Mandated Reporter Training:

1. Mandated Reporter Training: Identifying and Reporting Child Abuse and Maltreatment/Neglect

3. LEGAL DEFINITIONS An abused child is one who is less than 18 years of age and whose parent or other person legally responsible for his care : • - inflicts or allows to be inflicted serious physical injury by other than accidental means • - creates or allows to be created a substantial risk of such injury • - commits or allows to be committed a sex offense against such child

5. National Incidence Study National study conducted in the 1980s: Found professionals report only half the incidents they knew about. The reasons for this are: • Confusion or misunderstanding about reporting laws and procedures • Lack of knowledge or awareness of warning signs/clues

6. University of Rochester Study Mandated Reporters disclosed they were: • Not clear about abuse/neglect as defined in State Law • Often influenced by their professional beliefs, values, and experiences

8. Child Protective Services Act of 1973 Local Child Protective Services MandatedReporter State Central Register (1973)

9. Reports Registered 2005 Mandated Reporter Non-Mandated Reporter

10. Role of Mandated Reporter To report suspected incidents of child abuse or maltreatment/neglect while acting in their professional capacity.

11. Reasonable Cause The diagnosis of child abuse or maltreatment should be made when the level of suspicion is reasonably sufficient to entertain such a possibility. Special attention should be paid to: • injuries that are unexplained or are inconsistent with the parent’s/caretaker’s explanation • developmental stage of the child.

12. Reasonable Cause • The law does not require absolute certainty. It does require reasonable cause to suspect abuse or maltreatment. • You only need to have "reasonable cause to believe" that a child is being abused or neglected for you to make a report-you don't need proof. If you think a child is being hurt in any way, you have a legal (if you are functioning in a professional capacity) and moral responsibility to report it. You can report suspected abuse even if the child doesn't tell you about it. You may observe signs of abuse/neglect or someone may verbalize their experiences to you. • Any person or institution making a reportof suspected child abuse or maltreatment in good faith has immunity from civil orcriminal liability which might otherwise be incurred. The good faith of any person required to report shall be presumed.

13. Consequences for Failure to Report • Criminal Sanction: It is Class A misdemeanor for a mandated reporter to willfully fail to report a case of suspected child abuse or maltreatment. • Civil Sanction: A mandated reporter who knowingly and willfully fails to make a report of suspected child abuse or maltreatment is civilly liable for damages caused by such failure.

15. Legal Framework • Immunity • Confidentiality • Penalties

16. Mandated Reporter Records • Requires mandated reporters to provide records regarding a mandated report necessary for a CPS investigation, irrespective of HIPPA proscriptions or any other privilege. • SSL §415

17. Consider the Child • Must be less than 18 years of age • What has happened? • Who is responsible?

18. Abuse • Inflicts or allows to be inflicted injury • Creates or allows to becreated substantial riskof physical injury • Commits or allows to becommitted a sex offense

19. Recognizing Child Abuse and Neglect Physical Abuse • Signs of Physical Abuse • Bruises, welts on face, neck, chest, back • Injuries in the shape of an object-belt, cord, iron • Unexplained burns on palms, soles, back • Fractures that do not fit story of injury • Delay in seeking medical help • Extremes in child's behavior-very aggressive or withdrawn and shy (unlike the child's typical behavior) • Afraid to go home • Frightened of parents/caregivers • Fearful of other adults

22. Maltreatment/Neglect • A child whose physical, mental, or emotional condition has been impaired or is at imminent danger of becoming impaired • A parent’s or custodian’s failure to provide a minimum degree of care

23. Types of Neglect • Fails to provide: • adequate food, clothing, shelter, education, and medical care • proper supervision OR • Inflicts/allows to be inflicted harm, including the infliction of excessive corporal punishment • Misuses alcohol or other drugs • Abandonment

24. A neglected child is one who is less than 18 years of age whose physical, mental or emotional condition has been impaired or is in danger of becoming impaired due to the parents': • - failure to provide adequate food, clothing, shelter, medical care or education • - failure to provide proper supervision or guardianship • - infliction of excessive corporal punishment • - abandonment of the child

25. Neglect Signs of Neglect • Poor hygiene, body odor • Inappropriately dressed for weather • Needs medical or dental care • Left alone, unsupervised, for long periods of time (depending on child's age) • Failure to thrive, malnutrition • Constant hunger, begs or steals food • Extreme willingness to please • Frequent absence from school • Arrives early and stays late at school or play areas or other people's homes

27. Neglected ChildrenAuthor unknown (but had to be a Nursing student!) Our home is seldom very cleanThe meals are not as goodAnd we don’t take a bath,As we ordinarily would. The hamper is overflowing,The ironing is seldom done,And the socks that were neatly in the drawer,Are practically down to none.

28. She was a model mother,The house was shiny and bright,She was so even-tempered,And a perfect “guiding light”.But all that now has changed,Dust “neath the bed does pool”,Where is that wonderful motherWhy Mother goes to school! She has no time for cleaning,We kids must do our best,We’re having eggs for dinner,Cause Mom is having a test! She got a terrible longing,A nurse she wanted to be,So she nagged our dad for tuitionAnd the poor guy had to agree!

29. So every morning she packs her booksAnd walks out of the door,We’d like to try and stop her, But we’re sticking to the floor!We take our vitamins and drink our juice,Cause it would be terribly cruel, If we caught a cold and feverAnd Mother couldn’t go to school!So if you’re in the hospital,And on your back you lieIf you happen to see a student nurseTell Mom we all said – Hi!

30. Bruising Areas Normal Bruising Areas Suspicious Bruising Areas Back Elbows Knees Buttocks Back of Thighs Shin Back of Calves

31. Common Indicators • Child’s Physical Indicators • Child’s Behavioral Indicators • Parent’s Behavioral Indicators

32. Handprint Injury

33. Looped Cord Injury

34. Steam Iron Injury

35. Emotional Abuse Signs of Emotional Abuse • Low self-esteem • Self-denigration • Severe depression • Aggression • Withdrawal • Severe anxiety • Failure to learn

36. Sexual Abuse Signs of Sexual Abuse • Pain, swelling, or itching in genital area • Bruises, bleeding, discharge in genital area • Difficulty walking or sitting, frequent urination • Stained or bloody underclothing • Sexually transmitted infections • Refusal to take part in gym or other exercises • Poor peer relationships • Unusual interest in sex for age, unusual knowledge of sex terminology • Drastic change in school achievement • Runaway or delinquent • Regressive or childlike behavior

37. Consider the possibility of sexual abuse if the parent: • Is overly protective of the child or severely limits the child's contact with other children, especially of the opposite sex • Is secretive and isolated • Describes marital difficulties involving family power struggles or sexual relations • Behaves in a sexual manner toward the child

38. Indications by the child: Some examples of less direct approaches may be: • "My father wouldn't let me sleep last night," or "My babysitter keeps bothering me." • Developmentally, the child may not have the specific vocabulary to explain themselves. • The child may feel too ashamed to talk more directly. • The child may have promised not to tell.

41. If you suspect abuse: • Be aware of both physical and behavioral signs • Be approachable-Let the child know that you are available to talk; build a relationship with the child that will allow him/her to feel comfortable sharing such difficult information with you • Evaluate the situation-Contact local law enforcementif you think there is immediate danger to the child or get medical help immediately if you think the child has been injured

42. If a Child Tells You About Abuse or Neglect • Listen to and believe the child - Show through your words and actions that you are listening to the child and that you believe what the child is telling you. Encourage the child to talk but don't push him/her to do so. Use open-ended questions (such as, ''What happened?'') rather than leading questions (such as, ''When did she hit you?''). • Be supportive of the child - Tell the child she/he did the right thing in telling you, and stress that the child is not to blame for what happened. Let the child know that you will try to help, but don't make any promises (such as, ''I'll make things better'') that you may not be able to keep. • Don't overreact -Try to stay calm; this will help keep the child from becoming more frightened and may encourage him/her to tell you more. Do not talk negatively about the suspected abuser in front of the child; simply reassure the child that it is not the child's fault. • Write down what the child says and report it - Write down as much of the child's actual words as possible so that you can share those words with the appropriate agency. Describe in writing any signs of abuse/neglect you observe.

43. Talking with Children Do: - Find a private place - Remain calm - Be honest, open, up-front, supportive - Be an advocate - Listen to the child - Report the situation immediately

44. Talking with Children Don’t: - Overreact - Make judgments/promises - Interrogate or investigate

45. Appropriate response • Use open-ended questions such as: • “How is this upsetting you?" • “Can you tell me more?" • Help the child to focus to encourage specifics • Don’t suggest, give ideas or put specific “words into the child’s mouth.”

46. “IMAGINARY” • “What would happen if a girl told someone her mother beat her?" • "I know someone who is being touched in a bad way." Although a child might be talking about a friend or sibling, she or he may likely be talking about herself or himself.

47. Appropriate response • Encourage the child to tell you more about the "other child." • The child will most likely tell you about whom he or she is talking at some time during the conversation. • A trusting relationship will encourage the child to disclose information.

48. "If I tell you about something, will you promise not to tell anyone else." Most children realize that there will be negative consequences when the abuse is revealed. The fear is often related to abusers threats if the child doesn’t maintain silence.

49. Appropriate response • First, reassure the child that you want to help him or her • Tell the child, from the beginning, you may need to get help with the problem in order to help them. Special people may need to get involved. • The time element for this particular time to disclose this is important, because the child may be feeing desperate and therefore will often agree to seek help if you talk about it ahead of time. • Assure the child that you will not discuss the abuse with anyone other than that are absolutely necessary for getting help. If the child is developmentally capable of understanding the process of getting help, it may allay some fears.

50. Who can be Reported? • Day Care Provider • Parent • Guardian • Residential Child Care Staff