1. Conversations About Our Children Harold Johnson, Janet DesGeorges & Susan Schmidt Hands & Voices National Leadership Conference June 19, 2009 - Lake Tahoe, NV

2. O.U.R. Children2 Goals: Inform… Encourage… Support… Enhance our ability to observe, understand and respond to our children. Engage in conversations to protect our children. … one another as we:

3. O.U.R. Children3 Introductions Harold Johnson –Professor/Michigan State University – Deaf Education Teacher Preparation Program Janet DesGeorges –Outreach Director/Hands & Voices + Executive Director, Colorado Families for Hands Susan Schmidt –Director/ National Child Abuse Hotline – ChildHelp

4. O.U.R. Children4 Format Four brief presentations: –Harold Johnson: What are we talking about? –Susan Schmidt: Realities of child abuse and neglect (CA/N) –Harold Johnson: Incidence and impact of CA/N as experienced by children who are deaf/hard of hearing (d/hh) –Janet DesGeorges: CO GBYS CA/N Pilot Project Facilitated, Small Group Discussions Summary Information, Next Steps & Resources

5. O.U.R. Children5 InformWhat are we talking about? At one level...we are talking about enhancing parents ability to observe, understand, and respond to their children. At another level...we are talking about establishing a system to protect children from the horrors of neglect and abuse. At both levels...we are talking about improving the odds that our children will grow up happy and successful.

6. O.U.R. Children6 Realities of Child Abuse & Neglect (CA/N) Susan Schmidt, NC, MCC Childhelp Director, Childhelp National Child Abuse Hotline

7. O.U.R. Children7 What is Child Abuse? Neglect is failure to provide for a child's basic needs; food, water, appropriate clothing, appropriate supervision, etc. Physical abuse is physical injury as a result of hitting, kicking, shaking, burning, or otherwise harming a child. Sexual abuse is any situation where a child is used for sexual gratification. This may include indecent exposure, fondling, rape, or commercial exploitation through prostitution or the production of pornographic materials. Emotional abuse is any pattern of behavior that impairs a child's emotional development or sense of self-worth, including constant criticism, threats, and rejection.

8. O.U.R. Children8 What are Indicators of Abuse? Neglect: Signs of malnutrition Poor hygiene Unattended physical or medical problems Physical abuse: Unexplained bruises, burns, or welts Child appears frightened of a parent or caregiver Sexual abuse: Pain, bleeding, redness, or swelling in anal or genital area, Age-inappropriate sexual play with toys, self, or others, Age-inappropriate knowledge of sex, age inappropriate use of sexual language Emotional abuse: Extremes in behavior, ranging from overly aggressive to overly passive, Delayed physical, emotional, or intellectual development

9. O.U.R. Children9 Other Forms of Abuse Sometimes the very youngest children, even babies not yet born, suffer physical abuse. Because many chemicals pass easily from a pregnant womans system to that of a fetus, a mothers use of drugs or alcohol during pregnancy can cause serious neurological and physiological damage to the unborn child, such as the effects of fetal alcohol syndrome; mothers can also pass on drugs or alcohol in breast milk. A woman who drinks or uses drugs when she knows shes pregnant can be charged with child abuse in many jurisdictions if her baby is born with problems because of the substance use. Another form of child abuse involving babies is shaken baby syndrome, in which a frustrated caregiver shakes a baby roughly to make the baby stop crying. The babys neck muscles cant support the babys head yet, and the brain bounces around inside its skull, suffering damage that often leads to severe neurological problems and even death. While the person shaking the baby may not mean to hurt him, shaking a baby in a way that can cause injury is a form of child abuse. An odd form of physical child abuse is Munchausens syndrome by proxy, in which a parent causes a child to become ill and rushes the child to the hospital or convinces doctors that the child is sick. Its a way for the parent to gain attention and sympathy, and its dangers to the child constitute child abuse.

10. O.U.R. Children10 How Many Children Are Abused and Neglected in the United States? In 2007, approximately 3.2 million child abuse and neglect reports were made to Child Protective Services –These reports included about 5.8 million children As a result about 899,000 children were found to be victims of child abuse or neglect: –more than 60 percent were neglected –almost 10 percent were physically abused –less than 8 percent were sexually abused –less than 5 percent were emotionally maltreated In 2007, an estimated 1,760 children died due to abuse or neglect. More than 30 percent of these deaths were attributed to neglect. Almost 5 children die per day due to neglect and abuse!! Find more information on the U.S. Department of Health and Human Services, Administration for Children and Families website: http://www.acf.hhs.gov/programs/cb/index.htm http://www.acf.hhs.gov/programs/cb/index.htm –This website includes the annual report Child Maltreatment 2007, with national data regarding child abuse and neglect.Child Maltreatment 2007

11. O.U.R. Children11 How to ameliorate Abuse Observe –Know your child and his/her behavior. Pay attention to any differences in behavior –Know your childs friends, teachers, care givers, and make sure they know you –Be visible in your childs life –Know your childs routine, where they go, what they do –Observe how your childs caregiver interacts with him/her Observe

12. O.U.R. Children12 Observation Observation is basic to everything that child care providers do in their work. It helps them learn about children so that they can measure each child's progress and acquisition of skills. Over time, the written records of these observations provide a history of the children's lives in child care, as well as an insight into their development, strengths, needs, and interests. If a child's behavior changes suddenly, reviewing the records might help the providers to understand the causes for this shift in behavior. Since these records can be subpoenaed if there is a child abuse or neglect investigation, they should be concise and objective. Child care providers should observe the children at different times of the day, when the children are alone and with other children, and in different settings. Children may behave quite differently during a diaper change compared to when they are playing or listening to a song. When taking notes, the child care provider should be as objective as possible so that facts, rather than opinions, are recorded. Rather than writing, "Jill was very selfish when she stole Tammy's toy," the provider should note, "Jill took Tammy's stuffed animal while Tammy was playing with it." Although child care providers have busy schedules, it is important for them to find time to go over their observations and to discuss their thoughts and concerns with colleagues and supervisors. In addition to being used in planning, in evaluating, and in reporting to parents the child's behavior and activities throughout the day, these records can be used to identify possible signs that a child has been abused or neglected. For example, if a child care provider observes potential signs of abuse or neglect, the provider can review notes from previous observations to see if the child's behaviors follow a certain pattern. This may also assist CPS, if it becomes involved. In addition, caregivers may want to explore the causes of changes in behavior. For example, if a normally at-ease child recently has been throwing temper tantrums during mealtimes and cries hysterically during diaper changes, the caregiver might want to understand what may be happening at home that could cause this sudden change in behavior.

13. O.U.R. Children13 How to Ameliorate Abuse Understand –Understand that open communication and education may prevent the occurrence of abuse –Understand the symptoms of all abuse types –Understand that there are resources and help for those who experience abuse –Understand that it is not the childs fault –Understand that you must act now to eliminate abuse

14. O.U.R. Children14 How to Ameliorate Abuse Respond –Respond by remaining calm –Respond with love and non-judgmental language –Respond by reassuring your child –Respond by taking appropriate action –Respond by making a report –Respond by taking your child for professional help

15. O.U.R. Children15 Get Proactive Work with your child and your childs care givers and teachers to agree in advance how your child will be touched. Agree with your child and all care givers that if anything other than the agreed touch occurs your child will inform you. Do this with normalcy not suspicion

16. O.U.R. Children16 What to do If You Suspect Abuse If a child discloses abuse to you, carefully listen and do not push him/her to say more than is comfortable. REMAIN CALM! Assure the child that you believe him/her and that what has happened is not his/her fault. The child is not bad. Reassure the child. Let him/her know telling was the right thing to do and you appreciate that you were trusted. Do what you can to make him/her feel safe. Let the child know you will report the abuse and get help.

17. O.U.R. Children17 What to do If You Suspect Abuse Although the childs disclosure may make you angry or disgusted, do not attempt to take matters in your own hands. The situation requires professionals. Your interference can make matters worse. If you suspect the child has been sexually assaulted, do not change his/her clothes nor wash the child. Go immediately to the emergency room. Make a report by calling your local child protective services hotline or local police or sheriffs department. REMAIN CALM! If you are unsure whom to call, contact the 24-hour Child National Child Abuse Hotline at 1-800-4-A-CHILD for that information.

18. O.U.R. Children18 What to do If You Suspect Child Abuse ? Report

19. O.U.R. Children19 What Happens When CPS Receives a Report? The following information is based on the structure in a particular state. If a report is not taken, CPS can make a referral to an appropriate agency. A report is taken and assigned. A low priority case means there is not enough evidence to go out and investigate. CPS has legal limits, which sometimes prevents an investigation from occurring. These cases are written up and kept on file for a period of time – which varies state to state, county to county. A high priority case warrants an investigation. States will vary as to what constitutes a high priority situation, and each state will have a method for coding these situations. Response time will vary depending on the severity – an example would be a response within 24 hours for severe situations and a weeks response time for less severe situations.

20. O.U.R. Children20 What Happens When CPS Receives a Report? After a report is investigated, there are several possible outcomes. Case closed: worker was unable to validate occurrence of abuse. Validated and closed: abuse did occur but the child is protected from its recurrence. For example, if live-in girlfriend was the abuser and dad kicked her out when child disclosed the abuse. Validated and open: abuse did occur and services will help the family. Services may include parent aide, parenting classes, counseling, or day care for the child. Validated and In-home petition: abuse did occur, CPS has custody of the children but it is decided that the children can remain in the home while the family receives services. Validated and children are removed: abuse did occur and it is determined that the childrens well-being depends on their removal from the home. Goals are set for the family and for reunification. If these goals are not met, options may include adoption, guardianship, long-term foster care, or independent living (if the child is a teenager).

21. O.U.R. Children21 Reporting child abuse: Myths and Facts I dont want to interfere in some one elses family. The effects of child abuse are lifelong, affecting future relationships, self esteem, and sadly putting even more children at risk of abuse as the cycle continues. Help break the cycle of child abuse. What if I break up someones home? The priority in child protective services is keeping children in the home. A child abuse report does not mean a child is automatically removed from the home - unless the child is clearly in danger. Support such as parenting classes, anger management or other resources may be offered first to parents if safe for the child. They will know it was me who called. Reporting is anonymous. In most states, you do not have to give your name when you report child abuse. The child abuser cannot find out who made the report of child abuse. It wont make a difference what I have to say. If you have a gut feeling that something is wrong, it is better to be safe than sorry. Even if you dont see the whole picture, others may have noticed as well, and a pattern can help identify child abuse that might have otherwise slipped through the cracks.

22. O.U.R. Children22 Getting help for an abused child Although many people are reluctant to get involved in other families lives, when it comes to child abuse, you dont have the option of keeping mum. If you know of a child being abused or even suspect abuse, you have the responsibility to report it. In the United States, Canada, and Australia, the concept of mandatory reporting of suspected child abuse is well established and is beginning to catch on in other countries around the world. Laws on mandatory reporters designate classes of professionals typically school personnel, social workers, health care workers, mental health professionals, childcare providers, and law enforcement personnel, but in some states also clergy, film processors, and drug abuse counselors who must report suspected child abuse. Eighteen states and Puerto Rico require all citizens to report suspected abuse or neglect.

23. O.U.R. Children23 By reporting, you can make a tremendous difference in the life of a child and the childs family, especially if you help stop the abuse early. Early identification and treatment can help mitigate the long-term effects of abuse. If the abuse is stopped and the child receives competent treatment, the abused child can begin to regain a sense of self-confidence and trust. Parents may also benefit from support, parent training and anger management.

24. O.U.R. Children24 The best first place to call to report suspected child abuse is The Childhelp National Child Abuse Hotline: 1-800-4-A-CHILD (1-800-422-4453) Counselors at the hotline can help: Victims: children and teens who have been abused Survivors of child abuse Abusers: people who have abused a child or who are afraid that they may abuse a child Witnesses to child abuse Childhelp cannot make a report of child abuse for you, but it can set up a three-way call with your local enforcement agency. You can also call your local enforcement agency directly to report child abuse. Childhelp has a list of local phone numbers you can call for your county or state in the U.S.list of local phone numbers

25. O.U.R. Children25 Incidence & Impact of CA/N as Experienced by Children who are deaf/hard of hearing (d/hh) –Where: (Shakeshaft, 2004) anyplace that the abuser and the child can be alone –How Often & When: (Sullivan & Knuton, 2000) 9% of children w/o disabilities –Occurs most frequently during elementary school ages 31% of children w/ disabilities –Occurs most frequently during preschool ages

26. O.U.R. Children26 Types & Incidence: (Child Maltreatment Report, 2007) –59.0% Neglect –10.8% Physical Abuse – 7.6% Sexual Abuse – 4.2% Emotional Abuse – 13.1% Multiple Maltreatments *Note: This data does not differentiate between the occurrence of CA/N as experienced by children with and without disabilities.

27. O.U.R. Children27 While presence of a disability is noted as a risk factor for CA/N (Child Maltreatment Report, 2007), incidences of CA/N, as experienced by children with disabilities, are considered to be substantially underreported (Sullivan, Brookhouser, Scanlan, 2000) due to a lack of professional preparation by human services personnel ( Bonner & Hensley, 1997) and current reporting protocols. Available research indicates a significantly higher rate of sexual abuse experienced by individuals who are d/hh (Obinna, Osterbaan, & DeVore, Wendy, 2005; Obinna, Krueger, Osterbaan, Sadusky, DeVore, 2005; Willis & Vernon, 2002).

28. O.U.R. Children28 Impact of CA/N: (Wang, C-T., & Holton, J. (2007) –Poor Physical Health... e.g., chronic fatigue, altered immune function, hypertension, sexually transmitted diseases, obesity –Behavior Problems... e.g., aggression, juvenile delinquency, adult criminality, abusive or violent behavior –High-risk Behaviors... e.g., a higher number of lifetime sexual partners, younger age at first voluntary intercourse, teen pregnancy, alcohol and substance abuse –Social Difficulties... e.g., insecure attachments with caregivers, which may lead to difficulties in developing trusting relationships with peers and adults later in life –Poor emotional and mental health... e.g., depression, anxiety, eating disorders, suicidal thoughts and attempts, post-traumatic stress disorder –Cognitive dysfunction... e.g., deficits in attention, abstract reasoning, language development, and problem-solving skills, which ultimately affect academic achievement and school performance); Note: Information applies to all children, there is insufficient data re. children with disabilities.

29. O.U.R. Children29 Causes of CA/N for all children: (Caregiver Factors) –Neglect Too little income & affordable housing Need to work two or more jobs Mental health problems Substance abuse (Freundlich (2007) –History of Maltreatment –Domestic Violence –Age When Individual Became a Parent –Single Parent Household –Knowledge and attitude re. parent/child interactions (Goldman, Wolcott, & Kennedy, 2003)

30. O.U.R. Children30 Possible Causes of CA/N with Children who are disabled: (Hibbard & Desch, 2007) –limited access to info re. personal safety and/or sexual abuse prevention –may be accustomed having their bodies touched by adults –parental perspective that their child does not need information re. sex education as the child matures –child with disability may be conditioned to comply with the commands of adults –child with disability may not understand the difference between appropriate/needed discomfort associated with therapy and the discomfort associated with inappropriate actions taken on their body

31. O.U.R. Children31 Possible Causes of CA/N with Children who are d/hh –May lack the language skills needed to effectively understand, or convey to others that they have been sexually abused. (Vernon & Miller, 2002) –Conditioned to comply with authority figures, are naive re. sexual norms, and may misinterpret the attention of the abuser in relation to feels of being loved. (Sullivan, Vernon, & Scanlan, 1987) –Lack of sufficient school based learning opportunities and instructional materials needed to recognize, avoid, or report instances of abuse and neglect. (Obinna, et al., 2005) –Perception that children who are d/hh do not need information concerning appropriate and inappropriate sexual behavior. (Obinna, et al., 2005)

32. O.U.R. Children32 Deaf Education Professionals Ability to Recognize & Respond to Possible Incidences of CA/N (Johnson, 2009) –323 survey respondents –80% indentified self as professional –82% interacted on a daily basis with indi. who were d/hh –Professional preparation re. CA/N: 64% had some formal preparation –44% concerning children with disabilities –29% concerning children who are d/hh While most felt that they could find accurate info. (55%), most were uncertain re. their ability to effectively recognize (61%), or respond (58%), to possible instances of CA/N as experienced by children who are d/hh

33. EncourageThe Colorado Experience: O.U.R. Childrens Safety

34. O.U.R. Children34 Dipping our toes into the water… –Janets Log –CO H&V First Questions we are Asking Speaking Up….what happened? –With each other –To Groups –Investigating in our communities Permission for Joy

35. O.U.R. Children35 Next Steps in CO: –Opportunity to be part of our Pilot group –Contact: Janet@handsandvoices.orgJanet@handsandvoices.org –Commitment Requirements

36. O.U.R. Children36 We have been talking to you for quite a while. Now we need your help. At the onset of this presentation two goals were identified, i.e., 1.Enhance our ability to observe, understand and respond to our children; and 2.Engage in conversations to protect our children We now need your feedback and suggestions concerning these two goals. We will establish two to three groups, with each group facilitated by one of the presenters. Group facilitators will serve as recorders to note information generated by the group. Once the small group discussions have been completed, the group facilitators will summarize the information generated by the group. Summarized information will serve to guide the next stage of our work. Small Group Discussions

37. O.U.R. Children37 Small group questions: 1.How can parents ability to observe, understand and respond to their children be further enhanced? 2.When, where, and how can parents engage in conversations with other parents and professionals concerning protecting our children from child abuse and neglect? 3.What information and support would you need to have such conversations concerning child abuse and neglect in your local community?

38. O.U.R. Children38 Support Small Group Response 1.How can parents ability to observe, understand and respond to their children be further enhanced? –[type responses here]

39. O.U.R. Children39 2. When, where, and how can parents engage in conversations with other parents and professionals concerning protecting our children from child abuse and neglect? –[type responses here]

40. O.U.R. Children40 3. What information and support would you need to have such conversations concerning child abuse and neglect in your local community? –[type responses here]

41. O.U.R. Children41 Next Steps The better we can observe, understand, and respond to our children... –...the more informed that we become, –....the better we can protect, encourage and support our children, –....the more likely our children will experience happiness and success. In reality, many parents, especially those who just recently learned of their childs hearing loss, lack the confidence, knowledge and experience to effectively observe, understand, and respond to their children. In addition, most parents of children who are d/hh and the professionals who work with them, are unaware of the increased risk their children face in relation to child abuse and neglect. Ignorance is not bliss, it is dangerous!

42. O.U.R. Children42 Hands & Voices, in collaboration with Michigan State University, Child Help, and the National Exchange Club Foundation, do not accept the status quo. We do not accept that while our children are at greater risk to experience abuse and neglect, the powers-that-be remain focused on other topics that are deemed to be more pressing and more important. We can lead the way by enhancing our ability to observe, understand, respond to, and protect our children through three simple actions.

43. O.U.R. Children43 Three Actions 1.Pass-it-on: Share this presentation, and it related resources, with at least one other parent, and then ask them to pass-it-on. 2.Share the Story: Have a conversation with your child about abuse and neglect (see attached Helping Parents Talk to Children document), then share the story of how it went so that other parents can learn from your experience. 3.Recognize the best and Challenge the Rest: Ask the professionals who work with your child what they are doing to protect your child from abuse and neglect, then share the resulting reactions, information, resources, programs, and questions so that we recognize the best and challenge the rest. Send the resulting information to: Janet DesGeorges or Harold Johnson.

44. O.U.R. Children44 Three Actions + In addition to the requested Three Actions, the following is being done to support our work: –Enhanced......Web based resources...Hot Line counselors...Data collection –Collaborative......Pilot Project...Grant Efforts...Community of Learners

45. O.U.R. Children45 Resources Deaf Education Child Abuse & Neglect wiki –http://deafed-childabuse-neglect-col.wiki.educ.msu.edu/http://deafed-childabuse-neglect-col.wiki.educ.msu.edu/

46. O.U.R. Children46 MANY more resources

47. O.U.R. Children47 Child Help –http://www.childhelp.org/

48. O.U.R. Children48

49. O.U.R. Children49 National Exchange Club Foundation –http://preventchildabuse.com/ Three documents: Talking to your children about child abuse. Resources for parents. Disclosures about child abuse. http://deafed-childabuse-neglect-col.wiki.educ.msu.edu/Resources

50. O.U.R. Children50 Contact Information Harold Johnson/Professor - Michigan State University –343A Erickson Hall, East Lansing MI 48824-1034 –hjohnson@msu.edu, –517 432-3926 [v], 35.8.171.220 [video phone], Harold A. Johnson [Skype] –www.deafed.netwww.deafed.net Janet DesGeorges/Outreach Director – Hands & Voices + Executive Director, Colorado Families for Hands –730 South 44 th Street, Boulder, CO 80305 –janet@handsandvoices.org –(303) 492-6283 [v], Janet DesGeorges [Skype] –http://www.handsandvoices.org/index.htmhttp://www.handsandvoices.org/index.htm Susan Schmidt/Director – National Child Abuse Hotline –15757 North 78th Street, Scottsdale, Arizona, 85260 –SSchmidt@Childhelp.org –480-922-8212 [v] –http://www.childhelp.orghttp://www.childhelp.org

51. O.U.R. Children51 Thank You We hope you will join in this effort to observe, understand, respond to and protect our children.

52. O.U.R. Children52 References Bonner, B.L. & Hensley, L.D. (1997). State efforts to identify maltreated children with disabilities: A follow-up study. Child Maltreatment, 2(1), 52-60. Child Maltreatment Report 2007. Retrieved on 6/7/09 from: http://www.acf.hhs.gov/programs/cb/pubs/cm07/index.htm http://www.acf.hhs.gov/programs/cb/pubs/cm07/index.htm Freundlich, M. (2007). Time for reform: Investing in prevention: Keeping children safe at home. Retrieved on 6/5/09 from: http://www.preventchildabuse.org/about_us/media_releases/pew_kaw_prevention_r eport_final.pdf http://www.preventchildabuse.org/about_us/media_releases/pew_kaw_prevention_r eport_final.pdf Goldman, J., Wolcott, D., & Kennedy, K.Y. (2003). A coordinated response to child abuse and neglect: The foundation for practice. Retrieved on February 8, 2008 from: http://www.childwelfare.gov/pubs/usermanuals/foundation/index.cfmhttp://www.childwelfare.gov/pubs/usermanuals/foundation/index.cfm Hibbard, R.,A., Desch, L.D. (2007). Clinical report: Maltreatment of children with disabilities. Pediatrics, 119(5), 1018-1025. Johnson, H. (2009). Child abuse and neglect: Professionals preparation and ability to recognize and respond. Unpublished survey.

53. O.U.R. Children53 Obinna, Jennifer, Krueger, Sarah, Osterbaan, Constance, Sadusky, Jane M, DeVore, Wendy (2005). Understanding the Needs of the Victims of Sexual Assault in the Deaf Community: A Needs Assessment and Audit. Retrieved on 6/5/09 from: http://www.ncjrs.gov/pdffiles1/nij/grants/212867.pdf http://www.ncjrs.gov/pdffiles1/nij/grants/212867.pdf Shakeshaft, C. (2004). Educator Sexual Misconduct: A synthesis of existing literature. Retrived on 6/5/09 from http://www.ed.gov/rschstat/research/pubs/misconductreview/re port.pdf http://www.ed.gov/rschstat/research/pubs/misconductreview/re port.pdf Sullivan, Patricia M., Brookhouser, Patrick, & Scanlan, M. (2000). Maltreatment of deaf and hard of hearing children, Ch. 7, pp149-184. In Hindley, Peteer & Kitson, Nick (Ed.) Mental Health and Deafness. Whurr Publishers, London & Philadelphia Sullivan, P.M., & Knuton, J.F. (2000). Maltreatment and disabilities: A population-based epidemiological study. Child Abuse & Neglect, 24(10), 1257-1273.

54. O.U.R. Children54 Sullivan, Patricia M., Vernon, McCay, & Scanlan, John, M (1987). Sexual abuse of deaf youth. American Annals of the Deaf, 32(4), 256-262 Vernon, McCay & Miller, Katrina (2002). Issues in the sexual molestation of deaf youth. American Annals of the Deaf, 147(5), 28-35 Wang, C-T., & Holton, J. (2007). Total estimated cost of child abuse and neglect in the United States. Retrieved on 2/3/2008 from: http://www.preventchildabuse.org/about_us/media_releases/pc aa_pew_economic_impact_study_final.pdf http://www.preventchildabuse.org/about_us/media_releases/pc aa_pew_economic_impact_study_final.pdf Willis, Richard G., & Vernon, McCay (2002). Residential psychiatric treatment of emotionally disturbed deaf youth. American Annals of the Deaf, 147(1), pp 31-37