DH 46 Child Abuse Reporting

Legally Mandated Reporters

-Child visitation monitors. -Health practitioners (nurses, physicians, etc.) -Commercial or photographic print processors in specified instances. -Specified public positions, ex. teachers, social workers, probation officers, etc. -Public protection positions, ex. police, sheriff, CPS, etc. -Clergy members. -Fire fighters (except volunteer firefighters), Animal control officers, Humane society officers.

Physical indicators in the child of physical abuse

-Fractures, lacerations, bruises that cannot be explained, or explanations which are improbable given the extent of the injury. -Burns, ex. cigarette, rope, scalding water, iron, radiator. -Facial injuries (black eyes, broken jaw, broken nose, bloody or swollen lips) with implausible or nonexistent explanations. -Subdural hematomas, long-bone fractures, fractures in different states of healing. -Pattern of bruising (e.g., parallel or circular bruises) or bruises in different stages of discoloration, indicating repeated trauma over time.

Environmental Problems revealing abuse

-Hazardous conditions, ex., broken windows. -Health risks, ex. presence of rats, feces, no running water, no heat. -Extreme dirt or filth affecting health

Assessment With the Family

-If abuse is occurring in the family, parents and other family members may not be inclined to discuss this area of concern. -Meeting with the child separately from parents may help gather info. -If the parents/caretakers make statements such as "we know how to take care of him," "we have a sure-fire cure for that," or similar references regarding their parenting strategies it is critical to get a clear description of the parents' behavior.

What to Tell the Parents/Caretaker

-If the child is at risk due to disclosure, it is important to discuss this with the parents and make a statement about further harm to the child. -Tell the parents the reasons for the referral

Parental or Caregiver Clues revealing abuse

-Is unable/unwilling to meet child's basic needs and provide a safe environment. -Tells you of homicidal thoughts/feelings toward child. -Tells you of use of objects (belts, whips, clothes hanger) to discipline the child. -Is unable to describe positive characteristics of child. -Has unrealistic expectations of child. -Unduly harsh or rigid about childrearing. -Singles out child as "bad" "evil" "out-of-control". -Berates, humiliates child. -Turns to child to have his/her own needs met. -Is impulsive, unable to use internal controls. -Cannot see child realistically, attributes badness to child, or misinterprets child's normal behavior (e.g. Takes an infant's crying as a sign of intentional meanness). -Is indifferent to child.

Assessments of False Allegations

-Keep abreast of current research on improved methods of interviewing and treatment. -Maintain integrity by assessing each case on its own merits. -Suspend judgments until all the information is gathered. -Do not rely on a single-source techniques; the most reliable evaluations include the use of multiple techniques

Assessment with a nonverbal child

-Nonverbal children will often "act out" their concerns in play. -It is important to assess abuse based on extreme or persistent behaviors that are consistent with indicators of abuse. -This by itself doesn't mean abuse is occurring.

Four basic areas in which abuse may be revealed

1) Environmental Problems. 2) Parental or Caregiver Clues. 3) Physical Indicators in the Child. 4) Behavioral Indicators in the Child.

Fictitious allegation populations

1. "Coached" children in custody disputes. 2) Adolescents who "make up" convincing reports out of boredom, infatuation, or in an effort to retaliate.

What must be reported by all legally mandated reporters

1. A physical injury. 2. Child sexual abuse. 3. Willful cruelty or unjustified punishment. 4. Unlawful corporal punishment or injury. 5. Severe or general Neglect. 6. Child exploitation, child pornography and child prostitution

Assessment with a verbal child

1. Create a safe environment. 2. Provide opportunities for spontaneous disclosure through verbal and non-verbal messages. 3. Ask the child to describe a particular day, the house and who lives there, etc. 4. Note changes in affect or voice.

Professionals' Internal barriers to reporting

1. Denial - refuse to believe child abuse is occurring. 2. Rationalizing - accept unrealistic explanations for how an injury occurred. 3. Betrayal - feel they are damaging the client-provider relationship. 4. Fear of breaking up a family

Basic elements in the process of determining whether there are grounds for reasonable suspicion

1. Do not try to conduct an investigation. 2. Do not make promises to the child you cannot keep, ex., promise not to tell anyone. 3. Avoid jumping to conclusions. 4. Must have a willingness and ability to inquire further - active, ongoing process. 5. Do not lead the child to say what they think you want to hear - no leading/coercive questions`

How to report suspected abuse

1. Make a report immediately by phone. 2. Within 36 hr. a written report must be forwarded.

If he child has given info that leads to a reasonable suspicion that he/she is being abused, let the child know...

1. You are concerned about what is going on (describe what the child has revealed) and that it is important to get some help now. 2. What to expect once the decision to report is made (i.e., that parents will be called and the Emergency Response Unit in the Child Protective Agency will be notified, etc.). 3. Make no guarantees about what will happen

Child abuse

A physical injury inflicted by other than accidental means on a child by another person. -Includes emotional abuse, sexual abuse, neglect, abuse in out-of-home care

Assessing sexual abuse with a verbal child

Ask non-leading questions about touching and affection in the family but use discretion(!); detailed questions will usually be asked by CWS/CPS: -Do you like it when people hug you? Is hugging a good thing or bad thing? If it is a bad thing, what makes it bad? • Where do you sleep? Where do others in your house sleep? What happens when you go to sleep? • What happens when you take a bath? • Does anyone ever touch you in a way that makes you feel uncomfortable? Where do they touch you? Does it make you feel scared or sad?

Assessing physical abuse with a verbal child

Ask non-leading questions about what happens at home when people get angry, drink or take drugs: -What happens when you get in trouble? • Does anyone throw objects Who does this? • Does anyone ever get mad enough to hit someone else? • What do they hit with? Who do they hit? Does anyone ever get hit hard enough so that the blow causes bruises or bleeding? How often does this happen? Is it scary?

T/F - It is legally required to inform parents that a referral is being made

False - in some cases informing parents may be contraindicated

T/F - A mandated reporter can both determine whether there are grounds for reasonable suspicion and conduct an investigation of the report

False - only a child protective agency or county designee can conduct an investigation

Therapists, and other mandated reporters, investigate and collect evidence

False - the investigation is conducted by Child Protective Agencies

T/F - Mandated reporters can report suspected abuse anonymously

False - they are required to give their names, but child protective agencies are required to keep the mandated reporter's name confidential, unless a court orders the information disclosed.

Emotional abuse

Infliction of mental suffering or endangerment of emotional well-being

Reasonable suspicion

It is objectively reasonable for a person to entertain a suspicion, based upon facts that could cause a reasonable person in a like position, drawing, when appropriate, on his or her training and experience, to suspect child abuse or neglect."

Severe neglect

Negligent failure of a person having the care or custody of a child to protect the child from severe malnutrition or medically diagnosed non-organic failure to thrive. -Includes the intentional failure to provide adequate food, clothing, shelter, or medical care

Assessing neglect with a verbal child

Remember that homelessness does not necessarily mean neglect. • Do you have food in your house? What kind of food do you have? • Do you have a coat to wear?Does someone wash your clothes for you? • Do you have electricity?

Behavioral Indicators in the Child of abuse

There is no one single reaction that can clearly be associated with child abuse. -The presence of behavioral indicators does not prove abuse but suggests to look further

To whom do you report suspected abuse?

To a county welfare department or probation department or a police or sheriff's department, not including a school district police or security department.

T/F - If a mandated reporter confers with a superior about suspected abuse, and the superior disagrees and refuses to report, the individual with the original suspicion must report.

True

T/F - The best source of information is not what the child says, it is how the child behaves

True

T/F - Those persons legally mandated to report suspected child abuse have immunity from criminal or civil liability for reporting

True - No individual can be dismissed, disciplined or harassed for making a report of suspected child abuse.

T/F- Young kids are unlikely to fantasize or lie about abuse.

True - they are more likely to lie to protect an abusive parent

T/F - A person who fails to make a required report is guilty of a misdemeanor

True - they may also be found civilly liable for damages

When is child abuse reported?

When one who is a legally mandated reporter has knowledge of or observes a child in his or her professional capacity, or within the scope of his or her employment whom he or she knows or reasonably suspects has been the victim of child abuse or neglect

General neglect

negligent failure of a person having the care or custody of a child to provide adequate food, clothing, shelter, medical care, or supervision where no physical injury to the child has occurred

Physical indicators in the child of sexual abuse

• Bruising around genital area. • Swelling or discharge from vagina/penis. • Tearing around genital area, including rectum. • Visible lesions around mouth or genitals. • Complaint of lower abdominal pain. • Painful urination, defecation.

Behavioral Indicators in the Child of neglect

• Clingy or indiscriminate attachment. • Self imposed isolation. • Depression or passivity.

Physical indicators in the child of neglect

• Failure to thrive, a child's failure to gain weight at the expected rate for a normal child. A child who fails to thrive may have medical or psychosocial problems, or a combination of these. • Malnutrition or poorly balanced diet, ex. bloated stomach, extremely thin, dry, flaking skin, pale, fainting. • Inappropriate dress for weather. • Extremely offensive body odor. • Dirty, unkempt. • Unattended medical conditions e.g. infected minor burns, impetigo.

Behavioral Indicators in the Child of physical abuse

• Hostile or aggressive behavior toward others. • Extreme fear or withdrawn behavior around others. • Destructiveness, ex. breaks windows, sets fires • Verbal abusiveness. • Out-of-control behavior, ex. angry, panics, easily agitated.

Behavioral Indicators in the Child of emotional abuse

• Lacks self-esteem; puts self down constantly. • Seeks approval to an extreme. • Unable to be autonomous e.g., makes few choices, fears rejection. • Hostile, verbally abusive, provocative.

Behavioral Indicators in the Child of sexual abuse

• Sexualized behavior, ex. has precocious knowledge of explicit sexual behavior and engages self or others in overt or repetitive sexual behavior. • Hostility or aggression. • Fearfulness or withdrawn. • Self-destructiveness, ex. self-mutilates. • Pseudo-maturity, ex. seems mature beyond chronological age. • Eating disorders. • Alcoholism/drug abuse. • Running away. • Promiscuity.