A local concern, a national and worldwide issue ... December 26 marks the fifth anniversary of the death of JonBenet Ramsey ...

JonBenet's legacy: Protect our children

Our community has been reminded of her death in many ways over the past years: the lawsuits, the investigations, the supermarket tabloids. We have continued to focus on identifying JonBenet's killer, yet the real dilemma remains. Despite her high-profile death, over the past five years another 6,000 children have died nationally from fatal child abuse, nearly 200 in Colorado, most of them without attendant media attention.

So what have we really learned over the past five years from the death of this young child?

Clearly, her death has increased our awareness of child homicides. Just as the death of Matthew Eappen at the hands of his English nanny raised the awareness of Shaken Baby Syndrome, so JonBenet Ramsey's death increased the periodic attention paid to fatal child abuse to new heights.

But what has this awareness ultimately done to prevent other children from dying?

For the first time, some of us began to question our belief system about child abuse. With the death of JonBenet Ramsey, America was forced to think about child abuse in a new way. We saw the death of a child in an affluent neighborhood, with wealthy and powerful parents, reinforcing what Dr. C. Henry Kempe of the Kempe Children's Center taught us decades ago: No family, rich or poor, is immune from this problem.

“ ... the vast majority of fatal abuse is perpetrated by someone known to the child, usually a caregiver, and it is rarely intentional or premeditated.”

We were also forced to consider whether our own children were safe from intruders who might kidnap and kill them. Although there are a small number of such kidnappings in the United States every year, the vast majority of fatal abuse is perpetrated by someone known to the child, usually a caregiver, and it is rarely intentional or premeditated.

In addition to the increased awareness, we have made some improvements since JonBenet's death in 1996. In the 2000 legislative session, a portion of Colorado's tobacco settlement was allocated toward home nurse visitation programs to improve child and family health, and, as one of its important outcomes, to prevent physical abuse and neglect of children. These programs have been proven effective and their proliferation throughout the United States may be one of several reasons for a 20 percent reduction in reported child abuse nationally - from more than 1 million cases to 826,000. These types of programs must continue to receive funding. Even though we are in uncertain economic times, we must not go back on this commitment to our children.

Regardless of our potential or real budget shortfalls, programs that can produce such dramatic reductions must be treasured and funded. This is, at the moment, the best way for us to prevent child abuse deaths.

Since JonBenet's death, a state child fatality review committee has continued to assess all child deaths in Colorado. Additionally, seven counties in Colorado now have local child fatality review teams. This means that all child abuse deaths are reviewed by professionals to help analyze what might have been done differently and to discuss systems-response issues that may need improvement or change in order to prevent child abuse deaths.

As a result of these review teams, system responses have improved. Communication between police, human services and medical examiners' offices has improved greatly. For example, in Denver, the child fatality review team suggested and effected policy change requiring Denver County Human Services' caseworker involvement in all cases of suspicious death. This enables Human Services to investigate the child's home environment in order to protect siblings or arrange for treatment for surviving children and family.

The Colorado Department of Public Health and Environment and the State Department of Human Services organized and conducted infant and child death investigations training to hundreds of professionals all over the state.

These training sessions have ensured that other communities are prepared to investigate, discuss and analyze child abuse homicides thoroughly.

But we still have a long way to go. Additional changes must be made.

The media have continued to focus on catching the killer(s) - or our failure to do so. But we cannot continue to look at child abuse only as a criminal problem. The focus should also be on what to do to prevent these deaths in the future.

“Since JonBenet Ramsey died, we have gone through presidential, gubernatorial, congressional and legislative cycles, yet not once did the topic of child abuse come up. Worse, there are no outcome studies on how the system is performing. Nothing happens until the next high profile case. There is a wringing of hands, and then we go back to ignoring the issue again.”

More than a decade ago, a congressional board was asked to study the problems of the child protection system in the United States. The group found that the state of the child protection system was "an emergency." Among its dozens of recommendations were several that called on our elected officials (governors, mayors, legislators, etc.) to take the time to develop a national child protection policy. We have none. Each county approaches each case differently. Since JonBenet Ramsey died, we have gone through presidential, gubernatorial, congressional and legislative cycles, yet not once did the topic of child abuse come up. Worse, there are no outcome studies on how the system is performing. Nothing happens until the next high profile case. There is a wringing of hands, and then we go back to ignoring the issue again.

And so, five years later, we have made some progress, but not enough. We still have much to learn from the death of JonBenet and the thousands of other child abuse homicides. Each of these children will have died in vain if we do not broaden our thinking, stimulate public discussion about our successes and failures, and continue to fund programs that are effective in preventing child abuse and neglect.

Dr. Richard Krugman and Dr. Andrew Sirotnak, Sunday, December 23, 2001 -

Dr. Richard Krugman is professor of pediatrics and dean of the University of Colorado School of Medicine and is the former director of the Kempe Children's Center. Dr. Andrew Sirotnak is associate professor of pediatrics at CU and heads the Kempe Child Protection Team at the Kempe Children's Center and The Children's Hospital.

http://www.denverpost.com/Stories/0,1002,158%257E290532,00.html