Child Abuse

1. Child Abuse Howell County Health Department

2. Child abuse….by the numbers • Each year in the United States, hotline reports are filed on more than 6 million children. • On average, between four and seven children die every day from abuse and neglect. • More than 90% of juvenile sexual abuse victims know their perpetrator in some way • Child abuse occurs at every socioeconomic level, across ethnic and cultural lines, within all religions and at all levels of education. Hollywood star Judith Barsi • About 30% of abused and neglected children will later abuse their own children, continuing the horrible cycle of abuse.  • About 80% of 21 year olds that were abused as children meet criteria for at least one psychological disorder. • Children who experience child abuse & neglect are about 9 times more likely to become involved in criminal activity.

3. By the numbers…cont’d • 47.3 %of child victims are male, and 50.7 % are female. Victimization rates are highest among the youngest population of children, birth to 3 years, at a rate of 16.5 per 1,000 children • 49.7 %of children who are maltreated are white, 23.1 % are African American, and 17.4 % are Hispanic. American Indians and Alaska Natives account for 1.2 % of victims, and Asian-Pacific Islanders account for less than 1 percent of victims 79.4 percent of perpetrators are parents and 6.8 percent are other relatives. The largest remaining categories of perpetrators are the unmarried partner of a child’s parent (3.8 percent) and other perpetrators (4.1 percent)

4. Child abuse around the world: how does the US shape up? • 25thof 27 among developed nations based on the rate of child deaths from abuse and neglect. • The rate of child abuse fatalities in the United States is three times the rate of Germany’s, more than twice the rate of the UK or Japan, and almost twice the rate of France.

5. How about Missouri? • Childcare workers (child care providers) are MANDATEDREPORTERS. • In 2012, 72,110children were reported to DFS. Of those children, 57,727 had only one report during the year. The remaining 14,383 children had more than one report during 2012. • Fifty-nine percent (59%) of the reports made in 2012 were made by mandated reporters and thirty-eight percent (38%) were made by permissive reporters. • Childcare center or other child care worker 554 reports or 0.8% • Missour CTF YouTube site

6. What is Abuse? • Physical AbuseCitation: Ann. Stat. § 210.110'Abuse' means any physical injury inflicted on a child by other than accidental means by those responsible for the child's care, custody, and control.  • NeglectCitation: Ann. Stat. § 210.110'Neglect' means failure to provide, by those responsible for the care, custody, and control of the child, proper or necessary support; education as required by law; nutrition; or medical, surgical, or any other care necessary for the child's well-being. 

7. Statutes cont’d.. • Sexual Abuse/ExploitationCitation: Ann. Stat. § 210.110The term 'abuse' includes sexual abuse. Emotional AbuseCitation: Ann. Stat. § 210.110The term 'abuse' includes emotional abuse inflicted on a child by those responsible for the child's care, custody, and control. 

8. Statutes cont’d….. • AbandonmentThis issue is not addressed in the statutes reviewed. Standards for ReportingCitation: Ann. Stat. § 210.115A report is required when there is reasonable cause to suspect that a child has been or may be subjected to abuse or neglect. 

10. Statistics of Child Abuse for 2012

11. Warning signs of Neglect Possible signs of neglect could include: • Soiled clothing or clothing not appropriate for the weather • Signs of hunger, hoarding or stealing food, poor nutrition • Listlessness or fatigue • Poor hygiene (urine or feces, bad breath, poor oral hygiene) • Untreated medical problems Observe regular or frequent: • Poor relationships • Withdrawal from others • Craving attention (even to get negative responses from others) • Low self-esteem • Cared for regularly or frequently by another child too young or immature to be a responsible caregiver

12. Physical Abuse • Injury location: elbows, knees, shins, hands, chin, forehead are all more likely to be from common childhood accidental injuries • Injuries on thighs, calves, genitals, buttocks, cheeks, earlobes, lips, neck and back are more frequently associated with abuse • Bruises on infants are suspicious considering their limited ability to either be mobile, or to cause harm to themselves

13. Warning Signs of Physical Abuse • Child is fearful of being touched • Child is wary of adult contact • Appears to be or says they are frightened of parents or others • Afraid to go home or to another location • Appears to feel they deserve punishment • Are apprehensive when other children cry • Behavioral extremes (aggression and withdrawal) • Manipulates to get attention • Seeks affection indiscriminately • Poor self esteem • Stays very still while surveying a room • Vacant or frozen stare • Physical aggression

14. Emotional Abuse • The indicators of child abuse and neglect vary. No child or caretaker will exhibit all of the physical or behavioral indicators and some of the indicators are contradictory. The behavior of an abused or neglected child and other family members may be sporadic and unpredictable. Indicators should be used only as a general guide.

15. Warning Signs of Emotional Abuse • Lags in physical development • Failure to thrive • Lags in emotional development • Empty or blank expression • Speech disorders • Lags in intellectual development • Attempted suicide • Avoidance of eye contact • Habit disorders (sucking, biting, rocking, bedwetting, feeding) • Self-destructive or antisocial behavior • Sleep problems, depression, anxiety, fearfulness • Behavior extremes—demanding or overly compliant; passive or aggressive; impulsive or withdrawn • Inappropriately adult behaviors (parenting) or infantile (rocking, thumb sucking, head-banging)

16. Sexual Abuse • The indicators of child abuse and neglect vary. No child or caretaker will exhibit all of the physical or behavioral indicators listed and some of the indicators are contradictory. The behavior of an abused or neglected child and other family members may be sporadic and unpredictable. Indicators should be used only as a general guide. The presence of indicators alone does not establish that sexual abuse or exploitation has occurred. It should be noted that physical indicators are present in only a very small percentage of sexual abuse cases.

17. Warning Signs of Sexual Abuse • Bizarre or unusual knowledge about sex; masturbation • Sexual acting out; extreme curiosity • Fear of men or women; affectionless or overly affectionate • Confusion over sexual identity • Night terrors • Difficulty sitting or walking • Withdrawn, unstable emotions, depressed, regressed, poor peer relationships • Aggressive, problems in school, defiant, tells lies, retreats into fantasy world • Self destructive

19. Reporting • Reports are to be made immediately to the 24 hour, 7 day a week Child Abuse/Neglect Hotline telephone number (1-800-392-3738 & TDD 1-800-669-8689) maintained by CD. The Hotline is staffed by trained Children’s Service Workers whose responsibility is to accept the information and make the determination that the information constitutes a child abuse/neglect report. Missouri ChildAbuse Reporting Webpage

21. Children’s Service Worker Role • Determine if the alleged victim is a child (less than eighteen (18) years-old) at the time of the hotline call; • Whether or not the person who is alleged to have abused the child was “responsible for the care, custody, and control” of the child at the time of the incident; • The alleged abuse or neglect is having an adverse effect on the child; • The incident occurred in Missouri; • The report meets the definition of abuse or neglect as defined by law; and • Identifying information is available to locate the child/family. • *from Child Care Basics module #1*

22. Reporter (You) • The name, address, present whereabouts, sex, race, and birth date or estimated age of the reported child or children and of any other children in the household; • The name(s), address(es), and telephone number(s) of the child’s parent(s), or other person(s) responsible for the child’s care; • The name(s), address(es), and telephone number(s) of the person(s) alleged to be responsible for the abuse or neglect, if different from the parent(s); • Directions to the home, if available, when the child’s address is general delivery, rural route, or only a town; • Other means of locating the family; • Parents’/alleged perpetrators’ place of employment and work hours, if known; The full nature and extent of the child’s injuries, abuse, or neglect, and any indication of prior injuries, including the reason for suspecting the child may be subjected to conditions resulting in abuse or neglect; • Any event that precipitated the report • *from Child Care Basics module #1*

23. Reporter (You) cont’d… • Adverse reactions to the child(ren); • An assessment of the risk of further harm to the child and, if a risk exists, whether it is imminent; • If the information was provided by a third party, or if there were witnesses, the identity of that person(s); • The circumstances under which the reporter first became aware of the child’s alleged injuries, abuse or neglect; • The action taken, if any, to treat, shelter, or assist the child; • Present location of the child; • Whether the subjects of the report are aware a report is being made; The name, address, work and home telephone numbers, profession, and relationship to the child of the reporter; When was the child last seen by the reporter; Whether other children are in the home. • *from Child Care Basics module #1*

25. After the Call If the call is accepted as a child abuse/neglect report, the information is transmitted electronically to the county Children’s Division office within a designated circuit, and an investigation or family assessment is begun immediately or initiated within 24 hours, depending on the severity of the allegations. The worker completing the investigation or family assessment will contact the reporter in order to ensure that full information has been received, to obtain any additional information, and to determine the safety of the child. The mandated reporter shall be contacted when the report is sent to the county office or within 48 hours of receipt of the report. If the worker is unable to contact the reporter, the investigation or family assessment will be initiated by seeing the child. *from Child Care Basics module #1*

26. What if I don’t report? • Section 210.135 RSMO • Failure to report is a Class A misdemeanor for a person who is required under the law to report. Filing a false report is also a Class A misdemeanor. • The law provides immunity from civil or criminal liability to those who are required to make reports . • Immunity is provided regardless of the outcome of the investigation/family assessment . Immunity does not protect persons filing false reports. • *from Child Care Basics module #1*

28. Stats…cont’d….

31. Don’t look away…DO SOMETHING!

35. Grace's Story

36. Resources/References • http://www.safehorizon.org/ • http://www.helpguide.org/ • http://www.childhelp.org/ • http://www.thecapcenter.org/ • http://www.lcsun-news.com/ci_21106150/baby-briannas-death-still-resonates-after-10-years?source=most_viewed • http://ripeace.wordpress.com/2013/01/17/the-worst-case-of-child-abuse-in-us-history-the-murder-of-baby-brianna/ • https://www.firststar.org/library/national-statistics.aspx • http://dss.mo.gov/cd/pdf/guidelines_can_reports.pdf • http://dss.mo.gov/re/pdf/can/2012-missouri-child-abuse-neglect-annual-report.pdf • Some slides taken from Child Care Basics series module #1 on Shaken Baby Syndrome/Abusive Head Trauma/Mandated Reporter: Child Abuse