Ending Child Maltreatment

Alice Munro’s story shows it’s time for a child protection revolution

Many lives were upended last year when Andrea, a woman in her late fifties publicly shared a long-suppressed testimony of a taboo violation. Aged 9 she traversed the logistics of parental separation by travelling across Canada to spend the summer with her mother. When summer was over, Andrea returned home to her dad and shared a secret with a sibling. Her mom’s new partner had molested her. Soon the whole household knew. Andrea’s dad forbade anyone confronting her mom or initiating action against the abuser, though he took measures to ensure it never happened again.

Sixteen years later, aged 25 Andrea finally told her mom. As feared, rather than showing empathy her mom primarily felt aggrieved by the partner’s betrayal. She left him momentarily but soon returned.

Older abuse survivors would recognize this sequence of events as just the way things were done in the 1970s. It wasn’t until the mid-1980s the anglosphere found a vocabulary to discuss child sex abuse, despite it affecting one in five girls and eight percent of boys.

In 1984, sixty million Americans watched Ted Danson play an abusive father in Something About Amelia, the first major television drama about child sex abuse. Helplines for child victims were swamped and soon publications like Newsweek ran their first ever cover stories on the theme.

Prime-time BBC in the UK broadcast a special called Childwatch in 1986. Britain’s most popular broadcaster, Dame Esther Rantzen, opened with a bombshell.

“Childwatch has undertaken one of the biggest national surveys into cruelty to children. Tragically, well over one million children in this country are suffering now because of cruelty . . . victims like Catherine who want today’s children to get the help and support she never had.”

Aghast viewers, who never heard anything like this before, saw the camera cut to a silhouetted woman describing childhood abuse she had never told anyone about. Rantzen spoke directly to children watching at home and told them if they were being abused, they weren’t alone, and it wasn’t their fault. Childwatch launched a helpline and just as with Something About Amelia in the US, the lines jammed after the broadcast.

This cultural shift turbo-charged policy. Child protection investments increased and barriers to reporting abuse were removed. Annual US reporting of child abuse and neglect increased from 60,000 in the mid-seventies to two million by 1990. Population surveys showed increased reporting accompanied decreased abuse in the US and Canada. This taboo-busting revolution measurably improved millions of children’s lives, but the revolution is unfinished.

Andrea told her story soon after her mother had died at the age of 92 last summer. Her mother was author and Nobel Laureate Alice Munro and the lives upended were readers who made sense of their own lives growing up through Munro’s empathetic, relatable writing. It was a shock to the system. As the US author Rebecca Makkai said of Munro’s indifference to her own daughter’s abuse“the revelations don’t just defile the artist, but the art itself”.

A Canadian colleague who has campaigned against child abuse globally asked ‘do you think it’s still okay to read her writing?’ The public discourse was shaped by headlines like ‘global literary community is reeling from Munro’s failure to protect her daughter’. Readers couldn’t process a conflict between the empathy in Munro’s writing and the brutal dissociation and neglect that so harmed her daughter.

The revelation didn’t ignite public curiosity about the prevalence, impact and aggregated public costs of this type of trauma. Not just the sexual abuse itself, but how the absence of an attuned parent leaves a child vulnerable to harm.

The Buffer

The primary protection for a child from harm or exploitation is an attuned parent. Nine out of ten of the early UK Childline callers, whose stories of sexual abuse are recounted in Dame Esther Rantzen’s 2011 book Running Out of Tears, also suffered what we would describe today as emotional neglect from the non-abusing parent. They lacked a protective buffer. In the tenth case, the parent intervened immediately, confronted the abuser and soothed the child.

The taboo that was broken in the mid-80s was on child sexual abuse, an unambiguous criminal act with intent to harm the child. In 2025 we also know the damage done by other adverse childhood experiences too, including physical violence, emotional neglect, living with addicted parents or witnessing domestic violence. But we know the causes and solutions too and are the first generation in history to know how to prevent child maltreatment at scale.

.Child maltreatment doesn’t only happen in chaos and rage-filled homes or where poverty is present. More than half of adults experienced a potentially traumatic incident at home in childhood. Adverse Childhood Experiences (ACEs) studies from 37 diverse countries show 57% of us endured one of 10 listed categories of household violence, neglect or dysfunctional parenting. Around 15 per cent have an ‘ACE score’ of four or more. The prevalence is similar across countries, continents and even generations with similar ACE scores from those who grew up in the 1940s or 1990s. This entrenched endemic of child maltreatment is more prevalent than Covid at its height.

Yet it is hidden in plain sight, and for understandable reasons. Those affected live with internal shame, fear of external stigma and conflicting feelings of loving our parents and hating the pain they cause us. This scaffolding of silence is underpinned by myth: children should be seen and not heard (a license for neglect) and spare the rod spoil the child (a license for abuse)

It’s a costly problem to hide. The US Centre For Disease Control (CDC) measures the 40 most important health and wellbeing outcomes across every US state. The higher the ACE score, the worse the outcome on every measure.

Data from Wales shows adults with high ACEs are four times likelier to be alcoholic or develop diabetes, 14 and 15 times more likely to be a victim or perpetrator of violence respectively and 20 times more likely to end up in prison. High-ACE teens are the type groomers, gangs, radicalizers, and drug pushers seek to recruit.

At a very conservative estimate, adult outcomes of adverse childhood experiences cost around 8% of GDP, trillions of dollars.

Most can rationalize a correlation between a Dickensian childhood and a life of addiction or crime, but how do we explain worse health and wellbeing outcomes?

When children experience anguish and fear, unbuffered by parents or teachers, they endure what Harvard scientists call toxic stress-the chronic elevation of the stress response system. This wreaks havoc on the fragile and evolving neurobiology of the child, leaving an imprint of trauma, low self-esteem and hyper-alertness to threat. Toxic stress in childhood derails normal human development and is especially dangerous if not addressed before adolescent brain development kicks off the riskiest phase in the human life cycle.

Emotional neglect is as harmful as physical abuse. Children have a biological need for a deep bond with a primary caregiver, its absence is terrifying. For children danger is not just the presence of violence, it is the absence of love. Often it happens because the parent is unwittingly just replicating what they experienced as children themselves This is intergenerational trauma. But it is beatable.

If I saw the BBC Childwatch broadcast, it would have been through a shop window. I was 15 and living on the streets, having fled a violent UK inner city children’s home. Decades later and after some therapy and healing, I held our newborn son in a New York maternity ward. As I held him on my chest, his tiny head against my beating heart I knew what happened to me as a child was now unimaginable to myself. I would walk to the end of the earth for him to feel safe and loved. The inter-generational cycle ends with me. The more I held him, read, and sang with him, the further away that desolate children’s home and the torturous remnants of its memory felt. This is because love heals.

But it begged a question: if I can end the cycle can everyone end it? Could we prevent it at scale? Many child development and public health thought leaders think we can.

Child Development Revolution

The former British Conservative party grandee and A-list podcaster Rory Stewart recently lamented that 21^st century technology fails to drive positive human outcomes the way 20^th century advances like piped water or vaccines had.

The best example of a 20^th century breakthrough is the Child Survival Revolution. In 1980 American epidemiologist Dr John Rohde wrote a paper arguing 14 million children die annually due to three problems already solved in the industrialised world. 1) Children were not vaccinated against major diseases 2) Families couldn’t access oral rehydration solution for acute childhood diarrhoea and 3) Early nutrition wasn’t protected by breastfeeding promotion or routine growth monitoring.

If governments sharply focussed on universalizing these three interventions, child deaths would plummet.

Despite acute cold-war polarisation, disparate governments coalesced on saving children’s lives. Prime ministers and royals, health systems and village doctors joined the world’s biggest ever public health campaign. Vaccine coverage of under-fives leapt from 15% to 80% in a decade and soon child mortality was halved. Today millions of children live each year because of the Child Survival Revolution, perhaps modern humanity’s greatest accomplishment.

But it almost didn’t happen. Opposition and scepticism were prolific. All the 20^th century advances Stweart celebrated were once harebrained, unimaginable dreams. In a Growth A History and a Reckoning, Daniel Susskind reminds us even the concept of measurable economic growth driving our modern political economy and culture, was unimaginable for 99% of human history. Tap water, antibiotics and road safety were all nuts’ ideas once.

Ending child maltreatment is not just a challenge for the global south, it’s universal and may seem insurmountable at a moment when we are more polarised than ever and our ability to focus is battered in an attention economy. Bur the world needs a new idea to build shared purpose. Reformed polarizer and pollster Frank Luntz argues the only cause with potential to de-polarize politics is children. Bipartisan interest from JD Vance to Gavin Newsom in the costs and prevalence of ACEs suggest we are ready for a new child revolution. Like many public health campaign, it needs three components: Prevent transmission, treat those affected and ensure everyone is aware of the risk

Primary Prevention

Scientists at Oxford and World Health Organisation recently completed a study potentially as impactful for child development, as John Rohde’s paper for survival. They rigorously reviewed evidence-based parenting programs delivered through home visits or group sessions to build parenting skills and knowledge. The home visitor doesn’t impose or judge the parent. If the parent has strong attachment and development skills already, the home visitor builds off these strengths.They assessed 435 trials from 65 countries and found improved outcomes in responsive caregiving, maltreatment reduction, learning and behaviour.

The review also found a telling, unintended benefit of the programmes. An improvement in parental mental health. One of the explanations is when parents can bond with their child, as I did with my son, the emerging relationship is reciprocal and healing. Anyone returning home from a stressful day with a horrible boss or client and soothed holding their child know this. Again, love heals.

When we had our son, there was no parenting program offered. In any given year there are over 600,000 babies born in the state of New York. According to the National Home Visiting Service, only 14,000 receive home visits yet 63% of children in the State have at least one ACE. Home visits need to be universally available and supported by decent parental-leave and perinatal health care as pre-requisites for primary prevention.

The Antidote

When children feel unsafe or unloved at home, the next best hope is an attuned teacher. We now know that healthy relationships are the antidote to toxic stress. They literally de-activate the stress response system. Extensive research shows healthy relationships with teachers are the leading driver of good learning outcomes for all children. For vulnerable children they provide a layer of protection as a foundation for healing and learning. I would not be here today writing this if it wasn’t for a teacher Jan Rapport, who eventually helped me see a pathway to a better future.

One of the world’s leading authorities on child development, Professor Peter Fonagy describes this as epistemic trust. As a lone refugee child from Hungary in 1960s London, Professor Fonagy recalls how the simple act of his teacher gifting a book to each child in the class was transformative in helping him cope with the trauma and focus on his studies:

“She gave them out randomly. But, at the same time, we all felt recognized by her. We all felt that she treated us as individuals, and we all had our minds wide open to her.”

Can we systemise healthy relationships in school without overburdening already stressed teachers? Educationalists at Harvard developed a simple approach for school authorities called Relationship Mapping. Every teacher in a school goes through the register and puts a yellow dot next to a child they know has healthy relationships. The school then intentionally works with children who have no yellow dots at all to link them up to healthy relationships. The goal is for no child to be unseen. It’s not rocket science, but it is brain science. The absence of healthy adult relationships is the major risk factor for teens.

Ensuring every child has healthy teacher relationships should start in pre-school as the child’s brain development and sense of self and the world is growing most rapidly. If we are serious about preventing risk, it should be especially robust as children enter adolescence. For children with acute vulnerability, we need well-resourced, high quality social work and mental health support.

Awareness

The earliest research on attachment had a key finding. Parents who were able to process and understand the trauma they had experienced as children were less likely to transmit it to their own children.

I thought about at this at the third birthday party for one of our son’s pre-school classmates. As our children bounced up and down in unison to Baby Shark, a group of dads discussed modern parenting when one chuckled

“I love my parents, but no way am I giving my kids the trauma they gave me!”

It wasn’t a heavy conversation, everyone laughed and agreed. But that conversation wouldn’t have happened a generation ago. Evidence based parenting apps and books on nurturing care, child development and trauma are devoured by an educated minority. It wouldn’t take much to make that knowledge universally available, so everyone is aware of the risks of child trauma the way we are aware of Covid, HIV or smoking. Through public awareness campaigns that ensure a conversation in every communityand mainstreaming mental health and child development in schools, we can provide the vocabulary and understanding to prevent transmission of child trauma.

Making these three interventions universally available to parents, school and children everywhere would cost a fraction of the trillions we lose globally each year to the negative outcomes of child maltreatment. It is not enough to be the first generation in history to know the causes and solutions to child trauma we need to be the last to accept it as intractable or insurmountable.

Every major gain in child protection over the past decades has come after a shocking public revelation or tragedy. It would be a fitting tribute to Andrea’s courage to harness the shockwaves her testimony caused to ignite a child protection revolution that ensures every child grows up safe and loved.

Benjamin Perks book Trauma Proof: Healing, Attachment and the Science of Prevention is out in North America here and in the UK and Commonwealth here

Teenage Clicks

How Netflix’s Adolescence Highlights a Void we can Fill to Protect all Children

Like many parents, I watched Adolescence through fingers, with a wince.

It’s difficult viewing, but the four-part series may be the most consequential show since 1984, when 60 million Americans watched Something About Amelia break a public taboo on child sexual abuse and unleash a wave of investment in child protection systems.

Adolescence opens with an early morning armed police raid on a modest suburban family in the north of England. The British police are rarely over-dramatic, and the firepower deployed denotes a grave offence. Everyone I know who watched it, assumed it was the wrong house. The suspect is be-pimpled thirteen-year-old Jamie, slumbering under a blue duvet with matching solar system wallpaper. He could be my son or yours.

After mundanely polite processing by the duty sergeant, Jamie is led to a police cell through a chorus of adult prisoners yelling abuse. In the first of many viscerally distressing sequences, Jamie’s dad, played by the monumental Stephen Graham, witnesses his son’s intimate strip-search.

You just want it to be over or rewound like an old VHS. Mistaken identity declared, an apology issued, and Jamie safely returned to his cosmic-themed bedroom. But that doesn’t happen.

An equally precious thirteen-year-old: Katie, has been murdered by multiple knife wounds. The police have surveillance footage of Jamie committing the crime. We don’t hear Katie’s story or see her parents. Adolescence not a suspenseful whodunnit, but an exploration of unfathomable motive . Inspired by real-life tragedy, filmed in single takes, with flawless acting, Adolescence has ignited public debate the world over.

The forensic police interview of Jamie reveals a world his dad doesn’t know. Isolated in his bedroom, Jamie navigated the teenage complexity of his changing body, relationships, and place in the world with the online help of the ‘manosphere’, a network aggrieved by fear males are falling behind in an age of feminism.

Like most conspiracy groups, they exploit mainstream fears. Surveys show male teenagers are unsure of their place in a changing world. Boys are failing in school, twice as likely to be suspended or diagnosed with ADHD and four times more likely in adulthood to die from suicide. But gender is not a zero-sum game. Girls are more likely to suffer sexual violence, online bullying and grow up to a pay-gap and work-place harassment. As Richard Reeves argues ‘we can be passionate about the rights of girls and compassionate about boys too’. There is not much of a compassionate public narrative about boyhood and history shows bad people love a void. Cue Andrew Tate and the online, radical misogynists.

Since Shakespeare wrote Romeo and Juliet, there is resignation that parenting adolescents involves preventing them going over a cliff edge. Adolescent propensity for risk was always seen as inevitable and unpreventable. Recent neuroscience shows where this risk comes from. In the teen years two mutually dependent brain functions evolve with the worst possible timing. The brain region that seeks novelty, emotional spark and social engagement is live by the age of twelve, while the stern impulse control function that filters and manages risk hasn’t matured until the end of adolescence. This miscalibration means the teenagers’ brain can act like a sports car without the brakes, airbags, or seat belts. Teenagers are more likely than any other cohort to die from accidents and make life-destroying decisions.

Most parents worry about their teen’s safety, but few will be groomed into extreme violence. Gangsters, traffickers and radicalizers target a certain type of teen, those who feel unsafe, unloved or unseen at home and school. Interviewed by a psychologist, Jamie wells up recounting a pivotal incident earlier in childhood. His dad took him to boys ‘soccer, the ultimate shared masculine activity, but he is just no good at it. After a few bad moves provoke teammate badmouthing and sniggers from parents on the touch line, Jamie tries to make eye contact with his dad, who looks away in shame. In another memory, his mom ushers him upstairs while his dad tears down the garden shed in a blinding rage. Our view of the intergenerational path this pain travelled along clears later in the series. Jamie’s Dad describes the extreme physical violence, he experienced at the hands of his own father. Despite his best intentions not to harm Jamie, the suppressed anger, shame and fear erodes his capacity to connect with Jamie’s inner world and make him feel safe.

Potentially traumatic events at home are defined and measured as Adverse Childhood Experiences (ACEs). The Center for Disease Control (CDC) describes ten different forms of abuse, neglect and dysfunctional parenting. In a normal population around 57% of people report one ACE and 13% report four or more. But within radicalized, groomed or gang-recruited teens around 90% have for or more ACEs. The manosphere is a variation of an old tactic, weaponizing or exploiting troubled teens. Worryingly misogynist radicals are expanding this reach online to a broader group of vulnerable children in a moment when the tech world is dismantling safeguards in the name of a brakes-off variety of free speech.

Adolescent risk is not the only negative outcome of ACEs. Center for Disease Control surveillance across US states shows multiple ACEs strongly correlate with worse outcomes across 40 major wellbeing and heath indicators. At a conservative estimate, the long-term costs of ACEs are around 8% of GDP.

Most ACEs occur in ordinary looking families like Jamie’s. They are transmitted across generations unwittingly and hidden in plain by shame, stigma and myth. Teens with ACEs are more likely to have low self-esteem, hyper-vigilance and poor decision-making. They are less likely to have regular, engaged conversation about their daily activities with parents. The leading US expert on parenting Lisa Damour told me.

“I can accurately measure how safe a teenager is by measuring their proximity to loving adults. If you come to adolescence without a sense of trust, affection, and warmth, the child is at a disadvantage for safety and risk.”

Culture warriors now dismiss the term psychological safety, but it’s very real. From the moment they are born, children have a biological imperative to feel protected by a parent. For children safety is not just the absence of violence, it’s the presence of love. When Jamie felt humiliated on the football field and turned to his avoidant, ashamed Dad, it was probably socially terrifying.

As parents we all screw up at times, but repair is essential. Far on the cinematic spectrum from Adolescence, Will Ferrel plays a hapless husband with two teenage sons in a middling US comedy about a family skiing vacation Downhill. The atmosphere darkens after he abandons his family to flee an avalanche . Despite simmering fury, his wife eventually feigns an injury so Ferrel’s character can rescue her and restore his role as family protector in the eyes of the boys. She knows they need it

Some parents inherit that kind of foresighted attunement from their own childhood, others of us must learn it. But it is learnable. Nurse home visits that teach nurturing care in early childhood and at critical milestones like adolescence, are evidenced by hundreds of robust trials to improve child safety, communications and even parental mental health. In New York where we live, 60% of the population have one ACE, yet less than 5% of parents in the state receive a parenting program. parenting programs could be universally available for a fraction of the poor life outcomes they prevent.

Emotionally untethered at home, Jamie experiences another major public humiliation at school, a social media pile-on where he is branded an ‘involuntary celibate’ (Incel), something he shouldn’t have to worry about at 13. The chaotic school makes little effort to understand or manage this cruelty. Research shows healthy relationships with teachers improve learning outcomes for all children, but for vulnerable children they promote healing and reduce risk too. Its unfathomable schools in the UK or US are not expected to systematically promote healthy relationships and belonging when it’s known to drive learning outcomes and risk reduction. We are the first generation in history with an understanding of the causes and costs of childhood adversity and the solutions to eradicate it. Rather than seeing the manosphere as a new and mysterious challenge, it’s just another group of violent extremists with Fagin style child-exploitation tactics . We need to find a way of regulating the internet to protect children and bring predators to account. In the meantime, by scaling up parenting and school programs that ensure children are safe, seen and soothed, we can minimize risk and cut off predator’s supply lines.

My book Trauma Proof: Healing, Attachment and the Science of Prevention is out in Hardback, kindle and Audio in the UK now and in North America on the 15th April

Photo copyright Netflix

Don’t Politicize Grooming, Eradicate It.

Photo credit: UNICEF Srbija/ Bicanski

Manhattan magnates like Epstein or cabbie cartels in Yorkshire know their pray. They scour the same blind spots that drug dealers and violent extremist do. They seek out teenagers either without parental care or living in emotionally fragile families that can’t protect them. Predators act on instinct, but there is a science to what they do. Children who feel unloved or unsafe become teenagers afflicted with toxic stress, hyper-alertness, and low self-esteem. The period of adolescence heightens risk for all, but for a teen growing with emotional poverty or violence, that risk is explosive.

Passed unwittingly and automatically across generations, this trauma is not new. It is an endemic disease that has always been there, and for 99% of human history, hidden in plain sight. To varying degrees, it affects more than half of children and is a preventable driver of mental illness, addiction, obesity, loneliness and non-communicable disease. At a conservative estimate, outcomes of child trauma cost 8% of global GDP. Yet there is cause for optimism. We are the first generation in history to know its causes, commonality and costs. And the first to know how to end it, and for a fraction of the money lost in trauma’s long-term health and social costs.

Firstly we need to cut off the supply line by strengthening the primary and secondary attachments as the two main protective factors for any child.

When parents get simple, non-judgmental guidance and support in basic parenting skills from a home visitor or support group-the automatic transmission is disrupted and the outcomes for the child improve dramatically. The mental health and wellbeing of the parent improves too. We need to make parenting programs universally available likes vaccines or school.

Attachments in school are an essential buffer for children too. As many of us will attest, an attuned teacher can make all the difference for a vulnerable child. Robust research shows positive relationships with teachers also boost learning outcomes for all children. We need to ensure every child is safe, seen, and soothed in school. This needs to happen early-as the brain as the child’s sense of self and the world is formed. This needs to be start with universal pre-school from 3-6.

Empowered parents and attuned teachers can sever the supply line to exploitation groups. Children who fall through the cracks must be served by adequately resourced, agile social workers who respond to the unique needs of each child and intelligence-led policing and justice systems that are ruthless on predators and empathetic to children.

Grooming is not an insurmountable problem. We can end it.

Benjamin perks new book Trauma Proof is available here in the UK and most countries now and in North America from 8th April: https://bit.ly/3W4XoDJ

The Common Good

Global progress requires three things. A laser-focus on results, measurable targets and ability to find common ground. In the period between the end of the cold war and the global economic crisis, child mortality was halved, primary school attendance doubled and Polio cases reduced by 99%. This accompanied a near-global endorsement of the Convention on the Rights of the Child and UN Development Goals. Such a consensus is always contingent on a shared view of human rights and global development as a Common Good. The aspiration is that this progress must be universal, not selective.

After the global economic crisis, populism soared and health and education results stagnated. A sense of common good gave way to growing inequality and polarisation. Populists tried to shift from a universal view of human rights to a selective one that tied rights to identity. Culture warriors present a unique threat to universal progress. They suck the oxygen from public discourse without providing any improvement in the lives of the people they claim to serve.

Our vulnerability to the pandemic was turbo-boosted by surging inequality. When schools closed in New York city, the poorest 300,000 children did not have access to online learning. Globally 40% of families had no consistent means of hand hygiene. The virus mutated while those in poorer countries who wished to be vaccinated could not be. In rich countries the misinformed fought for air in hospital beds having refused the jab. Vaccine inequality and vaccine refusal are mutually reinforcing pandemic prolongers driven by bad politics.

Despite all of this, it is a moment to be optimistic. There is the knowledge and technology now to end preventable childhood death and disease and dramatically reduce abuse, neglect and harmful practices. It is possible to deliver fairer and more relevant education in countries currently suffering what the World bank has termed a Learning Crisis. With better global collaboration and leadership we could uphold the protection of the one in four children currently living in conflict zones. Equally, it is not a moment to be complacent. Climate change and population growth bring new challenges which require hard work to maintain prior progress and build out from it.

When we think about the leaders we love, they carried themselves with an abiding sense of the common good. They served all constituencies and took responsibility for what they said and the secondary impacts of how it may be interpreted by others. They delivered results by producing policies that may not have been loved by anyone, but which were acceptable to all.

Reimagining a post-pandemic world needs to bring focus back to a universal common good that appeals across constituencies. We need to talk about how nationalism, isolationism and inequality made us vulnerable to the pandemic. To reward politicians for humility, service and delivering progress for the people they serve. Building a better world, based on values of human rights and a common good is more possible now than it has ever been.

The Ghislaine Maxwell Story Must Be About The Victims.

The media noise of the Ghislaine Maxwell trial drowned out victim’s voices. The ‘socialite’s’ fall eclipsed the pain of lives devastated by organised criminal exploitation. Ghislaine Maxwell was found, through due process, to be a groomer and trafficker of vulnerable children.

What does it do to the life of a young teenager to be groomed for exploitation? Groomers have a laser-focused recruitment strategy. They identify, target and exploit the most vulnerable children and young people. Children who are already in pain. Those who feel unloved or unworthy. Those already affected by violence. Girls without a reliable adult to call for advice on an offer of a trip or friendship from an older stranger. Groomers take broken lives and break them further. They are ruthless and heartless.

Our society lacks both understanding of the grooming process and compassion for the victims. The victims evoke misogyny and class prejudice. That prejudice prevents or delays prosecution. Trauma, the lapsed time and absence of witnesses to sex crimes means testimonies can be inconsistent. Former Public Prosecutor for North- West England Nazir Afzal said that inconsistency itself is a sign of the authenticity of the testimony.

From a base of vulnerability, the victims show heroic tenacity in fighting their case. Defence lawyers try to denigrate their character. The strategy is to brazenly play into public prejudice and re-traumatize the victims. The use of a ‘false testimony’ expert was rightfully dismissed by the judge and jury at the Maxwell trial. Do we as a society believe allowing defence lawyers to roast traumatised victims of historic child sex abuse is a pathway to a fair hearing? Is it in the public interest? Does it serve justice?

Maxwell’s defence team requested a retrial on finding a juror mentioned lived experience of child abuse during jury deliberations-as if this was an outlier. According to CDC population surveillance data, between 11 and 20% of adults experienced sexual abuse as children. Data from the Council of Europe shows 1 in 5 European adults experienced sexual abuse as children. Tragically, child sex abuse is not marginal it is mainstream. A jury that did not include survivors of abuse would in itself be an anomaly-and arguably itself an injustice for a trial on organised sexual abuse.

The 2021 prosecution of Ghislaine Maxwell is rare and hopeful. Before Nazir Afzal re-opened a case against grooming gangs in Rochdale in England they had abused an estimated 1400 children with impunity between 1997 and 2013. Hundreds of complaints of systematic abuse were met with fear, incompetence and misguided politics. The eventual successful prosecution was a game-changing breakthrough.

Where do we go from here? Investigate those implicated in this case without fear or favour, regardless of how powerful they are. Turbo-charge the capacity of justice and police systems to detect, disrupt and destroy grooming gangs whether managed by Rochdale roughnecks or Manhattan socialites. Beyond that we need to address vulnerability. The first line of defence is family, friends and community. Investment in services that support families and communities to protect children and help them flourish. This enriches our society and yields an unrivaled return on public investment.

The case in Rochdale was a pre-cursor for the #MeToo movement in the UK. #MeToo later exposed widespread sexual violence against women and girls everywhere. It networked victims and activists to dismantle the structural inequalities and barriers that protect perpetrators and bring them to justice. We can build on that by scaling up action to prosecute the organised gangs that so ruthlessly exploit our most vulnerable children and young people.

A Safe Place to Return

There were many jobs that helped me pay my way through university. Selling leather jackets on Camden market, a very bad wedding DJ and a bartender in more places than I can remember. One of my favorites was driving a private-hire cab in North London. It had downsides: Nauseous drunks, exhibitionist backseat love-makers and menacing football hooligans who wanted to know which team I supported. But in general, it was a decent gig.

It was rare then for someone from state care to go to university. A fragile milestone on a long journey from one world to another. At times it felt like a no mans land. In my rear view mirror there was a world that seemed dysfunctional and full of violence, poverty and pain. Just across the horizon I imagined somewhere bathed in prosperity, purpose and safety. A university degree would be my rite of passage.

Driving a cab at Christmas, there was one thing worse than the small number of horrible customers. It was the much larger number of nice ones. They would jump into the back of the cab, armed with gifts, en-route to relatives or for Christmas drinks. After a few sherries they would sing Christmas songs and exchange shared memories of Christmas past.

Their joy illuminated what I lacked. I was so focussed on getting through that stage of life, I had not yet developed an adequate vocabulary to describe my life to myself. I now realize that no mans land was an unfathomably lonely place. I was 22, but had already had 25 addresses. It felt like there was no single thread tying it all together. The early roots of friendships and relationships that would endure for a lifetime were beginning to take shape. I was lucky enough to be one of the few care leavers who now always had a Christmas dinner invitation. The awkwardness of being an outsider at Christmas and a festive novice was brilliantly captured in the recent film ‘Alex Wheedle/ Small Axe’ by Steve McQueen. I am still a bit of a Christmas novice, but maybe a slightly improved one!

I guess my heart told me the world was divided into two. Those who someone cared about and those who nobody cared about at all. Deep inside I felt I was one of the second group and there because I was unworthy. What I didn’t know was that this a completely normal feeling for someone from my background.

The whole field of attachment psychology started in the 1940s when John Bowlby interviewed young offenders in London. He noted that many self- blamed for being abandoned by their parents and felt similarly unworthy. This research led to decades of work which helped the world to understand the way that childhood experience shapes adult outcomes. Inconsistent or absent affection in childhood may affect up to 40% of any given population. The situation of young people from care is just the most severe and manifest part of a much more widespread social problem that otherwise had remained taboo.

Our modern, idyllic image of Christmas comprises jolly people singing and feasting around a warm family hearth while snow falls outside. We owe this partially to Charles Dickens whose Christmas Carol did much to shape the identity and aesthetic of Christmas. His formative childhood years coincided with a rare decade of snowy London winters and a spell of abandonment and child labour at the age of 12 , as his parents languished in a debtors prison. Christmas Carol is ultimately a joyous tale when Scrooge overcomes emotional poverty and trauma and finds his place at a Christmas hearth. Many popular Christmas songs represent an aesthetic of the return to this hearth.

In the UK there is now a movement to de-Grinch Christmas for Care Leavers. An army of volunteers make sure that careleavers across the country have a Christmas dinner. Sophia Alexander Hall sensitively created a list of care-leaver Christmas films that don’t go overboard on the whole family thing. Less sensitive was Paperchase’s ‘comedy’ greeting card featuring a Mommy rabbit demanding a refund from the orphanage for a young foster rabbit who spilt milk. Sophia and Lemn Sissay led an online protest and the card was withdrawn.

Though my young feelings of being unworthy were normal, they were also false. As the years went by, I also understood that the world is not divided between the cared for and uncared for . The land across the horizon of university degrees, suburbs and families is also broken. There is addiction, violence and emotional poverty there too. Care leavers are worthy. I saw that people will wait for us, come across town to see us on a bus or keep us in their thoughts or prayers. Through the beauty of human acknowledgement and connection we can recover and build our own hearth.

Recently a UNICEF colleague (namecheck Aleksandra) visited a juvenile detention facility, as Bowlby had done over 75 years earlier. She commented that most of the problems the young people found themselves in, happened because they had no-one to turn to. For them, any small challenge could quickly morph into something much greater. The cost of running the juvenile facility and the the crimes committed are way higher than the costs of prevention.

If the idea of a return to a safe and warm hearth is so central to our main annual holiday and therefore to our national culture, should it not also be central to our social policy? Could we guarantee a safe place of return for every child? A place of love, safety and belonging. Of shared memories and a soothing sense that one matters as an individual. If this sounds ambitious, just remember that in Dicken’s time the idea that we could do anything about childhood disease, hunger and illiteracy was considered fanciful.

The solutions are known. The evidence shows we can reduce neglect and abandonment through parenting support and social protection. We can also invest in resilient communities and schools We could realistically arrive at a point where it is simply no longer culturally acceptable or imaginable that a child would live or grow in such isolation. Even for pre-epiphany Scrooge types, the return on investment is compelling and cannot be dismissed as humbug.

It was once said that ‘safety, is not just the absence of violence, it is the presence of relationships’. This Christmas lets reimagine a world beyond the pandemic where every child has a safe place to return.

This Blog is part two in the ‘Because I Grew Up in An Orphanage’ Triology. Part one is here

What We Talk About When We Talk About Emotional Poverty

If you put your mask on and go for a socially distanced trawl through New York City’s bookshops, you will note the most in-demand book of the moment hails from Glasgow. Shuggie Bain by Glaswegian New Yorker Stuart Douglas just won the Booker Prize. Its’about a 1980s childhood derailed by poverty, exclusion and adversity, and recovery through love and resilience.

‘ Glasgow was losing its purpose’ pondered Shuggie’s father while surveying the working class communities fractured by pit and shipyard closures.

Glasgow has certainly found new purpose in its world-inspiring efforts to reduce violence and adverse childhood experiences (ACEs). The eminent public health thinker Sir Michael Marmot lauded Glasgow’s community-based violence reduction work for halving gang violence in the city. Sir Micheal described their approach as an example of ‘building resilient communities’. Martin Luther King used to describe community based work on violence and exclusion as striving for a ‘beloved community’. They are one and the same. Love is resilience.

It was a pleasure to join Sir Michael last week in an online public discussion on poverty and adverse childhood experiences (ACEs), hosted by the incredible Ace-Aware Scotland.

This pandemic has shone the light on poverty everywhere. Austerity and prior stagnation on child health coupled with growing inequality had made us more vulnerable to the shocks of Covid19. Globally the number of children in poverty is estimated to have already risen by 15% as a result of the pandemic. We know child poverty is a disaster for children and their families, but it is also bad for society. Tackling child poverty increases wealth and growth for everyone. When we don’t, the scars last a lifetime and can be passed from one generation to another.

I see three catastrophic burdens in childhood that can drive lifelong inequality: Income Poverty through a lack of the basic means to survive, thrive and reach one’s potential. Discrimination or Exclusion based on race, gender or disability for example. Emotional Poverty ( also known as ACEs ) the absence of the basic nurturing and protective parental relationships due to violence, neglect or dysfunctional parenting .

The three burdens often converge and exacerbate each other. But not always. Most middle class respondents to the first ever ACE survey in 1998 had experienced one ACE and 12. 5 % had four or more. We all know people raised in wealthy and loving families who suffer devastating social exclusion because of disability, race or gender. We also meet people from so-called ‘privileged elites’ whose lives have been ruined by devastating emotional neglect or sexual violence in childhood. All need our compassion and our policy advocacy must focus on protecting all children in all circumstances always.

Shuggie Bain was afflicted by income and emotional poverty as well as exclusion because of homophobia. In those days only income poverty had a widely recognized and understood public and policy narrative . Homophobia was endemic and entrenched, as immortalized in the anthem’s of Glasgow’s own Bronski Beat. In 1988 the Conservatives introduced legislation through section 28 of the Local Government Act against promotion of positive images of Lesbians and Gay Men. 23 years later the Scottish Conservatives had an openly Lesbian leader. Ruth Davidson was so talented she could even promote a positive image of the Conservative party…in Scotland! Along with other forms of exclusion, including on gender, race and disability, those 23 years saw a public narrative emerge with clear policy asks to address homophobia.

The narrative on poverty may have begun in the 18th and 19th century and on exclusion and discrimination in the 20th century. Some post-2016 soul searching has blamed the rise in populism on a post-industrial working class perception that the left had abandoned fighting poverty to fight exclusion. Thats another blog! But both struggles continue and perceived competition between them is bad for each other and for progress in general.

Our understanding of emotional poverty as a risk factor for lifelong inequality is a 21st century idea. It accompanies an explosion of new knowledge about how our brains develop, emotions work, decisions are made. It shows how healthy relationships are essential for wellbeing. This is powered through new evidence at the intersection of neuroscience, biology, psychology and sociology. It is a crucial part of the jigsaw puzzle with attachment theory, toxic stress and resilience that powers a much better understanding of child development.

This idea is so new, we don’t even have an agreed title yet. For most of us Adverse Childhood Experiences tell a story at a population level, as data sets on prevalence of ACEs and life outcomes. There have been around 30 ACE surveys in different parts of the world and across most US states. They all demonstrate remarkably similar results, though they are not yet nationally representative in the way data on childhood disease is, for example.

The ACEs methodology is often used by WHO, UNICEF, CDC and other major public health bodies. We use it with caution and humility in the knowledge that it is an emerging field of research. But there is now enough knowledge to act and call on governments to invest in the following strength-based population-wide interventions: 1)universal support for early parenting through home visits 2) reducing stress on the caregiver 3) resilient communities, including policing and schools that promote connection and belonging 4) breaking taboos and building a public narrative. These are all accelerators that can drive forward progress on multiple public health and social fields.

In the future we may have internationally comparable data sets for all countries. We can then measure progress in reducing ACEs and poor life outcomes against investments in strength-based policies on parenting and resilience. I have seen internationally comparable data leveraged for policy advocacy to reduce child mortality, disability exclusion and deinstitutionalization and to improve education outcomes. ACEs data used internationally at the population level could be as transformative as when expansion of immunisation, safe water access and improved nutrition dramatically reduced child mortality during the child survival revolution of the 1970s and 1980s.

While we must work to craft a clear narrative, we can also think about the type of conversation we want to have. Here are some initial thoughts:

Poverty and exclusion are system failures. We have a right to be angry and loud about these injustices. Transmission of emotional poverty or ACEs is different. It is when things go wrong in the home and relationships-often inter-generationally and unintentionally. It becomes a system failure when we don’t address it. We need a calm thoughtful conversation that doesn’t blame or create competing victimhoods.
We need to look out at any population and recognize that anyone can be in pain, often even without being aware of it. That everyone is at risk. This topic can be a trigger or a source of healing, or both at the same time. There is no ‘us and them’ as everyone’s life is touched in some way. If we have not had ACEs ourselves, our partners, neighbors or co-workers have. We need compassion.
You cannot have a conversation about emotional poverty or ACEs that is judgemental. The subject feeds into how people feel about their parents, themselves and their children. These are usually complex and deeply private feelings. The policy makers and parliamentarians who we want to legislate and invest in this sphere, are no different to anyone else in this respect.
Addressing ACEs does not detract from the struggle to end poverty and exclusion. Equally it doesn’t always need to take them into account. It is a different framework of analysis. It can also be used alongside child poverty and social exclusion research to advocate for a holistic advocacy agenda to child and human development. There is no competition between the three. Individuals and groups will be drawn to work on the one that is of most interest to them. We cannot talk about ACEs in an atmosphere of polarization or competition.

I write all of this with the humility of knowing it is a much less evolved sphere than say child survival or nutrition. Our knowledge is evolving. But from what I have seen thus far, we need to have a calm, compassionate, non-judgmental and inclusive policy narrative on emotional poverty and ACEs. Child psychologist Peter Fonagy highlighted that parents who become self-aware of the risks of transmitting inter-generational trauma are less likely to do so. With the right type of public narrative we can harness community wide self-awareness to bring an end to emotional poverty in the lives of children everywhere.

A Right to Love?

“He feels a dark star of pain in his throat and the last warmth of her touch on his fingers”
― Kit de Waal, My Name is Leon

At 92 years of age, Stuart, was reluctantly bought by his son to see psychologist Daniel Siegel. Despite initial protests, he warmed to the therapy sessions. The more he talked, the more he saw his lifelong feelings of emptiness and emotional detachment. That realization motivated him to continue with the therapy and to become a better companion for his wife in their retirement . The therapy began to chip away at rigid walls that prevented intimacy and affection and made him numb.

Stuart’s wife saw how tuned-in to her feelings he became through the therapy. They were now happier than at any previous point in their 62 years of marriage. She told Professor Siegel that Stuart’s parents were the coldest and emotionally distant people she had ever met.

Stuart’s painful journey had indeed began at the start of life, not towards the end . Babies are programmed for connection, warmth and love. When it’s absent or disrupted because of emotional neglect or loss, it is scary. Their rapidly evolving young brain and body adapts to survive this trauma. But that adaption can become a lifelong maladaption. We cannot remember or recall our relationships as infants. But the earliest years define how we navigate the world and relate to others.

Neglect is often inter-generational and unintentional. We rarely think about how life was for our parents as children. If their parents were emotionally unavailable or unreliable in their affection, then it leaves an imprint. Children don’t come with a handbook and parenting is largely automatic and instinctive. What if our instincts are distorted by an early deficit of love?

9 year old Leon has a “dark star of pain” at losing his beloved brother and mother for the uncertainty of foster care. Between Leon’s 9 and Stuart’s 92, dark stars that are not soothed can be the source of much silent pain. Such stars are everywhere. Up to 40 % of adults struggle to connect or to thrive within relationships due to scars of childhood

I recently heard love defined as the promotion and protection of another’s internal emotional world. Love empowers with the soothing sense of being a “we”. To truly love, we need to be emotionally present and in-tune with another. This can be intolerably painful and uncomfortable for someone who has not previously felt part of a “we”.

On one level we know all this. We identify it immediately in the detached James Bond or insecure Bridgette Jones. In the songs of Amy Winehouse. It has driven plot lines from Tolstoy, Dickens and Hugo to many 2020 Oscar nominee films. But it rarely drives us to demand a public conversation about how we may address it.

The right to Love is not set out as a specific right in the 1989 UN Convention on the Rights of the Child although the preamble states: Recognizing that the child, for the full and harmonious development of his or her personality, should grow up in a family environment, in an atmosphere of happiness, love and understanding,” The latest science on human development shows child protection and development depends on the presence of love. Is it time to have an internationally recognized right to love?

We await any sequel from Kit De Waal to see how Leon’s life pans out.. An authentic connection with a teacher or another caring adult can help a traumatised child recover. Leon’s foster carer Maureen soothed him and helped him to believe that in the end “things would be alright”. Crucially, she helped him understand he mattered as an individual. We live in a world where mental health services are scarce and stigmatized and only accessed by a fraction of those who need them. Soothing relationships are the best hope for recovery for most.

Stuart’s healing began when he became self-aware that mental maps from his childhood were not serving him well. We can imagine how much richer his life may have been if this had occurred earlier. Or if the emotional neglect was prevented from the start. Research shows that mothers who become similarly self-aware are less likely to neglect their own children. This knowledge has informed parenting programmes designed to give attached and nurturing caregiving.

A right to love would call on governments to ensure every child has a loving family in which they are protected. It would call for parenting programs to be universally available and stressors removed from parents. It would demand that schools and communities prevent loneliness and isolation of children. That no adolescent reaches adulthood without being part of a “we”. That everyone knows how to talk about about attachment, neglect, belonging and connection. That we talk about it without stigma or judgement.

Over recent decades we have seen unprecedented, game-changing results in public health. The world has harnessed the latest science to reduce child and maternal mortality and expand life expectancy. The next frontier of human rights in many countries has shifted from survival and basic protections, to helping us thrive and flourish. We need the public demand and political will to ensure, within this, everyone has the right to love .

All Of Our Dignity

I will never forget Antonio. His abandonment and isolation was so complete, nobody knew how old he was. We guessed 8 or 9. He lay in a cot, lifeless and listless in a dark corner. The lack of animation wasn’t an outcome of severe disability and blindness but of extreme neglect. The institution “housed” around 150 adults and children. It wreaked of human waste and human disregard.

I gently brushed my index finger against his palm and he responded with a tight grip as his face broke into a toothless smile. His entire life had been lived adrift from love, attention or even basic human acknowledgment .

Antonio was one of many children who inspired a campaign to end placement of children in large scale institutions in North Macedonia. Children like Antonio could be cared for within family settings in foster care or small group homes providing family-based care, connection and stimulation in community settings.

The plan was knocked off script when locals in the town of Timjanik protested a mayor’s request to accommodate a small group home . When we travelled to Timjanik, along with the minister of social welfare, to find out why, we were confronted with a three hour volley of abuse and hostility from several hundred protesters. There was violence in the air. People watching this back in the capital on live news were horrified. Urban influencers began lambasting the protesters as primitive, callous and hillbilly.

But we listened carefully to the protesters. Timjanik was a small town in decline. It could have been in Oklahoma or South Yorkshire. Locals had once been been dependent on industry and agriculture. Abandoned plant a forlorn testimony to that loss. For generations their income and opportunities had been on a modest, upward trajectory. They feared their children would have a more precarious future and a lower quality of life than the one they had enjoyed. Their list of unfulfilled promises was longer and more depressing than a Radiohead song: unfixed roads, collapsing schools and no pre-school. They longed for a voice for their plight , alongside all the campaigns that came from the capital for migrants, sexual minorities and people with disability. Like Antonio, in their own way, they felt abandoned.

But why did these two different forms of deprivation and abandonment compete with each other? Besides humanitarian crisis, there are three catastrophic burdens in childhood that drive lifelong inequality:

Discrimination or Exclusion based on race, gender or disability for example. It creates barriers that exclude one from opportunities, justice and often the basic safety that others take for granted.
Income Poverty through a lack of the basic means to survive, thrive and access opportunities to reach one’s potential.
Emotional Poverty through the absence of the basic nurturing and protective parental relationships due to violence, neglect or other forms of dysfunctional parenting (also known as childhood adversity). This is often transmitted inter-generationally and unintentionally.

If you look at Black Lives Matter, Hillbilly Ellergy and Good Will Hunting through the lens of identity, they seem so different to each other. When we look at them through the lens of fairness and dignity for all, they seem the same. It feels like we lost a sense of ourselves as a whole, we are looking for the differences and barriers. This fragmentation polarises us into differing sides in a counter-productive culture war.

People in places like Timjanik perceive human rights champions as selective. But human rights are supposed to be universal. Those living with rural and town poverty feel politically and economically abandoned. They get the bum deal in a painful transition from an industrial to a knowledge economy. This transition has concentrated opportunity in large cities at the expense of everywhere else. Human rights champions scratch their heads as populists have hoovered up support away from these knowledge economy hubs . Despite the best intentions, we human rights proponents bear some responsibility for the growth in populism and polarisation

At an unrelated press conference the day after our visit, a journalist asked the Minister and I about Timjanik. We were expected to echo public condemnation of the protesters behaviour. Instead we articulated their local grievances with empathy and said we understood why they protested though did not agree with them.

Within two hours our inboxes were flowing with warm messages from Timjanik. They had never expected to be listened to or for their story to be relayed across news channels. They needed to be acknowledged and heard. To understand that we think they matter too. From a collective refusal to host the small group home just 24 hours prior, it was now back on.

From that moment on, we numerically balanced our public facing advocacy. We gave equal attention to the situation of the overall population and to those living with one or more of the three catastrophic burdens . If we did a public event on exclusion of Roma minority or children with disability one month, we made sure we also had an event on poverty or a population-wide issue like education or health the next. This struck us as fair, just and effective and rebuilt public ownership of human rights as a universal principle.

A few weeks after the protest, the government agreed a strategy to transfer all children out of large scale institutions through family re-unification, foster care and small group homes. The strategy “Timjanik” in testimony to what we had all learnt from those events.

On October 15th last year, the last remaining children were removed from large scale institutions. The situation has improved for children in state care in North Macedonia, but there is still so much to do to prevent exclusion, poverty and adversity in the lives of children the world over. We can only do this when everyone finds their place in a shared story of universal,and not selective, human rights. We need to “re-universalize” our human rights story.

And the child in the story? Antonio is out of the cot, living in a small group home with adequate care and stimulation and for the first time in his life, he is enrolled in school. Today in Timjanik, the locals visit with cakes and play with the children at the small group home. Just ordinary people in an ordinary place with the extraordinary courage to reimagine a better tomorrow in a world that protects all of our dignity.

COVID-19, Violence & The Need To Act with Urgency

Amidst the fear and uncertainty of the Covid19 lockdown in China, 26 year old Lele experienced something more terrifying than the virus itself. Her husband fashioned a weapon from a kitchen stool and beat her semi-conscious as she held her 11 month old baby in her arms. There was nowhere to go, no services to support, no possibility to flee. She had to spend several more weeks with her abuser before she could reach safety.

On the other side of the world in Greenland, the capital city banned alcohol sales to prevent growing child abuse during lockdown. In India the were 92,000 calls to a child abuse helpline in the first 11 days of lockdown. France experienced a 34% increase in abuse helpline calls by children and an even bigger increase in the number of peers and school mates calling on behalf of friends. . As closed schools and stay at home orders spread, so did the risk of abuse.This pattern played out across the world, in three ways:

The first is the way that lockdown piles pressure on households . Even the calmest, securely attached and ‘child development-aware’ parents are being tested by ‘pandemic-parenting’. Often they are working in uncertain jobs while teaching ‘cabin fever kids’ while adapting to loss of space and privacy. But most will not suddenly become abusive or neglectful. In more volatile families however, this stress can spill over into violence or exacerbate existing abuse patterns. The biggest beneficiaries of #StayAtHome are the serial abusers who practice coercive control and other forms of psychological aggression. the lockdown increase the likelihood of adverse childhood experiences.

Secondly, the means of reporting severe child abuse or neglect have been dramatically reduced. According to the US Department of Health & Human Services child protection interventions are initiated by reports from teachers, social workers or nurses. Social distancing measures have reduced reporting. From the 1980s onwards increased reporting of family violence was a major mark of success and progress in protecting the rights of women and children. Momentarily, reporting is in decline.

The third issue, is complex but equally serious. In normal circumstances less than 1 or 2 % of children are subject to interventions by social workers. Yet Adverse Childhood Experience (ACE) research across populations suggests between 15 and 20% of children are affected by chronic, multiple forms of abuse, neglect or dysfunctional parenting at home. This 15 to 20% of children are now in a state of isolation. Children have a biological imperative to have protective, soothing relationships with an adult and are simply not built to be isolated. When a positive relationship at home is absent, the child interprets it at risk. It over-activates their stress response system which wreaks havoc on all aspects of healthy development. Unaddressed it can lead to catastrophic health and wellbeing outcomes throughout life. But when the stress is buffered and soothed by a healthy relationship with a teacher, grandparent or friend and the child is made to feel they matter on an individual level-then the recovery can begin. Right now around the world, hundreds of millions of children have been cut off from those relationships.

This is deeply distressing. Accounts of childhood maltreatment often recall a despairing loneliness and unbearable slowness. Loneliness when the parent who should soothe the pain, is actually the source of that pain. Slowness during long pauses of waiting for a violent outburst or scarce moments of maybe feeling loved. The isolation of the pandemic amplifies this pain exponentially. It is malleable with no end in sight. Relationships with teachers, grandparents and friends were cut off suddenly with no date for restoration.

We need to act with urgency on all three issues. Governments and communities could appoint ministers or local leaders to coordinate child wellbeing during lockdown. A priority must be engagement with parents on managing stress, home schooling and positive discipline, tailored to lockdown conditions. Online and media platforms could be adapted to facilitate a conversation with families and disseminate pandemic-specific parenting tips, similar to the global UNICEF parenting hub. Social protection and housing support must be adapted to reduce the stress on vulnerable families. Behavioural insights and technology innovations should be used to understand how we can best support parents and protect children.

Expanded helplines and channels that enable neighbours and friends to report maltreatment anonymously need to be provided . Equally we need to encourage extended family and friends to maintain regular communication with children in lockdown with abusive or neglectful parents. One of the most moving stories of the pandemic so far is the upsurge in calls by friends of victims reporting maltreatment in France.

Innovation and adaptation could help teachers and social workers restore normal levels of communication with children, despite lockdown. If they are not giving lessons, can they call each child for five minutes? These measures need to be population-wide and not just targeted to 1-2% of children who are child protection cases.

Decades ago, it became normal to ensure every child was immunised against deadly disease with a vaccine. In the future we could hope for a world were every child is buffeted from trauma by a calm and predictable adult connection. A world in which we improve prospects for parenting in every family at the earliest possible stage and maltreatment is managed and prevented as a part of routine public health . All we can do now is demand protection for Lele, her baby and millions of abused children and women locked down, unreported and isolated around the world as part of our immediate and shared struggle to defeat Covid19