Let's take a moment to talk about a very serious
topic called child abuse and neglect, a subject
none of us really want to talk about, but
is vitally important, especially if you work
in an industry where you might be mandated
to report such abuse or neglect. First though,
let's cover a little bit of background about
this subject. According to the statistics
covered by the United States Department of
Health and Human Services, Administration
for Children & Families, an estimated 679,000
children were victims of abuse and neglect
and of those, over 1,500 children died from
abuse and neglect just in 2013. Of these children,
80% suffered from neglect; 18% suffered a
physical form of abuse; and 9% were victims
of sexual abuse. As you can clearly see, this
is a problem that is serious and far too common.
My hope is that this training will give you
the knowledge to recognize true abuse and
neglect, and help you protect the innocent.
Now, depending on your state laws, you may
have a legal requirement to report suspected
abuse as a person called a “mandated reporter.”
A mandated reporter is a person who is legally
required to ensure a report is made to the
proper authorities when abuse is observed
or suspected. Specific details vary across
states and jurisdictions so make sure you
know your particular details. Abuse that must
be reported typically includes that which
can be categorized as neglect, physical, or
sexual in nature. Mandated reporters may be
paid staff or volunteers, but who have assumed
full or even limited responsibility for the
care of a child. This often includes: teachers,
daycare providers, EMS personnel, coaches,
camp staff, and other professionals. Unfortunately,
abuse can occur anywhere, some examples include:
childcare centers, schools, religious institutions,
recreational and athletic programs, camps,
residential facilities and even at home. The
most predominant type of abuse is neglect.
Neglect is something that means, “despite
available resources, the parent or legal caregiver
fails to provide adequate food, clothing,
shelter, and supervision and may not seek
appropriate medical attention for illness
or injury. This can happen for a number of
reasons, but may specifically may include
a family crisis, or a job loss, a serious
illness to a caregiver. A divorce or separation
of parents may cause a chaotic household with
no structure or routines, or the home may
seem to have little space for the child. Indicators
of neglect may include: a child who looks
undernourished and hungry. These children
might be beggars for food because of this
persistent hunger. The child may be lethargic,
like they’re not getting enough sleep due
to disrupted schedules. -They have noticeably
poor hygiene. Maybe they're inappropriately
dressed for the weather. The child may have
injuries that can be attributed to a lack
of supervision, including those associated
from being harmed by other people. The trigger
that makes them suspect of abuse is that they
say they have frequent “accidents and injuries”.
Along with these injuries, they have a poor
ability to relate to others and have poor
self-esteem. Maybe they have attachment difficulties
or other social problems like the inability
to say no to inappropriate requests. These
are all different ways we can suspect neglect
and recognize that there may be a problem.
Unlike neglect, physical abuse is any act
that, regardless of intent, results in a non-accidental,
physical injury to a child. It can happen
as a result of a parent becoming frustrated
or angry and strikes, shakes or even throws
a child. Physical abuse may be an intentional,
deliberate assault, such as burning, biting
or cutting, the child. It’s vital to remember
that all children get bumps, bruises and cuts,
but it's important to recognize when those
bumps and bruises may be the indication that
there's physical abuse rather than just normal,
childhood accidents. In all cases, consider
the context. Take into account the child's
explanation of the injury, the child's age
and overall behavior that you notice in the
child. The following is a closer look at specific
signs of physical abuse. Questionable bruises
and welts or other injuries on the face, around
the lips and mouth. Cuts and bruises on the
torso, back, buttocks and thighs, in various
stages of healing. In other words, the bruises
might be different colors like some red and
purple while others are yellowish green. The
bruises reflect the shape of the object used
to inflict the injury, like an electric cord
or belt buckle. Look for questionable burns,
like cigarette burns, especially on the soles
of the feet, palms of the hands, the back
or even the buttocks of the children. You
may see signs of something we call immersion
burns. This can be “socklike” burns where
we've seen they've put the baby or child into
hot water. Donut shaped burns on the buttocks
or genitalia or burn patterns that are like
electric stove burners, where they're round
and circular or look like the surface of an
iron. Rope burns on arms and legs, neck or
torso. Look for fractures to the skull, nose,
face, and black eyes in various stages of
healing. These all could indicate signs of
physical abuse. Now let’s look at behavioral
indicators. Some behavioral indications might
be that the child is uncomfortable with physical
contact, being weary of adults and being apprehensive
when other children cry. They may show emotional
extremes like being overly aggressive or extremely
withdrawn. In some cases the child may be
frightened of the parents and afraid to go
home. They may arrive to school very early
or stay very late, again, possible indicators
that the child is avoiding the need to go
home. Look for a track record where the child
has made repetitive attempts to run away from
home. Be alert to reports that the child is
being hurt by a parent or someone at home
or in their community and maybe complaining
of body or limb soreness or moving uncomfortably.
Maybe the child is wearing clothing inappropriate
to the weather, like big loose or bulky shirts
and pants in order to cover the body or wounds.
Additionally they may be reluctant to change
clothes in public or for gym activities. This
again being an attempt to hide injuries or
bruises as a result of abuse. So, how do you
tell the difference between normal discipline
and abuse? It's important that there be some
objective guidelines between corporal punishment
and abuse. Corporal punishment, which is allowed
in some areas of the United States, such as
spanking, may be used as a discipline technique
by parents or guardians to teach appropriate
behavior. Discipline is a learning process;
the goal is to teach appropriate behavior.
Abuse is not a learning process, where the
goal is not to stop inappropriate behavior
but to inflict pain and is usually the result
of anger, loss of control and frustration.
There’s a difference between accidents and
purposeful injury. But how does one tell the
difference between abuse and accidental injury?
Well, abuse and accidental injury can look
similar but there are important differences.
Cuts and bruises caused by accidents normally
occur in outside areas of the body, like the
elbows and the knees. Accidental injuries
to soft tissue areas like the stomach and
the buttocks are less likely. If the same
type of injury happens frequently it's less
likely to be an accident unless it’s in
a location that is socially acceptable for
the appropriate age and activity level of
the child. If multiple injuries are present,
especially in different stages of healing,
it's less likely to be an accident unless
the child is in a full contact sport. If a
series of injuries appear in a pattern or
resemble an object like an electrical cord
or wooden spoon, it’s very suspicious and
may have been inflicted by abuse. If a child's
caregiver gives an explanation for injuries
that is inconsistent with the facts, then
the injury may be suspect. Here's an example.
Steve, a ten year old boy, arrived at school
with a bruise on his elbow and a scrape on
his knee. So, you ask him what happened and
Steve says, "I got hurt riding my bike when
I hit a curb. I fell on the road." He says
his father gave him a spanking because he
told him not to ride on the road. Steve's
father stated the same thing when he picked
Steve up from school, and Steve was glad to
see his father. In this situation, abuse would
not be suspected. Steve's injuries are consistent
with his explanation. His father's explanation
was the same, and his injuries are on the
outer, boney areas of the body, not the soft
inner tissues. Steve behaved normally with
his father and had no bruises or injuries
from the corporal punishment, again, indicating
that this was probably not abuse. Now, here's
a second example. You notice that Susie, a
nine year old, is trying to hide from the
other girls in the locker room when she changes
into her gym t-shirt. You notice that she
has bruises on her upper arms and back as
well as strap welts and bruises on her lower
back in various stages of healing. When you
question her about it, she says, "Well, I
fell down the stairs." She's very afraid that
you might ask her mother about it. In this
situation, you should suspect abuse. Susie's
secrecy, her fear of her mother being called,
the bruises on her upper arms andback, the
specific injury pattern, and the evidence
of the various stages of healing are all multiple
indicators of possible abuse. Remember, reporting
suspected abuse is helping to protect those
who are being abused. Now let's talk about
sexual abuse. It's a complex type of abuse
with significant implications for the child
victim. Often there are no physical signs
or behavioral indicators that can be seen
or are subtle and attributed to other things
The adult abuser usually tries to manipulate
them into silence, "This is our little secret."
With real or implied threats. This type of
manipulation is far beyond the child's ability
to understand. This is emotionally confusing
to the child and will often create a wide
range of emotional responses. Sexual abuse
can be defined as any illegal sexual act upon
a child. This includes incest, rape, indecent
exposure, fondling, child prostitution, and
child pornography. Indicators of child sexual
abuse include inappropriate knowledge of sex
or sex behaviors, sexually explicit drawings
or highly sexualized play, expressions of
unexplained fear of a person or place, avoiding
or attempting to avoid a familiar adult, nightmares,
sleep interruptions, withdrawal, guilt- like
feelings like "It's my fault." They may also
indicate shame. They may have serious depression
or maybe depression in general, anxiety, or
mood swings. One the strongest indicators
of sexual abuse is when a child says that
he or she has been sexually abused. Take the
statement serious. Resolve doubt in favor
of the child and error on the side of protection.
If it's not truly abuse, a good justice will
find that out. So how should you respond to
the abuse? Abusers often tell children that
bad things will happen if they tell others
about it or that it's a secret that is not
to be shared. Because of this fear, children
are more likely to share information in an
indirect way, hoping that you'll figure it
out and figure out what they're trying to
tell you. There are different forms of disclosure.
Indirect disclosure might sound like this,
"My babysitter keeps bothering me." Disguised
disclosure might sound like this, "What would
happen if a girl was being touched in a bad
way and she told someone about it?" Disclosure
with strings might be something like, "I have
a problem but if I tell you about it, you
have to promise not to tell." If a child wants
to tell you something, listen to them and
remain calm. Encourage the child to tell you
what happened but do not press for details
beyond that which the child is willing to
provide. It’s important not to promise you
won't tell anyone else. Let the child know
that you may need to tell a person who can
help them. Remember, you are not responsible
to prove that the abuse or neglect occurred.
Just that you have a suspicion that a child
is being abused or neglected. If you have
reason to suspect abuse has occurred then
report the situation to a local child protective
service office. And if you're a mandated reporter,
you have a legal responsibility to report.
There may be a policy that governs who actually
makes a report to child protective services
when abuse is suspected. It is important that
you know your reporting policies and procedures.
Don't shirk your responsibilities and please
don't overestimate the strength and power
of a healthy relationship that is simply good
discipline and training. It's going to take
discernment and wisdom on your part, but when
you do suspect true abuse because of multiple
indicators, you're acting on the part of a
true rescuer for a child who may be in serious
danger.
