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Child Maltreatment: Recognize it & Respond

Welcome to this short course concerning child abuse and neglect. Because child maltreatment is pandemic in our society, and professional helpers must confront it frequently, this is an important course. In this course you will learn how prevalent child abuse and neglect are in our society. You will also learn what your responsibilities are as a professional when you encounter cases where you suspect a child is being mistreated. You will receive training to help you recognize child abuse and neglect. Finally, you will receive guidance as to how to handle the stress that accompanies coping with such cases.

 Please note as you proceed that some quiz items are drawn from the listed resources. Be careful to read the materials. Pursuing additional research will also broaden your education and make answering quiz items easier.

 1. The Prevalence of Child Maltreatment

            The abuse and neglect of children in our society—and in the world—has been called “pandemic.” That means it is so widespread it exceeds the normal limits of an epidemic. The statistics can be overwhelming. Remember as you consider the numbers that each one represents a real child. Right now, somewhere close to where you live, a child is at risk.

 1.1  The national data for 1999 showed 3,244,000 children were reported to Child Protective Services as alleged victims of child maltreatment. In order of prevalence were neglect, sexual abuse, and physical abuse.

1.2  The incidence of child maltreatment is not in decline. In fact, it seems to be rising, judging from the number of reports made. Just in the one year from 1998 to 1999 the rate rose 1.6% in the number of reports. In the five years ending the decade, the rate increased about 4%. For sexual abuse alone, it is now commonly estimated that from1-in-4, to 1-in-3 girls will experience some form of it before age 18. The estimates for boys are less certain, but also significantly high.

1.3   Neglect accounted for 54.9% of all cases of child maltreatment in the 1990 Census data. In 1999, according to the National Center on Child Abuse Prevention Research (Working Paper #808, Current Trends in Child Abuse, Prevention, Reporting, and Fatalities: The 1999 Fifty State Survey [April, 2001]), neglect cases accounted for 46% of all substantiated cases. About 18%, or some 500,000 children, were reported as physically abused. About 9% were reported as sexually abused and about 4% as emotionally abused. Of the total number of cases reported, 23% fit into an “other” category that included both abuse and neglect, or threat of harm, or child abandonment. An estimated 1,070,000 children—15 out of every 1,000—were substantiated as victims of child abuse or neglect in 1999.

1.4  The number of children who die as a result of child maltreatment is less than 1%, but another 11% experience life-threatening injuries. Homicide consistently ranks among the top five causes of death for children at any age. According to the U.S. Department of Justice, a parent is the perpetrator in most homicides of children under age five—and it is equally likely that the perpetrator will be the mother or the father.

 RESOURCES: There are many materials that paint the grim picture of child maltreatment, including statistical breakdowns. Explore  National Data Base

 ERIC_NO: EJ497154. Reported Child Abuse and Neglect. By Lewit, Eugene M. (1994) ABSTRACT: Examines sources of national data on child abuse, the number of cases reported, and recent trends. The author addresses the issues of substantiation rates and the various categories of abuse, then provides brief examinations of the characteristics of the victims of abuse and of child fatalities related to maltreatment. (GLR) Abstract at http://ericae.net/ericdb/EJ497154.htm

 2. Recognizing Child Maltreatment

             While it is unpleasant to face the reality that children are mistreated, both as citizens and as professional helpers it is imperative to do so.

            2.1 Abuse and neglect may be defined very broadly as parental over-involvement (abuse) and under-involvement (neglect). In the former case, parents overstep their bounds, while in the latter situation they abandon their responsibilities. However, both terms have more precise defining features.

            2.2 Abuse is always the result of a disparity in power. It most often arises from one or more of the following factors: ignorance of normal child development; poor coping skills by the abuser; and inaccurate models of a “child” held by the abuser.

            2.3 It is common to divide abuse into physical abuse and sexual abuse. In the former, the child is mishandled through inappropriate and/or excessive punishment. The result is physical injury, but emotional distress and psychological difficulties generally accompany the bodily damage. In sexual abuse, the child is involved in activities designed to provide sexual gratification to the abuser. These may include activities ranging from sharing pornography with a child, to taking pictures of the child naked or engaged in sexual activity, to engaging in sexual activity with the child. Many professionals also distinguish emotional abuse where no physical harm is inflicted and no sexual activity takes place but the child sustains emotional wounds from the cruel behavior of the abuser. These wounds also can produce long-term effects. Some therapists also believe there is a form of abuse called identity abuse. In this situation the child is not permitted to form and develop a healthy independent identity. Instead, the child must live out the desires of the abuser. This form of abuse occurs slowly over time and across a wide range of life issues.

            2.4 Neglect is the failure of the caregivers to provide properly for a child, especially habitually. While generally this is noticed in a lack of proper nutrition, shelter, or clothing, neglect can take many forms, including a failure to meet a child’s emotional needs. Many professionals consider neglect even more of a problem than abuse though it receives less media attention.

            RESOURCES: There are many materials available to assist in the recognition of child maltreatment. Pursue some resources on your own: Maryland Child Protective Services, Indicators of Child Maltreatment  Definitions.

 ERIC_NO: EJ530729 Educational Implications of Child Abuse. By Lowenthal, Barbara (1996) ABSTRACT: This article describes child physical abuse, sexual abuse, emotional abuse, and neglect. Signs that indicate abuse are provided and state reporting guidelines are examined. Special education implications of child abuse are evaluated. The unique role of the teacher in identifying abuse and interventions that teachers can employ are addressed. (CR) Abstract at http://ericae.net/ericdb/EJ530729.htm

3. Professional Responsibilities When Child Maltreatment Is Suspected

             What should you do if you suspect a child is being mistreated? The obligation to report suspected child maltreatment is both moral and legal. While laws vary a little from state to state, mandatory reporting laws exist throughout the country; every state has them. Professionals most often included in mandatory reporting statutes are those most likely to be in contact with children, including teachers, social workers, nurses and doctors, and police officers. Various professional groups are often required to learn these duties as part of their education. However, it is wise to periodically review the legal requirements and professional guidelines for your position.

             Broadly speaking, there are four duties related to child maltreatment. The first is the duty to be alert. Child maltreatment is so common you will encounter it at some point. Second, there is a duty to be educated. The matter of child maltreatment is so serious that there can be no excuse for not being prepared to recognize it and prepared to report it. The third duty is to be sensitive. Child maltreatment is a painful reality. It is important to display sensitivity to everyone involved. The final duty is to report child maltreatment when it is known or suspected. The professional is not required to have proof before reporting. Each of these duties is further detailed below.

             3.1 The duty to be alert has at least the following elements: being conscious of the possibility of child maltreatment in many different situations, being attuned to the signs of maltreatment, and being responsive to the suggestion of others that maltreatment might be occurring. Your own professional duties will guide the kind of signs you will be most naturally alert to. For example, nurses will be especially attentive to physical indicators, such as bruising. Social workers will be particularly alert to family interactions or behavior problems. However, regardless of the specific nature of your job duties, an alertness to signs of child maltreatment in all areas—physical, emotional, social and so forth—is important. When your “radar” is alerted by anything, then check it out!

            3.2 The duty to be educated is an ongoing one. This course is just one step among the many you need to take. Though not an easy subject to face, the satisfaction of knowing that you can make a difference—and may even save a life—should provide significant motivation. At least once a year some review of information and an effort to learn more should be undertaken to keep yourself alert and prepared to act promptly and appropriately. Consider books, college courses, or program series on public television for longer exposures. Use journals such as Child Abuse & Neglect for specific detailed information. Many professional publications in nursing, social work, and education offer occasional pieces on the subject oriented for the needs of that specific group.

            3.3 The duty to be sensitive is both easy and hard. It can be easy when dealing with a child, and hard when working with an abuser or a neglectful caregiver. But most abusers and neglectful caregivers are not monsters. They are people whose situations have exceeded their skills or who possess deficits that can be filled. Given the proper help and support they often can become non-abusive and/or properly attentive. You may have a role in accomplishing this end. When the perpetrator is the child’s caregiver, such help is often to the child’s ultimate benefit because, whether abusive or neglectful, caregivers are still loved by the children they victimize. Remember, “There but for the grace of God go I.”

            3.4 The duty to report is governed by the specific legal requirements of your area and the guidelines of your professional position. State statutes generally detail at least the following information: definitions of child maltreatment (both abuse and neglect); who is mandated to report; to whom the suspected or known maltreatment must be reported; and the manner of reporting (i.e.., the form and content of the report).

California provides a good example of how state statutes handle this subject. The various issues of child maltreatment are discussed in several places in the code. For example, in the Penal Code, the “Child Abuse and Neglect Reporting Act” is Sections 11164-11174.3. It begins by specifying the intent and purpose of the Act, which is to consider the needs of the child victim and to do whatever is necessary to protect the child victim from psychological harm. The Act goes on to cover, in order, legal definitions of child abuse and neglect; who is included as mandated reporters (33 groups are listed); to whom the reporting should be made (law enforcement agencies or the county welfare department); the grounds for making a report (“whenever the mandated reporter, in his or her professional capacity or within the scope of his or her employment, has knowledge

of or observes a child whom the mandated reporter knows or reasonably suspects has been the victim of child abuse or neglect”-- §11166); what should be included in the report; and many other matters.   

            Generally, reporting known or suspected maltreatment requires contacting either law enforcement (local police or county sheriff’s department), or the county Department of Social Services, specifically Child Protective Services. Typically, the address and phone number for report making is given at the front of your local telephone directory. It is important not to delay making a report because the safety of the child may depend on prompt response by the agency to whom the report is given. Responsible agencies maintain 24/7 alertness and response protocols, meaning a report can be given at any time and a response by the appropriate official will take place very quickly.

A police officer or social worker will want as much information as you can provide. If possible, it is well to have available the name, address, and age of the child. In addition, the name and address (if different) of the child’s parents or other caretakers will be wanted. Your knowledge of the child’s condition, situation, or circumstances is important. You should note, for example, any physical injuries, even as minor as suspicious bruises. You should also be observant of any behaviors exhibited by the child that strike you as relevant. If you have any knowledge about the presence of weapons, any alcohol or substance abuse, or any other factors that might jeopardize the child or anyone investigating, this information is critical. In general, whatever alerted you to the possibility should be shared with the official to whom you report. Don’t worry about what you don’t know; tell what you do know.

Remember, you must stay current on these matters to remain in good standing in the profession. You must report known or suspected cases of child maltreatment. You are protected by law when you do so. When you do not, you are liable under the law for prosecution.

RESOURCES: There are many materials that speak further about the duties discussed above, especially the duty to report.  Please check out the following and other resources that you find on your own: Child Maltreatment Lesson Plans  FAQ

 ERIC_NO: EJ508028. Training and Knowledge of Professionals on Specific Topics in Child Sexual Abuse.By Campbell, James A.; Carlson, Karen (1995) ABSTRACT: Examines the training background and self-reported knowledge levels held by a group of professionals on specific topics in child sexual abuse. It was found that many professionals working in the area of child abuse treatment, including social workers, medical personnel, and psychologists, have not had training on topics directly related to their work. (JPS) Abstract at http://ericae.net/ericdb/EJ508028.htm

 ERIC_NO: EJ532447. Reporting Child Abuse and Neglect: Legal Requirements. By Yell, Mitchell L. (1996). ABSTRACT: This article reviews federal and state legal mandates to report child abuse. It addresses the issue of immunity from civil suit and criminal prosecution for reporting suspected child abuse or neglect, along with the criminal prosecution that may result if suspected child abuse or neglect is not reported. (CR) Abstract at http://ericae.net/ericdb/EJ532447.htm

 ERIC_NO: EJ521892. Reports of Child Maltreatment from Mandated and Non-mandated Reporters. By Giovannoni, Jeanne M. (1995). ABSTRACT: Compared reports of child maltreatment from individuals legally mandated to report such incidents (medical, school, social services, and law enforcement personnel) and those not required to report such incidents (children, responsible caretakers, absent spouses, other relatives, and neighbors). Found numerous similarities and differences among the types of maltreatment reported by mandated and nonmandated individuals. (MDM) Abstract at http://ericae.net/ericdb/EJ521892.htm

ERIC_NO: EJ510622. Reporting Suspected Child Abuse—and Dealing with the Aftermath. By Russell, J. C. (1995). ABSTRACT: Contains information to help child-care practitioners appropriately report child abuse. Addresses how to recognize and document abuse, what reporting abuse entails, and what happens after a report is filed. Contains state-by-state listing of abuse hotlines, sources for mandatory reporting laws, and resources such as telephone numbers and books. (JW) Abstract at http://ericae.net/ericdb/EJ510622.htm

  4. Managing Personal Stress with Suspected Child Maltreatment Cases

             There may be no more difficult a circumstance for the professional than having to work with a situation where child maltreatment is suspected or known. The work is stressful and difficult to leave at work when you go home.

             4.1 It is important to recognize why child maltreatment affects us so strongly. The stress and grief you may experience is likely to be especially hard if the child dies. Some of the reasons child maltreatment bothers us so greatly include: a sense that the proper order in nature has been violated—adults are supposed to be protective of children, not exploit or neglect them; a recognition of the child’s losses, which may remind us of our own; a kind of guilt that we did not do enough, or act quickly enough; and a heightened awareness that the children we love are also at risk.

            4.2 It is essential to talk to others about what you are feeling and thinking. Those professionals who work regularly with cases of child maltreatment rely on others with whom they can talk out their experiences. Even if legal or professional obligations keep you from disclosing particulars about a case, nothing need prevent you from talking about your own thoughts and feelings. It is natural to experience distress and healthy to seek the emotional support of loved ones.

            4.3 Be aware that working with a case of child maltreatment may leave you with some posttraumatic stress. This is a subjective experience of stress occurring after exposure to a traumatic event or situation. It can affect you even though you did not directly experience the abuse or neglect! Our ability to identify with others also makes us susceptible to an imaginative experiencing alongside them. Their pain can become our own. We can hurt for them, cry for them—and experience posttraumatic stress. The signs and symptoms of posttraumatic stress are found in the Diagnostic and Statistical Manual of Mental Disorders, 4^th ed. (DSM-IV), and the International Classification of Diseases, 9^th Revision, Clinical Modification (ICD-9-CM).

            4.4 Take time to develop better coping skills. This is always a good idea in a society where most people die of stress-related conditions. There are many useful articles, books, websites, videos, audio tapes, and classes that address stress and coping.

 RESOURCES: There are many materials available to help you understand posttraumatic stress and to develop better coping skills. Do some independent research.

ERIC_NO: EJ511366. Adjustment to Occupational Stress: The Relationship of Perceived Control to Effectiveness of Coping Strategies. By Bowman, Glen D.; Stern, Marilyn (1995). ABSTRACT: Reports results of a study of 187 nurses about stressful occupational episodes and the coping strategies and perceived controllability for each, controlling for negative affectivity. Effectiveness of coping was measured across three dimensions: perceived coping effectiveness, job affect, and psychological adjustment. Discusses implication of findings for theory and practice. (LKS) Abstract at http://ericae.net/ericdb/EJ511366.htm

 Other Helps & Resources

             Fortunately, there is an extensive body of literature available on child maltreatment. There is no excuse for not knowing what a professional needs to know.

The following are representative sites and materials.  

1. The Child Safety Institute’s Child Abuse Prevention Services website: http://www.kidsafe-caps.org/
2. National Clearinghouse on Child Abuse and Neglect Information. 
3. Child Abuse and Neglect Prevention Task Force http://www.childabuseprevention.com/
4. National Data Archive on Child Abuse and Neglect http://www.ndacan.cornell.edu/

 ERIC Document abstracts and search help can be found at http://www.eric.ed.gov/

 Please be careful to put in adequate time on this course. The desire to gain continuing education credits should never exceed the desire to learn material that might save a life!

Now take the Test 

Study this web-site for 3 hours for an approved (RN-CEP 11430, MFT- PCE 39) 3-hours Continuing Education Certificate (0.3 CEUs) and take the Test.   Click here for the self-correcting test & online payment, and 2) receive your certificate immediately online. All is online, nothing by post-mail. 
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This course was developed by G. G. Bolich, Ph.D., 100 White Rock Rd.,Grover, NC 28073-8717, e-mal: susanb516@earthlink.net