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Child abuse is the major issue under discussion at the Australian Child Protection Conference held this week at Macquarie University

PETER THOMPSON: The hidden issue of child abuse is getting much needed attention this week at the Australian Child Protection Conference at Macquarie University in Sydney. During the 1980s child abuse emerged from being a virtual taboo into a key concern in child welfare. Of course, most child abuse cases still go unreported. Dr Kieran Moran is a specialist in the area of psycho-social and medical assessment of abuse cases and he's delivering two papers to the conference. Dr Moran, from the Prince of Wales Hospital in Sydney, is with me now. Well, what is the extent of the problem?

KIERAN MORAN: In 1988 about 12,500 new cases of child abuse were reported to Family and Community Services in New South Wales.

PETER THOMPSON: So, if you look at the national figures, can you multiply that three or four times?

KIERAN MORAN: Yes, I think you can. Unfortunately, those figures in fact don't reflect the full extent of child abuse within the country because it's generally recognised that most cases are not referred to any agency.

PETER THOMPSON: So what percentage or proportion may be referred, do you think? Is is difficult to estimate?

KIERAN MORAN: Extremely difficult to estimate. American figures would suggest that about one in 10 are referred to any agency.

PETER THOMPSON: Now of that figure you mentioned for New South Wales, 12,500 cases, what proportion of those would actually be legitimate?

KIERAN MORAN: Our figures in Australia would suggest that about half of those would be proven as cases of child abuse and neglect.

PETER THOMPSON: Proven in what sense?

KIERAN MORAN: Well, an investigation would take place, an assessment of the situation would take place, and a professional opinion would be reached that this, in fact, represented a true case of child abuse or neglect.

PETER THOMPSON: So there is an investigation for each reported case?

KIERAN MORAN: There is.

PETER THOMPSON: Well, who are these children, who are being abused?

KIERAN MORAN: In general, children who are being abused are the children of people who have a predisposition to abuse. In other words, they have been abused themselves. They're usually isolated people who live in a stressful situation and they have misperceptions of the child. In other words, they view the child usually as an object of gratification for themselves, which is a misperception of the child and when that child doesn't measure up to the standards that they have, they tend to abuse the child.

PETER THOMPSON: In talking about the predisposition, does that suggest that child abuse often carries from generation to generation?

KIERAN MORAN: Absolutely. There's what is called an intergenerational transmission and that has been well documented right from the time Henry Kampf gave his paper in 1962 about the battered baby syndrome.

PETER THOMPSON: Do you have any idea of what proportion of cases might fit into that category?

KIERAN MORAN: It's difficult to say. There are obviously many factors which impinge on whether or not a person was going to abuse, and just because you were abused yourself doesn't necessarily mean that you will abuse your child. There are many other factors and usually they have to do with stress. So that the greater the stress, the greater the likelihood - stress and isolation, I would put the two together - that you will abuse, if those two factors are in combination.

PETER THOMPSON: What do you mean by stress?

KIERAN MORAN: Stress is a difficult thing to measure, but in general we're talking about family stress here, so that when there are great difficulties within the family - and stress can come from poverty, it can come from being unable to pay your bills, it can come from having a husband who is of no support to you, a husband who beats you, for instance. All of those factors add to the stress within a family.

PETER THOMPSON: Does that mean that people with better incomes are less likely to abuse their children?

KIERAN MORAN: I think that it's clear that there is a greater incidence of child abuse in poorer communities. Some people would suggest that that's because they are reported more frequently, but I think that it's also generally recognised that there are greater stresses in poorer communities.

PETER THOMPSON: Who reports the cases?

KIERAN MORAN: Anybody reports the cases. There are some people who are mandated to notify the cases, such as doctors and some social workers and school counsellors. But anybody can report cases to Family and Community Services.

PETER THOMPSON: Do parents often report cases?

KIERAN MORAN: Parents report themselves, you mean?

PETER THOMPSON: Yes, or report the other parent.

KIERAN MORAN: Yes. I haven't got a breakdown of the actual reporting agencies, but yes, certainly, the general public often reports other cases.

PETER THOMPSON: But most of the cases are reported by doctors, is that right?

KIERAN MORAN: No, they're not. Most cases are reported by professionals, but certainly not by doctors. Unfortunately, even though doctors are mandated to notify, doctors have a particular block about notifying and I think that that's one of the areas where we are trying to improve professional knowledge in this areas so that doctors will notify cases.

PETER THOMPSON: What's the long term impact on the abused children?

KIERAN MORAN: These children grow up to have poor self-esteem; they grow up unable to trust other people, and they grow up with a poorly controlled sense of aggression. And unfortunately the cycle repeats itself, because often they feel that their loneliness will be improved by having a child and they misperceive the idea of a child, and as a result the intergenerational cycle goes on.

PETER THOMPSON: Now that this issue is more in the open, has help improved?

KIERAN MORAN: I think help has improved a lot. There are various kinds of help that one can give and from initial treatment to long term treatment to preventive measures.

PETER THOMPSON: Dr Kieran Moran, thanks very much for coming into our Sydney studio this morning.