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

2. The Plan Introductions What do you want to learn while you’re here?
Activity
Costs and national overview
Risk factors
Types of abuse and typical signs
Reporting requirements, legal and ethical, while supporting the child
Reporting how to’s
The Real World: audience’s experiences
What happens after a report is made
Prevention: The Cutting Edge
Q&A

3. Costs of Child Abuse and Neglect
An 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.

4. The Federal Child Protection Law: CAPTA (The Child Abuse Prevention and Treatment Act)
Purpose and Goals:
Federal Law first enacted in 1974; amended most recently in 2003.
To improve prevention, identification, investigation, and treatment of child maltreatment
Defines a minimum standard of child abuse and neglect that States use as a foundation to specify their own definitions.
Requires certain professionals, as specified by each State, to report suspected child abuse/neglect to the State agency.
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.

5. CAPTA: minimum 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)

6. Risk Factors Child 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

7. 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

8. What is Physical Abuse? Punching Beating Kicking Shaking Slapping
Physical injury ranging from minor bruises to severe fractures or death as a result of any method or harm, including:
Punching
Beating
Kicking
Shaking
Slapping
Hitting
Choking
Burning
Throwing
Stabbing
Biting
Others?
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

9. What is Sexual Abuse?
Includes activities by a parent or caretaker such as:
Fondling a child’s genitals
Penetration
Exploitation through prostitution or pornographic materials
Rape
Incest
Sodomy
Indecent exposure
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

10. 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

11. 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.

12. 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 or call 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.

13. The Real World: Our Experiences with Child Abuse and Neglect

14. What happens after I make a report?
Screened by CPS staff. Enough credible information to indicate maltreatment or risk= referred to an investigator
Investigated within a specific time period, prioritized based on potential severity
Investigator may interview child, family, teachers, childcare workers, doctors, or others
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.
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:
Mental health care
Medical care
Parenting skills classes
Employment assistance
Financial or housing assistance
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.

15. Prevention: Protective Factors to Build On
Child 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

16. Child Abuse/Neglect Prevention: The Cutting Edge
Primary: Stop it before it starts, for everyone
Secondary: Stop it before it starts, for families considered “at risk”
Tertiary: It happened, but let’s stop it from happening again
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
The Front Porch Project

17. Questions and Answers