1. CHILD ABUSE Responsibilities and Reporting Procedures Georgia CTAE Resource Network Instructional Resources Office

2. Child Abuse Basics The brain never forgets Experiences children have, good or bad, are forever stored in our memory Child abuse and neglect will have an effect on a child the rest of his/her life. Help is available to those who have experienced abuse 4/29/2015

3. 10 Terms to Know Child Abuse – mistreatment of a child by a parent or guardian, including neglect, beating, and sexual molestation. Physical abuse – harm to a person that can be seen Sexual abuse - rape, sexual assault, or sexual molestation. Neglect – to be remiss in the care or treatment of: to neglect one's family; to neglect one's appearance. Reprimand – a severe reproof or rebuke, especially a formal one by a person in authority. 4/29/2015

4. Latch-key child - a child who must spend at least part of the day alone and unsupervised, as when the parents are away at work Intentionally – done with intention or on purpose Punishment – a penalty inflicted for an offense, fault, etc., severe handling or treatment. Failure to thrive – A condition in which babies fail to grow and develop properly because of a lack of love and attention Shaken Baby Syndrome – Severe shaking of a baby, usually in effort to get a baby to stop crying. Leads to brain damage, mental retardation, cerebral palsy, or blindness. 4/29/2015

5. www.health-nurses- doctors.blogspot.com CHILD ABUSE 80% OF CHILD ABUSERS ARE PARENTS OR OTHER RELATIVES 3 out of 4 child slayings in the industrialized world occur in USA 1 out of 3 girls are sexually abused before they reach age 18 1 out of 5 boys will be sexually abused before they reach age 18

6. www.health-nurses- doctors.blogspot.com RISING INCIDENCE OF CHILD ABUSE The number of cases of child abuse or neglect reported to State Child protective Services Agencies rose 65%, and the number of substantiated cases rose 44%. Because many cases are never reported, actual incident rates are much higher.

7. www.health-nurses- doctors.blogspot.com RISKS: Child doesn’t match well with parent (emotional or developmental disabilities) Parent under stress Little community support (child care or medical care) CHILD + STRESS = ABUSE (Remove child or stress to avoid abuse)

8. www.health-nurses- doctors.blogspot.com Parental Characteristics Abused as child Belief in corporal discipline May have spouse violence Belief that father should dominate Low self-esteem Unrealistic expectations of children Role reversal, uses child to gratify their needs Unconcerned about seriousness of abuse

9. www.health-nurses- doctors.blogspot.com Child Characteristics “Normal” but born out of wedlock or unplanned “Abnormal” – low birth weight or serious illness “Difficult” – may be fussy

10. www.health-nurses- doctors.blogspot.com Family Characteristics Unemployment Isolated Low income, economic stress Unsafe neighborhood Home is crowded, dirty, unhealthy Often single parent (overstressed) One or more family members has health problems Larger family Sibling/sibling violence is most common form of family violence

11. www.health-nurses- doctors.blogspot.com IS THIS ABUSE? A girl is slapped for screaming at her mother; the slap stings, but leaves no lasting mark or pain. A boy is punished in a way that requires stitches. A father burns his daughter’s palms with a lighted cigarette when he finds her smoking. A mother is careless and spills scalding coffee on her daughter, who is seriously burned. A boy’s arm is broken after wrestling with his father for sport. A girl is spanked so hard she is badly bruised, but the father says he did not mean to hurt her. A boy is grounded for a week for a minor offense. A father takes away his son’s driver’s license for getting a parking ticket. A young mother was asked to get help and get off drugs but her baby was born addicted to drugs.

12. www.health-nurses- doctors.blogspot.com SHAKEN BABY SYNDROME – NEVER SHAKE A BABY Head trauma is the leading cause of disability and death among infants and children. Violent shaking is involved in many of these cases. 25-50% of the American public does NOT know that shaking an infant can cause brain damage or death. The brain keeps vibrating within the skull cavity after shaking occurs. The brain swells, creating pressure, leading to retinal bleeding and can lead to blindness. Veins feeding the brain are torn away, leading to brain damage or brain visual disability, speech disability, and seizures.

13. www.health-nurses- doctors.blogspot.com PLAY ACTIVITIES THAT ARE HAZARDOUS: Tossing a small child into the air Jogging while carrying an infant on the back or shoulders “Riding a horse” – bouncing on the knee Swinging the child around by his/her ankles Spinning a child around WARNING: If this happens take child to Emergency Room immediately. The child can be treated.

14. www.health-nurses- doctors.blogspot.com TECHNIQUES FOR SOOTHING A CRYING BABY: TOUCH: Cuddling, swaddling, warm water bottle, warm bath MOTION: Rocking, walking, stroller, car ride, rhythmic patting SOUND: Rhythmic chants, ticking clock, singing, recording of heartbeat or womb sounds

15. www.health-nurses- doctors.blogspot.com PHYSICAL ABUSE: Behavior indicators:  Aggressive or withdrawn  Afraid to go home  Stealing  Lying  Layered clothing Non-accidental injury of a child that leaves marks, scars, bruises, or broken bones.

16. www.health-nurses- doctors.blogspot.com NEGLECT: Behavior indicators: Hunger Poor hygiene Excessive sleepiness Lack of appropriate supervision Unattended physical problems or medical needs Abandonment Inappropriate clothing for weather conditions Failure of parents or caretakers to provide needed, age appropriate care. Including food, clothing, shelter, protection from harm, supervision appropriate to the child’s development, hygiene, and medical care.

17. www.health-nurses- doctors.blogspot.com EMOTIONAL ABUSE: Behavior indicators: Failure to thrive Speech disorders Lags in physical development Habit disorders, conduct disorders Sleep disorders or inhibition of play Aggressive or passive Rejecting, terrorizing, berating, ignoring, and isolating, that is likely to cause serious impairment of the physical, social, mental, or emotional capacities of the child.

18. www.health-nurses- doctors.blogspot.com SEXUAL ABUSE: Behavior indicators: Inappropriate sexual knowledge Abrupt change in personality Withdrawn Poor peer relationships Promiscuous behavior/seductive behavior Sleep disturbances Regressive behavior Fondling, sexual intercourse, assault, rape, date rape, incest, child prostitution, exposure and pornography

19. www.health-nurses- doctors.blogspot.com CHILD SEX ABUSE Pedophilia: Adult sexual attraction to prepubescent children that is intense and recurring; an adult’s use of children for sexual purposes. Incest: Sexual intercourse between individuals too closely related to marry, usually interpreted to mean father/daughter, mother/son, or brother/sister. At risk: 8-12 years, girls, stepfathers, poor parent relationships. (no relation between race & socio economics)

20. www.health-nurses- doctors.blogspot.com LOOK OUT FOR: A person always alone with the child. A person always buying things for the child. A person always wanting to take the child places.

21. www.health-nurses- doctors.blogspot.com WHY CHILDREN DON’T TELL Too young Fear, threatened Bribed Affection Told that the abuse is normal Want to please adults Guilt

22. www.health-nurses- doctors.blogspot.com PROCEDURES FOR CHILD CARE PROFESSIONALS: Always ask parents about injuries. Watch their reaction and explanation which should be logical. They should not be defensive and should willingly give explanations. Any suspected child abuse should first be reported to the director of the day care..5% of children don’t tell the truth about abuse

23. www.health-nurses- doctors.blogspot.com PRIMARY TARGET ZONE: Most NORMAL injuries occur on the front of the body. Primary target zone for abuse is the back, the elbows and knees, also includes the face, hands & wrists.

24. www.health-nurses- doctors.blogspot.com CHARACTERISTICS OF ABUSE INJURIES: Most abuse injuries occur in multiples. Parent was out of control. Wrist and upper arms may have finger bruises. The back of the arms may have bruises where the child put arm in front of face to protect self.

25. www.health-nurses- doctors.blogspot.com DOCUMENTATION: Document every injury noticed. (date, time, description, comments by child, etc.) Even document injuries that occur at the daycare. Send a copy home to parents.

26. www.health-nurses- doctors.blogspot.com DECLARATION OF ABUSE: When a child gives you a declarative statement about abuse Document the words exactly as you heard them. Get other witnesses to document what was said. Record date, time, location, etc.

27. www.health-nurses- doctors.blogspot.com HOW TO REACT IF A CHILD TELLS YOU ABOUT ABUSE: Listen, do not infer, assume or interrogate. Reassure the child that he/she has done the right thing by telling you and that you are glad they told you. Make sure they understand it was not their fault. Remain calm and accepting, don’t over react. Do not promise not to tell. Be honest and tell the child what to expect. Reassure them you will do what needs to be done to make sure it doesn’t happen again. Determine the child’s needs for safety.

28. www.health-nurses- doctors.blogspot.com YOUR ROLE: To protect To love To teach It is important to rebuild self-esteem through sincere praise and reassurance of the child’s abilities.

29. www.health-nurses- doctors.blogspot.com THE LAW: UNDER Georgia Law, EVERYONE HAS A LEGAL OBLIGATION TO REPORT SUSPICION OR KNOWLEDGE OF CHILD ABUSE!!!! It is a misdemeanor if you don’t report it. Reporters name can remain anonymous.

30. www.health-nurses- doctors.blogspot.com WHO TO CALL TO REPORT CHILD ABUSE: Georgia Department of Human Resources Division of Family & Children Services Constituent Services 2 Peachtree Street, NW Suite 18-486 Atlanta, Georgia 30303 404-651-9361 Domestic Violence 1-800-869-1150 Local Police Report in a request for an investigation, not a proven fact. Reports can be done anonymously.