COLUMBUS, Ohio -- Sometimes, the impacts of physical abuse run deeper than a scar, and researchers in Ohio are digging deeper into cognitive injuries caused by domestic violence.

Working with researchers from Ohio State University, the Ohio Domestic Violence Network's CARE project discovered that a majority of survivors have lived through extensive violence directed at the head, neck and face, and through strangulation.

At ODVN's Center on Partner-Inflicted Brain Injury, Director Rachel Ramirez said such injuries can be linked to brain trauma.

"So, when we think of the very first picture of a battered woman being a woman with a black eye, we now should be thinking that that woman very well could have had a concussion, and her brain could have been hurt," Ramirez said.

The project's work was featured in a recent federal report, which recommends improved data collection on brain injuries from intimate-partner violence.

According to Ramirez, with better data comes a better understanding, which will help providers better serve survivors.

Ramirez explained that brain injury often is not diagnosed and not well understood by domestic violence prevention programs or survivors. It can manifest in such cognitive challenges as problems with attention or memory; such physical problems as headaches and fatigue; and emotional issues, including depression and anxiety.

"When these issues are untreated and unidentified, things end up getting worse for the survivor," she added. "They aren't getting better; they don't understand what happened to them, and they blame themselves -- instead of understanding what happened to them as a result of an injury that wasn't their fault."

ODVN has developed a new conceptualization of brain injury, known as the CARE framework. CARE stands for "connect, acknowledge, respond, evaluate."

Ramirez described the framework as focusing on building positive relationships with survivors, and acknowledging and responding to the individualized needs of each person accessing services.

April is Sexual Assault Awareness Month. Crimes against men and women ranging from grabbing and fondling to rape to criminally deviant conduct are more common than people want to believe.

Beth White, president and CEO of Indiana Coalition to End Sexual Assault, said three in five women and one in four men in Indiana will experience a sexual assault in their lifetime, and added that a stigma exists among victims of sexual assault and sexual violence, causing too many incidents to go underreported.

"People are afraid to come forward," she explained. "They think they will be blamed and shamed based on what's happened to them. So in the month of April in particular, we talk about how important it is for people to realize they are not alone."

Another misconception is that the crime is a random act by a stranger. White said the vast majority of sexual violence occurs between people who know each other - a trusted family member or an intimate partner - which only adds to the victim feeling they will be blamed, especially if alcohol or another substance was a factor.

Historically, sexual assault reports by women point to a man as the aggressor. But those statistics are changing. White asserted that sexual abuse is an equal opportunity crime, and explained that men, non-binary and transgender people are more at risk. The organization works with law enforcement to underline that when men report a sexual-violence incident, they should be believed.

"When people come forward, we start by believing them, and then we make sure that they can seek the help they need. They do not have to suffer in silence, whether they are men, women, transgender, or nonbinary people, it's really important to understand this happens to anyone," she continued.

The National Sexual Violence Resource Center website lists sexual abuse, assault and harassment to include sexual exploitation and trafficking and nonconsensual image sharing or coercion, including AI-generated imagery.

April is National Child Abuse Prevention Month, and new research at Utah State University finds one in seven Utah children experiences sexual abuse -- higher than the national average of one in nine. The data also find Utah girls experience a higher rate of sexual abuse than boys.

Kolene Anderson, associate director of the Utah Women and Leadership Project, suspects those figures are even higher. She contends there is a gap between what people think is happening in their communities and what is actually taking place.

While the state ranks fifth in the nation for the number of people sentenced for sexual abuse, according to the United States Sentencing Commission, Anderson noted the cases that actually reach the sentencing stage are only a fraction of all sexual crimes.

"Sure, we need to continue with the accountability side, but we've got to start having conversations about child sexual abuse in terms of prevention -- and it can't always just focus on parents and children," she explained.

The report indicates the state did allocate funding for child sexual abuse prevention in K-6 curriculum last year, which Anderson sees as a positive, but said additional support and resources are still needed. She's calling for more investment to teach Utahns about respect, consent and bystander intervention.

If you or someone you know is a victim, you can call 801-736-4356 or 801-924-0860 for assistance in Spanish.

Anderson said the state has historically focused on policies that punish offenders after abuse has happened. She added there is a narrative that registered sex offenders are the ones people should be worried about. But according to the Centers for Disease Control and Prevention, in most cases, a child is victimized by someone they know and trust.

"It's not the registry that we need to be focusing on," she said. "It is really understanding the vulnerabilities that our children have and the various places that individuals may insert themselves to be able to gain access."

Anderson is convinced that the state needs to reconceptualize its outlook on child sexual abuse and start looking at the issue from every angle.

"It is much like training everyone out on the roads how to avoid a drunk driver -- and punishing the drunk driver after someone is killed. That is already impacting a family, and our approach to child sexual abuse has kind of been like that," she concluded.

More than 100 people came to the Ohio Statehouse to mark National Sexual Assault Awareness and Prevention Month late last week. As part of the 13th Annual Advocacy Day to End Sexual Violence, they urged state lawmakers to protect survivors and expand prevention efforts.

Rep. Dani Isaacsohn, D-Cincinnati, told the group it is about channeling emotion into action.

"Advocating on issues that matter most to your community, that is one of the answers to the question: How do we use that energy?" Isaacsohn explained. "We should all be using it to fight for things we believe in, by coming together collectively."

Survivors are also voicing concerns over House Bill 172, which would require parental consent for teen mental health care, saying it could silence young people. Supporters of the bill argued it would restore parental rights in making sensitive decisions.

Leanna Rocheleau told the group she survived a 2021 assault by a massage therapist. She said she tried every official channel in her pursuit of justice but was met with silence.

"It became a story of betrayal by a system that was never designed with survivors in mind," Rocheleau recounted. "I believed in a system that didn't believe me. It has been 1,325 days since I reported my assault; 12 more victims came forward and he still works there."

Now, she said advocacy is her path to healing and to fixing the system.

Sen. Nathan Manning, R-North Ridgeville, who received an award for championing survivor legislation, said hearing those voices makes a difference.

"They're a huge help, not only in reaching out to other senators and representatives trying to push the legislation through, but also helping craft the legislation as well," Manning emphasized.

Advocates are asking lawmakers to maintain $15 million in funding in the operating budget for Ohio's network of rape crisis centers. Last year, those services reached more than 30,000 survivors in 78 counties.


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