1. “Strategies, Resources, & Research Opportunities in the Preparation of Teachers as Mandatory Reporters of Child Abuse & Neglect” Harold Johnson/MSU 2/19/2010 ACE-D/HH 2010 Conference Lexington, KY

2. Presentation Outline ► What are we talking about? ► Why do WE have to deal with this? ► What is stopping us? ► Where can we go for more information and help when we need it? ► What can we realistically do? H. Johnson/MSU2

3. What are we talking about? H. Johnson/MSU3 http://www.dcmp.org/FlashLanding/SecureFlash.aspx?G=31653p:// http://www.dcmp.org/http://www.childhelp.org/

4. Why do WE have to deal with this? ► Every State legally mandates that educators report suspected child abuse and neglect (Crosson-Tower, 2003). H. Johnson/MSU4 http://www.childwelfare.gov/systemwide/laws_policies/state/

5. Why do WE have to...(cont) H. Johnson/MSU5 Example: Kentucky

6. H. Johnson/MSU6 What is stopping us? ► Barriers to reporting CA/N: 1. Belief that CA/N is not a common, or sufficiently important problem to warrant attention. [info] [info] 2. Insufficient knowledge re.... ►...the signs and symptoms of CA/N; and ►...CA/N reporting procedures and/or conflicting school policies. [info] [info] 3. Perceived negative consequences of reporting, i.e.,... ►...make things worse for the child; and ►...fear of disapproval from parents, parental denial, lack of administrative support and legal ramifications for false allegations. [info] [info]

7. H. Johnson/MSU7 Barriers...(cont.) 4. Lessons learned from past reporting, e.g., nothing happened. 5. Negative attitude towards Child Protective Services. [Info: 4 & 5] [Info: 4 & 5] [Info: 4 & 5] 6. The lack of training, and ongoing support, concerning recognizing, reporting and responding to possible incidences of CA/N. 7. The belief that someone else is dealing with this problem. [info: 6 & 7] [info: 6 & 7][info: 6 & 7] Alvarex, Kenny, Donohue, & Carpin, 2004; Bonner, & Hensley, 1997; Kenny, 2001, 2004

8. Barriers (cont.) ► In summary, we do not deal with CA/N because we... ...think it is not a significant problem ...are uncertain how to recognize, or report it ...are afraid of the possible consequences ...do not think anything positive will occur ...think someone else is dealing with it ► I would also suggest that we have not dealt with CA/N because it is such a controversial, and unpleasant topic to discuss and think about. H. Johnson/MSU8

9. Barriers (cont.) ► In reality,... ►...30+% of our students will experience CA/N prior to the 12 th grade, with the greatest risk occurring from birth to age two years. ►...we are legally required to report possible instances of CA/N ►...yet we are neither prepared for, nor supported in, meeting our legal responsibility as mandatory reporters of CA/N. H. Johnson/MSU9

10. Barriers (cont.) ► In reality,... ...our lack of attention, preparation and support to Observe, Understand, and Respond serves to increase the duration and the impact of CA/N ...all of our work to prepare the best possible teachers will be negated, if our students are not physically, or mentally able to learn. ...WE can start to address the horrific realities of CA/N by enhancing out ability to observe, understand, and respond to children who are d/hh. H. Johnson/MSU10

11. Where can we go for more information and help when we need it? ► A “Community of Learners” has been established to address the issue of CA/N as experienced by children who are d/hh. H. Johnson/MSU11 http://deafed-childabuse-neglect-col.wiki.educ.msu.edu/ Hands & Voices has been a partner in this effort since 2007

12. Go for more info... H. Johnson/MSU12 http://www.childhelp.org/hotline Call and discuss your concerns with an expert...

13. Report your concerns... H. Johnson/MSU13 http://www.childwelfare.gov/responding/reporting.cfm

14. What can we realistically do? ► We can... 1....recognize CA/N as a frequent and significant barrier to the physical, emotional and academic success of OUR students who are d/hh. 2....find the local CA/N experts and begin a conversation about OUR students who are d/hh. H. Johnson/MSU14

15. What can we do...(cont.) ► We can... 3....provide learning opportunities for our college students and support our colleagues as they learn how to Observe, Understand, and Respond to possible instances of CA/N. 4....join the Deaf Education Community of Learners (http://deafed-childabuse-neglect- col.wiki.educ.msu.edu/) to identify, document, and recognize those early intervention and K- 12 programs that have established effective CA/N prevention and response programs, while we challenge those who have yet to do so. http://deafed-childabuse-neglect- col.wiki.educ.msu.edu/http://deafed-childabuse-neglect- col.wiki.educ.msu.edu/ H. Johnson/MSU15

16. Thank You I hope you will join with me in an effort to Observe, Understand, and Respond to possible instances of CA/N. Together we CAN make a difference! H. Johnson/MSU16

17. H. Johnson/MSU17 Contact Information ► Harold A. Johnson/Professor ► Deaf Education Teacher Preparation ► 343A Erickson Hall ► Michigan State University ► East Lansing, MI 48824 ► 517 432-3926 [office] ► 517 353-6393 [fax] ► 35.8.171.220 [video ph] ► Harold.a.johnson3 [Skype] ► MSUE_H_Johnson [iVisit] ► www.educ.msu.edu/deafed [Web] www.educ.msu.edu/deafed

18. What do we Know about Child Abuse and Neglect (CA/N)? H. Johnson/MSU18

19. Barrier #1: CA/N not a big problem...  CA/N is experienced by 09% of children w/o disabilities vs. 31% of children w/ disabilities (Sullivan & Knutson, 2000).  Existent research indicates that while 10% of hearing boys and 25% of hearing girls report sexual abuse, vs. 54% of boys who are d/hh and 50% of girls who are d/hh report sexual abuse (Sullivan, Vernon, Scanlan, John, 1987).  It is estimated that 83% of women with disabilities will be sexually assaulted during their life times (Obinna, Krueger, Osterbaan, Sadusky, DeVore, 2005). H. Johnson/MSU19

20. Barrier #1: Belief CA/N is not important... (cont.) ► Consequences of CA/N  Wang, Holton, 2007 ► Poor physical health  chronic fatigue, altered immune function, hypertension, sexually transmitted diseases, obesity ► Social difficulties  insecure attachments with caregivers, which may lead to difficulties in developing trusting relationships with peers and adults later in life ► Cognitive dysfunctions  deficits in attention, abstract reasoning, language development, and problem-solving skills, which ultimately affect academic achievement and school performance 20

21. Barrier #1: Belief CA/N is uncommon... (cont.) ► Consequences of CA/N (cont.)  Wang, Holton, 2007 ► Behavioral problems, e.g. aggression, juvenile delinquency, adult criminality, abusive or violent behavior  Willis & Vernon, 2002 ► Emotional disturbance  Shakeshaft, 2004 ► Lose trust in adults and authority figures  Sullivan & Knutson, 2000 ► Running away from home Back

22. H. Johnson/MSU22 Barrier #2...Insufficient knowledge...the signs & symptoms of CA/N. ►*►*►*►* Child Welfare Information Gateway, 2007b OOOObserve the child... ►S►S►S►Shows sudden changes in behavior or school performance ►H►H►H►Has not received help for physical or medical problems brought to the parents' attention ►I►I►I►Is always watchful, as though preparing for something bad to happen ►I►I►I►Is overly compliant, passive, or withdrawn ►C►C►C►Comes to school or other activities early, stays late, and does not want to go home *See Appendix “A” for definitions of CA/N & Appendix “B” for signs for specific types of abuse

23. H. Johnson/MSU23 Barrier #2... (cont.) ►O►O►O►Observe the parent... SSSShows little concern for the child ►D►D►D►Denies the existence of—or blames the child for—the child's problems in school or at home ►A►A►A►Asks teachers or other caregivers to use harsh physical discipline if the child misbehaves ►S►S►S►Sees the child as entirely bad, worthless, or burdensome ►D►D►D►Demands a level of physical or academic performance the child cannot achieve ►L►L►L►Looks primarily to the child for care, attention, and satisfaction of emotional needs

24. H. Johnson/MSU24 Barrier #2... (cont.) Observe Parent/Child Interactions: RRRRarely touch or look at each other CCCConsider their relationship entirely negative SSSState that they do not like each other BBBB aaaa cccc kkkk

25. H. Johnson/MSU25 Barrier #2... (cont.) ►...Insufficient knowledge re...the reporting procedures.  Most (58%) instances of CA/N are reported by professionals, with teachers representing the single largest (17%) category of professionals.  While protocols have been established to guide educator’s reporting of CA/N (Crosson-Tower, 2003), most (87%) educators submit reports to school officials vs. Child Protective Services (CPS), with less than 30% of suspected cases subsequently shared with CPS.

26. 26 Barrier #3. Perceived negative consequences of reporting ►...make things worse for the child;  In the majority of cases, maltreatment does not increase as a result of reporting and in less than 3% of reported cases result in children being removed from the home (Alvarex, et al, 2004)

27. Barrier #3. (cont.) ►...fear of disapproval from parents, parental denial, lack of administrative support and legal ramifications for false allegations.  Most (76%) educators do not think that their school administrators will support them if they made a CA/N report (Kenny, 2004).  All states provide immunity to those professionals who report CA/N in good faith (Alvarex, et al, 2004) Back H. Johnson/MSU27

28. H. Johnson/MSU28 Barriers #4 & 5 ► Barriers #4 & 5. Lessons learned from past reporting, e.g., nothing happened, and Negative attitude towards Child Protective Services (CPS).  Interactions between mandatory reporters and CPS are often difficult (Alvarex, et al, 2004)  CPS services are underfunded and overwhelmed, with most of the available funds being used to respond to, vs. prevent CA/N (Freundlich, 2007)

29. 29 Barriers #4 & 5 (cont.)  Insufficient CPS data collection and training concerning the documentation, recognition and response to CA/N as experienced by children with disabilities (Alvarex et al, 2004; Horner- Johnson, & Drum, 2006; Kendall-Tackett, Lyon, Tallaferro, & Little, 2005).  In relation to instances of sexual abuse, educational systems frequently disbelieve victims, and fail to effectively deal with perpetrators (Shakeshaft, 2004)  Back Back

30. H. Johnson/MSU30 Barriers #6 & 7 ► Barriers # 6 & 7. The lack of training, and ongoing support, concerning recognizing, reporting and responding to possible incidences of CA/N & The belief that someone else is dealing with this problem.  Who in Deaf Education is providing leadership, training, support and services re. CA/N? ► Ed Shroyer (200?) briefly funded a center concerning CA/N as experienced by children who d/hh

31. Barriers #6 & 7 (cont.)  Who in Deaf Education is providing leadership...(cont.) ► CEASD has a 2002 position paper entitled “Safe Schools for all deaf & hard of hearing children” + a range of existing programs concerning both bullying and CA/N ► NAD has a 2008 position statement on “Mental health services for deaf children” that notes a higher rate of sexual abuse. ► DOVE Advocacy Services for Abused Deaf Women and Children has established a multi state program of services and training  http://www.deafdove.org/ http://www.deafdove.org/ H. Johnson/MSU31

32. Barriers #6 & 7 (cont.)  Who in Deaf Education is providing leadership...(cont.) ► Hands & Voices has been providing presentations and piloting parent/professional information programs  http://www.handsandvoices.org/ http://www.handsandvoices.org/ ► ACE-D/HH? ► AGBell? ► ASDC? ► CAID? ► CEC/DCDD? ► CED? ► EHDI? H. Johnson/MSU32

33. Barriers #6 & 7 (cont.) ► In light of this lack of information, in 2008 I conducted a survey of extent to which parents and professionals are aware, informed and prepared to recognize and respond to possible incidences of CA/N as experienced by children who are d/hh.  322 respondents  Demographic Overview: ► Most (60%) were between the ages of 35-54. ► Most (80%) had greater than a B.A./B.S. degree. ► Most (90%) were female ► Most (88%) were professionals ► Most (82%) were hearing H. Johnson/MSU33

34. Barriers #6 & 7 (cont.) ► Survey results...  Demographic Overview: (cont.) ► Most (70%) had 11+ years of experience in interacting with individuals who were d/hh ► Most (82%) had daily interactions with individuals who were d/hh ► A majority (51%) used speech & sign in those interactions, with the rest using speech (25%), or sign (18%)  Training re. CA/N: ► Most (64%) had formal training re. CA/N, but only in a minority (29%) of cases, was the training specific to children who were d/hh H. Johnson/MSU34

35. Barriers #6 & 7 (cont.) ► Survey results...  Training re. CA/N: (cont.) ► Training resulted in mixed results, i.e.,  In response to the question “How well prepared do you now consider yourself to be in relation to recognizing and reporting possible cases of child abuse and neglect? ► 48% indicated that they were well, or sufficiently prepared vs. 49% indicated that they were somewhat, or unprepared  In contrast, a majority (55%) indicated that well/sufficiently confident they could find accurate information concerning CA/N H. Johnson/MSU35

36. Barriers #6 & 7 (cont.) ► Survey results...  Training re. CA/N: (cont.) ► A minority (09%) indicated that they were very confident that they could recognize if a child who is d/hh was experiencing CA/N ► A majority (53%) indicated that they were very/sufficiently confident in their knowledge of how to report possible incidences of CA/N as experienced by a child who is d/hh. H. Johnson/MSU36

37. Barriers #6 & 7 (cont.) ► Survey results...  Training re. CA/N: (cont.) ► A minority (15%) indicated they were very/sufficiently (27%) confident in their knowledge regarding how to respond to a child who is d/hh and possible the victim of CA/N ► Most (87%) wanted to learn more about the prevention of CA/N as experienced by children who were d/hh H. Johnson/MSU37

38. Barriers #6 & 7 (cont.) ► Survey results...  Resulting knowledge: ► Most have had some general, formal training re. CA/N, few in relation to students who are d/hh ► CA/N training resulted in mixed results, i.e.,  while a majority thought they could find accurate information, and knew how to make a report,  few thought they could effectively recognize, or respond to a child who is d/hh and who may have experienced CA/N ► Most would like learn more re. how to prevent CA/N as experienced by children who are d/hh H. Johnson/MSU38

39. Barriers #6 & 7 (cont.) ► Survey Results & the literature base  Kenny (2001; 2004) indicates... ►...that less than 30% of suspected CA/N cases known to school personnel are formally reported. ►...teachers need more training re. legal mandates of reporting, how to recognize and how to report suspected instances of CA/N. ►...training should be ongoing and include experientially exercises and hypothetical situations. ►...the better the CA/N training, the more cognizant teachers became of the difficulty in recognizing the signs and systems of CA/N H. Johnson/MSU39

40. Barriers #6 & 7 (cont.) ► Survey Results & the literature base  Kenny (2001; 2004) indicates...(cont.) ►...SPED teaches made more reports of CA/N, but did not receive any better training H. Johnson/MSU40

41. Barriers #6 & 7 (cont.) ► Implications:  Children who are d/hh are three times more likely to experience CA/N than their hearing peers  Deaf Education professionals are not well prepared to recognize, report, or respond to possible instances of CA/N  With a few notable exceptions, CA/N has largely been ignored by the major organizations within the field of Deaf Education.  Ignoring CA/N increase the length and impact of the abuse. H. Johnson/MSU41 Back

42. Reference List H. Johnson/MSU42

43. H. Johnson/MSU43 ► Alvarex, K.M., Kenny, M.C., Donohue, B., & Carpin, K. M. (2004). Why are professionals failing to initiate mandated reports of child maltreatment, and are there any empirically based training programs to assist professionals in the reporting process? Aggression and Violent Behavior, 9, 563-578. ► 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. ► CEASD (2002). Safe schools for all deaf & hard of hearing children. Retrieved on 2/15/2010 from: http://www.ceasd.org/acrobat/CEASD_safe_schools.pdf http://www.ceasd.org/acrobat/CEASD_safe_schools.pdf ► 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 ► Child Welfare Information Gateway (2007a). Definitions of child abuse and neglect. Retrieved on 1/25/2010 from: http://www.childwelfare.gov/systemwide/laws_policies/statutes/define.cfm http://www.childwelfare.gov/systemwide/laws_policies/statutes/define.cfm ► Child Welfare Information Gateway (2007b). Recognizing child abuse and neglect: Signs and Symptoms. Retrieved on 1/25/2010 from: http://www.childwelfare.gov/pubs/factsheets/signs.cfm http://www.childwelfare.gov/pubs/factsheets/signs.cfm

44. H. Johnson/MSU44 ► Child Welfare Information Gateway (2006). Long-term consequences of child abuse and neglect: fact sheet. Retrieved on 2/3/2008 from: http://www.childwelfare.gov/pubs/factsheets/long_term_consequences.cfm http://www.childwelfare.gov/pubs/factsheets/long_term_consequences.cfm http://www.childwelfare.gov/pubs/factsheets/long_term_consequences.cfm ► Crosson-Tower, Cynthia (2003). The Role of Educators in Preventing and Responding to Child Abuse and Neglect. Office on Child Abuse and Neglect., Caliber Associates, Retrieved on 5/13/2009 from http://www.childwelfare.gov/pubs/usermanuals/educator/index.cfm http://www.childwelfare.gov/pubs/usermanuals/educator/index.cfm ► DePanfilis, D. (2006). Child neglect: A guide for prevention, assessment, and intervention. Retrieved on February 8, 2008 from: http://www.childwelfare.gov/pubs/usermanuals/neglect/index.cfm http://www.childwelfare.gov/pubs/usermanuals/neglect/index.cfm ► Freundlich, M. (2007). Time for reform: Investing in prevention: Keeping children save at home. Retrieved from: http://www.preventchildabuse.org/about_us/media_releases/pew_kaw _prevention_report_final.pdf http://www.preventchildabuse.org/about_us/media_releases/pew_kaw _prevention_report_final.pdf http://www.preventchildabuse.org/about_us/media_releases/pew_kaw _prevention_report_final.pdf ► Horner-Johnson, W., & Drum, C.E. (2006). Prevalence of maltreatment of people with intellectual disabilities: A review of the recently published research. Mental Retardation and Developmental Disabilities Research Reviews, 12(1), 57-69.

45. H. Johnson/MSU45 ► Kendall-Tackett, K., Lyon, T., Tallaferro, G., & Little, L. (2005). Why child maltreatment researchers should include children’s disability status in their maltreatment studies. Child Abuse & Neglect, 29(2), 147-151 ► Kenny, M. C. (2001). Child abuse reporting: Teachers’ perceived deterrents. Child Abuse & Neglect, 25, 81-92. ► Kenny, M. (2004). Teachers’ attitudes toward and knowledge of child maltreatment. Child Abuse & Neglect, 28, 1311-1319. ► NAD (2008). Position statement on mental health services for deaf children. Retrieved February 15, 2008 from http://www.nad.org/issues/health-care/mental-health-services/for- deaf-children http://www.nad.org/issues/health-care/mental-health-services/for- deaf-children http://www.nad.org/issues/health-care/mental-health-services/for- deaf-children ► 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 January 11, 2009 from http://www.ncjrs.gov/pdffiles1/nij/grants/212867.pdf ttp://www.ncjrs.gov/pdffiles1/nij/grants/212867.pdf

46. ► Shakeshaft, Charol (2004). Educator Sexual Misconduct: A synthesis of existing literature. U.S. Dept of Education (purchase order ED-02- PO-3281) Policy and Program Studies Service. Retrieved January 11, 2009 from http://www.ed.gov/rschstat/research/pubs/misconductreview/report.p df http://www.ed.gov/rschstat/research/pubs/misconductreview/report.p df http://www.ed.gov/rschstat/research/pubs/misconductreview/report.p df ► Sullivan, P.M., & Knutson, J.F. (2000). Maltreatment and disabilities: A population-based epidemiological study. Child Abuse & Neglect, 24(10), 1257-1273. ► Sullivan, Patricia M., Vernon, McCay, & Scanlan, John, M. (1987). Sexual abuse of deaf youth. American Annals of the Deaf, 32(4), 256- 262 ► 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/pcaa_pe w_economic_impact_study_final.pdf http://www.preventchildabuse.org/about_us/media_releases/pcaa_pe w_economic_impact_study_final.pdf http://www.preventchildabuse.org/about_us/media_releases/pcaa_pe w_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. H. Johnson/MSU46

47. Bibliography H. Johnson/MSU47

48. H. Johnson/MSU48 ► Do? Tell! Kids Against Child Abuse DVD (n.d.). Information presented in ASL, English, & Spanish. Retrieved on February 8, 2008 from: http://www.kidsagainstchildabuse.org/ http://www.kidsagainstchildabuse.org/ ► Durity, Richard & Oxman, Amy (2006). Addressing the Trauma Treatment Needs of Children Who Are Deaf or Hard of Hearing and the Hearing Children of Deaf Parents. Retrieved January 11, 2009, from http://www.nctsnet.org/nctsn_assets/pdfs/edu_materials/Trauma_Dea f_Hard-of-Hearing_Children.pdf http://www.nctsnet.org/nctsn_assets/pdfs/edu_materials/Trauma_Dea f_Hard-of-Hearing_Children.pdf http://www.nctsnet.org/nctsn_assets/pdfs/edu_materials/Trauma_Dea f_Hard-of-Hearing_Children.pdf ► Horner-Johnson, W., & Drum, C.E. (2006). Prevalence of maltreatment of people with intellectual disabilities: A review of the recently published research. Mental Retardation and Developmental Disabilities Research Reviews, 12(1), 57-69.

49. H. Johnson/MSU49 Appendixes ► Appendix “A”: Definitions of CA/H ► Appendix “B”: Recognizing Child Abuse and Neglect: Signs and Symptoms

50. H. Johnson/MSU50 Appendix “A”: Definitions of CA/N ► Child Welfare Information Gateway (2007a). Definitions of child abuse and neglect. Retrieved on 1/25/2010 from: http://www.childwelfare.gov/systemwide/la ws_policies/statutes/define.cfm http://www.childwelfare.gov/systemwide/la ws_policies/statutes/define.cfm http://www.childwelfare.gov/systemwide/la ws_policies/statutes/define.cfm

51. H. Johnson/MSU51 Definitions ► *Definitions: (Child Welfare Information Gateway, 2007)  Broad Definitions: ► “Child abuse and neglect are defined by Federal and State laws. The Child Abuse Prevention and Treatment Act (CAPTA) is the Federal legislation that provides minimum standards that States must incorporate in their statutory definitions of child abuse and neglect. The CAPTA definition of "child abuse and neglect" refers to:  "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, or exploitation, or an act or failure to act which presents an imminent risk of serious harm" *Note: for state specific definitions, go to: http://www.childwelfare.gov/systemwide/laws_policies/ state/ http://www.childwelfare.gov/systemwide/laws_policies/ state/ http://www.childwelfare.gov/systemwide/laws_policies/ state/

52. H. Johnson/MSU52 Definitions...(cont.) ► Specific Definitions  Physical Abuse: ► “ Physical abuse is generally defined as "any non-accidental physical injury to the child" and can include striking, kicking, burning, or biting the child, or any action that results in a physical impairment of the child.”  Neglect: ► “ Neglect is frequently defined in terms of deprivation of adequate food, clothing, shelter, medical care, or supervision.”  Sexual Abuse/Exploitation: ► "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 interfamilial relationships, statutory rape, molestation, prostitution, or other form of sexual exploitation of children, or incest with children"

53. H. Johnson/MSU53 Definitions...(cont.) ► Emotional Abuse:  “ All States and territories except Georgia and Washington include emotional maltreatment as part of their definitions of abuse or neglect.” ► Parental Substance Abuse:  “ Parental substance abuse is an element of the definition of child abuse or neglect in some States. Circumstances that are considered abuse or neglect in some States include: ► Prenatal exposure of a child to harm due to the mother's use of an illegal drug or other substance ► Manufacture of a controlled substance in the presence of a child or on the premises occupied by a child ► Allowing a child to be present where the chemicals or equipment for the manufacture of controlled substances are used or stored ► Selling, distributing, or giving drugs or alcohol to a child ► Use of a controlled substance by a caregiver that impairs the caregiver's ability to adequately care for the child ► Abandonment:  “... it is considered abandonment of the child when the parent's identity or whereabouts are unknown, the child has been left by the parent in circumstances in which the child suffers serious harm, or the parent has failed to maintain contact with the child or to provide reasonable support for a specified period of time.”

54. H. Johnson/MSU54 Appendix B: Recognizing Child Abuse and Neglect: Signs and Symptoms ► Child Welfare Information Gateway (2007b). Recognizing child abuse and neglect: Signs and Symptoms. Retrieved on 1/25/2010 from: http://www.childwelfare.gov/pubs/factsheet s/signs.cfm http://www.childwelfare.gov/pubs/factsheet s/signs.cfm http://www.childwelfare.gov/pubs/factsheet s/signs.cfm

55. H. Johnson/MSU55 Signs & Symptoms ► Signs of Physical Abuse  Consider the possibility of physical abuse when the child: ► Has unexplained burns, bites, bruises, broken bones, or black eyes ► Has fading bruises or other marks noticeable after an absence from school ► Seems frightened of the parents and protests or cries when it is time to go home ► Shrinks at the approach of adults ► Reports injury by a parent or another adult caregiver  Consider the possibility of physical abuse when the parent or other adult caregiver: ► Offers conflicting, unconvincing, or no explanation for the child's injury ► Describes the child as "evil," or in some other very negative way ► Uses harsh physical discipline with the child ► Has a history of abuse as a child

56. H. Johnson/MSU56 Signs...(cont.) ► Signs of Neglect  Consider the possibility of neglect when the child: ► Is frequently absent from school ► Begs or steals food or money ► Lacks needed medical or dental care, immunizations, or glasses ► Is consistently dirty and has severe body odor ► Lacks sufficient clothing for the weather ► Abuses alcohol or other drugs ► States that there is no one at home to provide care  Consider the possibility of neglect when the parent or other adult caregiver: ► Appears to be indifferent to the child ► Seems apathetic or depressed ► Behaves irrationally or in a bizarre manner ► Is abusing alcohol or other drugs

57. H. Johnson/MSU57 Signs...(cont.) ► Signs of Sexual Abuse  Consider the possibility of sexual abuse when the child: ► Has difficulty walking or sitting ► Suddenly refuses to change for gym or to participate in physical activities ► Reports nightmares or bedwetting ► Experiences a sudden change in appetite ► Demonstrates bizarre, sophisticated, or unusual sexual knowledge or behavior ► Becomes pregnant or contracts a venereal disease, particularly if under age 14 ► Runs away ► Reports sexual abuse by a parent or another adult caregiver  Consider the possibility of sexual abuse when the parent or other adult caregiver: ► Is unduly protective of the child or severely limits the child's contact with other children, especially of the opposite sex ► Is secretive and isolated ► Is jealous or controlling with family members

58. H. Johnson/MSU58 Signs...(cont.) ► Signs of Emotional Maltreatment  Consider the possibility of emotional maltreatment when the child: ► Shows extremes in behavior, such as overly compliant or demanding behavior, extreme passivity, or aggression ► Is either inappropriately adult (parenting other children, for example) or inappropriately infantile (frequently rocking or head-banging, for example) ► Is delayed in physical or emotional development ► Has attempted suicide ► Reports a lack of attachment to the parent  Consider the possibility of emotional maltreatment when the parent or other adult caregiver: ► Constantly blames, belittles, or berates the child ► Is unconcerned about the child and refuses to consider offers of help for the child's problems ► Overtly rejects the child