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Child abuse and domestic violence are related, and only when people begin to look at child, elderly and spouse abuse together will society make significant progress in dealing with it.

That's the message of SueEllen Fried, dance therapist and past president of the National Chapter for the Prevention of Child Abuse, and Dr. Linda McKibben, who helped draft Boston City Hospital's policy on prevention and treatment of all forms of abuse.The two participated in the National Conference on Child Abuse and Neglect in Salt Lake City on Tuesday.

"There's a huge overlap in the abuse of women and child abuse," McKibben said. "We may have taken our blinders off on child abuse, but we still have a long way to go with the battering of women."

"Dysfunctional families have multiple problems for all age groups and it isn't limited by age," Fried said. "Battering is the single most common factor among mothers of abused children. And mothers are eight times more likely to hurt their children when they're being battered. One kind of abuse can literally cause the other."

Americans "discovered" child abuse in the '60s, she said. In the '70s they started recognizing spouse battering. And in the '80s people finally started talking about abuse of the elderly.

"Those talking now about elderly abuse are being met with the same disclaimers child abuse experts encountered earlier. But it's not just because of statistics that we should look at the links. It's because of our vested self-interest. We treat all of these abuses as child abuse advocates would but still don't link them; elderly and spouse abuse are definitely related.

"So why are we trying to reinvent the wheel when we could share the information and experience we've gained?"

In one year, 2.2 million children are abused, according to Fried's statistics. "And 3.3 million children (who are not abused themselves) witness it. Every case that comes in, start looking at the other members of the family. If you find child abuse, you'll probably also find spouse abuse, etc."

"There's a strong need to look at the overlap," said McKibben. "And we need a combination of grassroots and public health advocates to address it."

McKibben has worked for institutional changes as a way of "ending the violence for women and children." Unfortunately, very little is being done anywhere to assess how programs work or even to keep track of how many victims institutions like hospitals are seeing, she said. And few of the service providers receive formal training in domestic violence prevention, although some have child abuse training.

"My feeling is that violence is an addiction and we haven't come to grips with that. It's not foisted on us. We demand it," Fried said. "But in recent years we've given up salt, sugar, smoking, butter, drinking. We've proved you can change ingrained habits. And we need to break this habit, as well."