often they do not know what is happening to them. They are helpless in numerous ways and can not be expected to defend themselves.

An important measure of the level of our civilization is the degree to which we defend and protect the least powerful among us. One barometer of the degree to which our nation is truly civilized is the degree to which we facilitate the protection and nurturing of our children and make this a high priority in our lives.

The "Child Abuse Prevention and Treatment Act" represents a small but pivotal recognition of the national responsibility to children. This display of federal concern has served as a major stimulant which has generated a chain reaction of positive activity throughout the nation. Any comparison of the way in which the problem was handled before the passage of the Act with the present level of reporting, coordination, resource sharing and the sharing of ideas quickly reveals the astonishing gains that have been made.

The "Child Abuse Prevention and Treatment Act" was signed into law more than ten years ago. It established the National Center on Child Abuse, NCCAN. The center's main responsibilities are to make grants to States to implement state child abuse and neglect prevention and treatment programs, including children who have been sexually abused. This act also authorized funds for research, demonstration and service improvement programs.

As a result of this act, we are now able to analyze data which gives us more accurate pictures of the types, levels and incidence of child abuse in America. One astonishing fact which is the result of such a study reveals that based on official death certificates and clinical records, child abuse fatalities may be as high as 5,000 annually in our nation. In New York State, the number of deaths reported was 162 in 1985. This figure represents an approximate 50 per cent increase over the previous year, and it still only represents cases which were identifiable. Nationally, the incidence of child abuse is reported to have increased by 54.9 per cent between 1981 and 1985.

Family Violence Prevention is not merely an area closely related to Child Abuse Prevention, it is an inseparable component of what must be a united effort. Where there is violence of any kind in a home, there is usually violence directed at children. Even the witnessing of violence directed at others inflicts serious damage on the psyche of children.

Preventing daily violence will usually prevent damage to several individuals, including the perpetrator. Of still greater importance is the prevention of the damage or destruction of the family, an institution whose whole is much greater than the sum total of the persons who make up its parts. It is not by accident that the family is the most universal and most enduring of all human institutions.

However, for some individuals the family can turn into a living hell; it has been estimated that three to four million women are beaten each year by ex-husbands, boyfriends or lovers. We have learned that attacks by husbands on wives result in more injuries that require medical treatment than rape, auto accidents and muggings put together. The "Family Violence Prevention and Services Act" was designed to meet an overwhelming need to provide imme

diate shelters for those subject to such abuse. The Act authorizes the creation of demonstration grants to local public agencies and non-profit organizations for programs within the state to prevent incidence of family violence. By these means, battered women can find the help they need to restore their torn lives. We need programs such as these to be fully funded so that they can effectively meet a growing national need.

The family structure fulfills needs and solves problems that all other organizations are incapable of meeting. The preservation and nurturing of firm and functioning families is not only a humane national goal, it is also a wise and practical policy which contributes to the general welfare and the long-term security of the nation. Each dollar allocated to preserve families saves thousands of dollars which would otherwise be spent on remedial treatment, corrective, prosecutorial and prison activities. Programs like the Family Violence Prevention and Services programs greatly lessen the amount of dollars utilized for such negative purposes and, thus, contribute to the resources available for the all important positive national priorities agenda.

Today, we have also added a third panel to discuss the "Education for the Handicapped Act." Despite the fact that this legislation was recently reauthorized, an immediate dialogue and review is in order. So monumental is the scope of the program funded by the Act that ongoing, detailed oversight is a necessity. Today, witnesses will testify as to how this legislation is currently working. We need to discover the way complex systems of evaluation and referral of handicapped children are functioning. We also need information on how these systems can provide even more effective delivery of services.

Of equal importance is the fact that large numbers of the children served in education programs for the handicapped are the victims of child abuse or are considered to be at great risk of victimization.

As we consider the reauthorization of the "Child Abuse Prevention and Treatment Act," and the reauthorization of the "Family Violence Prevention and Treatment and Services Act," it is of utmost importance that we examine the close relationship of the Education for the Handicapped program to these two programs. Some golden opportunities to gain more impressive results and greater benefits at no additional costs may be lost if we fail to take this step. We are definitely interested in exploring the possibility of a more meaningful role for schools in the prevention and treatment of child abuse. One obvious point of entry and expansion is through the existing education programs for the handicapped.

Existing teams, funded with dollars provided for the Education of the Handicapped, which already include social workers and psychologists, may greatly facilitate the effort to prevent child abuse and family violence, or they may be critical components in the detection of abuse and in guiding the process of treatment for abuse. Certainly the education agendas of our schools would be greatly enhanced by the reduction of the pain of many children and the promotion of more stable families for more children.

There will be three panels from whom we will take testimony. The order of the day shall proceed as follows: First, we will have

testimony on the subject of child abuse; then, the panel on family violence; and, lastly, the panel on education of the handicapped. I will direct questions at the conclusion of each panel.

Before we begin our testimony, I yield to my colleague, Mario Biaggi.

Mr. BIAGGI. Thank you, Mr. Chairman.

As a ranking New York member of this Subcommittee, I am pleased to participate in this hearing today. I would also like to pay tribute to the new chairman of the Subcommittee, Chairman of the Subcommittee on Select Education, my friend and colleague from New York, Major Owens.

As evidenced by this hearing on the upcoming reauthorization of the Child Abuse Prevention and Treatment Act, it is indicative of his commitment to see to it that this vital law is extended. There is, perhaps, no subject I feel more strongly about, than child abuse prevention. The first bill I introduced in Congress in 1969 was a Child Abuse Prevention and Treatment Act. It became a forerunner to the legislation we are considering today for reauthorization. I was proud to be the co-author of the original Child Abuse Act in 1974, and I worked actively on all of its reauthorizations.

There is special significance in the sight we selected to hold this hearing today, the New York Foundling Hospital, under the direction of my dear friend, Dr. Vincent Fontana. The hospital has been at the forefront of programs at the national level of treating victims of child abuse. No organization has worked longer or harder or any more effectively to fight child abuse than Dr. Vincent Fontana, who will testify here. Our association goes back even before my time in the Congress. When I was a young police officer in the 24th precinct, he and I came to know each other. He introduced me to the subject in a meaningful way.

We approach the upcoming reauthorization with a sense of urgency about the problem of child abuse and the rate of increase. We have, in fact, regressed over the last few years in respect to our national commitment to fight child abuse. Results have been predictable. In this decade alone we have witnessed a startling and disturbing increase of 55 percent in the number of incidents of child abuse and neglect. Accordingly, if not directly related to that fact, is that funding for the Child Abuse Prevention and Treatment Act has actually declined a million dollars, at that same time. It is with a sense of urgency that I pledge to work to not only extend, but to expand this important law, as well.

Essentially, the law as written is fine. I am proud to point to a number of provisions I authored which have expanded services under this law as passed. I have authored the program specifically designed to combat sexual abuse. I led the efforts to produce a family violence program to assist families fight violence against

spouses.

Finally, I wrote the language which allows the Child Abuse Prevention Treatment program to operate through institutional facilities. Institutional children within the correctional system, as well as in handicapped residential facilities were previously uncovered by this program. The problem of child abuse and neglect has reached epidemic proportions in the United States. Each year almost two million children suffer from abuse; physical, mental

and sexual. Over 2,000 children will die from their injuries each year, and this is only the tip of the iceberg because most cases of abuse and neglect are not even reported. Child abuse is an increasing tragedy which cuts across all boundaries of economic levels, of race, ethnic heritage, and religious faith. It is undoubtedly one of our nation's greatest health risks to children. The personal and social costs of child abuse are staggering. Child abuse increases the rates of juvenile delinquency and criminal behavior. Studies reveal that 80 to 90 percent of all incarcerated felons were victims of child abuse. 80 percent of those abused are more likely to abuse their own child. Child abuse leaves not only consequences for the child, but leaves a scar on future generations.

The federal and state programs that now address this problem are some of the most important domestic programs we have in operation at this time. They are programs which reflect on society, that mirror a national conscience of concerns for children suffering from abuse and neglect. Although efforts have permitted us to take this problem out of the closet and into the national spotlight, we must renew and strengthen our commitment to this appalling problem and prevent its spread throughout society.

Abuse and neglect have become apparent in New York State in our foster care system. Our foster care system is overloaded, bursting at the seams. I intend to work during this authorization to extend the legislation and fight the problems occurring in foster care. We must promote appropriate and quality care for the youngster that facilitates permanent placement. Children in foster care must not be allowed to languish in the system for years, merely existing as a life on hold. We must promote quality standards for our nation's foster care system and assist states in meeting these goals. Let us review some of the numbers, not just to illustrate the problem, but to compel us to move forward to a solution.

In 1985, 1.9 million incidents of child abuse were reported in our nation. The American Humane Society tells us these cases have increased by more than 125 percent since 1976. Tragically, the incidents of child sexual abuse have risen 24 percent in just the past year. In our own City of New York, we have witnessed more of the same. New York State continues to be a leader in this nation in child abuse incidents, reporting 750,733 in 1986. This represents a 62 percent increase since the beginning of this decade. Tragically, New York State is no different. In 1986, 75,344 instances were reported, an astounding and powerful 129 percent increase since 1980. Obviously, our greatest responsibility is to work to have results backed up by law. In 1987, $26 million was appropriated, a decline of six million real dollars since the beginning of the decade. Congressional intent is one thing and it is clear: this is an advocacy law on behalf of the victims of child abuse. It is a preventative law. However, unless we see significant increases in appropriation for this program, the law will be a paper tiger in our battle against child abuse.

I yield to the Chair.

Mr. OWENS. The first panel is Dr. Perales, Dr. Vincent Fontana, Joanne Johnson-Hershman, Denis Walcott, and Dr. Andrea Savage. I have copies here of their written statements, and their written testimony will be included in the record.

We would like for you to take no more than five minutes to summarize your testimony, or to make any remark that you wish to make.

We will hold up a sign, to just let you know when you only have two minutes remaining, and when your testimony is up.

I am going to vary a little from the order listed on the paper. Since Dr. Fontana is our host, I am going to ask Dr. Fontana to testify first.

Again, Dr. Fontana, I would like to express my appreciation for your hosting of this hearing on such short notice, and to introduce Dr. Fontana, I would like to yield to my colleague, Congressman Biaggi.

STATEMENTS OF DR. VINCENT FONTANA, MEDICAL DIRECTOR AND PEDIATRICIAN-IN-CHIEF ON CHILD ABUSE AND NEGLECT FOR NEW YORK CITY; CESAR PERALES, COMMISSIONER OF SOCIAL SERVICES FOR NEW YORK STATE; JOANNE JOHNSONHERSHMAN, ASSISTANT DIRECTOR OF SOCIAL WORKERS, ST. LUKE'S HOSPITAL; DENIS WALCOTT, DIRECTOR OF HARLEM DOWLING CHILDREN SERVICE PROGRAM, PREVENTION AND TREATMENT OF ABUSED CHILDREN; AND DR. ANDREA SAVAGE, ASSISTANT PROFESSOR OF CHILD ABUSE TRAINING FOR CHILD ABUSE SOCIAL WORKERS, HUNTER COLLEGE

Mr. BIAGGI. I think I said it all about Dr. Fontana in my opening comments, and those of you who have been associated with child abuse problems in our nation don't need an introduction to Dr. Fontana. He is a paragon of the issue; he has been there long before so many of us, and his commitment has been unflagging, and he has been kind of an inspiration for my own participation. I am sure he enjoys that role in the minds and hearts of many of us who have been concerned with the problem over the years, and we always look forward to hearing from Dr. Fontana.

Dr. FONTANA. Thank you very much, Congressman Biaggi, and Congressman Owens for the invitation.

Before going into formal remarks, I must say that many of the accomplishments in this nation, the state and the city have been due to the fact that we have had the support of our members of Congress such as Congressman Mario Biaggi, who I remember in the early 70's asking me up to the Hill to meet with Senator Humpherie, Senator Mondale, and Tip O'Neal, and trying to convince and "educate" the people at the head of our government that child abuse indeed was something to be dealt with. I can remember Tip O'Neal saying to me in those days, "Well, Doctor, I think I read something about child abuse in one of the magazines a few months ago," but that was the essence of what the remarks were. So it was Congressman Biaggi's support and leadership, at that time, that convinced people and the Congressmen on a high level, the PresiIdent and Vice President at the time, that we needed something like the Treatment and Prevention Act of 1974. Those will be history; and Congressman Biaggi is a member of Congress who will be known as being the father of the child abuse legislation.