01 Child Abuse

The definition of "reasonable suspicion"

"that 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" - if a mandated reporter has reasonable suspicion that child abuse has occurred, a suspected child abuse report must be completed

What are the long-term consequences of babies who survive shaken baby syndrome?

- developmental delay and mental retardation - vision problems (damaged occipital lobes)

The mortality rate is highest for children of what age due to abuse?

0-2 years

Which agencies are involved with reports of household child abuse?

1. Child Protective Agencies (county welfare or probation department, police or sheriff's department) investigate the referral 2. Law enforcement

The types of abuse that must be reported

1. physical injury 2. child sexual abuse 3. willful cruelty or unjustified punishment 4. unlawful corporal punishment or injury 5. neglect (#1 leading allegation) mental suffering is not required to be reported by law

Under what age are two minors allowed to have sex?

14 (if one is older than 14, then it is illegal)

T/F it is likely that children less than 6 months will bruise by accident

False (less than 1% rate) - if you don't cruise, you don't bruise

What is the fine line between physical abuse and discipline?

If the discipline is excessive or forceful enough to leave injuries. Some injuries may not be easily visible (buttocks, thighs, back), but reports must still be made if you have reasonable suspicion

Are cases of domestic violence with children in the home reportable as child abuse?

It depends. It could be reported as emotional abuse, or can be reported as child abuse when it is suspected that the child is in immediate and present danger of abuse in that situation. Domestic violence abuse almost always manifests into child abuse down the line.

Is the goal to take the child away from the abusive home or to keep the family together?

Keep the family together unless removing the child is the only way to keep the child safe

Can anonymous reports be given by mandated reporters?

No

Questions that are helpful in assessing for a) physical abuse b) sexual abuse c) neglect

Pg. 11-12 in child abuse law (15-17 on notability) ...as non-leading questions... a) ask what happens at home when people get angry, drink, or take drugs b) ask about touching and affection in the family c) ask if basic needs are met (remember that homelessness not not necessarily mean neglect)

Clues indicating possible abuse a) environmental b) parental c) physical exam d) behavioral

Pg. 7-9 in child abuse law (12-14 on notability)

What type of fractures are hallmarks for abuse in children less than one year old?

Rib fractures

Diagnose this baby - brain injury - subdural hematoma (venous - crescent moon) - retinal hemorrhage (bilateral) - however, no signs of external injury

Shaken baby syndrome

What is Munchausen syndrome by proxy? What are the red flags?

The mother of a child will purposefully induce an illness on her child to satisfy her need for attention - unusual presentation - keeps recurring - not responding to treatment

T/F most people who abuse their children can be successfully treated

True

T/F it is not required by law to tell the parent that a report is being made

True (but if it is safe to do so, telling them is therapeutically advisable)

Is suspected abuse of disabled children reportable as child abuse?

Yes. any suspected cild abuse or neglect should be reported, and children with disabilities are more likely to be victims of maltreatment than non-disabled children.

a) what percent of children in San Bernardino County under the age of 18 are referred to Child Protective services? b) what percentage of those cases are related to drug use?

a) 10% b) 80%

Are these associated with abuse or accident? a) hands, elbows, knees b) buttocks, back, genitals, inner thighs, ears, mouth, neck

a) accident b) abuse

If you suspect a child is in immediate risk for harm, what do you do?

a) admit the child for further evaluation to in actuality provide protection and observation b) call the police or hospital security

Neglect a) severe b) general

a) failure to protect the child from severe malnutrition or medically diagnosed nonorganic failure to thrive b) failure to provide adequate food, clothing, shelter, medical care, or supervision where no physical injury to the child has occurred

When are children most likely to be abused?

a) first year of life (parents react to constant crying) b) two years old (potty training)

Bruising pattern of a) abuse b) accident

a) neck up b) knees down

What should you do if you see suspicious looking bruises on a child?

admit them for an x-ray (fractures) and a CT scan (head trauma)

How should you begin to ask a parent about possible child abuse? If you decide to report what should you say?

begin: "have you ever thought that someone may be hurting your child?" report: "I am only doing this based on suspicious and I am required by law to report it"

What is the #1 cause of trauma death for children under the age of 4?

child abuse

What is the leading Child Protective Services allegation?

general neglect

What age is most likely to sustain serious injuries (infants, toddlers, adolescents)

infants and toddlers

Legal consequences for failing to report

misdemeanor punishable by up to 6 months in jail and/or up to $1000 fine, or both may be found civilly liable for damages, especially if the child or another child is further victimized because of the failure to report

Begin inquiring about suspected abuse by making a statement about what you saw, heard, or believe that makes you suspect abuse or neglect. Then follow with "as a mandated reporter, I am required by law to report any reasonable suspicion of child abuse or neglect". What tone of voice should this conversation be in?

non-judemental

Reasons why professionals hesitate to report, and arguments that counter these reasons a) denial b) rationalizing c) betrayal d) family break up

pg. 16 in child abuse law (21 in notability) a) need to accept that abuse happens in any family setting in order to be able to stop it b) don't accept unrealistic explanations of how an injury occurred; if in doubt continue the assessment c) it will protect the child and parent in the long run, but don't try to convince the parent that they are being helped since that is difficult to see in the initial stages. Approach abuse as a matter-of-fact mandatory duty to help prevent destruction of the therapeutic relationship d) in reality, the goal is to keep the family intact by providing services and thus relatively few of the child abuse reports lead to a removal of the child from their home

What is the state law for reporting child abuse?

requires reporting all cases of reasonably suspected abuse

what is the primary cause of death due to physical abuse in children less than 1 year old?

shaken baby syndrome (peak incidence being at 6 months of age)

What if an adult states that they were abused as a child?

the reporting law only mandates a report when minors are in need of protection, so report if there is a reasonable suspicion that there may be another potential child victim

To whom reports are made

to a county welfare department or probation department (if designated by the country to receive mandated reports) or a police or sheriff's department, NOT including a school district police or security department

Are the professionals required to testify in court?

yes