Identifying, reporting, and preventing child abuse and neglect Navigating the Child Welfare System Nanette Bishop, MBS, LPC, LADC Administration for Children.

Identifying, reporting, and preventing child abuse and Identifying, reporting, and preventing child abuse and neglectneglect

Navigating the Child Welfare System

Nanette Bishop, MBS, LPC, LADC Administration for Children and Families, Region VI [email protected]

The PlanThe Plan IntroductionsIntroductions What do you want to learn while you’re here? What do you want to learn while you’re here? ActivityActivity Costs and national overviewCosts and national overview Risk factorsRisk factors Types of abuse and typical signsTypes of abuse and typical signs Reporting requirements, legal and ethical, while Reporting requirements, legal and ethical, while

supporting the childsupporting the child Reporting how to’sReporting how to’s The Real World: audience’s experiencesThe Real World: audience’s experiences What happens after a report is madeWhat happens after a report is made Prevention: The Cutting EdgePrevention: The Cutting Edge Q&AQ&A

Costs of Child Abuse and NeglectCosts of Child Abuse and NeglectAn estimated 906,000 children were victims of child abuse or neglect in 2003.

Physical health Injuries directly caused by abuse & those afterward.

Shaken baby syndrome leads to blindness, learning disabilities, mental retardation, cerebral palsy, paralysis

Psychological problems can result in high-risk behaviors. For example, depression/anxiety may result in increased sexual activity, smoking, alcohol/drug abuse, or overeating, which can lead to sexually transmitted diseases, cancer, heart disease, obesity, and other diseases.

Mental, emotional, intellectual, behavioral health Impaired brain, cognitive, and language development and functioning, academic

achievement, and social functioning A wide range of psychiatric disorders (depression, anxiety, ADHD, PTSD, etc…) Delinquency, teen pregnancy, drug use, incarceration, etc...

Societal Costs Direct: An estimated 24 billion per year (Prevent Child Abuse America, 2001) Indirect: An estimated 69 billion per year (Prevent Child Abuse America, 2001)

Fifty percent of investigated reports come from professionals just like you.

The Federal Child Protection Law: CAPTA (The Child Abuse Prevention and Treatment Act)

Purpose and Goals:Purpose and Goals: Federal Law first enacted in 1974; amended most recently in 2003.Federal Law first enacted in 1974; amended most recently in 2003. To improve prevention, identification, investigation, and treatment of To improve prevention, identification, investigation, and treatment of

child maltreatmentchild maltreatment Defines a minimum standard of child abuse and neglect that States use Defines a minimum standard of child abuse and neglect that States use

as a foundation to specify their own definitions.as a foundation to specify their own definitions. Requires certain professionals, as specified by each State, to report Requires certain professionals, as specified by each State, to report

suspected child abuse/neglect to the State agency.suspected child abuse/neglect to the State agency.

Two major programs are funded through CAPTA:Two major programs are funded through CAPTA: CAPTA general program: State CPS agencies administer CAPTA. Community Based Child Abuse Prevention (CBCAP): Focused on

preventing child maltreatment. Can be run by the State CPS agency OR a separate agency chosen by the governor.

CAPTA:CAPTA:minimum standard definition of child maltreatmentminimum standard definition of child maltreatment

Any recent act or failure to act on the part of a parent or caretaker which results in death, serious physical or emotional harm, sexual abuse and exploitation; or

An act or failure to act which presents an imminent risk of serious harm

(States take it from there)

Risk FactorsRisk FactorsChild Risk Factors Birth: Premature, low birth weight, disabilities, exposure to toxins in utero, Older: Difficult to warm up, aggression, behavior problems, attention deficits Physical/cognitive/emotional disability, chronic or serious illness, trauma Age, anti-social peer group

Parental/Family Risk Factors External locus of control, unwanted pregnancy, unrealistic expectations about child

development, poor parent-child interaction, negative attitudes about child's behavior Psychopathology, poor impulse control, substance abuse, depression, anxiety,

insecurity Stressful life events, low tolerance for frustration Abused as children, lack of trust High conflict, domestic violence, divorce (especially high conflict divorce) Young, unsupported, single parent, high number of children in household, isolation

Social/Environmental Risk Factors Poverty (the most frequently and persistently noted risk factor of all) Unemployment, homelessness, dangerous/violent community Lack of medical care, health insurance, adequate child care, and social services Poor schools, environmental toxins, racism/discrimination

What is Neglect?What is Neglect? Failure to provide for a child’s needs. We need to be careful, however. Cultural

values, standards of care in the community, and poverty may contribute to what we may or may not personally consider neglect.

Neglect comprises over 50% of all reports Types of neglect include:

Physical: lack of food, shelter, supervision Medical: medical or mental health treatment Educational (including special education needs) Emotional: Lack of parental attention and guidance, permitting a child to use

alcohol or drugs

Typical signs of neglect in a child: Appears malnourished, begs, steals, or hoards food Has poor hygiene, matted hair, dirty skin, severe body odor Unattended medical or physical problems Says that no one is home to care for them Child or caretaker abuses drugs or alcohol

What is Physical Abuse? Physical injury ranging from minor bruises to severe fractures or death as a result of

any method or harm, including:

•Slapping•Hitting•Choking•Burning

•Punching•Beating•Kicking•Shaking

These injuries are considered abuse whether or not the caretaker meant to hurt the child.

Physical abuse comprises around 25% of all reports.

Typical signs include (especially in various stages of healing): Broken bones, unexplained bruises, burns, welts Child cannot explain an injury OR explanations given by the child or caretaker

are not consistent with the injury Child is unusually frightened by a caretaker or is afraid to go home Child reports intentional injury by caretaker

•Throwing•Stabbing•Biting•Others?

Includes activities by a parent or caretaker such as:

•Fondling a child’s genitals•Penetration•Exploitation through prostitution or pornographic materials

Sexual abuse comprises around 11% of all reports

Typical signs of sexual abuse in a child:• Pain or bleeding in anal or genital area, often with redness or swelling,

pregnancy, sexually transmitted diseases• Age-inappropriate play with toys, self, or others• Inappropriate knowledge about sex• Child reports sexual abuse

What is Sexual Abuse?

•Rape•Incest•Sodomy•Indecent exposure

What is Emotional Abuse?What is Emotional Abuse? A pattern of behavior by a caretaker that impairs a child’s emotional

development or sense of self worth.

Almost always present when other forms are identified.

Often difficult to prove and CPS may not be able to intervene without evidence of harm.

Comprises around 3% of all reports

Typical signs of emotional abuse include: Caretaker constantly criticizes, threatens, belittles, insults, or rejects

child Caretaker withholds love, support, or guidance Child exhibits extremes in behavior from overly aggressive to overly

passive Child displays delayed physical, emotional, or intellectual development

Reporting: Legalities and Ethics Most medical personnel, law enforcement, educators, social service providers

and child care providers are bound by professional ethics and/or State law to report suspected child abuse/neglect.

Eighteen States require every citizen to report it regardless of their profession.

Know your State’s laws (handout) and your professional organizations’ ethical requirements

Reporting abuse or neglect frequently becomes an ethical dilemma due to complex and conflicting ethical requirements. Breaching confidentiality and breaking the law both constitute unethical behavior.

Regardless of potential professional difficulties, caring adults must intervene on behalf of children who may be suffering from abuse or neglect. Remember: over fifty percent of all investigated reports come from professionals.

Reporting Child Maltreatment Contact your State or Local CPS office. In some States, you can file a report online.

Not all States have one hotline. Some are not open 24 hours. Some do not work outside the State.

The National Child Abuse Hotline can provide the most updated reporting contact info 24/7 if you cannot locate it. Visit www.childhelpusa.org or call 1-800-4-A-CHILD

Have the following information ready as much as possible: Child’s name and location Suspected perpetrator’s name and relationship to the child A description of what you saw or heard Names of any other people who may know about the abuse Your name and phone number

Names of reporters are not disclosed, but your identity may become known to the family during the course of the investigation. Discussing this with involved parties up front is best.

The best way to protect yourself and your clients is to tell them when you first meet them that you must report any abuse you may suspect. To formalize this agreement, provide it in writing and have them sign it.

The Real World:The Real World:

Our Experiences with Child Our Experiences with Child Abuse and NeglectAbuse and Neglect

What happens after I make a report?What happens after I make a report?

1. Screened by CPS staff. Enough credible information to indicate maltreatment or risk= referred to an investigator

2. Investigated within a specific time period, prioritized based on potential severity

3. Investigator may interview child, family, teachers, childcare workers, doctors, or others

4. IF the investigator believes the State’s standard for abuse/neglect has not been met, the case will be closed. The family may or may not be referred elsewhere for services.

5. IF the investigator believes the child is at risk of harm, the family may be referred to services to reduce the risk of harm including:

1. Mental health care2. Medical care3. Parenting skills classes4. Employment assistance5. Financial or housing assistance

6. In some cases where the child’s safety cannot be ensured, the child may be removed from the home and placed in a foster home while the agency works further with the caretakers.

Prevention: Protective Factors to Build OnPrevention: Protective Factors to Build OnChild Protective Factors Good health, development, and self-esteem, social skills/peer relationships, intelligence Hobbies and interests Easy temperament, positive disposition, resilience Internal locus of control, active coping style, balance between help seeking and autonomy

Parental/Family Protective Factors Secure attachment to family: positive, stable, warm, supportive parent-child-family

relationships Household rules/structure; parental monitoring, expectations of pro-social behavior Extended family support and involvement, including care giving help Parents have a model of competence and good coping skills, high parental education

Social/Environmental Protective Factors Mid to high socioeconomic status Access to health care, adequate housing, social services Consistent parental employment Family religious faith participation Good schools Supportive adults outside of family who serve as role models/mentors to child

Child Abuse/Neglect Prevention: The Cutting EdgeChild Abuse/Neglect Prevention: The Cutting Edge

Common features of effective prevention programs Strengthen family and community connections/support systems Approach parents as important contributors to their child’s development Create opportunities for parents to be successful and feel empowered Respect every family’s integrity Provide settings where families can gather, support and learn from each other Enhance coordination and integration of supports and services Enhance community awareness of the importance of healthy parenting Ensure round the clock support (such as hotlines) Evening and weekend hours, meeting in family’s home (home visitors)

Current Best Practice Examples: Nurse Home Visiting

http://www.oph.dhh.state.la.us/maternalchild/nursehome/ The Front Porch Project

http://www.americanhumane.org/site/PageServer?pagename=pc_prevention

Primary: Stop it before it starts, for everyoneSecondary: Stop it before it starts, for families considered “at risk”Tertiary: It happened, but let’s stop it from happening again

Questions and AnswersQuestions and Answers