A 1-year-old child died because of acute alcohol intoxication and extensive burn wounds. The child had burns over 11.5 percent of the body, and a blood alcohol level of 0.145 percent. The child also suffered from malnutrition. It was determined the child was burned about one month before death. --- A 1-year-old child died as a result of a ruptured stomach with chemical peritonitis, fracture of the cervical spine and extensive scalp hemorrhages. The mother admitted whipping the child with a belt four to five times per day for the past month because of behavioral issues. --- A 22-day-old child died from positional asphyxia with a contributing factor of acute mixed drug intoxication. The child’s mother fell asleep in a reclining position on a couch while breast feeding the child. When the mother awoke, the child was unresponsive with her face between the mother's chest and arm.
ANDERSON — These clinical descriptions represent the life stories of three Indiana children who died of abuse or neglect in 2015.
The 77 deaths covered in the report are abuse and neglect cases that child service officials could "substantiate," out of 258 fatalities the department reviewed.
About half the deaths were traumatic — beatings and gunshot wounds. Head trauma was the main cause of death in abuse cases.
One-third of the children died as a result of neglect. Unsafe sleep practices leading to asphyxia were the primary cause of death in this category, and the misuse of drugs and alcohol were frequent contributing factors, according to the report.
What's more concerning: The number of substantiated child abuse/neglect fatalities in Indiana keeps rising, from 34 in 2012, to 49 in 2013, to 66 in 2014, to 77 in 2015.
Of the total fatalities in 2015, 32, or 42 percent, were attributed to abuse. Forty-five (58 percent) were attributed to neglect.
In other key findings:
• In the case of abuse, 85 percent of victims were less than 3 years old.
• In the case of neglect, 73 percent were less than 3 years old.
"This finding demonstrates a consistent trend (nationally and in Indiana) that young children are at the highest risk of abuse and neglect," according to the report's executive summary.
Another disturbing trend revealed in the fatality report: Abuse and neglect is often inflicted by a child's biological parents.
• 84 percent of neglect fatalities and 68 percent of abuse fatalities were caused by a biological parent.
• 10 percent of neglect fatalities and 26 percent of abuse fatalities were caused by a parent's intimate partner or another relative.
The report also showed the most common stress factors associated with child deaths were insufficient income and unemployment, substance abuse and domestic violence.
"Each one of these deaths was 100 percent preventable," said Mary Beth Bonaventura, director of the Indiana Department of Child Services, in a statement.
"Our infants and toddlers are the most vulnerable of all our children," Bonaventura added. "Younger children demand active supervision, attention, care and patience — which may be difficult to give if someone has low or poor parenting skills, or is dealing with multiple stress factors, including substance abuse."
Data complied by the Indiana Youth Institute provides context for Madison County's struggle with neglect, physical abuse and sexual abuse, especially if you contrast the community with affluent neighbor Hamilton County.
Hamilton County's population in 2015 was about 309,700, and Madison County's was about 129,300.
Though Hamilton County's population was 2.4 times larger than Madison's, far fewer cases of neglect were reported there: 259 compared to 729 in Madison County. Reports of physical abuse were also lower, 20 in Hamilton County versus 68 in Madison County.
The recently released Department of Child Services report notes that of the 77 deaths in Madison County, DCS officials had prior contact with only four of the children.
Behind these numbers are families and children struggling to cope with poverty, mental illness and rampant drug and alcohol abuse, Madison County child advocates say.
"A lot of people gloss over violence in the home," said Denise Valdez, director of Kids Talk. "We need to look at why there's violence in the home. There are so many factors."
Kids Talk interviews victims of child abuse and neglect and provides information to local law enforcement.
Valdez believes education is a key element in changing the behavior of abusive or neglectful parents.
Valdez also believes humans are born with an innate sense of right and wrong. While many people might not be prepared for the job of parenting, the episodes documented in the fatality report unmask a disturbing pathology.
"I think people who do that have some deep psychological issues that need to be addressed," she said.
Efforts are afoot in Madison County to advocate for victimized children, but there are so many of them and too few resources.
Currently 400 people are on the agency's waiting list for services.
CASA is an acronym for Court Appointed Special Advocates. Its volunteers advocate on behalf of abused and neglected children in the welfare system. Working with children who have been abused, the volunteers are often the first to see trends and behaviors that affect the well-being of kids.
Like Valdez, Craycraft believes education can help change behavior. After reading this year's fatality report, she said, "The thing that really stood out is that a lot of these deaths could have been prevented."
Craycraft believes Madison County's medical community does a good job of providing information to new parents about safe sleep practices, but it's hard to know what happens when couples arrive home.
For children who are older, Craycraft believes community mentors and organized programs such as those at the new Anderson Township Trustee Girls and Boys Club can help break cycles of violence.
But until whole communities become truly aware of the needs and come together, the fatalities will mount, and there will be more sordid stories like these three.
• In the case of the 1-year-old burn victim, no medical treatment was sought.
The mother's boyfriend initially told investigators the child was burned accidentally when water he was heating for a sibling's formula fell from the stove on the child. Later, the boyfriend told investigators the child was accidentally burned in bath water that was too hot.
Both caregivers said the mother was not home when the injuries occurred. The child's mother was charged with criminal neglect of a dependent and false informing. The mother's boyfriend was charged with criminal neglect of a dependent, battery and false informing. Both criminal cases are pending.
• In the case of the 1-year-old who was whipped, both the mother and father and were charged with murder, neglect of a dependent and battery. Both are awaiting trial. The Department of Child Services found that the death was caused by physical abuse, medical neglect, malnutrition and environmental conditions attributed to both parents.
• The 22-day-old's mother tested positive for benzodiazepines and Tramadol at the time of death, and an autopsy found the child had both pseudoephedrine and nortramadol in her system. The child's pediatrician was aware the mother was breastfeeding, but was not aware she was taking Tramadol. No criminal charges were filed in the case.