A Child Rights Approach to Child Protection in

A Child Rights Approach to Child Protection in Early Childhood Dr Sue Bennett Professor Pediatrics, University of Ottawa, Director Child & Youth Protection Program, Children’s Hospital Of Eastern Ontario, Canada

Objectives Introduction to the UN Convention on the Rights of the Child and a Child Rights approach to Child Protection Highlight the science behind Early Childhood Development as a Social Determinant of Health

United Nations Convention on the Rights of the Child (1989 -2014) 1

UN Convention on the Rights of the Child Ø Adopted by UN GA on November 20, 1989 Ø Entered into force September 2, 1990 Ø 193 ratifications (excluding US and Somalia) Ø Contains 54 articles setting international minimum standards and aspirations for proper care & treatment of all children everywhere Ø First international instrument covering economic, social, cultural, civil and political rights, including special protection measures Ø For everyone under the age 18 Ø Children previously seen as passive victims of charity vs. active rights holders with responsibilities

Three Optional Protocols to CRC 1) On Children in Armed Conflict (2000) 2) On the Sale of Children, Child Prostitution and Child Pornography (2000) 3) On a Communications Procedure (2011)

Convention’s Four Guiding Principles 1) Right to life, survival and development (Article 6) 2) Best interests of the child (Article 3. 1) 3) Non discrimination (Article 2) 4) Participation (Article 12)

UN Committee on the Rights of the Child Ø Monitors how well States are meeting their Ø Ø Ø obligations under the Convention Facilitates State Party implementation States must report initially 2 years after joining and then every 5 years thereafter Parallel/Alternative reports from NGOs, UN Agencies, other intergovernmental organizations, academic institutions and children themselves 18 members with 4 year mandate Committee publishes its concerns and recommendations in “Concluding Observations”

17 General Comments Aims of education 2) Role of independent national HR institutions 3) HIV/AIDS and the rights of the child 4) Adolescent health 5) General measures of implementation for the CRC 6) Treatment of unaccompanied and separated children outside their country of origin 7) Implementing child rights in early childhood 8) Right of the child to protection from corporal punishment & other cruel or degrading forms of punishment 9) Rights of children with disabilities 10) Children’s rights in juvenile justice 1)

17 General Comments 11. Indigenous children and their rights under the Convention 12. Right of the child to be heard 13. Right of the child to freedom from all forms of violence 14. Right of the child to have his or her best interests taken as a primary consideration 15. Right of the child to enjoyment of the highest attainable standard of health 16. On State obligations regarding the impact of the business sector on child rights 17. Right of the child to rest, leisure, play, recreational activities, cultural life and the arts

The need for change in child protection orientation Ø Children throughout the world continue to be maimed and killed and to have their quality of life and development limited, corrupted and distorted by violence, abuse, neglect and exploitation Ø There is widespread agreement that significant changes are needed in our orientation to child protection to enable us to secure the survival, well-being, health and development of all children

UN SG’s Study on Violence Against Children (VAC) 2003 - 2006 3

UN Secretary-General’s Study on Violence against Children Ø Commissioned by OHCHR, UNICEF & WHO Ø Nature, extent, causes and consequences of violence in 5 main settings (family, schools, institutions, work and communities ) Ø 9 regional consultations with govts, ngos, professionals, public & child participation Ø Final report & recommendations to GA October 2006

Paulo Sergio Pinheiro (leader of the study) “I have been struck by the fact that violence against children in all settings and contexts is very prevalent and knows no boundaries of geography, class, politics, race or culture. ”

A Child Rights approach to Child Protection frames child maltreatment as a human rights violation & not just a social or health problem

A Child Rights Approach to Child Protection Ø Major paradigm shift in core values & practices Ø Respect and promotion of human dignity and physical and psychological integrity of children as rights bearing individuals rather than primarily as “victims” Ø Historically has been a narrow corrective emphasis on child’s bodily survival with fear of imminent harm & loss of life Ø Investment of full social ecology to foster “bottom-up” and “top-down” initiatives and involves international cooperation

A Child Rights Approach to Child Protection Ø Child participation: employing child’s present and future contributions Ø Children have a right to be heard and to have their views taken seriously & must be respected systematically in all decision-making processes and their empowerment and participation should be central to child protection strategies and programs Ø Very compatible with a public health, ecological, injury prevention and economic approach

PROTECTION of child from maltreatment to PROTECTION & PROMOTION of child survival, physical, mental, social, moral and spiritual health, well being, development, personal security, dignity and indeed all their rights.

Article 19 of the UN CRC 1. States Parties shall take all appropriate legislative, administrative, social and educational measures to protect the child from all forms of physical or mental violence, injury or abuse, neglect or negligent treatment, maltreatment or exploitation, including sexual abuse, while in the care of parent(s), legal guardian(s) or any other person who has the care of the child. 2. Such protective measures should, as appropriate, include effective procedures for the establishment of social programmes to provide necessary support for the child and for those who have the care of the child, as well as for other forms of prevention and for identification, reporting, referral, investigation, treatment and follow -up of instances of child maltreatment described heretofore, and, as appropriate, for judicial involvement.

Timeline & process for a General Comment on Article 19 April 2008: ISPCAN & IICRD conversation with Committee on the Rights of the Child (Cte. RC) Oct 2008: letter of invitation from Cte. RC Jan 2009: formation of “Program of Development Team”

‘Programme of Development Team’ (POD) Expert Advisory Panel Working Group Exec Committee (IICRD & ISPCAN) Cte. RC Focal Group

Ø General Comment 13 on CRC Article 19: the right of the child to freedom from all forms of violence was adopted by the UN Committee on the Rights of the Child, Feb 2011 Ø http: //www 2. ohchr. org/english/bodies/crc/comments. htm

GC 13 Overview Ø Ø Ø Ø No violence against children is justifiable; all violence against children is preventable A child rights approach to care & protection Importance of concept of dignity, empowerment & participation of children and best interests of the child Primary prevention through public health and other approaches Primary position of families in child care and protection Outlines negative impact of violence on children, their families and society as a whole Highlights resources for implementation and need for international cooperation Emphasises need for a national coordinating framework on violence against children

Overall approach to implementation of Article 19 Ø All “measures” (paragraph 1 of Article 19) need to be applied to all “stages of intervention” (paragraph 2 of Article 19) ) through a comprehensive coordinating framework on violence against children

UNICEF ‘Protective Environment Framework’ Monitoring & oversight 8 1 Basic & targeted services 7 Government commitme to fulfilling protection rights 2 Legislation & enforcement Child protection Capacity of those in contact 6 with children Children’s life skills, knowledge & participation 3 5 4 Attitudes, traditions, customs, behaviour & practices Open discussion, includ engagement of media & civil society

GC 13 Implementation Strategy Ø Dissemination Ø Resource Program Ø Education and Training (www. cred-pro. org) Ø Accountability Ø Advocacy

Global Consultations on GC 13 Draft 3 (July - August 2010) Online survey developed in 4 languages (English, French, Spanish & Portuguese) circulated to key individuals & groups in global child serving organizations Child friendly version developed with help from Plan International Consultation as an individual or as part of a group (virtual or face to face) Consultations continued online for implementation feedback until Oct 31 st, 2010

Other ‘Arab countries’, Australia, Canada, Israel, USA EUROPE Albania, Armenia, Azerbaijan, Belarus, Belgium, Bosnia Herzegovina, Estonia, France, Georgia, Greece, Ireland, Latvia, Lithuania, Portugal , Russian Federation, Serbia, Turkey ASIA China, India, Malaysia, Pakistan, Singapore, Thailand, Hong Kong, Macau, Indonesia, Cambodia, Philippines, Vietnam, Mongolia, Nepal, Philippines, Sri Lanka LATIN AMERICA Argentina, Brazil, Chile, Colombia, Costa Rica, Paraguay, Peru, Uruguay, Venezuela AFRICA Benin, Burkina Faso, Cameroun, Cote d'Ivoire, Democratic Republic of Congo, Egypt, Gambia, Ghana, Guinee-Bissau, Kenya, Liberia, Malawi, Mali, Morocco, Niger, Senegal, Sierra Leone, South Africa, Togo, Tunisia, Uganda, Zimbabwe

Global consultation feedback: Implementation priorities

Next Steps …

WHO’s Commissioner on Social Determinants of Health (2005 -2008) 9 Knowledge Network (KN), 2005 -2007 HELP designated as WHO’s KN for Early Child Development Commissioner's Report in August of 2008 Courtesy of Dr. Ziba Vaghri, Human Early Learning Partnership; HELP

“Equity from the Start” Courtesy of Dr. Ziba Vaghri, Human Early Learning Partnership; HELP

The Commissioner identified ECD as one of the most potent social determinant of health Courtesy of Dr. Ziba Vaghri, Human Early Learning Partnership; HELP

The New Science of Child Development Convergence of evidence from neurobiology, epidemiology, epigenetics 1. Adverse Childhood Experiences (ACE) 2. Stress studies 3. Epigenetics

1. The Adverse Childhood Experience Study (ACE) www. acestudy. org ongoing collaboration between the CDC & Kaiser Permanente analyses relationship between childhood trauma (ACEs) to later health & behavioral outcomes exposure to 1 category = 1 points are added up = ACE score

ACE categories 1) 2) 3) 4) 5) 6) 7) 8) 9) Recurrent emotional abuse Recurrent physical abuse Contact sexual abuse Emotional & physical neglect Alcohol/drug abuse in household Incarcerated household member Household mental illness Mother treated violently Separated/divorced parents

ACE Study Results Compared to persons with ACE score of 0, those with score 4+ • • • x 2 smokers x 12 attempted suicide x 7 alcoholic x 10 injected street drugs x 2 sexual promiscuity (> 50 partners)

DISEASES AND DISORDERS OF ADULTS Disease/Disorder Coronary Artery Disease Liver Disease or jaundice Skeletal Fractures Chronic Obstructive Lung Disease (Chronic bronchitis or emphysema) Auto immune disease Somatic symptoms with unknown medical etiology Depression and suicide attempts Hallucinations Prescriptions for anti depressants, anti psychotics, anti anxiolytics Impaired memory of childhood Cancer Premature death Health Threatening Behaviour Obesity Smoking Alcoholism Married an alcoholic Injection related drug abuse Multiple sexual partners Intercourse by 15 Teenage pregnancy and abortion Teenage Paternity Physical inactivity Low Educational Achievement Poor self-rated job performance Absenteeism (>/= 2 days a month Serious financial Problems Serious job problems Felitti VJ, Anda RF et al. Relationship of childhood abuse and household dysfunction to many of the leading causes of death in adults: The Adverse Childhood Experiences (ACE) Study. Am J Pres Med 1998; 14(4) 245 -258. 37

Adult Mental and Physical health and Developmental Programming Pat Levitt Ph. D 2010 -06 -03 39

The Good, the Bad and the Damaging: Chronic Stress and the Concepts of Allostatic Load Matthew Hill Ph. D 2010 -06 -01 wade. junek@iwk. nshealth. ca 40

USE IT OR LOSE IT The more a system, or set of brain cells is activated, the more that system changes in response. The stronger the repetitions the stronger the memory.

Brain Development Relationships are the “Active Ingredients” of Environmental Influence on Early Brain Development Nurturing, responsive, individualized interactions build healthy brain architecture that provides strong foundation for all future learning, behavior and health Excessive, repeated stress causes release of chemicals that impair cell growth and interfere with the formation of healthy neural circuits

Brain Development Early experiences are built into our bodies and brains--- for better or for worse …. biological embedding Healthy development in the early years provides the building blocks for: l educational achievement l economic productivity l responsible citizenship l lifelong health l strong communities l successful parenting of the next generation

3. Epigenetics: the study of environmental factors that change whether DNA of genes will be “expressed, ” without altering the DNA sequence itself Factors that change the likelihood that A genetic ‘book’ will be read. Champagne and Mashoodh 2009 Eight (Failed) Assumptions: What We Thought We Knew About Early Child Development Thomas Boyce MD 2010 -05 -31 wade. junek@iwk. nshealth. ca 44

Kib-Koon & Thanks et Merci