Module 6

4 Forms of Sex Trafficking: Pimp Trafficking

- 3rd party who is "brokering" the exchanges of the sexual act for a tangible item, typically money - pimps can be any age, any gender, & come from all types of backgrounds

Pool Safety

- FL leads nation for children ages 1-4 who drown in pools - CADR recommendations: pool alarms; fences; locked gates; other protective barriers - many investigations revealed that the caregivers were distracted, using the Internet or other computer-related activities, and/or impaired by substance abuse - bath tubs are 2nd most common bodies of water to claim children by drowning & can occur w/ very little standing water

Is it Physical Abuse or Not? BRUISE - Is it a medical condition?

- Hemophilia - Leukemia - Idiopathic Thrombocytopenic Purpura - Mongolian spots - Maculae ceruleae - Salmon patches - Hemangiomas

4 Forms of Sex Trafficking: Familial Trafficking

- a family member is involved in the trafficking of the child - there may be an exchange for money, for drugs, for rent, etc.

Child Abuse Critical Indicators

- age of child - any prior history of injuries to child - location of injury on the child's body - multiplicity of the injury - type of trauma inflicted

CPT: Mandatory Referrals

- any STD in a prepubescent child - injuries to head, bruises to neck or head, burns, or fractures in a child of any age - bruises anywhere on a child 5 or younger - any report alleging sexual abuse of a child - reporting malnutrition or failure of a child to thrive - reported medical neglect of child - symptoms of serious emotional problems in a child when emotional or other abuse, abandonment, or neglect is suspected - a sibling or other child remaining in a home where 1 or more children have been pronounced dead on arrival or have been injured & later died as a result of suspected abuse, abandonment, or neglect

Most Life Threatening Physical Abuse

- any abuse resulting in head injuries - Battered Child Syndrome - internal injuries - burns - weapon injury - poisioning

"Sexual Abuse of a Child" (Florida Statutes) - means 1 or more of what acts

- any penetration, however slight, of the vagina or anal opening of 1 person by the penis of another person, w/ or w/o semen emission - any sexual contact b/w the genitals or anal openings of 1 person & the mouth or tongue of another - any intrusion by 1 person into the genitals or anal openings of another person, including the use of any object for this purpose, except that it doesn't include any act intended for a valid medical purpose - intentional touching of the genitals or intimate parts, including the breasts, genital area, groin, inner thighs, & buttocks, or the clothing covering them, of either the child or the perpetrator, except that this doesn't include any act which may reasonably construed to be a normal caregiver responsibility, any interaction w/, or affection for a child; or intended for a valid medical purpose - intentional masturbation of the perpetrator's genitals in the presence of a child - intentional exposure of the perpetrator's genitals in the presence of a child, or any other sexual act intentionally perpetrated in the presence of a child, if such exposure or sexual act is for the purpose of sexual arousal or gratification, aggression, degradation, or similar purposes - sexual exploitation of a child, which includes allowing, encouraging, or forcing a child to solicit for or engage in prostitution; engage in a sexual performance; participate in the trade of human trafficking

Abuse: Florida Statutes 39.01(2)

- any willful act or threatened act that results in any physical, mental, or sexual abuse injury or harm that causes or is likely to case the child's physical, mental, or emotional health to be significantly impaired - abuse of a child includes acts or omissions

Is it Physical Abuse or Not? BURNS - Is it a medical condition? Staph Scalded Skin Syndrome; Toxic Epidermal Necrolysis - Steps to Confirm

- ask about symptoms of fever, malaise, & sore threat - check for mouth & nose crusting - ask about onset of medical conition

Safe Sleeping: Characteristics of Safe Sleeping Environment

- baby sleeps alone - no secondhand smoke - no pillows, stuffed animals, toys, or bumper pads - if using a blanket, it must be tucked in & only as high as the baby's chest - no heavy or loose blankets - crib sheets fit tightly over mattress - on a firm mattress - in a safe, infant bed - not too hot - on his/her back - "feet to foot" (position the baby so his/her feet are near the foot of the crib)

Is it Physical Abuse or Not? HEAD INJURY - Is it non-intentional?

- birth trauma causing effusion, cephalohematoma, diffuse cerebral edema, infarction, cerebral contusions, post-traumatic hypoituitarism - insect bit on head

Is it Physical Abuse or Not? Fracture - Is it non-intentional?

- birthing trauma - little league elbow - nurse-maid elbow - fractures from passive exercises for therapeutic reasons

5 Sexual Abuse Phases: Disclosure

- can be accidental or initiated by 1 of the participants, & therefore, purposeful - how this happens & how others respond are critical to the impact on the child

What is NOT neglect?

- caused primarily by financial inability, unless actual services have been offered & rejected OR - the parent/legal guardian is legitimately practicing his/her religious beliefs under a recognized church or religious organization & thereby doesn't provide specific medical treatment for a child

Assessing Warning Signs to Determine if a Child is Unsafe

- certain family factors might influence the occurrence of maltreatment, while behaviors exhibited by parents may serve as a clue that abuse is already occurring - the effective & sufficient collection of info from the 6 domains (maltreatment, surrounding circumstances, child functioning, adult functioning, parenting general, parenting discipline), as well as the critical assessment & analysis of this info, enable the child welfare professional to determine if the child is unsafe

Is it Physical Abuse or Not? HEAD INJURY - Is it a medical condition? - Steps to Confirm

- check compatibility b/w the history & physical findings - consider child's developmental maturity

Is it Physical Abuse or Not? BURNS - Is it non-intentional? Falling into a hot bath - Steps to Confirm

- check for clear lines of demarcation; non-intentional burns have no clear line separating burned & unburned skin - check deepness of burn; non-intentional burns typically are not as deep as forced burns - check to see if perineum & feet are burned, but not the hands; it's impossible for a child to non-intentionally fall into a tub w/o hands going into water - check for doughnut hole, parallel lines, & flexion burns; these burns may be indicative of abuse - check for discrepancies b/w appearance of burns & history provided by caregiver

Is it Physical Abuse or Not? BRUISE - Is it non-intentional? Non-Intentional Falls - Steps to Confirm

- check for location of bruises; bruises on knees, shins, forehead, or elbows are often non-intentional - check for bruises on forehead; bruises to the forehead often drain through soft tissue to give appearance of black eyes 24-72 hours afterward, usually confirmed w/ history & when/if bruise is not tender - check to see if bruises are on a single surface or clustered; 1 bruise on a single surface is caused accidentally - correlate non-intentional accident w/ developmental age & motor skills of child - check for discrepancies b/w appearance of bruise & history provided by caregiver

Is it Physical Abuse or Not? BURNS - Is it a medical condition? Varicella (chickenpox) - Steps to Confirm

- check history - consult w/ physician

Is it Physical Abuse or Not? EAR INJURY - Is it non-intentional? - Steps to Confirm

- check if laceration is of the ear canal; this injury can occur only by inserting a pointed objected into the ear - check for discrepancies b/w the type of or appearance of injury & history provided by caregiver

Is it Physical Abuse or Not? BURNS - Is it a medical condition? Coming into contact w/ a burning object - Steps to Confirm

- check location of burn; some areas of the body are clearly more difficult for a child to self-inflict burn - check pattern of burn; an irregular burn will be left when a young child moves away from a burning object reflexively - check deepness of burn; non-intentional burns are usually deep on 1 edge of burn - check margins of burn; non-intentional burns usually don't have crisp overall margins - check for discrepancies b/w appearance of burns & history provided by caregiver

Is it Physical Abuse or Not? BURNS - Is it a medical condition? - brushing against a cigarette - Steps to Confirm

- check location of burns; often non-intentional if found on child's face, arms, or trunk - check shape of burn; usually non-intentional if burn is more elongated than round, w/ a higher degree of intensity on 1 side - check for discrepancies b/w appearance of burn & history provided by caregiver

Is it Physical Abuse or Not? Burns - Is it non-intentional? - spilling of a hot liquid - Steps to Confirm

- check location of splash burns; non-intentional burns are most likely to occur on front of head, neck, trunk, & arms; it's usually possible to estimate the direction from which the liquid came & the position of the body - check for discrepancies b/w appearance of burn & history provided by caregiver

Is it Physical Abuse or Not? HEAD INJURY - Is it non-intentional? - Steps to Confirm

- check onset of injury; injuries from birth traumas should become apparent shortly after birth - check for discrepancies b/w the appearance of the injury & history provided by caregiver; subdural hematomas found in an infant or toddler w/o adequate explanation of trauma may be indicative of abuse

Is it Physical Abuse or Not? BITE MARKS - Is it non-intentional - Steps to Confirm

- check to see if flesh is torn or just compressed; torn flesh is commonly from a dog bite & compressed flesh is commonly from a human bite - measure distance b/w center of the canine teeth, typically the 3rd tooth on each side; it it's greater than 3 cm, bite is most likely from an adult - check for discrepancies b/w appearance of injury & history provided by caregiver

Is it Physical Abuse or Not? NASAL INJURY - Is it non-intentional? - Steps to Confirm

- check to see if foreign bodies are found in more than 1 site; if only found in nose, this is common in the developing child - check for discrepancies b/w appearance of injury & history provided by caregiver

Is it Physical Abuse or Not? HAIR LOSS - Is it a medical condition? - Steps to Confirm

- check to see if loss of hair is in a localized spot - varying bald spots may be indicative of abuse - localized spot is usually on back of head - a child will be at least 3-years-old for this condition to occur - check for scaly skin - fungal culture of scalp by physician - check history

Is it Physical Abuse or Not? EYE INJURY - Is it non-intentional?

- chemical burns - non-intentional foreign body to eye

Factors that Impact Neglect of a Child

- child's age - length of time neglected - frequency - child's relationship w/ caretaker - availability of support - child's personality

Is it Physical Abuse or Not? - Fracture: Is it a medical condition?

- congenital syphilis - infantile cortical hyperostosis (Caffey disease) - Leukemia - Menkes kinky hair disease - Osteogenesis imperfecta - Osteomyelitis - Rickets - Scurvy

Is it Physical Abuse or Not? Fracture - Is it non-intentional? - Steps to Confirm:

- consult w/ physician to decide cause of fracture - check for discrepancies b/w the fracture & the history provided by caregiver

Child Fatality Prevention Website

- created to raise awareness about child fatalities throughout the state - assists communities w/ identifying where additional resources or efforts are needed to help struggling families - includes info regarding all child fatalities called into the Hotline alleged to be the result of abuse or neglect - data can be sorted by county, child's age, casual factors, & prior involvement - prior involvement indicates that the deceased child or the family of the deceased child had contact w/ FL's child welfare system - cases listed as verified indicate that enough evidence exists to determine that the child's death was caused by abuse, abandonment, or neglect - includes info about DCF's prevention campaigns relating to the leading causes of child fatality in FL: unsafe sleep, drowning, inflicted trauma

High Temperatures & Hot Cars

- criminal offense to leave a child unattended in a vehicle

Sections of the Child Maltreatment Index

- definition - examples of maltreatment - factors to consider in assessment of maltreatment - assessing for frequently associated maltreatments - excluding factors - information necessary to support verified finding

According to Section 383.402, FL Statutes, the purpose of the child abuse review process is to

- develop a community-based approach to address child abuse deaths & contributing factors - achieve a greater understanding of the causes & contributing factors of deaths resulting from child abuse or neglect - identify gaps, deficiencies or problems in the delivery of services by public & private agencies to children & their families; the services may be related to child abuse deaths - develop & implement data-driven recommendations for reducing child abuse & neglect deaths

Behavioral & Emotional Effects of Neglect

- developmental delays - unresponsiveness - hunger/fatigue - out-of-control behavior - school failure - physical signs of stress & anxiety - aggression - school-age child shows many of the same characteristics as pre-school child - child assumes the "adult" role in his/her relationship w/ parent - difficulty in relating - chronic anxiety - fear of parents

Florida Child Abuse Death Review Committee

- established by statute in 1999 - administered by the FL Department of Health - utilizes state & locally developed multidisciplinary committees to conduct detailed reviews of the facts & circumstances surrounding child abuse & neglect deaths

Common Effects of Child Neglect: Toddlers

- extremely w/drawn & passive - engage in random, undisciplined activity - impaired brain, motor, & physical development - deficits in coping skills: displays frustration, anger, & noncompliance - attention/affection need sought indiscriminately from adults - malnutrition, significant health problems

Common Effects of Child Neglect: Infants

- failure to thrive - lack of attachment to mother - impaired brain, motor, & physical development - malnutrition, significant health problems - development of anxious, insecure attachments in other relationships - insecurity limits ability to explore environment - development of feelings of incompetence

Is it Physical Abuse or Not? BRUISE - Is it a medical condition? - Steps to Confirm

- have medical tests done to check bleeding function: prothrombin time, partial prothrombin time, bleeding time, platelet count, & complete blood count - have histopathologic exam by physician - find out if spots were present at birth - check history; 90% of skin medical conditions are detected w/in 1st month of life

Maltreatment Index & Physical Abuse

- hotline counselor's responsibility: to gain as much descriptive evidence of what the reporter has seen or heard in order to make a determination of whether maltreatment has or is likely to occur is warranted - CPI's responsibility: to make a true determination of whether or not maltreatment has occurred

Sex Trafficking

- if the victim is under the age of 18, there is a process + goal - a finding of human trafficking doesn't require a ways or means - process: recruitment or transportation or transferring or harboring or receiving - goal: prostitution or porn or violence/sexual exploitation or forced labor or involuntary servitude or debt bondage (w/ unfair wages) or slavery/similar practices

5 Sexual Abuse Phases: Supporession

- in most cases, there's a period of suppression following disclosure - family may try to suppress publicity, info, & intervention - perpetrator may exploit power position & pressure the child & family

Indicators of Sexual Abuse: Physical Indicators - Bladder or Urinary Tract Infection (UTI)

- includes pain when urinating, blood & pus in urine, & high frequency urination - can be common in sexually active women - uncommon in children, unless the child has a physical abnormality of the urinary system, such as children w/ spina bifida who have chronic UTIs as a result of neurological dysfunction - any UTI in a child must be medically evaluated for the possibility of sexual abuse

Child Maltreatment Index

- incorporates the mandates of state law, administrative rules, operating procedures, & recognized best practices, allowing each specific type of abuse & neglect to be clearly defined & assessed consistently throughout the state - objective: improve the consistency & accuracy of findings made by child welfare professionals when dealing w/ similar allegations of harm or threatened harm

Indicators of Sexual Abuse:

- indicators vary in child of different ages - sexual abuse includes a wide range of behaviors & activities, some of which have no physical signs: kissing, fondling, genital exposure, observation of adult sexual activity by a child

5 Sexual Abuse Phases: Engagement

- initial stage when child is "groomed" by the abuser - the abuser: (1) is usually in child's family (2) has power & authority over child (3) has opportunity

Indicators of Sexual Abuse: Physical Indicators - Physical Injury to the Genitals

- injuries include bruising, cuts or lacerations, bite marks, stretch rectum or vagina, fissures in rectum, or swelling & redness of genital tissues - these injuries may have been caused by penetration of the vagina or rectum w/ fingers, an adult penis, or other objects - injuries to genitals in older infants & toddlers may be the result of physical punishment for toileting accidents

Is it Physical Abuse or Not? NASAL INJURY - Is it non-intentional?

- injury from inserting foreign bodies into nose

Common Effects of Child Neglect: Kindergarten/School-Aged Children

- lack of attachment - significant health problems - delayed or impaired speech - developmental delays - violent acts - severely w/drawn - inability to concentrate - serious learning deficits & delays - low self-esteem - curiosity blunted, almost non-existent

Long-Term Impacts of Physical Abuse

- long-term physical disabilities - disordered interpersonal relationships - predisposition to emotional disturbance - feelings of low self-esteem - depression - increased potential for child abuse as a parent - drug or alcohol abuse

Common Effects of Child Neglect: Adolescents

- low self-esteem - poor school attendance - work & learn below avg levels - high risk for delinquent behavior - high risk for "ungovernable" behavior

Services Provided by CPT

- medical diagnosis & evaluation - nursing assessments - child & family assessments - multidisciplinary staffing's - psychological & psychiatric evaluations - specialized & forensic interviews - expert court testimony

Failure to Thrive

- medical term used to diagnose infants who are underweight & malnourished - doctors compare the infant's weight & height to a chart of standard height/weight measurements for infants - weight or height is below the 5th percentile of the population on a standard height/weight curve - actual weight is 20% or more below the ideal weight for the height - weight gain is significantly slower than normal - triceps skin-fold thickness (total body fat measurement) is below 15th percentile for the population - children at risk often come from families in which the mother experienced maltreatment - caregivers of FTT infants tended to: blame their babies for not gaining weight; interpreted the meaning of their babies' crying in negative ways; had difficulty bonding w/ their infants b/c they prioritized their own needs - can occur due to organic or non-organic reasons

Child Protection Team

- medically directed, multidisciplinary program that works w/ local Sheriff's offices & DCF in cases of child abuse & neglect to supplement investigation activities - provide expertise in evaluating alleged child abuse & neglect, assessing risk & protective factors, & providing recommendations for interventions to protect children & enhance a caregiver's capacity to provide a safer environment when possible

Indicators of Sexual Abuse: Physical Indicators - Painful Bowel Movements or Retention of Feces

- might indicate that the rectum has been penetrated - chronic constipation may also cause painful bowel movements & retention of feces by a child

4 Forms of Sex Trafficking: Renegade/Survival Sex

- no 3rd party; no pimp - victim may "broker" exchanges for a sexual act independently - there may be an exchange of a sexual act for money, food, housing, clothing, etc.

5 Sexual Abuse Phases: Sexual Interactions

- over time, abuser will engage the child in sexual activity - it'll likely begin w/ a behavior such as inappropriate touching & progress to a more serious behavior, such as intercourse

Short-Term Impacts of Physical Abuse

- pain & other problems stemming from the actual physical harm - emotional & behavioral problems can arise quickly, including anger, hostility, fear, anxiety, humiliation, aggression toward others, self-destructive behavior, hyperactivity, & other manifestations in child

Maltreatment

- parenting behavior that's harmful & destructive to a child's cognitive, social, emotional, and/or physical development - the resulting harm that occurs as the result of harmful parenting behavior

Crisis/Situational Neglect

- parents fundamentally able to cope but temporarily overwhelmed - major crisis, or series of crises - history of adequate child care - regular employment - sufficient income & skills - emotional support from friends & relatives - avg problem-solving abilities - generally good physical health, minimal use of illegal substances, & essentially no illegal activity - intimacy is non-sexualized - understanding & acceptance of their respective roles - adequate education & housing that allow for individual space & organization of belongings - generally good mental health - likely to be cooperative w/ genuinely supportive child protection personnel - likely to regain ability to solve problems themselves when crisis has passed

Chronic Neglect

- parents w/ continual & serious child-rearing difficulties - constantly in stressful situation or crisis - little parenting knowledge - limited education/vocational opportunities & skills - generational poverty - extreme social isolation - little support from relatives or friends - poor problem-solving skills; blame others - ill health, substance abuse, drug-dealing, legal problems, physical/developmental disability - overcrowded or run-down housing - prostitution - abuse b/w adults - untreated mental illness - parental history involves neglect as a child - distrustful of professional helpers - new crises constantly arise even as old crises are resolved

Is it Physical Abuse or Not? - Fracture: Is it a medical condition? - Steps to Confirm

- physician can use radiology to decide if fracture exists & also to gain insight into how it was produced - request pediatric radiologist if possible - it's critical to tell radiologist that child abuse is suspected - X-ray is fine for screening - bone scan can be used to reveal old, healed fractures caused by suspected abuse

Indicators of Sexual Abuse: Physical Indicators - Sexually Transmitted Diseases (STDs)

- presence of STDs strongly suggests sexual exposure - Yeast Infection: presence in a female child or adolescent may not necessarily be the result of sexual abuse; may occur from taken systemic antibiotics, or from excessive douching; in a preadolescent child it warrants a medical exam & further investigation

5 Sexual Abuse Phases: Secrecy

- primary task for the abuser is to ensure the child keeps the activity secret - essential & enables repetition - encouraged w/ rewards - enforced w/ threats - this phase often lasts months or years

Safe Sleeping: Factors related to infant sleeping positions & sleeping environments that increase the risk of infant death from asphyxia due to suffocation or overlay

- prone sleeping positions - bed-sharing - soft bedding

What are the 4 forms of sex trafficking?

- renegade/survival sex - pimp trafficking - familial trafficking - gang trafficking

Sexual Battery

- sexual conduct involving the oral, anal, or vaginal penetration by, or union w/, the sexual organ of a child - the forcing or allowing a child to perform oral, anal, or vaginal penetration on another person - the anal or vaginal penetration of another person by an object: this includes digital penetration, oral sex, coitus, & copopulation

Sexual Abuse

- sexual conduct w/ a child for arousal or gratification of the sexual needs or desires of the caregiver(s) - form of maltreatment includes allegations of sexual abuse & the threat of harm by sexual abuse

What are the 3 forms of sexual abuse?

- sexual molestation - sexual battery - sexual exploitation

Sexual Exploitation

- sexual use of a child for sexual arousal, gratification, advantage, or profit - includes, but is not limited to: (1) indecent solicitation of a child or explicit verbal enticement (2) allowing a child to participate in porn (3) exposing sexual organs to a child for the purpose of sexual arousal or gratification, aggression, degradation, or similar purposes (4) intentionally perpetrating a sexual act in the presence of a child for the purpose of sexual arousal, gratification, aggression, degradation, or similar purposes (5) intentional masturbation of the caregiver's genitals in the child's presence

Child Abuse Death Review (CADR)

- statewide multidisciplinary, multiagency child abuse death assessment & prevention system that consists of state & local review committees

Is it Physical Abuse or Not? EYE INJURY - Is it a medical condition?

- sub-conjuctival hemorrhaging during birth - allergy conditions

Is it Physical Abuse or Not? EYE INJURY - Is it a medical condition? - Steps to Confirm

- sub-conjuctival hemorrhaging during birth usually disappears by 1 month - check history

Most Life Threatening Physical Abuse: Head Injuries

- subdural hematomas - abusive head trauma: serious, often fatal injuries caused by violent shaking of a very young child; shaken infants don't often show visible signs of external trauma; generally seen in children ages 2 or younger, most common in children less than 6 months old

Most Life Threatening Physical Abuse: Head Injuries - Abusive Head Trauma: 3 main signs

- subdural hematomas - retinal hemorrhage - metaphyseal lesions

Is it Physical Abuse or Not? BURNS - Is it a medical condition? Impetigo; Insect Bites - Steps to Confirm

- suspicious blisters are generally cultured by a physician to test for streptococcal infections that may be found w/ impetigo & treated w/ antibiotics

What 2 situations quality for Threatened Harm?

- the preventable death of 1 child provides reason to suspect that another child is at risk - the caregiver's children are currently in out-of-home care or parental rights have been terminated

Labor Trafficking

- there is a process + a way or means + a goal to support a finding of human trafficking - process: recruitment or transportation or transferring or harboring or receiving - way/means: threat or coercion or abduction or fraud or deceit or deception or abuse of power - goal: prostitution or porn or violence/sexual exploitation or forced labor or involuntary servitude or debt bondage (w/ unfair wages) or slavery/similar practices

4 Forms of Sex Trafficking: Gang Trafficking

- trafficking is a source of generating money for the gang, & the gang member is involved in the trafficking of the victim - might be a local, state, or transnational gang - gang: an association of 3 or more individuals whose purpose, in part, is to engage in criminal activity

Training Services Provided by CPT

- training for child protection investigators & other community providers of child welfare services - training for ER staff & other medical providers in the community

Is it Physical Abuse or Not? HAIR LOSS - Is it a medical condition?

- trichotillomania - tinea capitis - idiopathic of unknown cause - nutritional deficiencies

Indicators of Sexual Abuse: Physical Indicators

- when a child has been physically injured in sexual activity, there may be physical indicators or injury; these may be validated through a medical exam by a physician trained in sexual abuse - depending upon how recent & how extensive the sexual activity, there may be no clear physical evidence - physical injury to genitals - STDs - suspicious stains, blood, or semen on child's underwear, clothing, or body - bladder or UTI - painful bowel movements or retention of feces - early, unexplained pregnancy

5 Sexual Abuse Phases

1. Engagement 2. Sexual Interactions 3. Secrecy 4. Disclosure 5. Suppression

Threatened Harm

a behavior that isn't accidental & which is likely to result in harm to the child

Abandonment

a situation in which the parent(s) or legal custodian(s) of a child or, in the absence of a parent or legal custodian, the caregiver(s), while being able, makes no provision for the child's support & has failed to establish or maintain a substantial & positive relationship w/ the child

Is it Physical Abuse or Not? EYE INJURY - Is it non-intentional? - Steps to Confirm

check for discrepancies b/w appearance of injury & history provided by caregiver

Is it Physical Abuse or Not? HEAD INJURY - Is it a medical condition?

infectious meningitis

Is it Physical Abuse or Not? EAR INJURY - Is it non-intentional?

injury from inserting cotton swab

Is it Physical Abuse or Not? BRUISE - Is it non-intentional?

non-intentional falls

grooming

offender sets a kid up to be sexually abused

Indicators of Sexual Abuse: Physical Indicators - Early, Unexplained Pregnancy

particularly in a child whose history & behavior doesn't suggest sexual activity w/ peers

Indicators of Sexual Abuse: Physical Indicators - Suspicious Stains, Blood, or Semen on the Child's Underwear, Clothing, or Body

presence of blood or semen strongly suggests sexual exposure & all evidence must be collected by law enforcement

Non-Organic Failure to Thrive

results from action or non-action on the part of the caregiver

Organic Failure to Thrive:

results from congenital or genetic causes

Sexual Molestation

sexual conduct w/ a child when contact, touching, or interaction is used for arousal or gratification of the sexual needs or desires of the caregiver(s), including but not limited to: - the intentional touching of the genitals or intimate body parts, including the breasts, genital area, groin, inner thighs, penis, & buttocks, or the clothing covering them - encouraging, forcing, or permitting the child to inappropriately touch the same parts of the caregiver(s) body

Danger Threats

specific family situations or behaviors, emotions, motives, perceptions, or capacities of a family member that are out-of-control, imminent, & likely to have severe effects on a vulnerable child

Neglect: - What can the court do?

the court can order that services be provided when the health of the child requires: - medical services from a licensed physician, dentist, optometrist, podiatrist, or other qualified health care provider - treatment by an accredited practitioner who relies solely on spiritual means for healing under the tenants & practices of a well-organized church or religious organization

Human Trafficking

transporting, soliciting, recruiting, harboring, providing, enticing, maintaining, or obtaining another person for the purpose of exploitation of that person