BCCO PCT #4 PowerPoint AND COURSE TITLE Intermediate Child Abuse TCOLE Course # 2105 Participant Handout UNIT THREE

3.0 This section will introduce the participant to four categories of child abuse and neglect. DEFINING CHILD SEXUAL ABUSE & EXPLOITATION

Learning Objectives Learning Objective 3.1 Learning Objective 3.1: The student will be able to identify examples of child abuse as defined in the Texas Family Code Learning Objective 3.2 Learning Objective 3.2:The student will be able to identify different factors involving children targeted for child abuse Learning Objective 3.3 Learning Objective 3.3:: The student will be able identify examples of child neglect as defined in the Texas Family Code Learning Objective 3.4 Learning Objective 3.4:The student will be able to identify examples of child emotional abuse and neglect.

Learning Objective 3.5 Learning Objective 3.5:The student will be able to identify general environmental and health indicators of child abuse and neglect. Learning Objective 3.6 Learning Objective 3.6:The student will be able to identify physical indicators of child physical abuse. Learning Objective 3.7 Learning Objective 3.7:The student will be able to identify behavioral indicators of child physical abuse. Learning Objective Learning Objective 3.8:The student will be able to identify physical indicators of child physical neglect. Learning Objective 3.9 Learning Objective 3.9:The student will be able to identify behavioral indicators of child physical neglect.

Learning Objective 3.10 Learning Objective 3.10:The student will be able to identify physical indicators of emotional abuse and neglect. Learning Objective 3.11 Learning Objective 3.11:The student will be able to identify behavioral indicators of emotional abuse and neglect. Learning Objective 3.12 Learning Objective 3.12:The student will be able to identify various aspects of child sexual abuse and exploitation. Learning Objective 3.13 Learning Objective 3.13:The student will be able to identify physical indicators of child sexual abuse. Learning Objective 3.14 Learning Objective 3.14: The student will be able to identify behavioral indicators of child sexual abuse.

3.1 Examples of CHILD ABUSE (Texas Family Code) A. ______ or __________ injury to a child that results in an observable and material impairment in the child's growth, development, or psychological functioning. 3.1

B. _______ or __________ the child to be in a situation in which the child sustains a mental or emotional injury that results in an observable and material impairment in the child's growth, development, or psychological functioning. 3.1

C. ___________ injury that results in substantial harm to the child, or the genuine threat of substantial harm from physical injury to the child, including an injury that is at variance with the history or explanation given and excluding an accident or reasonable discipline by a parent, guardian, or managing or possessory conservator that does not expose the child to a substantial risk of harm. 3.1

D. Failure to make a ____________ effort to prevent an action by another person that results in physical injury that results in substantial harm to the child. E. _____ conduct harmful to a child's mental, emotional, or physical welfare. 3.1

F. Failure to make a reasonable effort to prevent _________ conduct harmful to a child. G. _________ or ____________ the child to engage in sexual conduct. 3.1

photographing H. Causing, permitting, encouraging, engaging in, or allowing the photographing, filming, or depicting of the child if the person knew or should have known that the resulting photograph, film, or depiction of the child is _______ or ______________. 3.1

I. The current use by a person of a _________ __________ in a manner or to the extent that the use results in physical, mental, or emotional injury to a child. Causing, expressly permitting, or encouraging a child to use a controlled substance. 3.1

3.2 Children Targeted for CHILD ABUSE Factors 3.2 Children Targeted for CHILD ABUSE ( Factors ) A. ____________ most likely to be abused physically, are infants or pre-school age children, because they are defenseless, demanding, or lacking in communication skills. 3.2

B. Other children targeted for abuse are ____________ children (retarded, hyperactive, speech defective, etc.) C. _______ and emotional abuse are not restricted to any group or class. D. The victim of _______ abuse may be a boy or girl of any age, but it is most often a school age or adolescent girl. 3.2

3.3 Examples of CHILD NEGLECT (TFC) A. The ______ of a child in a situation where the child would be exposed to a substantial risk of physical or mental harm, without arranging for necessary care for the child, and the demonstration of an intent not to return by a parent, guardian, or managing or possessory conservator of the child. 3.3

B. The following acts or omissions by a person 1. ________ a child in or failing to remove a child from a situation that a reasonable person would realize requires judgment or actions beyond the child's level of maturity, physical condition, or mental abilities and that results in bodily injury or a substantial risk of immediate harm to the child. 3.3

B. 2. ______ to seek, obtain, or follow through with medical care for a child, with the failure resulting in or presenting a substantial risk of death, disfigurement, or bodily injury or with the failure resulting in an observable and material impairment to the growth, development, or functioning of the child. 3.3

B. 3. The _______ to provide a child with food, clothing, or shelter necessary to sustain the life or health of the child, excluding failure caused primarily by financial inability unless relief services had been offered and refused. Placing a child in or failing to remove the child from a situation in which the child could be exposed to a substantial risk of sexual conduct harmful to the child. 3.3

C. The failure by the person responsible for a child's care, custody, or welfare to permit the child to return to the child's home without arranging for the necessary ______ for the child after the child has been absent from the home for any reason, including having been in residential placement or having run away. 3.3

3.4 Examples of Child Emotional Abuse & Neglect A. Emotional abuse and neglect are difficult to _________ and prosecute. B. Those ___________ who fail to provide a loving environment in which a child can thrive, learn, and develop normally commit these forms of abuse. 3.4

C. Specific ____________ or lack of behaviors on the part of a parent can emotionally affect a child and the way that child grows or interacts with others. 3.4

D. Two examples of ____________ neglect would be a baby who is never picked up out of the crib or parents who are totally undemonstrative in loving or giving affection toward their children. 3.4

E. Other examples of emotional neglect include _____________ and distancing, depreciation, and domination of a child. 3.4 F. The effects of emotional abuse or neglect are not always _______ until later in the child's life.

3.5 Environmental & Health Indicators of Child Abuse & Neglect Abuse and Neglect Indicators A. Abuse and Neglect Indicators 1. ________ of the caretaker may arouse suspicions. The caretaker may be purposely vague or evasive or may not volunteer any information. 3.5

Abuse and Neglect Indicators A. Abuse and Neglect Indicators 2. Abusive __________ often take the child to many different physicians for treatment. If the abused child has been taken to a hospital or physician located far f rom his house, this could be an indicator of abuse. 3.5

A.3. The child's behavior may also arouse suspicions. a. Statistically, the vast majority of abused children are under _____ years old. Nearly half of all reported cases involve children under six months old. Abused or neglected children of this age seldom cry. When they do, it 3.5

A. 3. The child's behavior may also arouse suspicions. Cont’d a. Cont’d : is a hopeless, mournful sound that merely accompanies pain and sorrow. The ____ is not urgent. It contains no expectation of comfort and relief 3.5

A. 3. The child's behavior may also arouse suspicions. b. Abused children may also be wary of __________ contact with adults. Sometimes the child will exhibit Extreme fright, reacting to any physical contact with whimpering or attempts to hide. Others show extreme apathy & unresponsiveness. 3.5

Living Condition B. Living Condition. 1. Officers should consider the child's complete ____________ and make particular effort to avoid associating low income as being synonymous with neglect. 2. Burned-out or condemned buildings should be regarded as ________ housing. 3.5

Living Condition B. Living Condition. 3. ___________ conditions, such as human and animal waste on the floors, are indicative of neglect. 4. Lack of ________ in the house during the winter months is neglect. 3.5

Living Condition B. Living Condition. 5. Danger of _______ from open heating units such as buckets of burning wood or coal should be considered as unsafe conditions. 6. Children ___________ on cold floors or in beds that are dirty, soiled, and wet with human waste are neglected. 3.5

Living Condition B. Living Condition. 7. ____________ of rodents (rats and mice) demonstrates neglected homes. 3.5

Health Hazards C. Health Hazards. 1. ______________ of children is indicated by if there are signs of being underweight and small in stature. 2. Most neglected children will appear obviously ___________. 3.5

Health Hazards C. Health Hazards. 3. Officers should also be aware of the condition of _______ in the house. If there is not any food for the children to eat, or what food there is has spoiled, it indicates neglect. 3.5

Health Hazards C. Health Hazards. 4. The child's failing to thrive may be due to a legitimate _______ condition that a doctor is attempting to cure. This can be determined by asking the parents if the child is receiving any medical care and checking that information with the Texas Department of Protective and Regulatory Services and/or the Dr.. 3.5

Health Hazards C. Health Hazards. 5. ________ children usually will not be receiving doctor's care. 6. Care must be taken while investigating cases of neglect; ______ families may be providing the best care possible within their means. 7. Apply community ________ to the family situation. 3.5

3.6 Physical Indicators of CHILD ABUSE Unexplained Bruises and Welts A. Unexplained Bruises and Welts 1. __________ result from bleeding under the skin caused from trauma. 3.6

Age dating Bruises A. 2. Age dating Bruises Initial Injury Within 6 to 12 hours Within 12 to 24 hours Within 4 to 6 days Within 5 to 10 days ___________ _____ – _______ _____ Tint – Dark Pale _______ to ______ (Sometimes brown tint) 3.6

B. Primary target zone: 1. Extends from the back of the ____ to the back of the _______. 2. Includes back of the _______ and __________. C. Injuries located on head and ____ D. Injuries in several different surface areas: an indication that the child has been struck from several different ______________. 3.6

E. Injuries in various stages of ____________. 3.6

F. Injuries reflecting ________ of the object used to inflict the injury, such as hand, hose coupling, belt buckle. 1. ____-around or ____ injuries from flexible objects such as a belt, strap or electrical cord. 2. ___________ wounds to the neck, ankles and wrists as a result of being tied up. 3.6

G. __________ that regularly appear after an absence, like a weekend or vacation. H. Unexplained _________. 1. ___________ burns, especially on soles of feet, palms, back or buttocks. 3.6

H. Unexplained Burns. 2. __________ burns; having a sock- like or glove-like shape; donut shape around buttocks indicates that the child was held down in hot liquid. 3. Burn that is in a pattern of the _______ used to inflict the injury such as an iron. 4. ____ burns on arms, legs, neck or torso. 3.6

I. Unexplained Skeletal Injuries. 1. To skull, _____ or _____ structure. 2. To ______. 3. In various stages of __________. 4. Multiple, or spiral ____________. 3.6

J. Unexplained _______________ or Abrasions. 1. To ________, inside lips, gums, or eyes. 2. To ___________ or ______ areas. 3. Unexplained __________ injuries. 4. Absence of _____ in various spots. 3.6

J. Unexplained Lacerations or Abrasions – Cont’d: 5. Bilateral subdural _____________ (bruises to the brain) caused by shaking a child. 6. Retinal _________ or detachment. 7. _______________ ear. 3.6

J. Unexplained Lacerations or Abrasions – Cont’d: 8. Clotted ______ in the nose and/or deviated septum. 9. ______________. 3.6

K. Unexplained Internal Injuries 1. Difficult to detect because frequently there are no ___________ ____________ injuries. 2. Lacerated _____, bruised ______, ruptured __________, and damaged ______ are common internal injuries. 3.6

K. Unexplained Internal Injuries 3. Usually caused by direct blows, being thrown against wall, door, furniture, ______________ (repeated blows to the body with hands or fists), or kicking. 3.6

K. Unexplained Internal Injuries 4. Internal injury without ________ of falls from high places or automobile accidents should be considered suspicious. 3.6 K. Unexplained Internal Injuries 5. Children who fall from couches, beds, and cribs don't injure ________ organs.

3.7 Behavioral Indicators of CHILD Physical ABUSE A. May be _________ of adult. B. May be ___________ when other children cry. C. May suffer __________ extremes (withdrawal, aggressiveness, and regression). 3.7

D. May be __________ of parents or care providers. E. May refuse to _______ in front of parents. F. May be ________ to go home. 3.7

G. May wear long sleeved shirts, knee socks, or other covering clothes that are unseasonable to hide ____________. H. May report _______ by parent or care provider 3.7

3.8 Physical Indicators of CHILD Physical Neglect A. _______________ neglect. B. Child appears _____ and ______ C. Poor ____________. 3.8

D. Wears ________ or inappropriate clothing. E. _____________ physical problems, medical or dental ____________. 3.8 F. Leaving a child _____________ or inadequately supervised for long periods of time. G. _______________ neglect.

3.9 Behavioral Indicators of CHILD Physical Neglect A. Begging, _____________ food. B. Constant _______, listlessness, or falling ________ in school. 3.9

C. _________ days at school (early arrival or late departure). D. Frequently ________ from school. 3.9 E. Abuses _______ or _________. F. __________________ (i.e. thefts). G. States there is no _________ ____________.

H. Failure to thrive caused by improper ___________: A child who is below the _______ percentile in weight and height compared to standard height and weight charts may indicate a failure to thrive. 3.9

3.10 Physical Indicators of Emotional Abuse & Neglect A. _______________ disorders. B. Lag in ________ or ___________ development C. Failure to thrive caused by lack of _______________ or touching. D. Nervous skin _______________.

3.11 Behavioral Indicators of Emotional Abuse & Neglect A. _______ disorders (sucking, biting, and rocking). B. _______ disorders (causes trouble or interferes with others) C. Has abnormal _________. D. Suffers ____________ extremes.

E. Suffers overly ________ behavior (inappropriately adult or infant). F. Has developmental ______ G. May attempt ____________. H. _______ -____________.

3.12 Aspects of Child Sexual Abuse & Exploitation A. Child ______ _____ is any _____ contact, or _______ activity between any person and a child B. It may include sexual assault, ________, fondling of the genitals, fondling of the breasts or exhibitionism.

C. Sexual exploitation encompasses child ____________________, child pornography, and child prostitution. It generally relates to sexual abuse outside the family setting. 3.12

3.13 Physical Indicators of Child Sexual Abuse A. Difficulty in _______ or sitting up B. Torn, stained, or bloody __________________. C. Pain, or itching in ________ area.

D. _______ or _________ in external genitalia, vaginal, or anal areas. E. __________ disease, especially in pre-teens. F. __________________ disorders. 3.13

3.14 Behavioral Indicators of Child Sexual Abuse A. Exhibits withdrawal, __________, or infantile behavior. B. Has bizarre, sophisticated, or unusual ____________ behavior, or knowledge 3.14

C. Is unwilling to change _________ for gym, or participate in education class. D. Has poor __________ relations. 3.14

E. Is __________, or runs away from home often. F. Reports ________ assault by care provider. 3.14

G. Has feelings of _____ or ______. H. ____________. 3.14

I. Demonstrates _____-__________ behavior, such as alcohol or drug abuse. J. ____________ Disorders. 3.14

Questions?