makes it more difficult to deal with: “I don’t think any man would feel particularly comfortable admitting that they had been sexually abused by a woman. It is almost like a dark world that has yet to be revealed.”

Dr Michele Elliott knows all about challenging accepted beliefs and trying to expose what Bill calls that “dark world”: she runs Kidscape, a charity set up to support the victims of childhood abuse. In the 1980s, when the issue of sexual abuse by men had only just begun to receive mainstream acknowledgement, Elliott was one of the first in this country to raise the possibility that women could sexually harm children. She was pilloried for it.

“I vividly remember talking at an RAF base about the sexual abuse of children,” she tells me. “I never said anything about women abusing; I didn’t even think that was possible. Afterwards a man came up in his uniform standing very straight and he said, ‘You know, it isn’t only men who do it. My mother did it to me.’ Then he walked out and I was left so shaken that I started to think maybe I should ask questions.” Elliott began to talk about the issue on radio and TV and the response was immediate: “It was like a floodgate had opened.”

Among those who contacted her was a woman who had spent 40 years locked in an asylum after reporting that she had been sexually abused at school by a nun. More than 800 victims have now been in touch with her because of female sexual abuse. But Elliott says that she often feels like a lone voice.

“No one really wants to talk about it. But the professionals are the ones who really annoy me. I’d say that 75 per cent of them are in denial — a mental block. I think there are professionals working in the field who have staked a career on a certainty that it is men who do the abusing. They are very threatened by the idea that that might not be true.”

There is also, among professionals, a very real concern that focusing on the abusive behaviour of a very small minority of women causes unnecessary panic in a society that is already stressed about child safety.

But most of those working in this field welcome a chance to break the silence. They believe that the issue has been underresearched and ignored for too long.

Diana Cant is a psychologist who counsels those who have suffered female sexual abuse. While there are still some who do not believe that female sexual abuse is even possible, given that “women don’t have the necessary physical equipment”, Cant has found that there are many forms of abusive behaviour. These can range from watching inappropriate videos and TV programmes to inappropriate exposure, masturbation, stimulation and penetration.

The harm it does is terrible: “If you think about the experience that we have as children, we expect a degree of safety and security and primary care from our mothers. If that expectation is confounded, something at a very primitive level is broken and gets destroyed. The child grows up immediately with a sense of fear and threat. That can lead to an underlying degree of anger, resentment and fury that colours adult life.”

Tragically the children that women most often abuse are the ones closest to them. Women are less likely to be predatory in their criminal behaviour, according to Hill, although the CEOP does come across occasional exceptions.

“Predominantly the female sex offenders we know about offend against children they know,” says Hill. “They offend in a controlled environment. They tend to stay close to home.”

And they often also tend to stay close to the internet. It appears that, while sexual offending most certainly predates the development of the internet and digital photography, the emergence of both have made offending easier. “These people have always had a sexual interest in children,” says Hill. “But the internet validates and fuels those existing beliefs. And it puts them in touch with like-minded people.”

That the internet is affecting the pattern of offending is clear to everyone involved in this area of criminal behaviour.

Sherry Ashfield, from the child protection charity, the Lucy Faithfull Foundation, is one of the few people in this country who has spent time talking to convicted female offenders. She has seen an increase in the number of women who use chatrooms to meet like-minded adults and then go on to use the web to share obscene and illegal material.

So what do we know about the women who offend and what motivates them? Through her work at Lucy Faithfull, Ashfield has been able to build up a profile of sorts. Although she stresses that these women do come from a wide range of backgrounds, vary in age and personal histories, “they all have very complex personal histories, often with complex issues and experience of abuse,” she says. “They tend to be women with low selfesteem; women who are socially isolated, and who find dealing with emotion extremely difficult. They tend to have a history of depression.”

Their motivation varies too. Ashfield’s research suggests that while some women will abuse to please or keep a partner, others will abuse to meet their own sexual needs. Some may also abuse for money: “We have had women who have had debts who have met someone on the internet who has suggested that if they would take part in making abusive films or pictures of children they would pay them significant sums,” she says.

There is no simple answer as to why women do it. No clear trigger either — although most difficult of all for me to hear was that for some women caring for a tiny, helpless newborn can trigger abusive behaviour. It’s an awful thought; one of many I’ve had to contend with while investigating this difficult subject.

While making this programme my aunt asked me why, when there is so much beauty in the world, must I explore something so ugly? And here is my answer: everyone I interviewed while making the documentary told me how important it was that we examine this crime and force it into the open.

“It’s an issue that has been locked away for too long and we need to get everyone talking about this problem openly and honestly,” says Hill. “That in itself will be a major step forward in our battle against child sex abuse.”

Hill, like the victims and all those I spoke to during this investigation, agreed to talk because they felt that breaking the silence surrounding the issue of female sexual abuse will better help the victims and better protect our children.

http://women.timesonline.co.uk/tol/life_and_style/women/article6860532.ece