Jennie Noll: The Lasting Impact of Child Maltreatment – Conversation from Penn State

>> I do some consulting work on
American — [ Multiple speakers ] [ Silence ] >> Satalia: Jennie Noll is the
director of Penn
State’s Network on Child Protection and Well-Being and a professor of Human
Development and Family Studies. An internationally recognized
researcher
on child maltreatment, her work focuses on the
long-term
consequences of childhood sexual abuse. We’ll talk with her about the
findings of a unique,
decades-long study of women who were abused as children, about translating those findings
into policy and practice,
and about what we can all do to protect children. Here’s our conversation with
Jennie Noll… >> Satalia: Jennie Noll, thanks
so much for joining us. >> Noll: Thanks Patty. Great to be here. >> Satalia: If there is a silver
lining
as a result of the Sandusky Scandal is that it has focused national
attention
on the problem of child sexual abuse. Penn State has made a commitment
to
become national leaders in this field. What exactly does that mean? >> Noll: Right, this is a real
commitment Patty. This is a faculty initiated–
initiative and it comes
out of the president’s office to really turn the dial on child abuse and neglect
research
and treatment and education. In my field which is as, you
know, pretty
small, nothing like this has ever happened. And when Penn– >> Satalia: Nothing like a
university
saying, “We’re going to take this on?” >> Noll: We’re going to tackle
this. This is a real problem that
hasn’t
had the attention that it needs. It’s a bigger problem than
people think and it deserves
a large investment and that’s a big silver lining of this and I’m just very excited to be
here to sort of charge
this, and that’s why I came from other places to do this and why we’re trying to attract
other
researchers to do the same thing. >> Satalia: Well, in fact you
came from Cincinnati
Children’s Hospital, where you were involved in a landmark study that I want
to talk with you about
in just a moment, but what do you do here at Penn State that you couldn’t do in that
hospital setting? >> Noll: Well, it was just me
and
a few other researchers there. But here, there is a long
standing tradition of
experts and family systems and health psychology and behavioral integration with
health issues, the
faculty that are already here are world renowned. So to come here and integrate
what I do and what
other researchers of child and maltreatment do with that expertise that’s going
to be how the fields
are going to change so that’s the exciting part. >> Satalia: Now the network on
Child Protection
and well-being which head up will be developed, really built with faculty over
three years. It will be a twelve member team
and as you said, working
collaboratively with folks who are in human development and family studies and other
places
throughout the university. Why is integration and
collaboration so important? And I ask that because it’s not
just in the work you’re
doing but when you hear about children’s advocacy centers, everyone’s talking collaboration
like you cannot wrestle
this problem to the ground without collaboration. >> Noll: Well, and
multi-disciplinary is really the
key too because what we’re understanding about this kind of childhood adversity is it
doesn’t
affect just one part of the person either. There’s a family system around
this. This is a community around this. There are law enforcement issues
around this,
there are criminal justice issues around this. There are health issues that are
far-reaching, consequences
that are just not just mental health but physical health. To be able to bring a
multi-disciplinary collaborative
effort to this, that’s what’s going to turn the dial, new treatments, new prevention
efforts,
new way to reach these families, new ways to help communities
understand the
problem and work on prevention together. That’s really the innovative
part of all of
this and that’s what a cluster hire does. And Penn State has done this
before in other
areas and this was just a really good idea and it shows the commitment from
the president’s office on down. >> Satalia: One of the things
you said is,
President Erickson, child maltreatment, the child maltreatment field is
extremely small
as you mentioned and within the field research into child’s sexual abuse is
even smaller which makes me
wonder, what brought you into this field in the first place? >> Noll: Yeah, well that’s an
interesting question. Part of it had to do with my
background
methodology in studying lives in general so I– I got to learn from some of the
experts in
methodology and developmental psychology. And through that I started to
learn about the
best ways to follow people through their lives. >> Satalia: But why child abuse? >> Noll: Why child abuse, well,
you know,
sometimes, you know, you choose your sciences, sometimes your science chooses
you and I
really felt like the latter happened to me. I met Penny Trickett who’s my
long time collaborator and
Frank Putnam my long time collaborator on landmark study and I got really inspired by how
they were talking about
the ways in which they were listening to pediatricians, they were listening to
practitioners
about these kids are just different. And when we start at the study
we didn’t think
we would follow them this long but I knew that some good methodologies
could be injected into this
idea and then we could really learn something powerful. >> Satalia: You mentioned
Penelope Trickett
who started this landmark study 25 years ago. NIH has just given you funding
to continue with for another
5 years which is allowing you to track some 250 women who some of whom were victimized
as two year olds. They entered the study at age 10
or around that age that you’ve been following them
all these
years, you yourself for the last 20 years. One of the most remarkable
things about the study
is that 85 to 95 percent of the people who started in the study are still with you
and Penelope Trickett attributes that to you and your involvement
with these women. >> Noll: Well, she’s being very
generous first of all
but I think the credit goes to the women themselves because what we really tried to
do in
this study was not make it about abuse. We made about their life story
and we made
it about their contribution to science. So every time we would meet we
would talk about
that and they were able to take tremendous pride in doing something sort of
larger
than themselves and they all see that. You know, they’ll call me on my
phone, they’ll
say, “Ms. Jennie, you know, I just graduated” or “I just got my kids back from
protective services,”
or, “I want to be social worker now, what do you think?” It’s sort of commitment to being
able to tell their
stories and make a difference and they see that. And every time I interview them
and we
just started a new round of interviews, we haven’t seen them for about 7
or
8 years so I’m seeing them again. >> Satalia: Oh my. >> Noll: And they’ll say, “Oh I
remember you
and you had– you still have curly hair.” Or, I say, “Yeah, I remember you
and your mom
when you did this test together and I’ll say, “What was that been like to see
these life change and?” It’s an inspiration for them and
now they’re children
are involved in this study, and we have about 450 kids, and they also see the importance
of understanding
sort of the intergenerational aspect of all of this. It’s a tremendous amount of
pride. >> Satalia: And for you this
really humanizes it. This is no longer just a number
1.2 million
children in the US who are victims of maltreatments. >> Noll: Rights. Sort of one thing it does is
when I put all of our research
together and all my quantification and all my questionnaires and then I’d do the whole
protocol and at the end of it
I feel sometimes like I don’t know if I capture it all. I don’t know. I don’t know if her story really
is
captured here and is captured well enough. So sometimes I feel like, you
know, I would like
to write a book sometimes or like to tell the story from the real visceral level and
that’s what
these kinds of venues sort of allow us to do because I think there’s a lot
more to these lives that we’re
going to learn about and these women are able to look back on their lives and tell us
something about what made the
difference or what made it worse or how did they get better or what has the real struggle
been
that we haven’t really seen so far. >> Satalia: Let’s talk about
some of the long-term
consequences that you have found as a result of this study. They are enormous. >> Noll: Yeah, well, we didn’t
really know much
about health consequences when we started the study. I mean I was looking at teen
pregnancy and
I was looking at the things that were unique to sexual abuse in terms of
female development. And we started noticing other
things that were happening
like we started noticing how heavy these women were and we started tracking their
obesity rates
and we started listening to how they would talk about going to the emergency
room a lot or having– >> Satalia: Lots of health
issues. >> Noll: Health issues. And so we started tracking that,
we started
looking at like their premature delivery rates and we started really
understanding that there are
some health disparities that are directly attributable to abuse because as you know we’ve
studied a group or non-abused
women alongside these women and the differences that we see we can talk about as
attributable to the
abuse and the chronic adversity and the chronic stress, even different from women who
grew
up in the exact same neighborhood. >> Satalia: Under the same
economic situations or– >> Noll: Yeah, exactly. >> Satalia: Or also in a single
parent family. >> Noll: Right exactly. And so what we’re learning about
is not just obesity
rates but, you know, things about inflammatory markers and we’ll getting whole blood
panels now so we’re going
to learn about risk for diabetes and risk for cancers so that we could maybe say,
“What has been different about
those women who developed them and those women who don’t and what kind of interventions
might we try to design
that could curtail some of these health disparity. >> Satalia: One of the members
of your team
who will be joining you in just a couple of months is actually studying
telomeres, biomarkers– >> Noll: Right. >> Satalia: That are showing
premature
aging among people who suffered the kind of stress you suffer when you’ve
been the victim of trauma. >> Noll: Right, and that will
manifest, you
know, when we start looking at different– he’s going to do some animal
model research and so forth and
at some basic science to help us connect some of these dots. Because what I see behaviorally
in my study, I’ve
also looked at their cognitive abilities, you know, how they take test and how their
memory is
and those kinds of things and we’re starting to see what we think is
premature
cognitive aging in this group. And so these– this next round
of funding is allowing me to
collaborate with some researchers at Penn State who have– who understand this in a fine
grain way so that I can
start giving different kinds of test that are going to give us the early clues of
what we might be
seeing in terms of premature cognitive aging. >> Satalia: You mentioned that
this is really now
becoming a multigenerational study and so you’re looking at the children of these women,
many of
whom had children as teenagers five times, at a five times greater rate
than the general population. The surprising thing here to me
is you would think
that if someone were a victim of child sexual abuse that they would be hypervigilant
as the
parent and it’s actually the exact opposite. Is it because they’re not
reading the
danger cues because there are some studies about this facial affect
recognition
that they seem not to have. >> Noll: Well, I think that’s a
multifaceted problem as
well because initially people would assume that the abuser that they abuse became the
abuser in some ways and so we
were looking for those sorts of pathways we didn’t see but see environments that are
recreated, you know, for these
women’s children that were there when they were children. So, it’s not that they are
abusing their kids themselves
is that they might substance abuse, there might depression, there might multiple sort of
stepfathers and other
men coming into the household, in some cases, the grandfather that was the
original
abuser has access to those kids still. So there are environments that
are sort of allowed to
persist, and moms may not be that adept at understanding when there is danger or reading
cues from the kid
that says, “Hey, mom, this guy’s kind of creepy. I don’t want to go with this
kid.” Or, you know, I need something
you’re not giving me.” >> Satalia: The presenters had
been for decades
that we want to keep biological families together. Do you think there’s a chance
that your
research will change that thinking? >> Noll: I don’t think that sort
of a thread that I want
to– that I want to weave into this research because, you know the foster care system
is wonderful in
a lot of ways and it also has its own problems. They’re really trying to
understand how kinship care is
effective for some families but maybe not as effective for others where there is sort
of
environment that doesn’t change as a result of keeping the kids within the
kinship care. But I think more than that is
teaching the
mothers, the non-abuser caretaker that ends up with the child no matter
what, how to effectively
parent and how to effectively have relationship that don’t endanger that
environment any further. So it’s not a simple as to say
we should or
should not keep the biological family together but I think multiple systems
need to understand
just a wide variation that goes on in those. >> Satalia: You have also
studied
internet use among maltreated girls. What do you finding there? >> Noll: That’s interesting. So when you have these long term
studies, one
thing you have to do is find people, right? And when the social networking
started and I started to
find people on Facebook, in Myspace and all of those things, I started noticing a little bit
about how the
women in my studies would present themselves online as more provocatively and a
little bit of sort of risque
than kids their age in different kinds of circumstances. So I thought to myself what–
what it is that
predisposed of someone who has had an abused history to maybe present themselves in a
way that
might be, you know, attractive to a perpetuator who is maybe trolling the
internet
and looking for a vulnerable teen. So I started looking at this
more in a
very large sample at children hospital where we are actually are
tracking the internet use and
social media behaviors of abused and non-abused teens to try to understand this propensity a
little bit more and
try to understand why it is that they go these routes. >> Satalia: Could it be in part
because their value was all tied up in their sexuality that’s
what they’ve
been taught since a very young age. >> Noll: Well I think, I think
that
there’s likely multiple courses. But first of all what we know
about abused girls is that
they have sex earlier, they’re a little bit promiscuous, there sort of an orientation
towards sex and sort
of a sexual identity earlier on but we also know that they have a larger
propensity to be
re-victimized so there are pathways there like why is it that they are entertaining
sexual advances from
exploitive individuals when someone else may say, “No,” or “Stop or be bullied
more and you know? And when they get older there’s
a high
propensity of rape and domestic violence. So there’s a propensity not just
about being involved in sexual situations earlier but
the propensity for
re-victimization. >> Satalia: And that early
experience, that early
violation, that set them up for all of the– >> Noll: Well, if you sort of
think about– think about
what happened to an abused victim and when they’re young and they’re sexual boundary
violations are so egregious
at ages when they don’t even understand what that is and they become perhaps the
object of
sexual desire of someone who is a care taker or someone who’s supposed to be
taking care of them. A lot of confusion can ensue
around what is sex,
what is intimacy, who am I at a sexual being and when you’ve been reached
adolescence or late adolescence
when you have that own identity to discover and to form, it’s very difficult to make that
transition
from what it was and it was unhealthy to what it might be in a more
healthy way. So there is certainly a direct
correlation for some victim. For some victims it doesn’t seem
to affect them much at all. >> Satalia: One most difficult
things
for victims is this question of why me. >> Noll: Right. >> Satalia: You know, why was I
the one chosen? What was it about me that made
someone think
they could take advantage of me in that way? >> Noll: Yes, it’s such an
unfortunate place for a victim
to be at because one of the things that is so tragic is that there is sometimes guilt
and
self blame that comes along with it because it’s something that no
one can understand at that age. It’s something so poor unto what
the
developmental experience should be. So when we see victims where
there wasn’t–
sometimes there’s violence involved like, if you don’t do this I’m going
to hurt you or I’m going
to hurt your mom or hurt your sister or something so, you sort of, the victim stand in
the way and
say, “Yeah, you take me, don’t take them,” OK? And there’s some kind of threat. That’s a little bit, you know,
almost easier sometimes
in some sort of instances, because it wasn’t me– >> Satalia: You were protecting
somebody. >> Noll: Right. But it’s the– I worry more
about the more classic
incest victim there it perhaps a biological father and she’s groomed for a long
time as if she were
a romantic partner and there is some, you know, relationship there that’s under
auspices of love and all those
things. That’s– I think a little bit
harder for victims to
overcome the guilt and shame about that what everybody needs to understand is no kids is
responsible for this and that’s
probably one of the biggest aspects of treatment is to try to understand the sickness
inherent in the perpetrator. >> Satalia: Speaking of the
perpetrator, the real problem
here is stopping the demand, why are perpetuators interested in young girls or boys and how
do we stop that? >> Noll: Well, one of the
beautiful things
about this cluster hire is that we get to have– we get to try to hire some
experts who help us understand
that because as a field I don’t think we understand that very well because what we–
let’s take Sandusky for an
example. I mean no one expected him. He was very good at what he did. He groomed and kept things very,
very secret
and he was good at making the boys not want to say anything or not say
anything for years and years. So it’s hard to spot something
like that. But what we can learn is subtle
ways that he was able to do this and the ways he took
opportunities to be alone with
boys. And this happens when we study
perpetuators,
you know, retrospectively, when they’re caught and we say, what happened, how
did it work. It’s much more difficult to
create sort of
a society where we’re all out there looking for these people because they
work at this. And I think it’s going to be
more important for us
as a society to know that if we suspect something or see something, feel weird
about something,
it’s OK, to tell someone or make the call and say, “I think something weird is
going on
here” and some experts can help figure out whether there is something
that’s going on here. >> Satalia: The reality is that
very, very few parents
report when a child has been the victim of physical or sexual abuse, and even among
physicians, primary care
physicians according to a survey they say that in 27 percent of the times where they believe
that some kind
of abuse is taking place, they don’t report it. What keeps people from
reporting? >> Noll: Well, first of all
people don’t understand kind
of what abuse is and so to educate people about what it is and sort of the harmful effects
of it will
help motivate people to make those calls but we have also have the
resources
for people to make those calls. We have to have facilities
there, we have to have
phone numbers, we have to have people standing by that can say, “Yes, OK, I’ll
take it from here.” Because the burden is– is
placed on the professionals not
on the pediatricians who don’t understand that process. But when there are no resources,
people don’t
want to do that or when people don’t know about the resources they won’t
do it as readily. So one of the things that we’re
trying to
do is affect public policy by saying, “Look, if we know about it earlier, we
can change the course of life.” But resources have to be
funneled
in to those efforts, real resources. And in the state of Pennsylvania
those resources
are beginning, but we have a long way to go. >> Satalia: You say that abused
and maltreated children
are dramatically or drastically underserved nationwide. And that brings me to the Great
Recession which we just
experienced. >> Noll: Right. >> Satalia: And there were
reports that came out saying,
“Look, we went through this terrible economic time and the rate of child abuse and
maltreatment went down. >> Noll: Right. >> Satalia: Some
entrepreneurial,
Harvard-educated economist took another look on some of this and he said that it really came down to a
lack of
resources in times of economic stress. >> Noll: Right. When we look at rates of child
abuse
and those are reported nationally. Those are about substantiated
cases that actually go to
the system and are successfully prosecuted and so forth. And that’s an expensive process
too. And that’s a process that’s has
to start with people
actually making the call and they’re being resources in the county where that call is
made, so it’s really hard
to pin down the exact rate of child abuse in this country because what we know from adult
retrospective reports is
that a lot of people never have told anybody about it. You know, so it’s really, very
hard to understand
or the prevalence rate and systems in this country. >> Satalia: Should it be a red
flag if you see on your child’s Facebook’s page
very promiscuous
pictures of as a teacher if you see that. Is that a red flag that
something
inappropriate maybe going on in that home? >> Noll: Well, I think I would
probably start with
why that judgment is not so good with that kid. And I might say, “Hey, do you
know that by doing this,
other people can see this and it’s just try to get a job and have Facebook things like
that, try to get
a baby-sitting gig and have someone see that.” That’s going to keep you from
going ahead in life. And I think that kids don’t
really
understand those implications as teenagers, but if that kind of behavior
persists,
and if there’s– you know, insistence– “No, this is who I am and this
is what I do and
this is how I’m going to get attention” I think that warrants a deeper
conversation about what
might be going on with that kid or in that family that might warrant some, you
know, talking to the
parents or understanding the history a little bit. >> Satalia: Going forward, what
are your
research priorities here at Penn State? >> Noll: Boy, oh boy. Well, the first priority is to
get the right
faculty here and to fill in the gaps in our field. We want to understand how to do
more universal prevention
better. We want to understand how to
educate communities
about what is child abuse and how to report it, and how to make a difference in
these families before it
happens. So that’s a hole in our field
that we want to fill and Penn
State has fantastic researches who have been doing this in a lot of other areas for
many, many
years so we’re going to learn from them. I also want to understand what
kind of treatments
we can augment with sexual abuse-specific modules, so say there’s a treatment out
there
for substance abuse or something and how why is it not as
effective for victims of abuse? What can we– how can we augment
those treatments. And then what kind of
coordinated care can we
provide for kids who are in protective services? Not just effective mental health
treatment
which there are several mental health treatments that we should be promoting more
thoroughly, but
coordinated physical health care, coordinated, you know, watching kids go through
adolescence and what kind of
struggles they are having and having some sort of revisiting of a coordinated care throughout
their adolescence and early
adulthood. >>Satalia: Alright Jennie Noll
thank
you so much for talking with us. >>Noll: Well thank you Patty
it’s been great. >>Satalia: I hope you enjoyed
our
conversation with Jennie Noll. Comcast subscribers can watch
this
program anytime on Penn State On Demand. Find out how through our
website:
conversations-dot-psu-dot-edu, where you’ll also find more on Penn State’s Network on child
Protection and Well-being. I’m Patty Satalia. We hope you’ll join us for our
next
“Conversation from Penn State!” [ Music ] [ Silence ] >> Production funding provided
in part by the Corporation
for Public Broadcasting and by viewers like you. Thank you. >> This has been a production of
WPSU.

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