Tip of the iceberg: Predicting risk, protecting children is group’s mission

By Erika Pedroza | Published Saturday, May 4, 2013

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Wise County, we have a problem.

“That problem is child abuse and neglect,” Dena Silvers, chair of the Wise Coalition for Healthy Children, told the crowd gathered at the Wise County Child Health Summit last month. She went on to explain.

“When our daughter was a child, a loud crash would occassionally come from another room,” she said. “This would usually be followed by her yelling, ‘Houston, we have a problem!’, and, of course, someone would come running to help.

“Well, today I need to say … ‘Wise County, we have a problem’,” she continued. “And we, too, must come running to help those among us that are the most defenseless.”

Most disturbing, she continued, is who is doing the abusing.

“We all now realize that a stranger harming a child is a very small percentage of child abuse cases,” she said. “Our national news frequently has stories that horrify us about coaches, Scout leaders, clergy, teachers, doctors and other professionals with whom children are entrusted.

“Local reports and articles are equally disturbing, if not moreso,” she continued. “Those stories usually involve parents, relatives, neighbors or older children … Sadly, we know this is just the tip of the iceberg.”

In an effort to glimpse the rest of that iceberg, Silvers and the coalition mailed out surveys to 1,200 Wise County households in November.

“We wanted to know more than just what the rate of child abuse is,” said Joyce Hood, director of occupational health services at Cook Children’s Health Care system, who leads coalitions in six area counties.

The coalition presented those findings – from the more than 400 who responded – along with plans of action to not only address child abuse, but prevent it. The vision is to ensure that all Wise County children have the opportunity to grow in a safe and loving environment, free of abuse and neglect.

“The needs have been identified, and implementations have been planned to achieve our goal of improving the lives of our children,” Silvers said.


The Wise County group selected child abuse prevention after the results of a survey were presented at an inaugural summit in 2010.

In that survey, 5.5 percent of parents in the six-county area reported child abuse or neglect (physically, psychological, sexual and gang threat). In Wise County, that number was 3.4 percent.

“That doesn’t sound like a big number, but that’s 5.5 percent too much,” Silvers said. “When children are abused, it changes who they are. It affects the quality of life they have, and the type of adults they become.”

According to data provided by The Center of Children’s Health at Cook Children’s Health Care System, abused children are more likely to have:

  • school problems, including suspension;
  • physical health problems and mental illness;
  • higher rates of unemployment, poverty and use of social services; and
  • severe injury and death when under 4 years old.

Research also indicates that child abuse is cyclical. In the most recent Wise County survey, 15 percent of parents said they had been abused as a child.

“Thirty percent of parents who were abused as children go on to abuse their own children,” Hood said. “They also go on to have depression, substance abuse which leads to suicide and other health issues.”

To stem the epidemic, the coalition embarked on a strategic plan that promotes healthy family relationships and engages the community to build healthy families.

“Our vision is to be proactive and preventative, not reactive, although, unfortunately, there will always be need for that, too,” Silvers said.

Hood added: “By the time you start working at the individual level – take a kid out of a home or provide counseling to families abusing their children – it’s too late. That’s not what public health is. Public health is getting to the root of an issue and preventing it from the very beginning.”


To get to the root of an issue, you first have to find it.

At the April 18 workshop held at the Decatur Civic Center, coalition members and “community stakeholders” discussed three types of factors.

When predictive factors such as substance abuse are present, it is highly likely that child abuse is going to occur.

“If we look at the CPS cases we know about – because there are so many that we don’t know about – 80 percent of those have substance abuse (drugs or alcohol) involved,” Hood said.

Risk factors highly increase the likelihood that a child will be abused.

“These are things like the age of the parent – the younger parent, the higher the risk,” Hood said. “Poverty, a lack of support, large families of three or more children (that’s more of a neglect issue than it is an abuse issue), marital stability.”

Other examples include isolation and a lack of extended family support. Nine percent of Wise County parents didn’t agree with the following statement: “Whenever I feel lonely, there are several people I could talk to at least half of the time.” – and 4.6 percent said they don’t have anyone to turn to in times of crisis.

“These are opportunities to start building cohesiveness,” Hood said.

Of the responses from Wise County parents, 62 percent said they were not very familiar or not familiar at all with the support services available locally.

The Wise County coalition has pounced on that opportunity, joining 2-1-1 Texas.

The database is a compilation of community agencies that can provide support services such as assistance with bills, food pantries and Medicaid contacts. It provides citizens with accurate and easy-to-find information from more than 60,000 state and local health and human services programs.


But the key to improving the rate of child abuse lies in the third category.

“Protective factors are what buffer children from being abused,” Hood said. “And there are plenty – plenty of opportunities to provide support and be the difference.”

More specifically, the key may be incorporating healthy parenting practices.

“Do you know what is normal for a child to do when they’re growing up?,” Hood asked. “Do you know that it’s normal when an infant cries for four hours at a time despite everything you do (change them, feed them)? And it’s OK. You can put that baby in a bed crying and go take a shower, and it’s OK.

“How many parents know that teenagers rebelling is absolutely normal? They’re growing up – they want their own lives. We have a hard time dealing with that, even parents who know that it is normal. Parents knowing that those things are normal is extremely important, and that’s where parenting skills come in.”

In the survey, 39 percent of Wise County parents strongly agreed there are times when they don’t know what to do as a parent, and 10 percent agreed with the statement, “When I discipline my child, I lose control.”

“Even though it’s a small percent, we would like to see that move the other direction,” Hood said. “Some intervention can be done. It’s a great opportunity to work on.”

On the flip side, 80 percent reported that they were frequently close to their child.

“That’s a great opportunity to provide support,” Hood said. “I firmly believe that most parents truly love their children and want to do what’s right. We have to help them sometimes.”

In response to that cry for help, the coalition has organized a two-day “relaxed” parenting seminar Friday and Saturday, Aug. 16-17, at Wise Christian Counseling Center in Decatur.

Programs on understanding feelings; praising children and their behavior; understanding and developing family morals, values and beliefs; alternatives to spanking; and learning positive ways to deal with stress and anger are the focus for Friday. Participants will learn about the philosophy and practices of nurturing parenting; ages and stages of growth for infants and toddlers; ways to enhance positive brain development in children and teens; communicating with respect; and building self-worth in children on Saturday.

“Parenting is multi-factoral,” Hood said. “It is complicated, but the very greatest help is doing it with a community, at a community level. That’s the best intervention possible … You can’t do anything about many individual factors. Family level issues are important, and you can do something about them. Same thing at the community level. You are more effective at that level.

“There are great strengths to build on in this county,” she continued. “The social support is great. Whether it’s faith-based, recreation-based – the people in this county are social.

“The close parent/child relationship is a great strength,” she continued. “And with the coalition, you have a great strength to build on, a venue through which to start working on these issues.”


To jump-start the initiative, the coalition invites community members to become involved.

“The information provided (at the summit) is what the coalition will use to direct its actions,” Silvers said. “The way to prevent child abuse in Wise County is to educate parents, grandparents raising grandchildren, stepparents, foster parents and family members who take in and raise children on the practices for parenting. And we need your help.”

She suggested joining the coalition, whose future meeting dates are noon to 1:30 p.m. Fridays, June 7, Aug. 2, Oct. 4, and Dec. 6, at Decatur City Hall.

Membership opportunities include volunteering or providing volunteers for special projects/events; providing food and/or space for meetings or events; giving children’s health education presentations; distributing pertinent information to colleagues, employees and community contacts as appropriate; or making a financial contribution.

For more information, visit or email

“In Wise County, 21.4 percent of the population is children (ages) 0 to 14,” Tubbs said. “But they are 100 percent of our future. Thank you for helping us keep our promise. It is all of us working together that makes it happen. We can’t do it alone; we must do it together.”

Silvers echoed the sentiment.

“Never doubt that a small group of thoughtful, committed citizens can change the world,” she said. “Indeed, it’s the only thing that ever has. As individuals, we all can make strides simply by keeping our ears, eyes, minds and hearts open to this sensitive issue and taking action when appropriate. But sometimes we have to step out of our comfort zone to make real changes.

“It truly does take a village, but Wise County always rises to the occasion,” she said. “Please let child abuse be no exception. Let’s all come running to help.”

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