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Shirley Stitt, L.C.P.C. Stacey Brown, M.Ed, LCPC The Family Tree

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1 Shirley Stitt, L.C.P.C. Stacey Brown, M.Ed, LCPC The Family Tree
Child Maltreatment for Maryland Association of Resources for Families and Youth Shirley Stitt, L.C.P.C. Stacey Brown, M.Ed, LCPC The Family Tree

2 Welcome MARFY

3 Overview of Presentation
Define and Identify Characteristics of Child Abuse and Neglect Define and Identify Symptoms of Child Sexual Abuse Learn Why Professional Boundaries are Important How to Report Suspected Abuse and Maltreatment

4 Child Physical Abuse and Neglect

5 Maryland’s Child Abuse Statistics
In 2012 Maryland had 55,775 Referrals of Child Abuse & Neglect 13,079 were victims of child abuse or neglect 26 Children in Maryland died as a result of abuse or neglect About 6,098 Children Spend Time Out of Their Homes Each Year Due to Maltreatment (2010)

6 Types and Occurrence of Reports on Child Maltreatment in Maryland
Neglect % Physical % Sexual %

7 Maryland State Definitions of Child Abuse and Neglect –Family Law 5-701
Abuse means: The physical or mental injury of a child by any parent or other person who has permanent or temporary care, custody, or responsibility for supervision of a child, or by any household or family member, under circumstances that indicate that the child's health or welfare is harmed or at substantial risk of being harmed Sexual abuse of a child, whether physical injuries are sustained or not

8 Neglect Neglect Means:
The leaving of a child unattended or other failure to give proper care and attention to a child by any parent or other person who has permanent or temporary care or custody or responsibility for supervision of the child under circumstances that indicate: That the child's health or welfare is harmed or placed at substantial risk of harm Mental injury to the child or a substantial risk of mental injury

9 Victims of Physical Abuse and Neglect
Males and Females equally victimized Rate of victimization is inversely related to child’s age Recurrence of abuse 9% within 6 months of first incidence Children who were neglected are at highest risk Increased risk when maltreated by mother Children whose families received services including placement are at great risk of recurrence NCANDS (2007)

10 Perpetrators of Physical Abuse and Neglect
Female 55%, Male 40% Parents account for 88% of perpetrators Neglect is the most common type of maltreatment for all perpetrators Breakdown of most likely perpetrator Neglect: both parents Physical abuse: unmarried partner (not child’s parent) Sexual abuse: other relative NCANDS (2012)

11 Characteristics of Physically Abusive Caregivers
Unfulfilled need for nurturance Isolation or fear of relationships Lack of support systems Marital/Intimate Partner problems Life crises Inability to care for or protect a child Lack of nurturing child-rearing practices

12 Characteristics of Maltreated Children
Weak Parent-Child bonding and attachment Slow expressive language development, delays in receptive language, deficits in articulation Problematic transactions with extra-familial systems Inadequate coping skills Parentified behaviors

13 Characteristics of Maltreated Children
Considers disorganization and chaos the norm Emotional desensitization to violence Defensive world view Tendencies towards low self-esteem, depression, anti-social behavior and/or self injury Little ability to draw from past experiences or anticipate future consequences

14 Indicators of Abuse Unusual or unexplained injuries, in various stages of healing May suffer from chronic illnesses, headaches, or stomachaches Signs of neglect such as dirty clothes, poor hygiene, or excessive hunger May be withdrawn from everyone around them May show signs of depression or have low self-esteem May use violence in order to solve conflicts that arise Have a hard time falling or staying asleep and may also fall asleep during school May experience flashbacks

15 Indicators of Abuse Problems in school including frequent absences, fights, and fatigue May act overly responsible She/he may become very worried over poor results in grades or sports May act out sexually or have a mature sexual vocabulary May come up with extravagant stories about bruises or scratches May become very upset when a worker needs to leave or when they have to leave school or child care May act out the violence in play or in story A difficulty in expressing emotions other than anger

16 Let’s Educate Ourselves
Developmentally Expected Behaviors in Children

17 Developmental Milestones

18 School Age 6 to 12 Encouraging competence and confidence

19 School Age (6 to 12) Physical/ Motor development
Copies a triangle (6year), diamonds (7year), prints letters, draws recognizable man with head, body & limbs Ties shoes Skips with alternating feet Rides bicycle Gains sports skills and coordination increases Social/ Emotional Development Peers gain importance, and the child has increased interest in the world outside home Identifies with the peer group rather than with the family Learns to differentiate between personal goals and those of the group Intelligent Development Ability to reason and solve problems improves, and concerned about right and wrong Can entertain another point of view Attention span increases Vocabulary expands geometrically (50,000 words by age 12)

20 Teenage Years (13-17) Staying connected when kids what to fly

21 Teenage Years 13-17 Physical/ Motor development
Adolescent growth spurt Onset of sexual maturity (after 10 years-old) Development of primary and secondary sexual characteristics Social/ Emotional Development Identity is key issue Conformity most impossible Organized sports diminish for many Cross-gender relationships Cognitive / Language Development Systematic problem-solving strategies Can handle hypotheticals Deals with past, present, future Adopts personal speech patterns Communication becomes focus of relationships

22 Child Sexual Abuse

23 Definition of Child Sexual Abuse
The Federal Child Abuse Prevention and Treatment Act (CAPTA) (42 U.S.C.A. § 5106g), as amended by the CAPTA Reauthorization Act of 2010, defines child sexual abuse as, at minimum: Sexual abuse - “the employment, use, persuasion, inducement, enticement, or coercion of any child to engage in, or assist any other person to engage in, any sexually explicit conduct or simulation of such conduct for the purpose of producing a visual depiction of such conduct; or the rape, and in cases of caretaker or inter-familial relationships, statutory rape, molestation, prostitution, or other form of sexual exploitation of children, or incest with children.” Definition of child sexual abuse Part I: Understanding child sexual abuse as a public health problem The Enough Abuse Campaign

24 Touching Behaviors Can Include:
Deliberate contact with a child or teen’s genitals, buttocks or Deliberate contact with a child or teen’s genitals, buttocks or chest/breasts; Penetration of the child or teen’s mouth, anus, or vagina with an object or body part; Making a child or teen touch another person’s anus, penis, or vagina; and, Coercing a child or teen to touch him/herself, the offender or another child.

25 Non-Touching Behaviors Can Include:
Exposing oneself to a child or a teen; Viewing and violating the private behaviors of a child or teen; Taking sexually explicit or provocative photographs of a child or teen; Showing pornography to a child or teen; and, Communicating with a child or teen about sexually explicit fantasies or experiences (in person, by phone, via or Internet, etc.)

26 Indicators of Sexual Abuse
Withdrawn Behavior Angry Outbursts Anxiety Depression Not wanting to be left alone with a particular individual Sexual knowledge, language and/or behaviors that are inappropriate for child’s age Bedwetting and/or inability to control bladder functions

27 1 in 4 women and 1 in 6 men report
Child sexual abuse statistics 1 in 4 women and 1 in 6 men report having experienced child sexual abuse. The vast majority (87%) of sexual abuse is never reported Research shows that children rarely make up accusations of sexual abuse. Statistic #1: Definition of child sexual abuse used in ACE study: “…During the first 18 years of life, did an adult (… or someone at least 5 years older…), relative, family friend, or stranger ever (1) touch or fondle your body in a sexual way, (2) have you touch or fondle their body in a sexual way, (3) attempt to have any type of sexual intercourse with you (oral, anal, or vaginal), or (4) actually have any type of sexual intercourse with you (oral, anal, or vaginal)?” It is likely that you have seen a range of statistics on this point. There are many challenges to collecting data on the incidence (number of separate occurrences) and prevalence (number of individuals affected) of childhood sexual abuse. These challenges include: Studies use different definitions of child sexual abuse. For example, some studies like the Adverse Childhood Experiences Study avoid using the word ‘abuse’ at all and instead ask questions about specific experiences. This technique allows researchers to identify abuse among individuals who might not label their experiences as abusive. Studies use different populations (for example, college students or convicted perpetrators) that are not representative of the general population. Because most cases of sexual abuse are never reported to child protective services or law enforcement, statistics gathered from these sources greatly underestimate the problem. Not only that, we cannot assume that what we learn from those cases that are reported can be generalized to those cases that aren’t reported. Much of what we know about child sexual abuse comes from retrospective studies in which adults are asked to recall childhood events. Some people who were abused as children might not remember the abuse or the specific details. Citation: Dube SR, Anda RF, Whitfield CL, Brown DW, Felitti VJ, Dong M, Giles WH. Long-Term Consequences of Childhood Sexual Abuse by Gender of Victim. American Journal of Preventive Medicine 2005; 28(5): It is estimated that there are currently XX million survivors of child sexual abuse in the U.S. with 1/3 under the age of 18. (Citation.) According to researchers Finkelhor and Jones, substantiated rates of child sexual abuse are down 49% from 1990 to However, while these rates of confirmed abuse are down, advocates believe the increase of child sexual exploitation through the Internet is climbing significantly. For example, the National Center for Missing and Exploited Children’s Cyber Tip Line receives 2,000 reports each week about possible sexual exploitation of children. Ninety percent (90%) of these reports involve suspected images/videos depicting children being sexually exploited. Since 2002, the Center has reviewed 18.5 million images of pornography involving children. Nearly 250,000 children each year are at risk of becoming victims of commercial sexual exploitation or prostitution. The average age of girls involved is 14. Runaway and throwaway kids are at high risk of engaging in “survival sex” after 7 to 10 days on the street. Statistic #2: According to a national phone survey of adolescents (ages 12-17) conducted in 1995, 86% of sexual assaults experienced by these youth were not reported to any authorities (police, CPS, schools, or other). Retrospective studies done with adults have found similarly low reporting rates for childhood sexual victimization. U.S. Department of Justice, Office of Justice Programs, National Institute of Justice. Youth Victimization: Prevalence and Implications, Research in Brief. April 2003. Statistic #3: It is a common misconception that children lie about being sexually abused. Researchers have found that false reports are statistically uncommon, and estimates range from less than 1% to 10% of cases, depending partly on whether or not reports based on simple misunderstandings are included. In fact, it is far more common for children to minimize or deny the extent of abuse they have experienced than to overstate what has occurred. Children will often test the waters by disclosing lesser offenses first to see how the adult reacts. There are also many reasons why children recant after a disclosure (don’t want to break up the family, don’t like to see parents upset, feel out of control of events, etc.), and clinicians with expertise in working with child victims consider this to be a common part of the disclosure process rather than an indication that abuse did not occur. Citations: For a good summary titled “How often do children’s reports of abuse turn out to be false?”, visit The Leadership Council website at Mikkelson EJ, Gutheil TG, Emens M. False Sexual-Abuse Allegations by Children and Adolescents: Contextual Factors and Clinical Subtypes. American Journal of Psychotherapy 46: , 1992. U.S. Department of Health and Human Services, Administration for Children and Families, Children’s Bureau. (1999). Child Maltreatment 1997: Reports from the States to the National Child Abuse and Neglect Data System. Washington, D.C.: Government Printing Office.

28 Why Children Won’t Tell if They are Being Sexually Abused
The abuser convinces the child that they won’t believed, and they are somehow responsible for the abuse and will be punished The child may care about or feel protective of the abuser Children remain silent in order to protect the non- abusive parent A child may be confused by the abuse if they experience physical pleasure, arousal or emotional intimacy from the abuse A child may feel they allowed the abuse to happen and should be able to stop it

29 Why Children Won’t Tell (con’t)
People who abuse children may give them gifts and treats and may threats about what will happen if the child says “no” or tells someone In order to keep the abuse secret, the abuser will play on the child’s fear, embarrassment or guilt about what is happening

30 Secrets May Not Be Good For Children But Surprises Are
You are a special person and deserve to be treated with love and respect.

31 Common Deficits of People who Sexually Abuse Children
Communication Difficulty discussing emotions and needs Empathy Insensitivity to needs of others Accountability Sense of entitlement

32 Characteristics of Male Offenders :
Fewer than 5% have a psychotic mental illness Many who sexually abuse children do not meet the criteria for pedophilia The vast majority are heterosexual More than half report committing their first offense before the age of 18; avg. age 25-34 40% high school grads 50% under supervision for property or drug offense Most of what we know about sexual abusers is based on studies of individuals who have been convicted of child sexual abuse. As we discussed earlier, those who have been caught and convicted are not necessarily representative of those individuals who sexually abuse but have not been caught or convicted. Psychosis = loss of contact with reality Pedophilia: “Although virtually all pedophiles are child molesters, not all child molesters are pedophiles. Pedophiles have a clear sexual attraction for children. The focus of a pedophile is a child or children generally under the age of 13. Pedophiles often report they are attracted to children in a particular age range (DSM-IV). Child molesters are sexual offenders who have committed either intra-familial sexual offense (incest) against a child victim or extra-familial sexual offenses against a child victim or both.” see citation #2. Citations: #1 : Association for the Treatment of Sexual Abusers. Ten Things You Should Know about Sex Offenders & Treatment. (2001) Available at #2: Association for the Treatment of Sexual Abusers. Pedophiles and Child Molesters – The Differences. (2001) Available at #3 & #4: Abel GG, Harlow, N. The Stop Child Molestation Book. (2001) Xlibris books. #5: Juvenile Sexual Offending. (1997) Edited by Ryan, G & Lane, S. Jossey-Bass, Inc. San Francisco.

33 Characteristics of Female Offenders
50% report prior abuse by spouse, boy friend. 1/3 report abuse by parent 89% report drug usage; PTSD prominent Like men, tend to abuse children they know Victims may have an even harder to find support Predisposed: Histories of incestuous sexual victimization, psychological difficulties and deviant sexual fantasies are common among these women who generally act alone in their offending. Some may see themselves as psychologically fused with their children and unable to function as a maternal figure. The majority are not mentally ill, but may experience depression or personality disorders. They tend to victimize their own children or other young children within their families or who they are close to. Male-Coerced: These women tend to be passive and dependent individuals with histories of sexual abuse and relationship difficulties. Fearing abandonment, they are pressured by male partners to commit sex offenses often against their own children. Teacher/Lover: At the time of their offending, these women are often struggling with peer relationships. They perceive themselves as having romantic or sexually mentoring "relationships" with under-aged adolescent victims of their sexual preference, and therefore, do not consider what they are doing to be wrong or criminal in nature. Citation: Predators: Pedophiles, Rapists, and Other Sex Offenders – Who They Are, How They Operate, and How We Can Protect Ourselves and Our Children. Salter, Anna Basic Books. New York (2003).

34 Who Sexually Abuses Children
93% of victims were abused by someone they knew. 34% of victims were abused by family members. 40% of victims were abused by peers or older children. * Bureau of Justice Statistics report: Sexual Assault of Young Children as Reported to Law Enforcement: Victim, Incident, and Offender Characteristics, July 2000.

35 Witnessing violence, cultural messages, unsafe community Experience:
Why do some children sexually offend? Exposure: Witnessing violence, cultural messages, unsafe community Experience: Things which happen to the child Deficits: Failure to develop skills, lack of supportive environment Deviance: Genetic or neurobiological differences URSBC Deficits: Failure to develop skills like empathy, communication and accountability Deviance: IMPORTANT – We are NOT saying that there is a genetic or biological excuse for perpetrating. Some children have cognitive, developmental or psychiatric issues that can contribute to their motivations for sexually abusing. Citation: Understanding & Responding to the Sexual Behaviors of Children. Curriculum developed by Ryan, Blum, Sandau Christopher, Law, Weber, Sundine, Astler, Teske & Dale, 1988 (Revised Ryan & Blum, 1993; Ryan 1997) Additional Revisions/Additions By Gail Ryan, 4/2000; 9/2002. Kempe Children’s Center, University of Colorado School of Medicine, Department of Pediatrics.

36 Let’s Educate Ourselves
Developmentally Expected Sexual Behaviors in Children

37 Developmentally expected behaviors
Early childhood (ages 3 – 5): Touch genitals for pleasure (masturbate) Play games like doctor to explore physical differences between boys and girls Ask questions about where babies come from and how they are born Sources: The Society of Obstetricians and Gynecologists of Canada: Advocates for Youth: Developmentally expected behaviors Preventing child sexual abuse The Enough Abuse Campaign

38 Developmentally expected behaviors
Middle childhood (ages 6-8): Engage in sexual exploration with peers Begin looking to peers and media for information about sex and gender expectations Develop more complex understanding of sex and sexuality Masturbate Socialize mainly with own gender and maintain rigid expectations for behavior based on gender Developmentally expected behaviors #3: Understand distinctions between homosexuality, heterosexuality and bisexuality. Understand that sex isn’t just about making a baby. Sources: The Society of Obstetricians and Gynecologists of Canada: Advocates for Youth: Developmentally expected behaviors Preventing child sexual abuse The Enough Abuse Campaign

39 Developmentally expected behaviors Preoccupation with sexuality
Late childhood (ages 9-12): Preoccupation with sexuality Develop crushes and may begin dating Have concerns about being ‘normal’ Masturbate Reluctant and/or embarrassed to ask questions of caregivers Value privacy Kids this age are starting to go through puberty and are likely to have many questions about what to expect and about whether or not they are ‘normal’. At the same time that they are experiencing this anxiety about sex, they are also increasingly private and unwilling to discuss sensitive topics with caregivers. Sources: The Society of Obstetricians and Gynecologists of Canada: Advocates for Youth: Developmentally expected behaviors Preventing child sexual abuse The Enough Abuse Campaign

40 Developmentally expected behaviors Express their sexuality Masturbate
Adolescence (ages 13-17): Express their sexuality Masturbate Have the capacity to distinguish between healthy and unhealthy relationships Understand that media messages influence views about sex Understand consequences of sexual activity (pregnancy, STDs, etc.) Adapted from “Growth and Development, Ages 13 to 17 – What Parents Need to Know” Developmentally expected behaviors Sources: The Society of Obstetricians and Gynecologists of Canada: Advocates for Youth: Developmentally expected behaviors Preventing child sexual abuse The Enough Abuse Campaign

41 Developmentally expected behaviors Express their sexuality Masturbate
Adolescence (ages 13-17): Express their sexuality Masturbate Have the capacity to distinguish between healthy and unhealthy relationships Understand that media messages influence views about sex Understand consequences of sexual activity (pregnancy, STDs, etc.) Adapted from “Growth and Development, Ages 13 to 17 – What Parents Need to Know” Developmentally expected behaviors Sources: The Society of Obstetricians and Gynecologists of Canada: Advocates for Youth: Developmentally expected behaviors Preventing child sexual abuse The Enough Abuse Campaign

42 Scenario You walk into the other room to find your son and one of his friends with their pants down, touching each other’s genitals. Scenario Preventing child sexual abuse The Enough Abuse Campaign

43 Is there an obvious difference in power?
Assessing the situation Is there an obvious difference in power? Age Size Intelligence URSBC Obvious differences: Age (One child is 3 or more years older.) Size (One child is larger or one is small for his age.) Intelligence (One child may be developmentally disabled.) Citation: Understanding & Responding to the Sexual Behaviors of Children. Curriculum developed by Ryan, Blum, Sandau Christopher, Law, Weber, Sundine, Astler, Teske & Dale, 1988 (Revised Ryan & Blum, 1993; Ryan 1997) Additional Revisions/Additions By Gail Ryan, 4/2000; 9/2002. Kempe Children’s Center, University of Colorado School of Medicine, Department of Pediatrics. Assessing the situation Preventing child sexual abuse The Enough Abuse Campaign

44 Is there a subtle difference in power?
Assessing the situation Is there a subtle difference in power? Strength Popularity Self-image URSBC Sometimes, however, the differences in power or authority among children are not always obvious to adults. When evaluating the sexual interactions of children, it is important for adults to understand the ways children think about themselves in relation to their peers and older children. Some of the factors that can greatly influence children’s behaviors can be more subtle, for example, when there is a difference in: Strength (One child is physically strong, or the other slight.) Popularity (One child's popularity gives him influence over others.) Self-image (One child has low-self esteem and little confidence.) Citation: Understanding & Responding to the Sexual Behaviors of Children. Curriculum developed by Ryan, Blum, Sandau Christopher, Law, Weber, Sundine, Astler, Teske & Dale, 1988 (Revised Ryan & Blum, 1993; Ryan 1997) Additional Revisions/Additions By Gail Ryan, 4/2000; 9/2002. Kempe Children’s Center, University of Colorado School of Medicine, Department of Pediatrics. Assessing the situation Preventing child sexual abuse The Enough Abuse Campaign

45 Is there a temporary difference in power? Baby-sitting ‘In charge’
Assessing the situation Is there a temporary difference in power? Baby-sitting ‘In charge’ Fantasy roles In addition to these obvious and subtle differences, there are also temporary differences in power or authority that can result from the actions of adults or through child play. For example, when: An older child is put in charge of another child, such as when babysitting; or, Children are playing a game where someone is made the "king" or the "leader". Citation: Understanding & Responding to the Sexual Behaviors of Children. Curriculum developed by Ryan, Blum, Sandau Christopher, Law, Weber, Sundine, Astler, Teske & Dale, 1988 (Revised Ryan & Blum, 1993; Ryan 1997) Additional Revisions/Additions By Gail Ryan, 4/2000; 9/2002. Kempe Children’s Center, University of Colorado School of Medicine, Department of Pediatrics. Assessing the situation Preventing child sexual abuse The Enough Abuse Campaign

46 Professional Boundaries

47 What Are Professional Boundaries?
Clearly established limits that allow for safe connections between yourself and children A clear understanding of the limits and responsibilities of your role

48 The Importance of Boundaries
Role modeling to the children/youth healthy communication and professional relationship Staying focused on one’s responsibilities to the youth in your care, the provision of helpful and appropriate services based on your position description

49 Consequences of Having Loose/Poor Boundaries
Compassion fatigue Youth may not be given appropriate or helpful services, which could affect the youth’s willingness to accept other services available Youth may feel betrayed, abandoned, and/or poorly served Staff and/or youth may be emotionally traumatized and/or put in physical danger

50 Why Is It Difficult To Establish And Maintain Professional Boundaries?
Dual relationships Values conflicts Vicarious Trauma Playing the “hero” role Poor teamwork Dual relationships – Facility staff and youth know each other in a personal context from another setting. Values conflicts –The youth choices, history, relationships, feelings, lifestyle/or life circumstances conflict with the staff’s values, beliefs and know of what works Vicarious Trauma – Staff experiences trauma symptoms from hearing about youth experiences. This information may trigger this reaction due to a history similar to the youth’s history. Playing the “hero” role – Staff feels the need to “save” the client. Poor teamwork – Staff does not trust that other team members are fulfilling their responsibilities to the youth and that the staff can do a much better job then others can for the youth. Staff takes on the roles of other team members.

51 Techniques for Creating and Maintaining Healthy Professional Boundaries
Begin by establishing an appropriate professional relationship When boundary issues or warning signs appear address issue immediately Use your supervisor and/or human resources as a sounding board when you have questions.

52 Techniques for Creating and Maintaining Healthy Professional Boundaries (con’t)
Use your professional judgment when interacting with the youth, youth’s family and others in social setting Promote and role model positive, open communication and respectful sharing of information Take care of yourself!

53 How to Make the Report Reporting Suspected Child Maltreatment

54 Maryland Reporting Requirements
Reporting Suspected Child Abuse or Neglect CODE OF MARYLAND REGULATIONS, Section Requires reporting child abuse or neglect in the following manner: An individual shall immediately report suspected child abuse or neglect to the local department of social services, or report the suspected incident to a local law enforcement agency. Health practitioners, educators, human service workers, and police officers are required to report, both orally and in writing, any suspected child abuse or neglect, with oral report being made immediately and the written report being made within 48 hours of the contact which disclosed the suspected abuse or neglect. Reports of abuse shall be made to the local departments of social services or the appropriate law enforcement agency. Reports of neglect shall be made to local departments of social services. An employee of a local department of social services who receives a report of suspected child abuse or neglect, shall report the information to the protective services unit within the local department at once so as to initiate prompt handling of the report of suspected child abuse or neglect.

55 The Report Why Don’t Some People Report Child Abuse and Neglect?
Reasons people don’t report include: Choosing instead to effectively intervene independent of the formal system Fear or unwillingness to get involved Fear that a report will make matters worse Reluctance to risk angering the family Concern that making a report will negatively impact an existing relationship with the child or others Belief that someone else will speak up and do something

56 The Report A report shall include:
The name and home address of the child and the parent or other individual responsible for the care of the child The present location of the child The age of the child The names and ages of other children in the home The nature and extent of injuries or sexual abuse or neglect of the child, including any information known to the individual making the report of previous possible physical or sexual abuse or neglect

57 The Report If reporting abuse or neglect of a child involving mental injury, a description of the substantial impairment of the child's mental or psychological ability to function that was observed and identified, and why it is believed to be attributable to an act of maltreatment or omission of proper care and attention

58 Your Responsibility as a Reporter
A mandated reporter shall make an oral report, by telephone or direct communication, as soon as possible: To the local department or appropriate law enforcement agency if the person has reason to believe that the child has been subjected to abuse or neglect The mandated reporter shall make a written report to the local department not later than 48 hours after the contact, examination, attention, or treatment that caused the individual to believe that the child had been subjected to abuse or neglect

59 Confidentiality of Report
The name of the reporter may only be revealed under a court order. However, if the reporter is a professional, he or she may give written permission for his or her identity to be revealed. The identity of any other person whose life or safety is likely to be endangered by disclosing the information must not be disclosed. This is extremely important when sharing information with parents or the person who is suspected of child neglect or abuse. Information should only be disclosed when doing so would be in the best interest of the child who is the subject of the report. Professionals discretion should be exercised to disclose only that information which is relevant for the care or treatment of the child. In 1986, the Maryland confidentiality law was amended to permit the disclosure of information concerning abuse and neglect to licensed practitioners, or an institution which, is providing treatment or care to a child who is the subject of a report of child abuse or neglect. Maryland law also permits information to be shared with members of a multidisciplinary case consultation team who are investigating or providing services in response to a report of suspected abuse or neglect. Maryland Department of Human Resources

60 Alternative Response

61 Alternative Response is an approach that:
Involves families Encourages workers and families to collaborate Focuses on identifying concerns and finding solutions Forms stronger connections with community based agencies

62 Alternative Response Assessment Investigation Response
All referrals that meet the statutory definitions of maltreatment must be screened in: CPS Response Alternative Response Assessment Investigation Response All screened in referrals must receive a CPS response according to law

63 Investigative Response
Both Alternative Response Focus on Incident Safety Focus on Family Determine Findings Performance Focus on family functioning and healthy child development Identify Perpetrator Child and family well being Emphasize partnership between parents, DSS, extended family and community supports Useful in moderate to high risk cases Recognized agency authority No findings made, families identified as in need of support Gathers forensic evidence for use in court proceedings Responds to family unique circumstances

64 State and Local Resources

65 Resources Maryland Department of Human Resources www.dhr.md.gov
Child Abuse Prevention Network Childhelp USA Prevent Child Abuse America The Family Tree Child Welfare League of America The Enough Abuse Campaign


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